Changes of left ventricular function at exercise after lung resection

International Nuclear Information System (INIS)

Fujisaki, Takashi; Gomibuchi, Makoto; Shoji, Tasuku

1992-01-01

To determine the effect of lung resection on left ventricular function, 29 surgical patients were examined by using a nuclear stethoscope as a non-invasive means for measuring ventricular function at exercise. Pre- and post-operative parameters were obtained at rest and exercise. At rest, postoperative stroke volume (SV), end-diastolic volume (EDV), ejection fraction (EF), and ejection rate (ER) were significantly decreased; heart rate (HR) was significantly increased; and both filling rate (FR) and cardiac output (CO) remained unchanged. At maximum exercise, postoperative EDV, SV, ER and FR were significantly decreased; and there was no significant difference in either HR or EF, resulting in a significantly decreased CO. A ratio of CO and FR at maximum exercise to at rest was significantly decreased after surgery, as compared with that before surgery. According to the number of lobe resection, similar findings for all parameters, except for EF, were observed in the group of two lobe or more resection (n=13); and only two parameters, ER and FR, had the same tendency as those mentioned above in the group of a single lobe resection (n=16). The age group of 60 years or less (n=14) had similar findings for all parameters. In the group of 65 years or more (n=10), resting HR after surgery was not different from that before surgery; and postoperative CO was significantly decreased at rest, but not different from preoperative value at maximum exercise. In conclusion, left ventricular function associated with lung resection is reflected by decreased EDV and SV resulting from reduced pre-load. These changes may be corrected at rest, but not corrected at maximum exercise, resulting in decreased CO. More noticeable decrease in EDV and SV seems to be associated with larger lung resection. In older patients, HR is not corrected well, resulting in a decrease in CO at rest. (N.K.)

Separation of left and right lungs using 3D information of sequential CT images and a guided dynamic programming algorithm

Science.gov (United States)

Park, Sang Cheol; Leader, Joseph Ken; Tan, Jun; Lee, Guee Sang; Kim, Soo Hyung; Na, In Seop; Zheng, Bin

2011-01-01

Objective this article presents a new computerized scheme that aims to accurately and robustly separate left and right lungs on CT examinations. Methods we developed and tested a method to separate the left and right lungs using sequential CT information and a guided dynamic programming algorithm using adaptively and automatically selected start point and end point with especially severe and multiple connections. Results the scheme successfully identified and separated all 827 connections on the total 4034 CT images in an independent testing dataset of CT examinations. The proposed scheme separated multiple connections regardless of their locations, and the guided dynamic programming algorithm reduced the computation time to approximately 4.6% in comparison with the traditional dynamic programming and avoided the permeation of the separation boundary into normal lung tissue. Conclusions The proposed method is able to robustly and accurately disconnect all connections between left and right lungs and the guided dynamic programming algorithm is able to remove redundant processing. PMID:21412104

Residual motion of lung tumors in end-of-inhale respiratory gated radiotherapy based on external surrogates

International Nuclear Information System (INIS)

Berbeco, Ross I.; Nishioka, Seiko; Shirato, Hiroki; Jiang, Steve B.

2006-01-01

It has been noted that some lung tumors exhibit large periodic motion due to respiration. To limit the amount of dose to healthy lung tissues, many clinics have begun gating radiotherapy treatment using externally placed surrogates. It has been observed by several institutions that the end-of-exhale (EOE) tumor position is more reproducible than other phases of the breathing cycle, so the gating window is often set there. From a treatment planning perspective, end-of-inhale (EOI) phase might be preferred for gating because the expanded lungs will further decrease the healthy tissue within the treatment field. We simulate gated treatment at the EOI phase, using a set of recently measured internal/external anatomy patient data. This paper attempts to answer three questions: (1) How much is the tumor residual motion when we use an external surrogate gating window at EOI? (2) How could we reduce the residual motion in the EOI gating window? (3) Is there a preference for amplitude- versus phase-based gating at EOI? We found that under free breathing conditions the residual motion of the tumors is much larger for EOI phase than for EOE phase. The mean values of residual motion at EOI were found to be 2.2 and 2.7 mm for amplitude- and phase-based gating, respectively, and, at EOE, 1.0 and 1.2 mm for amplitude- and phase-based gating, respectively. However, we note that the residual motion in the EOI gating window is correlated well with the reproducibility of the external surface position in the EOI phase. Using the results of a published breath-coaching study, we deduce that the residual motion of a lung tumor at EOI would approach that at EOE, with the same duty cycle (30%), under breath-coaching conditions. Additionally, we found that under these same conditions, phase-based gating approaches the same residual motion as amplitude-based gating, going from a 28% difference to 11%, for the patient with the largest difference between the two gating modalities. We conclude

Unusual case of a vanishing bronchus of the left allograft in a lung transplant recipient

Directory of Open Access Journals (Sweden)

Don Hayes

2013-01-01

Full Text Available We present an interesting case of a complete vanishing of the left main bronchus in a lung transplant recipient who had a successful outcome due to acute respiratory support with venovenous extracorporeal membrane oxygenation in order to perform airway dilation.

Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system.

Science.gov (United States)

Zhao, Yandong; Jiao, Wenjie; Ren, Xiaoyang; Zhang, Liangdong; Qiu, Tong; Fu, Bo; Wang, Lei

2016-04-12

Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.

Cardiac dynamic magnetic resonance of a giant lung carcinoma invading the left atrium : do not let the imaging fool you

NARCIS (Netherlands)

Pozzoli, Alberto; Klinkenberg, Theo J.; De Maat, Gijs E.; Mariani, Massimo A.

This study aimed to report on a non-small-cell lung cancer (NSCLC) originating from the right lung lower lobe and circulatory extension into the left atrium. Atrial involvement is an uncommon feature of advanced NSCLC, occurring in up to 10% of patients with bronchogenic carcinoma. In this case, the

Post-mortem detection of gasoline residues in lung tissue and heart blood of fire victims.

Science.gov (United States)

Pahor, Kevin; Olson, Greg; Forbes, Shari L

2013-09-01

The purpose of this study was to determine whether gasoline residues could be detected post-mortem in lung tissue and heart blood of fire victims. The lungs and heart blood were investigated to determine whether they were suitable samples for collection and could be collected without contamination during an autopsy. Three sets of test subjects (pig carcasses) were investigated under two different fire scenarios. Test subjects 1 were anaesthetized following animal ethics approval, inhaled gasoline vapours for a short period and then euthanized. The carcasses were clothed and placed in a house where additional gasoline was poured onto the carcass post-mortem in one fire, but not in the other. Test subjects 2 did not inhale gasoline, were clothed and placed in the house and had gasoline poured onto them in both fires. Test subjects 3 were clothed but had no exposure to gasoline either ante- or post-mortem. Following controlled burns and suppression with water, the carcasses were collected, and their lungs and heart blood were excised at a necropsy. The headspace from the samples was analysed using thermal desorption-gas chromatography-mass spectroscopy. Gasoline was identified in the lungs and heart blood from the subjects that were exposed to gasoline vapours prior to death (test subjects 1). All other samples were negative for gasoline residues. These results suggest that it is useful to analyse for volatile ignitable liquids in lung tissue and blood as it may help to determine whether a victim was alive and inhaling gases at the time of a fire.

Prediction of residual lung function after lung surgery, and examination of blood perfusion in the pre- and postoperative lung using three-dimensional SPECT

Energy Technology Data Exchange (ETDEWEB)

Shimatani, Shinji [Toho Univ., Tokyo (Japan). School of Medicine

2001-01-01

side residual lung. Our findings indicate that 3-D imaging volume, as determined by the volume rendering method at the blood perfusion threshold with {sup 99m}Tc-MAA lung perfusion SPECT, is useful in both the prediction of pulmonary function after lung surgery and the examination of changes in blood perfusion. (author)

Spleen-lung interface as diagnostic information

International Nuclear Information System (INIS)

DeLuca, S.A.; Kolodny, G.M.

1975-01-01

Left anterior, lateral, and posterior views on 50 consecutive /sup 99m/Tc-sulfur colloid lung scans were examined. Normal patients had continuity of activity between the left lung and the spleen on all three views. Patients with subphrenic abscess or large left pleural effusions showed no continuity between lung and spleen activity on any view, while other abnormalities, most commonly cardiomegaly, accounted for lack of lung-spleen continuity on the anterior view only. It is suggested that in all combined /sup 99m/Tc-sulfur colloid lung studies, the left side be examined as well as the right for abnormalities adjacent to the left diaphragm. (auth)

Kinetics of badminton lunges in four directions.

Science.gov (United States)

Hong, Youlian; Wang, Shao Jun; Lam, Wing Kai; Cheung, Jason Tak Man

2014-02-01

The lunge is the most fundamental skill in badminton competitions. Fifteen university-level male badminton players performed lunge maneuvers in four directions, namely, right-forward, left-forward, right-backward, and left-backward, while wearing two different brands of badminton shoes. The test compared the kinetics of badminton shoes in performing typical lunge maneuvers. A force plate and an insole measurement system measured the ground reaction forces and plantar pressures. These measurements were compared across all lunge maneuvers. The left-forward lunge generated significantly higher first vertical impact force (2.34 ± 0.52 BW) than that of the right-backward (2.06 ± 0.60 BW) and left-backward lunges (1.78 ± 0.44 BW); higher second vertical impact force (2.44 ± 0.51 BW) than that of the left-backward lunge (2.07 ± 0.38 BW); and higher maximum anterior-posterior shear force (1.48 ± 0.36 BW) than that of the left-backward lunge (1.18 ± 0.38 BW). Compared with other lunge directions, the left-forward lunge showed higher mean maximum vertical impact anterior-posterior shear forces and their respective maximum loading rates, and the plantar pressure at the total foot and heel regions. Therefore, the left-forward lunge is a critical maneuver for badminton biomechanics and related footwear research because of the high loading magnitude generated during heel impact.

Bronchial Blocker Versus Left Double-Lumen Endotracheal Tube for One-Lung Ventilation in Right Video-Assisted Thoracoscopic Surgery.

Science.gov (United States)

Lu, Yao; Dai, Wei; Zong, Zhijun; Xiao, Yimin; Wu, Di; Liu, Xuesheng; Chun Wong, Gordon Tin

2018-02-01

The aim of this study was to compare the quality of lung deflation of a left-sided double-lumen endotracheal tube (DLT) with a bronchial blocker (BB) for one-lung ventilation in video-assisted thoracic surgery (VATS). A prospective, randomized, clinical study. A university-affiliated teaching hospital. Forty-five adult patients undergoing esophageal tumor surgery using VATS with right lung deflation. Patients were assigned by a computer-generated randomization sequence to either the left-sided DLT or BB group. The correct positioning of the airway device was confirmed using fiberoptic bronchoscopy. The variables assessed included: (1) time required to correctly place the devices and to achieve lung collapse; (2) the number of times the device malpositioned; (3) the quality of lung deflation as rated by the surgeon; (4) blood pressure and heart rate at baseline (T 1 ), immediately before (T 2 ) and after (T 3 ) and 1 minute (T 4 ) after intubation; (5) the number of patients with hypoxemia (SpO 2 one-lung ventilation (OLV) period; and (6) postoperative hoarseness of voice, sore throat, or pulmonary infection. Of the 45 patients approached for the study, 21 patients in the DLT group and 19 patients in the BB group were analyzed. The time required to place the device in the correct position was similar between the 2 groups. The time to achieve right lung collapse in the BB group was significantly longer (mean difference: 3.232, 95% confidence interval [CI]: 1.993-4.471; p = 0.003). The quality of lung collapse, OLV duration, number of patients with device malposition, and hypoxemia in both groups were similar. There were more patients suffering hoarseness (odds ratio [OR]: 4.85, 95% CI: 1.08-21.76; p = 0.034) or sore throat (OR: 4.29, 95% CI: 1.14-16.18; p = 0.030) in the DLT group, while no patients developed postoperative lung infection in either group. Compared to T 1 , systolic blood pressure (sBP), diastolic BP (dBP), and heart rate (HR) at T 2 in both groups

Bronchoplastic and lung preservation surgery

International Nuclear Information System (INIS)

Moore, E.H.; Templeton, P.A.; Grillo, H.C.; Shepard, J.A.O.; McLoud, T.C.

1988-01-01

Candidates for bronchoplastic surgery include patients previously considered inoperable because of central endobronchial tumors or inability to tolerate pneumonectomy, patients at risk for a second primary neoplasm, and young active patients. The authors reviewed over 50 bronchoplastic procedures, including carinal resections with bronchial reimplantations, carinal pneumonectomies, sleeve resections, and resections of the left interlobar carina. Conventional tomography provided the most accurate assessment of endobronchial anatomy. Computed tomography, unsuitable for intraluminal disease due to volume averaging of obliquely oriented bronchi, provided information about the extraluminal extent of disease, nodes, and the lung parenchyma. Complications including stricture, air leak, atelectasis, pneumonia, and residual tumor

Bronchial blocker versus left double-lumen endotracheal tube in video-assisted thoracoscopic surgery: a randomized-controlled trial examining time and quality of lung deflation.

Science.gov (United States)

Bussières, Jean S; Somma, Jacques; Del Castillo, José Luis Carrasco; Lemieux, Jérôme; Conti, Massimo; Ugalde, Paula A; Gagné, Nathalie; Lacasse, Yves

2016-07-01

Double-lumen endotracheal tubes (DL-ETT) and bronchial blockers (BB) have both been used for lung isolation in video-assisted thoracic surgery (VATS). Though not well studied, it is widely thought that a DL-ETT provides faster and better quality lung collapse. The aim of this study was to compare a BB technique vs a left-sided DL-ETT strategy with regard to the time and quality of lung collapse during one-lung ventilation (OLV) for elective VATS. Forty patients requiring OLV for VATS were randomized to receive a BB (n = 20) or a left-sided DL-ETT (n = 20). The primary endpoint was the time from pleural opening (performed by the surgeon) until complete lung collapse. The time was evaluated offline by reviewing video recorded during the VATS. The quality of lung deflation was also graded offline using a visual scale (1 = no lung collapse; 2 = partial lung collapse; and 3 = total lung collapse) and was recorded at several time points after pleural incision. The surgeon also graded the time to complete lung collapse and quality of lung deflation during the procedure. The surgeon's guess as to which device was used for lung isolation was also recorded. Of the 40 patients enrolled in the study, 20 patients in the DL-ETT group and 18 in the BB group were analyzed. There mean (standard deviation) time to complete lung collapse of the operative lung was significantly faster using the BB compared with using the DL-ETT [7.5 (3.8) min vs 36.6 (29.1) min, respectively; mean difference, 29.1 min; 95% confidence interval, 1.8 to 7.2; P < 0.001]. Overall, a higher proportion of patients in the BB group than in the DL-ETT group achieved a quality of lung collapse score of 3 at five minutes (57% vs 6%, respectively; P < 0.004), ten minutes (73% vs 14%, respectively; P = 0.005), and 20 min (100% vs 25%, respectively; P = 0.002) after opening the pleura. The surgeon incorrectly guessed the type of device used in 78% of the BB group and 50% of the DL-ETT group (P = 0.10). The time and

Changes of left ventricular function at exercise after lung resection; Study with a nuclear stethoscope

Energy Technology Data Exchange (ETDEWEB)

Fujisaki, Takashi; Gomibuchi, Makoto; Shoji, Tasuku (Nippon Medical School, Tokyo (Japan))

1992-09-01

To determine the effect of lung resection on left ventricular function, 29 surgical patients were examined by using a nuclear stethoscope as a non-invasive means for measuring ventricular function at exercise. Pre- and post-operative parameters were obtained at rest and exercise. At rest, postoperative stroke volume (SV), end-diastolic volume (EDV), ejection fraction (EF), and ejection rate (ER) were significantly decreased; heart rate (HR) was significantly increased; and both filling rate (FR) and cardiac output (CO) remained unchanged. At maximum exercise, postoperative EDV, SV, ER and FR were significantly decreased; and there was no significant difference in either HR or EF, resulting in a significantly decreased CO. A ratio of CO and FR at maximum exercise to at rest was significantly decreased after surgery, as compared with that before surgery. According to the number of lobe resection, similar findings for all parameters, except for EF, were observed in the group of two lobe or more resection (n=13); and only two parameters, ER and FR, had the same tendency as those mentioned above in the group of a single lobe resection (n=16). The age group of 60 years or less (n=14) had similar findings for all parameters. In the group of 65 years or more (n=10), resting HR after surgery was not different from that before surgery; and postoperative CO was significantly decreased at rest, but not different from preoperative value at maximum exercise. In conclusion, left ventricular function associated with lung resection is reflected by decreased EDV and SV resulting from reduced pre-load. These changes may be corrected at rest, but not corrected at maximum exercise, resulting in decreased CO. More noticeable decrease in EDV and SV seems to be associated with larger lung resection. In older patients, HR is not corrected well, resulting in a decrease in CO at rest. (N.K.).

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

International Nuclear Information System (INIS)

Abolmaali, Nasreddin; Koch, Arne; Goetzelt, Knut; Vogelberg, Christian; Hahn, Gabriele; Fitze, Guido

2010-01-01

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

Energy Technology Data Exchange (ETDEWEB)

Abolmaali, Nasreddin; Koch, Arne [Dresden University of Technology, OncoRay - Molecular and Biological Imaging, Medical Faculty Carl Gustav Carus, Dresden (Germany); Goetzelt, Knut; Vogelberg, Christian [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatrics - Pediatric Pulmonology, Dresden (Germany); Hahn, Gabriele [University Clinics Carl Gustav Carus, Dresden University of Technology, Institute and Policlinic for Radiology - Pediatric Radiology, Dresden (Germany); Fitze, Guido [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatric Surgery, Dresden (Germany)

2010-07-15

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results.

Science.gov (United States)

Abolmaali, Nasreddin; Koch, Arne; Götzelt, Knut; Hahn, Gabriele; Fitze, Guido; Vogelberg, Christian

2010-07-01

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment.

Heterochrony and early left-right asymmetry in the development of the cardiorespiratory system of snakes.

Science.gov (United States)

van Soldt, Benjamin J; Metscher, Brian D; Poelmann, Robert E; Vervust, Bart; Vonk, Freek J; Müller, Gerd B; Richardson, Michael K

2015-01-01

Snake lungs show a remarkable diversity of organ asymmetries. The right lung is always fully developed, while the left lung is either absent, vestigial, or well-developed (but smaller than the right). A 'tracheal lung' is present in some taxa. These asymmetries are reflected in the pulmonary arteries. Lung asymmetry is known to appear at early stages of development in Thamnophis radix and Natrix natrix. Unfortunately, there is no developmental data on snakes with a well-developed or absent left lung. We examine the adult and developmental morphology of the lung and pulmonary arteries in the snakes Python curtus breitensteini, Pantherophis guttata guttata, Elaphe obsoleta spiloides, Calloselasma rhodostoma and Causus rhombeatus using gross dissection, MicroCT scanning and 3D reconstruction. We find that the right and tracheal lung develop similarly in these species. By contrast, the left lung either: (1) fails to develop; (2) elongates more slowly and aborts early without (2a) or with (2b) subsequent development of faveoli; (3) or develops normally. A right pulmonary artery always develops, but the left develops only if the left lung develops. No pulmonary artery develops in relation to the tracheal lung. We conclude that heterochrony in lung bud development contributes to lung asymmetry in several snake taxa. Secondly, the development of the pulmonary arteries is asymmetric at early stages, possibly because the splanchnic plexus fails to develop when the left lung is reduced. Finally, some changes in the topography of the pulmonary arteries are consequent on ontogenetic displacement of the heart down the body. Our findings show that the left-right asymmetry in the cardiorespiratory system of snakes is expressed early in development and may become phenotypically expressed through heterochronic shifts in growth, and changes in axial relations of organs and vessels. We propose a step-wise model for reduction of the left lung during snake evolution.

Heterochrony and early left-right asymmetry in the development of the cardiorespiratory system of snakes.

Directory of Open Access Journals (Sweden)

Benjamin J van Soldt

Full Text Available Snake lungs show a remarkable diversity of organ asymmetries. The right lung is always fully developed, while the left lung is either absent, vestigial, or well-developed (but smaller than the right. A 'tracheal lung' is present in some taxa. These asymmetries are reflected in the pulmonary arteries. Lung asymmetry is known to appear at early stages of development in Thamnophis radix and Natrix natrix. Unfortunately, there is no developmental data on snakes with a well-developed or absent left lung. We examine the adult and developmental morphology of the lung and pulmonary arteries in the snakes Python curtus breitensteini, Pantherophis guttata guttata, Elaphe obsoleta spiloides, Calloselasma rhodostoma and Causus rhombeatus using gross dissection, MicroCT scanning and 3D reconstruction. We find that the right and tracheal lung develop similarly in these species. By contrast, the left lung either: (1 fails to develop; (2 elongates more slowly and aborts early without (2a or with (2b subsequent development of faveoli; (3 or develops normally. A right pulmonary artery always develops, but the left develops only if the left lung develops. No pulmonary artery develops in relation to the tracheal lung. We conclude that heterochrony in lung bud development contributes to lung asymmetry in several snake taxa. Secondly, the development of the pulmonary arteries is asymmetric at early stages, possibly because the splanchnic plexus fails to develop when the left lung is reduced. Finally, some changes in the topography of the pulmonary arteries are consequent on ontogenetic displacement of the heart down the body. Our findings show that the left-right asymmetry in the cardiorespiratory system of snakes is expressed early in development and may become phenotypically expressed through heterochronic shifts in growth, and changes in axial relations of organs and vessels. We propose a step-wise model for reduction of the left lung during snake evolution.

Heterochrony and Early Left-Right Asymmetry in the Development of the Cardiorespiratory System of Snakes

Science.gov (United States)

van Soldt, Benjamin J.; Metscher, Brian D.; Poelmann, Robert E.; Vervust, Bart; Vonk, Freek J.; Müller, Gerd B.; Richardson, Michael K.

2015-01-01

Snake lungs show a remarkable diversity of organ asymmetries. The right lung is always fully developed, while the left lung is either absent, vestigial, or well-developed (but smaller than the right). A ‘tracheal lung’ is present in some taxa. These asymmetries are reflected in the pulmonary arteries. Lung asymmetry is known to appear at early stages of development in Thamnophis radix and Natrix natrix. Unfortunately, there is no developmental data on snakes with a well-developed or absent left lung. We examine the adult and developmental morphology of the lung and pulmonary arteries in the snakes Python curtus breitensteini, Pantherophis guttata guttata, Elaphe obsoleta spiloides, Calloselasma rhodostoma and Causus rhombeatus using gross dissection, MicroCT scanning and 3D reconstruction. We find that the right and tracheal lung develop similarly in these species. By contrast, the left lung either: (1) fails to develop; (2) elongates more slowly and aborts early without (2a) or with (2b) subsequent development of faveoli; (3) or develops normally. A right pulmonary artery always develops, but the left develops only if the left lung develops. No pulmonary artery develops in relation to the tracheal lung. We conclude that heterochrony in lung bud development contributes to lung asymmetry in several snake taxa. Secondly, the development of the pulmonary arteries is asymmetric at early stages, possibly because the splanchnic plexus fails to develop when the left lung is reduced. Finally, some changes in the topography of the pulmonary arteries are consequent on ontogenetic displacement of the heart down the body. Our findings show that the left-right asymmetry in the cardiorespiratory system of snakes is expressed early in development and may become phenotypically expressed through heterochronic shifts in growth, and changes in axial relations of organs and vessels. We propose a step-wise model for reduction of the left lung during snake evolution. PMID:25555231

Hypoplastic left heart syndrome and the nutmeg lung pattern in utero: a cause and effect relationship or prognostic indicator?

Energy Technology Data Exchange (ETDEWEB)

Saul, David; Johnson, Ann M.; Victoria, Teresa [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); Degenhardt, Karl; Rychik, Jack [The Children' s Hospital of Philadelphia, Cardiac Center and Fetal Heart Program, Philadelphia, PA (United States); Iyoob, Suzanne D.; Johnson, Mark P. [The Children' s Hospital of Philadelphia, Center for Fetal Diagnosis and Treatment, Philadelphia, PA (United States); Surrey, Lea F. [The Children' s Hospital of Philadelphia, Pathology Department, Philadelphia, PA (United States)

2016-04-15

Hypoplastic left heart syndrome (HLHS) is the third most common cause of critical congenital heart disease in newborns, and one of the most challenging forms to treat. Secondary pulmonary lymphangiectasia has been recognized in association with HLHS, an appearance described on fetal MRI as the ''nutmeg lung.'' To investigate the association of fetal nutmeg lung with HLHS survival. A retrospective search of the fetal MRI database was performed. The nutmeg lung pattern was defined as T2 heterogeneous signal with tubular structures radiating peripherally from the hila. Postnatal echocardiograms and charts were reviewed. Forty-four fetal MR studies met inclusion criteria, of which 4 patients (9%) had the nutmeg lung pattern and 3 of whom also had restrictive lesions. Mortality in this nutmeg lung group was 100% by 5 months of age. Of the 40 patients without nutmeg lung, mortality/orthotopic heart transplant (OHT) was 35%. Of these 40 patients without nutmeg lung, 5 had restriction on echo, 3 of whom died/had OHT before 5 months of age (60% of patients with restriction and non-nutmeg lung). There was a significantly higher incidence of restrictive lesions (P = 0.02) and mortality/OHT (P = 0.02) in patients with nutmeg lung compared to those without. The nutmeg lung MR appearance in HLHS fetuses is associated with increased mortality/OHT (100% in the first 5 months of life compared to 35% with HLHS alone). Not all patients with restrictive lesions develop nutmeg lung, and outcome is not as poor when restriction is present in isolation. Dedicated evaluation for nutmeg lung pattern on fetal MR studies may be useful to guide prognostication and aid clinicians in counseling parents of fetuses with HLHS. (orig.)

Hypoplastic left heart syndrome and the nutmeg lung pattern in utero: a cause and effect relationship or prognostic indicator?

International Nuclear Information System (INIS)

Saul, David; Johnson, Ann M.; Victoria, Teresa; Degenhardt, Karl; Rychik, Jack; Iyoob, Suzanne D.; Johnson, Mark P.; Surrey, Lea F.

2016-01-01

Hypoplastic left heart syndrome (HLHS) is the third most common cause of critical congenital heart disease in newborns, and one of the most challenging forms to treat. Secondary pulmonary lymphangiectasia has been recognized in association with HLHS, an appearance described on fetal MRI as the ''nutmeg lung.'' To investigate the association of fetal nutmeg lung with HLHS survival. A retrospective search of the fetal MRI database was performed. The nutmeg lung pattern was defined as T2 heterogeneous signal with tubular structures radiating peripherally from the hila. Postnatal echocardiograms and charts were reviewed. Forty-four fetal MR studies met inclusion criteria, of which 4 patients (9%) had the nutmeg lung pattern and 3 of whom also had restrictive lesions. Mortality in this nutmeg lung group was 100% by 5 months of age. Of the 40 patients without nutmeg lung, mortality/orthotopic heart transplant (OHT) was 35%. Of these 40 patients without nutmeg lung, 5 had restriction on echo, 3 of whom died/had OHT before 5 months of age (60% of patients with restriction and non-nutmeg lung). There was a significantly higher incidence of restrictive lesions (P = 0.02) and mortality/OHT (P = 0.02) in patients with nutmeg lung compared to those without. The nutmeg lung MR appearance in HLHS fetuses is associated with increased mortality/OHT (100% in the first 5 months of life compared to 35% with HLHS alone). Not all patients with restrictive lesions develop nutmeg lung, and outcome is not as poor when restriction is present in isolation. Dedicated evaluation for nutmeg lung pattern on fetal MR studies may be useful to guide prognostication and aid clinicians in counseling parents of fetuses with HLHS. (orig.)

Low tidal volume ventilation ameliorates left ventricular dysfunction in mechanically ventilated rats following LPS-induced lung injury.

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Cherpanath, Thomas G V; Smeding, Lonneke; Hirsch, Alexander; Lagrand, Wim K; Schultz, Marcus J; Groeneveld, A B Johan

2015-10-07

High tidal volume ventilation has shown to cause ventilator-induced lung injury (VILI), possibly contributing to concomitant extrapulmonary organ dysfunction. The present study examined whether left ventricular (LV) function is dependent on tidal volume size and whether this effect is augmented during lipopolysaccharide(LPS)-induced lung injury. Twenty male Wistar rats were sedated, paralyzed and then randomized in four groups receiving mechanical ventilation with tidal volumes of 6 ml/kg or 19 ml/kg with or without intrapulmonary administration of LPS. A conductance catheter was placed in the left ventricle to generate pressure-volume loops, which were also obtained within a few seconds of vena cava occlusion to obtain relatively load-independent LV systolic and diastolic function parameters. The end-systolic elastance / effective arterial elastance (Ees/Ea) ratio was used as the primary parameter of LV systolic function with the end-diastolic elastance (Eed) as primary LV diastolic function. Ees/Ea decreased over time in rats receiving LPS (p = 0.045) and high tidal volume ventilation (p = 0.007), with a lower Ees/Ea in the rats with high tidal volume ventilation plus LPS compared to the other groups (p tidal volume ventilation without LPS (p = 0.223). A significant interaction (p tidal ventilation and LPS for Ees/Ea and Eed, and all rats receiving high tidal volume ventilation plus LPS died before the end of the experiment. Low tidal volume ventilation ameliorated LV systolic and diastolic dysfunction while preventing death following LPS-induced lung injury in mechanically ventilated rats. Our data advocates the use of low tidal volumes, not only to avoid VILI, but to avert ventilator-induced myocardial dysfunction as well.

Re-expansion pulmonary oedema - differential lung ventilation comes to the rescue

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Shreepathi K Achar

2014-01-01

Full Text Available Re-expansion pulmonary oedema (REPE is a rare complication following re-inflation of a chronically collapsed lung, which is often fatal. We present a case of a 22-year-old male who presented to the hospital with severe respiratory distress and a history of blunt abdominal trauma 3 months back. He was diagnosed to have left sided diaphragmatic hernia with a mediastinal shift to the right, and was posted for emergency repair of the same. After surgical decompression of the left hemi-thorax and reduction of the abdominal contents, re-expansion of the left lung was achieved, following which patient developed REPE. A left sided double lumen tube was then inserted to prevent flooding and cross contamination of the right lung and ventilation of both lungs was maintained intraoperatively. Post-operatively, REPE was successfully managed by differential lung ventilation with a lung salvage strategy to the left lung and a lung protective strategy to the right lung.

Evaluation of a new irradiation left breast method in the inhalation phase

International Nuclear Information System (INIS)

Silva, Laura E. da; Gullo, Rafael G.; Ferreira, Diogo A.V.; Silva, Leonardo P. da

2016-01-01

Radiation therapy is the primary therapeutic approach to breast cancer and involves significant exposure of heart and lungs, especially in cases of left breast. The implementation of a methodology to reduce the dose in these sites is important to ensure better quality of life to the patient. This work aims reduced heart and lung dose when performing the radiotherapy planning considering only the inhalation phase. Three patients with breast left present were scanning with CT during free breathing and respiratory monitoring and the planning has done on both images series. The results showed a reduction in mean heart dose of 53% on average. As for lung volumes, was obtained a mean reduction of 44.6% and 51% of the left lung which received 10 Gy and 20 Gy, respectively. This study showed that the use of the respiratory gating radiotherapy in the left breast in inhalation phase can reduce heart and lung doses. (author)

Left main bronchus compression as a result of tuberculous lymphnode compression of the right-sided airways with right lung volume loss in children.

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Andronikou, S; Van Wyk, M J; Goussard, P; Gie, R P

2014-03-01

The superior mediastinal space is confined by the sterno-manubrium anteriorly and the vertebral column posterior. An abnormal relationship between the superior mediastinal structures may result in compression of the left main bronchus. In patients with right-sided pneumonectomy an exaggerated compensatory response may lead to stretching and compression of the remainder of the intra-thoracic airway. Lymphobronchial TB mimics pneumonectomy when it causes compression of the bronchus intermedius, between nodal lymphnode groups with resultant volume loss in the right lung and displacement of the mediastinum to the right. The left main bronchus may be at risk of compression due to rotation and displacement of the major vessels. To report pediatric cases of right-sided lymphobronchial TB with volume loss, demonstrate the use of angle measurements to quantify mediastinal dynamics and support a pathogenetic theory for left main bronchus compression. CT scans in children with TB and right lung volume loss, were compared retrospectively with controls using angle measurements based on descriptions of the aorta-carinal syndrome and the post-pneumonectomy syndrome. The Mann-Whitney U-test was used to compare groups. The "Pulmonary bifurcation angle" between the main pulmonary arteries reached statistical significance (P = 0.025). The "Pulmonary outflow tract rotation" angle (pulmonary trunk with the mid sagittal plane) approached statistical significance (P = 0.078). The left main bronchus ranged from complete obliteration in two patients to 0.7 cm. In 16 of 30 patients the size was reduced to less than 75% of expected. In children with right lung volume loss from TB, the compression of the contralateral bronchus is due to narrowing of the pulmonary artery bifurcation angle as the main trunk rotates towards the midline. This is comparable to the post-pneumonectomy syndrome. © 2012 Wiley Periodicals, Inc.

A case of squamous cell lung cancer after treating with radiation for small cell lung cancer

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Hayashi, Toshinari; Ide, Hiroshi; Siomi, Katsuhiko; Nakamura, Yukinobu; Tada, Shinya; Kageyama, Hiroshi; Kido, Masamitsu

1999-01-01

A 77-year-old man was admitted due to an abnormal shadow on a chest X-ray film in September 1993. Small cell lung cancer was diagnosed by transbronchial lung biopsy of left S 3 . Because of his pulmonary and renal dysfunction, he received only 40 Gy irradiation alone, and the tumor shadow disappeared. After 38 months' observation, a new nodular shadow was detected in the left upper lung field in March 1997. A tumor was found in left B 3 by bronchoscopy, and biopsy revealed squamous cell carcinoma. Because of his advanced age and hypoxia, he has had no active treatment. This was a rare case of small cell lung cancer with long term survival, treated only by radiation, in which a different histologic type of carcinoma appeared in the same radiation field. (author)

Myocardial visualization on a routine perfusion lung scintigram: Relationship to the amount of right-to-left shunt

International Nuclear Information System (INIS)

Seto, H.; Futatsuya, R.; Kamei, T.; Kakishita, M.; Hisada, K.

1983-01-01

Three cases of myocardial visualization on a routine perfusion lung scintigram with sup(99m)Tc-macroaggregaed albumin were reported in patients with congenital heart diseases; two cases of tetralogy of Fallot and one case of truncus arteriosus type IV. Large right-to-left shunts greater than 39% and marked hypertrophy of the ventricle suggesting the presence of increased coronary blood flow were noted in all cases. In the two patients with tetralogy of Fallot myocardial activity appeared to be located in the hypertrophic right venticles. (orig.)

Myocardial visualization on a routine perfusion lung scintigram: Relationship to the amount of right-to-left shunt

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Seto, H.; Futatsuya, R.; Kamei, T.; Kakishita, M.; Hisada, K.

1983-11-14

Three cases of myocardial visualization on a routine perfusion lung scintigram with sup(99m)Tc-macroaggregated albumin were reported in patients with congenital heart diseases; two cases of tetralogy of Fallot and one case of truncus arteriosus type IV. Large right-to-left shunts greater than 39% and marked hypertrophy of the ventricle suggesting the presence of increased coronary blood flow were noted in all cases. In the two patients with tetralogy of Fallot myocardial activity appeared to be located in the hypertrophic right venticles.

Isolated Left Pulmonary Artery Agenesis: A Case Report

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Tansel Ansal Balcı

2012-08-01

Full Text Available Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation- perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. (MIRT 2012;21:80-83

An intractable empyema proceeded from radiation pneumonitis after operation of lung cancer

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Masuya, Daiki; Gotoh, Masashi; Nakashima, Takashi; Okamoto, Taku; Liu, Dage; Ishikawa, Shinya; Yamamoto, Yasumichi; Huang, Cheng-Long; Yokomise, Hiroyasu

2005-01-01

A 54-year-old man underwent left upper lobectomy with c-stage IIIA lung squamous cell carcinoma after concurrent chemo-radiotherapy. Radiation pneumonitis focusing on the residual left S 6 appeared after operation. Following steroid pulse treatment, the pneumonitic focus was cavitated and proceeded to pulmonary abscess. Although chest drainage was performed, control of the pulmonary fistula was poor, so an operation was performed. Pulmonary decortication and pleurodesis were performed, but failed to control the fistula and infection. Finally, thoracoplasty, omentoplasty and free rectus abdominis musculocutaneous flap were filled in intrathorasic to manage the fistula. In this case of operation following concurrent chemo-radiotherapy, the original recovery power declined. We therefore conclude this was an intractable case of empyema. (author)

Estimation of 123I-metaiodobenzylguanidine lung uptake in heart and lung diseases. With reference to lung uptake ratio and decrease of lung uptake

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hiroshi; Koizumi, Tomonori; Sekiguchi, Morie; Gomi, Tsutomu; Yano, Kesato; Itoh, Atsuko.

1997-01-01

123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed in 64 patients with heart and lung diseases. Distribution of MIBG in the chest was evaluated by planar images, using counts ratios of the heart to the mediastinum (H/M) and the unilateral lung to the mediastinum (Lu/M). Most of patients with heart diseases showed obvious lung uptake of MIBG. The ratios of H/M were 1.75±0.20 in the group without heart failure and 1.55±0.19 in the group with heart failure. The ratios of Lu/M in the right and left lung were 1.56±0.16 and 1.28±0.16 in the group without heart failure. And those were 1.45±0.16 and 1.19±0.15 in the group with heart failure. But 3 patients complicated with chronic pulmonary emphysema and one patient with interstitial pneumonia due to dermatomyositis showed markedly decreased lung uptake. The ratios of Lu/M in the right and left lung of these patients were 1.20, 1.17; 1.17, 1.13; 1.01, 0.97 and 1.27, 0.94, respectively. These results suggest that the lung uptake of MIBG may reflect the state of pulmonary endothelial cell function in clinical situations, considering that it has been demonstrated that MIBG may be useful as a marker of pulmonary endothelial cell function in the isolated rat lung. (author)

Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos.

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Merler, Enzo; Somigliana, Anna; Girardi, Paolo; Barbieri, Pietro Gino

2017-03-01

To evaluate the lungs asbestos fibres concentration in participants with malignant pleural mesothelioma (MPM) who have been occupationally exposed. The lung samples were obtained from pleuropneumonectomies or autopsies of 271 male MPMs. The lung samples were examined through scanning electron microscopy. Retrospective assessment was used to assess for asbestos exposure. This study includes 248 MPMs with an occupational exposure defined as either 'definite' or 'probable' or 'possible'. The participants had finished working in asbestos exposure conditions more than 20 years ago (on average 26.1±11.0 years). The fibre burden resulted with a geometric mean equal to 2.0 (95% CI 1.6 to 2.4) million fibres per gram of dry lung tissue. The burden was higher among participants employed in asbestos textiles industry and in shipyards with insulation material, if compared with construction workers or non-asbestos textile workers or participants working in chemicals or as auto mechanics. 91.3% of MPMs had a detectable amount of amphibole fibres. A strong lung clearance capability was evident among workers exposed to chrysotile fibres. Owing to that, the 1997 Helsinki Criteria for occupational exposure were reached in industry, in chemical or textile industry and among those performing brake repair activities. The MPM cases are now occurring in Italy in participants who ceased occupational asbestos exposure decades before the analysis. A large majority still shows a residual content of amphibole fibres, but given the lung clearance capability, attribution to occupational exposure cannot rely only on fibres detection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing.

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Jahani, Nariman; Choi, Sanghun; Choi, Jiwoong; Iyer, Krishna; Hoffman, Eric A; Lin, Ching-Long

2015-11-15

This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R(2) ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs. Copyright © 2015 the American Physiological Society.

Lung transplantation in the rat. III. Functional studies in iso- and allografts

International Nuclear Information System (INIS)

Marck, K.W.; Prop, J.; Wildevuur, C.R.

1983-01-01

Recently a microsurgical technique for orthotopic left lung transplantation in the rat was developed. The aim of this study was to investigate the influence of the operation itself and of an unmodified rejection reaction on the function of the transplanted rat lung. Orthotopic left lung transplantation was performed in 59 rats (34 isografts and 25 allografts). Isografts demonstrated a mean left lung perfusion of 23.1% in the first two postoperative weeks. Seven out of the 10 animals, subjected to a repeated scintigraphy 5-10 weeks later, had an increased graft perfusion, resulting in an almost normal mean left lung perfusion of 34.8%. At that time chest roentgenography revealed a good aeration of the grafts, that at autopsy had a normal aspect. Allografts showed an initial mean left lung perfusion (24.6%) similar to the isografts, which, however, declined sharply a few days later (4.3%). At that time chest roentgenography revealed totally opalescent grafts that at autopsy had the hepatized aspect characteristic of lung allograft rejection. These results of isogeneic and allogeneic lung transplantation in the rat were comparable with those of canine auto- and allotransplantation. For immunogenetic and economical reasons lung transplantation in the rat is a good alternative animal model in lung transplantation research

Automatic lung segmentation in functional SPECT images using active shape models trained on reference lung shapes from CT.

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Cheimariotis, Grigorios-Aris; Al-Mashat, Mariam; Haris, Kostas; Aletras, Anthony H; Jögi, Jonas; Bajc, Marika; Maglaveras, Nicolaos; Heiberg, Einar

2018-02-01

Image segmentation is an essential step in quantifying the extent of reduced or absent lung function. The aim of this study is to develop and validate a new tool for automatic segmentation of lungs in ventilation and perfusion SPECT images and compare automatic and manual SPECT lung segmentations with reference computed tomography (CT) volumes. A total of 77 subjects (69 patients with obstructive lung disease, and 8 subjects without apparent perfusion of ventilation loss) performed low-dose CT followed by ventilation/perfusion (V/P) SPECT examination in a hybrid gamma camera system. In the training phase, lung shapes from the 57 anatomical low-dose CT images were used to construct two active shape models (right lung and left lung) which were then used for image segmentation. The algorithm was validated in 20 patients, comparing its results to reference delineation of corresponding CT images, and by comparing automatic segmentation to manual delineations in SPECT images. The Dice coefficient between automatic SPECT delineations and manual SPECT delineations were 0.83 ± 0.04% for the right and 0.82 ± 0.05% for the left lung. There was statistically significant difference between reference volumes from CT and automatic delineations for the right (R = 0.53, p = 0.02) and left lung (R = 0.69, p automatic quantification of wide range of measurements.

Medical image of the week: lung entrapment

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Natt B

2016-07-01

Full Text Available No abstract available. Article truncated at 150 words. A 74-year-old woman with a history of breast cancer 10 years ago treated with lumpectomy and radiation presented for evaluation of shortness of breath. She was diagnosed with left sided pleural effusion which was recurrent requiring multiple thoracenteses. There was increased pleural fludeoxyglucose (FDG uptake on PET-CT indicative of recurrent metastatic disease. She underwent a medical pleuroscopy since the pleural effusion analysis did not reveal malignant cells although the suspicion was high and tunneled pleural catheter placement as adjuvant chemotherapy was initiated. Figure 1 shows a pleurscopic view of the collapsed left lung and the effusion in the left hemi thorax. Figure 2 shows extensive involvement of the visceral pleura with metastatic disease preventing complete lung inflation. Figure 3 shows persistent pneumothorax-ex-vacuo despite pleural catheter placement confirming the diagnosis of entrapment. Incomplete lung inflation can be due to pleural disease, endobronchial lesions or chronic telecasts. Lung entrapment and trapped lung ...

Lung Cancer in uranium miners

International Nuclear Information System (INIS)

Zhou Chundi; Fan Jixiong; Wang Liuhu; Huang Yiehan; Nie Guanghua

1987-01-01

This paper analyese the clinical data of 39 uranium miners with lung cancer and of 20 patients with lung cancer who have not been exposed to uranium as control. The age of uranium miners with lung cancer was 36∼61 with an average of 48.8, nine years earlier than that of the control group (57.3). In the uranium miner patients the right lung was more susceptible to cancer than the left, the ratio being 2.5:1. However, in the control group the right lung had an equal incidence of cancer as the left lung. The relative frequency of small cell anaplastic carcinoma in uranium miner was higher than that in the control group. In the miner patients the mean occupation history was 11.1 ± 5.2 years; the exposure dose to radon and its daughters in 50% patients was 0.504J(120 WLM). The etiologic factor of lung cancer in uranium miners is strongly attributed, in addition to smoking, to the exposure to radon and its daughters in uranium mines

[Left postpneumonectomy syndrome: early endoscopic treatment].

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Rombolá, Carlos A; León Atance, Pablo; Honguero Martínez, Antonio Francisco; Rueda Martínez, Juan Luis; Núñez Ares, Ana; Vizcaya Sánchez, Manuel

2009-12-01

Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung. We present the case of an adult patient who underwent left pneumonectomy and developed postpneumonectomy syndrome 15 months later. Stenosis of the intermediate bronchus occurred between the vertebral body and the right pulmonary artery. Endoscopic treatment with a self-expanding metal stent was successful, and complete remission was observed over the 6 months of follow-up.

Visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy

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Yasushi Mizukami

2017-10-01

Full Text Available Abstract Background Pulmonary visceral subpleural hematoma is rare. We report visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy. This very rare case was difficult to distinguish from thoracic abscess. Case presentation A 68-year-old man with hypertension had undergone video-assisted thoracoscopic left upper division segmentectomy for suspected lung carcinoma. Deep vein thrombosis of the lower leg was identified and edoxaban, a so-called novel oral anticoagulant, was started on postoperative day 7. The chest drainage tube was removed on postoperative day 12 because of persistent air leakage, but fever appeared the same day. Computed tomography revealed a cavity with mixed air and fluid, so antibiotics were started on suspicion of abscess. Computed tomography-guided drainage was attempted, but proved unsuccessful. Fever continued and surgical investigation was therefore performed. Visceral subpleural hematoma was identified under the diaphragmatic surface of the left basal lung. We excised the pleura, then performed drainage and applied running sutures. The parenchyma and visceral pleura were covered with polyglycolic acid sheet and fibrin glue. Edoxaban was restarted on postoperative day 12 of video-assisted thoracoscopic surgery and no recurrence of hematoma has been revealed. Conclusions Visceral subpleural hematoma after thoracic surgery is extremely rare. Furthermore, correct diagnosis was difficult and surgery offered a good diagnostic and therapeutic procedure.

Frequency and number of ultrasound lung rockets (B-lines) using a regionally based lung ultrasound examination named vet BLUE (veterinary bedside lung ultrasound exam) in dogs with radiographically normal lung findings.

Science.gov (United States)

Lisciandro, Gregory R; Fosgate, Geoffrey T; Fulton, Robert M

2014-01-01

Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B-lines, representing interstitial edema) versus dry lung (A-lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A-lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B-lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8-view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left-sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6-19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74-100%) in those with left-sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions. © 2014 American College of Veterinary Radiology.

Single-Lung Ventilation with Contralateral Lung Deflation

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Dallan, Luís Alberto O.; Lisboa, Luiz Augusto F.; Platania, Fernando; Oliveira, Sérgio A.; Stolf, Noedir A.

2007-01-01

There are many new alternative methods of minimally invasive myocardial revascularization that can be applied in selected patients who have multivessel coronary artery disease. However, these techniques often require new and expensive equipment. Most multivessel myocardial revascularization is performed via median sternotomy and involves the use of a conventional endotracheal tube. Both lungs are ventilated, and frequently the left pleural cavity is opened. In contrast, single-lung deflation naturally moves the mediastinum within the thorax toward the collapsed lung, without the need to open the pleural cavities. Herein, we describe a simple alternative procedure that facilitates off-pump multivessel coronary artery bypass grafting via complete median sternotomy: single-lung ventilation with contralateral lung deflation. This technique better exposes the more distal right and circumflex coronary artery branches with or without the opening of the pleural cavities. PMID:17622364

Histogram based analysis of lung perfusion of children after congenital diaphragmatic hernia repair.

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Kassner, Nora; Weis, Meike; Zahn, Katrin; Schaible, Thomas; Schoenberg, Stefan O; Schad, Lothar R; Zöllner, Frank G

2018-05-01

To investigate a histogram based approach to characterize the distribution of perfusion in the whole left and right lung by descriptive statistics and to show how histograms could be used to visually explore perfusion defects in two year old children after Congenital Diaphragmatic Hernia (CDH) repair. 28 children (age of 24.2±1.7months; all left sided hernia; 9 after extracorporeal membrane oxygenation therapy) underwent quantitative DCE-MRI of the lung. Segmentations of left and right lung were manually drawn to mask the calculated pulmonary blood flow maps and then to derive histograms for each lung side. Individual and group wise analysis of histograms of left and right lung was performed. Ipsilateral and contralateral lung show significant difference in shape and descriptive statistics derived from the histogram (Wilcoxon signed-rank test, phistogram derived parameters. Histogram analysis can be a valuable tool to characterize and visualize whole lung perfusion of children after CDH repair. It allows for several possibilities to analyze the data, either describing the perfusion differences between the right and left lung but also to explore and visualize localized perfusion patterns in the 3D lung volume. Subgroup analysis will be possible given sufficient sample sizes. Copyright © 2017 Elsevier Inc. All rights reserved.

Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease. Effects of modern radiotherapy techniques

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Corradini, Stefanie; Ballhausen, Hendrik; Weingandt, Helmut; Freislederer, Philipp; Schoenecker, Stephan; Niyazi, Maximilian; Belka, Claus [University Hospital, LMU Munich, Department of Radiation Oncology, Munich (Germany); Simonetto, Cristoforo; Eidemueller, Markus [Helmholtz Zentrum Muenchen, Institute of Radiation Protection, Neuherberg (Germany); Ganswindt, Ute [University Hospital, LMU Munich, Department of Radiation Oncology, Munich (Germany); Medical University, Department of Radiation Oncology, Innsbruck (Austria)

2018-03-15

Modern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques. Four different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH. Dose-volume histograms were used for organ equivalent dose (OED) calculations using linear, linear-exponential, and plateau models for the lung. A linear model was applied to estimate the long-term risk of ischemic heart disease as motivated by epidemiologic data. Excess relative risk (ERR) and 10-year excess absolute risk (EAR) for radiation-induced secondary lung cancer and ischemic heart disease were estimated for different representative baseline risks. The DIBH maneuver resulted in a significant reduction of the ERR and estimated 10-year excess absolute risk for major coronary events compared to FB in 3D-CRT plans (p = 0.04). In VMAT plans, the mean predicted risk reduction through DIBH was less pronounced and not statistically significant (p = 0.44). The risk of radiation-induced secondary lung cancer was mainly influenced by the radiotherapy technique, with no beneficial effect through DIBH. VMAT plans correlated with an increase in 10-year EAR for radiation-induced lung cancer as compared to 3D-CRT plans (DIBH p = 0.007; FB p = 0.005, respectively). However, the EARs were affected more strongly by nonradiation-associated risk factors, such as smoking, as compared to the choice of treatment technique. The results indicate that 3D-CRT plans in DIBH pose the lowest

The Effect of Compartmental Asymmetry on the Monitoring of Pulmonary Mechanics and Lung Volumes.

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Keenan, Joseph C; Cortes-Puentes, Gustavo A; Adams, Alexander B; Dries, David J; Marini, John J

2016-11-01

Esophageal pressure measurement for computation of transpulmonary pressure (P tp ) has begun to be incorporated into clinical use for evaluating forces across the lungs. Gaps exist in our understanding of how esophageal pressure (and therefore P tp ), a value measured at a single site, responds when respiratory system compartments are asymmetrically affected by whole-lung atelectasis or unilateral injury as well as changes in chest wall compliance. We reasoned that P tp would track with aerated volume changes as estimated by functional residual capacity (FRC) and tidal volume. We examined this hypothesis in the setting of asymmetric lungs and changes in intra-abdominal pressure. This study was conducted in the animal laboratory of a university-affiliated hospital. Models of unilateral atelectasis and unilateral and bilateral lung injury exposed to intra-abdominal hypertension (IAH) in 10 deeply sedated mechanically ventilated swine. Atelectasis was created by balloon occlusion of the left main bronchus. Unilateral lung injury was induced by saline lavage of isolated right lung. Diffuse lung injury was induced by saline lavage of both lungs. The peritoneum was insufflated with air to create a model of pressure-regulated IAH. We measured esophageal pressures, airway pressures, FRC by gas dilution, and oxygenation. FRC was reduced by IAH in normal lungs (P volume in the setting of thoracic asymmetry and changes in intra-abdominal pressure. However, used alone, it cannot distinguish the relative contributions of air-space distention and recruitment of lung units. Copyright © 2016 by Daedalus Enterprises.

A case of luftsichel sign for left upper lobe collapse

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Erden Erol Ünlüer

2015-01-01

Full Text Available The differential diagnosis of dyspnea in Emergency Department (ED patients is broad and atelectasis is one of the differentials among these. We present a 29-year-old women presented to our ED for evaluation of shortness of breath. On her chest examination, air entry and breath sounds were diminished on the left side but normal on the right. A posteroanterior chest radiograph showed radioluscent area in the upper zone of the left lung, around the aortic arch and also hyperdens area neighbouring this, like covered by a veil. Luftsichel sign together with this hiperdensity were consistent with the diagnose of left lung upper lobe collapse. The Luftsichel sign represents the hyperexpanded superior segment of the left lower lobe interposed between the atelectatic left upper lobe and aortic arch. Patient was discharged to home with chest physiotherapy and breathing exercises together with analgesic prescreption.

Lung volumes: measurement, clinical use, and coding.

Science.gov (United States)

Flesch, Judd D; Dine, C Jessica

2012-08-01

Measurement of lung volumes is an integral part of complete pulmonary function testing. Some lung volumes can be measured during spirometry; however, measurement of the residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC) requires special techniques. FRC is typically measured by one of three methods. Body plethysmography uses Boyle's Law to determine lung volumes, whereas inert gas dilution and nitrogen washout use dilution properties of gases. After determination of FRC, expiratory reserve volume and inspiratory vital capacity are measured, which allows the calculation of the RV and TLC. Lung volumes are commonly used for the diagnosis of restriction. In obstructive lung disease, they are used to assess for hyperinflation. Changes in lung volumes can also be seen in a number of other clinical conditions. Reimbursement for measurement of lung volumes requires knowledge of current procedural terminology (CPT) codes, relevant indications, and an appropriate level of physician supervision. Because of recent efforts to eliminate payment inefficiencies, the 10 previous CPT codes for lung volumes, airway resistance, and diffusing capacity have been bundled into four new CPT codes.

Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis.

Directory of Open Access Journals (Sweden)

Hiroaki Kuroda

Full Text Available Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC located in the left upper division.We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako's method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station.We enrolled 417 patients (237 men, 180 women. Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC.Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC.

Treatment of intractable interstitial lung injury with alemtuzumab after lung transplantation

DEFF Research Database (Denmark)

Kohno, M; Perch, M; Andersen, E

2011-01-01

A 44-year-old woman underwent left single-lung transplantation for end-stage emphysema due to α1-antitrypsin deficiency in January 2010. Cyclosporine, azathioprine, and prednisolone were administered for immunosuppression and antithymocyte globulin for induction therapy at the time...... of transplantation. Routine examination of a lung biopsy, 4 months after transplantation, showed nonspecific, diffuse interstitial inflammation with alveolar septal fibrosis. The patient's clinical status and imaging studies, consistent with nonspecific interstitial pneumonitis, which was considered as signs......, posttransplant antirejection drug regimen. We have since successfully treated with alemtuzumab three additional patients who developed interstitial lung injury after lung transplantation, who are also summarized in this report....

Thoracoscopic lung lobectomy for treatment of lung tumors in dogs.

Science.gov (United States)

Lansdowne, Jennifer L; Monnet, Eric; Twedt, David C; Dernell, William S

2005-01-01

To report use of thoracoscopic lung lobectomy (TLL) for treatment of lung tumors (LT) in dogs. Retrospective study. Nine dogs. Dogs that had TLL for tumor removal were included. Using general anesthesia and 1-lung ventilation, TLL was performed using a 30-60 mm endoscopic gastrointestinal anastomosis stapler. If the visual field was obscured, lobe resection was completed via thoracotomy. Metastatic and primary LT were resected by thoracoscopic lobectomy in 9 dogs (6 male, 3 female; mean (+/-SD) weight, 29+/-7 kg; mean age, 10.7+/-1.9 years). Six dogs had a solitary mass and 3 dogs had 2 masses within a single lobe. The left caudal lobe was removed in 3 dogs. In 5 dogs, TLL was used alone whereas conversion to thoracotomy was required in 4 dogs because of poor visibility. There were 7 metastatic LT and 2 primary LT. Mean duration of thoracoscopic surgery was 108.8+/-30.3 minutes compared with 150.75+/-55.4 minutes in dogs requiring conversion to thoracotomy. Mean hospitalization was 3.1+/-1.3 days. Provided the visual field is not obscured, TLL can be performed effectively in dogs. Dogs with metastatic or primary LTs should be considered for TLL, particularly for small masses positioned away from the hilus in the left caudal lung lobe.

Tetralogy of Fallot with origin of left pulmonary artery from the ascending aorta

Energy Technology Data Exchange (ETDEWEB)

Robida, A.; Fettich, D.

1985-09-01

Anomalous origin of the left pulmonary artery in tetralogy of Fallot was diagnosed in a 4-year-old boy by cardiac catheterization. Corrective surgery was performed. The child died immediately following the surgical procedure. Postmortem examination revealed obstructive pulmonary vascular disease of the left lung and normal histology of right lung vessels. Early recognition and surgical correction of the anomaly is important with the view to preventing obstructive pulmonary vascular disease.

Alternatives to crop residues for soil amendment

OpenAIRE

Powell, J.M.; Unger, P.W.

1997-01-01

Metadata only record In semiarid agroecosystems, crop residues can provide important benefits of soil and water conservation, nutrient cycling, and improved subsequent crop yields. However, there are frequently multiple competing uses for residues, including animal forage, fuel, and construction material. This chapter discusses the various uses of crop residues and examines alternative soil amendments when crop residues cannot be left on the soil.

Model-based approach for quantitative estimates of skin, heart, and lung toxicity risk for left-side photon and proton irradiation after breast-conserving surgery.

Science.gov (United States)

Tommasino, Francesco; Durante, Marco; D'Avino, Vittoria; Liuzzi, Raffaele; Conson, Manuel; Farace, Paolo; Palma, Giuseppe; Schwarz, Marco; Cella, Laura; Pacelli, Roberto

2017-05-01

Proton beam therapy represents a promising modality for left-side breast cancer (BC) treatment, but concerns have been raised about skin toxicity and poor cosmesis. The aim of this study is to apply skin normal tissue complication probability (NTCP) model for intensity modulated proton therapy (IMPT) optimization in left-side BC. Ten left-side BC patients undergoing photon irradiation after breast-conserving surgery were randomly selected from our clinical database. Intensity modulated photon (IMRT) and IMPT plans were calculated with iso-tumor-coverage criteria and according to RTOG 1005 guidelines. Proton plans were computed with and without skin optimization. Published NTCP models were employed to estimate the risk of different toxicity endpoints for skin, lung, heart and its substructures. Acute skin NTCP evaluation suggests a lower toxicity level with IMPT compared to IMRT when the skin is included in proton optimization strategy (0.1% versus 1.7%, p < 0.001). Dosimetric results show that, with the same level of tumor coverage, IMPT attains significant heart and lung dose sparing compared with IMRT. By NTCP model-based analysis, an overall reduction in the cardiopulmonary toxicity risk prediction can be observed for all IMPT compared to IMRT plans: the relative risk reduction from protons varies between 0.1 and 0.7 depending on the considered toxicity endpoint. Our analysis suggests that IMPT might be safely applied without increasing the risk of severe acute radiation induced skin toxicity. The quantitative risk estimates also support the potential clinical benefits of IMPT for left-side BC irradiation due to lower risk of cardiac and pulmonary morbidity. The applied approach might be relevant on the long term for the setup of cost-effectiveness evaluation strategies based on NTCP predictions.

Alternating versus synchronous ventilation of left and right lungs in piglets

NARCIS (Netherlands)

A. Versprille (Adrian); V. Hrachovina (V.); J.R.C. Jansen (Jos)

1995-01-01

textabstractObjective: We tested whether alternating ventilation (AV) of each lung (i.e. with a phase difference of half a ventilatory cycle) would decrease central venous pressure and so increase cardiac output when compared with simultaneous ventilation (SV) of both lungs. Theory: If, during AV,

Brain abscess mimicking lung cancer metastases; a case report.

Science.gov (United States)

Asano, Michiko; Fujimoto, Nobukazu; Fuchimoto, Yasuko; Ono, Katsuichiro; Ozaki, Shinji; Kimura, Fumiaki; Kishimoto, Takumi

2013-01-01

A 76-year-old woman came to us because of staggering, fever, dysarthria, and appetite loss. Magnetic resonance imaging (MRI) of the brain revealed multiple masses with surrounding edema. Chest X-ray and computed tomography demonstrated a mass-like lesion in the left lung and left pleural effusion. Lung cancer and multiple brain metastases were suspected. However, the brain lesions demonstrated a high intensity through diffusion-weighted MRI. The finding was an important key to differentiate brain abscesses from lung cancer metastases. Copyright © 2013 Elsevier Inc. All rights reserved.

Lymph Node Metastases and Prognosis in Left Upper Division Non-Small Cell Lung Cancers: The Impact of Interlobar Lymph Node Metastasis

Science.gov (United States)

Kuroda, Hiroaki; Sakao, Yukinori; Mun, Mingyon; Uehara, Hirofumi; Nakao, Masayuki; Matsuura, Yousuke; Mizuno, Tetsuya; Sakakura, Noriaki; Motoi, Noriko; Ishikawa, Yuichi; Yatabe, Yasushi; Nakagawa, Ken; Okumura, Sakae

2015-01-01

Background Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC) located in the left upper division. Methods We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy) with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako’s method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station. Results We enrolled 417 patients (237 men, 180 women). Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC. Conclusions Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC. PMID:26247881

Disentegrating lung tumor

International Nuclear Information System (INIS)

Mamedbekov, Eh.N.; Kyazimova, L.G.; Mamed''yarova, F.A.

1992-01-01

Clinical and roentgenological appearances of tuberculosis and tumoral lesions of bronchi and lungs are similar. It makes possible of wrong diagnosis of disease. Complications in diagnosis are connected with that fact that increase of frequency of pulmonary carcinoma both in patients with active tuberculosis and in persons with residual posttuberculous changes in respiratory organs is observed. Patients with specific processes in the lungs was presented. Additional X-ray examination was carried out on the base of clinical symptoms and results of X-ray examination. The diagnosis was established: disintegrating blastoma of the right lung with metastases to mediastinum lymph nodes

Tetralogy of Fallot with origin of left pulmonary artery from the ascending aorta

International Nuclear Information System (INIS)

Robida, A.; Fettich, D.

1985-01-01

Anomalous origin of the left pulmonary artery in tetralogy of Fallot was diagnosed in a 4-year-old boy by cardiac catheterization. Corrective surgery was performed. The child died immediately following the surgical procedure. Postmortem examination revealed obstructive pulmonary vascular disease of the left lung and normal histology of right lung vessels. Early recognition and surgical correction of the anomaly is important with the view to preventing obstructive pulmonary vascular disease. (orig.)

Non-intubated uniportal left-lower lobe upper segmentectomy (S6).

Science.gov (United States)

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Sesma, Julio; Lirio, Francisco; Galiana, Maria; Rivera, Maria Jesus

2017-01-01

Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision video-assisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

Adenocarcinoma of the lung presenting as retinal detachment

Directory of Open Access Journals (Sweden)

Kaushik Saha

2014-01-01

Full Text Available Retinal detachment is a rare presentation of lung cancer. A young female presented with blurring of vision in her right eye for the last 10 days without any history of trauma. On indirect ophthalmoscopy, there was a presence of right sided retinal detachment which was treated with oral prednisolone (60 mg/day. After 1 month of continuous treatment, she came back with dry cough left sided chest pain and deterioration of her eye symptoms. Chest X-ray showed left lung mass. Computed tomography guided fine needle aspiration cytology and with immunohistochemistry confirmed adenocarcinoma of the lung. She was treated with 6 cycles of chemotherapy with paclitaxel and gemcitabine.

Left is right and right is wrong: fluorodeoxyglucose uptake in left hemi-diaphragm due to right phrenic nerve palsy

International Nuclear Information System (INIS)

Joshi, Prathamesh; Lele, Vikram

2013-01-01

A 36-year-old Indian man, a recently diagnosed case of the right lung carcinoma underwent fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) for staging of the malignancy. PET/CT showed increased FDG uptake in the right lung mass, consistent with the known primary tumor. Right hemidiaphragm was found to be elevated on CT, suggesting right diaphragmatic paresis. The PET scan demonstrated asymmetric, intense FDG uptake in the left hemidiaphragm and accessory muscles of respiration, which was possibly due to compensatory increased workload related to contralateral right diaphragmatic paresis. The right diaphragmatic paresis was hypothesized to be caused by phrenic nerve palsy by right lung neoplasm. (author)

Left is right and right is wrong: Fluorodeoxyglucose uptake in left hemi-diaphragm due to right phrenic nerve palsy.

Science.gov (United States)

Joshi, Prathamesh; Lele, Vikram

2013-01-01

A 36-year-old Indian man, a recently diagnosed case of the right lung carcinoma underwent fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) for staging of the malignancy. PET/CT showed increased FDG uptake in the right lung mass, consistent with the known primary tumor. Right hemidiaphragm was found to be elevated on CT, suggesting right diaphragmatic paresis. The PET scan demonstrated asymmetric, intense FDG uptake in the left hemidiaphragm and accessory muscles of respiration, which was possibly due to compensatory increased workload related to contralateral right diaphragmatic paresis. The right diaphragmatic paresis was hypothesized to be caused by phrenic nerve palsy by right lung neoplasm.

Left–Right Asymmetry in Spectral Characteristics of Lung Sounds Detected Using a Dual-Channel Auscultation System in Healthy Young Adults

Science.gov (United States)

Tsai, Jang-Zern; Chang, Ming-Lang; Yang, Jiun-Yue; Kuo, Dar; Lin, Ching-Hsiung; Kuo, Cheng-Deng

2017-01-01

Though lung sounds auscultation is important for the diagnosis and monitoring of lung diseases, the spectral characteristics of lung sounds have not been fully understood. This study compared the spectral characteristics of lung sounds between the right and left lungs and between healthy male and female subjects using a dual-channel auscultation system. Forty-two subjects aged 18–22 years without smoking habits and any known pulmonary diseases participated in this study. The lung sounds were recorded from seven pairs of auscultation sites on the chest wall simultaneously. We found that in four out of seven auscultation pairs, the lung sounds from the left lung had a higher total power (PT) than those from the right lung. The PT of male subjects was higher than that of female ones in most auscultation pairs. The ratio of inspiration power to expiration power (RI/E) of lung sounds from the right lung was greater than that from the left lung at auscultation pairs on the anterior chest wall, while this phenomenon was reversed at auscultation pairs on the posterior chest wall in combined subjects, and similarly in both male and female subjects. Though the frequency corresponding to maximum power density of lung sounds (FMPD) from the left and right lungs was not significantly different, the frequency that equally divided the power spectrum of lung sounds (F50) from the left lung was significantly smaller than that from the right lung at auscultation site on the anterior and lateral chest walls, while it was significantly larger than that of from the right lung at auscultation site on the posterior chest walls. In conclusion, significant differences in the PT, FMPD, F50, and RI/E between the left and right lungs at some auscultation pairs were observed by using a dual-channel auscultation system in this study. Structural differences between the left and the right lungs, between the female and male subjects, and between anterior and posterior lungs might account for the

Left–Right Asymmetry in Spectral Characteristics of Lung Sounds Detected Using a Dual-Channel Auscultation System in Healthy Young Adults

Directory of Open Access Journals (Sweden)

Jang-Zern Tsai

2017-06-01

Full Text Available Though lung sounds auscultation is important for the diagnosis and monitoring of lung diseases, the spectral characteristics of lung sounds have not been fully understood. This study compared the spectral characteristics of lung sounds between the right and left lungs and between healthy male and female subjects using a dual-channel auscultation system. Forty-two subjects aged 18–22 years without smoking habits and any known pulmonary diseases participated in this study. The lung sounds were recorded from seven pairs of auscultation sites on the chest wall simultaneously. We found that in four out of seven auscultation pairs, the lung sounds from the left lung had a higher total power (PT than those from the right lung. The PT of male subjects was higher than that of female ones in most auscultation pairs. The ratio of inspiration power to expiration power (RI/E of lung sounds from the right lung was greater than that from the left lung at auscultation pairs on the anterior chest wall, while this phenomenon was reversed at auscultation pairs on the posterior chest wall in combined subjects, and similarly in both male and female subjects. Though the frequency corresponding to maximum power density of lung sounds (FMPD from the left and right lungs was not significantly different, the frequency that equally divided the power spectrum of lung sounds (F50 from the left lung was significantly smaller than that from the right lung at auscultation site on the anterior and lateral chest walls, while it was significantly larger than that of from the right lung at auscultation site on the posterior chest walls. In conclusion, significant differences in the PT, FMPD, F50, and RI/E between the left and right lungs at some auscultation pairs were observed by using a dual-channel auscultation system in this study. Structural differences between the left and the right lungs, between the female and male subjects, and between anterior and posterior lungs might

Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Fujii, Tadashige [Shinshu Univ., Matsumoto, Nagano (Japan). School of Allied Medical Sciences; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hirosi; Koizumi, Tomonori; Kubo, Keisi; Sekiguchi, Morie; Yano, Kesato

1999-06-01

To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09{+-}1.28 for the normal subjects, 1.97{+-}0.89 for the patients with lung disease, and 1.59{+-}0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (>20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease. (author)

Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy

International Nuclear Information System (INIS)

Fujii, Tadashige; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hirosi; Koizumi, Tomonori; Kubo, Keisi; Sekiguchi, Morie; Yano, Kesato

1999-01-01

To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09±1.28 for the normal subjects, 1.97±0.89 for the patients with lung disease, and 1.59±0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (>20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease. (author)

Extent of Spine Deformity Predicts Lung Growth and Function in Rabbit Model of Early Onset Scoliosis.

Directory of Open Access Journals (Sweden)

J Casey Olson

Full Text Available Early onset deformity of the spine and chest wall (initiated <8 years of age is associated with increased morbidity at adulthood relative to adolescent onset deformity of comparable severity. Presumably, inhibition of thoracic growth during late stage alveolarization leads to an irreversible loss of pulmonary growth and thoracic function; however the natural history of this disease from onset to adulthood has not been well characterized. In this study we establish a rabbit model of early onset scoliosis to establish the extent that thoracic deformity affects structural and functional respiratory development. Using a surgical right unilateral rib-tethering procedure, rib fusion with early onset scoliosis was induced in 10 young New Zealand white rabbits (3 weeks old. Progression of spine deformity, functional residual capacity, total lung capacity, and lung mass was tracked through longitudinal breath-hold computed tomography imaging up to skeletal maturity (28 weeks old. Additionally at maturity forced vital capacity and regional specific volume were calculated as functional measurements and histo-morphometry performed with the radial alveolar count as a measure of acinar complexity. Data from tethered rib rabbits were compared to age matched healthy control rabbits (N = 8. Results show unilateral rib-tethering created a progressive spinal deformity ranging from 30° to 120° curvature, the severity of which was strongly associated with pulmonary growth and functional outcomes. At maturity rabbits with deformity greater than the median (55° had decreased body weight (89%, right (59% and left (86% lung mass, right (74% and left (69% radial alveolar count, right lung volume at total lung capacity (60%, and forced vital capacity (75%. Early treatment of spinal deformity in children may prevent pulmonary complications in adulthood and these results provide a basis for the prediction of pulmonary development from thoracic structure. This model may

Biomechanical interpretation of a free-breathing lung motion model

International Nuclear Information System (INIS)

Zhao Tianyu; White, Benjamin; Lamb, James; Low, Daniel A; Moore, Kevin L; Yang Deshan; Mutic, Sasa; Lu Wei

2011-01-01

The purpose of this paper is to develop a biomechanical model for free-breathing motion and compare it to a published heuristic five-dimensional (5D) free-breathing lung motion model. An ab initio biomechanical model was developed to describe the motion of lung tissue during free breathing by analyzing the stress–strain relationship inside lung tissue. The first-order approximation of the biomechanical model was equivalent to a heuristic 5D free-breathing lung motion model proposed by Low et al in 2005 (Int. J. Radiat. Oncol. Biol. Phys. 63 921–9), in which the motion was broken down to a linear expansion component and a hysteresis component. To test the biomechanical model, parameters that characterize expansion, hysteresis and angles between the two motion components were reported independently and compared between two models. The biomechanical model agreed well with the heuristic model within 5.5% in the left lungs and 1.5% in the right lungs for patients without lung cancer. The biomechanical model predicted that a histogram of angles between the two motion components should have two peaks at 39.8° and 140.2° in the left lungs and 37.1° and 142.9° in the right lungs. The data from the 5D model verified the existence of those peaks at 41.2° and 148.2° in the left lungs and 40.1° and 140° in the right lungs for patients without lung cancer. Similar results were also observed for the patients with lung cancer, but with greater discrepancies. The maximum-likelihood estimation of hysteresis magnitude was reported to be 2.6 mm for the lung cancer patients. The first-order approximation of the biomechanical model fit the heuristic 5D model very well. The biomechanical model provided new insights into breathing motion with specific focus on motion trajectory hysteresis.

How absolute EIT reflects the dependence of unilateral lung aeration on hyper-gravity and weightlessness?

Science.gov (United States)

Hahn, G; Just, A; Hellige, G; Dittmar, J; Quintel, M

2013-09-01

We studied the influence of three gravity levels (0, 1 and 1.8 g) on unilateral lung aeration in a left lateral position by the application of absolute electrical impedance tomography. The electrical resistivity of the lung tissue was considered to be a meaningful indicator for lung aeration since changes in resistivity have already been validated in other studies to be proportional to changes in lung volume. Twenty-two healthy volunteers were studied during parabolic flights with three phases of different gravity, each lasting ∼20-22 s. Spontaneous breathing at normal tidal volume VT and at increased VT was performed. During transition to hyper-gravity mean expiratory resistivities (±SD in Ωm) increased at normal VT in the upper (right) lung from 7.6 ± 1.5 to 8.0 ± 1.7 and decreased from 5.8 ± 1.2 to 5.7 ± 1.2 in the lower (left) lung. Inspiratory resistivity values are 8.3 ± 1.6 to 8.8 ± 1.8 (right) and 6.3 ± 1.3 to 6.0 ± 1.3 (left). At increased VT, the changes in resistivities at end-expiration were 7.7 ± 1.5 to 8.0 ± 1.7 (right) and 5.8 ± 1.2 to 5.7 ± 1.2 (left). Corresponding end-inspiratory values are 9.9 ± 1.9 to 10.0 ± 2.0 (right) and 8.6 ± 2.1 to 7.9 ± 2.0 (left). During weightlessness, the distortion in the lungs disappeared and both lungs showed a nearly identical aeration, which was between the levels displayed at normal gravity. The small increase in resistivity for the upper lung during transition to hyper-gravity from 1 to 1.8 g at increased VT suggests that the degressive part of the pressure-volume curve has already been reached at end-inspiration. The results for a left lateral position are in agreement with West's lung model which has been introduced for cranio-caudal gravity dependence in the lungs.

Effect of one-lung ventilation on end-tidal carbon dioxide during cardiopulmonary resuscitation in a pig model of cardiac arrest.

Science.gov (United States)

Ryu, Dong Hyun; Jung, Yong Hun; Jeung, Kyung Woon; Lee, Byung Kook; Jeong, Young Won; Yun, Jong Geun; Lee, Dong Hun; Lee, Sung Min; Heo, Tag; Min, Yong Il

2018-01-01

Unrecognized endobronchial intubation frequently occurs after emergency intubation. However, no study has evaluated the effect of one-lung ventilation on end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR). We compared the hemodynamic parameters, blood gases, and ETCO2 during one-lung ventilation with those during conventional two-lung ventilation in a pig model of CPR, to determine the effect of the former on ETCO2. A randomized crossover study was conducted in 12 pigs intubated with double-lumen endobronchial tube to achieve lung separation. During CPR, the animals underwent three 5-min ventilation trials based on a randomized crossover design: left-lung, right-lung, or two-lung ventilation. Arterial blood gases were measured at the end of each ventilation trial. Ventilation was provided using the same tidal volume throughout the ventilation trials. Comparison using generalized linear mixed model revealed no significant group effects with respect to aortic pressure, coronary perfusion pressure, and carotid blood flow; however, significant group effect in terms of ETCO2 was found (P < 0.001). In the post hoc analyses, ETCO2 was lower during the right-lung ventilation than during the two-lung (P = 0.006) or left-lung ventilation (P < 0.001). However, no difference in ETCO2 was detected between the left-lung and two-lung ventilations. The partial pressure of arterial carbon dioxide (PaCO2), partial pressure of arterial oxygen (PaO2), and oxygen saturation (SaO2) differed among the three types of ventilation (P = 0.003, P = 0.001, and P = 0.001, respectively). The post hoc analyses revealed a higher PaCO2, lower PaO2, and lower SaO2 during right-lung ventilation than during two-lung or left-lung ventilation. However, the levels of these blood gases did not differ between the left-lung and two-lung ventilations. In a pig model of CPR, ETCO2 was significantly lower during right-lung ventilation than during two-lung ventilation. However

Neuro-endocrine carcinoma of lung

International Nuclear Information System (INIS)

Castillo P, Luis Fernando; Restrepo Uribe, Santiago

1996-01-01

Review of a case of pathologically proven neuroendocrine tumour of the lung, with clinical and radiological correlation. The case of a young patient is presented that in the first month, it presents two episodes of pneumonitis of the superior lobe from the left lung to the one who after the imagenologic studies and pathological practiced, it was made the diagnose definitive of tumor carcinoid of the lung. Due to the drop incidence in the presentation of this type of tumors in the lung, a revision of the general aspects so much is made clinical as pathological, as well as of the discoveries but important from the imagenologic point of view

Characteristics of Plantar Loads in Maximum Forward Lunge Tasks in Badminton.

Science.gov (United States)

Hu, Xiaoyue; Li, Jing Xian; Hong, Youlian; Wang, Lin

2015-01-01

Badminton players often perform powerful and long-distance lunges during such competitive matches. The objective of this study is to compare the plantar loads of three one-step maximum forward lunges in badminton. Fifteen right-handed male badminton players participated in the study. Each participant performed five successful maximum lunges at three directions. For each direction, the participant wore three different shoe brands. Plantar loading, including peak pressure, maximum force, and contact area, was measured by using an insole pressure measurement system. Two-way ANOVA with repeated measures was employed to determine the effects of the different lunge directions and different shoes, as well as the interaction of these two variables, on the measurements. The maximum force (MF) on the lateral midfoot was lower when performing left-forward lunges than when performing front-forward lunges (p = 0.006, 95% CI = -2.88 to -0.04%BW). The MF and peak pressures (PP) on the great toe region were lower for the front-forward lunge than for the right-forward lunge (MF, p = 0.047, 95% CI = -3.62 to -0.02%BW; PP, p = 0.048, 95% CI = -37.63 to -0.16 KPa) and left-forward lunge (MF, p = 0.015, 95% CI = -4.39 to -0.38%BW; PP, p = 0.008, 95% CI = -47.76 to -5.91 KPa). These findings indicate that compared with the front-forward lunge, left and right maximum forward lunges induce greater plantar loads on the great toe region of the dominant leg of badminton players. The differences in the plantar loads of the different lunge directions may be potential risks for injuries to the lower extremities of badminton players.

Depressed glucose utilization in lungs of BB wistar spontaneously diabetic rats

International Nuclear Information System (INIS)

Uhal, B.D.; Moxley, M.A.; Longmore, W.J.

1986-01-01

Lungs of BB wistar spontaneously diabetic rats were perfused with [ 14 C(U)]glucose in modified Krebs Ringer bicarbonate medium for 1.5 hours. Lungs from non-diabetic BB Wistar rats were perfused simultaneously and served as controls. The perfusions were terminated by rapid freezing of the tissue in liquid N 2 followed by separation of surfactant and residual lung fractions. The rates of glucose incorporation into surfactant DSPC, PG, and PE were decreased 4.7, 2.4 and 2.5-fold, respectively, in lungs of spontaneously diabetic rats when expressed as final product specific activities. The rate of glucose incorporation into residual PC was also reduced by 2.3-fold. Expressed as moles incorporated per gram wet weight of lung, incorporations into surfactant DSPC, PG and residual PC were also reduced by 4.1, 6.3 and 3.8-fold respectively. These data; (1) agree with previous studies of the lungs of streptozotocin and alloxan-diabetic rats; (2) show that the depressed glucose utilization for lipid synthesis observed previously is not due to streptozotocin or alloxan toxicity; (3) suggest that the BB Wistar rat will provide a useful model for the study of the effects of insulin-dependent diabetes on lung metabolism

Enhanced tumor growth in the remaining lung after major lung resection.

Science.gov (United States)

Sano, Fumiho; Ueda, Kazuhiro; Murakami, Junichi; Hayashi, Masataro; Nishimoto, Arata; Hamano, Kimikazu

2016-05-01

Pneumonectomy induces active growth of the remaining lung in order to compensate for lost lung tissue. We hypothesized that tumor progression is enhanced in the activated local environment. We examined the effects of mechanical strain on the activation of lung growth and tumor progression in mice. The mechanical strain imposed on the right lung after left pneumonectomy was neutralized by filling the empty space that remained after pneumonectomy with a polypropylene prosthesis. The neutralization of the strain prevented active lung growth. According to an angiogenesis array, stronger monocyte chemoattractant protein-1 (MCP-1) expression was found in the strain-induced growing lung. The neutralization of the strain attenuated the release of MCP-1 from the lung cells. The intravenous injection of Lewis lung cancer cells resulted in the enhanced development of metastatic foci in the strain-induced growing lung, but the enhanced development was canceled by the neutralization of the strain. An immunohistochemical analysis revealed the prominent accumulation of tumor-associated macrophages in tumors arising in the strain-induced growing lung, and that there was a relationship between the accumulation and the MCP-1 expression status. Our results suggested that mechanical lung strain, induced by pulmonary resection, triggers active lung growth, thereby creating a tumor-friendly environment. The modification of that environment, as well as the minimizing of surgical stress, may be a meaningful strategy to improve the therapeutic outcome after lung cancer surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Skin metastases from lung cancer: a case report.

Science.gov (United States)

Pajaziti, Laura; Hapçiu, Syzana Rexhepi; Dobruna, Shkendije; Hoxha, Naim; Kurshumliu, Fisnik; Pajaziti, Artina

2015-04-11

Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7(th) segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.

Soil water evaporation and crop residues

Science.gov (United States)

Crop residues have value when left in the field and also when removed from the field and sold as a commodity. Reducing soil water evaporation (E) is one of the benefits of leaving crop residues in place. E was measured beneath a corn canopy at the soil suface with nearly full coverage by corn stover...

Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

International Nuclear Information System (INIS)

Ward, H.E.; Jones, R.L.; King, E.G.; Sproule, B.J.; Fortune, R.L.

1982-01-01

An intraluminal carcinoid tumor obstructing the left mainstem bronchus produced hypoxemia through alteration in ventilation/perfusion matching. Studies of regional lung function using 133-xenon (/sup 133/Xe) and a multiprobe computerized instrumentation system documented a reduction of perfusion to 22 percent and ventilation to 6 percent of the total. There was negligible washout of intravenously injected /sup 133/Xe from the left lung consistent with air trapping. Four days after left mainstem bronchial sleeve resection, perfusion, ventilation and washout of injected xenon had significantly improved and by four months postresection, all measurements were virtually normal, although complete restoration of perfusion in relation to ventilation was delayed. Regional lung function studied with a multiprobe system in this patient provided a clinical model for the study of ventilation and perfusion inter-relationships in large airway obstruction and demonstrated that a prolonged time may be required for return of perfusion to normal

A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment

Energy Technology Data Exchange (ETDEWEB)

Rhee, Chong Heon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1967-09-15

In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurement and lung perfusion scans by {sup 131}I-Macroaggregated albumin, lung inhalation scans by colloidal {sup 198}Au and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1) The normal distribution of pulmonary blood flow was found to be 54.5{+-}2.82% to the right lung and 45.5{+-}2.39% to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p<0.01). In the minimal pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 52.5{+-}5.3% to the right lung and 47.5{+-}1.0% to the left lung when the tuberculous lesion was in the right lung, and 56.2{+-}4.4% to the right lung and 43.8{+-}3.1% to the left lung when the tuberculous lesion was in the left lung. The difference of pulmonary arterial blood flow between the right and left lung was statistically not significant compared with the normal distribution. In the moderately advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 26.9{+-}13.9% to the right lung and 73.1{+-}13.9% to the left lung when the tuberculous lesion was more severe in the right lung, and 79.6{+-}12.8% to the right lung and 20.4{+-}13.0% to the left lung when the tuberculous lesion was more severe in the left lung. These were found to be highly significant statistically compared with the normal distribution of pulmonary arterial blood flow (p<0.01). When both lungs were evenly involved, the average distribution of pulmonary arterial blood flow was found to be 49.5{+-}8.01% to the right lung and 50.5{+-}8.01% to the left lung. In the far advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be 18.5{+-}11.6% to the right lung and 81

[Heparin-induced thrombocytopenia developed during the acute phase after left upper lobectomy for lung cancer].

Science.gov (United States)

Mitomo, Hideki; Miyamoto, Akira; Tabata, Toshiharu; Sugawara, Takafumi; Yabuki, Hiroshi; Fujimura, Shigefumi

2014-12-01

Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin administration. This must not be rarely encountered but is not often reported in Japan compared to Western countries. A 68-year-old woman underwent left upper lobectomy for lung cancer. Low-dose unfractionated heparin was administrated to prevent thromboembolism after the operation. Two days later, sudden dyspnea appeared and ultracardiosonography showing an extensive thromboembolus from the main trunk to both main branches of pulmonary artery indicated pulmonary embolization. After the establishment of percutaneous cardiopulmonary support (PCPS) support, the embolus was removed by emergent open heart surgery. However, despite further unfractionated heparin administration following embolization surgery, other thrombus was identified in both the bi-lateral internal jagular veins and inferior vena cava by ultrasonography and contrast computed tomography( CT). Her platelet count was decreased gradually despite platelet transfusion. Plate factor 4( PF4) antibody against heparin in her blood examination was found, and HIT II was diagnosed. Discontinuation of unfractionated heparin and administration of antithrombin agent improved platelet count, and no additional embolization was identified.

Lung regeneration by fetal lung tissue implantation in a mouse pulmonary emphysema model.

Science.gov (United States)

Uyama, Koh; Sakiyama, Shoji; Yoshida, Mitsuteru; Kenzaki, Koichiro; Toba, Hiroaki; Kawakami, Yukikiyo; Okumura, Kazumasa; Takizawa, Hiromitsu; Kondo, Kazuya; Tangoku, Akira

2016-01-01

The mortality and morbidity of chronic obstructive pulmonary disease are high. However, no radical therapy has been developed to date. The purpose of this study was to evaluate whether fetal mouse lung tissue can grow and differentiate in the emphysematous lung. Fetal lung tissue from green fluorescent protein C57BL/6 mice at 16 days' gestation was used as donor material. Twelve-month-old pallid mice were used as recipients. Donor lungs were cut into small pieces and implanted into the recipient left lung by performing thoracotomy under anesthesia. The recipient mice were sacrificed at day 7, 14, and 28 after implantation and used for histological examination. Well-developed spontaneous pulmonary emphysema was seen in 12-month-old pallid mice. Smooth and continuous connection between implanted fetal lung tissue and recipient lung was recognized. Air space expansion and donor tissue differentiation were observed over time. We could clearly distinguish the border zones between injected tissue and native tissue by the green fluorescence of grafts. Fetal mouse lung fragments survived and differentiated in the emphysematous lung of pallid mice. Implantation of fetal lung tissue in pallid mice might lead to further lung regeneration research from the perspective of respiratory and exercise function. J. Med. Invest. 63: 182-186, August, 2016.

How absolute EIT reflects the dependence of unilateral lung aeration on hyper-gravity and weightlessness?

International Nuclear Information System (INIS)

Hahn, G; Just, A; Hellige, G; Dittmar, J; Quintel, M

2013-01-01

We studied the influence of three gravity levels (0, 1 and 1.8 g) on unilateral lung aeration in a left lateral position by the application of absolute electrical impedance tomography. The electrical resistivity of the lung tissue was considered to be a meaningful indicator for lung aeration since changes in resistivity have already been validated in other studies to be proportional to changes in lung volume. Twenty-two healthy volunteers were studied during parabolic flights with three phases of different gravity, each lasting ∼20–22 s. Spontaneous breathing at normal tidal volume V T and at increased V T was performed. During transition to hyper-gravity mean expiratory resistivities (±SD in Ωm) increased at normal V T in the upper (right) lung from 7.6 ± 1.5 to 8.0 ± 1.7 and decreased from 5.8 ± 1.2 to 5.7 ± 1.2 in the lower (left) lung. Inspiratory resistivity values are 8.3 ± 1.6 to 8.8 ± 1.8 (right) and 6.3 ± 1.3 to 6.0 ± 1.3 (left). At increased V T , the changes in resistivities at end-expiration were 7.7 ± 1.5 to 8.0 ± 1.7 (right) and 5.8 ± 1.2 to 5.7 ± 1.2 (left). Corresponding end-inspiratory values are 9.9 ± 1.9 to 10.0 ± 2.0 (right) and 8.6 ± 2.1 to 7.9 ± 2.0 (left). During weightlessness, the distortion in the lungs disappeared and both lungs showed a nearly identical aeration, which was between the levels displayed at normal gravity. The small increase in resistivity for the upper lung during transition to hyper-gravity from 1 to 1.8 g at increased V T suggests that the degressive part of the pressure–volume curve has already been reached at end-inspiration. The results for a left lateral position are in agreement with West's lung model which has been introduced for cranio-caudal gravity dependence in the lungs. (paper)

Characteristics of Plantar Loads in Maximum Forward Lunge Tasks in Badminton.

Directory of Open Access Journals (Sweden)

Xiaoyue Hu

Full Text Available Badminton players often perform powerful and long-distance lunges during such competitive matches. The objective of this study is to compare the plantar loads of three one-step maximum forward lunges in badminton.Fifteen right-handed male badminton players participated in the study. Each participant performed five successful maximum lunges at three directions. For each direction, the participant wore three different shoe brands. Plantar loading, including peak pressure, maximum force, and contact area, was measured by using an insole pressure measurement system. Two-way ANOVA with repeated measures was employed to determine the effects of the different lunge directions and different shoes, as well as the interaction of these two variables, on the measurements.The maximum force (MF on the lateral midfoot was lower when performing left-forward lunges than when performing front-forward lunges (p = 0.006, 95% CI = -2.88 to -0.04%BW. The MF and peak pressures (PP on the great toe region were lower for the front-forward lunge than for the right-forward lunge (MF, p = 0.047, 95% CI = -3.62 to -0.02%BW; PP, p = 0.048, 95% CI = -37.63 to -0.16 KPa and left-forward lunge (MF, p = 0.015, 95% CI = -4.39 to -0.38%BW; PP, p = 0.008, 95% CI = -47.76 to -5.91 KPa.These findings indicate that compared with the front-forward lunge, left and right maximum forward lunges induce greater plantar loads on the great toe region of the dominant leg of badminton players. The differences in the plantar loads of the different lunge directions may be potential risks for injuries to the lower extremities of badminton players.

Intermittent cranial lung herniation in two dogs.

Science.gov (United States)

Guglielmini, Carlo; De Simone, Antonio; Valbonetti, Luca; Diana, Alessia

2007-01-01

Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.

NF-κB-Activating Complex Engaged in Response to EGFR Oncogene Inhibition Drives Tumor Cell Survival and Residual Disease in Lung Cancer

Directory of Open Access Journals (Sweden)

Collin M. Blakely

2015-04-01

Full Text Available Although oncogene-targeted therapy often elicits profound initial tumor responses in patients, responses are generally incomplete because some tumor cells survive initial therapy as residual disease that enables eventual acquired resistance. The mechanisms underlying tumor cell adaptation and survival during initial therapy are incompletely understood. Here, through the study of EGFR mutant lung adenocarcinoma, we show that NF-κB signaling is rapidly engaged upon initial EGFR inhibitor treatment to promote tumor cell survival and residual disease. EGFR oncogene inhibition induced an EGFR-TRAF2-RIP1-IKK complex that stimulated an NF-κB-mediated transcriptional survival program. The direct NF-κB inhibitor PBS-1086 suppressed this adaptive survival program and increased the magnitude and duration of initial EGFR inhibitor response in multiple NSCLC models, including a patient-derived xenograft. These findings unveil NF-κB activation as a critical adaptive survival mechanism engaged by EGFR oncogene inhibition and provide rationale for EGFR and NF-κB co-inhibition to eliminate residual disease and enhance patient responses.

Lung and heart dose volume analyses with CT simulator in radiation treatment of breast cancer

International Nuclear Information System (INIS)

Das, Indra J.; Cheng, Elizabeth C.; Freedman, Gary; Fowble, Barbara

1998-01-01

Purpose: Radiation pneumonitis and cardiac effects are directly related to the irradiated lung and heart volumes in the treatment fields. The central lung distance (CLD) from a tangential breast radiograph is shown to be a significant indicator of ipsilateral irradiated lung volume. Retrospective analysis of the pattern of dose volume of lung and heart with actual volume data from a CT simulator in the treatment of breast cancer is presented with respect to CLD. Methods and Materials: The heart and lung volumes in the tangential treatment fields were analyzed in 108 consecutive cases (52 left and 56 right breast) referred for CT simulation. All patients in this study were immobilized and placed on an inclined breast board in actual treatment setup. Both arms were stretched over head to avoid collision with the scanner aperture. Radiopaque marks were placed on the medial and lateral borders of the tangential fields. All patients were scanned in spiral mode with slice width and thickness of 3 mm each, respectively. The lung and heart structures as well as irradiated areas were delineated on each slice and respective volumes were accurately measured. The treatment beam parameters were recorded and the digitally reconstructed radiographs (DRRs) were generated for the measurement of the CLD and analysis. Results: Using CT data the mean volume and standard deviation of left and right lungs were 1307.7 ± 297.7 cm 3 and 1529.6 ± 298.5 cm 3 , respectively. The magnitude of irradiated volume in left and right lung is nearly equal for the same CLD that produces different percent irradiated volumes (PIV). The left and right PIV lungs are 8.3 ± 4.7% and 6.6 ± 3.7%, respectively. The PIV data have shown to correlate with CLD with second- and third-degree polynomials; however, in this study a simple straight line regression is used to provide better confidence than the higher order polynomials. The regression lines for the left and right breasts are very different based on

Compensatory lung growth in autologus lobar implant after pneumonectomy in dogs Crescimento pulmonar compensatório em implante lobar autólogo pós-pneumonectomia em cães

Directory of Open Access Journals (Sweden)

Antônio José Maria Cataneo

2005-10-01

Full Text Available PURPOSE: Evaluate compensatory lung growth (CLG in lobar transplant and see if it is similar to CLG after lobectomy. METHODS: We used 48 dogs in three groups (G1=control, G2=left cranial lobectomy, and G3=pneumonectomy with reimplantation of left caudal lobe. Five months after surgery animals underwent lung scintigraphy and were then sacrificed for lung morphometric study. RESULTS: There was no correlation between scintigraphy and lung mass or lung volume. There was both mass and residual volume CLG in the operated groups, both contralateral and epsilateral to surgery; there was no compensation for total lung capacity or compliance in the remaining caudal lobe (G2 or the reimplanted caudal lobe (G3 5 months after surgery, there was more damage in the reimplanted lobe. As previous studies have show that CLG starts with increased mass and residual volume and that compliance is later compensated, this study seems to have documented the beginning of CLG, with lung compliance being the limiting factor of CLG after 5 months of study. CONCLUSION: There is CLG in both reimplanted lobe and contralateral lung but compliance is still reduced. CLG was similar in both groups but implanted lobe compliance was more prejudiced.OBJETIVO: Avaliar se existe crescimento compensatório pulmonar em transplante lobar e verificar se este crescimento é semelhante ao que ocorre após lobectomia. MÉTODOS: Foram utilizados 48 cães, distribuídos em 3 grupos (G1=controle, G2=lobectomia cranial esquerda e G3=pneumonectomia com reimplante do lobo caudal esquerdo. Após 5 meses da cirurgia, os animais foram submetidos à cintilografia pulmonar e a seguir sacrificados para estudo morfométrico pulmonar. RESULTADOS: Os resultados mostraram que não existe correlação da cintilografia nem com a massa nem com o volume do pulmão. Houve crescimento compensatório em massa e volume residual nos dois grupos operados, tanto no pulmão contralateral como no ipsilateral à cirurgia

Radionuclide Angiocardiographic Evaluation of Left-to-Right Cardiac Shunts: Analysis of Time-Active Curves

International Nuclear Information System (INIS)

Kim, Ok Hwa; Bahk, Yong Whee; Kim, Chi Kyung

1987-01-01

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atriurn, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/ QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

Science.gov (United States)

Ford, N. L.; Martin, E. L.; Lewis, J. F.; Veldhuizen, R. A. W.; Holdsworth, D. W.; Drangova, M.

2009-04-01

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

International Nuclear Information System (INIS)

Ford, N L; Martin, E L; Lewis, J F; Veldhuizen, R A W; Holdsworth, D W; Drangova, M

2009-01-01

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Quantifying lung morphology with respiratory-gated micro-CT in a murine model of emphysema

Energy Technology Data Exchange (ETDEWEB)

Ford, N L [Department of Physics, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 (Canada); Martin, E L; Lewis, J F; Veldhuizen, R A W [Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario N6A 4V2 (Canada); Holdsworth, D W; Drangova, M [Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, PO Box 5015, London, Ontario N6A 5K8 (Canada)], E-mail: nlford@ryerson.ca

2009-04-07

Non-invasive micro-CT imaging techniques have been developed to investigate lung structure in free-breathing rodents. In this study, we investigate the utility of retrospectively respiratory-gated micro-CT imaging in an emphysema model to determine if anatomical changes could be observed in the image-derived quantitative analysis at two respiratory phases. The emphysema model chosen was a well-characterized, genetically altered model (TIMP-3 knockout mice) that exhibits a homogeneous phenotype. Micro-CT scans of the free-breathing, anaesthetized mice were obtained in 50 s and retrospectively respiratory sorted and reconstructed, providing 3D images representing peak inspiration and end expiration with 0.15 mm isotropic voxel spacing. Anatomical measurements included the volume and CT density of the lungs and the volume of the major airways, along with the diameters of the trachea, left bronchus and right bronchus. From these measurements, functional parameters such as functional residual capacity and tidal volume were calculated. Significant differences between the wild-type and TIMP-3 knockout groups were observed for measurements of CT density over the entire lung, indicating increased air content in the lungs of TIMP-3 knockout mice. These results demonstrate retrospective respiratory-gated micro-CT, providing images at multiple respiratory phases that can be analyzed quantitatively to investigate anatomical changes in murine models of emphysema.

Logarithmic residues of analytic Banach algebra valued functions possessing a simply meromorphic inverse

OpenAIRE

Bart, Harm; Ehrhardt, T.; Silbermann, B.

2001-01-01

textabstractA logarithmic residue is a contour integral of a logarithmic derivative (left or right) of an analytic Banach algebra valued function. For functions possessing a meromorphic inverse with simple poles only, the logarithmic residues are identified as the sums of idempotents. With the help of this observation, the issue of left versus right logarithmic residues is investigated, both for connected and nonconnected underlying Cauchy domains. Examples are given to elucidate the subject ...

Evaluation of chest computed tomography in patients after pneumonectomy to predict contralateral pneumothorax

International Nuclear Information System (INIS)

Maniwa, Tomohiro; Saito, Yukihito; Saito, Tomohito; Kaneda, Hiroyuki; Imamura, Hiroji

2009-01-01

Contralateral pneumothorax is a severe complication after pneumonectomy. We evaluated the mediastinal shift and the residual lung in patients who had undergone pneumonectomy to predict the incidence of contralateral pneumothorax. We evaluated 21 cases of pneumonectomy performed from 1996 to 2006. For this study, we excluded patients with recurrent neoplasm, empyema, or hemothorax. We reviewed the computed tomography (CT) results of 13 patients who had undergone pneumonectomy to compare the bullae in the residual lungs, carina shifts, and herniation of the residual lungs before and after pneumonectomy. When evaluating the degree of herniation 4-6 cm below the carina, the anterior and posterior pulmonary hernias were classified as grade A, B, or C. We also investigated the preoperative respiratory function in all 13 patients. Two patients suffered contralateral pneumothorax after left pneumonectomy. Both patients who suffered contralateral pneumothorax after pneumonectomy had bullae. The percentage forced expiratory volume in 1 s (FEV 1.0% ) was <70% in these two patients. Carina shifts and lung herniation were found to be greater after left pneumonectomy than after right pneumonectomy. The bullae in the lung and obstructive pulmonary disease are associated not only with spontaneous pneumothorax but also with contralateral pneumothorax after pneumonectomy. Lung herniation and mediastinal shift are greater after left pneumonectomy than after right pneumonectomy, which may be related to contralateral pneumothorax after pneumonectomy. (author)

Brain abscesses associated with right-to-left shunts in adults.

Science.gov (United States)

Memon, Kashif A; Cleveland, Kerry O; Gelfand, Michael S

2012-04-01

Although brain abscesses are frequently cryptogenic in origin, bacteria must reach the brain either by direct or hematogenous spread. Right-to-left shunts, caused either by intrapulmonary vascular malformations or congenital heart defects, may allow microorganisms to evade the normal host defenses in the lungs and lead to development of brain abscesses. Two patients recently presented with brain abscesses and were found to have conditions associated with right-to-left shunts. The diagnosis of brain abscess should prompt the clinician to consider right-to-left shunts as a possible predisposing condition for brain abscess.

[Amplitude Changes of Low Frequency Fluctuation in Brain Spontaneous Nervous Activities Induced by Needling at Hand Taiyin Lung Channel].

Science.gov (United States)

Zhou, You-long; Su, Cheng-guo; Liu, Shou-fang; Jin, Xiang-yu; Duan, Yan-li; Chen, Xiao-yan; Zhao, Shu-hua; Wang, Quan-liang; Dang, Chang-lin

2016-05-01

To observe amplitude changes of low frequency fluctuation in brain spontaneous nervous activities induced by needling at Hand Taiyin Lung Channel, and to preliminarily explore the possible brain function network of Hand Taiyin Lung Channel. By using functional magnetic resonance imaging (fMRI), 16 healthy volunteers underwent resting-state scanning (R1) and scanning with retained acupuncture at Hand Taiyin Lung Channel (acupuncture, AP). Data of fMRI collected were statistically calculated using amplitude of low frequency fluctuations (ALFF). Under R1 significantly enhanced ALFF occurred in right precuneus, left inferior parietal lobule, bilateral superior temporal gyrus, bilateral middle frontal gyrus, left superior frontal gyrus, left inferior frontal gyrus, left medial frontal gyrus. Under AP significantly enhanced ALFF occurred in right precuneus, bilateral superior frontal gyrus, cerebellum, bilateral middle frontal gyrus, right medial frontal gyrus, and so on. Compared with R1, needing at Hand Taiyin Lung Channel could significantly enhance ALFF in right gyrus subcallosum and right inferior frontal gyrus. Significant decreased ALFF appeared in right postcentral gyrus, left precuneus, left superior temporal gyrus, left middle temporal gyrus, and so on. Needing at Hand Taiyin Lung Channel could significantly change fixed activities of cerebral cortex, especially in right subcallosal gyrus, right inferior frontal gyrus, and so on.

Ventilation-perfusion lung imaging in diaphragmatic paralysis

International Nuclear Information System (INIS)

Chopra, S.K.; Taplin, G.V.

1977-01-01

Clinical, radiological, physiological, and lung imaging findings from a patient with paralysis of the diaphragm are described. Dyspnea, hypoxemia and hypercapnia increased when the patient changed from the upright to the supine positions. Ventilation (V) and perfusion (P) images of the right lung appeared to be relatively normal and remained nearly the same in the upright and supine positions. In contrast, V/P images of the left lung were smaller than those of the right lung in the upright position and decreased further in the supine position. In addition, the size of the ventilation image was much smaller than that of the perfusion

MRI investigation of normal fetal lung maturation using signal intensities on different imaging sequences

International Nuclear Information System (INIS)

Balassy, Csilla; Kasprian, Gregor; Weber, Michael; Hoermann, Marcus; Prayer, Daniela; Brugger, Peter C.; Csapo, Bence; Mittermayer, Christoph

2007-01-01

To purpose of this paper is to study the relation between normal lung maturation signal and changes in intensity ratios (SIR) and to determine which magnetic resonance imaging sequence provides the strongest correlation of normal lung SIs with gestational age. 126 normal singleton pregnancies (20-37 weeks) were examined with a 1.5 Tesla unit. Mean SIs for lungs, liver, and gastric fluid were assessed on six different sequences, and SIRs of lung/liver (LLSIR) and lung/gastric fluid (LGSIR) were correlated with gestational age for each sequence. To evaluate the feasibility of SIRs in the prediction of the state of the lung maturity, accuracy of the predicted SIRs (D*) was measured by calculating relative residuals (D*-D)/D for each sequence. LLSIRs showed significant changes in every sequence (p<0.05), while LGSIRs only on two sequences. Significant differences were shown for the mean of absolute residuals for both LLSIRs (p<0.001) and for LGSIRs (p=0.003). Relative residuals of LLSIRs were significantly smaller on T1-weighted sequence, whereas they were significantly higher for LGSIRs on FLAIR sequence. Fetal liver seems to be adequate reference for the investigation of lung maturation. T1-weighted sequence was the most accurate for the measurement of the lung SIs; thus, we propose to determine LLSIR on T1-weighted sequence when evaluating lung development. (orig.)

MRI investigation of normal fetal lung maturation using signal intensities on different imaging sequences

Energy Technology Data Exchange (ETDEWEB)

Balassy, Csilla; Kasprian, Gregor; Weber, Michael; Hoermann, Marcus; Prayer, Daniela [Medical University of Vienna, Department of Radiology, Vienna (Austria); Brugger, Peter C. [Medical University of Vienna, Center of Anatomy and Cell Biology, Vienna (Austria); Csapo, Bence [Medical University of Vienna, Department of Obstetrics and Gyneocology, Vienna (Austria); Mittermayer, Christoph [Medical University of Vienna, Department of Pediatrics, Vienna (Austria)

2007-03-15

To purpose of this paper is to study the relation between normal lung maturation signal and changes in intensity ratios (SIR) and to determine which magnetic resonance imaging sequence provides the strongest correlation of normal lung SIs with gestational age. 126 normal singleton pregnancies (20-37 weeks) were examined with a 1.5 Tesla unit. Mean SIs for lungs, liver, and gastric fluid were assessed on six different sequences, and SIRs of lung/liver (LLSIR) and lung/gastric fluid (LGSIR) were correlated with gestational age for each sequence. To evaluate the feasibility of SIRs in the prediction of the state of the lung maturity, accuracy of the predicted SIRs (D*) was measured by calculating relative residuals (D*-D)/D for each sequence. LLSIRs showed significant changes in every sequence (p<0.05), while LGSIRs only on two sequences. Significant differences were shown for the mean of absolute residuals for both LLSIRs (p<0.001) and for LGSIRs (p=0.003). Relative residuals of LLSIRs were significantly smaller on T1-weighted sequence, whereas they were significantly higher for LGSIRs on FLAIR sequence. Fetal liver seems to be adequate reference for the investigation of lung maturation. T1-weighted sequence was the most accurate for the measurement of the lung SIs; thus, we propose to determine LLSIR on T1-weighted sequence when evaluating lung development. (orig.)

Differential diagnosis and cancer staging of a unique case with multiple nodules in the lung - lung adenocarcinoma, metastasis of colon adenocarcinoma, and colon adenocarcinoma metastasizing to lung adenocarcinoma.

Science.gov (United States)

Bai, Yun; Qiu, Jianxing; Shang, Xueqian; Liu, Ping; Zhang, Ying; Wang, Ying; Xiong, Yan; Li, Ting

2015-05-01

Lung cancer is the most common cancer in the world. Despite this, there have been few cases of simultaneous primary and metastatic cancers in the lung reported, let alone coexisting with tumor-to-tumor metastasis. Herein, we describe an extremely unusual case. A 61-year-old man with a history of colon adenocarcinoma was revealed as having three nodules in the lung 11 months after colectomy. The nodule in the left upper lobe was primary lung adenocarcinoma, the larger one in the right upper lobe was a metastasis of colon adenocarcinoma, and the smaller one in the right upper lobe was colon adenocarcinoma metastasizing to lung adenocarcinoma. Our paper focused on the differential diagnosis and cancer staging of this unique case, and discussed the uncommon phenomenon of the lung acting as a recipient in tumor-to-tumor metastasis.

Lung function

International Nuclear Information System (INIS)

Sorichter, S.

2009-01-01

The term lung function is often restricted to the assessment of volume time curves measured at the mouth. Spirometry includes the assessment of lung volumes which can be mobilised with the corresponding flow-volume curves. In addition, lung volumes that can not be mobilised, such as the residual volume, or only partially as FRC and TLC can be measured by body plethysmography combined with the determination of the airway resistance. Body plethysmography allows the correct positioning of forced breathing manoeuvres on the volume-axis, e.g. before and after pharmacotherapy. Adding the CO single breath transfer factor (T LCO ), which includes the measurement of the ventilated lung volume using He, enables a clear diagnosis of different obstructive, restrictive or mixed ventilatory defects with and without trapped air. Tests of reversibility and provocation, as well as the assessment of inspiratory mouth pressures (PI max , P 0.1 ) help to classify the underlying disorder and to clarify treatment strategies. For further information and to complete the diagnostic of disturbances of the ventilation, diffusion and/or perfusion (capillar-)arterial bloodgases at rest and under physical strain sometimes amended by ergospirometry are recommended. Ideally, lung function measurements are amended by radiological and nuclear medicine techniques. (orig.) [de

Evaluation of a new irradiation left breast method in the inhalation phase; Avaliacao de uma nova metodologia de irradiacao de mama esquerda na fase de inspiracao

Energy Technology Data Exchange (ETDEWEB)

Silva, Laura E. da; Gullo, Rafael G.; Ferreira, Diogo A.V.; Silva, Leonardo P. da, E-mail: aura.emilia.fm@gmail.com [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil)

2016-07-01

Radiation therapy is the primary therapeutic approach to breast cancer and involves significant exposure of heart and lungs, especially in cases of left breast. The implementation of a methodology to reduce the dose in these sites is important to ensure better quality of life to the patient. This work aims reduced heart and lung dose when performing the radiotherapy planning considering only the inhalation phase. Three patients with breast left present were scanning with CT during free breathing and respiratory monitoring and the planning has done on both images series. The results showed a reduction in mean heart dose of 53% on average. As for lung volumes, was obtained a mean reduction of 44.6% and 51% of the left lung which received 10 Gy and 20 Gy, respectively. This study showed that the use of the respiratory gating radiotherapy in the left breast in inhalation phase can reduce heart and lung doses. (author)

Dilemmas in Lung Cancer Staging.

Science.gov (United States)

Vlahos, Ioannis

2018-05-01

The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Predictive models of forest logging residues of Triplochiton ...

African Journals Online (AJOL)

The model developed indicated that logarithmic functions performed better than other form of equation. The findings of this study revealed that there is significant logging residues left to waste in the forest after timber harvest and quantifying this logging residue in terms of biomass model can serve as management tools in ...

Bronchoplastic operations for lung cancer

International Nuclear Information System (INIS)

Cicenas, S.; Naujokaitis, P.; Jackevicius, A. and others

2002-01-01

Objective of our work was to evaluate efficacy of bronchoplastic operations for lung cancer and time to progression in combined treatment. From 1997 till 2001, 57pts were operated for early I-IIB stages of lung cancer. Operations were: tracheal resections in 3pts (5.2%), window right pneumonectomies in 5pts (8.7%), window left pneumonectomies in 2pts (3.5%), window right upper lobe in 22pts (38.5%), bifurcation resections 2pts (3.5%), sleeve right upper lobe resections 7pts (12.2%), sleeve left upper lobe resections in 11pts (19.2%). We had complications: in 7pts (12.2%) suture failure, 26pts (45.6%) obstructive pneumonia, 3pts (5.2%) kinking of anastomosis, 2pts (3.7%) bronchial bleeding, 6pts (10.5%) covered bronchial fistulas, 5pts (8.7%) died after operations. 32pts (56%) underwent radiation after surgery, 13pts (22.8%) radiation and chemotherapy. Three-year survival was in 82.4% (47pts), in 10pts (17.4%) disease progressed. Bronchoplastic operations are sufficient for early lung cancer treatment. Three-year was in survival 82.7% of pts. Seventeen percent of patients failed after combined treatment. (author)

[Left ventricular projectile migration after an accidental close-range gunshot wound].

Science.gov (United States)

Driessen, A; Tjardes, T; Eikermann, C; Trojan, S; Fröhlich, M; Grimaldi, G; Kosse, N

2016-07-01

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.

Radionuclide detection and differential diagnosis of left-to-right cardiac shunts by analysis of time-activity curves

International Nuclear Information System (INIS)

Kim, Ok-Hwa

1986-01-01

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity histograms of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunts level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was hight than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. (J.P.N.)

Effect of indacaterol on lung deflation improves cardiac performance in hyperinflated COPD patients: an interventional, randomized, double-blind clinical trial.

Science.gov (United States)

Santus, Pierachille; Radovanovic, Dejan; Di Marco, Silvia; Valenti, Vincenzo; Raccanelli, Rita; Blasi, Francesco; Centanni, Stefano; Bussotti, Maurizio

2015-01-01

COPD is often associated with cardiovascular comorbidity. Treatment guidelines recommend therapy with bronchodilators as first choice. We investigated the acute effect of single-dose indacaterol on lung hyperinflation in COPD subjects, for the first time evaluating the potential effects on right heart performance. In this Phase IV, randomized, interventional, double-blind, crossover clinical study, we recruited 40 patients (50-85 years of age) with stable COPD. Patients were treated with 150 μg indacaterol or placebo and after 60 minutes (T60) and 180 minutes (T180) the following tests were performed: trans-thoracic echocardiography (TTE), plethysmography, diffusing capacity of the lung for carbon monoxide, saturation of peripheral oxygen, and visual analog scale dyspnea score. Patients underwent a crossover re-challenge after a further 72 hours of pharmacological washout. All TTE measurements were conducted blindly by the same operator and further interpreted by two different blinded operators. Consensus decisions were taken on every value and parameter. The primary outcome was the effect of the reduction of residual volume and functional residual capacity on right heart systolic and diastolic function indexes evaluated by TTE in patients treated with indacaterol, as compared to placebo. Vital capacity, inspiratory capacity, and forced expiratory volume in 1 second were significantly increased by indacaterol, when compared with placebo, while residual volume, intrathoracic gas volume, and specific airway resistance were significantly reduced in patients treated with indacaterol. Tricuspid annular plane systolic excursion was significantly increased versus placebo, paralleled by an increase of tricuspid E-wave deceleration time. The cardiac frequency was also significantly reduced in indacaterol-treated patients. Indacaterol significantly reduces lung hyperinflation in acute conditions, with a clinically relevant improvement of dyspnea. These modifications are

Clinical significance of increased lung/heart ratio in 210Tl stress myocardial image

International Nuclear Information System (INIS)

Liu Zaoli; Chang Fengqin; Zhang Fengge; Wang Xiaoyuan; Liu Liuhua

1990-01-01

230 cases were studied with 201 Tl stress image. The results showed that the lung/heart ratio closely correlated with the presence and severity of coronary heart disease (CHD). Among them, 18 cases (7.8%) showed significantly elevated lung/heart ratio (> 0.50). It was confirmed that all of the 18 cases have severe CHD with left ventricular insufficiency. The author emphasizes that measurement of the lung/heart ratio during 201 Tl stress myocardial image may be useful for the assessment of the severity, evalation of the left ventricular function and judgement of prognosis in CHD

Glycoconjugate sugar residues in the chick embryo developing lung: a lectin histochemical study.

Science.gov (United States)

Gheri, G; Sgambati, E; Bryk, S G

2000-03-01

A lectin histochemical study was performed to investigate the distribution and changes of the oligosaccharidic component of the glycoconjugates in the lung of chick embryos, of 1-day-old chick, and of the adult animal. For this purpose, a battery of seven horseradish peroxidase-conjugated lectins (PNA, SBA, DBA, WGA, Con A, LTA, and UEA I) were employed. During the first phase of parabronchi and atria formation, D-galactose-(beta1-->3)-N-acetyl-D-galactosamine, beta-N-acetyl-D-galactosamine, D-glucosamine, alpha-D-mannose, and sialic acid, present at the level of the surface and of cytoplasmic granules of the lining epithelial cells, seem to play a role in regulating morphogenetic phenomena. In the subsequent phases, the parabronchial lumen and the atrial cavities were characterized by the presence of lectin-reactive material rich in terminal D-galactose-(beta1-->3)-N-acetyl-D-galactosamine, beta-N-acetyl-D-galactosamine, D-glucosamine and alpha-D-mannose. From day 18 onwards and immediately after hatching, the free border of the cells lining the air capillaries was characterized by the presence of beta-N-acetyl-D-galactosamine and alpha-D-mannose. The appearance of these sugar residues was concomitant with the beginning of respiratory activity. Copyright 2000 Wiley-Liss, Inc.

[Lung perfusion studies after percutaneous closure of patent ductus arteriosus using the Amplatzer Duct Occluder in children].

Science.gov (United States)

Parra-Bravo, José Rafael; Apolonio-Martínez, Adriana; Estrada-Loza, María de Jesús; Beirana-Palencia, Luisa Gracia; Ramírez-Portillo, César Iván

2015-01-01

The closure of patent ductus arteriosus with multiple devices has been associated with a reduction in lung perfusion. We evaluated the pulmonary perfusion after percutaneous closure of patent ductus arteriosus with the Amplatzer Duct Occluder device using perfusion lung scan. Thirty patients underwent successful percutaneous patent ductus arteriosus occlusions using the Amplatzer Duct Occluder device were included in this study. Lung perfusion scans were preformed 6 months after the procedure. Peak flow velocities and protrusion of the device were analyzed by Doppler echocardiography. A left lung perfusionductus arteriosus and the minimum and maximum diameter/length of the ductus arteriosus ratio were statistically significant in patients with abnormalities of lung perfusion. It was observed protrusion the device in 6 patients with a higher maximum flow rate in the left pulmonary artery. The left lung perfusion may be compromised after percutaneous closure of patent ductus arteriosus with the Amplatzer Duct Occluder. The increased flow velocity in the origin of the left pulmonary artery can be a poor indicator of reduction in pulmonary perfusion and can occur in the absence of protrusion of the device. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen

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Sbragia, L. [Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil, Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nassr, A.C.C. [Departamento de Hidrobiologia do Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, SP, Brasil, Departamento de Hidrobiologia do Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, SP (Brazil); Gonçalves, F.L.L. [Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil, Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Schmidt, A.F. [Pediatrics House Office, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH, USA, Pediatrics House Office, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Zuliani, C.C. [Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP (Brazil); Garcia, P.V. [Departamento de Histologia e Embriologia, Instituto de Biologia, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil, Departamento de Histologia e Embriologia, Instituto de Biologia, Universidade Estadual de Campinas, UNICAMP, Campinas, SP (Brazil); Gallindo, R.M. [Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil, Divisão de Cirurgia Pediátrica, Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Pereira, L.A.V. [Departamento de Histologia e Embriologia, Instituto de Biologia, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil, Departamento de Histologia e Embriologia, Instituto de Biologia, Universidade Estadual de Campinas, UNICAMP, Campinas, SP (Brazil)

2014-02-17

Changes in vascular endothelial growth factor (VEGF) in pulmonary vessels have been described in congenital diaphragmatic hernia (CDH) and may contribute to the development of pulmonary hypoplasia and hypertension; however, how the expression of VEGF receptors changes during fetal lung development in CDH is not understood. The aim of this study was to compare morphological evolution with expression of VEGF receptors, VEGFR1 (Flt-1) and VEGFR2 (Flk-1), in pseudoglandular, canalicular, and saccular stages of lung development in normal rat fetuses and in fetuses with CDH. Pregnant rats were divided into four groups (n=20 fetuses each) of four different gestational days (GD) 18.5, 19.5, 20.5, 21.5: external control (EC), exposed to olive oil (OO), exposed to 100 mg nitrofen, by gavage, without CDH (N-), and exposed to nitrofen with CDH (CDH) on GD 9.5 (term=22 days). The morphological variables studied were: body weight (BW), total lung weight (TLW), left lung weight, TLW/BW ratio, total lung volume, and left lung volume. The histometric variables studied were: left lung parenchymal area density and left lung parenchymal volume. VEGFR1 and VEGFR2 expression were determined by Western blotting. The data were analyzed using analysis of variance with the Tukey-Kramer post hoc test. CDH frequency was 37% (80/216). All the morphological and histometric variables were reduced in the N- and CDH groups compared with the controls, and reductions were more pronounced in the CDH group (P<0.05) and more evident on GD 20.5 and GD 21.5. Similar results were observed for VEGFR1 and VEGFR2 expression. We conclude that N- and CDH fetuses showed primary pulmonary hypoplasia, with a decrease in VEGFR1 and VEGFR2 expression.

VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen

Directory of Open Access Journals (Sweden)

L. Sbragia

2014-02-01

Full Text Available Changes in vascular endothelial growth factor (VEGF in pulmonary vessels have been described in congenital diaphragmatic hernia (CDH and may contribute to the development of pulmonary hypoplasia and hypertension; however, how the expression of VEGF receptors changes during fetal lung development in CDH is not understood. The aim of this study was to compare morphological evolution with expression of VEGF receptors, VEGFR1 (Flt-1 and VEGFR2 (Flk-1, in pseudoglandular, canalicular, and saccular stages of lung development in normal rat fetuses and in fetuses with CDH. Pregnant rats were divided into four groups (n=20 fetuses each of four different gestational days (GD 18.5, 19.5, 20.5, 21.5: external control (EC, exposed to olive oil (OO, exposed to 100 mg nitrofen, by gavage, without CDH (N-, and exposed to nitrofen with CDH (CDH on GD 9.5 (term=22 days. The morphological variables studied were: body weight (BW, total lung weight (TLW, left lung weight, TLW/BW ratio, total lung volume, and left lung volume. The histometric variables studied were: left lung parenchymal area density and left lung parenchymal volume. VEGFR1 and VEGFR2 expression were determined by Western blotting. The data were analyzed using analysis of variance with the Tukey-Kramer post hoc test. CDH frequency was 37% (80/216. All the morphological and histometric variables were reduced in the N- and CDH groups compared with the controls, and reductions were more pronounced in the CDH group (P<0.05 and more evident on GD 20.5 and GD 21.5. Similar results were observed for VEGFR1 and VEGFR2 expression. We conclude that N- and CDH fetuses showed primary pulmonary hypoplasia, with a decrease in VEGFR1 and VEGFR2 expression.

VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen

International Nuclear Information System (INIS)

Sbragia, L.; Nassr, A.C.C.; Gonçalves, F.L.L.; Schmidt, A.F.; Zuliani, C.C.; Garcia, P.V.; Gallindo, R.M.; Pereira, L.A.V.

2014-01-01

Changes in vascular endothelial growth factor (VEGF) in pulmonary vessels have been described in congenital diaphragmatic hernia (CDH) and may contribute to the development of pulmonary hypoplasia and hypertension; however, how the expression of VEGF receptors changes during fetal lung development in CDH is not understood. The aim of this study was to compare morphological evolution with expression of VEGF receptors, VEGFR1 (Flt-1) and VEGFR2 (Flk-1), in pseudoglandular, canalicular, and saccular stages of lung development in normal rat fetuses and in fetuses with CDH. Pregnant rats were divided into four groups (n=20 fetuses each) of four different gestational days (GD) 18.5, 19.5, 20.5, 21.5: external control (EC), exposed to olive oil (OO), exposed to 100 mg nitrofen, by gavage, without CDH (N-), and exposed to nitrofen with CDH (CDH) on GD 9.5 (term=22 days). The morphological variables studied were: body weight (BW), total lung weight (TLW), left lung weight, TLW/BW ratio, total lung volume, and left lung volume. The histometric variables studied were: left lung parenchymal area density and left lung parenchymal volume. VEGFR1 and VEGFR2 expression were determined by Western blotting. The data were analyzed using analysis of variance with the Tukey-Kramer post hoc test. CDH frequency was 37% (80/216). All the morphological and histometric variables were reduced in the N- and CDH groups compared with the controls, and reductions were more pronounced in the CDH group (P<0.05) and more evident on GD 20.5 and GD 21.5. Similar results were observed for VEGFR1 and VEGFR2 expression. We conclude that N- and CDH fetuses showed primary pulmonary hypoplasia, with a decrease in VEGFR1 and VEGFR2 expression

Left-Sided Catamenial Pneumothorax with Thoracic Endometriosis and Bullae in the Alveolar Wall.

Science.gov (United States)

Takahashi, Ryo; Kurihara, Masatoshi; Mizobuchi, Teruaki; Ebana, Hiroki; Yamanaka, Sumitaka

2017-04-20

Catamenial pneumothorax (CP) is generally caused by intraperitoneal air leaking from the uterus into the thoracic cavity via a defect in the endometrial tissue of the diaphragm and is usually detected in the right thorax. We report a case of left-sided CP caused by endometriosis in the visceral pleura and with no abnormal findings in the diaphragm. A 33-year-old female patient presented at the end of a course of low-dose contraceptive pills for pelvic endometriosis, with spontaneous pneumothorax in the left chest. Chest CT revealed a bulla in the left upper lung lobe. The patient underwent partial resection of the lung. Immunohistochemistry confirmed the presence of endometrial stromal tissue in the visceral pleura and confirmed this as the cause of pneumothorax since there were no observable abnormalities in the diaphragm. This case suggests that immunohistochemical examination of patients with spontaneous pneumothorax can detect alternative endometrial lesions.

SU-E-T-532: Left-Sided Breast Cancer Irradiation Using Volumatric Modulated Arc Therapy: An Evaluation of Multiple Commercial Systems

International Nuclear Information System (INIS)

Liu, R; Liu, T; Qi, S

2015-01-01

Purposes: There has been growing interest in treating breast cancer using VMAT technique. Our goal is to compare the dosimetry and treatment delivery parameters for the left-sided breast cancer treatment using various VMAT platforms from commercially available planning systems. Methods: Five consecutive left-sided breast cancer patients initially treated with conventional 3D-conformal radiotherapy (3DCRT) were selected. Four VMAT plans using most popular treatment planning systems, including Eclipse (Version 11, Varian), Pinnacle (Version 9.8, Philips), Monaco (Version 2.03, Elekta) and helical Tomotherapy (V4.0, Accuray). The same structure set and same planning goals were used for all VMAT plans. The dosimetric parameters including target coverage and minimum/maximum/mean, dose-volume endpoints for the selected normal structures: the heart, ipsilateral-/contralateral lung and breast, were evaluated. Other dosimetric indices including heterogeneity index (HI) were evaluated. The treatment delivery parameters, such as monitor unit (MUs) and delivery time were also compared. Results: VMAT increases dose homogeneity to the treated volume and reduces the irradiated heart and left-lung volumes. Compared to the 3DCRT technique, all VMAT plans offer better heart and left-lung dose sparing; the mean heart doses were 4.5±1.6(Monaco), 1.2±0.4(Pinnacle), 1.3± (Eclipse) and 5.6±4.4(Tomo), the mean left-lung doses were 5.9±1.5(Monaco), 3.7±0.7(Pinnacle), 1.4± (Eclipse) and 5.2±1.6 (Tomo), while for the 3DCRT plan, the mean heart and left-Lung doses were 2.9±2.0, and 6.8±4.4 (Gy) respectively. The averaged contralateral-breast and lung mean doses were higher in VMAT plans than the 3DCRT plans but were not statistically significant. Among all the VMAT plans, the Pinnacle plans often yield the lowest right-lung/breast mean doses, and slightly better heterogeneity indices that are similar to Tomotherapy plans. Treatment delivery time of the VMAT plans (except helical

Effect of increases in lung volume on clearance of aerosolized solute from human lungs

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Marks, J.D.; Luce, J.M.; Lazar, N.M.; Wu, J.N.; Lipavsky, A.; Murray, J.F.

1985-10-01

To study the effect of increases in lung volume on solute uptake, we measured clearance of /sup 99m/Tc-diethylenetriaminepentaacetic acid (Tc-DTPA) at different lung volumes in 19 healthy humans. Seven subjects inhaled aerosols (1 micron activity median aerodynamic diam) at ambient pressure; clearance and functional residual capacity (FRC) were measured at ambient pressure (control) and at increased lung volume produced by positive pressure (12 cmH2O continuous positive airway pressure (CPAP)) or negative pressure (voluntary breathing). Six different subjects inhaled aerosol at ambient pressure; clearance and FRC were measured at ambient pressure and CPAP of 6, 12, and 18 cmH2O pressure. Six additional subjects inhaled aerosol at ambient pressure or at CPAP of 12 cmH2O; clearance and FRC were determined at CPAP of 12 cmH2O. According to the results, Tc-DTPA clearance from human lungs is accelerated exponentially by increases in lung volume, this effect occurs whether lung volume is increased by positive or negative pressure breathing, and the effect is the same whether lung volume is increased during or after aerosol administration. The effect of lung volume must be recognized when interpreting the results of this method.

Effect of increases in lung volume on clearance of aerosolized solute from human lungs

International Nuclear Information System (INIS)

Marks, J.D.; Luce, J.M.; Lazar, N.M.; Wu, J.N.; Lipavsky, A.; Murray, J.F.

1985-01-01

To study the effect of increases in lung volume on solute uptake, we measured clearance of /sup 99m/Tc-diethylenetriaminepentaacetic acid (Tc-DTPA) at different lung volumes in 19 healthy humans. Seven subjects inhaled aerosols (1 micron activity median aerodynamic diam) at ambient pressure; clearance and functional residual capacity (FRC) were measured at ambient pressure (control) and at increased lung volume produced by positive pressure [12 cmH 2 O continuous positive airway pressure (CPAP)] or negative pressure (voluntary breathing). Six different subjects inhaled aerosol at ambient pressure; clearance and FRC were measured at ambient pressure and CPAP of 6, 12, and 18 cmH 2 O pressure. Six additional subjects inhaled aerosol at ambient pressure or at CPAP of 12 cmH 2 O; clearance and FRC were determined at CPAP of 12 cmH 2 O. According to the results, Tc-DTPA clearance from human lungs is accelerated exponentially by increases in lung volume, this effect occurs whether lung volume is increased by positive or negative pressure breathing, and the effect is the same whether lung volume is increased during or after aerosol administration. The effect of lung volume must be recognized when interpreting the results of this method

Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

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Apostolakis Efstratios

2006-09-01

Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

Ex vivo lung perfusion with adenosine A2A receptor agonist allows prolonged cold preservation of lungs donated after cardiac death.

Science.gov (United States)

Wagner, Cynthia E; Pope, Nicolas H; Charles, Eric J; Huerter, Mary E; Sharma, Ashish K; Salmon, Morgan D; Carter, Benjamin T; Stoler, Mark H; Lau, Christine L; Laubach, Victor E; Kron, Irving L

2016-02-01

Ex vivo lung perfusion has been successful in the assessment of marginal donor lungs, including donation after cardiac death (DCD) donor lungs. Ex vivo lung perfusion also represents a unique platform for targeted drug delivery. We sought to determine whether ischemia-reperfusion injury would be decreased after transplantation of DCD donor lungs subjected to prolonged cold preservation and treated with an adenosine A2A receptor agonist during ex vivo lung perfusion. Porcine DCD donor lungs were preserved at 4°C for 12 hours and underwent ex vivo lung perfusion for 4 hours. Left lungs were then transplanted and reperfused for 4 hours. Three groups (n = 4/group) were randomized according to treatment with the adenosine A2A receptor agonist ATL-1223 or the dimethyl sulfoxide vehicle: Infusion of dimethyl sulfoxide during ex vivo lung perfusion and reperfusion (DMSO), infusion of ATL-1223 during ex vivo lung perfusion and dimethyl sulfoxide during reperfusion (ATL-E), and infusion of ATL-1223 during ex vivo lung perfusion and reperfusion (ATL-E/R). Final Pao2/Fio2 ratios (arterial oxygen partial pressure/fraction of inspired oxygen) were determined from samples obtained from the left superior and inferior pulmonary veins. Final Pao2/Fio2 ratios in the ATL-E/R group (430.1 ± 26.4 mm Hg) were similar to final Pao2/Fio2 ratios in the ATL-E group (413.6 ± 18.8 mm Hg), but both treated groups had significantly higher final Pao2/Fio2 ratios compared with the dimethyl sulfoxide group (84.8 ± 17.7 mm Hg). Low oxygenation gradients during ex vivo lung perfusion did not preclude superior oxygenation capacity during reperfusion. After prolonged cold preservation, treatment of DCD donor lungs with an adenosine A2A receptor agonist during ex vivo lung perfusion enabled Pao2/Fio2 ratios greater than 400 mm Hg after transplantation in a preclinical porcine model. Pulmonary function during ex vivo lung perfusion was not predictive of outcomes after transplantation. Copyright �

Primary left ventricular hydatid cyst in a child: case report

International Nuclear Information System (INIS)

Turkvatan, A.; Yelgec, N.S.; Calikoglu, U.; Olcer, T.

2000-01-01

The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

Primary left ventricular hydatid cyst in a child: case report

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Turkvatan, A. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey); Yelgec, N.S. [Turkiye Yuksek Ihtisas Hospital, Dept. of Cardiology, Ankara (Turkey); Calikoglu, U.; Olcer, T. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey)

2000-12-01

The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

Thallium-201 right lung/heart ratio during exercise in patients with coronary artery disease: relation to thallium-201 myocardial single-photon emission tomography, rest and exercise left ventricular function and coronary angiography

International Nuclear Information System (INIS)

Morel, O.; Pezard, P.; Le Jeune, J.J.; Denizot, B.; Jallet, P.; Furber, A.; Vielle, B.

1999-01-01

The aim of this study was to correlate lung thallium-201 uptake on exercise with 201 Tl single-photon emission tomography (SPET) myocardial perfusion imaging, rest and exercise equilibrium radionuclide angiographic and coronary angiographic findings in patients with coronary artery disease (CAD) using a simple, reproducible lung/heart (L/H) ratio that would be easy to use in clinical practice. L/H ratio was defined on the anterior planar image obtained during exercise 201 Tl SPET acquisition as the mean counts per pixel in an entire right lung field region of interest divided by the mean counts per pixel in the hottest myocardial wall region of interest. We studied 103 patients. Fifty-nine patients (group I) with 201 Tl SPET, radionuclide angiographic and coronary angiographic variables. The group I L/H ratio of 0.35±0.05 (mean ±1 SD) was significantly lower (P 0.45 (mean+2 SD in group I) was considered abnormal. In group II, L/H ratio showed a significant correlation with stress and rest 201 Tl perfusion defect size (r=0.39 and r=0.42, P<0.01, respectively), but not with extent of ischaemic myocardium. The mean L/H ratio was 0.41±0.10 in patients with one-vessel disease (n=15), 0.46±0.08 in those with two-vessel disease (n=17) and 0.47±0.12 in those with three-vessel disease (n=12), but no significant difference was found between the three subgroups. L/H ratio showed a significant inverse relation with rest and exercise left ventricular ejection fraction (r=-0.37 and r=-0.50, P<0.05 and P<0.001, respectively). Using stepwise multiple regression analysis, exercise left ventricular ejection fraction and previous history of hypertension were the sole two variables independently predictive of the L/H ratio. In conclusion, although lung thallium uptake is usually found to correlate with extent and severity of CAD, increased L/H ratio should primarily be considered as a marker of exercise-induced left ventricular systolic and perhaps diastolic dysfunction, probably

Anestesthesiological approach to pediatric patient for lobectomy due to lung abscess: Lung separation and epidural analgesia (lung separation and epidural analgesia

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Vranić Lana

2017-01-01

Full Text Available Introduction: Acute lymphoblastic leukemia is the most common malignancy in childhood. Main characteristics of the disease are fast proliferation of lymphoblastic cells in bone marrow, destruction of other cells, causing insufficiency in the bone marow and infiltration of the liver, spleen and the lymphatic nodes. Pulmonary abscess and necrotizing pneumonia are rarely found in pediatric population and usually represent a significant problem for treatment. These conditions often require some surgical treatment modalities. The main goal of anesthesiological approach is to provide good and safe perioperative conditions and adequate analgesia. Case report: During treatment of acute leukemia in a 15-year-old boy, complication inform absenting pneumonia left side lung was developed. After four months antibiotic and antifungal therapy wide broad,(nije jasno decision of consilium was to perform left inferior lobectomy. Antibiotic prophylaxis with Ceftazidime 50 mg/kg BM. We performed a combination of general anesthesia and thoracic epidural anesthesia. Intubation with Robertshaw double lume tube. Ultrasound guided central venous catheter in left jugular veine and arterial line in right radial arteria. Anesthesia depth was controlled with entropy method. Epidural catheter was intoduded on level Thl0-Th 11. Conclusion: One ventilation with double lumen tube prevents spillage of infection sputum into the healthy lung. Epidural analgesia in this clinical situation held numerous benefits especially as a way to reduce postoperative respiratory complications caused by acute pain.

Fetal lung interstitial tumor: the first Japanese case report and a comparison with fetal lung tissue and congenital cystic adenomatoid malformation/congenital pulmonary airway malformation type 3.

Science.gov (United States)

Yoshida, Mariko; Tanaka, Mio; Gomi, Kiyoshi; Iwanaka, Tadashi; Dehner, Louis P; Tanaka, Yukichi

2013-10-01

Fetal lung interstitial tumor, a newly recognized lung lesion in infants, was first reported in 2010. Here, we report the first Japanese case of fetal lung interstitial tumor which was originally diagnosed as atypical congenital cystic adenomatoid malformation/congenital pulmonary airway malformation type 3. A 7-day-old girl was referred to our hospital with respiratory distress and a left lung mass and she subsequently underwent left lower lobectomy. The specimen showed a 5 cm solid mass with a fibrous capsule. Histological examination revealed immature airspaces and interstitium, containing bronchioles and cartilage. The epithelial and interstitial cells contained abundant glycogen granules. Immunohistochemistry showed nuclear/cytoplasmic expression of β-catenin in the epithelial and interstitial cells. β-catenin gene mutations and trisomy 8 were not detected, so a neoplastic origin could not be confirmed. The histological findings were partly consistent with normal fetal lung at the canalicular stage, pulmonary interstitial glycogenosis, and congenital cystic adenomatoid malformation/congenital pulmonary airway malformation type 3. In this report, we compare the above conditions and discuss the pathogenesis of fetal lung interstitial tumor. © 2013 The Authors. Pathology International © 2013 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

Prenatal diagnosis of fetal lung maturity by magnetic resonance imaging

International Nuclear Information System (INIS)

Itoh, Hitoshi; Kakizaki, Dai; Nagai, Atsushi; Akutagawa, Osamu; Itokazu, Isao; Iso, Kazuo; Abe, Kimihiko; Takayama, Masaomi; Nohira, Tomoyoshi

2003-01-01

The objective of this study was to evaluate the usefulness of magnetic resonance imaging (MRI) for prenatal diagnosis of fetal lung maturity. The subjects comprised 28 singleton fetuses, and underwent MRI in the third trimester (32.71±3.00 wks). After obtaining axial and coronal scout images of the whole pelvis, we obtained a transverse image, a coronal image and a sagittal image of fetuses with a half-Fourier acquisition single-shot turbo-spin-echo (HASTE) sequence, determined the intensity level of the fetal lung (right lung intensity level: RL, left lung intensity level: LL). The intensity level of background outside of the maternal body was obtained as the control intensity level (CL). The contrast value (CV) of each fetal lung was calculated by the numerical formula; CV=(RL or LL-CL)/CL. We evaluated the changes of CV during the third trimester and relationship between CV and gestational weeks. There was no significant correlation between gestational weeks and RL (P=.3887), LL (P=.2367). There was a significant increase in both right and left CV (RCV=(RL-CL)/CL: P=.0108, LCV=(LL-CL)/CL: P=.0165) with gestational age. It was suggested that the fetal lung maturation could be diagnosed with HASTE using the CV formula. (author)

Prenatal diagnosis of fetal lung maturity by magnetic resonance imaging

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Itoh, Hitoshi; Kakizaki, Dai; Nagai, Atsushi; Akutagawa, Osamu; Itokazu, Isao; Iso, Kazuo; Abe, Kimihiko; Takayama, Masaomi [Tokyo Medical Coll. (Japan); Nohira, Tomoyoshi [Tokyo Medical Coll. (Japan). Hachioji Medical Center

2003-04-01

The objective of this study was to evaluate the usefulness of magnetic resonance imaging (MRI) for prenatal diagnosis of fetal lung maturity. The subjects comprised 28 singleton fetuses, and underwent MRI in the third trimester (32.71{+-}3.00 wks). After obtaining axial and coronal scout images of the whole pelvis, we obtained a transverse image, a coronal image and a sagittal image of fetuses with a half-Fourier acquisition single-shot turbo-spin-echo (HASTE) sequence, determined the intensity level of the fetal lung (right lung intensity level: RL, left lung intensity level: LL). The intensity level of background outside of the maternal body was obtained as the control intensity level (CL). The contrast value (CV) of each fetal lung was calculated by the numerical formula; CV=(RL or LL-CL)/CL. We evaluated the changes of CV during the third trimester and relationship between CV and gestational weeks. There was no significant correlation between gestational weeks and RL (P=.3887), LL (P=.2367). There was a significant increase in both right and left CV (RCV=(RL-CL)/CL: P=.0108, LCV=(LL-CL)/CL: P=.0165) with gestational age. It was suggested that the fetal lung maturation could be diagnosed with HASTE using the CV formula. (author)

How patient positioning affects radiographic signs of canine lung disease

International Nuclear Information System (INIS)

Steyn, P.F.; Green, R.W.

1990-01-01

A single radiographic projection risks missing signs of lung disease. Four case reports of dogs are given to emphasize inadequate visualization with just one or two radiographs. It is advisable to take both right and left lateral views along with a dorsoventral view in a patient, that might have lung disease

Using cotton plant residue to produce briquettes

Energy Technology Data Exchange (ETDEWEB)

Coates, W. [University of Arizona, Tucson, AZ (United States). Bioresources Research Facility

2000-07-01

In Arizona, cotton (Gossypium) plant residue left in the field following harvest must be buried to prevent it from serving as an overwintering site for insects such as the pink bollworm. Most tillage operations employed to incorporate the residue into the soil are energy intensive and often degrade soil structure. Trials showed that cotton plant residue could be incorporated with pecan shells to produce commercially acceptable briquettes. Pecan shell briquettes containing cotton residue rather than waste paper were slightly less durable, when made using equivalent weight mixtures and moisture contents. Proximate and ultimate analyses showed the only difference among briquette samples to be a higher ash content in those made using cotton plant residue. Briquettes made with paper demonstrated longer flame out time, and lower ash percentage, compared to those made with cotton plant residue. (author)

Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives

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Aman Jyoti

2014-01-01

Full Text Available The lung tumors with carinal involvement are frequently managed with tracheal sleeve pneumonectomy and tracheobronchial anastomosis without use of cardiopulmonary bypass (CPB. Various modes of ventilation have been described during tracheal resection and anastomosis. Use of CPB during this period allows the procedure to be conducted in a more controlled way. We performed tracheal sleeve pneumonectomy for adenoid cystic carcinoma of left lung involving carina. The surgery was performed in two stages. In the first stage, left pneumonectomy was performed and in the second stage after 48 h, tracheobronchial resection and anastomosis was performed under CPB. Second stage was delayed to avoid excessive bleeding (due to heparinization from the extensive vascular raw area left after pneumonectomy. Meticulous peri-operative planning and optimal post-operative care helped in successful management of a complex case, which is associated with high morbidity and mortality.

Lung scan alterations in congenital heart disease

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Dietrich, R; Sanchez, J; Munoz, A; Lanaro, A E; Pico, A M

1975-04-01

This report analyzes the patterns in 54 lung scannings of 34 patients with altered pulmonary blood flow due to congenital heart disease. The technique and the results are presented. According to the images obtained, the patients are classified in three groups: Group I--normal distribution with more concentration of particles over the right lung and the bases. Group II--normal scannings found in left to right shunts unless there is pulmonary venous hypertension in which case the apex-base relationship was inverted. Group III--patients with right to left shunts of different types presenting various patterns according to severity, associated anomalies and palliative surgery. The hemodynamics created by cardiac defects and surgical procedures explain these alterations. This method is recommended in view of its advantages and accurate results.

Unusual metastasis of left colon cancer: considerations on two cases.

Science.gov (United States)

Gubitosi, Adelmo; Moccia, Giancarlo; Malinconico, Francesca Antonella; Gilio, Francesco; Iside, Giovanni; Califano, Umberto G A; Foroni, Fabrizio; Ruggiero, Roberto; Docimo, Giovanni; Parmeggiani, Domenico; Agresti, Massimo

2009-04-01

Usually, left colon cancer metastasis concerns liver, abdominal lymph nodes and lungs. Other localizations are quite rare occurrences. In spite of this, some uncommon metastasis sites are reported in literature, such as: peritoneum, ovaries, uterus, kidney testis, bones, thyroid, oral cavity and central nervous system. We report two cases of unusual localizations of left colon cancer metastasis localization, one into the retroperitoneal space and the other at the left axillary lynphnodes and between liver and pancreas. In the first reported case the diffusion pathway may have been the lymphatic mesocolic vessels, partially left in place from the previous surgery. In the second case the alleged metastatic lane may have been through the periumbilical lymph nodes to the parasternal lymph nodes and then to the internal mammary ones, finally reaching the axillary limph nodes.

Lung split function test and pneumonectomy. A lower limit for operability

DEFF Research Database (Denmark)

Tønnesen, K H; Dige-Petersen, H; Lund, J O

1978-01-01

Regional 133Xe ventilation/perfusion studies were used to predict residual lung function after pulmonary resections. The accuracy of the method was good as checked by postoperative spirometry in 11 patients. In 25 patients with impaired lung function and pulmonary cancer, who were consecutively...

Downregulation of aquaporin-1 in alveolar microvessels in lungs adapted to chronic heart failure

DEFF Research Database (Denmark)

Müllertz, Katrine M; Strøm, Claes; Trautner, Simon

2011-01-01

The threshold pressure for lung edema formation is increased in severe chronic heart failure (CHF) due to reduced microvascular permeability. The water channel aquaporin-1 (AQP1) is present in the pulmonary microvascular endothelium, and a number of studies suggest the importance of AQP1 as a mol......The threshold pressure for lung edema formation is increased in severe chronic heart failure (CHF) due to reduced microvascular permeability. The water channel aquaporin-1 (AQP1) is present in the pulmonary microvascular endothelium, and a number of studies suggest the importance of AQP1...... as a molecular determinant of pulmonary microvascular water transport. The present study examined the abundance and localization of AQP1 in lungs from rats with CHF. We used two different models of CHF: ligation of the left anterior descending coronary artery (LAD ligation) and aorta-banding (AB). Sham......-operated rats served as controls. Echocardiographic verification of left ventricular dysfunction, enhanced left ventricular end-diastolic pressure, and right ventricular hypertrophy confirmed the presence of CHF. Western blotting of whole-lung homogenates revealed significant downregulation of AQP1 in LAD...

The frequency and the degree of fusion of the lung on high-resolution CT

International Nuclear Information System (INIS)

Shin, Hwan Sik; Kim, Sung Jin; Bae, Il Hun; Song, Kyung Sup; Kim, Joo Chang; Han, Ki Suk; Cha, Sang Hoon; Park, Kil Sun

2000-01-01

To evaluate the frequency and degree of fusion of the lung as seen on high-resolution CT (HRCT). In 210 patients high-resolution CT scans from the apex to the diaphragm were obtained at 1 mm collimation and 7 mm interval. We retrospectively analysed the frequency and degree of fusion of the lung bordering each interlobar fissure. Fusion of the lung was defined when fissure appeared without complete lobar separation. The degree of lung fusion was classified as mild (less than 1/3 of the fissure), moderate (greater than 1/3 and less than 2/3 of fissure), or severe (greater than 2/3 of the fissure). In 90 of 210 patients, all fissures were identified. In 73 of these 90 (81.1%), lung fusion was noted, the most frequent site of this being between the right upper and right middle lobe (53.3%) . The least frequent site was between the upper portion of the left upper and left lower lobe (32.2%). Am mild degree of fusion was most frequently found between the right middle and right lower lobe (83.9%0, while a severe degree was most frequent between the right middle and right upper lobe (50.0%), followed by the lingular division and the left lower lobe (41.9%). HRCT can be used to evaluate the frequency and degree of interlobar lung fusion. (author)

Pulmonary artery hypertension in chronic obstructive lung disease

International Nuclear Information System (INIS)

Dinkel, E.; Mundinger, A.; Reinbold, W.D.; Wuertemberger, G.

1989-01-01

Standard biplane chest X-rays were tested for the validity of morphometric criteria in the diagnosis of pulmonary artery hypertension. Twenty-seven patients suffering from chronic obstructive lung disease were examined and compared with a control group without cardiopulmonary disease. The diameter of the right and left pulmonary artery, pulmonary conus and the hilar-to-thoracic ratio were significantly increased in patients with chronic obstructive lung disease (p [de

Inverted Lobes Have Satisfactory Functions Compared With Noninverted Lobes in Lung Transplantation.

Science.gov (United States)

Kayawake, Hidenao; Chen-Yoshikawa, Toyofumi F; Motoyama, Hideki; Hamaji, Masatsugu; Hijiya, Kyoko; Aoyama, Akihiro; Goda, Yasufumi; Oda, Hiromi; Ueda, Satoshi; Date, Hiroshi

2018-04-01

To overcome the problem of small-for-size grafts in standard living-donor lobar lung transplantation (LDLLT), we developed inverted LDLLT, in which a right lower lobe from 1 donor is implanted as a right graft and another right lower lobe from another donor is implanted as a left graft. We retrospectively analyzed the functions of inverted grafts vs noninverted grafts. Between 2008 and 2015, 64 LDLLTs were performed. Included were 35 LDLLTs whose recipients were adults and monitored for more than 6 months without developing chronic lung allograft dysfunction. Among them, 65 implanted lobes were eligible for this analysis. There were 31 right lower lobes implanted as right grafts (right-to-right group), 7 right lower lobes as inverted left grafts (right-to-left group), and 27 left lower lobes as left grafts (left-to-left group). We evaluated the graft forced vital capacity (G-FVC) and graft volume of the 65 lobes before and 6 months after LDLLT and compared them among the three groups. Preoperatively, G-FVC in the right-to-left group (1,050 mL) was comparable to that in the right-to-right group (1,177 mL) and better than that in the left-to-left group (791 mL, p satisfactory compared with those of noninverted grafts. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Computed tomography research about the artery and vein of separated pig lung

International Nuclear Information System (INIS)

Ji Jiansong; Gong Jianping; Qian Minghui

2003-01-01

Objective: To evaluate the artery and vein of the separated lung of pig, and analyse the value of routine CT in differentiating the arteries from veins, and to prove the results by anatomizing, making vessel cast specimens, 3-D reconstruction techniques and so on. Method: Thirty normal fresh pig lungs, GE spiral CT Hispeed/I and workstation, anatomic tools, red and blue dyestuff 100 ml and so on were used. Result: Pig lungs are divided into left, lingua and right lung. 85.7% left lungs have three lobes coded as superior, middle and inferior; 93.75% right have the three lobes coded in the same way. Segments and subsegments can be analysed through thin thickness scanning and MIP of spiral CT; arteries and veins of separated pig lung can be resolved to order of 6-7, by Kassab improved Strahler ordering system, but can only be measured to order 5-6; their angles of going out and going positions of those arteries and veins above segments and below subsegments were statistically different (P<0.05). Conclusion: CT can discriminate the arteries well from the veins to order 11-12 in separated pig lung which demonstrates that CT can differentiate the arterial grain and venous grain

Medical image of the week: achalasia with lung abscess

Directory of Open Access Journals (Sweden)

Tey KR

2016-05-01

Full Text Available No abstract available. Article truncated after 150 words. An 80-year old woman with past medical history of high grade serous fallopian tube carcinoma presented with 2 months history of productive cough. This was associated with shortness of breath and subjective fever, chills and weight loss of 5 pounds over 2 months. She was treated with outpatient antibiotics without improvement of symptoms. Patient was afebrile on presentation, hemodynamically stable, and saturating at 99% on room air. Lung examinations revealed dullness on percussion of left lower lung field and reduced breath sounds on the same area. Computed tomographic imaging revealed a large lung abscess on left lower lobe (Figure 1 and moderately dilated esophagus and fluid filled to the level of gastro-esophagus junction. Barium swallow study showed a classic bird-beak like appearance (Figure 2. There was no contrast that passed through the gastro-esophagus junction during the entire course of the barium study. Upper endoscopy was performed to rule out intraluminal ...

Extended resections of non-small cell lung cancers invading the aorta, pulmonary artery, left atrium, or esophagus: can they be justified?

Science.gov (United States)

Reardon, Emily S; Schrump, David S

2014-11-01

T4 tumors that invade the heart, great vessels, or esophagus comprise a heterogenous group of locally invasive lung cancers. Prognosis depends on nodal status; this relationship has been consistently demonstrated in many of the small series of extended resection. Current National Comprehensive Cancer Network guidelines do not recommend surgery for T4 extension with N2-3 disease (stage IIIB). However, biopsy-proven T4 N0-1 (stage IIIA) may be operable. Localized tumors with invasion of the aorta, pulmonary artery, left atrium, or esophagus represent a small subset of T4 disease. Acquiring sufficient randomized data to provide statistical proof of a survival advantage for patients undergoing extended resections for these neoplasms will likely never be possible.Therefore, we are left to critically analyze current documented experience to make clinical decisions on a case-by-case basis.It is clear that the operative morbidity and mortality of extended resections for locally advanced T4 tumors have significantly improved over time,yet the risks are still high. The indications for such procedures and the anticipated outcomes should be clearly weighed in terms of potential perioperative complications and expertise of the surgical team. Patients with T4 N0-1 have the best prognosis and with complete resection may have the potential for cure. The use of induction therapy and surgery for advanced T4 tumors may improve survival. Current data suggest that for tumors that invade the aorta, pulmonary artery,left atrium, or esophagus, resection should be considered in relation to multidisciplinary care.For properly selected patients receiving treatment at high volume, experienced centers, extended resections may be warranted. Published by Elsevier Inc.

Physiological Interaction of Heart and Lung in Thoracic Irradiation

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Ghobadi, Ghazaleh; Veen, Sonja van der [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Bartelds, Beatrijs [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Boer, Rudolf A. de [Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Dickinson, Michael G. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Jong, Johan R. de [Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Faber, Hette; Niemantsverdriet, Maarten [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Brandenburg, Sytze [Kernfysisch Versneller Instituut, University of Groningen, Groningen (Netherlands); Berger, Rolf M.F. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Coppes, Robert P. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Luijk, Peter van, E-mail: p.van.luijk@umcg.nl [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)

2012-12-01

Introduction: The risk of early radiation-induced lung toxicity (RILT) limits the dose and efficacy of radiation therapy of thoracic tumors. In addition to lung dose, coirradiation of the heart is a known risk factor in the development RILT. The aim of this study was to identify the underlying physiology of the interaction between lung and heart in thoracic irradiation. Methods and Materials: Rat hearts, lungs, or both were irradiated to 20 Gy using high-precision proton beams. Cardiopulmonary performance was assessed using breathing rate measurements and F{sup 18}-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG-PET) scans biweekly and left- and right-sided cardiac hemodynamic measurements and histopathology analysis at 8 weeks postirradiation. Results: Two to 12 weeks after heart irradiation, a pronounced defect in the uptake of {sup 18}F-FDG in the left ventricle (LV) was observed. At 8 weeks postirradiation, this coincided with LV perivascular fibrosis, an increase in LV end-diastolic pressure, and pulmonary edema in the shielded lungs. Lung irradiation alone not only increased pulmonary artery pressure and perivascular edema but also induced an increased LV relaxation time. Combined irradiation of lung and heart induced pronounced increases in LV end-diastolic pressure and relaxation time, in addition to an increase in right ventricle end-diastolic pressure, indicative of biventricular diastolic dysfunction. Moreover, enhanced pulmonary edema, inflammation and fibrosis were also observed. Conclusions: Both lung and heart irradiation cause cardiac and pulmonary toxicity via different mechanisms. Thus, when combined, the loss of cardiopulmonary performance is intensified further, explaining the deleterious effects of heart and lung coirradiation. Our findings show for the first time the physiological mechanism underlying the development of a multiorgan complication, RILT. Reduction of dose to either of these organs offers new opportunities to

Computed tomography of the lung of healthy snakes of the species Python regius, Boa constrictor, Python reticulatus, Morelia viridis, Epicrates cenchria, and Morelia spilota.

Science.gov (United States)

Pees, Michael; Kiefer, Ingmar; Thielebein, Jens; Oechtering, Gerhard; Krautwald-Junghanns, Maria-Elisabeth

2009-01-01

Thirty-nine healthy boid snakes representing six different species (Python regius, Boa constrictor, Python reticulatus, Morelia viridis, Epicrates cenchria, and Morelia spilota) were examined using computed tomography (CT) to characterize the normal appearance of the respiratory tissue. Assessment was done subjectively and densitometry was performed using a defined protocol. The length of the right lung was calculated to be 11.1% of the body length, without a significant difference between species. The length of the left lung in proportion to the right was dependent on the species examined. The most developed left lung was in P. regius (81.2%), whereas in B. constrictor, the left lung was vestigial or absent (24.7%). A median attenuation of -814.6 HU and a variability of 45.9 HU were calculated for all species with no significant difference between species. Within the species, a significantly higher attenuation was found for P. regius in the dorsal and cranial aspect of the lung compared with the ventral and caudal part. In B. constrictor, the reduced left lung was significantly hyperattenuating compared with the right lung. Results of this study emphasize the value of CT and provide basic reference data for assessment of the snake lung in these species. Veterinary Radiology &

Fluorescence imaging to quantify crop residue cover

Science.gov (United States)

Daughtry, C. S. T.; Mcmurtrey, J. E., III; Chappelle, E. W.

1994-01-01

Crop residues, the portion of the crop left in the field after harvest, can be an important management factor in controlling soil erosion. Methods to quantify residue cover are needed that are rapid, accurate, and objective. Scenes with known amounts of crop residue were illuminated with long wave ultraviolet (UV) radiation and fluorescence images were recorded with an intensified video camera fitted with a 453 to 488 nm band pass filter. A light colored soil and a dark colored soil were used as background for the weathered soybean stems. Residue cover was determined by counting the proportion of the pixels in the image with fluorescence values greater than a threshold. Soil pixels had the lowest gray levels in the images. The values of the soybean residue pixels spanned nearly the full range of the 8-bit video data. Classification accuracies typically were within 3(absolute units) of measured cover values. Video imaging can provide an intuitive understanding of the fraction of the soil covered by residue.

Effect of dependency versus nondependency on lung lesion visualization

International Nuclear Information System (INIS)

Pechman, R.D. Jr.

1987-01-01

Paraffin blocks and mineral oil were used as a model to determine the effect of dependency versus nondependency on radiographic visualization of lung lesions in lateral thoracic radiographs. It was concluded that the increased opacity of the material surrounding the lesion, not contact between the heart and the lesion, was responsible for the inability to detect lung disease in the dependent lung. The results were tested in dogs with pneumonia in the right middle lung lobe. When the dog was in right lateral recumbency, the dependent right lung was increased in opacity and decreased in volume and the pulmonary lesion was difficult to detect. When the dog was in left lateral recumbency, the non dependent right lung was increased in volume and decreased in opacity and the pulmonary disease was clearly visible. A single recumbent lateral radiograph must not be used to assess a dog with suspected lung disease because lesions in the dependent lung lobes may not be detected

Hypothalamic digoxin, hemispheric chemical dominance, and interstitial lung disease.

Science.gov (United States)

Kurup, Ravi Kumar; Kurup, Parameswara Achutha

2003-10-01

The isoprenoid pathway produces three key metabolites--endogenous digoxin, dolichol, and ubiquinone. This was assessed in patients with idiopathic pulmonary fibrosis and in individuals of differing hemispheric dominance to find out the role of hemispheric dominance in the pathogenesis of idiopathic pulmonary fibrosis. All 15 cases of interstitial lung disease were right-handed/left hemispheric dominant by the dichotic listening test. The isoprenoidal metabolites--digoxin, dolichol, and ubiquinone, RBC membrane Na(+)-K+ ATPase activity, serum magnesium, tyrosine/tryptophan catabolic patterns, free radical metabolism, glycoconjugate metabolism, and RBC membrane composition--were assessed in idiopathic pulmonary fibrosis as well as in individuals with differing hemispheric dominance. In patients with idiopathic pulmonary fibrosis there was elevated digoxin synthesis, increased dolichol and glycoconjugate levels, and low ubiquinone and elevated free radical levels. There was also an increase in tryptophan catabolites and a reduction in tyrosine catabolites. There was an increase in cholesterol phospholipid ratio and a reduction in glycoconjugate level of RBC membrane in patients with idiopathic pulmonary fibrosis. Isoprenoid pathway dysfunction con tributes to the pathogenesis of idiopathic pulmonary fibrosis. The biochemical patterns obtained in interstitial lung disease are similar to those obtained in left-handed/right hemispheric chemically dominant individuals by the dichotic listening test. However, all the patients with interstitial lung disease were right-handed/left hemispheric dominant by the dichotic listening test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Interstitial lung disease occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function.

Regional lung function evaluation with nitrogen-13

Energy Technology Data Exchange (ETDEWEB)

Ahluwalia, B; Brownell, G L; Hales, C; Kazemi, H

1981-10-01

Regional ventilation and perfusion studies are routinely performed with molecular nitrogen-13 (a short-lived positron emitter), a multicrystal positron camera, and a computer. These studies have the advantage of viewing with equal sensitivity all sections of the lung simultaneously. Nitrogen-13 is less soluble than xenon in blood and therefore allows more accurate ventilation imaging. The short half-life of the radiopharmaceutical allows simultaneous ventilation and perfusion scintigraphy of the lung. Unlike other imaging techniques in which the residual radioactivity persists in the lung for hours, nitrogen-13 is rapidly cleared allowing repetitive imaging. Ventilation and perfusion studies are part of the routine preoperative evaluation for lung cancer resection or for bullectomy in patients with chronic obstructive pulmonary disease and for assessment of pulmonary emboli in the presence of chronic obstructive disease.

Case of right atrial myxoma with right to left shunt

Energy Technology Data Exchange (ETDEWEB)

Nakai, Kenji; Suzuki, Tomoyuki; Ohzeki, Tetsuro (Iwate Medical Coll., Morioka (Japan). School of Medicine)

1982-12-01

A case of 49-year-old woman with right atrial myxoma resulting to right to left shunt, diagnosed by cardiac pool isotope image, was reported. She was admitted to our clinic because of progressive shortness of breath. At admission lip cyanosis was noted. Laboratory data included polycythemia, low O/sub 2/ saturation (89%) and high erythrocyte sedimentation rate (65 mm/1 h). Chest x-p showed slight right atrial enlargement, but no pulmonary congestion. The electrocardiogram showed sinus regular rhythm with biphasic p wave in leads II, III, aVf. Although 1st heart sound at the apex was splited, no heart murmur was heard. In usual echocardiographic approach, no abnormal echogram was obtained in the right ventricular region. Lung perfusion scintiscan with Tc-99 m-MAA showed visualization of thyroid gland and kidney, which suggested intracardiac right-to-left shunt. Cardiac pool image with Tc-99m-HSA revealed large photo-deficient area in the right atrium and early visualization of aortic arch. Computor tomography showed large round low density region 8 x 7 cm in size. Based on their findings, this patient was diagnosed as right atrial tumor. At operation a large tumor (diameter 8 x 7 x 7 cm, weight 160g) filled the lower part of the right atrium and was adherent to the anterolateral wall in the right atrium. As a cause of R-L shunt, streched foramen ovale (5 x 10 mm) was found. Tumor histology was typical of atrial myxoma. Post-operative gated cardiac isotope image showed no evidence of residual atrial tumor. Cardiac blood pool isotope imaging was a method for the noninvasive detection and assessment of right atrial myxoma.

Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

International Nuclear Information System (INIS)

Goddu, S. Murty; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N.; Low, Daniel A.

2009-01-01

Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 ± 1.3 Gy vs. 27.9 ± 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 ± 1.8 Gy vs. 37.5 ± 26.9 Gy). The mean percentage of the left lung volume receiving ≥20 Gy in the tomotherapy plans decreased from 32.6% ± 4.1% to 17.6% ± 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving ≥5 Gy for the total lung increased from 25.2% ± 4.2% for the three-dimensional technique to 46.9% ± 8.4% for the tomotherapy plan. The mean volume receiving ≥35 Gy for the heart decreased from 5.6% ± 4.8% to 2.2% ± 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 ± 3.4 Gy to 12.2 ± 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses

CT features of lung cancer associated with idiopathic pulmonary fibrosis

International Nuclear Information System (INIS)

Kim, Jun Hyoung; Song, Koun Sik; Lee, Deok Hee; Kim, Jin Suh; Lim, Tae Hwan

1996-01-01

It is well known that the incidence of lung cancer is high in patients with idiopathic pulmonary fibrosis(IPF). We analyzed the CT features of lung cancer associated with IPF. Retrospective analyzed the CT features of lung cancer associated with IPF. Retrospective analysis was performed in 23 patients with lung cancer(24 lung cancers) associated with IPF. The diagnosis of IPF was made by clinical and CT findings, and lung cancer was confirmed pathologically. We divided the location of lung cancer by lobar distribution and central or peripheral lung zone, and measured the size of mass. We classified the mediastinal lymph node enlargement by American Thoracic Society (ATS) mapping scheme. We evaluated the CT pattern of IPF. The subjects consisted of 6 cases of small cell carcinoma and 18 cases of non-small cell lung cancer. Non-small cell lung cancers were located in the right upper lobe in 5 cases, left upper lobe in 6 cases, right middle lobe in 1 case, right lower lobe in 9 cases, and left lower lobe in 3 cases. Twenty cancers(85%) were located in the peripheral lung zone. Eighteen cancers(73%) were surrounded by fibrotic lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3 cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung cancers. CT patterns of underlying IPF were honey-combing in 18 patients(78%) and mixed honey-combing and ground-glass opacity in 5 patients(22%). The lung cancer associated with IPF shows variable cell types. Most of the lung cancers were located peripherally, surrounded by end-stage fibrosis, and were associated with mediastinal lymph node enlargement

CT features of lung cancer associated with idiopathic pulmonary fibrosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Jun Hyoung; Song, Koun Sik; Lee, Deok Hee; Kim, Jin Suh; Lim, Tae Hwan [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

1996-01-01

It is well known that the incidence of lung cancer is high in patients with idiopathic pulmonary fibrosis(IPF). We analyzed the CT features of lung cancer associated with IPF. Retrospective analyzed the CT features of lung cancer associated with IPF. Retrospective analysis was performed in 23 patients with lung cancer(24 lung cancers) associated with IPF. The diagnosis of IPF was made by clinical and CT findings, and lung cancer was confirmed pathologically. We divided the location of lung cancer by lobar distribution and central or peripheral lung zone, and measured the size of mass. We classified the mediastinal lymph node enlargement by American Thoracic Society (ATS) mapping scheme. We evaluated the CT pattern of IPF. The subjects consisted of 6 cases of small cell carcinoma and 18 cases of non-small cell lung cancer. Non-small cell lung cancers were located in the right upper lobe in 5 cases, left upper lobe in 6 cases, right middle lobe in 1 case, right lower lobe in 9 cases, and left lower lobe in 3 cases. Twenty cancers(85%) were located in the peripheral lung zone. Eighteen cancers(73%) were surrounded by fibrotic lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung. The size of the mass ranged from 1 to 12 cm, and in 12 cases it was below 3 cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung cancers. CT patterns of underlying IPF were honey-combing in 18 patients(78%) and mixed honey-combing and ground-glass opacity in 5 patients(22%). The lung cancer associated with IPF shows variable cell types. Most of the lung cancers were located peripherally, surrounded by end-stage fibrosis, and were associated with mediastinal lymph node enlargement.

Magnetic Nanoparticles of Chitosan for Targeted Delivery System of Plasmids to the Lungs

International Nuclear Information System (INIS)

Baez, C.A.A.; Cruz, I.E.L.; Padilla, M.C.R.; Gonzalez, J.M.A.

2014-01-01

One of the major problems of gene therapy is the efficient, specific, and targeted delivery as well as the safety of the materials used in such systems. The specific targeted delivery of genes to the lung offers the possibility to treat a variety of specific diseases. We developed chitosan nanoparticles with the plasmid pCEM-Luc, which contains a promoter activated by magnetic field. Nanoparticles of 200-250 nm obtained by ionic gelation with a 99% retention rate were transfected in B16F10 cells and in vivo in the lungs of Balb/c mice by intratracheal administration. We observed that an external magnetic field increased the expression of the luciferase reporter gene in B16F10 cells transfected with magnetic nanoparticles and in homogenized lungs of mice which determined differences in levels of expression between different regions of the lungs (apical or distal and left or right). The highest levels of luciferase activity were observed in the apical left region. The magnetic nanoparticles prove an efficient delivery system to in vitro transfection of cells and lung tissue.

Use of the Amplatzer ASD Occluder for Closing a Persistent Left Vertical Vein

International Nuclear Information System (INIS)

Zanchetta, Mario; Zennaro, Marco; Zecchel, Roberto; Mancuso, Daniela; Pedon, Luigi

2009-01-01

We report the case of a very large anomalous connection of the veins draining the upper lobe of the left lung to both the left-sided vertical vein and the left atrium, associated with mild rheumatic mitral valve stenosis, in which the atrial septum was intact and the remaining venous system, including the coronary sinus, was otherwise normal (a variant of Lutembacher's syndrome). In order to abolish the left-to-right shunting, a transcatheter approach to close this venous structure was successfully attempted using an Amplatzer ASD Occluder device. The technical aspects and the alternative options of performing a procedure with a device for a purpose outside the scope of its approved label are discussed.

Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children.

Science.gov (United States)

Tusman, Gerardo; Acosta, Cecilia M; Böhm, Stephan H; Waldmann, Andreas D; Ferrando, Carlos; Marquez, Manuel Perez; Sipmann, Fernando Suarez

2017-10-13

Atelectasis is a common finding in mechanically ventilated children with healthy lungs. This lung collapse cannot be overcome using standard levels of positive end-expiratory pressure (PEEP) and thus for only individualized lung recruitment maneuvers lead to satisfactory therapeutic results. In this short communication, we demonstrate by lung ultrasound images (LUS) the effect of a postural recruitment maneuver (P-RM, i.e., a ventilatory strategy aimed at reaerating atelectasis by changing body position under constant ventilation). Data was collected in the operating room of the Hospital Privado de Comunidad, Mar del Plata, Argentina. Three anesthetized children undergoing mechanical ventilation at constant settings were sequentially subjected to the following two maneuvers: (1) PEEP trial in the supine position PEEP was increased to 10 cmH 2 O for 3 min and then decreased to back to baseline. (2) P-RM patient position was changed from supine to the left and then to the right lateral position for 90 s each before returning to supine. The total P-RM procedure took approximately 3 min. LUS in the supine position showed similar atelectasis before and after the PEEP trial. Contrarily, atelectasis disappeared in the non-dependent lung when patients were placed in the lateral positions. Both lungs remained atelectasis free even after returning to the supine position. We provide LUS images that illustrate the concept and effects of postural recruitment in children. This maneuver has the advantage of achieving recruitment effects without the need to elevate airways pressures.

Reactive oxygen species produced by NADPH oxidase and mitochondrial dysfunction in lung after an acute exposure to Residual Oil Fly Ashes

Energy Technology Data Exchange (ETDEWEB)

Magnani, Natalia D.; Marchini, Timoteo; Vanasco, Virginia [Instituto de Bioquímica Medicina Molecular (IBIMOL-UBA-CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires (Argentina); Tasat, Deborah R. [CESyMA, Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, San Martín, Buenos Aires (Argentina); Alvarez, Silvia [Instituto de Bioquímica Medicina Molecular (IBIMOL-UBA-CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires (Argentina); Evelson, Pablo, E-mail: pevelson@ffyb.uba.ar [Instituto de Bioquímica Medicina Molecular (IBIMOL-UBA-CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires (Argentina)

2013-07-01

Reactive O{sub 2} species production triggered by particulate matter (PM) exposure is able to initiate oxidative damage mechanisms, which are postulated as responsible for increased morbidity along with the aggravation of respiratory diseases. The aim of this work was to quantitatively analyse the major sources of reactive O{sub 2} species involved in lung O{sub 2} metabolism after an acute exposure to Residual Oil Fly Ashes (ROFAs). Mice were intranasally instilled with a ROFA suspension (1.0 mg/kg body weight), and lung samples were analysed 1 h after instillation. Tissue O{sub 2} consumption and NADPH oxidase (Nox) activity were evaluated in tissue homogenates. Mitochondrial respiration, respiratory chain complexes activity, H{sub 2}O{sub 2} and ATP production rates, mitochondrial membrane potential and oxidative damage markers were assessed in isolated mitochondria. ROFA exposure was found to be associated with 61% increased tissue O{sub 2} consumption, a 30% increase in Nox activity, a 33% increased state 3 mitochondrial O{sub 2} consumption and a mitochondrial complex II activity increased by 25%. During mitochondrial active respiration, mitochondrial depolarization and a 53% decreased ATP production rate were observed. Neither changes in H{sub 2}O{sub 2} production rate, nor oxidative damage in isolated mitochondria were observed after the instillation. After an acute ROFA exposure, increased tissue O{sub 2} consumption may account for an augmented Nox activity, causing an increased O{sub 2}{sup ·−} production. The mitochondrial function modifications found may prevent oxidative damage within the organelle. These findings provide new insights to the understanding of the mechanisms involving reactive O{sub 2} species production in the lung triggered by ROFA exposure. - Highlights: • Exposure to ROFA alters the oxidative metabolism in mice lung. • The augmented Nox activity contributes to the high tissue O{sub 2} consumption. • Exposure to ROFA

CT findings of a displaced left upper division bronchus in adults: Its importance for performing safe left pulmonary surgery

Energy Technology Data Exchange (ETDEWEB)

Oshiro, Yasuji, E-mail: oshiro4211@yahoo.co.jp [Department of Radiology, National Hospital Organization Okinawa Hospital, 20-14 Ganeko 3-chome, Ginowan city, Okinawa 901-2214 (Japan); Murayama, Sadayuki [Department of Radiology, University of the Ryukus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 903-0215 (Japan); Ohta, Morio [Department of Surgery, Nakagami Hospital, 6-25-5 Chibana, Okinawa-city, Okinawa 904-2195 (Japan); Teruya, Takao [Second Department of Surgery, University of the Ryukus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 903-0215 (Japan)

2013-08-15

Purpose: The aim of this study was to describe the CT findings of a displaced left upper division bronchus (DLUDB) in adults. Materials and methods: Ten patients with DLUDB were identified. The following CT features were assessed: origin of the DLUDB; distance between the origin of the DLUDB and the origin of the left upper lobe (LUL) bronchus; height of the origin of the DLUDB against the left pulmonary artery (LPA); difference of the main bronchial length; ventilated segment; course of the left pulmonary artery against the DLUDB; and presence of an accessory fissure or other anomalies. Results: DLUDB arose from the posterolateral or lateral aspect of the left main bronchus immediately proximal to the origin of the LUL bronchus. It tended to course along the posterior wall of the LPA and to ventilate the apicoposterior segment with or without the anterior segment. The LPA passed between the displaced bronchus and the lingular bronchus. The origin of the DLUDB was located lower than the inferior wall of the proximal LPA in 6 patients. The accessory fissure between the associated segment and remaining part of the LUL and right tracheal bronchus coexisted in 7 and 3 patients respectively. Conclusion: DLUDB has characteristic findings on CT. Radiologists should be aware of this entity and inform the surgeon as it can prevent serious complications in a patient who may undergo lobectomy of the left lung.

CT findings of a displaced left upper division bronchus in adults: Its importance for performing safe left pulmonary surgery

International Nuclear Information System (INIS)

Oshiro, Yasuji; Murayama, Sadayuki; Ohta, Morio; Teruya, Takao

2013-01-01

Purpose: The aim of this study was to describe the CT findings of a displaced left upper division bronchus (DLUDB) in adults. Materials and methods: Ten patients with DLUDB were identified. The following CT features were assessed: origin of the DLUDB; distance between the origin of the DLUDB and the origin of the left upper lobe (LUL) bronchus; height of the origin of the DLUDB against the left pulmonary artery (LPA); difference of the main bronchial length; ventilated segment; course of the left pulmonary artery against the DLUDB; and presence of an accessory fissure or other anomalies. Results: DLUDB arose from the posterolateral or lateral aspect of the left main bronchus immediately proximal to the origin of the LUL bronchus. It tended to course along the posterior wall of the LPA and to ventilate the apicoposterior segment with or without the anterior segment. The LPA passed between the displaced bronchus and the lingular bronchus. The origin of the DLUDB was located lower than the inferior wall of the proximal LPA in 6 patients. The accessory fissure between the associated segment and remaining part of the LUL and right tracheal bronchus coexisted in 7 and 3 patients respectively. Conclusion: DLUDB has characteristic findings on CT. Radiologists should be aware of this entity and inform the surgeon as it can prevent serious complications in a patient who may undergo lobectomy of the left lung

Feasibility study of image guided radiotherapy for lung tumor using online and offline cone-beam CT setup verification

International Nuclear Information System (INIS)

Li Hongsheng; Li Baosheng; Lu Jie; Yin Yong; Yu Ningsha; Chen Yiru

2009-01-01

Objective: To investigate the feasibility of online and offline cone-beam CT(CBCT) guided radiotherapy for lung cancer. Methods: Fourteen patients with lung tumor treated by three-dimensional conformal radiotherapy were investigated. Online kV CBCT scan, image registration and setup correction were performed before and immediately after radiotherapy. CBCT online-guided correction data were used to calculate the population-based CTV-PTV margins under the condition of non-correction and correction in every fraction respectively. The numbers of initial images and the population-based CTV-PTV margins after the offline compensation of the system setup error were evaluated with the permission of 0.5 mm and 1.5 mm maximal residue error, respectively. Results: Under the condition of non-correction, the required margins for total error were 5.7 mm, 8.0 mm and 7.8 mm in the left-right (x axis), cranio-caudal (y axis) and anterior-posterior(z axis) directions, respectively. When the tumor was corrected in every fraction, the required margins for intra-fraction error were 2.4 mm, 2.4 mm and 2.3 mm in x,y and z axes, respectively. To correct the systematic setup error, 9 sets of CBCT images for 3.3 mm, 3.7 mm and 3.6 mm PTV margins, and 7 sets of CBCT images for 3.9 mm, 4.3 mm and 4.3 mm PTV margins in x,y and z axes were necessary when 0.5 mm and 1.5 mm maximal residue error were permitted respectively. Conclusions: Both of the online CBCT correction and the offline adaptive correction can markedly reduce the impact of setup error and reduce the required PTV margins accordingly. It is feasible to deliver the online and offline image guided radiation for patients with lung tumor. (authors)

Emergency surgery for lung cancer with abscess formation after transbronchial biopsy.

Science.gov (United States)

Takanashi, Yusuke; Miyashita, Koichi; Tajima, Shogo; Hayakawa, Takamitsu; Neyatani, Hiroshi; Funai, Kazuhito

2017-03-01

Abscess formation in lung cancer after transbronchial biopsy (TBB) is a rare complication with no standard consensus on a coping strategy or prophylaxis. We describe an instructive case of lung cancer which developed into an abscess after TBB. An 80-year-old man with poorly controlled diabetes mellitus underwent TBB for diagnosing a mass lesion in the left upper lobe. The TBB specimen confirmed a diagnosis of lung cancer, and he was scheduled for radical surgery. However, the tumour was revealed to have progressed into an enlarged abscess 24 days after TBB. Prompt use of meropenem failed to relieve the infection, hence we performed emergency left upper lobectomy. Poorly controlled diabetes mellitus was considered to be a risk for the formation of a tumour abscess after TBB. It was difficult to control the infection with conservative treatment using antibiotics; emergency surgical resection was considered to be the safest strategy for recovery.

Coil occlusion of residual shunts after surgical closure of patent ductus arteriosus.

Science.gov (United States)

Fujii, Yoko; Keene, Bruce W; Mathews, Kyle G; Atkins, Clarke E; Defrancesco, Teresa C; Hardie, Elizabeth M; Wakao, Yoshito

2006-12-01

OBJECTIVE; To describe use of coil embolization to occlude residual flow through a patent ductus arteriosus (PDA) after incomplete surgical ligation. Clinical study. Dogs (n=4) with continuous murmur after surgical ligation of PDA. After PDA ligation, residual ductal flow through the PDA was visible on color-flow Doppler examination and left ventricular end-diastolic diameter remained increased. Coil embolization by an arterial approach was performed to achieve complete occlusion of the PDA. Embolization coils were delivered without complications and hemodynamically successful occlusion was achieved. Doppler-visible flow resolved in 2 dogs within 3 months after embolization. Left ventricular end-diastolic diameter indexed to body weight decreased in all dogs. Transcatheter coil embolization appears to be a safe and minimally invasive procedure for complete occlusion of residual PDA flow after incomplete surgical ligation. Transcatheter coil embolization should be considered for correction of hemodynamically significant residual shunts in dogs that have incomplete PDA occlusion after open surgical ligation.

A Community-acquired Lung Abscess Attributable to Streptococcus pneumoniae which Extended Directly into the Chest Wall.

Science.gov (United States)

Ko, Yuki; Tobino, Kazunori; Yasuda, Yuichiro; Sueyasu, Takuto; Nishizawa, Saori; Yoshimine, Kouhei; Munechika, Miyuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Miyajima, Hiroyuki; Mukasa, Yosuke; Ebi, Noriyuki

We herein report the case of 75-year-old Japanese female with a community-acquired lung abscess attributable to Streptococcus pneumoniae (S. penumoniae) which extended into the chest wall. The patient was admitted to our hospital with a painful mass on the left anterior chest wall. A contrast-enhanced chest computed tomography scan showed a lung abscess in the left upper lobe which extended into the chest wall. Surgical debridement of the chest wall abscess and percutaneous transthoracic tube drainage of the lung abscess were performed. A culture of the drainage specimen yielded S. pneumoniae. The patient showed a remarkable improvement after the initiation of intravenous antibiotic therapy.

Quantitative computed tomography for the prediction of pulmonary function after lung cancer surgery: a simple method using simulation software.

Science.gov (United States)

Ueda, Kazuhiro; Tanaka, Toshiki; Li, Tao-Sheng; Tanaka, Nobuyuki; Hamano, Kimikazu

2009-03-01

The prediction of pulmonary functional reserve is mandatory in therapeutic decision-making for patients with resectable lung cancer, especially those with underlying lung disease. Volumetric analysis in combination with densitometric analysis of the affected lung lobe or segment with quantitative computed tomography (CT) helps to identify residual pulmonary function, although the utility of this modality needs investigation. The subjects of this prospective study were 30 patients with resectable lung cancer. A three-dimensional CT lung model was created with voxels representing normal lung attenuation (-600 to -910 Hounsfield units). Residual pulmonary function was predicted by drawing a boundary line between the lung to be preserved and that to be resected, directly on the lung model. The predicted values were correlated with the postoperative measured values. The predicted and measured values corresponded well (r=0.89, plung cancer surgery and helped to identify patients whose functional reserves are likely to be underestimated. Hence, this modality should be utilized for patients with marginal pulmonary function.

Predictive equations for lung volumes from computed tomography for size matching in pulmonary transplantation.

Science.gov (United States)

Konheim, Jeremy A; Kon, Zachary N; Pasrija, Chetan; Luo, Qingyang; Sanchez, Pablo G; Garcia, Jose P; Griffith, Bartley P; Jeudy, Jean

2016-04-01

Size matching for lung transplantation is widely accomplished using height comparisons between donors and recipients. This gross approximation allows for wide variation in lung size and, potentially, size mismatch. Three-dimensional computed tomography (3D-CT) volumetry comparisons could offer more accurate size matching. Although recipient CT scans are universally available, donor CT scans are rarely performed. Therefore, predicted donor lung volumes could be used for comparison to measured recipient lung volumes, but no such predictive equations exist. We aimed to use 3D-CT volumetry measurements from a normal patient population to generate equations for predicted total lung volume (pTLV), predicted right lung volume (pRLV), and predicted left lung volume (pLLV), for size-matching purposes. Chest CT scans of 400 normal patients were retrospectively evaluated. 3D-CT volumetry was performed to measure total lung volume, right lung volume, and left lung volume of each patient, and predictive equations were generated. The fitted model was tested in a separate group of 100 patients. The model was externally validated by comparison of total lung volume with total lung capacity from pulmonary function tests in a subset of those patients. Age, gender, height, and race were independent predictors of lung volume. In the test group, there were strong linear correlations between predicted and actual lung volumes measured by 3D-CT volumetry for pTLV (r = 0.72), pRLV (r = 0.72), and pLLV (r = 0.69). A strong linear correlation was also observed when comparing pTLV and total lung capacity (r = 0.82). We successfully created a predictive model for pTLV, pRLV, and pLLV. These may serve as reference standards and predict donor lung volume for size matching in lung transplantation. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Emergency surgery for lung cancer with abscess formation after transbronchial biopsy

OpenAIRE

Takanashi, Yusuke; Miyashita, Koichi; Tajima, Shogo; Hayakawa, Takamitsu; Neyatani, Hiroshi; Funai, Kazuhito

2017-01-01

Abscess formation in lung cancer after transbronchial biopsy (TBB) is a rare complication with no standard consensus on a coping strategy or prophylaxis. We describe an instructive case of lung cancer which developed into an abscess after TBB. An 80?year?old man with poorly controlled diabetes mellitus underwent TBB for diagnosing a mass lesion in the left upper lobe. The TBB specimen confirmed a diagnosis of lung cancer, and he was scheduled for radical surgery. However, the tumour was revea...

[Lung Abscess Diagnosed as Adenocarcinoma by Needle Biopsy;Report of a Case].

Science.gov (United States)

Shomura, Shin; Suzuki, Hitoshi; Yada, Masaki; Kondo, Chiaki

2015-07-01

We report a case of lung abscess misdiagnosed as adenocarcinoma based on cytologic findings of the sample obtained from needle biopsy. A 45-year-old man consulted our hospital because of fever, wet cough and an abnormal shadow on a chest X-ray film. A chest computed tomography revealed gradually enlarging pulmonary mass in the left S6 infiltrating the S5. A diagnosis of lung cancer was suspected and surgery was performed. Pathological findings of the specimen showed atypical cells with a large nucleus and a gross papillary neoplasm by needle biopsy. The patient underwent left lower lobectomy and partial resection of upper lobe with standard nodal dissection. The final diagnosis was a lung abscess with pneumonia without evidence of malignancy. When an indeterminate pulmonary tumor must be diagnosed during an operation, we should perform partial resection if possible.

Radiological evaluation of lung volume among Koreans with silicosis

International Nuclear Information System (INIS)

Rhee, Byung Chull

1975-01-01

1. Radiological evaluation of lung volumes was carried out thirty Korean males patients with silicosis, and following results were obtained. 2. The mean radiological lung volume among those patients was 7,587 ml. 3. When compared with the group of normal Korean male adults ranging from 31 to 55 years of age, the mean lung volume was increased by 2,346 ml. 4. The lung volume of these patients was even slightly larger than that of the group of Korean athletes of all ages. 5. On the other hand, the vital capacity in patients with silicosis was markedly diminished, the mean vital capacity being 2,909 ml. 6. The patients with silicosis also revealed emphysematous changes in the lung as well as increased residual volumes. The vital capacity was smallest in the latest stage.

Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism.

Science.gov (United States)

Pesavento, Raffaele; Filippi, Lucia; Palla, Antonio; Visonà, Adriana; Bova, Carlo; Marzolo, Marco; Porro, Fernando; Villalta, Sabina; Ciammaichella, Maurizio; Bucherini, Eugenio; Nante, Giovanni; Battistelli, Sandra; Muiesan, Maria Lorenza; Beltramello, Giampietro; Prisco, Domenico; Casazza, Franco; Ageno, Walter; Palareti, Gualtiero; Quintavalla, Roberto; Monti, Simonetta; Mumoli, Nicola; Zanatta, Nello; Cappelli, Roberto; Cattaneo, Marco; Moretti, Valentino; Corà, Francesco; Bazzan, Mario; Ghirarduzzi, Angelo; Frigo, Anna Chiara; Miniati, Massimo; Prandoni, Paolo

2017-05-01

The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria.Residual pulmonary obstruction was detected in 324 patients (50.1%, 95% CI 46.2-54.0%). Patients with residual pulmonary obstruction were more likely to be older and to have an unprovoked episode. After a 3-year follow-up, recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension developed in 34 out of the 324 patients (10.5%) with residual pulmonary obstruction and in 15 out of the 323 patients (4.6%) without residual pulmonary obstruction, leading to an adjusted hazard ratio of 2.26 (95% CI 1.23-4.16).Residual pulmonary obstruction, as detected with perfusion lung scanning at 6 months after a first episode of pulmonary embolism, is an independent predictor of recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension. Copyright ©ERS 2017.

Unilateral absence of lung perfusion resulting from endarteritis of the pulmonary artery

International Nuclear Information System (INIS)

Calegaro, J.U.M.; Turini, T.L.

This case shows endarteritis of left pulmonary artery in the angiographic study with absent perfusion of the left lung in the MAA 131 I scintigraphy. Considerations are made conderning the presumable diagnosis of infection by 'toxocara canis' larval form. The literature review don't point out a similar case. (author) [pt

Positron emission tomography of the lung

International Nuclear Information System (INIS)

Wollmer, P.

1984-01-01

Positron emission tomography enables the distribution of positron emitting isotopes to be imaged in a transverse plane through the body and the regional concentration of the isotope to be measured quantitatively. This thesis reports some applications of positron emission tomography to studies of pulmonary pathophysiology. Measurements in lung phantoms showed that regional lung density could be measured from a transmission tomogram obtained with an external source of positron emitting isotope. The regional, fractional blood volume was measured after labelling the blood with carbon-11-monoxide. Regional extravascular lung density (lung tissue and interstitial water per unit thoracic volume) was obtained by subtracting fractional blood volume from lung density. Measurements in normal subjects revealed large regional variations in lung density and fractional blood volume in the supine posture. Extravascular lung density showed a more uniform distribution. The technique has been used to study patients with chronic interstitial pulmonary oedema, pulmonary sarcoidosis and fibrosis, pulmonary arterial hypertension and patients with intracardiac, left-to-right shunt. Tomographic measurements of pulmonary tissue concentration of radionuclides are difficult, since corrections for the blood content and the inflation of the lung must be applied. A simultaneous measurement of lung density and fractional blood volume allows such corrections to be made and the extravascular tracer concentration to be calculated. This has been applied to measurements of the tissue penetration of carbon-11-labelled erythromycin in patients with lobar pneumonia. (author)

Estimation of pulmonary hypertension of congenital heart diseases in children by lung perfusion scintigraphy

International Nuclear Information System (INIS)

Zheng Jinghao; Zhang Shantong; Zeng Jiye; Jia Hongli; Ji Zhiying; Chen Siyi

1993-01-01

The authors report that changes in the distribution of pulmonary perfusion caused by gravitation effect, namely, changes in the total count ratios of the right against the left lung between right and left lateral decubitus positions (rt/lt) could estimate pulmonary hypertension using lung perfusion scintigraphy with 99m Tc-labelled macroaggregated albumin. The results showed: rt/lt was inversely related to mean pulmonary arterial pressure. It is concluded that the method is simple, safe, reproducible, unaffected by cardiac structural abnormality and valuable as a noninvasive approach for the estimation of pulmonary hypertension

Utility of Lung Ultrasound in Near-Drowning Victims

DEFF Research Database (Denmark)

Laursen, Christian Borbjerg; Rømhild Davidsen, Jesper; Madsen, Poul Henning

2013-01-01

ultrasound may have a potential role in the evaluation of drowning or near-drowning victims. In this case report the authors describe a 71-year-old man who was brought to hospital with acute respiratory failure after a near-drowning accident. Lung ultrasound showed multiple B-lines on the anterior......Drowning and near-drowning are common causes of accidental death worldwide and respiratory complications such as non-cardiogenic pulmonary oedema, acute respiratory distress syndrome and pneumonia are often seen. In other settings lung ultrasound can accurately diagnose these conditions; hence lung...... and lateral surfaces of both lungs, consistent with pulmonary oedema. Focus assessed transthoracic echocardiography showed no pericardial effusion and a normal global left ventricular function. Based on these fi ndings the patient was diagnosed as having non-cardiogenic pulmonary oedema. Subsequent chest x...

Management of penetrating heart and accompanying lung injuries

International Nuclear Information System (INIS)

Ekim, H.; Basel, H.; Odabasi, D.; Tuncer, M.; Gumrukcuoglu, H.A.

2010-01-01

Objective: Penetrating heart injury is potentially a life threatening condition due to cardiac tamponade or exsanguinating hemorrhage. The aim of this study was to evaluate victims who were referred to our hospital with penetrating heart and accompanying lung injuries and to review our overall outcome with this type of combined injuries. Methodology: Twenty patients with combined penetrating heart and lung injuries were operated at Yuzuncu Yil University Research Hospital, between May 1999 and January 2010. The diagnosis of combined heart and lung injuries was proved by surgical exploration in all cases. The surgical procedures mainly included the relief of cardiac tamponade, control of bleeding, repair of cardiac and pulmonary lacerations, and coronary artery bypass grafting if required. Results: In this series of 20 patients; there were 18 males and two females between the age of 14 to 60 years, with a mean age of 34.8+-13.5 years. Seventeen victims sustained stab wounds, and the remaining three were injured by a gunshot wounds. In 20 patients there were 22 cardiac chamber injuries. The most commonly injured cardiac chamber was the right ventricle followed by the left ventricle. In addition to the injuries to heart muscle, injuries to the coronary arteries were found in two patients. The most commonly injured lung lobe was the left upper lobe. Conclusion: Our experience shows that early diagnosis and immediate surgical intervention are the main factors affecting patient survival after penetrating heart and lung injuries. Therefore, heart injury should always be kept in mind in victims with penetrating thoracic injuries. (author)

Poster - 48: Clinical assessment of ExacTrac stereoscopic imaging of spine alignment for lung SBRT

International Nuclear Information System (INIS)

Sattarivand, Mike; Summers, Clare; Robar, James

2016-01-01

Purpose: To evaluate the validity of using spine as a surrogate for tumor positioning with ExacTrac stereoscopic imaging in lung stereotactic body radiation therapy (SBRT). Methods: Using the Novalis ExacTrac x-ray system, 39 lung SBRT patients (182 treatments) were aligned before treatment with 6 degrees (6D) of freedom couch (3 translations, 3 rotations) based on spine matching on stereoscopic images. The couch was shifted to treatment isocenter and pre-treatment CBCT was performed based on a soft tissue match around tumor volume. The CBCT data were used to measure residual errors following ExacTrac alignment. The thresholds for re-aligning the patients based on CBCT were 3mm shift or 3° rotation (in any 6D). In order to evaluate the effect of tumor location on residual errors, correlations between tumor distance from spine and individual residual errors were calculated. Results: Residual errors were up to 0.5±2.4mm. Using 3mm/3° thresholds, 80/182 (44%) of the treatments required re-alignment based on CBCT soft tissue matching following ExacTrac spine alignment. Most mismatches were in sup-inf, ant-post, and roll directions which had larger standard deviations. No correlation was found between tumor distance from spine and individual residual errors. Conclusion: ExacTrac stereoscopic imaging offers a quick pre-treatment patient alignment. However, bone matching based on spine is not reliable for aligning lung SBRT patients who require soft tissue image registration from CBCT. Spine can be a poor surrogate for lung SBRT patient alignment even for proximal tumor volumes.

Poster - 48: Clinical assessment of ExacTrac stereoscopic imaging of spine alignment for lung SBRT

Energy Technology Data Exchange (ETDEWEB)

Sattarivand, Mike; Summers, Clare; Robar, James [Nova Scotia Cancer Centre, Nova Scotia Cancer Centre, Nova Scotia Cancer Centre (Canada)

2016-08-15

Purpose: To evaluate the validity of using spine as a surrogate for tumor positioning with ExacTrac stereoscopic imaging in lung stereotactic body radiation therapy (SBRT). Methods: Using the Novalis ExacTrac x-ray system, 39 lung SBRT patients (182 treatments) were aligned before treatment with 6 degrees (6D) of freedom couch (3 translations, 3 rotations) based on spine matching on stereoscopic images. The couch was shifted to treatment isocenter and pre-treatment CBCT was performed based on a soft tissue match around tumor volume. The CBCT data were used to measure residual errors following ExacTrac alignment. The thresholds for re-aligning the patients based on CBCT were 3mm shift or 3° rotation (in any 6D). In order to evaluate the effect of tumor location on residual errors, correlations between tumor distance from spine and individual residual errors were calculated. Results: Residual errors were up to 0.5±2.4mm. Using 3mm/3° thresholds, 80/182 (44%) of the treatments required re-alignment based on CBCT soft tissue matching following ExacTrac spine alignment. Most mismatches were in sup-inf, ant-post, and roll directions which had larger standard deviations. No correlation was found between tumor distance from spine and individual residual errors. Conclusion: ExacTrac stereoscopic imaging offers a quick pre-treatment patient alignment. However, bone matching based on spine is not reliable for aligning lung SBRT patients who require soft tissue image registration from CBCT. Spine can be a poor surrogate for lung SBRT patient alignment even for proximal tumor volumes.

Left atrial thrombus following bilobectomy: a case report

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Kaya Ugur

2010-02-01

Full Text Available Abstract Introduction Left atrial free floating ball thrombus is a relatively rare event, especially without mitral valve disease. Case presentation A 61-year-old Turkish man was admitted to our hospital with a thrombus mass in his left atrium. Five months earlier, he had undergone right bilobectomy and superior bronchoplasty due to squamous cell carcinoma in the lung. The patient had no evidence of cardiac disease except atrial fibrillation and there were no defined embolizations. The thrombus mass was surgically removed. The patient was discharged from hospital on the sixth postoperative day. Conclusion Surgery with cardiopulmonary bypass is a safe method for treatment. The patient should be medicated with warfarin, especially in the presence of atrial fibrillation.

Indirect measurement of lung density and air volume from electrical impedance tomography (EIT) data.

Science.gov (United States)

Nebuya, Satoru; Mills, Gary H; Milnes, Peter; Brown, Brian H

2011-12-01

This paper describes a method for estimating lung density, air volume and changes in fluid content from a non-invasive measurement of the electrical resistivity of the lungs. Resistivity in Ω m was found by fitting measured electrical impedance tomography (EIT) data to a finite difference model of the thorax. Lung density was determined by comparing the resistivity of the lungs, measured at a relatively high frequency, with values predicted from a published model of lung structure. Lung air volume can then be calculated if total lung weight is also known. Temporal changes in lung fluid content will produce proportional changes in lung density. The method was implemented on EIT data, collected using eight electrodes placed in a single plane around the thorax, from 46 adult male subjects and 36 adult female subjects. Mean lung densities (±SD) of 246 ± 67 and 239 ± 64 kg m(-3), respectively, were obtained. In seven adult male subjects estimates of 1.68 ± 0.30, 3.42 ± 0.49 and 4.40 ± 0.53 l in residual volume, functional residual capacity and vital capacity, respectively, were obtained. Sources of error are discussed. It is concluded that absolute differences in lung density of about 30% and changes over time of less than 30% should be detected using the current technology in normal subjects. These changes would result from approximately 300 ml increase in lung fluid. The method proposed could be used for non-invasive monitoring of total lung air and fluid content in normal subjects but needs to be assessed in patients with lung disease.

Logarithmic residues of analytic Banach algebra valued functions possessing a simply meromorphic inverse

NARCIS (Netherlands)

H. Bart (Harm); T. Ehrhardt; B. Silbermann

2001-01-01

textabstractA logarithmic residue is a contour integral of a logarithmic derivative (left or right) of an analytic Banach algebra valued function. For functions possessing a meromorphic inverse with simple poles only, the logarithmic residues are identified as the sums of idempotents. With the help

Ten year regeneration of southern Appalachian hardwood clearcuts after controlling residual trees

Science.gov (United States)

P.M. Zaldivar-Garcia; D.T. Tew

1991-01-01

Two upland hardwood stands were clearcut in 1978 and three treatments to control the unmerchantable and/or cull trees were applied. The treatments applied to the residual trees were chainsaw felling, herbicide injection, and a control, where residual trees were left standing. Regeneration was sampled 10 years after the cutting.

Single-Lung Transplant Results in Position Dependent Changes in Regional Ventilation: An Observational Case Series Using Electrical Impedance Tomography

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Kollengode Ramanathan

2016-01-01

Full Text Available Background. Lung transplantation is the optimal treatment for end stage lung disease. Donor shortage necessitates single-lung transplants (SLT, yet minimal data exists regarding regional ventilation in diseased versus transplanted lung measured by Electrical Impedance Tomography (EIT. Method. We aimed to determine regional ventilation in six SLT outpatients using EIT. We assessed end expiratory volume and tidal volumes. End expiratory lung impedance (EELI and Global Tidal Variation of Impedance were assessed in supine, right lateral, left lateral, sitting, and standing positions in transplanted and diseased lungs. A mixed model with random intercept per subject was used for statistical analysis. Results. EELI was significantly altered between diseased and transplanted lungs whilst lying on right and left side. One patient demonstrated pendelluft between lungs and was therefore excluded for further comparison of tidal variation. Tidal variation was significantly higher in the transplanted lung for the remaining five patients in all positions, except when lying on the right side. Conclusion. Ventilation to transplanted lung is better than diseased lung, especially in lateral positions. Positioning in patients with active unilateral lung pathologies will be implicated. This is the first study demonstrating changes in regional ventilation, associated with changes of position between transplanted and diseased lung.

Collagen crosslink location: a molecular marker for fibrosis in lungs of rats with experimental silicosis

International Nuclear Information System (INIS)

Gerriets, J.E.; Reiser, K.M.; Last, J.A.

1986-01-01

Collagen content is increased in lungs of animals with experimental silicosis. They hypothesize that the collagen deposited in such fibrotic lungs differs structurally from normal lung collagen. Silicotic lung collagen shows an increase in lysine hydroxylation. In addition, the ratio of the difunctional crosslinks DHLNL (dihydroxylysinonorleucine) to HLNL (hydroxylysinonorleucine) is sharply elevated compared to that in control lungs. The peptide α1(I)CB7 x α2(I)CB1 crosslinked by HLNL was demonstrated in NaB 3 H 4 -reduced, CNBr-digested collagen from rat tail tendon by peptide purification, followed by periodate oxidation and amino acid analysis. Further structural analysis of this peptide was obtained by digestion of the crosslinked peptide with trypsin and purification of the tryptic peptide containing this crosslink followed by amino acid analysis. They then examined the analogous collagenous peptide in normal and silicotic lungs and analyzed the crosslink it contained. They observed that DHLNL was present at specific sites previously containing HLNL; that is, the collagen in fibrotic lungs is altered at specific sites by post-translational modification of a lysine residue by hydroxylation in a predictable way. They conclude that such unusual hydroxylation of a specific lysine residue in the α2 chain provides a molecular marker for fibrotic lung collagen

Effect of Solder Flux Residues on Corrosion of Electronics

DEFF Research Database (Denmark)

Hansen, Kirsten Stentoft; Jellesen, Morten Stendahl; Møller, Per

2009-01-01

Flux from ‘No Clean’ solder processes can cause reliability problems in the field due to aggressive residues, which may be electrical conducting or corrosive in humid environments. The solder temperature during a wave solder process is of great importance to the amount of residues left on a PCBA...... testing and use in the field, consequences and recommendations are given. Failures, caused by harsh[1] customer environments, are not covered in this paper....

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

Science.gov (United States)

Lanjewar, Swapnil S; Chhabra, Lovely; Chaubey, Vinod K; Joshi, Saurabh; Kulkarni, Ganesh; Kothagundla, Chandrasekhar; Kaul, Sudesh; Spodick, David H

2013-01-01

The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

The evaluation of the degree of impairment of pulmonary perfusion in lung cancer patients treated by radiotherapy by the quantification of nonuniform distribution of lung perfusion scintigraphy SPECT

International Nuclear Information System (INIS)

Mitomo, Osamu; Tsunoda, Takashi; Kuwabara, Hidemasa

2004-01-01

By means of quantifying the nonuniform distribution of pulmonary perfusion in Lung Perfusion Scintigraphy SPECT (single photon emission tomography), which is called ''SPECT'' for short, we evaluated the degree of functional impairment of pulmonary perfusion in non-operated lung cancer patients treated by the radiotherapy. Sixty-eight patients with non-operated lung cancer treated with radiotherapy, and who either received or did not receive chemotherapy, from February, 1996 to August, 2002, were examined using SPECT within 6 weeks prior to, or within 2 weeks following radiotherapy. This group was called ''irradiated lung cancer patients''. Twenty-six patients, who were called ''follow-up irradiated lung cancer patients'', were reexamined within four weeks after radiotherapy. On the other hand, 323 patients without lung cancer, who were subdivided into four groups; pulmonary, cardiac, cardio-pulmonary, and non-cardiopulmonary. The SPECT was examined in the supine position after infusing Tc-99m-MAA, 185 MBq in a bolus, mainly into an antecubital vein with the patient's arm elevated. From reconstructed SPECT images, the volume of lung as a whole calculated at 10% of thresholds was assumed to be the ''Baseline Lung Perfusion Volume'' (BPV), and the functional volume rates were calculated in 10% threshold widths from 10% to 100% of the threshold. Assuming the total absolute differences in functional volume rate between each subject and the control to be the distribution index of the lung as a whole (D index), we quantified the degree of nonuniform distribution of the lung as a whole in each subject. In the same way, the distribution index of the left or right lung respectively was calculated as D l or D r index assuming the volume of left or right lung were calculated at 10% of the threshold as left or right BPV and calculating the functional volume rates of each lung in 10% threshold widths from 10% to 100% of the threshold. The D index of irradiated lung cancer

DNA quantification of basidiomycetous fungi during storage of logging residues

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Isabella Børja

2015-04-01

Full Text Available The demand for bioenergy caused an increased use of logging residues, branches and treetops that were previously left on the ground after harvesting. Residues are stored outdoors in piles and it is unclear to what extent fungi transform this material. Our objective was to quantify the amount of wood degrading fungi during storage using quantitative real-time PCR (qPCR to detect basidiomycetous DNA in logging residues, a novel approach in this field. We found that the qPCR method was accurate in quantifying the fungal DNA during storage. As the moisture content of the piled logging residues decreased during the storage period, the fungal DNA content also decreased. Scots pine residues contained more fungal DNA than residues from Norway spruce. Loose piles had generally more fungal DNA than bundled ones.

Charred olive stones: experimental and archaeological evidence for recognizing olive processing residues used as fuel

NARCIS (Netherlands)

Braadbaart, Freek; Marinova, E.; Sarpaki, A.

After extracting oil from olives a residue is left usually referred to as the olive oil processing residue (OPR). This study explores the way in which ancient societies may have used OPR as fuel for fires to generate heat and the various issues that are related to the residues of this fuel. After

Utility of lung ultrasound in near-drowning victims.

Science.gov (United States)

Laursen, Christian B; Davidsen, Jesper Rømhild; Madsen, Poul Henning

2012-06-21

Drowning and near-drowning are common causes of accidental death worldwide and respiratory complications such as non-cardiogenic pulmonary oedema, acute respiratory distress syndrome and pneumonia are often seen. In other settings lung ultrasound can accurately diagnose these conditions; hence lung ultrasound may have a potential role in the evaluation of drowning or near-drowning victims. In this case report the authors describe a 71-year-old man who was brought to hospital with acute respiratory failure after a near-drowning accident. Lung ultrasound showed multiple B-lines on the anterior and lateral surfaces of both lungs, consistent with pulmonary oedema. Focus assessed transthoracic echocardiography showed no pericardial effusion and a normal global left ventricular function. Based on these findings the patient was diagnosed as having non-cardiogenic pulmonary oedema. Subsequent chest x-ray showed bilateral infiltrates consistent with pulmonary oedema. The case report emphasises the clinical value of lung ultrasound in the evaluation of a near-drowning victim.

Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis

International Nuclear Information System (INIS)

Martinez, Gonzalo E.; Coursey, Courtney A.; Martinez, Salutario; Dodd, Leslie

2008-01-01

We present the case of a 41-year-old man with known large cell lung cancer who had undergone left pneumonectomy 7 months prior and who presented with a large intramuscular mass involving the posterior left thigh and upper calf. This thigh mass was ultimately surgically explored, and specimens yielded both Escherichia coli organisms and cells reflecting a skeletal muscle metastasis from the patient's known lung cancer. The patient was also found to have a rectal metastasis from his lung cancer. Intramuscular abscesses produced by gastrointestinal tract flora are a well-known presentation of colon cancer. To our knowledge, this is the first case report of the simultaneous occurrence of a skeletal muscle metastasis and an E. coli abscess in the same anatomic location. We believe the patient's rectal metastasis may have been the intermediate step in this process. (orig.)

Thoracic surgery in solving enormous elevation of the left hemidiaphragm

Directory of Open Access Journals (Sweden)

Cvijanović Vlado

2007-01-01

Full Text Available Background. Acquired elevation of the diaphragm is mostly the result of phrenic nerve paralysis, some of thoracic and abdominal patological states, and also some of neuromuscular diseases. Surgical treatment is rarely performed and is indicated when lung compression produces disabilitating dyspnea, and includes plication of diaphragm. The goal of this case report has been to show completely documented diagnostic procedures and surgical treatment one of rare pathological condition. Case report. A 62-year-old patient was admitted to our clinic because of surgical treatment of the enormous elevation of the left hemidiaphragm. After thoracotomy and plication of the bulging diaphragm, lung compression did not exist any more and mediastinum went back in the normal position. Conclusion. Elevation of the diaphragm rarely demands surgical correction. When it is complicated with lung compression and disabilitating dyspnea, surgical treatment has extremely useful functional effect.

4D CT and lung cancer surgical resectability: a technical innovation

International Nuclear Information System (INIS)

Troupis, John M.; Pasricha, Sundeep S.; Narayanan, Harish; Rybicki, Frank J.

2014-01-01

A 74-year-old man presents with a left upper lobe lung adenocarcinoma, which demonstrated a wide base intimately with the aortic arch. We utilised 4D CT technique with a wide field of view CT unit to preoperatively determine likely surgical resectability. We propose that 4D CT may be of use in further investigating lung cancer with likely invasion of adjacent structures.

Long-term local control with radiofrequency ablation or radiotherapy for second, third, and fourth lung tumors after lobectomy for primary lung cancer

International Nuclear Information System (INIS)

Yokouchi, Hideoki; Murata, Kohei; Miyazaki, Masaki; Miyamoto, Takeaki; Minami, Takafumi; Tsuji, Fumio; Mikami, Koji

2016-01-01

A 78-year-old woman developed second, third, and fourth lung tumors at intervals of 1-3 years after left upper lobectomy for primary lung cancer. The tumors were controlled with radiofrequency ablation (RFA) or conventional conformal radiotherapy for 9 years postoperatively. For the treatment of second primary lung cancer or lung metastasis after surgical resection of the primary lung cancer, reoperation is not recommended because of the impaired respiratory reserve. Thus, local therapy such as radiotherapy or RFA is applied in some cases. Among these, stereotactic body radiotherapy (SBRT) is a feasible option because of its good local control and safety, which is comparable with surgery. On the other hand, for cases of multiple lesions that are not suitable for radiotherapy or combination therapy, RFA could be an option because of its short-term local control, easiness, safety, and repeatability. After surgery for primary lung cancer, a second lung tumor could be controlled with highly effective and minimally invasive local therapy if it is recognized as a local disease but is medically inoperable. Therefore, long-term postoperative follow-up for primary lung cancer is beneficial. (author)

Factors influencing the development of lung fibrosis after chemoradiation for small cell carcinoma of the lung: Evidence for inherent interindividual variation

International Nuclear Information System (INIS)

Geara, Fady B.; Komaki, Ritsuko; Tucker, Susan L.; Travis, Elizabeth L.; Cox, James D.

1998-01-01

score residuals were calculated for each patient. The residual for each score is defined as the difference between the observed and expected score based on the dose and treatment schedule received. Average residuals varied significantly among patients (p = 0.005, Kruskal-Willis test). Using a modified version of the PO model, the coefficient of variation in patient heterogeneity was estimated to be 10.1% (95% confidence interval: 6.2-14.9%). Inclusion of the heterogeneity factor, in addition to total dose and fractionation schedule, improved the fit of the PO model to an extremely high level of significance (p -7 ). Conclusions: Our data indicate that the risk and severity of lung fibrosis analyzed radiographically on CT images increases with total dose and with the use of an accelerated radiation schedule, for patients treated with chemoradiation for small-cell lung cancer. There was also demonstrable patient-to-patient heterogeneity, suggesting that the risk of lung fibrosis is strongly affected by inherent factors that vary among individuals

B-lines with Lung Ultrasound: The Optimal Scan Technique at Rest and During Stress.

Science.gov (United States)

Scali, Maria Chiara; Zagatina, Angela; Simova, Iana; Zhuravskaya, Nadezhda; Ciampi, Quirino; Paterni, Marco; Marzilli, Mario; Carpeggiani, Clara; Picano, Eugenio

2017-11-01

Various lung ultrasound (LUS) scanning modalities have been proposed for the detection of B-lines, also referred to as ultrasound lung comets, which are an important indication of extravascular lung water at rest and after exercise stress echo (ESE). The aim of our study was to assess the lung water spatial distribution (comet map) at rest and after ESE. We performed LUS at rest and immediately after semi-supine ESE in 135 patients (45 women, 90 men; age 62 ± 12 y, resting left ventricular ejection fraction = 41 ± 13%) with known or suspected heart failure or coronary artery disease. B-lines were measured by scanning 28 intercostal spaces (ISs) on the antero-lateral chest, 2nd-5th IS, along with the midaxillary (MA), anterior axillary (AA), mid-clavicular (MC) and parasternal (PS) lines. Complete 28-region, 16-region (3rd and 4th IS), 8-region (3rd IS), 4-region (3rd IS, only AA and MA) and 1-region (left 3rd IS, MA) scans were analyzed. In each space, the B-lines were counted from 0 = black lung to 10 = white lung. Interpretable images were obtained in all spaces (feasibility = 100 %). B-lines (>0 in at least 1 space) were present at ESE in 93 patients (69%) and absent in 42. More B-lines were found in the 3rd IS and along AA and MA lines. The B-line cumulative distribution was symmetric at rest (right/left = 1.10) and asymmetric with left lung predominance during stress (right/left = 0.67). The correlation of per-patient B-line number between 28-S and 16-S (R 2  = 0.9478), 8-S (R 2  = 0.9478) and 4-S scan (R 2  = 0.9146) was excellent, but only good with 1-S (R 2  = 0.8101). The average imaging and online analysis time were 5 s per space. In conclusion, during ESE, the comet map of lung water accumulation follows a predictable spatial pattern with wet spots preferentially aligned with the third IS and along the AA and MA lines. The time-saving 4-region scan is especially convenient during stress, simply dismissing dry regions and

Case of a lung mass due to melioidosis in Mexico.

Science.gov (United States)

Truong, Kimberly K; Moghaddam, Samer; Al Saghbini, Samer; Saatian, Bahman

2015-05-06

Melioidosis, an infection caused by the gram-negative bacterium Burkholderia pseudomallei, is an important cause of pneumonia, skin infection, sepsis, and death in Southeast Asia and Australia, but is exceedingly rare in North America. Pulmonary melioidosis typically presents as acute bacterial pneumonia or cavitary lung lesions resembling tuberculosis. We report melioidosis in a 70-year-old active smoker from Mexico with no history of travel to disease-endemic areas. The patient presented with a left supraclavicular abscess and a non-cavitary, left lung mass encasing a pulmonary vein. Incision and drainage of the patient's subcutaneous abscess isolated B. pseudomallei, and fine-needle aspiration of enlarged mediastinal lymph nodes revealed the presence of intracellular gram-negative bacilli with no evidence of malignancy. Biochemical tests determined that the strain the patient acquired from Mexico is identical to only 1 other isolate from Thailand. This report highlights the blurring epidemiological borders of this organism, its rare presentation mimicking lung malignancy, and an aggressive antimicrobial treatment that resulted in resolution of the patient's symptoms.

Clinical value of 201Tl lung/heart ratio during exercise in hypertensive patients with coronary artery disease

International Nuclear Information System (INIS)

Ouyang Wei; He Guorong; Liu Jinhua; Huang Yuying

2002-01-01

Objective: The purpose of the study was to evaluate the relationship between 201 Tl lung/heart ratio during exercise and left ventricular diastolic function and its diagnostic value on severity of coronary artery disease. Methods: One hundred and two patients with documented coronary artery disease were divided into three groups, including no hypertension, hypertension without or with left ventricular hypertrophy groups. Exercise/delay 201 Tl myocardial perfusion tomography was performed on all patients included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results: The lung/heart ratios during exercise in no hypertension (0.43 +- 0.09, P 0.05). The lung/heart ratios of multi-vessel disease subgroup in no hypertension (0.46 +- 0.10 vs 0.40 +- 0.09, P 0.05). When lung/heart ratio was≥0.45, the sensitivities for predicting the presence of multi-vessel disease were 82%, 90%, 40% and specificities were 75%, 75%, 45%, respectively, in no hypertension, hypertension without and with hypertrophy groups. In no hypertension (r=0.402, P 0.05). In no hypertension (r=-0.413, P<0.01), hypertension without (r=-0.662, P<0.01) and with hypertrophy groups (r=-0.408, P<0.05), lung/heart ratios all showed a significant reverse correlation with correspondent E/A ratios. Conclusions: The exercise lung/heart ratios has a better diagnostic value for multi-vessel disease and left ventricular diastolic function abnormalities of coronary artery disease with or without hypertension, but not for multi-vessel disease in hypertension patients complicated with myocardial hypertrophy

Lung inflammatory pseudo tumor

International Nuclear Information System (INIS)

Veliz, Elizabeth; Leone, Gaetano; Cano, Fernando; Sanchez, Jaime

2005-01-01

The inflammatory pseudo tumor is a non neoplastic process characterized by an irregular growth of inflammatory cells. We described the case of a 38 year-old patient, she went to our institute for a in situ cervix cancer and left lung nodule without breathing symptoms; valued by neumology who did bronchoscopy with biopsy whose result was negative for malignancy. She went to surgery in where we find intraparenquima nodule in felt lingula of approximately 4 cms, we remove it; the result was: Inflammatory pseudotumor. This pathology is a not very frequent, it can develop in diverse regions of the organism, it is frequent in lung. The image tests are not specific for the diagnose, which it is possible only with the biopsy. The treatment is the complete resection. (The author)

A simultaneous minimally invasive approach to treat a patient with coronary artery disease and metastatic lung cancer.

Science.gov (United States)

Fu, Yuanhao; Zhang, Lufeng; Ji, Ling; Xu, Chenyang

2016-01-01

Concurrent lung cancer and coronary artery disease requiring treatment with percutaneous coronary intervention or coronary artery bypass grafting is not rare. An individualized perioperative anticoagulation regimen and minimal surgical trauma will benefit the patient's postoperative recovery. We successfully treated a 68-year-old female patient with a lesion in the left anterior descending artery and metastatic right lung carcinoma by simultaneous minimally invasive direct coronary artery bypass grafting via a small left thoracotomy and thoracoscopic wedge resection of the lung lesion. She recovered and was discharged on the eighth postoperative day. The patient showed no symptoms of myocardial ischemia postoperatively. Computed tomography scan did not indicate metastatic lesion of lung carcinoma at 1-year follow-up. In conclusion, minimally invasive direct coronary artery bypass grafting combined with thoracoscopic wedge resection is an effective minimally invasive treatment for concurrent lung cancer and coronary artery disease. This technique eliminates the risk of perioperative bleeding and provides satisfactory mid-term follow-up results.

The effect of minimally invasive surgical repair on the lung volumes of patients with pectus excavatum.

Science.gov (United States)

Sengul, Aysen Taslak; Sahin, Bunyamin; Celenk, Cetin; Basoglu, Ahmet; Sengul, Bilal

2014-04-01

To assess the increase in lung volume after Nuss surgery in patients with pectus excavatum (PE) by using stereological methods and to evaluate the correlation between the lung volume and spirometry findings. Twenty patients, treated for PE between 2008 and 2010, were evaluated prospectively. They underwent preoperative chest radiography, computed thorax tomography (CTT), and spirometry. Thereafter, the Haller index was calculated for each patient. In the third postoperative month, CTT and spirometry were repeated.Lung volumes and volume fractions were evaluated using CTT images, applying the Cavalieri principle for stereological methods. Then the correlation between the pre- and postoperative values of the lung volumes with spirometry findings was determined. Volumes of the right and left lungs were calculated stereologically, using CTT images. Postoperative volume increase of ∼417.6 ± 747.6 mL was detected. The maximum volume increase was observed in the left lung. In the postoperative period, the total volume increase and the volume increase detected in the left lung were found to be statistically significant (p volume in 1 second, and forced expiratory flow 25 to 75% were 0.67, 0.68, and 0.61, respectively; the postoperative r figures were 0.43, 0.42, and 0.35, respectively. Although there was a strong correlation between the preoperative lung volume and spirometry findings (p volume and spirometry findings (p > 0.05). Postoperative pulmonary volume increase occurs in patients with PE after Nuss surgery. However, postoperative spirometry findings may not reflect morphological improvement because pain restricts thoracic movements. Therefore, in patients with PE, quantitative evaluation of the results of surgical repair is possible using the CTT images through a combination of stereological methods. Georg Thieme Verlag KG Stuttgart · New York.

Carcinoembryonic antigen (CEA) as tumor marker in lung cancer

DEFF Research Database (Denmark)

Knudsen, Mie Grunnet; Sorensen, J B

2012-01-01

The use of CEA as a prognostic and predictive marker in patients with lung cancer is widely debated. The aim of this review was to evaluate the results from studies made on this subject. Using the search words "CEA", "tumor markers in lung cancer", "prognostic significance", "diagnostic...... significance" and "predictive significance", a search was carried out on PubMed. Exclusion criteria was articles never published in English, articles before 1981 and articles evaluating tumor markers in lung cancer not involving CEA. Initially 217 articles were found, and 34 were left after selecting those...... relevant for the present study. Four of these included both Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC) patients, and 31 dealt solely with NSCLC patients. Regarding SCLC no studies showed that serum level of CEA was a prognostic marker for overall survival (OS). The use of CEA...

Preemptive hemodynamic intervention restricting the administration of fluids attenuates lung edema progression in oleic acid-induced lung injury.

Science.gov (United States)

Gil Cano, A; Gracia Romero, M; Monge García, M I; Guijo González, P; Ruiz Campos, J

2017-04-01

A study is made of the influence of preemptive hemodynamic intervention restricting fluid administration upon the development of oleic acid-induced lung injury. A randomized in vivo study in rabbits was carried out. University research laboratory. Sixteen anesthetized, mechanically ventilated rabbits. Hemodynamic measurements obtained by transesophageal Doppler signal. Respiratory mechanics computed by a least square fitting method. Lung edema assessed by the ratio of wet weight to dry weight of the right lung. Histological examination of the left lung. Animals were randomly assigned to either the early protective lung strategy (EPLS) (n=8) or the early protective hemodynamic strategy (EPHS) (n=8). In both groups, lung injury was induced by the intravenous infusion of oleic acid (OA) (0.133mlkg -1 h -1 for 2h). At the same time, the EPLS group received 15mlkg -1 h -1 of Ringer lactate solution, while the EPHS group received 30mlkg -1 h -1 . Measurements were obtained at baseline and 1 and 2h after starting OA infusion. After 2h, the cardiac index decreased in the EPLS group (p<0.05), whereas in the EPHS group it remained unchanged. Lung compliance decreased significantly only in the EPHS group (p<0.05). Lung edema was greater in the EPHS group (p<0.05). Histological damage proved similar in both groups (p=0.4). In this experimental model of early lung injury, lung edema progression was attenuated by preemptively restricting the administration of fluids. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

A Rare Large Residual Cyst of the Mandible

Directory of Open Access Journals (Sweden)

Setareh Shojaei

2016-02-01

Full Text Available Introduction: A residual cyst is a periapical cyst persisted after its associated tooth had been extracted. Case Presentation: A 59-year-old Iranian man complaining of a dull pain in his left side of the mandible after falling down one month ago was referred to the department of oral and maxillofacial pathology, Hamadan University of Medical Sciences, Iran. Panoramic film revealed a radiolucent lesion and fracture of the mandible at the right side. An excisional biopsy was obtained. Based on the histopathologic findings, residual cyst was diagnosed. Conclusions: We reported a rare case of large residual cyst. Dental practitioners should consider this lesion in the differential diagnosis of radiolucent lesions of the jaw bone.

Quantification of regional early stage gas exchange changes using hyperpolarized {sup 129}Xe MRI in a rat model of radiation-induced lung injury

Energy Technology Data Exchange (ETDEWEB)

Doganay, Ozkan, E-mail: ozkan.doganay@oncology.ox.ac.uk [Department of Medical Biophysics, Western University, London, Ontario N6A5C1 (Canada); Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A5C1 (Canada); Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford OX3 7DQ (United Kingdom); Stirrat, Elaine [Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8 (Canada); McKenzie, Charles [Department of Medical Biophysics, Western University, London, Ontario N6A5C1 (Canada); Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A5C1 (Canada); Schulte, Rolf F. [General Electric Global Research, Munich 85748 (Germany); Santyr, Giles E. [Department of Medical Biophysics, Western University, London, Ontario N6A5C1 (Canada); Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A5C1 (Canada); Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8 (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G1L7 (Canada)

2016-05-15

Purpose: To assess the feasibility of hyperpolarized (HP) {sup 129}Xe MRI for detection of early stage radiation-induced lung injury (RILI) in a rat model involving unilateral irradiation by assessing differences in gas exchange dynamics between irradiated and unirradiated lungs. Methods: The dynamics of gas exchange between alveolar air space and pulmonary tissue (PT), PT and red blood cells (RBCs) was measured using single-shot spiral iterative decomposition of water and fat with echo asymmetry and least-squares estimation images of the right and left lungs of two age-matched cohorts of Sprague Dawley rats. The first cohort (n = 5) received 18 Gy irradiation to the right lung using a {sup 60}Co source and the second cohort (n = 5) was not irradiated and served as the healthy control. Both groups were imaged two weeks following irradiation when radiation pneumonitis (RP) was expected to be present. The gas exchange data were fit to a theoretical gas exchange model to extract measurements of pulmonary tissue thickness (L{sub PT}) and relative blood volume (V{sub RBC}) from each of the right and left lungs of both cohorts. Following imaging, lung specimens were retrieved and percent tissue area (PTA) was assessed histologically to confirm RP and correlate with MRI measurements. Results: Statistically significant differences in L{sub PT} and V{sub RBC} were observed between the irradiated and non-irradiated cohorts. In particular, L{sub PT} of the right and left lungs was increased approximately 8.2% and 5.0% respectively in the irradiated cohort. Additionally, V{sub RBC} of the right and left lungs was decreased approximately 36.1% and 11.7% respectively for the irradiated cohort compared to the non-irradiated cohort. PTA measurements in both right and left lungs were increased in the irradiated group compared to the non-irradiated cohort for both the left (P < 0.05) and right lungs (P < 0.01) confirming the presence of RP. PTA measurements also correlated with the

Turning into carbonate the residual sodium left in BN-350 circuits may alleviate concerns over their long term safe confinement

International Nuclear Information System (INIS)

Rahmani, L

2000-01-01

After the coolant is drained from the reactor vessel and from the primary and secondary circuits of the BN-350 nuclear power plant, what sodium is left in ponds and films may amount to hundreds of kilograms. For the long term safe storage period which is to follow, preliminary safety analyses (e.g. derived from those made for French sodium cooled reactors) might show that the risks incurred through loss of leaktightness are significant. The ingress of moisture into the circuits would generate, by reaction with the sodium, two undesirable products : sodium hydroxide and hydrogene. Even when considering that water would enter the circuits progressively, so that the heat of the reaction does not give rise to over-pressure, some main risk factors remain. The most promising solution to this challenge appears to be the carbonation of the sodium residues, by progressive diffusion of an appropriate association of carbon dioxyde and water vapour through the inert gaseous medium which fills the circuits. The desired product is porous sodium hydrogenocarbonate

Biological Modeling Based Outcome Analysis (BMOA) in 3D Conformal Radiation Therapy (3DCRT) Treatments for Lung and Breast Cancers

Science.gov (United States)

Pyakuryal, Anil; Chen, Chiu-Hao; Dhungana, Sudarshan

2010-03-01

3DCRT treatments are the most commonly used techniques in the treatment of lung and breast cancers. The purpose of this study was to perform the BMOA of the 3DCRT plans designed for the treatment of breast and lung cancers utilizing HART program (Med. Phys. 36, p.2547(2009)). The BMOA parameters include normal tissue complication probability (NTCP), tumor control probability (TCP), and the complication-free tumor control probability (P+). The 3DCRT plans were designed for (i) the palliative treatment of 8 left lung cancer patients (CPs) at early stage (m=8), (ii) the curative treatment of 8 left lung CPs at stages II and III (k=8), and (iii) the curative treatment of 8 left breast CPs (n=8). The NTCPs were noticeably small (esophagus in lung CPs (k=8). Assessments of the TCPs and P+s also indicated good improvements in local tumor control in all plans. Homogeneous target coverage and improved dose conformality were the major advantages of such techniques in the treatment of breast cancer. These achievements support the efficacy of the 3DCRT techniques for the efficient treatment of various types of cancer.

Heterotopic pancreatic tissue presenting as a solid and cystic lung lesion : A very unusual bronchopulmonary foregut malformation

NARCIS (Netherlands)

De Kruger, RR; Albers, MJIJ; Mooi, WJ; Bogers, J.J.C.

2004-01-01

We describe the history and lung pathology of a premature female infant, who presented with respiratory distress immediately after birth. A thoracic computerized tomography scan showed abnormalities suggestive of congenital cystic adenomatoid malformation of the left lung. In addition,

Prognostic factors of inoperable localized lung cancer treated by high dose radiotherapy

International Nuclear Information System (INIS)

Schaake-Koning, C.S.; Schuster-Uitterhoeve, L.; Hart, G.; Gonzalez, D.G.

1983-01-01

A retrospective study was made of the results of high dose radiotherapy (greater than or equal to 50 Gy) given to 171 patients with inoperable, intrathoracic non small cell lung cancer from January 1971-April 1973. Local control was dependent on the total tumor dose: after one year local control was 63% for patients treated with >65 Gy, the two year local control was 35%. If treated with 2 , the one year local control was 72%; the two year local control was 44%. Local control was also influenced by the performance status, by the localization of the primary tumor in the left upper lobe and in the periphery of the lung. Local control for tumors in the left upper lobe and in the periphery of the lung was about 70% after one year, and about 40% after two years. The one and two years survival results were correlated with the factors influencing local control. The dose factor, the localization factors and the performance influenced local control independently. Tumors localized in the left upper lobe did metastasize less than tumors in the lower lobe, or in a combination of the two. This was not true for the right upper lobe. No correlation between the TNM system, pathology and the prognosis was found

SU-E-T-483: Treatment Planning Study of Volumetric Modulated Arc Therapy for Left-Sided Breast and Chestwall Cancers

Energy Technology Data Exchange (ETDEWEB)

Xu, H [Department of Radiation Oncology, Dalhousie University, Halifax, NS (Canada); Cape Breton Cancer Centre, Sydney, NS (Australia)

2014-06-01

Purpose: To perform the comparison of dose distributions and dosevolume- histograms generated by VMAT and conventional field-in-field technique for left-sided breast and chestwall cancers; to determine whether VMAT offers more dosimetric benefits than does the field-in-field technique. Methods: All VMAT and field-in-filed plans were produced in Eclipse(version 10). Five plans were generated for left-sided breast and leftsided chestwall with supraclavicular nodes, respectively. A clockwise arc (CW) and a counter-clockwise arc (CCW) were used with start and stop angles being 310o±10o and 140o±10o. Collimator angles were 30o for CW and 330o for CCW. The conformity index (CI) is the ratio of V95% over PTV. The homogeneity index (HI) is the ratio of the difference between D2% and D98% over the prescribed dose. The V5, as an indicator of low dose bath to organs-at-risk, was used for ipsilateral lung, heart, contralateral lung, and contralateral breast. The V20, as an indicator of radiation pneumonitis, was used for ipsilateral lung. Results: Breast/chestwall VMAT delivers much higher low dose bath to ipsilateral lung, contralateral lung and contralateral breast/chestwall for both intact breast and chestwall with nodes. V5 for heart is increased in VMAT plans. V20 for ipsilateral lung is lower in VMAT plans. PTV coverage is similar for both techniques. For one particular chestwall patient with supraclavicular and internal mammary nodes, VMAT offers superior dose coverage of PTVs with slightly more low-dose-wash to heart, contralateral lung and contralateral breast. Conclusion: This study indicates that there is generally no benefit using VMAT for left-sided intact breast, due to large low-dose-bath (5Gy) to normal tissues with insignificant improvement in PTV coverage. Dosimetric benefits will be seen in VMAT plans for some chestwall patients with large size, and/or internal mammary nodes, etc. Whether a chestwall patient is treated with VMAT should be carefully

SU-F-T-418: Evaluation of Organs at Risk (OAR) Sparing in Left Breast Irradiation Techniques

Energy Technology Data Exchange (ETDEWEB)

Saini, A [Oviedo, FL (United States); Hwang, C [FLHOSP, Altamonte Springs, Florida (United States); Das, I [Indiana University- School of Medicine, Indianapolis, IN (United States)

2016-06-15

Purpose: To compare dose to organs at risk (OAR) for left sided breast radiation therapy with comparable planning target volume (PTV) coverage in three techniques; free breathing in supine position (FB), deep inspirational breath hold in supine (DIBH) and free breathing in prone position (PP). Methods: Ten left sided breast cancer patients suitable for this study underwent a CT scan in three techniques e.g. supine, FB and DIBH and prone position (PP). One radiation oncologist contoured the PTV and OAR (cardiac components) based on RTOG guidelines. Treatment plans were optimized using field-in-field technique with AAA algorithm. Each plan was optimized to provide identical coverage to PTV such that a reasonable comparison in OAR dosimetry can be evaluated. The prescribed dose to PTV were 42.56 Gy; 2.66 Gy in 16 fractions. Results: Average lung dose parameters; Dmean, V10, V20 and V30 were 0.5 Gy, 0.6%, 0.2%, and 0.1% respectively in PP which is significantly lower than FB (5.9 Gy, 14.2%, 10.7 %, and 8.4%) and DIBH (5.8 Gy, 14.3%, 10.2%, 7.8%). Similarly average heart Dmean, V2.5, V5, V10, and V20 were much lower in PP (1.2Gy, 9.1%, 2.1%, 0.8%, and 0.4%), and in DIBH (1.2 Gy, 10.6%, 1.7%, 0.5%, and 0.1%) compared to FB (2.6 Gy, 21%, 7.2%, 4.4% and 3.3%) respectively. Similar findings were also noted in the heart component left anterior descending artery (LAD) and Left ventricle (LV) which are correlated to radiation related toxicity. Conclusion: Based on the calculated dose, FB technique provides highest heart and lung dose. Prone has lowest lung dose, and DIBH has lowest LAD dose. It is found that PP is always superior for heart, LV, LAD and lung as compared to FB. This conclusion is in contrast to some published study concluding that prone position has no benefit for heart sparing.

Prevalence, Predictors and Clinical Outcome of Residual Pulmonary Hypertension Following Tricuspid Annuloplasty.

Science.gov (United States)

Chen, Yan; Liu, Ju-Hua; Chan, Daniel; Sit, Ko-Yung; Wong, Chun-Ka; Ho, Kar-Lai; Ho, Lai-Ming; Zhen, Zhe; Lam, Yui-Ming; Lau, Chu-Pak; Au, Wing-Kok; Tse, Hung-Fat; Yiu, Kai-Hang

2016-07-22

Tricuspid annuloplasty is increasingly performed during left heart valve surgery, but the long-term clinical outcome postoperatively is not satisfactory. The aim of this study was to determine whether residual pulmonary hypertension (PHT) contributes to the adverse outcome. One-hundred thirty-seven patients (age 61±11 years; men, 30%) who underwent tricuspid annuloplasty during left-side valve surgery were enrolled. The mean pulmonary artery systolic pressure before surgery was 49±13 mm Hg and 32±15 mm Hg following surgery. Patients were divided into 3 groups according to postoperative pulmonary artery systolic pressure: no residual PHT (n=78, 57%), mild residual PHT (n=43, 31%), or significant residual PHT (n=16, 12%). A preoperative larger right ventricular (RV) geometry and tricuspid valve tethering area were associated with mild or significant residual PHT. A total of 24 adverse events (20 heart failures and 4 cardiovascular deaths) occurred during a median follow-up of 25 months. Kaplan-Meier survival curve demonstrated that patients with significant residual PHT had the highest percentage of adverse events followed by those with mild residual PHT. Patients with no residual PHT had a very low risk of adverse events. Multivariable Cox regression analysis revealed that both mild (hazard ratio=4.94; 95% CI =1.34-18.16; P=0.02) and significant residual PHT (hazard ratio=8.67; 95% CI =2.43-30.98; P<0.01) were independent factors associated with adverse events. The present study demonstrated that 43% of patients who underwent tricuspid annuloplasty had residual PHT. The presence of mild or significant residual PHT was associated with adverse events in these patients. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis

Energy Technology Data Exchange (ETDEWEB)

Martinez, Gonzalo E. [Hospital Italiano, Department of Radiology, Cordoba (Argentina); Coursey, Courtney A.; Martinez, Salutario [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Dodd, Leslie [Duke University Medical Center, Department of Pathology, Durham, NC (United States)

2008-08-15

We present the case of a 41-year-old man with known large cell lung cancer who had undergone left pneumonectomy 7 months prior and who presented with a large intramuscular mass involving the posterior left thigh and upper calf. This thigh mass was ultimately surgically explored, and specimens yielded both Escherichia coli organisms and cells reflecting a skeletal muscle metastasis from the patient's known lung cancer. The patient was also found to have a rectal metastasis from his lung cancer. Intramuscular abscesses produced by gastrointestinal tract flora are a well-known presentation of colon cancer. To our knowledge, this is the first case report of the simultaneous occurrence of a skeletal muscle metastasis and an E. coli abscess in the same anatomic location. We believe the patient's rectal metastasis may have been the intermediate step in this process. (orig.)

Quantification of regional early stage gas exchange changes using hyperpolarized "1"2"9Xe MRI in a rat model of radiation-induced lung injury

International Nuclear Information System (INIS)

Doganay, Ozkan; Stirrat, Elaine; McKenzie, Charles; Schulte, Rolf F.; Santyr, Giles E.

2016-01-01

Purpose: To assess the feasibility of hyperpolarized (HP) "1"2"9Xe MRI for detection of early stage radiation-induced lung injury (RILI) in a rat model involving unilateral irradiation by assessing differences in gas exchange dynamics between irradiated and unirradiated lungs. Methods: The dynamics of gas exchange between alveolar air space and pulmonary tissue (PT), PT and red blood cells (RBCs) was measured using single-shot spiral iterative decomposition of water and fat with echo asymmetry and least-squares estimation images of the right and left lungs of two age-matched cohorts of Sprague Dawley rats. The first cohort (n = 5) received 18 Gy irradiation to the right lung using a "6"0Co source and the second cohort (n = 5) was not irradiated and served as the healthy control. Both groups were imaged two weeks following irradiation when radiation pneumonitis (RP) was expected to be present. The gas exchange data were fit to a theoretical gas exchange model to extract measurements of pulmonary tissue thickness (L_P_T) and relative blood volume (V_R_B_C) from each of the right and left lungs of both cohorts. Following imaging, lung specimens were retrieved and percent tissue area (PTA) was assessed histologically to confirm RP and correlate with MRI measurements. Results: Statistically significant differences in L_P_T and V_R_B_C were observed between the irradiated and non-irradiated cohorts. In particular, L_P_T of the right and left lungs was increased approximately 8.2% and 5.0% respectively in the irradiated cohort. Additionally, V_R_B_C of the right and left lungs was decreased approximately 36.1% and 11.7% respectively for the irradiated cohort compared to the non-irradiated cohort. PTA measurements in both right and left lungs were increased in the irradiated group compared to the non-irradiated cohort for both the left (P < 0.05) and right lungs (P < 0.01) confirming the presence of RP. PTA measurements also correlated with the MRI measurements for both

Logarithmic residues and sums of idempotents in the Banach algebra generated by the compact operators and the identity.

NARCIS (Netherlands)

H. Bart (Harm); T. Ehrhardt; B. Silbermann

2001-01-01

textabstractA logarithmic residue is a contour integral of the (left or right) logarithmic derivative of an analytic Banach algebra valued function. Logarithmic residues are intimately related to sums of idempotents. The present paper is concerned with logarithmic residues and sums of idempotents in

Lung and heart dose volume analyses with CT simulator in tangential field irradiation of breast cancer

International Nuclear Information System (INIS)

Das, Indra J.; Cheng, Elizabeth C.; Fowble, Barbara

1997-01-01

Objective: Radiation pneumonitis and cardiac effects are directly related to the irradiated lung and heart volumes in the treatment fields. The central lung distance (CLD) from a tangential breast radiograph is shown to be a significant indicator of ipsilateral irradiated lung volume based on empirically derived functions which accuracy depends on the actual measured volume in treatment position. A simple and accurate linear relationship with CLD and retrospective analysis of the pattern of dose volume of lung and heart is presented with actual volume data from a CT simulator in the treatment of breast cancer. Materials and Methods: The heart and lung volumes in the tangential treatment fields were analyzed in 45 consecutive (22 left and 23 right breast) patients referred for CT simulation of the cone down treatment. All patients in this study were immobilized and placed on an inclined breast board in actual treatment setup. Both arms were stretched over head uniformly to avoid collision with the scanner aperture. Radiopaque marks were placed on the medial and lateral borders of the tangential fields. All patients were scanned in spiral mode with slice width and thickness of 3 mm each, respectively. The lung and heart structures as well as irradiated areas were delineated on each slice and respective volumes were accurately measured. The treatment beam parameters were recorded and the digitally reconstructed radiographs (DRRs) were generated for the CLD and analysis. Results: Table 1 shows the volume statistics of patients in this study. There is a large variation in the lung and heart volumes among patients. Due to differences in the shape of right and left lungs the percent irradiated volume (PIV) are different. The PIV data have shown to correlate with CLD with 2nd and 3rd degree polynomials; however, in this study a simple straight line regression is used to provide better confidence than the higher order polynomial. The regression lines for the left and right

Effect of Hemodialysis on Left and Right Ventricular Volume and Function

International Nuclear Information System (INIS)

Han, Jin Suk; Koh, Chang Soon

1985-01-01

With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

Effect of Hemodialysis on Left and Right Ventricular Volume and Function

Energy Technology Data Exchange (ETDEWEB)

Han, Jin Suk; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1985-09-15

With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

A case of horseshoe lung and complex congenital heart disease in a term newborn

International Nuclear Information System (INIS)

Jeewa, Aamir; Culham, J.A.G.; Human, Derek G.

2010-01-01

We describe and illustrate a rare association of hypoplastic left heart syndrome, absent hilar left pulmonary artery, and an unusual bronchopulmonary malformation. This case highlights the utility of combination imaging of echocardiography and CT angiography in diagnosing a cyanotic newborn with a chest radiograph that is suspicious for lung hypoplasia. (orig.)

A case of horseshoe lung and complex congenital heart disease in a term newborn

Energy Technology Data Exchange (ETDEWEB)

Jeewa, Aamir [British Columbia Children' s Hospital and University of British Columbia, Department of Pediatrics, Division of Cardiology, Vancouver (Canada); Culham, J.A.G. [British Columbia Children' s Hospital, Department of Radiology, Vancouver (Canada); Human, Derek G. [British Columbia Children' s Hospital and University of British Columbia, Department of Pediatrics, Division of Cardiology, Vancouver (Canada); B.C. Children' s Hospital, Children' s Heart Centre, Vancouver (Canada)

2010-02-15

We describe and illustrate a rare association of hypoplastic left heart syndrome, absent hilar left pulmonary artery, and an unusual bronchopulmonary malformation. This case highlights the utility of combination imaging of echocardiography and CT angiography in diagnosing a cyanotic newborn with a chest radiograph that is suspicious for lung hypoplasia. (orig.)

Image-guided radiotherapy for fifty-eight patients with lung cancer

International Nuclear Information System (INIS)

Liang Jun; Zhang Tao; Wang Wenqin

2009-01-01

Objective: To study the value of image-guided radiotherapy (IGRT) in lung cancer. Methods: From Mar. 2007 to Dec. 2007,58 patients with lung cancer were treated with IGRT. Set-up errors in each axial direction was calculated based on IGRT images of each patient. The change of GTV was evaluated on both cone-beam CT and CT simulator images. Results: Twenty-two patients with left lung cancer,30 with right lung cancer, 5 with mediastinal lymphanode metastasis and one with vertebra metastasis were included. The set-up error in x, y and z axes was (0.02±0.26) cm, (0.14±0.49) cm and ( -0.13± 0.27) cm, respectively,while the rotary set-up error in each axis was -0.15 degree ± 1.59 degree, -0.01 degree ± 1.50 degree and 0.12 degree ±1.08 degree, respectively. The set-up errors were significantly decreased by using of IGRT. GTV movement was observed in 15 patients (25.9%) ,including 5 with left upper lung cancer. GTV moving to the anterior direction was observed in 9 patients,including 4 with]eft upper lung cancer. GTV reduced in 23 (44.2%) patients during treatment. Asymmetric GTV reduction of 22 lesions was observed,with a mean reductive volume of 4.9 cm 3 . When GTV began to shrink,the irradiation dose was 4 -46 Gy, with 20 -30 Gy in 9 patients. Conclusions: The use of IGRT can significantly reduce set-up errors. GTV movement and reduction are observed in some cases. The time to modify the target volume needs to be further studied. (authors)

Cognitive and brain structural changes in a lung cancer population.

Science.gov (United States)

Simó, Marta; Root, James C; Vaquero, Lucía; Ripollés, Pablo; Jové, Josep; Ahles, Tim; Navarro, Arturo; Cardenal, Felipe; Bruna, Jordi; Rodríguez-Fornells, Antoni

2015-01-01

No study has examined structural brain changes specifically associated with chemotherapy in a lung cancer population. The aim of this cross-sectional study was to assess differences in brain structure between small-cell lung cancer patients (C+) following chemotherapy, non-small-cell lung cancer patients (C-) before chemotherapy and healthy controls (HC). Twenty-eight small-cell lung cancer patients underwent a neuropsychological assessment and a structural magnetic resonance imaging, including T1-weighted and diffusion tensor imaging to examine gray matter density and white matter (WM) integrity, respectively, 1 month following completion of platinum-based chemotherapy. This group was compared with 20 age and education-matched non-small-cell lung cancer patients before receiving chemotherapy and 20 HC. Both C+ and C- groups exhibited cognitive impairment compared with the HC group. The C+ group performed significantly worse than HC in verbal fluency and visuospatial subtests; C- performed significantly worse than both C+ and HC in verbal memory. Voxel-based morphometry analysis revealed lower gray matter density in the insula and parahippocampal gyrus bilaterally, and left anterior cingulate cortex in C+ compared with HC. Diffusion tensor imaging indices showed focal decreased WM integrity in left cingulum and bilateral inferior longitudinal fasciculus in the C+ group and more widespread decreased integrity in the C- group compared with the HC group. This study demonstrates that lung cancer patients exhibit cognitive impairment before and after chemotherapy. Before the treatment, C- showed verbal memory deficits as well as a widespread WM damage. Following treatment, the C+ group performed exhibited lower visuospatial and verbal fluency abilities, together with structural gray matter and WM differences in bilateral regions integrating the paralimbic system.

Quantification of 99mTc-MIBI lung uptake in myocardial SPECT studies

International Nuclear Information System (INIS)

Qu Wanying; Lu Zhenping; Zhou Ying; He Qin

1996-01-01

To assess the significance of 99m Tc-MIBI lung uptake during myocardial SPECT studies in the evaluation of left ventricular dysfunction. 42 control subjects and 65 patients with coronary artery disease (CAD) were investigated with 99m Tc-MIBI myocardial SPECT and radionuclide ventriculography (RNV) within 1 week. The lung-to-heart ratios (LHR) both at rest and exercise were calculated from the anterior projection of the SPECT image sets. The left ventricular ejection fraction (LVEF) was determined using RNV. In the control group, a significant decrease in LHR was observed during exercise (P<0.01). The CAD group showed significantly high LHR values both at rest and exercise. A negative correlation was observed between LHR values and LVEF at rest (r -0.6234, P<0.001) and exercise (r = -0.6113, P<0.001). LHR both at rest and exercise are significantly correlated with LVEF and may be useful in the evaluation of left ventricular function

Interstitial Lung Disease in a 70-Year-Old Man with Ulcerative Colitis.

Science.gov (United States)

Collins, Hampton W; Frye, Jeanetta W

2018-01-01

Interstitial lung disease is a rare but increasingly recognized extraintestinal manifestation of inflammatory bowel disease that can have devastating consequences if left untreated. We report a case of ulcerative colitis-associated interstitial lung disease presenting with acute hypoxic respiratory failure during an ulcerative colitis flare. Gastroenterologists and pulmonologists should be aware of the numerous bronchopulmonary signs and symptoms that can suggest systemic illness in inflammatory bowel disease.

Production of decellularized porcine lung scaffolds for use in tissue engineering†

Science.gov (United States)

Balestrini, Jenna L.; Gard, Ashley L.; Liu, Angela; Leiby, Katherine L.; Schwan, Jonas; Kunkemoeller, Britta; Calle, Elizabeth A.; Sivarapatna, Amogh; Lin, Tylee; Dimitrievska, Sashka; Cambpella, Stuart G.; Niklason, Laura E.

2015-01-01

There is a growing body of work dedicated to producing acellular lung scaffolds for use in regenerative medicine by decellularizing donor lungs of various species. These scaffolds typically undergo substantial matrix damage due to the harsh conditions required to remove cellular material (e.g., high pH, strong detergents), lengthy processing times, or pre-existing tissue contamination from microbial colonization. In this work, a new decellularization technique is described that maintains the global tissue architecture, key matrix components, mechanical composition and cell-seeding potential of lung tissue while effectively removing resident cellular material. Acellular lung scaffolds were produced from native porcine lungs using a combination of Triton X-100 and sodium deoxycholate (SDC) at low concentrations in 24 hours. We assessed the effect of matrix decellularization by measuring residual PMID:26426090

Relation of exercise capacity with lung volumes before and after 6-minute walk test in subjects with COPD.

Science.gov (United States)

Wibmer, Thomas; Rüdiger, Stefan; Kropf-Sanchen, Cornelia; Stoiber, Kathrin M; Rottbauer, Wolfgang; Schumann, Christian

2014-11-01

There is growing evidence that exercise-induced variation in lung volumes is an important source of ventilatory limitation and is linked to exercise intolerance in COPD. The aim of this study was to compare the correlations of walk distance and lung volumes measured before and after a 6-min walk test (6MWT) in subjects with COPD. Forty-five subjects with stable COPD (mean pre-bronchodilator FEV1: 47 ± 18% predicted) underwent a 6MWT. Body plethysmography was performed immediately pre- and post-6MWT. Correlations were generally stronger between 6-min walk distance and post-6MWT lung volumes than between 6-min walk distance and pre-6MWT lung volumes, except for FEV1. These differences in Pearson correlation coefficients were significant for residual volume expressed as percent of total lung capacity (-0.67 vs -0.58, P = .043), percent of predicted residual volume expressed as percent of total lung capacity (-0.68 vs -0.59, P = .026), inspiratory vital capacity (0.65 vs 0.54, P = .019), percent of predicted inspiratory vital capacity (0.49 vs 0.38, P = .037), and percent of predicted functional residual capacity (-0.62 vs -0.47, P = .023). In subjects with stable COPD, lung volumes measured immediately after 6MWT are more closely related to exercise limitation than baseline lung volumes measured before 6MWT, except for FEV1. Therefore, pulmonary function testing immediately after exercise should be included in future studies on COPD for the assessment of exercise-induced ventilatory constraints to physical performance that cannot be adequately assessed from baseline pulmonary function testing at rest. Copyright © 2014 by Daedalus Enterprises.

Pulmonary vein stenosis after RF ablation diagnosed on a V/Q lung scan - a case study

International Nuclear Information System (INIS)

Edwards, Russell G.

2009-01-01

Full text: A 26-year-old female presented to the emergency department with pleuritic chest pain, acute SOB and raised D-dimer. A PE was suspected and a V/Q lung scan was performed. The initial V/Q lung scan displayed normal ventilation images but reduced perfusion throughout the left lung. Further evaluation was required and a CTPA and repeat perfusion scan were performed. After review of these imaging procedures it was discovered the patient had poor opacification of her left upper pulmonary vein compared to the left lower and right pulmonary veins. Further investigation into the patient's medical history revealed she had undergone radiofrequency ablation for atrial fibrillation 12 months prior. This was significant as it is well documented that a delayed complication of radiofrequency ablation is pulmonary vein stenosis. Although it is rare for the stenosis to be severe enough to cause symptomatic complications from this treatment for atrial fibrillation, it is becoming more widely used and therefore cases are becoming more prevalent. The patient subsequently had a stent inserted into her stenosed pulmonary vein with symptomatic relief.

Crop residue recycling for economic and environmental sustainability: The case of India

Directory of Open Access Journals (Sweden)

Devi Saroj

2017-09-01

Full Text Available India is one of the key producers of food grain, oilseed, sugarcane and other agricultural products. Agricultural crops generate considerable amounts of leftover residues, with increases in food production crop residues also increasing. These leftover residues exhibit not only resource loss but also a missed opportunity to improve a farmer’s income. The use of crop residues in various fields are being explored by researchers across the world in areas such as textile composite non-woven making processes, power generation, biogas production, animal feed, compost and manures, etc. The increasing trend in addition of bio-energy cogeneration plants, increasing demand for animal feedstock and increasing trend for organic agriculture indicates a competitive opportunity forcrop residue in Agriculture. It is to be noted that the use of this left over residue isoften not mutually exclusive which makes measurement of its economic value more difficult.For example, straw can be used as animal bedding and thereafter as a crop fertilizer. In view of this, the main aim of this paper envisaged to know about how much crop residue is left unutilized and how best they can be utilized for alternative purposes for environmental stewardship and sustainability. In this context, an attempt has been made to estimate the total crop residue across the states and its economic value though data available from various government sources and a SWOT analysis performed for possible alternative uses of residue in India. This paper also discusses the successful case studies of India and global level of use of crop residues in economic activities. Over all 516 Mtonnes of crop residue was produced in 2014-15 in India among which cereals were the largest producer of crop residue followed by sugarcane. The energy potential from paddy rice straw crop residue was estimated as 486,955 megawatt for 2014-15 and similarly for coarse cereals it was 226,200megawatt.

U-bearing particles in miners' and millers' lungs

International Nuclear Information System (INIS)

Paschoa, A.S.; Wrenn, M.E.; Singh, N.P.; Miller, S.C.; Jones, K.W.; Cholewa, M.; Hanson, A.L.; Saccomanno, G.

1984-01-01

The size distribution of uranium-bearing particles in air particulates in occupational areas of active uranium mines and mills is largely uninvestigated. Investigation of the size of residual uranium-bearing particles in uranium miners' and millers' lungs is warranted because significant inhalation of uranium can occur in certain occupational areas. Average uranium concentrations of about 0.3 ppM U in uranium miners' and millers' lungs have been reported. Local uranium concentrations in uranium-bearing particles inhaled and regionally deposited in the lungs of uranium miners and millers are orders of magnitude larger than the average uranium concentrations reported. The feasibility of using microPIXE (particle induced x-ray emission) techniques to search for such uranium-bearing particles embedded in lung tissues has been demonstrated. Proton microbeams 20 μm in diameter, scanning in 5 μm steps, were used to irradiate sections of lung tissues 10 to 40 μm thick. The paper will briefly describe the method, and present and discuss the results obtained in an extensive search for uranium-bearing particles embedded in lung tissues, collected at autopsy, of former uranium miners and millers. 13 references, 1 table

Lung assist devices influence cardio-energetic parameters: Numerical simulation study.

Science.gov (United States)

De Lazzari, C; Quatember, B; Recheis, W; Mayr, M; Demertzis, S; Allasia, G; De Rossi, A; Cavoretto, R; Venturino, E; Genuini, I

2015-08-01

We aim at an analysis of the effects mechanical ventilators (MVs) and thoracic artificial lungs (TALs) will have on the cardiovascular system, especially on important quantities, such as left and right ventricular external work (EW), pressure-volume area (PVA) and cardiac mechanical efficiency (CME). Our analyses are based on simulation studies which were carried out by using our CARDIOSIM(©) software simulator. At first, we carried out simulation studies of patients undergoing mechanical ventilation (MV) without a thoracic artificial lung (TAL). Subsequently, we conducted simulation studies of patients who had been provided with a TAL, but did not undergo MV. We aimed at describing the patient's physiological characteristics and their variations with time, such as EW, PVA, CME, cardiac output (CO) and mean pulmonary arterial/venous pressure (PAP/PVP). We were starting with a simulation run under well-defined initial conditions which was followed by simulation runs for a wide range of mean intrathoracic pressure settings. Our simulations of MV without TAL showed that for mean intrathoracic pressure settings from negative (-4 mmHg) to positive (+5 mmHg) values, the left and right ventricular EW and PVA, right ventricular CME and CO decreased, whereas left ventricular CME and the PAP increased. The simulation studies of patients with a TAL, comprised all the usual TAL arrangements, viz. configurations "in series" and in parallel with the natural lung and, moreover, hybrid configurations. The main objective of the simulation studies was, as before, the assessment of the hemodynamic response to the application of a TAL. We could for instance show that, in case of an "in series" configuration, a reduction (an increase) in left (right) ventricular EW and PVA values occurred, whereas the best performance in terms of CO can be achieved in the case of an in parallel configuration.

Role of metal-induced reactive oxygen species generation in lung ...

Indian Academy of Sciences (India)

Unknown

Inhalation of residual oil fly ash (ROFA) increases pulmonary morbidity in exposed workers. We examined the ... vated levels of ambient air pollutants is associated with increased .... study to assess the role that ROS play in the lung disease.

Important parameters in the detection of left main trunk disease using stress myocardial perfusion imaging

International Nuclear Information System (INIS)

Shiba, Chie; Chikamori, Taishiro; Hida, Satoshi

2009-01-01

We sought noninvasively to diagnose left main trunk (LMT) disease using myocardial perfusion imaging (MPI). Five hundred and eight patients with suspected coronary artery disease (CAD) underwent both stress MPI and coronary angiography. The extent and severity of perfusion abnormalities were assessed using a 20-segment model. In addition, perfusion defects in both left anterior descending and left circumflex arterial territories were defined as a left main (LM) pattern defect, and those in 3-coronary arterial territories as a 3-vessel pattern defect. In 42 patients with LMT disease, a summed stress score (19.4±10.0 vs. 13.5±10.0; p<0.0001) and a summed rest score (12.1±9.7 vs. 7.0±7.8; p=0.002) were greater than in 466 patients without LMT disease, while a summed difference score was similar (7.3±7.7 vs. 6.5±6.1; p=NS). The prevalence of an LM-pattern defect was low in both groups (12% vs. 8%; p=NS). However, a 3-vessel pattern defect (33% vs. 7%; p<0.0001), lung uptake of radiotracers (38% vs. 11%; p<0.0001), and transient ischemic dilation (31% vs. 13%; p=0.003) were more frequently observed in patients with LMT disease than in those without. Logistic regression analysis showed that a 3-vessel pattern defect (odds ratio (OR)=3.5, 95% confidence interval (CI)=1.4-8.8; p=0.007), lung uptake of radiotracers (OR=2.5, 95% CI=1.1-5.7; p=0.03), and previous myocardial infarction (MI) (OR=2.4, 95% CI=1.0-5.7; p=0.05) were the most important parameters to detect LMT disease. After excluding 163 patients with previous MI, a repeat analysis revealed that lung uptake of radiotracers (OR=8.2, 95% CI=2.3-29.2; p=0.001) and an LM-pattern defect (OR=6.3, 95% CI=1.4-27.2; p<0.02) were independent predictors for LMT disease. In the identification of LMT disease, lung uptake of radiotracers was a single best parameter, which was independent of the presence or absence of previous MI. (author)

Diffusing capacity for lung carbon monoxide (dlco) in chemical lung injuries due to the use of mustard gas in the poisoned soldiers of Iran-Iraq war 2006

International Nuclear Information System (INIS)

Rouhi, H.; Ganji, F.

2010-01-01

To assess the Mustard gas exposure effects on pulmonary system, particularly on diffusing capacity for lung carbon monoxide (DLCO) and simple spirometry. Sixty-five sulfur mustard- poisoned soldiers from Mostazafan and Janbazan organization were referred to our center in 2005. Complete history, physical examination, chest X ray, Echocardiography, Arterial blood gas, high - resolution computerized tomography, diffusion capacity for lung carbon monoxide and spirometry of these were performed and compared this result with normal value. The mean value of indices in studied injured subjects was: Spirometry: forced expiratory volume in one second (FEV1) = 70.4, Forced vital capacity (FVC) = 66.5, EFE 25-75=81.1, FEV1/FVC=101.9, Flow 25% = 28.7, Flow 50%= 72.9, Flow 75%= 100.1, Sample volume: Functional residual capacity of lungs (FRC) = 131.5, residual volume (RV) = 157.3, RV/TLC= 169.1, Total lung capacity (TLC) = 91.3, KCO= 131.6, TLCO= 116.3. No significant correlation was observed between TLCO values with HRCT, echocardiography, ABG and spirometry values (P>0.05). We recommend TLCO and RV/TLV tests to assess severity of Injuries as there is no a suitable criterion to measure the real consequences of mustard gas on affected combatants. and Biological markers are also needed to determine cause effect relations. (author)

Prospective longitudinal evaluation of lung function during the first year of life after extracorporeal membrane oxygenation.

Science.gov (United States)

Hofhuis, Ward; Hanekamp, Manon N; Ijsselstijn, Hanneke; Nieuwhof, Eveline M; Hop, Wim C J; Tibboel, Dick; de Jongste, Johan C; Merkus, Peter J F M

2011-03-01

To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation are lacking. Prospective longitudinal cohort study. Outpatient clinic of a tertiary level pediatric hospital. The cohort consisted of 64 infants; 33 received extracorporeal membrane oxygenation for meconium aspiration syndrome, 14 for congenital diaphragmatic hernia, four for sepsis, six for persistent pulmonary hypertension of the neonate, and seven for respiratory distress syndrome of infancy. Evaluation was at 6 mos and 12 mos; 39 infants were evaluated at both time points . None. Functional residual capacity and forced expiratory flow at functional residual capacity were measured and expressed as z score. Mean (sem) functional residual capacities in z score were 0.0 (0.2) and 0.2 (0.2) at 6 mos and 12 mos, respectively. Mean (sem) forced expiratory flow was significantly below average (z score = 0) (p capacity significantly above normal: mean (sem) z score = 1.2 (0.5). Infants treated with extracorporeal membrane oxygenation have normal lung volumes and stable forced expiratory flows within normal range, although below average, within the first year of life. There is reason to believe, therefore, that extracorporeal membrane oxygenation either ameliorates the harmful effects of mechanical ventilation or somehow preserves lung function in the very ill neonate.

Comparison of aerosol inhalation lung images using BARC and other nebulizers

International Nuclear Information System (INIS)

Isawa, Toyoharu; Teshima, Takeo; Anazawa, Yoshiki; Miki, Makoto

1994-01-01

Various factors determine the site of inhaled aerosol deposition in the lungs. They are the size of aerosol the composition of carrier gas of the aerosol, the airflow rate, physico-chemical properties of the carrier gas or the aerosol, the shape and structure of the airways, and the body position during inhalation. Aerosol inhalation lung images were obtained in the same subjects using 99m Tc-human serum albumin aerosol generated by 3 different aerosol generators each producing different-sized aerosol and 2 or 3 days apart from each study. The size of aerosol produced by an ultrasonic nebulizer (Mistogen) was 1.93 Micron in activity median aerodynamic diameter (AMAD) with its geometric standard deviation (σg) of 1.73, that by a jet nebulizer (Ultra Vent) was 1.04 micron in AMAD with its σg of 1.71, and that by our BARC nebulizer, a type of a jet nebulizer, was 0.84 micron in AMAD with its σg of 1.73. In addition Technegas was also applied to selected patients. The latter produced aerosol of less than 0.2 micron in size at the largest and the majority, say, 95% or more of the generated aerosol was less than 0.1 micron in size by electron Microscopy. Each subject inhaled aerosol in resting tidal breathing through a mouth-piece with a one way double J valve with the nose clipped in the sitting position. After inhaling approximately 2-3 mCi (74 to 111 MBq) in the thorax, four view lung images were taken: anterior, posterior, and right and left laterals. 300 K counts per view were collected. They were not only pictured on polaroid films as analogue data but also recorded and stored in a computer as digital data. In case of Technegas breathing it for the RV (residual volume) to the TLC (total lung capacity) level followed by breath-holding for 5 to 10 sec in duration was repeated 2 to 3 times as a breathing maneuver instead of tidal breathing. Otherwise deposition efficiency of Technegas is very little because of the small size of the Technegas. Representative 10

Anterior subcarinal node dissection on the left side using video thoracoscopy: an easier technique.

Science.gov (United States)

Baste, Jean-Marc; Haddad, Laura; Melki, Jean; Peillon, Christophe

2015-04-01

Lobectomy for lung carcinoma is usually associated with complete node dissection, but it is often difficult to perform using video thoracoscopy, especially on the left side. In this case, our team uses an anterior technique for subcarinal lymphadenectomy. After left lobectomy, we lift the bronchial stump by its anterior face to open and dissect the subcarinal space. Exposure is difficult using the more usual technique of posterior subcarinal lymphadenectomy, and the different techniques (often requiring retractors) remain complex because some vessels might be injured. We recommend using anterior lymphadenectomy, which should facilitate video thoracoscopy for lymphadenectomy on the left side. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation : Is IMRT more beneficial than VMAT?

Science.gov (United States)

Sakka, Mazen; Kunzelmann, Leonie; Metzger, Martin; Grabenbauer, Gerhard G

2017-10-01

Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

[A case of pulmonary malignant melanoma mimicking lung abscess].

Science.gov (United States)

Mochizuki, Hideaki; Chikui, Emiko; Tokumaru, Aya; Kato, Takayuki; Arai, Tomio; Takahashi, Hideki

2011-06-01

An 84-year-old man was admitted with paresis of the right lower limb. Hemorrhagic lesions were demonstrated in the left frontoparietal lobe and cerebellum by cranial computed tomography (CT) and magnetic resonance imaging (MRI). Chest CT revealed an ill-defined mass measuring 4 x 6 cm in the left lower lobe of the lung, although bronchoscopic examination failed to obtain pathological diagnosis. Clinical diagnosis of primary lung cancer with multiple brain metastases was made, and he underwent whole brain radiotherapy. The pulmonary and cerebral lesions mimicked abscesses during his clinical course, and he died of respiratory failure due to bilateral pneumonia three months after admission. Autopsy revealed that both the pulmonary and brain lesions were malignant melanomas, but no other melanoma lesions could be identified despite meticulous investigation. Although malignant melanoma with an unknown primary site is rare in Japan, careful evaluation of the CT and MRI findings might be the key to correct diagnosis in this case.

Production of decellularized porcine lung scaffolds for use in tissue engineering.

Science.gov (United States)

Balestrini, Jenna L; Gard, Ashley L; Liu, Angela; Leiby, Katherine L; Schwan, Jonas; Kunkemoeller, Britta; Calle, Elizabeth A; Sivarapatna, Amogh; Lin, Tylee; Dimitrievska, Sashka; Cambpell, Stuart G; Niklason, Laura E

2015-12-01

There is a growing body of work dedicated to producing acellular lung scaffolds for use in regenerative medicine by decellularizing donor lungs of various species. These scaffolds typically undergo substantial matrix damage due to the harsh conditions required to remove cellular material (e.g., high pH, strong detergents), lengthy processing times, or pre-existing tissue contamination from microbial colonization. In this work, a new decellularization technique is described that maintains the global tissue architecture, key matrix components, mechanical composition and cell-seeding potential of lung tissue while effectively removing resident cellular material. Acellular lung scaffolds were produced from native porcine lungs using a combination of Triton X-100 and sodium deoxycholate (SDC) at low concentrations in 24 hours. We assessed the effect of matrix decellularization by measuring residual DNA, biochemical composition, mechanical characteristics, tissue architecture, and recellularization capacity.

A case of rectal cancer successfully treated with surgery and stereotactic radiotherapy for metachronous lung metastases

International Nuclear Information System (INIS)

Oshima, Yu; Hosoda, Yohei; Tachi, Hidekazu

2016-01-01

A 64-year-old woman underwent polypectomy for a rectal polyp (Isp). Pathological findings were invasion of the submucosa (3,500 μm diameter), and she underwent anterior resection for rectal cancer (RS, pT1b, pN0, cM0, Stage I ) without adjuvant chemotherapy. Lung masses were found in her right (8 mm) and left lung (7 mm). The tumors enlarged during the 4 month follow-up period. We decided to perform left partial pneumonectomy. The tumor was diagnosed as a lung metastasis from colon cancer by pathology. Because the right tumor was located towards the center, performing right pneumonectomy would have been quite invasive and we feared occult metastases. We decided to apply SRT (50 Gy) to the right tumor. The tumor shrunk and became a scar after treatment. There were no complications such as radiation pneumonitis. The patient was in good health without any recurrence for 12 months after SRT. Surgical resection is an optimal method to control lung metastasis from colon cancer if the lesion is operable. However, in the case of a tumor centrally located, surgical resection may cause deterioration of lung function. There are also cases with contraindications for surgery due to co-morbidities. In addition, there is no consensus on observation periods to exclude occult metastases. SRT can be an effective treatment for lung metastases from colon cancer when there are bilateral lung metastases and no metastases outside the lungs. (author)

A new approach to assess COPD by identifying lung function break-points

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Eriksson G

2015-10-01

Full Text Available Göran Eriksson,1,* Linnea Jarenbäck,1,* Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson11Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden*These authors contributed equally to this workPurpose: COPD is a progressive disease, which can take different routes, leading to great heterogeneity. The aim of the post-hoc analysis reported here was to perform continuous analyses of advanced lung function measurements, using linear and nonlinear regressions.Patients and methods: Fifty-one COPD patients with mild to very severe disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Stages I–IV and 41 healthy smokers were investigated post-bronchodilation by flow-volume spirometry, body plethysmography, diffusion capacity testing, and impulse oscillometry. The relationship between COPD severity, based on forced expiratory volume in 1 second (FEV1, and different lung function parameters was analyzed by flexible nonparametric method, linear regression, and segmented linear regression with break-points.Results: Most lung function parameters were nonlinear in relation to spirometric severity. Parameters related to volume (residual volume, functional residual capacity, total lung capacity, diffusion capacity [diffusion capacity of the lung for carbon monoxide], diffusion capacity of the lung for carbon monoxide/alveolar volume and reactance (reactance area and reactance at 5Hz were segmented with break-points at 60%–70% of FEV1. FEV1/forced vital capacity (FVC and resonance frequency had break-points around 80% of FEV1, while many resistance parameters had break-points below 40%. The slopes in percent predicted differed; resistance at 5 Hz minus resistance at 20 Hz had a linear slope change of -5.3 per unit FEV1, while residual volume had no slope change above and -3.3 change per unit FEV1 below its break-point of 61

BULLOUS DEGENERATION OF THE LEFT LOWER LOBE IN A HEROIN-ADDICT

NARCIS (Netherlands)

SMEENK, FWJM; SERLIE, J; VANDERJAGT, EJ; POSTMUS, PE

1990-01-01

A 34 yr old heroin addict was referred because of chest pain caused by air-trapping in a bulla in the left lower lobe. There was a marked difference between the functional residual capacity measured by body-plethysmography and helium dilution. A slow wash-in and wash-out were demonstrated by

Residual neurovascular function and retinotopy in a case of hemianopia

DEFF Research Database (Denmark)

Ho, Yi-Ching; Cheze, Amandine; Sitoh, Yih-Yian

2009-01-01

INTRODUCTION: For occipital cortex strokes resulting in vision disorders, questions about the viability of residual visual cortex remain. CLINICAL PICTURE: In a patient with a one-year-old, left, complete, homonymous hemianopia due to a right, posterior cerebral artery, ischaemic infarct, we...

CT evaluation of decrease in attenuation in the superior segment of the left lower lobe

International Nuclear Information System (INIS)

Inaoka, Tsutomu; Takahashi, Koji; Ono, Hidetoshi

2003-01-01

We occasionally see decrease in attenuation in the superior segment of the left lower lobe on normal chest CT and notice that this finding could be seen in elder population. Then, we assessed the frequency, age distribution and cause of decrease in attenuation in the superior segment of the left lower lobe. Chest CT scans of 246 patients without lung or cardiac disorders were retrospectively reviewed. Segmental low attenuation area in the superior segment of the left lower lobe was identified in 12 patients (4.9%), which were 65-92 years old with mean age of 77.2 years old. In all of them, chest CT demonstrated that the tortuous descending aorta compressed directly the superior segmental bronchus of the left lower lobe. It is concluded that the lateral tortuousity of the descending aorta could cause decrease in attenuation in the superior segment of the left lower lobe. (author)

Influence of lavage therapy on the distribution patterns of inhaled, relatively insoluble particles in the lung

International Nuclear Information System (INIS)

Snipes, M.B.; Runkle, G.E.; Muggenburg, B.A.

1977-01-01

Four Beagle dogs were exposed by inhalation to a polydisperse fused aluminosilicate aerosol labeled with 147 Pm and 169 Yb. The left or right lung of each dog was lavaged one or five times to remove a portion of the lung burden. Autoradiographic and computer techniques were combined to determine the dispersion pattern of radioactive particles still in the lung after lavage therapy. For all four dogs the dispersion pattern of particles in the lung was the same for the lavaged and non-lavaged lung lobes. Examination of the autoradiograms indicated that lavage therapy did not preferentially remove particles from some areas of the lung. The similarity of particle dispersion patterns suggests that a minimal relocation of particles in lung results from lavage therapy

Left ventricular aneurysm in short axis: a comparison of magnetic resonance, ultrasound and thallium-201 SPECT images

International Nuclear Information System (INIS)

Ahmad, M.; Johnson, R.F. Jr.; Fawcett, H.D.; Schreiber, M.H.

1987-01-01

Short axis magnetic resonance images of a left ventricular aneurysm were compared to similar views obtained by echocardiography and by thallium-201 single photon emission computed tomography. Images of the dyskinetic left ventricular apex and the contractile left ventricular base were analyzed and compared. Unlike the previously reported orthogonal plane magnetic resonance images, short axis imaging provided representative and quantitative information in views comparable to those obtained by standard noninvasive imaging techniques. These data indicate that short axis magnetic resonance imaging is capable of identifying and sizing the aneurysmal and the residual segments of the left ventricle. The findings may be of prognostic value in patients with left ventricular aneurysm

Emphysema Is Common in Lungs of Cystic Fibrosis Lung Transplantation Patients: A Histopathological and Computed Tomography Study.

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Onno M Mets

Full Text Available Lung disease in cystic fibrosis (CF involves excessive inflammation, repetitive infections and development of bronchiectasis. Recently, literature on emphysema in CF has emerged, which might become an increasingly important disease component due to the increased life expectancy. The purpose of this study was to assess the presence and extent of emphysema in endstage CF lungs.In explanted lungs of 20 CF patients emphysema was semi-quantitatively assessed on histology specimens. Also, emphysema was automatically quantified on pre-transplantation computed tomography (CT using the percentage of voxels below -950 Houndfield Units and was visually scored on CT. The relation between emphysema extent, pre-transplantation lung function and age was determined.All CF patients showed emphysema on histological examination: 3/20 (15% showed mild, 15/20 (75% moderate and 2/20 (10% severe emphysema, defined as 0-20% emphysema, 20-50% emphysema and >50% emphysema in residual lung tissue, respectively. Visually upper lobe bullous emphysema was identified in 13/20 and more diffuse non-bullous emphysema in 18/20. Histology showed a significant correlation to quantified CT emphysema (p = 0.03 and visual emphysema score (p = 0.001. CT and visual emphysema extent were positively correlated with age (p = 0.045 and p = 0.04, respectively.In conclusion, this study both pathologically and radiologically confirms that emphysema is common in end-stage CF lungs, and is age related. Emphysema might become an increasingly important disease component in the aging CF population.

Validating excised rodent lungs for functional hyperpolarized xenon-129 MRI.

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David M L Lilburn

Full Text Available Ex vivo rodent lung models are explored for physiological measurements of respiratory function with hyperpolarized (hp (129Xe MRI. It is shown that excised lung models allow for simplification of the technical challenges involved and provide valuable physiological insights that are not feasible using in vivo MRI protocols. A custom designed breathing apparatus enables MR images of gas distribution on increasing ventilation volumes of actively inhaled hp (129Xe. Straightforward hp (129Xe MRI protocols provide residual lung volume (RV data and permit for spatially resolved tracking of small hp (129Xe probe volumes during the inhalation cycle. Hp (129Xe MRI of lung function in the excised organ demonstrates the persistence of post mortem airway responsiveness to intravenous methacholine challenges. The presented methodology enables physiology of lung function in health and disease without additional regulatory approval requirements and reduces the technical and logistical challenges with hp gas MRI experiments. The post mortem lung functional data can augment histological measurements and should be of interest for drug development studies.

Lung volumes and maximal respiratory pressures in collegiate swimmers and runners.

Science.gov (United States)

Cordain, L; Tucker, A; Moon, D; Stager, J M

1990-03-01

To determine whether respiratory muscle strength is related to pulmonary volume differences in athletes and nonathletes, 11 intercollegiate female swimmers, 11 female cross-country runners, and two nonathletic control groups, matched to the athletes in height and age, were evaluated for pulmonary parameters including maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax). Swimmers exhibited larger (p less than .05) vital capacities (VC), residual lung volumes (RV), inspiratory capacities (IC), and functional residual capacities (FRC) than both the runners or the controls but no difference (p greater than .05) in either PImax or inspiratory flow (FIV 25%-75%). Timed expiratory volumes (FEV 0.5 and FEV 1.0) were significantly (p less than .05) lower in the swimmers than in the controls. These data suggest that an adaptational growth may be responsible, in part, for the augmented static lung volumes demonstrated in swimmers.

[Prediction of the efficiency of endoscopic lung volume reduction by valves in severe emphysema].

Science.gov (United States)

Bocquillon, V; Briault, A; Reymond, E; Arbib, F; Jankowski, A; Ferretti, G; Pison, C

2016-11-01

In severe emphysema, endoscopic lung volume reduction with valves is an alternative to surgery with less morbidity and mortality. In 2015, selection of patients who will respond to this technique is based on emphysema heterogeneity, a complete fissure visible on the CT-scan and absence of collateral ventilation between lobes. Our case report highlights that individualized prediction is possible. A 58-year-old woman had severe, disabling pulmonary emphysema. A high resolution thoracic computed tomography scan showed that the emphysema was heterogeneous, predominantly in the upper lobes, integrity of the left greater fissure and no collateral ventilation with the left lower lobe. A valve was inserted in the left upper lobe bronchus. At one year, clinical and functional benefits were significant with complete atelectasis of the treated lobe. The success of endoscopic lung volume reduction with a valve can be predicted, an example of personalized medicine. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

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Lanjewar SS

2013-11-01

Full Text Available Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick21Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USABackground: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1 were computed and compared between the two subgroups.Results: There was no statistically significant difference in qualitative lung function (FEV1 between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic

Potential Application of Viral Empty Capsids for the Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome

Science.gov (United States)

2017-04-01

concept for the potential value of SV40 VLPs for the treatment of severe sepsis, justifying further studies in large animals under Intensive Care...at this time. These tests are continuing and will be included in the final manuscript. 4. Lung pathology: Fig. 5. Lung histology . The...left lung was fixed following inflation and stained with H&E for histological study. A. Vehicle only control; B. Vehicle-treated and 2CLP-operated

Ultrasound lung comets: new echographic sign of lung interstitial fibrosis in systemic sclerosis

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C. Giacomelli

2011-09-01

Full Text Available Objective: Interstitial lung disease (ILD and pulmonary arterial hypertension (PAH are common complications of systemic sclerosis (SSc. Echocardiography evaluates PAH, and chest sonography detects even mild ILC as ultrasound lung comets (ULC, i.e. multiple comet-tails fanning out from the lung surface and originating from subpleural interlobular septa thickened by fibrosis. Aim: to assess ILaD and PAH by integrated cardiac and chest ultrasound in SSc. Methods: We enrolled 30 consecutive SSc patients (age= 54±13 years, 23 females in the Rheumatology Clinic of Pisa University. In all, we assessed systolic pulmonary arterial pressure (SPAP, from maximal velocity of tricuspid regurgitation flow, and ULC score with chest sonography (summing the number of ULC from each scanning space of anterior and posterior right and left chest, from second to fifth intercostal space. All patients underwent plasma assay for anti-topoisomerase antibodies (anti-Scl70, and antiicentromere associated with development of pulmonary involvement. Twenty-eight patients also underwent high resolution computed tomography, HRCT (from 0= no fibrosis to 3= honey combing. Results: ULC number - but not SPAP - was correlated to HRCT fibrosis and presence Scl-70 antibodies. ULC number was similar in localized or diffuse forms (16±20 vs 21±19, p=ns and was unrelated to SPAP (r=0.216, p=ns. Conclusions: Chest sonography assessment and ULC allow a complete, simple, radiation-free characterization of interstitial lung involvement in SSc - all in one setting and with the same instrument, same transducer and the same sonographer. In particular, ULC number is associated with HRCT evidence of lung fibrosis and presence of Scl-70 antibodies.

Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring.

Science.gov (United States)

Bae, Kyungsoo; Jeon, Kyung Nyeo; Lee, Seung Jun; Kim, Ho Cheol; Ha, Ji Young; Park, Sung Eun; Baek, Hye Jin; Choi, Bo Hwa; Cho, Soo Buem; Moon, Jin Il

2016-11-01

The aim of this study was to determine the relationship between lobar severity of emphysema and lung cancer using automated lobe segmentation and emphysema quantification methods.This study included 78 patients (74 males and 4 females; mean age of 72 years) with the following conditions: pathologically proven lung cancer, available chest computed tomographic (CT) scans for lobe segmentation, and quantitative scoring of emphysema. The relationship between emphysema and lung cancer was analyzed using quantitative emphysema scoring of each pulmonary lobe.The most common location of cancer was the left upper lobe (LUL) (n = 28), followed by the right upper lobe (RUL) (n = 27), left lower lobe (LLL) (n = 13), right lower lobe (RLL) (n = 9), and right middle lobe (RML) (n = 1). Emphysema ratio was the highest in LUL, followed by that in RUL, LLL, RML, and RLL. Multivariate logistic regression analysis revealed that upper lobes (odds ratio: 1.77; 95% confidence interval: 1.01-3.11, P = 0.048) and lobes with emphysema ratio ranked the 1st or the 2nd (odds ratio: 2.48; 95% confidence interval: 1.48-4.15, P emphysema patients, lung cancer has a tendency to develop in lobes with more severe emphysema.

SU-F-T-415: Differences in Lung Sparing in Deep Inspiration Breath-Hold and Free Breathing Breast Plans Calculated in Pinnacle and Monaco

Energy Technology Data Exchange (ETDEWEB)

Saenz, D; Stathakis, S [University of Texas Health Science Center San Antonio, San Antonio, TX (United States)

2016-06-15

Purpose: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle{sup 3}. Methods: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle{sup 3}. Free breathing plans were also created to clinically assure a benefit. Both plans were re-calculated in Monaco to determine if there were any significant differences. The mean heart dose, mean left lung, and mean total lung dose were compared in addition to the V20 for left and both lungs. Dose was calculated as dose to medium as well as dose to water with a statistical precision of 0.7%. Results: Mean lung dose was significantly different (p < 0.003) between the two calculations for both DIBH (11.6% higher in Monaco) and free breathing (14.2% higher in Monaco). V20 was also higher in Monaco (p < 0.05) for DIBH (5.7% higher) and free breathing (4.9% higher). The mean heart dose was not significantly different between the dose calculations for either DIBH or free breathing. Results were no more than 0.1% different when calculated as dose to water. Conclusion: The use of Monte Carlo can provide insight on the lung dose for both free breathing and DIBH techniques for whole breast irradiation. While the sparing (dose reductions with DIBH as compared to free breathing) is equivalent for either planning system, the lung doses themselves are higher when calculated with Monaco.

Involved Node, Site, Field and Residual Volume Radiotherapy for Lymphoma: A Comparison of Organ at Risk Dosimetry and Second Malignancy Risks.

Science.gov (United States)

Murray, L; Sethugavalar, B; Robertshaw, H; Bayman, E; Thomas, E; Gilson, D; Prestwich, R J D

2015-07-01

Recent radiotherapy guidelines for lymphoma have included involved site radiotherapy (ISRT), involved node radiotherapy (INRT) and irradiation of residual volume after full-course chemotherapy. In the absence of late toxicity data, we aim to compare organ at risk (OAR) dose-metrics and calculated second malignancy risks. Fifteen consecutive patients who had received mediastinal radiotherapy were included. Four radiotherapy plans were generated for each patient using a parallel pair photon technique: (i) involved field radiotherapy (IFRT), (ii) ISRT, (iii) INRT, (iv) residual post-chemotherapy volume. The radiotherapy dose was 30 Gy in 15 fractions. The OARs evaluated were: breasts, lungs, thyroid, heart, oesophagus. Relative and absolute second malignancy rates were estimated using the concept of organ equivalent dose. Significance was defined as P risks of second cancers were significantly higher with IFRT compared with ISRT for lung, breast and thyroid; INRT and residual volume resulted in significantly lower relative risks compared with ISRT for lung, breast and thyroid. The median excess absolute risks of second cancers were consistently lowest for the residual technique and highest for IFRT in terms of thyroid, lung and breast cancers. The risk of oesophageal cancer was similar for all four techniques. Overall, the absolute risk of second cancers was very similar for ISRT and INRT. Decreasing treatment volumes from IFRT to ISRT, INRT or residual volume reduces radiation exposure to OARs. Second malignancy modelling suggests that this reduction in treatment volumes will lead to a reduction in absolute excess second malignancy. Little difference was observed in second malignancy risks between ISRT and INRT, supporting the use of ISRT in the absence of a pre-chemotherapy positron emission tomography scan in the radiotherapy treatment position. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

[Henoch-Schönlein Purpura with lung abscess].

Science.gov (United States)

Nakazawa, Junji; Watanabe, Atsushi; Nakajima, Tomohiro; Mishina, Taijiro; Miyajima, Masahiro; Higami, Tetsuya

2013-09-01

A 72-year-old man had underwent left lower lobectomy for squamous cell carcinoma in our hospital in 2008. Postoperative stage was I A (T1N0M0). In 2010, follow-up chest computed tomography (CT) images showed similar cavitary nodules in segments 2 and 8 of the right lung with positive uptake on fluorodeoxyglucose-positron emission tomography (FDG-PET) images. Physical examination, blood tests, and levels of serum tumor markers showed no abnormality. Transbronchial lung biopsy revealed the absence of malignant cells. Segment 8 of the right lower lobe with the nodule was partially resected, and pathological examination demonstrated lung abscess. He was discharged but was hospitalized in another hospital for purpuric rash, fever, and arthralgia. Microscopic albuminuria was noted, and renal biopsy revealed nephritis with immunoglobulin A( IgA)deposition. He was made a diagnosis of Henoch-Schönlein purpura. Oral steroid therapy( prednisolone 60 mg/d) was initiated, resulting in the improvement of symptoms and disapearance of the cavitary nodule in the right lung segment 2.

Radiographic findings of primary lung cancer with delayed detection on chest radiographs

International Nuclear Information System (INIS)

Kim, Young Min; Kim, Jin Hwan; Jung, Bin Young; Jun, Kwang Jin; Jeong, Ki Ho; Kim, Ju Ok; Kim, Sun Young; Yang, Chang Kyu

1999-01-01

To analyze the causes of delayed detection of lung cancer on chest radiographs. We retrospectively reviewed 105 cases in which an initial diagnosis of lung cancer, based on an examination of plain radiographs, had been missed or misinterpreted. All occurred between October 1993 and April 1997. We reviewed the initial chest radiographs and compared the features noted with those seen on later chest radiographs and computed tomographic (CT) images. Undetected lung cancer was identified in 56 patients (56/105, 53.3%) It had been hidden by superimposed structures (41, 73.2%), overlapped by combined benign diseases (12, 21.4%), or the nodules were subtle (3, 5.4%). Of the 41 lung cancers hidden by a superimposed structure, the central type accounted for 29 (70.7%) and the peripheral type for 12 (29.3%). The 29 central type had been hidden by the left hilum (n=15), the right hilum (n=10), the heart (n=3), or a rib (n=1). The twelve peripheral type were hidden by a rib (n=7), the heart (n=2), the diaphragm (n=2), or the left hilum (n=1). Of the 12 lung cancers overlapped by combined benign diseases, pulmonary tuberculosis (n=6), pleural effusion (n=4), congestive heart failure (n=1), and diffuse interstitial lung disease (n=1) were present at the time of interpretation. The misinterpreted lung cancers were identified in 49 patients (49/105, 46.7%) and were seen to be combined with benign disease (16, 32.6%), or as obstructive pneumonia without a central mass (15, 30.6%), air-space consolidation (7, 14.3%), cavity (7, 14.3%), double lesion (2, 4.1%), or young age below 26 years (2,4.1%). Of the 16 lung cancers misinterpreted as combined disease, pulmonary tuberculosis (n=14) and pleural disease (n=2) had been initially diagnosed. Most commonly, lung cancer was missed or misinterpreted because it was hidden by a normal structure or combined with a benign disease. Perceptual errors can be reduced by appropriate techniques and the scrutiny of trouble spots such as the

Successful 1:1 proportion ventilation with a unique device for independent lung ventilation using a double-lumen tube without complications in the supine and lateral decubitus positions. A pilot study.

Directory of Open Access Journals (Sweden)

Michał Kowalczyk

Full Text Available Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics. Secondly- to measure the gas distribution in supine and lateral decubitus position.69 patients who underwent elective thoracic surgery were eligible for the study. During general anaesthesia, after double lumen tube intubation, the aforementioned control system was placed between the anaesthetic machine and the patient. In the supine and lateral decubitus (left/right positions, measurements of conventional and independent (1:1 proportion ventilation were performed separately for each lung, including the following: tidal volume, peak pressure and dynamic compliance.Our results show that conventional ventilation using Robertshaw tube in the supine position directs 47% of the tidal volume to the left lung and 53% to the right lung. Furthermore, in the left lateral position, 44% is directed to the dependent lung and 56% to the non-dependent lung. In the right lateral position, 49% is directed to the dependent lung and 51% to the non-dependent lung. The control system positively affected non-dependent and dependent lung ventilation by delivering equal tidal volumes into both lungs with no adverse effects, regardless of patient's position.We report that gas distribution is uneven during conventional ventilation using Robertshaw tube in the supine and lateral decubitus positions. However, this recently released control system enables precise and safe independent ventilation in the supine and the left and right lateral decubitus

[Detection of metals and metalloids in the lavage fluid of whole-lung lavage of the cases of pneumoconiosis].

Science.gov (United States)

Wen, K; Ding, C G; Chen, G; Ma, G X; Wang, H Q

2017-11-20

Objective: To detect of the components and concentration of the metals and metalloids in the lavage fluid of whole-lung lavage (WLL) of the cases of pneumoconiosis, and analyze the characteristics, and explore the method to sample and process the samples of bronchoalveolar lavage fluid (BAL) . Methods: The samples of urine and serum of three cases of pneumoconiosis were collected before WLL, and the samples of BAL were collected during the WLL from the left and right lungs according to the sequence of four pressured gas flow and five negative pressure drainage. Each of 10ml original samples of WLL was collected firstly, and the left was centrifuged to acquire all the sediment samples and each of 10 ml samples from the centrifuge clear liquids, The components and concentration of the metals and metalloids in the samples were measured by Inductively Coupled Plasma mass spectrometer (ICP-MS) . Results: The average volume of BAL from unilat-eral lung for 3 patients was 10 758.3±1518 ml, and the average recovery rate was 89.7%. The average dry weight of sediment samples of BAL of three cases of pneumoconiosis was 0.292 gram with the right lung sam-ples slightly higher than the left lung samples. The detectable elements from the samples included Barium (Ba) , Strontium (Sr) , Calcium (Ca) , Magnesium (Mg) , Manganum (Mn) , Ferrum (Fe) , Cuprum (Cu) , Zinc (Zn) , Kalium (K) , Natrium (Na) , Selenium (Se) , Silicon (Si) and Uranium (U) . Each of concentration dis-tributions of these elements were not normal. Except for Cuprum, Selenium and Uranium, the concentrations of the other ten elements in the supernatant samples, mixture samples and sediments samples were statistical-ly different with the nonparametric test of Kruskal-Wallis. The concentrations of Natrium, Kalium and Barium in supernatant samples were higher, while the others in precipitation samples were higher. The concentration of elements in the sample from the right lung was slightly higher than that from the

18F-Fluoromisonidazole (FMISO) as a molecular marker of hypoxia in non small cell lung carcinoma (NSCLC)

International Nuclear Information System (INIS)

Pathmaraj, K.; Foo, S.; Sachinidis, J.; Scott, A.M.

2002-01-01

Full text: FMISO is a hypoxic marker with the potential ability to predict tumour resistance to chemoradiation. We present preliminary findings from pilot studies to determine the significance of FMISO Positron Emission Tomography (PET) in NSCLC. We are currently studying 2 cohorts of patients with NSCLC and a case study will be presented from each cohort. Patients in the first cohort have surgically resectable tumours: we aim to evaluate the extent of intratumoural hypoxia preoperatively and then validate and correlate this at a molecular level. Patients in the second cohort have locally advanced disease being treated with radiotherapy and will have pretreatment and sequential FMISO-PET scans. Mr GH, a 51 year old man presented with a suspicious lesion in the right upper lobe of the lung. Biopsy was non diagnostic and a FDG-PET scan showed a hypermetabolic focus in the right upper lobe highly indicative of malignancy. The FMISO-PET scan showed a small hypoxic area in the right upper lobe of the lung. The FDG-PET and FMISO-PET images were coregistered and the hypoxic focus correlated well with the hypermetabolic FDG focus. Wedge resection demonstrated moderately differentiated adenocarcinoma. Mr JS was a 61-year-old male with stage III inoperable NSCLC. CT scan showed extensive disease around the left lung hilum with mediastinal lymphadenopathy. The FDG-PET scan showed metabolic findings consistent with a large necrotic malignancy in the left lung with left hilar and mediastinal nodal involvement. FMISO uptake was observed in the left lung hilum corresponding to the areas of FDG uptake. A subsequent FMISO-PET study midway through his radiotherapy showed decreased tracer concentration in the left hilar region with a suggestion of cystic changes inferiorly to the hilum. To our knowledge, there has been no correlation of FMISO-PET studies with molecular markers of hypoxia. This pilot study will be important in confirming FMISO-PET studies as a feasible non invasive

Association Between Tangential Beam Treatment Parameters and Cardiac Abnormalities After Definitive Radiation Treatment for Left-Sided Breast Cancer

International Nuclear Information System (INIS)

Correa, Candace R.; Das, Indra J.; Litt, Harold I.; Ferrari, Victor; Hwang, W.-T.; Solin, Lawrence J.; Harris, Eleanor E.

2008-01-01

Purpose: To examine the association between radiation treatment (RT) parameters, cardiac diagnostic test abnormalities, and clinical cardiovascular diagnoses among patients with left-sided breast cancer after breast conservation treatment with tangential beam RT. Methods and Materials: The medical records of 416 patients treated between 1977 and 1995 with RT for primary left-sided breast cancer were reviewed for myocardial perfusion imaging and echocardiograms. Sixty-two patients (62/416, 15%) underwent these cardiac diagnostic tests for cardiovascular symptoms and were selected for further study. Central lung distance and maximum heart width and length in the treatment field were determined for each patient. Medical records were reviewed for cardiovascular diagnoses and evaluation of cardiac risk factors. Results: At a median of 12 years post-RT the incidence of cardiac diagnostic test abnormalities among symptomatic left-sided irradiated women was significantly higher than the predicted incidence of cardiovascular disease in the patient population, 6/62 (9%) predicted vs. 24/62 (39%) observed, p 0.001. As compared with patients with normal tests, patients with cardiac diagnostic test abnormalities had a larger median central lung distance (2.6 cm vs. 2.2 cm, p = 0.01). Similarly, patients with vs. without congestive heart failure had a larger median central lung distance (2.8 cm vs. 2.3 cm, p = 0.008). Conclusions: Contemporary RT for early breast cancer may be associated with a small, but potentially avoidable, risk of cardiovascular morbidity that is associated with treatment technique

Regression models for the restricted residual mean life for right-censored and left-truncated data

DEFF Research Database (Denmark)

Cortese, Giuliana; Holmboe, Stine A.; Scheike, Thomas H.

2017-01-01

The hazard ratios resulting from a Cox's regression hazards model are hard to interpret and to be converted into prolonged survival time. As the main goal is often to study survival functions, there is increasing interest in summary measures based on the survival function that are easier to inter......The hazard ratios resulting from a Cox's regression hazards model are hard to interpret and to be converted into prolonged survival time. As the main goal is often to study survival functions, there is increasing interest in summary measures based on the survival function that are easier...... to interpret than the hazard ratio; the residual mean time is an important example of those measures. However, because of the presence of right censoring, the tail of the survival distribution is often difficult to estimate correctly. Therefore, we consider the restricted residual mean time, which represents...... a partial area under the survival function, given any time horizon τ, and is interpreted as the residual life expectancy up to τ of a subject surviving up to time t. We present a class of regression models for this measure, based on weighted estimating equations and inverse probability of censoring weighted...

Measurement of lung volumes : usefulness of spiral CT

International Nuclear Information System (INIS)

Kang, Ho Yeong; Kwak, Byung Kook; Lee, Sang Yoon; Kim, Soo Ran; Lee, Shin Hyung; Lee, Chang Joon; Park, In Won

1996-01-01

To evaluate the usefulness of spiral CT in the measurement of lung volumes. Fifteen healthy volunteers were studied by both spirometer and spiral CT at full inspiration and expiration in order to correlated their results, including total lung capacity (TLC), vital capacity (VC) and residual volume (RV). 3-D images were reconstructed from spiral CT, and we measured lung volumes at a corresponding CT window range ; their volumes were compared with the pulmonary function test (paired t-test). The window range corresponding to TLC was from -1000HU to -150HU (p=0.279, r=0.986), and for VC from -910HU to -800HU (p=0.366, r=0.954) in full-inspiratory CT. The optimal window range for RV in full-expiratory CT was from -1000HU to -450HU (p=0.757, r=0.777), and TLC-VC in full-inspiratory CT was also calculated (p=0.843, r=0.847). Spiral CT at full inspiration can used to lung volumes such as TLC, VC and RV

Comparative modeling and docking studies of p16ink4/Cyclin D1/Rb pathway genes in lung cancer revealed functionally interactive residue of RB1 and its functional partner E2F1

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e Zahra Syeda Naqsh

2013-01-01

Full Text Available Abstract Background Lung cancer is the major cause of mortality worldwide. Major signalling pathways that could play significant role in lung cancer therapy include (1 Growth promoting pathways (Epidermal Growth Factor Receptor/Ras/ PhosphatidylInositol 3-Kinase (2 Growth inhibitory pathways (p53/Rb/P14ARF, STK11 (3 Apoptotic pathways (Bcl-2/Bax/Fas/FasL. Insilico strategy was implemented to solve the mystery behind selected lung cancer pathway by applying comparative modeling and molecular docking studies. Results YASARA [v 12.4.1] was utilized to predict structural models of P16-INK4 and RB1 genes using template 4ELJ-A and 1MX6-B respectively. WHAT CHECK evaluation tool demonstrated overall quality of predicted P16-INK4 and RB1 with Z-score of −0.132 and −0.007 respectively which showed a strong indication of reliable structure prediction. Protein-protein interactions were explored by utilizing STRING server, illustrated that CDK4 and E2F1 showed strong interaction with P16-INK4 and RB1 based on confidence score of 0.999 and 0.999 respectively. In order to facilitate a comprehensive understanding of the complex interactions between candidate genes with their functional interactors, GRAMM-X server was used. Protein-protein docking investigation of P16-INK4 revealed four ionic bonds illustrating Arg47, Arg80,Cys72 and Met1 residues as actively participating in interactions with CDK4 while docking results of RB1 showed four hydrogen bonds involving Glu864, Ser567, Asp36 and Arg861 residues which interact strongly with its respective functional interactor E2F1. Conclusion This research may provide a basis for understanding biological insights of P16-INK4 and RB1 proteins which will be helpful in future to design a suitable drug to inhibit the disease pathogenesis as we have determined the interacting amino acids which can be targeted in order to design a ligand in-vitro to propose a drug for clinical trials. Protein -protein docking of

Plaque-left-behind after brushing: intra-oral reservoir for antibacterial toothpaste ingredients.

Science.gov (United States)

Otten, Marieke P T; Busscher, Henk J; Abbas, Frank; van der Mei, Henny C; van Hoogmoed, Chris G

2012-10-01

Plaque is never fully removed by brushing and may act as a reservoir for antibacterial ingredients, contributing to their substantive action. This study investigates the contribution of plaque-left-behind and saliva towards substantivity of three antibacterial toothpastes versus a control paste without antibacterial claims. First, volunteers brushed 2 weeks with a control or antibacterial toothpaste. Next, plaque and saliva samples were collected 6 and 12 h after brushing and bacterial concentrations and viabilities were measured. The contributions of plaque and saliva towards substantivity were determined by combining control plaques with experimental plaque or saliva samples and subsequently assessing their viabilities. Bacterial compositions in the various plaque and saliva samples were compared using denaturing gradient gel electrophoresis. The viabilities of plaques after brushing with Colgate-Total® and Crest-Pro-Health® were smaller than of control plaques and up to 12 h after brushing with Crest-Pro-Health® plaques still contained effective, residual antibacterial activity against control plaques. No effective, residual antibacterial activity could be measured in saliva samples after brushing. There was no significant difference in bacterial composition of plaque or saliva after brushing with the different toothpastes. Plaque-left-behind after mechanical cleaning contributes to the substantive action of an antibacterial toothpaste containing stannous fluoride (Crest-Pro-Health®). The absorptive capacity of plaque-left-behind after brushing is of utmost clinical importance, since plaque is predominantly left behind in places where its removal and effective killing matter most. Therewith this study demonstrates a clear and new beneficial effect of the use of antibacterial toothpastes.

Usefulness of pulmonary scintigraphy in primary lung cancer patients treated by radiotherapy

International Nuclear Information System (INIS)

Mitomo, Osamu

1994-01-01

To assess the pulmonary function of lung cancer patients treated by radiotherapy, we tried qualitative and semiquantitative analysis of pulmonary scintigrams using 133 Xe and 99m Tc-MAA. Individual scores for ventilation, perfusion and the ventilation-perfusion ratio of tumor-bearing lungs were calculated on the basis of healthy control cases in order to analyze whether, and to what degree, the tumor-bearing lung was functionally impaired. The score was proportional to the severity of impairment, and when the ventilation and perfusion of tumor-bearing lungs had a score of one or greater than one, the tumor-bearing lung was functionally defined as an 'impaired lung'. Impaired lungs were demonstrated in 68% of tumor-bearing lungs. Hilar and left hilar-type cancers, clinically more advanced cancers, patients whose tumors were confirmed by bronchofiberscopy, small-cell and epidermoid cancers, etc., had higher rates of impairment and more severe impairment. Many patients with impaired lungs had a worse prognosis, but patients in whom scintigraphy showed improvement after radiotherapy had a better prognosis. It can be concluded that pulmonary scintigraphy scoring is capable of semiquantitatively indicating the degree of pulmonary impairment and is useful in deciding on a radiotherapeutic plan and predicting the outcome in pre- and post-radiotherapy lung cancer patients. (author)

The irradiation lung volume in tangential fields for the treatment of a breast

International Nuclear Information System (INIS)

Oh, Y. T.; Kim, J. R.; Kang, H. J.; Sohn, J. H.; Kang, S. H.; Chun, M. S.

1997-01-01

Radiation pneumonitis is one of the complications caused by radiation therapy that includes a portion of the lung tissue. The severity of radiation induced pulmonary dysfunction depends on the irradiated lung volume, total dose, dose rate and underlying pulmonary function. The lung volume was measured for 25 patients with breast cancer irradiated with tangential field from Jan. 1995 to Aug. 1996. Parameters that can predict the irradiated lung volume included; (1) the perpendicular distance from the posterior tangential edge to the posterior part of the anterior chest wall at the center of the field (CLD); (2) the maximum perpendicular distance from the posterior tangential field edge to the posterior part of the anterior chest wall (MLD); (3) the greatest perpendicular distance from the posterior tangential edge to the posterior part of anterior chest wall on CT image at the center of the longitudinal field (GPD); (4) the length of the longitudinal field (L). The irradiated lung volume(RV), the entire both lung volume(EV) and the ipsilateral lung volume(IV) were measured using dose volume histogram. The RV is 61-279cc, the RV/EV is 2.9-13.0% and the RV/EN is 4.9-29.6%. The CLD, the MLD and the GPD are 1.9-3.3cm and 1.4-3.1cm respectively. The significant relations between the irradiated lung volume such as RV, RV/EV, RV/IV and parameters such as CLD, MLD, GPD, L, CLD x L, MLD x L and GPD x L are not found with little variances in parameters. The RV/IV of the left breast irradiation is significances. The significant relationship between the irradiated lung volume and predictors is not found with little variation on parameters. The irradiated lung volume in the tangential field is less than 10% of entire lung volume when CLD is less than 3cm. The RV/IV of the left tangential field is larger than that of the right but there was no significant differences in RV/EVs. Symptomatic radiation pneumonitis has not occurred during minimum 6 months follow up. (author)

Bilateral lung masses: The same aetiology?

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C. Damas

2007-03-01

Full Text Available The authors describe the case of a 50 year old woman, smoker, healthy until September 2003 when she presented persistent dry cough, fatigue and weight loss. Chest x-ray showed two lung masses, one in the superior right lobe and the other in the lingula lobe of the left lung.The patient underwent TFNA (transthoracic fine needle aspiration and the cytological result was compatible with small cell lung cancer. Staging procedures identified hepatic lesions, probably secondary. Presence of hepatic metastasis and contralateral lung lesions defined the stage of the disease as disseminate. Chemotherapy with carboplatin and etoposide was started. Six months later the right lesion had decreased but the left lesion had increased. TFNA of this lesion revealed adenocarci-noma. A new treatment was started with vinorelbine and gemcitabine. After four cycles of chemotherapy without any response patient underwent radiotherapy of the left lesion.After 28 months of follow up the patient was asymptomatic and able to manage her normal daily routine. Multiple lung cancers can be considered as synchronous or metachronous, depending on the time of diagnosis. Metachronous lesions are the most frequent (50–70% of all cases and adenocarcinoma the more frequent histological pattern.In this case the disease was at a disseminate stage, which did not suggest a synchronous lung tumour. While the disease was at an advanced stage with poor prognosis at diagnosis, the evolution of the two different lung tumours did not seem to compromise patient's daily routine. Resumo: Os autores descrevem o caso de uma mulher de 50 anos, fumadora. Assintomática até Setembro de 2003, altura em que refere o aparecimento de tosse seca, cansaço e perda de peso. Na radiografia do tórax eram evidentes duas massas, uma no lobo superior direito e outra no lobo lingular. A doente foi submetida a biópsia aspirativa transtorácica e a citologia obtida foi compatível com carcinoma

Comparative study of three different approaches on the estimation of the lung-heart ratio in thallium 201 scintigrams in relation to the extent of coronary artery disease and left ventricular function

International Nuclear Information System (INIS)

Ilmer, B.; Reijs, A.E.M.; Fioretti, P.; Reiber, J.H.C.

1991-01-01

Uptake of thallium 201 ( 201 Tl) in the lungs has been proposed as a measure of left ventricular dysfunction with exercise. To study this hypothesis, we compared the lung/-heart (LH) ratio assessed from anterior planar images (ANT-P), from anterior images obtained during single photon emission tomography (SPET) acquisition (ANT-T) and from short-axis tomographic cross-sections (CS) in early post-exercise thallium 201 scintigrams. The study population consisted of 54 prepercutaneous transluminal coronary angioplasty (PTCA) studies (82% with single-vessel disease), 50 post-PTCA studies, 33 pre-coronary artery bypass surgery (CABG) studies (71% with three-vessel disease), 30 post-CABG studies and 30 patients with a left ventricular dysfunction (LVD) due to an acute myocardial infarction; 18 individuals with a low likelihood of coronary artery disease (CAD) served as a control group. The results demonstrated that, on average, the LH ratios obtained from ANT-P and ANT-T were not significantly different for all study groups; these ratios increased significantly with ischaemia and with LVD relative to non-ischaemic situations. However, the LH ratios in CS did not show a relation with ischaemia nor with LVD and differed significantly from the LH-ratios assessed from the anterior approaches. Each of the three approaches (ANT-P, ANT-T, CS) was characterized by large overlaps of LH ratios for the different study groups. In conclusion, the LH ratio should be determined from ANT-P or ANT-T projection images, not CS. However, due to large overlaps in the measurement data, it is not a clinically useful parameter for the detection of CAD or LVD in the individual patient. (orig.)

Effects of smoking on lung uptake of 201Tl during exercise myocardial perfusion imaging

International Nuclear Information System (INIS)

Ouyang Wei; He Guorong; Liu Jinhua

2004-01-01

Objective: To investigate the influence of smoking on lung uptake of 201 Tl during myocardial perfusion imaging. Methods: Ninety-two healthy subjects, with normal 201 Tl myocardial perfusion imaging findings but no evidence of left ventricular hypertrophy and pulmonary disease, were divided into three groups, smoker, nonsmoker and quitted smoker groups. Exercise/delay 201 Tl myocardial perfusion imaging was performed on all subjects included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results: Both the lung/heart ratios during exercise in smoker (0.40 ± 0.07, F=10.635, P 201 Tl lung/heart ratios in smokers are higher than in nonsmokers and this must be kept in mind when 201 Tl lung/heart ratios are used clinically, even in quitted smokers

The relationships between tracheal index and lung volume parameters in mild-to-moderate COPD

Energy Technology Data Exchange (ETDEWEB)

Eom, Jung Seop, E-mail: ejs00@hanmail.net [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Lee, Geewon, E-mail: rabkingdom@naver.com [Department of Radiology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 602-739 (Korea, Republic of); Lee, Ho Yun, E-mail: hoyunlee96@gmail.com [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Oh, Jin Young, E-mail: indr71@hanmail.net [Division of Pulmonology, Department of Internal Medicine, Dongguk University Ilsan Medical Center, 814 Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-773 (Korea, Republic of); Woo, Sook-young, E-mail: sookyoung12.woo@samsung.com [Biostatistics Team, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Jeon, Kyeongman, E-mail: kjeon@skku.edu [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Um, Sang-Won, E-mail: sangwonum@skku.edu [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Koh, Won-Jung, E-mail: wjkoh@skku.edu [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); Suh, Gee Young, E-mail: suhgy@skku.edu [Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 (Korea, Republic of); and others

2013-12-01

Background: Although elongated morphological changes in the trachea are known to be related to lung function in chronic obstructive pulmonary disease (COPD), whether the tracheal morphological changes are associated with airflow limitations or overinflation of the lung in the early stages of COPD has not yet been determined. Thus, our aim was to investigate the association of tracheal index (TI) with lung function parameters, including lung volume parameters, in COPD patients with mild-to-moderate airflow limitations. Materials and methods: A retrospective study was conducted in 193 COPD patients with GOLD grades 1–2 (post-bronchodilator forced expiratory volume in 1 s [FEV{sub 1}] ≥ 50% predicted with FEV{sub 1}/forced vital capacity ratio ≤ 70%; age range, 40–81) and 193 age- and gender-matched subjects with normal lung function as a control group (age range, 40–82). Two independent observers measured TI at three anatomical levels on chest radiographs and CT scans. Results: Compared with the control group, TI was reduced significantly and “saber-sheath trachea” was observed more frequently in COPD patients. Patients with GOLD grade 2 disease had a lower TI than those with GOLD grade 1. TI had apparent inverse correlations with total lung capacity, functional residual capacity, and residual volume, regardless of the anatomical level of the trachea. Even after adjustments for covariates, this association persisted. Conclusions: TI is reduced even in mild-to-moderate COPD patients, and TI measured on chest CT shows significant inverse relationships with all lung volume parameters assessed, suggesting that tracheal morphology may change during the early stages of COPD.

The relationships between tracheal index and lung volume parameters in mild-to-moderate COPD

International Nuclear Information System (INIS)

Eom, Jung Seop; Lee, Geewon; Lee, Ho Yun; Oh, Jin Young; Woo, Sook-young; Jeon, Kyeongman; Um, Sang-Won; Koh, Won-Jung; Suh, Gee Young

2013-01-01

Background: Although elongated morphological changes in the trachea are known to be related to lung function in chronic obstructive pulmonary disease (COPD), whether the tracheal morphological changes are associated with airflow limitations or overinflation of the lung in the early stages of COPD has not yet been determined. Thus, our aim was to investigate the association of tracheal index (TI) with lung function parameters, including lung volume parameters, in COPD patients with mild-to-moderate airflow limitations. Materials and methods: A retrospective study was conducted in 193 COPD patients with GOLD grades 1–2 (post-bronchodilator forced expiratory volume in 1 s [FEV 1 ] ≥ 50% predicted with FEV 1 /forced vital capacity ratio ≤ 70%; age range, 40–81) and 193 age- and gender-matched subjects with normal lung function as a control group (age range, 40–82). Two independent observers measured TI at three anatomical levels on chest radiographs and CT scans. Results: Compared with the control group, TI was reduced significantly and “saber-sheath trachea” was observed more frequently in COPD patients. Patients with GOLD grade 2 disease had a lower TI than those with GOLD grade 1. TI had apparent inverse correlations with total lung capacity, functional residual capacity, and residual volume, regardless of the anatomical level of the trachea. Even after adjustments for covariates, this association persisted. Conclusions: TI is reduced even in mild-to-moderate COPD patients, and TI measured on chest CT shows significant inverse relationships with all lung volume parameters assessed, suggesting that tracheal morphology may change during the early stages of COPD

A morphological study of bronchi and lung tissues in long-term survived dogs

OpenAIRE

松本, 伸

1984-01-01

Morphological changes of the bronchus and lung tissue of ten adult dogs were examined at various intervals after sleeve resection of the left upper lobe was performed in combination with bronchoplasty and pulmonary artery angioplasty. Postoperative changes in the bronchus and pulmonary artery were investigated by bronchoscopy and pulmonary angiography 8 months to 14 months after the operation. The dogs were sacrificed 9 months to 32 months after the operation, and the bronchus and lung tissue...

Lateral chest radiographic findings in lobar collapse of the left lung : the distance between both upper lobe bronchi

International Nuclear Information System (INIS)

Chin, G. H.; Sung, D. W.; Yoon, Y.; Kim, H. C.

1996-01-01

To evaluate the distance between both upper love bronchi on lateral radiographs and its change in left upper or lower lobe collapse. 144 true lateral radiographs were analyzed on which both upper lobe bronchi were clearly identified. They included 116 normal cases, 11 cases of left upper lobe collapse, 13 of left lower lobe collapse, and 4 cases of left lower lobe lobectomy. Line A was drawn parallel to the vertebral end plate through the upper margin of the lift upper lobe bronchus. Line B was drawn parallel to line A through the upper margin of the right upper love bronchus. The shortest distance between line A and line B was measured as the distance between both upper lobe bronchi. In normal cases, the mean value of the distance was 2.19 cm ± S.D. 0.37 cm on right and on right and 2.16 cm ± S.D. 0.40 cm on left lateral radiographs ; these results were not significantly different(P=0.79). In cases of collapse, the mean value of the distance was 0.43 cm ± S.D. 0.99 cm in upper lobe collapse and 3.56 cm ± S.D. 0.72 cm in lower lobe collapse, results which were significantly different from those of normal cases(p<0.01). In eight cases(73%) of left upper lobe collapse, the distance was less than 1 cm and in 10 cases(77%) of left lower lobe collapse, the distance was more than 3 cm. The distance between both upper lobe bronchi varies markedly in case of lobar collapse. A distance of less than 1 cm suggests collapse of the left upper lobe and a distance more than 3 cm suggests collapse of the left lower lobe

Mucoepidermoid carcinoma of the lung with initial presentation of microangiopathic hemolytic anemia and thrombocytopenia

Directory of Open Access Journals (Sweden)

Yuan-Chun Huang

2017-12-01

Full Text Available Mucoepidermoid carcinoma is a rare entity of lung malignancy that is subclassified into high-grade or low-grade types according to its histological features. High-grade mucoepidermoid carcinoma is a more aggressive form of malignancy, with a tendency towards lymph node involvement and distant metastasis. Cancer-related microangiopathic hemolytic anemia as a less common situation of paraneoplastic syndrome may be encountered with metastatic malignancy, but has not been reported previously in mucoepidermoid carcinoma of the lung. Herein, we report a 78-year-old male patient who presented with hemoptysis for one day. Laboratory tests showed microangiopathic hemolytic anemia and thrombocytopenia. A chest X-ray demonstrated consolidation in the left lung field. Chest computed tomography revealed a mass in the left upper lobe, and a subsequent bronchoscopic biopsy was performed. The histopathological results indicated a high-grade mucoepidermoid carcinoma. Magnetic resonance imaging of the brain demonstrated leptomeningeal carcinomatosis. The patient refused systemic chemotherapy, and palliative radiation therapy only was conducted for local disease control. The patient has performed well for 12 months to date since diagnosis of the tumor.

Lymphatic drainage of lung segments in the visceral pleura: a cadaveric study.

Science.gov (United States)

Fourdrain, Alex; Lafitte, Sophie; Iquille, Jules; De Dominicis, Florence; Havet, Eric; Peltier, Johann; Bagan, Patrick; Berna, Pascal

2018-01-01

Although peribronchial lymphatic drainage of the lung has been well characterized, lymphatic drainage in the visceral pleura is less well understood. The objective of the present study was to evaluate the lymphatic drainage of lung segments in the visceral pleura. Adult, European cadavers were examined. Cadavers with a history of pleural or pulmonary disease were excluded. The cadavers had been refrigerated but not embalmed. The lungs were surgically removed and re-warmed. Blue dye was injected into the subpleural area and into the first draining visceral pleural lymphatic vessel of each lung segment. Twenty-one cadavers (7 males and 14 females; mean age 80.9 years) were dissected an average of 9.8 day postmortem. A total of 380 dye injections (in 95 lobes) were performed. Lymphatic drainage of the visceral pleura followed a segmental pathway in 44.2% of the injections (n = 168) and an intersegmental pathway in 55.8% (n = 212). Drainage was found to be both intersegmental and interlobar in 2.6% of the injections (n = 10). Lymphatic drainage in the visceral pleura followed an intersegmental pathway in 22.8% (n = 13) of right upper lobe injections, 57.9% (n = 22) of right middle lobe injections, 83.3% (n = 75) of right lower lobe injections, 21% (n = 21) of left upper lobe injections, and 85.3% (n = 81) of left lower lobe injections. In the lung, lymphatic drainage in the visceral pleura appears to be more intersegmental than the peribronchial pathway is-especially in the lower lobes. The involvement of intersegmental lymphatic drainage in the visceral pleura should now be evaluated during pulmonary resections (and especially sub-lobar resections) for lung cancer.

Ground reaction forces and knee kinetics during single and repeated badminton lunges.

Science.gov (United States)

Lam, Wing Kai; Ding, Rui; Qu, Yi

2017-03-01

Repeated movement (RM) lunge that frequently executed in badminton might be used for footwear evaluation. This study examined the influence of single movement (SM) and RM lunges on the ground reaction forces (GRFs) and knee kinetics during the braking phase of a badminton lunge step. Thirteen male university badminton players performed left-forward lunges in both SM and RM sessions. Force platform and motion capturing system were used to measure GRFs and knee kinetics variables. Paired t-test was performed to determine any significant differences between SM and RM lunges regarding mean and coefficient of variation (CV) in each variable. The kinetics results indicated that compared to SM lunges, the RM lunges had shorter contact time and generated smaller maximum loading rate of impact force, peak knee anterior-posterior force, and peak knee sagittal moment but generated larger peak horizontal resultant forces (Ps < 0.05). Additionally, the RM lunges had lower CV for peak knee medial-lateral and vertical forces (Ps < 0.05). These results suggested that the RM testing protocols had a distinct loading response and adaptation pattern during lunge and that the RM protocol showed higher within-trial reliability, which may be beneficial for the knee joint loading evaluation under different interventions.

Low cost biological lung volume reduction therapy for advanced emphysema

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Bakeer M

2016-08-01

Full Text Available Mostafa Bakeer,1 Taha Taha Abdelgawad,1 Raed El-Metwaly,1 Ahmed El-Morsi,1 Mohammad Khairy El-Badrawy,1 Solafa El-Sharawy2 1Chest Medicine Department, 2Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt Background: Bronchoscopic lung volume reduction (BLVR, using biological agents, is one of the new alternatives to lung volume reduction surgery.Objectives: To evaluate efficacy and safety of biological BLVR using low cost agents including autologous blood and fibrin glue.Methods: Enrolled patients were divided into two groups: group A (seven patients in which autologous blood was used and group B (eight patients in which fibrin glue was used. The agents were injected through a triple lumen balloon catheter via fiberoptic bronchoscope. Changes in high resolution computerized tomography (HRCT volumetry, pulmonary function tests, symptoms, and exercise capacity were evaluated at 12 weeks postprocedure as well as for complications.Results: In group A, at 12 weeks postprocedure, there was significant improvement in the mean value of HRCT volumetry and residual volume/total lung capacity (% predicted (P-value: <0.001 and 0.038, respectively. In group B, there was significant improvement in the mean value of HRCT volumetry and (residual volume/total lung capacity % predicted (P-value: 0.005 and 0.004, respectively. All patients tolerated the procedure with no mortality.Conclusion: BLVR using autologous blood and locally prepared fibrin glue is a promising method for therapy of advanced emphysema in term of efficacy, safety as well as cost effectiveness. Keywords: BLVR, bronchoscopy, COPD, interventional pulmonology

Comparative Analysis of Processes for Recovery of Rare Earths from Bauxite Residue

Science.gov (United States)

Borra, Chenna Rao; Blanpain, Bart; Pontikes, Yiannis; Binnemans, Koen; Van Gerven, Tom

2016-11-01

Environmental concerns and lack of space suggest that the management of bauxite residue needs to be re-adressed. The utilization of the residue has thus become a topic high on the agenda for both academia and industry, yet, up to date, it is only rarely used. Nonetheless, recovery of rare earth elements (REEs) with or without other metals from bauxite residue, and utilization of the left-over residue in other applications like building materials may be a viable alternative to storage. Hence, different processes developed by the authors for recovery of REEs and other metals from bauxite residue were compared. In this study, preliminary energy and cost analyses were carried out to assess the feasibility of the processes. These analyses show that the combination of alkali roasting-smelting-quenching-leaching is a promising process for the treatment of bauxite residue and that it is justified to study this process at a pilot scale.

Productivity and cost analysis of a mobile pyrolysis system deployed to convert mill residues into biochar

Science.gov (United States)

Woodam Chung; Dongyeob Kim; Nathaniel Anderson

2012-01-01

Forest and mill residues are a promising source of biomass feedstock for the production of bioenergy, biofuels and bioproducts. However, high costs of transportation and handling of feedstock often make utilization of forest residues, such as logging slash, financially unviable. As a result, these materials are often considered waste and left on site to decompose or...

Head and pelvic movement asymmetry during lungeing in horses with symmetrical movement on the straight.

Science.gov (United States)

Rhodin, M; Roepstorff, L; French, A; Keegan, K G; Pfau, T; Egenvall, A

2016-05-01

Lungeing is commonly used as part of standard lameness examinations in horses. Knowledge of how lungeing influences motion symmetry in sound horses is needed. The aim of this study was to objectively evaluate the symmetry of vertical head and pelvic motion during lungeing in a large number of horses with symmetric motion during straight line evaluation. Cross-sectional prospective study. A pool of 201 riding horses, all functioning well and considered sound by their owners, were evaluated in trot on a straight line and during lungeing to the left and right. From this pool, horses with symmetric vertical head and pelvic movement during the straight line trot (n = 94) were retained for analysis. Vertical head and pelvic movements were measured with body mounted uniaxial accelerometers. Differences between vertical maximum and minimum head (HDmax, HDmin) and pelvic (PDmax, PDmin) heights between left and right forelimb and hindlimb stances were compared between straight line trot and lungeing in either direction. Vertical head and pelvic movements during lungeing were more asymmetric than during trot on a straight line. Common asymmetric patterns seen in the head were more upward movement during push-off of the outside forelimb and less downward movement during impact of the inside limb. Common asymmetric patterns seen in the pelvis were less upward movement during push-off of the outside hindlimb and less downward movement of the pelvis during impact of the inside hindlimb. Asymmetric patterns in one lunge direction were frequently not the same as in the opposite direction. Lungeing induces systematic asymmetries in vertical head and pelvic motion patterns in horses that may not be the same in both directions. These asymmetries may mask or mimic fore- or hindlimb lameness. © 2015 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.

Evaluation of right ventricular function for lung transplantation. Role of electron flow scan

International Nuclear Information System (INIS)

Stern, M.; Joint-Lambert, O.; Tainturier, C.; Seigneur, F.; Caubarrere, I.; Hernigou, A.

1994-01-01

Several invasive or not invasive technics were used to evaluate right ventricular insufficiency associated to severe chronic pulmonary insufficiency. But none of them were very accurate and now the use of EBT appears as a real improvement. We performed a prospective study with 50 patients waiting for a lung transplantation and we compared the values of right ventricular function obtained by EBT to those obtained by nuclear medicine and catheterism. Accuracy of EBT for left ventricle evaluation has already been proved. Stroke volumes calculated by EBT in right and left ventricles are similar and this constitutes a good validation of the method for right ventricle evaluation. Correlations with hemodynamic measurements are poor and nuclear medicine technics underestimate the ejection fraction. So, EBT is recommended for right ventricular study before and after lung transplantation. (authors). 11 refs., 4 figs

Assessment of lung function in a large cohort of patients with acromegaly.

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Störmann, Sylvère; Gutt, Bodo; Roemmler-Zehrer, Josefine; Bidlingmaier, Martin; Huber, Rudolf M; Schopohl, Jochen; Angstwurm, Matthias W

2017-07-01

Acromegaly is associated with increased mortality due to respiratory disease. To date, lung function in patients with acromegaly has only been assessed in small studies, with contradicting results. We assessed lung function parameters in a large cohort of patients with acromegaly. Lung function of acromegaly patients was prospectively assessed using spirometry, blood gas analysis and body plethysmography. Biochemical indicators of acromegaly were assessed through measurement of growth hormone and IGF-I levels. This study was performed at the endocrinology outpatient clinic of a tertiary referral center in Germany. We prospectively tested lung function of 109 acromegaly patients (53 male, 56 female; aged 24-82 years; 80 with active acromegaly) without severe acute or chronic pulmonary disease. We compared lung volume, air flow, airway resistance and blood gases to normative data. Acromegaly patients had greater lung volumes (maximal vital capacity, intra-thoracic gas volume and residual volume: P  acromegaly. Female patients had significantly altered lung function in terms of subclinical airway obstruction. In our cross-sectional analysis of lung function in 109 patients with acromegaly, lung volumes were increased compared to healthy controls. Additionally, female patients showed signs of subclinical airway obstruction. There was no difference between patients with active acromegaly compared with patients biochemically in remission. © 2017 European Society of Endocrinology.

Angiogenesis gene expression in murine endothelial cells during post-pneumonectomy lung growth

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Konerding Moritz A

2011-07-01

Full Text Available Abstract Although blood vessel growth occurs readily in the systemic bronchial circulation, angiogenesis in the pulmonary circulation is rare. Compensatory lung growth after pneumonectomy is an experimental model with presumed alveolar capillary angiogenesis. To investigate the genes participating in murine neoalveolarization, we studied the expression of angiogenesis genes in lung endothelial cells. After left pneumonectomy, the remaining right lung was examined on days 3, 6, 14 and 21days after surgery and compared to both no surgery and sham thoracotomy controls. The lungs were enzymatically digested and CD31+ endothelial cells were isolated using flow cytometry cell sorting. The transcriptional profile of the CD31+ endothelial cells was assessed using quantitative real-time polymerase chain reaction (PCR arrays. Focusing on 84 angiogenesis-associated genes, we identified 22 genes with greater than 4-fold regulation and significantly enhanced transcription (p

The whole-body scintigram with sup(99m)Tc-albumin microspheres for the determination of central and pulmonary right-to-left shunts

International Nuclear Information System (INIS)

Anger, K.

1980-01-01

In about 1970 the detection of cardiac and pulmonary right-to-left shunts by means of the intravenous injection of Technetium 99-marked albumin-macroaggregates was introduced and until now this determination method is the most simple and most precisely one. After the injection the main part of the particles reaches the lungs and is fixed there, the shunt-part is fixed in the systemic circulation in the organs with the best blood supply, i.e. brain, kidneys and liver. From a quantitative whole-body scintigram or from partial scintigrams of head, lungs and abdomen the relation of pulmonary and extrapulmonary activity is calculated, which corresponds precisely to the proportional right-to-left shunt. This method is illustrated by examples of its clinical application. (orig.) [de

Lung cancer in patients with idiopathic pulmonary fibrosis: frequency and CT findings

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Lee, Hak Jong; Im, Jung Gi; Ahn, Joong Mo; Yeon, Kyung Mo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

1994-12-15

The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(lPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40-85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower lobe; 10/19, left lower lobe; 5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the location where the most advanced fibrosis occur.

Lung cancer in patients with idiopathic pulmonary fibrosis: frequency and CT findings

International Nuclear Information System (INIS)

Lee, Hak Jong; Im, Jung Gi; Ahn, Joong Mo; Yeon, Kyung Mo

1994-01-01

The incidence of lung cancer in patients with idiopathic pulmonary fibrosis(lPF) is higher than that of general population. To evaluate the frequency and CT findings of lung cancer associated with idiopathic pulmonary fibrosis, we analyzed 19 patients with lung cancer associated with idiopathic pulmonary fibrosis. We analyzed retrospectively 19 patients with histologically confirmed lung cancer out of 208 patients diagnosed as IPF either by CT and clinical findings(n=188) or histologically(n=20). All 19 patients were male, aged 40-85 years (mean 66 years). Scanning techniques were conventional CT in 12 patients, HRCT in 1 patient and both conventional CT and HRCT in 6 patients. We analyzed the CT patterns of lung cancer and IPF, locations of the tumor and histologic types of lung cancer. The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was 9.1%(19/208). In 11 of 19 patients, CT findings of lung cancer were ill-defined consolidation-like mass. Lung cancer was located mainly in lower lobes(right lower lobe; 10/19, left lower lobe; 5/19) and at the periphery(12/19). Histologically, squamous cell carcinoma was the most common cell type (11/19). The incidence of lung cancer in patients with idiopathic pulmonary fibrosis was much higher than that of general population. Typical CT findings of lung cancer were predominantly ill-defined consolidation like mass at the peripheral lung portion which is the location where the most advanced fibrosis occur

Dexmedetomidine protects from post-myocardial ischaemia reperfusion lung damage in diabetic rats

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Kip, Gülay; Çelik, Ali; Bilge, Mustafa; Alkan, Metin; Kiraz, Hasan Ali; Özer, Abdullah; Şıvgın, Volkan; Erdem, Özlem; Arslan, Mustafa; Kavutçu, Mustafa

2015-01-01

Objective Diabetic complications and lipid peroxidation are known to have a close association. Lipid peroxidation commonly occurs at sites exposed to ischaemia, but distant organs and tissues also get damaged during ischaemia/reperfusion (I/R). Some of these targets are vital organs, such as the lung, liver, and kidney; the lung is the most frequently affected. The aim of our study was to investigate the effects of dexmedetomidine on I/R damage in lung tissue and on the oxidant/anti-oxidant system in diabetic rats. Material and methods Diabetes was induced with streptozotocin (55 mg/kg) in 18 Wistar Albino rats, which were then randomly divided into three groups (diabetes control (DC), diabetes plus ischaemia-reperfusion (DIR), and diabetes plus dexmedetomidine-ischaemia/reperfusion (DIRD)) after the effects of diabetes were clearly evident. The rats underwent a left thoracotomy and then ischaemia was produced in the myocardium muscle by a left anterior descending artery ligation for 30 min in the DIR and DIRD groups. I/R was performed for 120 min. The DIRD group received a single intraperitoneal dose of dexmedetomidine (100 µg/kg); the DIR group received no dexmedetomidine. Group DC was evaluated as the diabetic control group and also included six rats (C group) in which diabetes was not induced. These mice underwent only left thoracotomy and were closed without undergoing myocardial ischaemia. Histopathological changes, activities of catalase (CAT) and glutathione-S-transferase anti-oxidant enzymes, and malondialdehyde (MDA) levels were evaluated in the lung tissues of all rats. Results Neutrophil infiltration/aggregation was higher in the DIR group than in the C, DC, and DIRD groups (p=0.001, p=0.013, and p=0.042, respectively). The lung injury score was significantly higher in the DIR group than in the C and DC groups (p<0.0001 and p=0.024, respectively). The levels of MDA were significantly higher in the DIR group than in the C and DIRD groups. CAT activity

Dexmedetomidine protects from post-myocardial ischaemia reperfusion lung damage in diabetic rats

Directory of Open Access Journals (Sweden)

Gülay Kip

2015-09-01

Full Text Available Objective: Diabetic complications and lipid peroxidation are known to have a close association. Lipid peroxidation commonly occurs at sites exposed to ischaemia, but distant organs and tissues also get damaged during ischaemia/reperfusion (I/R. Some of these targets are vital organs, such as the lung, liver, and kidney; the lung is the most frequently affected. The aim of our study was to investigate the effects of dexmedetomidine on I/R damage in lung tissue and on the oxidant/anti-oxidant system in diabetic rats. Material and methods: Diabetes was induced with streptozotocin (55 mg/kg in 18 Wistar Albino rats, which were then randomly divided into three groups (diabetes control (DC, diabetes plus ischaemia-reperfusion (DIR, and diabetes plus dexmedetomidine-ischaemia/reperfusion (DIRD after the effects of diabetes were clearly evident. The rats underwent a left thoracotomy and then ischaemia was produced in the myocardium muscle by a left anterior descending artery ligation for 30 min in the DIR and DIRD groups. I/R was performed for 120 min. The DIRD group received a single intraperitoneal dose of dexmedetomidine (100 µg/kg; the DIR group received no dexmedetomidine. Group DC was evaluated as the diabetic control group and also included six rats (C group in which diabetes was not induced. These mice underwent only left thoracotomy and were closed without undergoing myocardial ischaemia. Histopathological changes, activities of catalase (CAT and glutathione-S-transferase anti-oxidant enzymes, and malondialdehyde (MDA levels were evaluated in the lung tissues of all rats. Results: Neutrophil infiltration/aggregation was higher in the DIR group than in the C, DC, and DIRD groups (p=0.001, p=0.013, and p=0.042, respectively. The lung injury score was significantly higher in the DIR group than in the C and DC groups (p<0.0001 and p=0.024, respectively. The levels of MDA were significantly higher in the DIR group than in the C and DIRD groups. CAT

[Lymphadenectomy performed along the left recurrent laryngeal nerve after anterior detachment of the esophagus via thoracoscopic esophagectomy in the prone position under artificial pneumothorax].

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Yamamoto, Shinichi; Ohshima, Hisami; Katsumori, Takashi; Hamaguchi, Hiromitsu; Tsukamoto, Yukika; Iwanaga, Tomohiro

2014-11-01

Thoracoscopic esophagectomy was performed in the prone position under artificial pneumothorax and did not affect the surgical area during lung ventilation; tracheal mobility was also improved. Lymphadenectomy around the left recurrent laryngeal nerve was performed by separating the left main bronchus and trachea between the esophagus and pericardium before detaching the dorsal side of the esophagus.

Decreased Lung Perfusion After Breast/Chest Wall Irradiation: Quantitative Results From a Prospective Clinical Trial

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Liss, Adam L., E-mail: adamliss68@gmail.com [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kapadia, Nirav S. [Department of Radiation Oncology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (United States); McShan, Daniel L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Rogers, Virginia E. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Moran, Jean M.; Brock, Kristy K.; Schipper, Matt J.; Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Flaherty, Kevin R. [Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Frey, Kirk A. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

2017-02-01

Purpose: To quantify lung perfusion changes after breast/chest wall radiation therapy (RT) using pre- and post-RT single photon emission computed tomography/computed tomography (SPECT/CT) attenuation-corrected perfusion scans; and correlate decreased perfusion with adjuvant RT dose for breast cancer in a prospective clinical trial. Methods and Materials: As part of an institutional review board–approved trial studying the impact of RT technique on lung function in node-positive breast cancer, patients received breast/chest wall and regional nodal irradiation including superior internal mammary node RT to 50 to 52.2 Gy with a boost to the tumor bed/mastectomy scar. All patients underwent quantitative SPECT/CT lung perfusion scanning before RT and 1 year after RT. The SPECT/CT scans were co-registered, and the ratio of decreased perfusion after RT relative to the pre-RT perfusion scan was calculated to allow for direct comparison of SPECT/CT perfusion changes with delivered RT dose. The average ratio of decreased perfusion was calculated in 10-Gy dose increments from 0 to 60 Gy. Results: Fifty patients had complete lung SPECT/CT perfusion data available. No patient developed symptoms consistent with pulmonary toxicity. Nearly all patients demonstrated decreased perfusion in the left lung according to voxel-based analyses. The average ratio of lung perfusion deficits increased for each 10-Gy increment in radiation dose to the lung, with the largest changes in regions of lung that received 50 to 60 Gy (ratio 0.72 [95% confidence interval 0.64-0.79], P<.001) compared with the 0- to 10-Gy region. For each increase in 10 Gy to the left lung, the lung perfusion ratio decreased by 0.06 (P<.001). Conclusions: In the assessment of 50 patients with node-positive breast cancer treated with RT in a prospective clinical trial, decreased lung perfusion by SPECT/CT was demonstrated. Our study allowed for quantification of lung perfusion defects in a prospective cohort of

Efficacy of lung volume optimization maneuver monitored by optoelectronic pletismography in the management of congenital diaphragmatic hernia

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G. Lista

2017-01-01

We report a case of left CDH with severe lung hypoplasia, managed applying open lung strategy in HFOV (pre-surgery period and in Assist-Control with Volume Guarantee (post-surgery period, guided by SpO2 changes, TcPO2 and TcPCO2 monitoring. Opto-electronic plethysmography was used to measure end-expiratory chest wall volume changes (ΔEEcw related to lung volume variations occurring during pressure changes. OEP confirmed the efficacy of using SpO2 and transcutaneous gas monitoring during this recruitment maneuver.

Field Test Kit for Gun Residue Detection; TOPICAL

International Nuclear Information System (INIS)

WALKER, PAMELA K.; RODACY, PHILIP J.

2002-01-01

One of the major needs of the law enforcement field is a product that quickly, accurately, and inexpensively identifies whether a person has recently fired a gun--even if the suspect has attempted to wash the traces of gunpowder off. The Field Test Kit for Gunshot Residue Identification based on Sandia National Laboratories technology works with a wide variety of handguns and other weaponry using gunpowder. There are several organic chemicals in small arms propellants such as nitrocellulose, nitroglycerine, dinitrotoluene, and nitrites left behind after the firing of a gun that result from the incomplete combustion of the gunpowder. Sandia has developed a colorimetric shooter identification kit for in situ detection of gunshot residue (GSR) from a suspect. The test kit is the first of its kind and is small, inexpensive, and easily transported by individual law enforcement personnel requiring minimal training for effective use. It will provide immediate information identifying gunshot residue

Clinical value of CT-based preoperative software assisted lung lobe volumetry for predicting postoperative pulmonary function after lung surgery

Science.gov (United States)

Wormanns, Dag; Beyer, Florian; Hoffknecht, Petra; Dicken, Volker; Kuhnigk, Jan-Martin; Lange, Tobias; Thomas, Michael; Heindel, Walter

2005-04-01

This study was aimed to evaluate a morphology-based approach for prediction of postoperative forced expiratory volume in one second (FEV1) after lung resection from preoperative CT scans. Fifteen Patients with surgically treated (lobectomy or pneumonectomy) bronchogenic carcinoma were enrolled in the study. A preoperative chest CT and pulmonary function tests before and after surgery were performed. CT scans were analyzed by prototype software: automated segmentation and volumetry of lung lobes was performed with minimal user interaction. Determined volumes of different lung lobes were used to predict postoperative FEV1 as percentage of the preoperative values. Predicted FEV1 values were compared to the observed postoperative values as standard of reference. Patients underwent lobectomy in twelve cases (6 upper lobes; 1 middle lobe; 5 lower lobes; 6 right side; 6 left side) and pneumonectomy in three cases. Automated calculation of predicted postoperative lung function was successful in all cases. Predicted FEV1 ranged from 54% to 95% (mean 75% +/- 11%) of the preoperative values. Two cases with obviously erroneous LFT were excluded from analysis. Mean error of predicted FEV1 was 20 +/- 160 ml, indicating absence of systematic error; mean absolute error was 7.4 +/- 3.3% respective 137 +/- 77 ml/s. The 200 ml reproducibility criterion for FEV1 was met in 11 of 13 cases (85%). In conclusion, software-assisted prediction of postoperative lung function yielded a clinically acceptable agreement with the observed postoperative values. This method might add useful information for evaluation of functional operability of patients with lung cancer.

Attempt of peripheral nerve reconstruction during lung cancer surgery.

Science.gov (United States)

Li, Hanyue; Hu, Yingjie; Huang, Jia; Yang, Yunhai; Xing, Kaichen; Luo, Qingquan

2018-05-01

Vagus nerve and recurrent laryngeal nerve (RLN) injury are not rare complications of lung cancer surgery and can cause lethal consequences. Until now, no optimal method other than paying greater attention during surgery has been available. Four patients underwent lung surgery that involved RLN or vagus nerve injury. The left RLN or vagus nerve was cut off and then reconstructed immediately during surgery. Two patients underwent direct anastomosis, while the remaining two underwent phrenic nerve replacing tension-relieving anastomosis. All patients were able to speak immediately after recovery. No or minimal glottal gap was observed during laryngoscopy conducted on the second day after surgery. Most patients achieved full recovery of voice quality. Immediate reconstruction of RLN is technically feasible and can be carried out with satisfying short-term and long-term outcomes. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Localization and stretch-dependence of lung elastase activity in development and compensatory growth.

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Young, Sarah Marie; Liu, Sheng; Joshi, Rashika; Batie, Matthew R; Kofron, Matthew; Guo, Jinbang; Woods, Jason C; Varisco, Brian Michael

2015-04-01

Synthesis and remodeling of the lung matrix is necessary for primary and compensatory lung growth. Because cyclic negative force is applied to developing lung tissue during the respiratory cycle, we hypothesized that stretch is a critical regulator of lung matrix remodeling. By using quantitative image analysis of whole-lung and whole-lobe elastin in situ zymography images, we demonstrated that elastase activity increased twofold during the alveolar stage of postnatal lung morphogenesis in the mouse. Remodeling was restricted to alveolar walls and ducts and was nearly absent in dense elastin band structures. In the mouse pneumonectomy model of compensatory lung growth, elastase activity increased threefold, peaking at 14 days postpneumonectomy and was higher in the accessory lobe compared with other lobes. Remodeling during normal development and during compensatory lung growth was different with increased major airway and pulmonary arterial remodeling during development but not regeneration, and with homogenous remodeling throughout the parenchyma during development, but increased remodeling only in subpleural regions during compensatory lung growth. Left lung wax plombage prevented increased lung elastin during compensatory lung growth. To test whether the adult lung retains an innate capacity to remodel elastin, we developed a confocal microscope-compatible stretching device. In ex vivo adult mouse lung sections, lung elastase activity increased exponentially with strain and in peripheral regions of lung more than in central regions. Our study demonstrates that lung elastase activity is stretch-dependent and supports a model in which externally applied forces influence the composition, structure, and function of the matrix during periods of alveolar septation. Copyright © 2015 the American Physiological Society.

Measurement of the fluorescence of crop residues: A tool for controlling soil erosion

Science.gov (United States)

Daughtry, C. S. T.; Mcmurtrey, J. E., III; Chappelle, E. W.; Hunter, W. J.

1994-01-01

Management of crop residues, the portion of a crop left in the field after harvest, is an important conservation practice for minimizing soil erosion and for improving water quality. Quantification of crop residue cover is required to evaluate the effectiveness of conservation tillage practices. Methods are needed to quantify residue cover that are rapid, accurate, and objective. The fluorescence of crop residue was found to be a broadband phenomenon with emission maxima at 420 to 495 nm for excitations of 350 to 420 nm. Soils had low intensity broadband emissions over the 400 to 690 nm region for excitations of 300 to 600 nm. The range of relative fluorescence intensities for the crop residues was much greater than the fluorescence observed of the soils. As the crop residues decompose their blue fluorescence values approach the fluorescence of the soil. Fluorescence techniques are concluded to be less ambiguous and better suited for discriminating crop residues and soils than reflectance methods. If properly implemented, fluorescence techniques can be used to quantify, not only crop residue cover, but also photosynthetic efficiency in the field.

Elastin Cables Define the Axial Connective Tissue System in the Murine Lung.

Science.gov (United States)

Wagner, Willi; Bennett, Robert D; Ackermann, Maximilian; Ysasi, Alexandra B; Belle, Janeil; Valenzuela, Cristian D; Pabst, Andreas; Tsuda, Akira; Konerding, Moritz A; Mentzer, Steven J

2015-11-01

The axial connective tissue system is a fiber continuum of the lung that maintains alveolar surface area during changes in lung volume. Although the molecular anatomy of the axial system remains undefined, the fiber continuum of the lung is central to contemporary models of lung micromechanics and alveolar regeneration. To provide a detailed molecular structure of the axial connective tissue system, we examined the extracellular matrix of murine lungs. The lungs were decellularized using a 24 hr detergent treatment protocol. Systematic evaluation of the decellularized lungs demonstrated no residual cellular debris; morphometry demonstrated a mean 39 ± 7% reduction in lung dimensions. Scanning electron microscopy (SEM) demonstrated an intact structural hierarchy within the decellularized lung. Light, fluorescence, and SEM of precision-cut lung slices demonstrated that alveolar duct structure was defined by a cable line element encased in basement membrane. The cable line element arose in the distal airways, passed through septal tips and inserted into neighboring blood vessels and visceral pleura. The ropelike appearance, collagenase resistance and anti-elastin immunostaining indicated that the cable was an elastin macromolecule. Our results indicate that the helical line element of the axial connective tissue system is composed of an elastin cable that not only defines the structure of the alveolar duct, but also integrates the axial connective tissue system into visceral pleura and peripheral blood vessels. © 2015 Wiley Periodicals, Inc.

Rudhe syndrome: reversible right middle lobe emphysema in infants with left-to-right shunts - an historical review

International Nuclear Information System (INIS)

Collins, Lee K.; Levin, Terry L.; Berdon, Walter E.; Cowles, Robert A.; Newman, Beverley

2010-01-01

In 1971, the Swedish radiologist Ulf Rudhe wrote a provocative paper on right middle lobe emphysema in infants with left-to-right shunts in which he suggested cardiac surgery rather than lung resection. At the time, this was counter to accepted medical practice. Earlier diagnosis and better medical management of ventricular septal defect in infants has proved Rudhe correct. However, two current cases of large left-to-right shunts in infants with emphysema of the right middle lobe prompt this historical review of what seemed a closed-episode in pediatric cardiac surgery. (orig.)

Integrin αβ3-Targeted Imaging of Lung Cancer

Directory of Open Access Journals (Sweden)

Xiaoyuan Chen

2005-03-01

Full Text Available A series of radiolabeled cyclic arginine-glycineaspartic acid (RGD peptide ligands for cell adhesion molecule integrin αβ3-targeted tumor angiogenesis targeting are being developed in our laboratory. In this study, this effort continues by applying a positron emitter 64Cu-labeled PEGylated dimeric RGD peptide radiotracer 64Cu-DOTA-PEG-E[c(RGDyK]2 for lung cancer imaging. The PEGylated RGD peptide indicated integrin αβ3 avidity, but the PEGylation reduced the receptor binding affinity of this ligand compared to the unmodified RGD dimer. The radiotracer revealed rapid blood clearance and predominant renal clearance route. The minimum nonspecific activity accumulation in normal lung tissue and heart rendered high-quality orthotopic lung cancer tumor images, enabling clear demarcation of both the primary tumor at the upper lobe of the left lung, as well as metastases in the mediastinum, contralateral lung, diaphragm. As a comparison, fluorodeoxyglucose (FDG scans on the same mice were only able to identify the primary tumor, with the metastatic lesions masked by intense cardiac uptake and high lung background. 64Cu-DOTA-PEGE[c(RGDyK]2 is an excellent positron emission tomography (PET tracer for integrin-positive tumor imaging. Further studies to improve the receptor binding affinity of the tracer and subsequently to increase the magnitude of tumor uptake without comprising the favorable in vivo kinetics are currently in progress.

A case of acute exacerbation of idiopathic pulmonary fibrosis after proton beam therapy for non-small cell lung cancer

International Nuclear Information System (INIS)

Nagano, Tatsuya; Kotani, Yoshikazu; Fujii, Osamu

2012-01-01

There have been no reports describing acute exacerbations of idiopathic pulmonary fibrosis after particle radiotherapy for non-small cell lung cancer. The present study describes the case of a 76-year-old Japanese man with squamous cell carcinoma of the lung that relapsed in the left upper lobe 1 year after right upper lobectomy. He had been treated with oral prednisolone 20 mg/day every 2 days for idiopathic pulmonary fibrosis, and the relapsed lung cancer was treated by proton beam therapy, which was expected to cause the least adverse effects on the idiopathic pulmonary fibrosis. Fifteen days after the initiation of proton beam therapy, the idiopathic pulmonary fibrosis exacerbated, centered on the left upper lobe, for which intensive steroid therapy was given. About 3 months later, the acute exacerbation of idiopathic pulmonary fibrosis had improved, and the relapsed lung cancer became undetectable. Clinicians should be aware that an acute exacerbation of idiopathic pulmonary fibrosis may occur even in proton beam therapy, although proton beam therapy appears to be an effective treatment option for patients with idiopathic pulmonary fibrosis. (author)

CHANGES IN LUNG FUNCTION IN THE TREATMENT OF PATIENTS WITH EXOGENOUS ALLERGIC ALVEOLITIS

OpenAIRE

V. B. Nefedov; L. A. Popova; E. A. Shergina; N. N. Makaryants

2014-01-01

Total lung capacity (TLC), lung capacity (LC), forced LC (FLC), intrathoracic volume (ITV), pulmonary residual volume (PRV), forced expiratory volume in one second (FEV1 ), (FEV1 )/LC%, peak expiratory flow (PEF), maximum expiratory flow rate (MEFR)25, MEFR50, MEFR75, Raw, Rin, Rex, DLCO-SB, DLCO-SB/VА, РаО2 , and РаСО2 were determined in 43 patients with exogenous allergic alveolitis (EAA) before, during, and after treatment with glucocorticosteroids, hemapheresis, ambroxol, and fluimucil. L...

Automatic segmentation of tumor-laden lung volumes from the LIDC database

Science.gov (United States)

O'Dell, Walter G.

2012-03-01

The segmentation of the lung parenchyma is often a critical pre-processing step prior to application of computer-aided detection of lung nodules. Segmentation of the lung volume can dramatically decrease computation time and reduce the number of false positive detections by excluding from consideration extra-pulmonary tissue. However, while many algorithms are capable of adequately segmenting the healthy lung, none have been demonstrated to work reliably well on tumor-laden lungs. Of particular challenge is to preserve tumorous masses attached to the chest wall, mediastinum or major vessels. In this role, lung volume segmentation comprises an important computational step that can adversely affect the performance of the overall CAD algorithm. An automated lung volume segmentation algorithm has been developed with the goals to maximally exclude extra-pulmonary tissue while retaining all true nodules. The algorithm comprises a series of tasks including intensity thresholding, 2-D and 3-D morphological operations, 2-D and 3-D floodfilling, and snake-based clipping of nodules attached to the chest wall. It features the ability to (1) exclude trachea and bowels, (2) snip large attached nodules using snakes, (3) snip small attached nodules using dilation, (4) preserve large masses fully internal to lung volume, (5) account for basal aspects of the lung where in a 2-D slice the lower sections appear to be disconnected from main lung, and (6) achieve separation of the right and left hemi-lungs. The algorithm was developed and trained to on the first 100 datasets of the LIDC image database.

Infective Endocarditis of the Left Main to Right Atrial Coronary Cameral Fistula

Science.gov (United States)

Mishra, Ramesh Chandra; Barik, Ramachandra; Patnaik, Amar Narayana

2016-01-01

A 7-year-old female child presented with pyrexia of unknown origin. She had received an empirical regimen of antibiotic for possible endocarditis. Evaluation included multiple imaging supports and blood culture. She had left main coronary artery to right atrium coronary cameral fistula, restricted patent ductus arteriosus, vegetation at the right atrial exit of fistula and negative blood culture. Ongoing fever more than 2 weeks, oscillating vegetation in the echo and histopathological evidence of healing vegetation suggested definite diagnosis of infective endocarditis. She was treated successfully by surgical closure of fistula from the right atrial approach. Device closure in this case would have resulted in a large residual cul-de-sac with or without tiny residual high-velocity jets, either being a threat for future enlargement, rupture of the residual aneurysmal sac, thromboembolism, prolonged anticoagulation, and infective endocarditis. PMID:28465978

Neurohormones as markers of right- and left-sided cardiac dimensions and function in patients with untreated chronic heart failure

DEFF Research Database (Denmark)

Kjaer, Andreas; Hildebrandt, Per; Appel, Jon

2005-01-01

and that neuroendocrine profiling could be of value. In order to study this, we investigated the relationship between hormones and cardiac dimensions and function of both the right and left ventricle. METHODS: Twenty-three patients with newly diagnosed, untreated CHF were included. Right (RVEF) and left ventricular...... was normal in all subjects as well as right ventricular volumes. Likewise, on average, the lung transit time (LTT) was normal. Brain natriuretic peptide (BNP) significantly correlated with LVEF, left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI...... ejection fractions (LVEF) and volumes were measured by means of first-pass and equilibrium radionuclide ventriculography. RESULTS: LVEF was 0.29 (range: 0.11-0.55). Two-thirds of the patients had dilated left ventricles with volumes above upper reference limit. Right ventricular ejection fraction...

Positron emission tomography/computed tomography data of a tuberculosis mimicking lung cancer: A Case report

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Amine Benjelloun

2014-10-01

Full Text Available PET/CT is a modern and very valuable tool for detecting primary or secondary lung cancers. However, in countries where tuberculosis is endemic, data must be interpreted with caution because of the frequent tuberculomas. We report here a case of a cancer-like tuberculoma of the lung with paralysis of the left vocal cord, and discuss the PET/CT contribution in tuberculomas as well as the noncancer etiologies of this damage.

Chlortetracycline and Oxytetracycline Residues in Poultry Tissues and Eggs

Science.gov (United States)

Meredith, W. E.; Weiser, H. H.; Winter, A. R.

1965-01-01

A pad-plate method of assaying residual amounts of chlortetracycline (CTC) and oxytetracycline (OTC) using Bacillus cereus 213 was used to determine amounts of antibiotic left in tissues and eggs of poultry fed 1,000 and 200 ppm of CTC and OTC in basal feed mixtures. The effects of various methods of cooking the tissues and eggs and the potentiating effect of terephthalic acid (TPA) were studied. It was found that normal methods of roasting, frying, and autoclaving poultry tissue destroyed all residual CTC and OTC, even with the potentiating effect of TPA. The largest amounts of residual antibiotic were found in the liver, then breast, and then thigh tissue when assayed for CTC. Tissue assays for CTC revealed that it was not taken up as extensively as CTC and the largest amounts were found in the liver, then breast. OTC residue was seldom found in the thigh tissue. Terephthalic acid in 0.5% concentration increased the concentration found in all cases. Cooking by poaching and scrambling eggs did not destroy the antibiotic in all cases. PMID:14264853

CT findings of primary lung cancer

International Nuclear Information System (INIS)

Park, Yeon Won; Kim, So Seon; Woo, Young Hoon; Kim, Ho Joon; Chun, Byung Hee; Suh, Jung Hyek; Suh, Soo Jhi

1985-01-01

Authors retrospectively analyzed the CT findings of 102 cases of histologically proven bronchogenic carcinoma during last 4 years from January 1980 to July 1984 at Kosin Medical College. The results were as follows: 1. The sex ratio was 86 males to 16 females and the greatest number (66.7%) of cases were seen in fourth and fifth decades. 2. The distribution of histologic types of primary lung cancer as follows: Squamous cell carcinoma 66 cases, Adenocarcinoma 10 cases, Small cell carcinoma 7 cases, Large cell carcinoma 5 cases, Bronchioloalveolar cell carcinoma 1 case, Unclassified 13 cases. 3. Location of primary lesions as follows: Right lung 61 cases, Left lung 40 cases. In both lungs, the greatest number of cases were found in the upper lobes. Ratio between central and peripheral mass was 2.5:1, except adenocarcinoma (6:4). 4. CT findings were as follows: Hilar or central mass (75 cases), Peripheral mass (26), Bronchial abnormalities such as narrowing, obstruction, or displacement (60), Thickening of the posterior wall of the right upper lobe bronchus, bronchus intermedius, or left main bronchus (17), Post-obstructive changes; Atelectasis, Pneumonitis, Emphysema (34, 17, 1 respectively), Hilar adenopathy (21), Mediastinal lymph node enlargement (50), Mediastinal invasion (51), Pericardial thickening (5), SVC syndrome with collateral vessels (3), Pleural effusion (27), Pleural thickening or invasion (14), Chest wall invasion (2), Distant metastasis (26). 5. In most of patients (92 cases), the size of mass was above 3cm, but in 9 cases below 3cm. Margins of the masses were serrated or lobulated in most cases. In 5 cases, cavitary formations were noted, walls of which were thick and irregular, and air-fluid level was noted in 1 case. In 2 cases, eccentric calcification were noted within mass. 6. Among 51 cases of whom direct mediastinal invasion was suspected, 8 cases were operated upon, and this revealed that the masses were not resectable. Among the patients in

The unequal influences of the left and right vagi on the control of the heart and pulmonary artery in the rattlesnake, Crotalus durissus

DEFF Research Database (Denmark)

Taylor, E.W.; Andrade, Denis V.; Abe, Augusto A.

2009-01-01

Autonomic control of the cardiovascular system in reptiles includes sympathetic components but heart rate (fH), pulmonary blood flow ( pul) and cardiac shunt patterns are primarily controlled by the parasympathetic nervous system. The vagus innervates both the heart and a sphincter on the pulmona....... This paves the way for an investigation of the role of the cardiac shunt in regulating metabolic rate, as chronic left vagotomy will cause a pronounced left–right shunt in recovered animals, whilst leaving intact control of the heart, via the right vagus....... artery. The present study reveals that whereas both the left and right vagi influence fH, it is only the left vagus that influences pulmonary vascular resistance. This is associated with the fact that rattlesnakes, in common with some other species of snakes, have a single functional lung, as the other...... lung regresses during development. Stimulation of the left cervical vagus in anaesthetised snakes slowed the heart and markedly reduced blood flow in the pulmonary artery whereas stimulation of the right cervical vagus slowed the heart and caused a small increase in stroke volume (VS) in both...

Relationship between linear and nonlinear dynamics of heart rate and impairment of lung function in COPD patients

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Mazzuco A

2015-08-01

Full Text Available Adriana Mazzuco,1 Wladimir Musetti Medeiros,2 Milena Pelosi Rizk Sperling,1 Aline Soares de Souza,2 Maria Clara Noman Alencar,2 Flávio Ferlin Arbex,2 José Alberto Neder,2,3 Ross Arena,4 Audrey Borghi-Silva1 1Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Carlos, 2Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil; 3Laboratory of Clinical Exercise Physiology, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen’s University, Kingston, ON, Canada; 4Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA Background: In chronic obstructive pulmonary disease (COPD, functional and structural impairment of lung function can negatively impact heart rate variability (HRV; however, it is unknown if static lung volumes and lung diffusion capacity negatively impacts HRV responses. We investigated whether impairment of static lung volumes and lung diffusion capacity could be related to HRV indices in patients with moderate to severe COPD. Methods: Sixteen sedentary males with COPD were enrolled in this study. Resting blood gases, static lung volumes, and lung diffusion capacity for carbon monoxide (DLCO were measured. The RR interval (RRi was registered in the supine, standing, and seated positions (10 minutes each and during 4 minutes of a respiratory sinus arrhythmia maneuver (M-RSA. Delta changes (Δsupine-standing and Δsupine-M-RSA of the standard deviation of normal RRi, low frequency (LF, normalized units [nu] and high frequency (HF [nu], SD1, SD2, alpha1, alpha2, and approximate entropy (ApEn indices were calculated. Results: HF, LF, SD1, SD2, and alpha1 deltas significantly correlated with forced expiratory volume in 1 second, DLCO, airway resistance, residual volume, inspiratory

Aquamous cell carcinomas of the lung which presented as numerous polypoid nodules in the tracheobronchial tree: A case report

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Lee, Hyun Gyu; Choi, Yo Won; Yoon, Hyun Jung; Paik, Seung Sam [Hanyang University Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2017-03-15

We report a case of squamous cell carcinomas of the lung, which presented as numerous polypoid nodules in the tracheobronchial tree. They occurred at two years and 7 months after resection of squamous cell carcinoma, which presented as a lung nodule in the left lower lobe, and at 7 months after resection of tracheal squamous cell carcinoma.

Aquamous cell carcinomas of the lung which presented as numerous polypoid nodules in the tracheobronchial tree: A case report

International Nuclear Information System (INIS)

Lee, Hyun Gyu; Choi, Yo Won; Yoon, Hyun Jung; Paik, Seung Sam

2017-01-01

We report a case of squamous cell carcinomas of the lung, which presented as numerous polypoid nodules in the tracheobronchial tree. They occurred at two years and 7 months after resection of squamous cell carcinoma, which presented as a lung nodule in the left lower lobe, and at 7 months after resection of tracheal squamous cell carcinoma

Effect of indacaterol on lung deflation improves cardiac performance in hyperinflated COPD patients: an interventional, randomized, double-blind clinical trial

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Santus P

2015-09-01

residual capacity on right heart systolic and diastolic function indexes evaluated by TTE in patients treated with indacaterol, as compared to placebo.Results: Vital capacity, inspiratory capacity, and forced expiratory volume in 1 second were significantly increased by indacaterol, when compared with placebo, while residual volume, intrathoracic gas volume, and specific airway resistance were significantly reduced in patients treated with indacaterol. Tricuspid annular plane systolic excursion was significantly increased versus placebo, paralleled by an increase of tricuspid E-wave deceleration time. The cardiac frequency was also significantly reduced in indacaterol-treated patients.Conclusion: Indacaterol significantly reduces lung hyperinflation in acute conditions, with a clinically relevant improvement of dyspnea. These modifications are associated with a significant increase of the right ventricular compliance indexes and may have a role in improving left ventricular preload leading to a reduction in cardiac frequency.Keywords: lung deflation, bronchodilator, cardiac performance, right ventricular function, echocardiography

Quantitative and regional evaluation methods for lung scintigraphs

International Nuclear Information System (INIS)

Fichter, J.

1982-01-01

For the evaluation of perfusion lung scintigraphs with regard to the quantitative valuation and also with regard to the choice of the regions new criteria were presented. In addition to the usual methods of sectioning each lung lobe into upper, middle and lower level and the determination of the per cent activity share of the total activity the following values were established: the median of the activity distribution and the differences of the per cent counting rate as well as of the median of the corresponding regions of the right and left lung. The individual regions should describe the functional structures (lobe and segment structure). A corresponding computer program takes over the projection of lobe and segment regions in a simplified form onto the scintigraph with consideration of individual lung stretching. With the help of a clinical study on 60 patients and 18 control persons with 99mTc-MAA and 133 Xe-gas lung scintigraphs the following results could be determined: depending on the combination of the 32 parameters available for evaluation and the choice of regions between 4 and 20 of the 60 patients were falsely negatively classified and 1 to 2 of the 18 controls were falsely positive. The accuracy of the Tc-scintigraph proved to be better. All together using the best possible parameter combinations comparative results were attained. (TRV) [de

Time-dependent climate benefits of using forest residues to substitute fossil fuels

International Nuclear Information System (INIS)

Sathre, Roger; Gustavsson, Leif

2011-01-01

In this study we analyze and compare the climate impacts from the recovery, transport and combustion of forest residues (harvest slash and stumps), versus the climate impacts that would have occurred if the residues were left in the forest and fossil fuels used instead. We use cumulative radiative forcing (CRF) as an indicator of climate impacts, and we explicitly consider the temporal dynamics of atmospheric carbon dioxide and biomass decomposition. Over a 240-year period, we find that CRF is significantly reduced when forest residues are used instead of fossil fuels. The type of fossil fuel replaced is important, with coal replacement giving the greatest CRF reduction. Replacing oil and fossil gas also gives long-term CRF reduction, although CRF is positive during the first 10-25 years when these fuels are replaced. Biomass productivity is also important, with more productive forests giving greater CRF reduction per hectare. The decay rate for biomass left in the forest is found to be less significant. Fossil energy inputs for biomass recovery and transport have very little impact on CRF. -- Highlights: → Cumulative radiative forcing (CRF) can measure climate impacts of dynamic systems. → Climate impact is reduced when forest slash and stumps are used to replace fossil fuels. → Forest biofuels may cause short-term climate impact, followed by long-term climate benefit. → Forest residues should replace coal to avoid short-term climate impact. → Fossil energy used for biofuel recovery and transport has very little climate impact.

Clinical evaluation of a software for automated localization of lung nodules at follow-up CT examinations

International Nuclear Information System (INIS)

Beyer, F.; Wormanns, D.; Heindel, W.; Kohl, G.

2004-01-01

Purpose: To evaluate a software algorithm for automated localization of pulmonary nodules at follow-up CT examinations of the chest and to determine factors influencing the rate of correctly matched nodules. Materials and Methods: The 'real-time automatic matching' (RAM) algorithm (Siemens LungCare TM software) was applied to 22 follow-up multirow-detector CT (MDCT) examinations in 11 patients (Siemens Somatom VolumeZoom, tube voltage 120 kVp; effective tube current 20 mAs (n=18) or 100 mAs (n=4); 4 x 1 mm detector configuration, 1.25 mm slice thickness; 0.8 mm reconstruction increment; standard lung kernel B50f) with a total of 190 lung nodules (mean diameter 6.7±3.5 mm, range 2-17 mm). The following nodule features were recorded: diameter, edge definition (well- or ill-defined), location (upper, middle or lower third; central or peripheral; right of left lung) and inspiration level (considered identical if the difference of diaphragm-apex distance between baseline and follow-up examination was 2 -test was used to describe influence of nodule features on detection rate. Influence of nodule size was assessed using Mann-Whitney-U-Test. Results: RAM correctly located 164 of 190 of all lung nodules (86.3%). Detection rate did not depend on nodule location (left vs. right lung: p=0.48; upper vs. middle vs. lower third: p=0.96; peripheral vs. central: p=0.47) or diameter (p=0.30). Influence of inspiration level was highly significant (p [de

Dosimetric Comparison of Intensity-Modulated Radiotherapy Plans, With or Without Anterior Myocardial Territory and Left Ventricle as Organs at Risk, in Early-Stage Left-Sided Breast Cancer Patients

International Nuclear Information System (INIS)

Tan Wenyong; Wang Xiaohong; Qiu Dasheng; Liu Dong; Jia Shaohui; Zeng Fanyu; Chen Zhengwang; Li Beihui; Xu Jiaozhen; Wei Lai; Hu Desheng

2011-01-01

Purpose: We evaluated heart sparing using an intensity-modulated radiotherapy (IMRT) plan with the left ventricle (LV) and/or the anterior myocardial territory (AMT) as additional organs at risk (OARs). Methods and Materials: A total of 10 patients with left-sided breast cancer were selected for dosimetric planning. Both lungs, the right breast, heart, LV, and AMT were defined as OARs. We generated one tangential field plan and four IMRT plans for each patient. We examined the dose–volume histogram parameters of the planning target volume and OARs. Results: Compared with the tangential field plan, the mean dose to the heart in the IMRT plans did not show significant differences; however, the dose to the AMT and LV decreased by 18.7–45.4% and 10.8–37.4%, respectively. The maximal dose to the heart decreased by 18.6–35.3%, to the AMT by 22.0–45.1%, and to the LV by 23.5–45.0%, And the relative volumes of the heart (V ≥12 ), AMT (V >11 ) and LV (V >10 ) decreased significantly with different levels, respectively. The volume of the heart, AMT, LV, both lungs, and right breast receiving ≥5 Gy showed a significant increase. Compared with the IMRT (H) plan, the mean dose to the heart, AMT, and LV decreased by 17.5–21.5%, 25.2–29.8%, and 22.8–29.8% and the maximal dose by 13.6–20.6%, 23.1–29.6%, and 17.3–29.1%, respectively. The IMRT plans for both lungs and the right breast showed no significant differences. Conclusions: The IMRT plans with the addition of the AMT and/or LV as OARs considerably increased heart sparing. We recommend including the LV as an additional OAR in such plans.

Uniform background assumption produces misleading lung EIT images.

Science.gov (United States)

Grychtol, Bartłomiej; Adler, Andy

2013-06-01

Electrical impedance tomography (EIT) estimates an image of conductivity change within a body from stimulation and measurement at body surface electrodes. There is significant interest in EIT for imaging the thorax, as a monitoring tool for lung ventilation. To be useful in this application, we require an understanding of if and when EIT images can produce inaccurate images. In this paper, we study the consequences of the homogeneous background assumption, frequently made in linear image reconstruction, which introduces a mismatch between the reference measurement and the linearization point. We show in simulation and experimental data that the resulting images may contain large and clinically significant errors. A 3D finite element model of thorax conductivity is used to simulate EIT measurements for different heart and lung conductivity, size and position, as well as different amounts of gravitational collapse and ventilation-associated conductivity change. Three common linear EIT reconstruction algorithms are studied. We find that the asymmetric position of the heart can cause EIT images of ventilation to show up to 60% undue bias towards the left lung and that the effect is particularly strong for a ventilation distribution typical of mechanically ventilated patients. The conductivity gradient associated with gravitational lung collapse causes conductivity changes in non-dependent lung to be overestimated by up to 100% with respect to the dependent lung. Eliminating the mismatch by using a realistic conductivity distribution in the forward model of the reconstruction algorithm strongly reduces these undesirable effects. We conclude that subject-specific anatomically accurate forward models should be used in lung EIT and extra care is required when analysing EIT images of subjects whose background conductivity distribution in the lungs is known to be heterogeneous or exhibiting large changes.

Uniform background assumption produces misleading lung EIT images

International Nuclear Information System (INIS)

Grychtol, Bartłomiej; Adler, Andy

2013-01-01

Electrical impedance tomography (EIT) estimates an image of conductivity change within a body from stimulation and measurement at body surface electrodes. There is significant interest in EIT for imaging the thorax, as a monitoring tool for lung ventilation. To be useful in this application, we require an understanding of if and when EIT images can produce inaccurate images. In this paper, we study the consequences of the homogeneous background assumption, frequently made in linear image reconstruction, which introduces a mismatch between the reference measurement and the linearization point. We show in simulation and experimental data that the resulting images may contain large and clinically significant errors. A 3D finite element model of thorax conductivity is used to simulate EIT measurements for different heart and lung conductivity, size and position, as well as different amounts of gravitational collapse and ventilation-associated conductivity change. Three common linear EIT reconstruction algorithms are studied. We find that the asymmetric position of the heart can cause EIT images of ventilation to show up to 60% undue bias towards the left lung and that the effect is particularly strong for a ventilation distribution typical of mechanically ventilated patients. The conductivity gradient associated with gravitational lung collapse causes conductivity changes in non-dependent lung to be overestimated by up to 100% with respect to the dependent lung. Eliminating the mismatch by using a realistic conductivity distribution in the forward model of the reconstruction algorithm strongly reduces these undesirable effects. We conclude that subject-specific anatomically accurate forward models should be used in lung EIT and extra care is required when analysing EIT images of subjects whose background conductivity distribution in the lungs is known to be heterogeneous or exhibiting large changes. (paper)

Red blood cells augment transport of reactive metabolites of monocrotaline from liver to lung in isolated and tandem liver and lung preparations

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Pan, L.C.; Lame, M.W.; Morin, D.; Wilson, D.W.; Segall, H.J. (Department of Veterinary Pharmacology, University of California, Davis (United States))

1991-09-01

Monocrotaline (MCT) is a pyrrolizidine alkaloid that causes pulmonary hypertension in rats by mechanisms which remain largely unknown. MCT is thought to be activated in the liver to a reactive intermediate that is transported to the lung where it causes endothelial injury. The authors previous pharmacokinetic work demonstrated significant sequestration of radioactivity in red blood cells (RBCs) of rats treated with (14C)MCT. To determine whether this RBC sequestration might be important in the transport of reactive MCT metabolites, they compared the effect of inclusion of RBCs in the perfusion buffer on the extent of covalent binding of (14C)MCT to rat lungs in tandem liver-lung preparations. The potential effect of RBCs in stabilizing reactive intermediates was evaluated by preperfusion of isolated liver preparations with (14C)MCT with and without RBCs, separation and washing of the RBC fraction, and subsequent (90 min later) perfusion of washed RBCs or buffer alone in isolated perfused lungs. Covalent binding to lung tissues was determined by exhaustive methanol/chloroform extractions of unbound label from homogenized lung tissue followed by scintillation counting of residual 14C. Covalent binding was expressed as picomole MCT molecular weight equivalents/mg protein. Comparison of the relative capability of these isolated organ preparations for conversion of MCT to polar metabolites was done by extraction and HPLC analysis of perfusate at the end of the experiment. Isolated livers converted 65-85% of MCT to polar metabolites compared with less than 5% conversion in the isolated lungs. Inclusion of RBCs in the buffer of tandem lung liver preparations perfused with 400 microM (14C)MCT increased the covalent binding to the lung from 97 {plus minus} 25 (buffer alone) to 182 {plus minus} 36 (buffer + RBC) pmol/mg protein.

Red blood cells augment transport of reactive metabolites of monocrotaline from liver to lung in isolated and tandem liver and lung preparations

International Nuclear Information System (INIS)

Pan, L.C.; Lame, M.W.; Morin, D.; Wilson, D.W.; Segall, H.J.

1991-01-01

Monocrotaline (MCT) is a pyrrolizidine alkaloid that causes pulmonary hypertension in rats by mechanisms which remain largely unknown. MCT is thought to be activated in the liver to a reactive intermediate that is transported to the lung where it causes endothelial injury. The authors previous pharmacokinetic work demonstrated significant sequestration of radioactivity in red blood cells (RBCs) of rats treated with [14C]MCT. To determine whether this RBC sequestration might be important in the transport of reactive MCT metabolites, they compared the effect of inclusion of RBCs in the perfusion buffer on the extent of covalent binding of [14C]MCT to rat lungs in tandem liver-lung preparations. The potential effect of RBCs in stabilizing reactive intermediates was evaluated by preperfusion of isolated liver preparations with [14C]MCT with and without RBCs, separation and washing of the RBC fraction, and subsequent (90 min later) perfusion of washed RBCs or buffer alone in isolated perfused lungs. Covalent binding to lung tissues was determined by exhaustive methanol/chloroform extractions of unbound label from homogenized lung tissue followed by scintillation counting of residual 14C. Covalent binding was expressed as picomole MCT molecular weight equivalents/mg protein. Comparison of the relative capability of these isolated organ preparations for conversion of MCT to polar metabolites was done by extraction and HPLC analysis of perfusate at the end of the experiment. Isolated livers converted 65-85% of MCT to polar metabolites compared with less than 5% conversion in the isolated lungs. Inclusion of RBCs in the buffer of tandem lung liver preparations perfused with 400 microM [14C]MCT increased the covalent binding to the lung from 97 ± 25 (buffer alone) to 182 ± 36 (buffer + RBC) pmol/mg protein

Variable Ventilation Improved Respiratory System Mechanics and Ameliorated Pulmonary Damage in a Rat Model of Lung Ischemia-Reperfusion.

Science.gov (United States)

Soluri-Martins, André; Moraes, Lillian; Santos, Raquel S; Santos, Cintia L; Huhle, Robert; Capelozzi, Vera L; Pelosi, Paolo; Silva, Pedro L; de Abreu, Marcelo Gama; Rocco, Patricia R M

2017-01-01

Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models. Thirty-six animals were randomly assigned to one of two groups: (1) ischemia-reperfusion (IR), in which the left pulmonary hilum was completely occluded and released after 30 min; and (2) Sham, in which animals underwent the same surgical manipulation but without hilar clamping. Immediately after surgery, the left (IR-injured) and right (contralateral) lungs from 6 animals per group were removed, and served as non-ventilated group (NV) for molecular biology analysis. IR and Sham groups were further randomized to one of two ventilation strategies: VCV ( n = 6/group) [tidal volume (V T ) = 6 mL/kg, positive end-expiratory pressure (PEEP) = 2 cmH 2 O, fraction of inspired oxygen (FiO 2 ) = 0.4]; or VV, which was applied on a breath-to-breath basis as a sequence of randomly generated V T values ( n = 1200; mean V T = 6 mL/kg), with a 30% coefficient of variation. After 5 min of ventilation and at the end of a 2-h period (Final), respiratory system mechanics and arterial blood gases were measured. At Final, lungs were removed for histological and molecular biology analyses. Respiratory system elastance and alveolar collapse were lower in VCV than VV (mean ± SD, VCV 3.6 ± 1.3 cmH 2 0/ml and 2.0 ± 0.8 cmH 2 0/ml, p = 0.005; median [interquartile range], VCV 20.4% [7.9-33.1] and VV 5.4% [3.1-8.8], p = 0.04, respectively). In left lungs of IR animals, VCV increased the expression of interleukin-6 and

Variable Ventilation Improved Respiratory System Mechanics and Ameliorated Pulmonary Damage in a Rat Model of Lung Ischemia-Reperfusion

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Patricia R. M. Rocco

2017-05-01

Full Text Available Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models. Thirty-six animals were randomly assigned to one of two groups: (1 ischemia-reperfusion (IR, in which the left pulmonary hilum was completely occluded and released after 30 min; and (2 Sham, in which animals underwent the same surgical manipulation but without hilar clamping. Immediately after surgery, the left (IR-injured and right (contralateral lungs from 6 animals per group were removed, and served as non-ventilated group (NV for molecular biology analysis. IR and Sham groups were further randomized to one of two ventilation strategies: VCV (n = 6/group [tidal volume (VT = 6 mL/kg, positive end-expiratory pressure (PEEP = 2 cmH2O, fraction of inspired oxygen (FiO2 = 0.4]; or VV, which was applied on a breath-to-breath basis as a sequence of randomly generated VT values (n = 1200; mean VT = 6 mL/kg, with a 30% coefficient of variation. After 5 min of ventilation and at the end of a 2-h period (Final, respiratory system mechanics and arterial blood gases were measured. At Final, lungs were removed for histological and molecular biology analyses. Respiratory system elastance and alveolar collapse were lower in VCV than VV (mean ± SD, VCV 3.6 ± 1.3 cmH20/ml and 2.0 ± 0.8 cmH20/ml, p = 0.005; median [interquartile range], VCV 20.4% [7.9–33.1] and VV 5.4% [3.1–8.8], p = 0.04, respectively. In left lungs of IR animals, VCV increased the expression of interleukin-6 and intercellular

020. Coexistence of lung adenocarcinoma and usual interstitial pneumonia: a case report

Science.gov (United States)

Baliaka, Aggeliki; Papaemmanouil, Styliani; Spyratos, Dionysis; Zarogoulidis, Paul; Sakkas, Leonidas

2015-01-01

Background Usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial pneumonia of unknown cause. The most common symptoms are progressively increased shortness of breath and dry cough. Some studies suggest an association between usual interstitial pneumonia and lung cancer through different pathogenetic mechanisms. Objective The case presentation of a patient with lung adenocarcinoma and UIP. Methods A 66-year-old male presented with persistent dry cough, hemoptysis and dyspnea. The chest radiographs revealed a mass in the lower lobe of the left lung, measuring 3 cm, as well as diffuse interstitial changes in the same lobe. Two partial lobectomies were performed. Results Histological examination of the mass showed moderately differentiated adenocarcinoma, focally with bronchoalveolar pattern (Immunohistochemical detection of EGFR: positive). The rest lung parenchyma presented histological appearance of UIP. Conclusions According to clinicopathological studies, the prevalence of lung cancer among patients with UIP/IPF varies between 4% and 9%. The overall median survival of IPF-Ca patients is seven months in comparison with IPF only patients (14 months).

Lung abscess presenting as tension pyopneumothorax in a gastrointestinal cancer patient.

Science.gov (United States)

Okita, Riki; Miyata, Yoshihiro; Hamai, Yoichi; Hihara, Jun; Okada, Morihito

2014-01-01

We report a surgical case of tension pyopneumothorax in a patient who was receiving chemotherapy for esophageal cancer. A 68-year-old man who had undergone total gastrectomy with splenectomy for gastric cancer and was receiving chemotherapy for esophageal cancer was presented to our hospital with dyspnea. Left tension pyopneumothorax was diagnosed, and he received left lower lobectomy after pleural drainage. His postoperative course was uneventful, and he is alive without any cancer recurrences 5 years after the lobectomy. Once tension pyopneumothorax has developed from lung abscess, emergent lobectomy may be a useful option to prevent lethal aspiration pneumonia.

Non-compact left ventricle/hypertrabeculated left ventricle

International Nuclear Information System (INIS)

Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

2005-01-01

Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

Anterior Myocardial Territory May Replace the Heart as Organ at Risk in Intensity-Modulated Radiotherapy for Left-Sided Breast Cancer

International Nuclear Information System (INIS)

Tan Wenyong; Liu Dong; Xue Chenbin; Xu Jiaozhen; Li Beihui; Chen Zhengwang; Hu Desheng; Wang Xionghong

2012-01-01

Purpose: We investigated whether the heart could be replaced by the anterior myocardial territory (AMT) as the organ at risk (OAR) in intensity-modulated radiotherapy (IMRT) of the breast for patients with left-sided breast cancer. Methods and Materials: Twenty-three patients with left-sided breast cancer who received postoperative radiation after breast-conserving surgery were studied. For each patient, we generated five IMRT plans including heart (H), left ventricle (LV), AMT, LV+AMT, and H+LV as the primary OARs, respectively, except both lungs and right breast, which corresponded to IMRT(H), IMRT(LV), IMRT(AMT), IMRT(LV+AMT), and IMRT(H+LV). For the planning target volumes and OARs, the parameters of dose–volume histograms were compared. Results: The homogeneity index, conformity index, and coverage index were not compromised significantly in IMRT(AMT), IMRT(LV) and IMRT(LV+ AMT), respectively, when compared with IMRT(H). The mean dose to the heart, LV, and AMT decreased 5.3–21.5% (p < 0.05), 19.9–29.5% (p < 0.05), and 13.3–24.5% (p < 0.05), respectively. Similarly, the low (e.g., V5%), middle (e.g., V20%), and high (e.g., V30%) dose-volume of the heart, LV, and AMT decreased with different levels. The mean dose and V10% of the right lung increased by 9.2% (p < 0.05) and 27.6% (p < 0.05), respectively, in IMRT(LV), and the mean dose and V5% of the right breast decreased significantly in IMRT(AMT) and IMRT(LV+AMT). IMRT(AMT) was the preferred plan and was then compared with IMRT(H+LV); the majority of dose–volume histogram parameters of OARs including the heart, LV, AMT, both lungs, and the right breast were not statistically different. However, the low dose-volume of LV increased and the middle dose-volume decreased significantly (p < 0.05) in IMRT(AMT). Also, those of the right lung (V10%, V15%) and right breast (V5%, V10%) decreased significantly (p < 0.05). Conclusions: The AMT may replace the heart as the OAR in left-sided breast IMRT after breast

Quantitation of postexercise lung thallium-201 uptake during single photon emission computed tomography

International Nuclear Information System (INIS)

Kahn, J.K.; Carry, M.M.; McGhie, I.; Pippin, J.J.; Akers, M.S.; Corbett, J.R.

1989-01-01

To test the hypothesis that analysis of lung thallium uptake measured during single photon emission computed tomography (SPECT) yields supplementary clinical information as reported for planar imaging, quantitative analysis of lung thallium uptake following maximal exercise was performed in 40 clinically normal subjects (Group 1) and 15 angiographically normal subjects (Group 2). Lung thallium uptake was measured from anterior projection images using a ratio of heart-to-lung activities. Seventy subjects with coronary artery disease (CAD) (Group 3) determined by angiography (greater than or equal to 70% luminal stenosis) underwent thallium perfusion SPECT. Thirty-nine percent of these subjects had multivessel and 61% had single vessel CAD. Lung thallium uptake was elevated in 47 of 70 (67%) Group 3 subjects. Group 3 subjects with elevated lung thallium uptake did not differ from Group 3 subjects with normal lung thallium uptake with respect to extent or distribution of coronary artery disease, left ventricular function, or severity of myocardial ischemia as determined by exercise and redistribution thallium SPECT. Thus, the measurement of thallium lung uptake from anterior projection images obtained during SPECT frequently identifies patients with CAD, but it may not provide supplementary information regarding the extent of myocardial ischemia or ventricular dysfunction

A new "twist" on right heart failure with left ventricular assist systems.

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Houston, Brian A; Shah, Keyur B; Mehra, Mandeep R; Tedford, Ryan J

2017-07-01

Despite significant efforts to predict and prevent right heart failure, it remains a leading cause of morbidity and mortality after implantation of left ventricular assist systems (LVAS). In this Perspective, we review the underappreciated anatomic and physiologic principles that govern the relationship between left and right heart function and contribute to this phenomenon. This includes the importance of considering the right ventricle (RV) and pulmonary arterial circuit as a coupled system; the contribution of the left ventricle (LV) to RV contractile function and the potential negative impact of acutely unloading the LV; the influence of the pericardium and ventricular twist on septal function; the role of RV deformation in reduced mechanical efficiency after device placement; and the potential of ongoing stressors of an elevated right-sided preload. We believe an appreciation of these complex issues is required to fully understand the expression of the unique phenotypes of right heart failure after LVAS implantation and for developing better prognostic and therapeutic strategies. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Intersections of lung progenitor cells, lung disease and lung cancer.

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Kim, Carla F

2017-06-30

The use of stem cell biology approaches to study adult lung progenitor cells and lung cancer has brought a variety of new techniques to the field of lung biology and has elucidated new pathways that may be therapeutic targets in lung cancer. Recent results have begun to identify the ways in which different cell populations interact to regulate progenitor activity, and this has implications for the interventions that are possible in cancer and in a variety of lung diseases. Today's better understanding of the mechanisms that regulate lung progenitor cell self-renewal and differentiation, including understanding how multiple epigenetic factors affect lung injury repair, holds the promise for future better treatments for lung cancer and for optimising the response to therapy in lung cancer. Working between platforms in sophisticated organoid culture techniques, genetically engineered mouse models of injury and cancer, and human cell lines and specimens, lung progenitor cell studies can begin with basic biology, progress to translational research and finally lead to the beginnings of clinical trials. Copyright ©ERS 2017.

Intersections of lung progenitor cells, lung disease and lung cancer

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Carla F. Kim

2017-06-01

Full Text Available The use of stem cell biology approaches to study adult lung progenitor cells and lung cancer has brought a variety of new techniques to the field of lung biology and has elucidated new pathways that may be therapeutic targets in lung cancer. Recent results have begun to identify the ways in which different cell populations interact to regulate progenitor activity, and this has implications for the interventions that are possible in cancer and in a variety of lung diseases. Today's better understanding of the mechanisms that regulate lung progenitor cell self-renewal and differentiation, including understanding how multiple epigenetic factors affect lung injury repair, holds the promise for future better treatments for lung cancer and for optimising the response to therapy in lung cancer. Working between platforms in sophisticated organoid culture techniques, genetically engineered mouse models of injury and cancer, and human cell lines and specimens, lung progenitor cell studies can begin with basic biology, progress to translational research and finally lead to the beginnings of clinical trials.

A case of unilateral lung edema after treatment of pulmonary adenocarcinoma

International Nuclear Information System (INIS)

Itoh, Hiromichi; Yamamoto, Tatsuo; Saida, Yukihisa; Ishikawa, Shigemi; Onizuka, Masataka; Noguchi, Masayuki

2005-01-01

As HRCT (high resolution computed tomography) has become increased commonly used, it has become apparent that GGA (ground-glass attenuation) is present in a variety of lung diseases. We report a case of unilateral lung edema represented as GGA in an opposite lung field after treatment of pulmonary adenocarcinoma. A 70-year-old man with uncontrolled diabetes was admitted because of an abnormal shadow discovered during a routine chest X-ray in June 2003. In 1994, he underwent a left lower lobectomy and post-operative mediastinal radiation for pulmonary adenocarcinoma (p-Stage IIIA). Chest CT on admission demonstrated widespread GGA in the right hilar lesion of the middle and lower lobes. Detailed examinations including transbronchial lung biopsy (TBLB), bacterial culture and a serological test could not confirm bronchioloalveolar carcinoma, interstitial pneumonia, viral pneumonia or alveolar proteinosis. The patient increased his weight by 5 kg and ultrasound examination showed dilatation of the inferior vena cava and a congestive liver. The GGA disappeared one month after the administration of furosemide. The clinical course, HRCT and pathological findings suggested that lung edema caused by volume overload affected as localized unilateral GGA in the chest CT. The decrease in pulmonary vessel beds due to surgical resection, obstruction of lymphatic circulation after mediastinal radiation, and increased permeability of microvessels associated with diabetes are supposed to be linked to lung edema. Localized lung edema should be considered as a possible cause of GGA after lung cancer treatment. (author)

Spirometry, Static Lung Volumes, and Diffusing Capacity.

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Vaz Fragoso, Carlos A; Cain, Hilary C; Casaburi, Richard; Lee, Patty J; Iannone, Lynne; Leo-Summers, Linda S; Van Ness, Peter H

2017-09-01

Spirometric Z-scores from the Global Lung Initiative (GLI) rigorously account for age-related changes in lung function and are thus age-appropriate when establishing spirometric impairments, including a restrictive pattern and air-flow obstruction. However, GLI-defined spirometric impairments have not yet been evaluated regarding associations with static lung volumes (total lung capacity [TLC], functional residual capacity [FRC], and residual volume [RV]) and gas exchange (diffusing capacity). We performed a retrospective review of pulmonary function tests in subjects ≥40 y old (mean age 64.6 y), including pre-bronchodilator measures for: spirometry ( n = 2,586), static lung volumes by helium dilution with inspiratory capacity maneuver ( n = 2,586), and hemoglobin-adjusted single-breath diffusing capacity ( n = 2,508). Using multivariable linear regression, adjusted least-squares means (adj LS Means) were calculated for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity. The adj LS Means were expressed with and without height-cubed standardization and stratified by GLI-defined spirometry, including normal ( n = 1,251), restrictive pattern ( n = 663), and air-flow obstruction (mild, [ n = 128]; moderate, [ n = 150]; and severe, [ n = 394]). Relative to normal spirometry, restrictive-pattern had lower adj LS Means for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity ( P ≤ .001). Conversely, relative to normal spirometry, mild, moderate, and severe air-flow obstruction had higher adj LS Means for FRC and RV ( P < .001). However, only mild and moderate air-flow obstruction had higher adj LS Means for TLC ( P < .001), while only moderate and severe air-flow obstruction had higher adj LS Means for RV/TLC ( P < .001) and lower adj LS Means for hemoglobin-adjusted single-breath diffusing capacity ( P < .001). Notably, TLC (calculated as FRC + inspiratory capacity) was not increased in severe air-flow obstruction ( P ≥ .11

Comparative biology of decellularized lung matrix: Implications of species mismatch in regenerative medicine.

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Balestrini, Jenna L; Gard, Ashley L; Gerhold, Kristin A; Wilcox, Elise C; Liu, Angela; Schwan, Jonas; Le, Andrew V; Baevova, Pavlina; Dimitrievska, Sashka; Zhao, Liping; Sundaram, Sumati; Sun, Huanxing; Rittié, Laure; Dyal, Rachel; Broekelmann, Tom J; Mecham, Robert P; Schwartz, Martin A; Niklason, Laura E; White, Eric S

2016-09-01

Lung engineering is a promising technology, relying on re-seeding of either human or xenographic decellularized matrices with patient-derived pulmonary cells. Little is known about the species-specificity of decellularization in various models of lung regeneration, or if species dependent cell-matrix interactions exist within these systems. Therefore decellularized scaffolds were produced from rat, pig, primate and human lungs, and assessed by measuring residual DNA, mechanical properties, and key matrix proteins (collagen, elastin, glycosaminoglycans). To study intrinsic matrix biologic cues, human endothelial cells were seeded onto acellular slices and analyzed for markers of cell health and inflammation. Despite similar levels of collagen after decellularization, human and primate lungs were stiffer, contained more elastin, and retained fewer glycosaminoglycans than pig or rat lung scaffolds. Human endothelial cells seeded onto human and primate lung tissue demonstrated less expression of vascular cell adhesion molecule and activation of nuclear factor-κB compared to those seeded onto rodent or porcine tissue. Adhesion of endothelial cells was markedly enhanced on human and primate tissues. Our work suggests that species-dependent biologic cues intrinsic to lung extracellular matrix could have profound effects on attempts at lung regeneration. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of KVCBCT based on deformable image registration of adaptive planning and static 3DCRT planning for patients with lung cancer

International Nuclear Information System (INIS)

Hou Yong; Yin Yong; Wang Pengcheng; Ma Chengsheng

2012-01-01

Objective: To comparison of kilo-voltage cone-beam CT (KVCBCT) deformable image registration of adaptive planning and static planning for patients with lung cancer,and evaluate their characters. Methods: Five patients with lung cancer were in the study. Two sets image were acquired every three days and were concatenated to one set. Ten sets CBCT image and planning CT image were transferred a commercial deformable image registration software. The planning CT was deformed to each set CBCT and the contours delineated, the new contour were labeled CBCT f1 -CBCT f10 . Transfer of each deformed planning CT and CBCT f1 -CBCT f10 back into the treatment planning system enable re-calculation of actual dose distribution, then we obtain CT planning and fractional CBCT contour planning, the CBCT planning were labeled CBCT p1 -CBCT p10 . Ten times CBCT planning of every patient were added to acquire a total dose accumulation planning (DA plan), comparison of dose distribution and dose-volume histogram in CT plan and DA plan for fractionation dose and accumulation dose of left, right, total lung, PTV and spinal-cord. The difference of two plan was analyzed by Wilcoxson's sign rank test. Results: The max and min dose of PTV, the left, right, total lung V 5 , V 10 , V 20 , V 30 , V 50 , spinal-cord max dose, and the left,right and total lung mean dose in DA plan were smaller than in CT plan (z=-2.02 - -2.03, P 95 in DA plan was as well as in CT plan (z=-1.48, -1.21, P=0.138, 0.225). Conclusions: KVCBCT based deformable image registration of adaptive planning reduce the dose of lung and spinal-cord, and enhance the dose of PTV. This provides a tool for exploring adaptive radiotherapy strategies. (authors)

Examination of post operative split lung function using quantitative xenon 133 (133Xe) inhalation scan

International Nuclear Information System (INIS)

Omote, Yoshiharu; Maeda, Tomio; Ikeda, Koichiro; Kubo, Yoshihiko

1992-01-01

133 Xe inhalation scan and ordinary lung function testing were performed three times in 34 patients undergoing pulmonary resection: before surgery, and one and six months postoperatively. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1.0 ) were used as spirometric parameters. From the 133 Xe inhalation scan, a split lung capacity (right to left, upper, middle and lower) and T1/2 (time required for half of the inhalation of 133 Xe gas to be expired) were calculated by computer and used as indices of split lung capacity and ventilation, respectively. The predicted postoperative lung functions were calculated using preoperative spirometric respiratory function and 133 Xe inhalation data according to the formula reported by Ali and associates. At sixth postoperative month, both predicted FVC (r=0.895, p 1.0 (r=0.897, p<0.001) correlated highly with those actually observed. These results appear to be very useful for preoperative evaluation of operative indications and the choice of surgical method. The ratios of observed to predicted lung capacity in the post operative state were examined by splitting the right and left lung and the means±S.D.(%) were 80.5±9.7% on the operated side and 119.2±11.7% on the opposite side one month after surgery. Six months after surgery, the corresponding figures were 111.0±5.6% and 96.7±16.4%. The post operative T1/2 values on the operated sides were about 2.4 times the preoperative values at one month after surgery but returned to the preoperative values by the six postoperative month. From these results, it can be said that respiratory functions after pulmonary resection are maintained primarily by compensatory lung function of opposite and operated sides at one and six months, respectively. These results also provide valuable information on postoperative respiratory care for patients who have undergone lung resection. (author)

Postoperative pulmonary complication after neurosurgery: A case of unilateral lung collapse.

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Misra, Shilpi

2016-01-01

Pulmonary complications, especially postoperative pulmonary complications, are an important cause of morbidity and mortality in neurosurgical patients. Hypoxemia due to mucus plug causing lung collapse is a rare event. We report a case of a 40-year-old female with right cerebellopontine angle space occupying lesion, scheduled for elective craniotomy and tumor excision. The patient underwent surgery uneventfully and was shifted to Intensive Care Unit (ICU) for monitoring. Eight hours after extubation, she developed hypoxemia due to mucus plug resulting in left lung collapse. She was intubated, and mucus plug was aspirated through sterile endobronchial tube suction which resulted in reexpansion of the collapsed lung. The patient was managed with postural drainage, chest physiotherapy, and antibiotics and extubated after 24 h. This type of pulmonary complication may have a catastrophic course, especially in neurosurgical patients, if not diagnosed and managed in time.

Successful lung transplantation for talcosis secondary to intravenous abuse of oral drug

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Dekel Shlomi

2008-06-01

Full Text Available Dekel Shlomi1, David Shitrit1, Daniele Bendayan1, Gidon Sahar2, Yitshak Shechtman3, Mordechai R Kramer11Pulmonary Institute, Departments of 2Cardiothoracic Surgery and 3Pathology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelAbstract: Talcosis due to intravenous injection of oral drugs can cause severe pulmonary disease with progressive dyspnea even when drug use is discontinued. We describe a 54-yearold woman with severe emphysema who underwent left lung transplantation. The patient had a remote history of intravenous injection of crushed methylphenidate (Ritalin tablets. Chest computed tomography showed severe emphysematous changes, more prominent in the lower lobes. Microscopic examination of the extracted lung demonstrated multinucleated giant cells with birefringent crystals, compatible with talcosis. At follow-up, daily symptoms were completely alleviated and lung function was good. We recommend that lung transplantation be considered as a viable option in the treatment of talcosis.Keywords: methylphenidate (Ritalin, emphysema

Investigation of lung cancer in atomic bomb survivors

International Nuclear Information System (INIS)

Sasaki, Hideo; Itoh, Chikako; Mitsuyama, Toyofumi; Katsuta, Shizutomo.

1976-01-01

Fourty two cases of lung cancer in A-bomb survivors experienced between 1971 and 1975 were compared to non-exposure cases with lung cancer, and discussed. The mean age of A-bomb survivors with lung cancer was 68.7 year old, and that of control cases was 60 year old. The incidence ratio of male to female in the group was 4 : 1, and that of control group was 5 : 1. Occupation was one of the predisposing causes, but patients who had engaged in the occupation which was considered to predispose lung cancer were three. Among 39 patients with lung cancer whose smoking histories were clarified, 20.5 per cent was nonsmoker, and 69.3 per cent was heavy smoker. Among 39 patients whose cancer histories were clarified, 28.2 per cent of the patients had family history of cancer. Subjective symptoms of this disease were cough, sputum, bloody sputum and chest pain, and some had no symptoms. Seventeen cases (40.5 per cent) were detected in the physical examination for the A-bomb survivors. For the early detection of lung cancer in A-bomb survivors, patients with high risk should be selected to have received clearly established diagnosis. Histologically, squamous cell carcinoma was seen in many cases, following adenoma, and undifferenciated large cell carcinoma and small cell carcinoma. Disturbances in pulmonary functions were obstructive ventilation, high rate of residual air, lowered diffusions ability. Therapy was operation in stage I, chemotherapy and radiation therapy in stage II and stage III. (Kanao, N.)

Decrease in the ability to detect elevated lung thallium due to delay in commencing imaging after exercise

International Nuclear Information System (INIS)

Rothendler, J.A.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.; Okada, R.D.

1985-01-01

Post-exercise elevation of the lung/myocardial thallium ratio and a high lung clearance rate between initial and delayed images have been reported to be markers for exercise-induced left ventricular (LV) dysfunction associated with coronary artery disease (CAD). The authors performed thallium exercise tests on 60 patients, 42 with CAD, in order to determine the effect of delaying initial imaging on detection of elevated lung thallium. In addition to images obtained at 2 minutes and at 2 hours after exercise, 18-minute images were also obtained to simulate such a delay. Because of rapid isotope clearance in those with initially elevated lung activity, there was decreased sensitivity of both the initial lung/myocardial ratio and lung thallium clearance for detecting CAD, using the 18-minute image as the initial post exercise study. They conclude that initial imaging should be done in the anterior view early after exercise to optimize detection of elevated lung thallium

Residual stresses analysis of friction stir welding using one-way FSI simulation

International Nuclear Information System (INIS)

Kang, Sung Wook; Jang, Beom Seon; Song, Ha Cheol

2015-01-01

When certain mechanisms, such as plastic deformations and temperature gradients, occur and are released in a structure, stresses remain because of the shape of the structure and external constraints. These stresses are referred to as residual stresses. The base material locally expands during heating in the welding process. When the welding is completed and cooled to room temperature, the residual stresses are left at nearly the yield strength level. In the case of friction stir welding, the maximum temperature is 80% to 90% of the melting point of the materials. Thus, the residual stresses in the welding process are smaller than those in other fusion welding processes; these stresses have not been considered previously. However, friction stir welding residual stresses are sometimes measured at approximately 70% or above. These residual stresses significantly affect fatigue behavior and lifetime. The present study investigates the residual stress distributions in various welding conditions and shapes of friction stir welding. In addition, the asymmetric feature is considered in temperature and residual stress distribution. Heat transfer analysis is conducted using the commercial computational fluid dynamics program Fluent, and results are used in the finite element structural analysis with the ANSYS Multiphysics software. The calculated residual stresses are compared with experimental values using the X-ray diffraction method.

Left regular bands of groups of left quotients

International Nuclear Information System (INIS)

El-Qallali, A.

1988-10-01

A semigroup S which has a left regular band of groups as a semigroup of left quotients is shown to be the semigroup which is a left regular band of right reversible cancellative semigroups. An alternative characterization is provided by using spinned products. These results are applied to the case where S is a superabundant whose set of idempotents forms a left normal band. (author). 13 refs

Thioredoxin priming prolongs lung allograft survival by promoting immune tolerance.

Directory of Open Access Journals (Sweden)

Hanbo Hu

Full Text Available Tolerance to allograft antigen is the major challenge and final goal of transplant medicine. Our previous study demonstrated that thioredoxin-1 (Trx priming of donor lung significantly protected allogeneic lung graft. To determine whether Trx priming of donor lung inhibits allograft rejection, extends allograft survival and induces immune tolerance, orthotopic left lung transplantation was performed from Lewis to Sprague-Dawley rats without immunosuppression. Donor lungs were primed with Trx at 4°C for 4 hr prior to transplantation. After up to 37 days post-transplantation, allograft lung morphology, recipient T cell and humoral alloantigen-specific immune responses were examined. We found that Trx-primed lungs exhibited much reduced acute rejection and associated lung injuries resulting in loss of graft functional area at 5-37 days post-transplant in contrast to the control groups. CD4+ T cells from the recipients with Trx-primed grafts responded to the stimulation of dendritic cells (DCs of donor origin, in contrast to DCs from the third party, with significantly reduced proliferation. Consistent with above findings, we observed that CD4+Foxp3+ regulatory T cells in spleen cells from the recipients with Trx-primed grafts were significantly increased compared to controls, and CD4+ T cells from the recipients with Trx-primed grafts produced much higher levels of immunosuppressive cytokine, IL-10 when stimulated with allogeneic donor DCs. In addition, humoral immune tolerance was also induced as there was no significant increase levels of serum antibodies against donor antigens in Trx-lung recipients when re-challenged with allogeneic donor antigens. Our results demonstrate that one-time Trx-priming of donor lung grafts prior to transplantation significantly prolongs the survival of the grafts through inducing or promoting cellular and humoral alloantigen-specific immune tolerance, which might be associated with the induction of

Transfer factor, lung volumes, resistance and ventilation distribution in healthy adults.

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Verbanck, Sylvia; Van Muylem, Alain; Schuermans, Daniel; Bautmans, Ivan; Thompson, Bruce; Vincken, Walter

2016-01-01

Monitoring of chronic lung disease requires reference values of lung function indices, including putative markers of small airway function, spanning a wide age range.We measured spirometry, transfer factor of the lung for carbon monoxide (TLCO), static lung volume, resistance and ventilation distribution in a healthy population, studying at least 20 subjects per sex and per decade between the ages of 20 and 80 years.With respect to the Global Lung Function Initiative reference data, our subjects had average z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC of -0.12, 0.04 and -0.32, respectively. Reference equations were obtained which could account for a potential dependence of index variability on age and height. This was done for (but not limited to) indices that are pertinent to asthma and chronic obstructive pulmonary disease studies: forced expired volume in 6 s, forced expiratory flow, TLCO, specific airway conductance, residual volume (RV)/total lung capacity (TLC), and ventilation heterogeneity in acinar and conductive lung zones.Deterioration in acinar ventilation heterogeneity and lung clearance index with age were more marked beyond 60 years, and conductive ventilation heterogeneity showed the greatest increase in variability with age. The most clinically relevant deviation from published reference values concerned RV/TLC values, which were considerably smaller than American Thoracic Society/European Respiratory Society-endorsed reference values. Copyright ©ERS 2016.

Fatal interstitial lung disease associated with icotinib.

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Zhang, Jiexia; Zhan, Yangqing; Ouyang, Ming; Qin, Yinyin; Zhou, Chengzhi; Chen, Rongchang

2014-12-01

The most serious, and maybe fatal, yet rare, adverse reaction of gefitinib and erlotinib is drug-associated interstitial lung disease (ILD), which has been often described. However, it has been less well described for icotinib, a similar orally small-molecule tyrosine kinase inhibitor (TKI). The case of a 25-year-old female patient with stage IV lung adenocarcinoma who developed fatal ILD is reported here. She denied chemotherapy, and received palliative treatment with icotinib (125 mg po, three times daily) on March 1, 2013. One month after treatment initiation, the patient complained of continuous dry cough and rapid progressive dyspnea. Forty one days after icotinib treatment, icotinib associated ILD was suspected when the patient became increasingly dyspnoeic despite of treatment of pericardial effusion, left pleural effusion and lower respiratory tract infection, and X-ray computed tomography (CT) of chest revealed multiple effusion shadows and ground-glass opacities in bilateral lungs. Then, icotinib was discontinued and intravenous corticosteroid was started (methylprednisolone 40 mg once daily, about 1 mg per kilogram) respectively. Forty three days after icotinib treatment, the patient died of hypoxic respiratory failure. ILD should be considered as a rare, but often fatal side effect associated with icotinib treatment.

[Right lung cancer with right aortic arch].

Science.gov (United States)

Kawaguchi, Yasuo; Noriyuki, T; Kuroda, Y; Kuranishi, F; Nakahara, M; Fukuda, T; Ishizaki, Y; Hotta, R; Akimoto, E; Mori, H

2008-02-01

An abnormal shadow was detected on chest X-ray mass screening in an asymptomatic 63-year-old man. The further examinations revealed the shadow to be primary lung cancer (Rt. S6. adenocarcinoma, cT2N0M0, c-stage IB) with right aortic arch. We used 3 dimentional-computed tomography (3D-CT) to assess an anatomical feature of vessels in detail. The right lower lobectomy and the dissection of medi astinal lymph nodes was performed. We confirmed no abnormal anatomy of pulmonary artery and vein at surgery, and it was possible to perform right lower lobectomy with the common procedure. Since lymph node was found by intraopetrative pathological examination, since no metastasis from interlobar to subcarinal lymph node was found, we did not perform dissection of upper mediastinal dissection, which was equivalent to ND2a lymph nodes dissection of the left lung cancer in General Rule for Clinical and Pathological Record of Lung Cancer. The patient with right aortic arch is known to have variant anatomy of other intrathoracic vessels occasionally. 3D-CT was quite useful in assessing anatomical feature, and enabled us to perform safe operation.

Quantification of ventilation distribution in regional lung injury by electrical impedance tomography and xenon computed tomography

International Nuclear Information System (INIS)

Elke, Gunnar; Weiler, Norbert; Frerichs, Inéz; Fuld, Matthew K; Halaweish, Ahmed F; Hoffman, Eric A; Grychtol, Bartłomiej

2013-01-01

Validation studies of electrical impedance tomography (EIT) based assessment of regional ventilation under pathological conditions are required to prove that EIT can reliably quantify heterogeneous ventilation distribution with sufficient accuracy. The objective of our study was to validate EIT measurements of regional ventilation through a comparison with xenon-multidetector-row computed tomography (XeCT) in an animal model of sub-lobar lung injury. Nine anesthetized mechanically ventilated supine pigs were examined before and after the induction of lung injury in two adjacent sub-lobar segments of the right lung by saline lavage or endotoxin instillation. Regional ventilation was determined in 32 anteroposterior regions of interest in the right and left lungs and the ventilation change quantified by difference images between injury and control. Six animals were included in the final analysis. Measurements of regional ventilation by EIT and XeCT correlated well before (r s = 0.89 right, r s = 0.90 left lung) and after local injury (r s = 0.79 and 0.92, respectively). No bias and narrow limits of agreement were found during both conditions. The ventilation decrease in the right injured lung was correspondingly measured by both modalities (5.5%±1.1% by EIT and 5.4%±1.9% by XeCT, p = 0.94). EIT was inferior to clearly separate the exact anatomical location of the regional injuries. Regional ventilation was overestimated (<2%) in the most ventral and dorsal regions and underestimated (2%) in the middle regions by EIT compared to XeCT. This study shows that EIT is able to reliably discern even small ventilation changes on sub-lobar level. (paper)

Net emissions of carbon dioxide to the atmosphere when using forest residues for production of heat and electricity

International Nuclear Information System (INIS)

Zetterberg, L.; Hansen, O.

1998-05-01

This study estimates net emissions of carbon dioxide to the atmosphere from the use of forest residues for production of heat and electricity. In the report, the use of forest residues for energy production is called residue-usage. Our results show that for a turnover period of 80 years, the net emission of CO 2 to the atmosphere is 15.8 kg CO 2 -C/MWh (3.1-31.6 kg CO 2 -C/MWh), which represents 16% of the total carbon content in the wood fuel (3%-32%). Fossil fuel consumption is responsible for 3.1 kg CO 2 -C/MWh of this. Residue-usage may produce indirect emissions or uptake of carbon dioxide, e.g. through changes in production conditions, changes in the turnover of carbon in the humus layer or through a reduction of the amount of forest fires. Due to uncertainties in data it is hard to quantify these indirect effects. In some cases it is hard even to determine their signs. As a consequence of this, we have chosen not to include the indirect effects in our estimates of net emissions from residue-usage. Instead we discuss these effects in a qualitative manner. It may seem surprising that the biogenic part of the residue-usage produces a net emission of carbon dioxide considering that carbon has originated from the atmosphere. The explanation is that the residue-usage systematically leads to earlier emissions than would be the case if the residues were left on the ground. If forest residues are left to decay, in the long run a pool of carbon might be created in the ground. This does not happen with residue-usage 33 refs, 4 figs, 12 tabs

Sagittal-lung CT measurements in the evaluation of asthma-COPD overlap syndrome: a distinctive phenotype from COPD alone.

Science.gov (United States)

Qu, Yanjuan; Cao, Yiyuan; Liao, Meiyan; Lu, Zhiyan

2017-07-01

This study aimed at investigating the capability of sagittal-lung computed tomography (CT) measurements in differentiating chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS). Clinical and high-resolution CT of 229 patients including 123 pure COPD patients and 106 ACOS patients were included. Sagittal-lung CT measurements in terms of bilateral lung height (LH), anterior-posterior lung diameter (APLD), diaphragm height (DH), and anterior sterno-diaphragmatic angle (ASDA), as well as inter-pulmonary septum length (IPSL) on axial images were measured both before and after bronchodilator (BD) administration. Comparisons of clinical characteristics and CT measurements between patient groups were performed. All pre-BD quantitative sagittal features measuring diaphragm flattening and hyperinflation were not significantly different between patients with COPD and patients with ACOS (P values all >0.05). Following BD administration, the ACOS patients exhibited lower left LH, bilateral APLD, and bilateral ASDA, but higher right DH, compared to pure COPD patients (P values all <0.05). Right LH, left DH and IPSL were not significantly different between patient groups. Besides, variations of all sagittal-lung CT measurements were significantly larger in patients with ACOS than in patients with pure COPD (P values all <0.001) and showed high performance in differentiating these two kinds of patient, with diagnostic sensitivities ranging from 76.4 to 97.2%, specificities ranging from 86.2 to 100.0%, and accuracies ranging from 80.9 to 90.7%. Sagittal-lung CT measurements allow for differentiating patients with ACOS from those with pure COPD. The ACOS patients had larger post-BD variations of sagittal-lung CT measurements than patients with pure COPD.

Left phrenic nerve anatomy relative to the coronary venous system: Implications for phrenic nerve stimulation during cardiac resynchronization therapy.

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Spencer, Julianne H; Goff, Ryan P; Iaizzo, Paul A

2015-07-01

The objective of this study was to quantitatively characterize anatomy of the human phrenic nerve in relation to the coronary venous system, to reduce undesired phrenic nerve stimulation during left-sided lead implantations. We obtained CT scans while injecting contrast into coronary veins of 15 perfusion-fixed human heart-lung blocs. A radiopaque wire was glued to the phrenic nerve under CT, then we created three-dimensional models of anatomy and measured anatomical parameters. The left phrenic nerve typically coursed over the basal region of the anterior interventricular vein, mid region of left marginal veins, and apical region of inferior and middle cardiac veins. There was large variation associated with the average angle between nerve and veins. Average angle across all coronary sinus tributaries was fairly consistent (101.3°-111.1°). The phrenic nerve coursed closest to the middle cardiac vein and left marginal veins. The phrenic nerve overlapped a left marginal vein in >50% of specimens. © 2015 Wiley Periodicals, Inc.

Assessment of airway lesion in obstructive lung diseases by CT

International Nuclear Information System (INIS)

Niimi, Akio; Matsumoto, Hisako; Ueda, Tetsuya; Mishima, Michiaki

2002-01-01

Airway lesion in obstructive pulmonary diseases, such as asthma or chronic obstructive pulmonary disease (COPD), has recently been assessed quantitatively. Especially in asthma, wall thickening of central airways, and its relation to the severity of disease or airflow obstruction has been clarified. Pathophysiologic importance of peripheral airway lesion has also been highlighted by pathologic or physiologic studies. However, direct evaluation of peripheral airway lesion is beyond resolutional limitation of CT. To assess airway trapping, an indirect CT finding of peripheral airway disease, by quantitative and semiquantitative measures and compare them with clinical indices such as pulmonary function, airway responsiveness, or airway inflammation. Patients with stable asthma (n=20) were studied. HRCT at 3 levels of both lungs were scanned. Low attenuation area (LAA)% and mean lung density were quantitatively assessed by an automatic method. Distribution of mosaic pattern was visually scored semiquantitatively. LAA% and mean lung density at full expiratory phase correlated with the degree of airflow obstruction. Mosaic score at full inspiratory phase correlated with the severity of disease and airflow obstruction. Expiratory/inspiratory ratio of mean lung density was also associated with airway responsiveness or residual volume/total lung capacity (RV/TLC). These CT findings may be useful as markers of asthma pathophysiology. (author)

Phosphodiesterase-4 inhibition combined with isoniazid treatment of rabbits with pulmonary tuberculosis reduces macrophage activation and lung pathology.

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Subbian, Selvakumar; Tsenova, Liana; O'Brien, Paul; Yang, Guibin; Koo, Mi-Sun; Peixoto, Blas; Fallows, Dorothy; Zeldis, Jerome B; Muller, George; Kaplan, Gilla

2011-07-01

Tuberculosis (TB) is responsible for significant morbidity and mortality worldwide. Even after successful microbiological cure of TB, many patients are left with residual pulmonary damage that can lead to chronic respiratory impairment and greater risk of additional TB episodes due to reinfection with Mycobacterium tuberculosis. Elevated levels of the proinflammatory cytokine tumor necrosis factor-α and several other markers of inflammation, together with expression of matrix metalloproteinases, have been associated with increased risk of pulmonary fibrosis, tissue damage, and poor treatment outcomes in TB patients. In this study, we used a rabbit model of pulmonary TB to evaluate the impact of adjunctive immune modulation, using a phosphodiesterase-4 inhibitor that dampens the innate immune response, on the outcome of treatment with the antibiotic isoniazid. Our data show that cotreatment of M. tuberculosis infected rabbits with the phosphodiesterase-4 inhibitor CC-3052 plus isoniazid significantly reduced the extent of immune pathogenesis, compared with antibiotic alone, as determined by histologic analysis of infected tissues and the expression of genes involved in inflammation, fibrosis, and wound healing in the lungs. Combined treatment with an antibiotic and CC-3052 not only lessened disease but also improved bacterial clearance from the lungs. These findings support the potential for adjunctive immune modulation to improve the treatment of pulmonary TB and reduce the risk of chronic respiratory impairment. Copyright © 2011 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Estimation of lung volume and pulmonary blood volume from radioisotopic images

International Nuclear Information System (INIS)

Kanazawa, Minoru

1989-01-01

Lung volume and pulmonary blood volume in man were estimated from the radioisotopic image using single photon emission computed tomography (SPECT). Six healthy volunteers were studied in a supine position with normal and altered lung volumes by applying continuous negative body-surface pressure (CNP) and by positive end-expiratory pressure (PEEP). 99m Tc labeled human serum albumin was administered as an aerosol to image the lungs. The CNP caused the diaphragm to be lowered and it increased the mean lung tissue volume obtained by SPECT from 3.09±0.49 l for baseline to 3.67±0.62 l for 10 cmH 2 O (p 2 O (p 2 O), respectively. The PEEP also increased the lung tissue volume to 3.68±0.68 l for 10 cmH 2 O as compared with the baseline (p 2 O PEEP. The lung tissue volume obtained by SPECT showed a positive correlation with functional residual capacity measured by the He dilution method (r=0.91, p 99m Tc-labeled red blood cells. The L/H ratio decreased after either the CNP or PEEP, suggesting a decrease in the blood volume per unit lung volume. However, it was suggested that the total pulmonary blood volume increased slightly either on the CNP (+7.4% for 10 cmH 2 O, p 2 O,p<0.05) when we extrapolated the L/H ratio to the whole lungs by multiplying the lung tissue volume obtained by SPECT. We concluded that SPECT could offer access to the estimation of lung volume and pulmonary blood volume in vivo. (author)

Non-invasive determination of absolute lung resistivity in adults using electrical impedance tomography

International Nuclear Information System (INIS)

Zhang, Jie; Patterson, Robert

2010-01-01

Lung resistivity is a physiological parameter that describes the electrical characteristics of the lungs. Lung composition changes due to changes in the lung tissues, fluid and air volume. Various diseases that can cause a change in lung composition may be monitored by measuring lung resistivity. Currently, there is no accepted non-invasive method to measure lung resistivity. In this study, we presented a method and framework to non-invasively determine lung resistivity using electrical impedance tomography (EIT). By comparing actual measurements from subjects with data from a 3D human thorax model, an EIT image can be reconstructed to show a resistivity difference between the model and the subject. By adjusting the lung resistivity in the model, the resistivity difference in the lung regions can be reduced to near zero. This resistivity value then is the estimation of the lung resistivity of the subject. Using the proposed method, the lung resistivities of four normal adult males (43 ± 13 years, 78 ± 10 kg) in the supine position at air volumes starting at functional residual capacity (FRC—end expiration) and increasing in 0.5 l steps to 1.5 l were studied. The averaged lung resistivity changes 12.59%, from 1406 Ω cm to 1583 Ω cm, following the inspiration of 1.5 l air from FRC. The coefficients of variation (CV) of precision for the four subjects are less than 10%. The experiment was repeated five times at each air volume on a subject to test the reproducibility. The CVs are less than 3%. The results show that it is feasible to determine absolute lung resistivity using an EIT-based method

Non-invasive determination of absolute lung resistivity in adults using electrical impedance tomography.

Science.gov (United States)

Zhang, Jie; Patterson, Robert

2010-08-01

Lung resistivity is a physiological parameter that describes the electrical characteristics of the lungs. Lung composition changes due to changes in the lung tissues, fluid and air volume. Various diseases that can cause a change in lung composition may be monitored by measuring lung resistivity. Currently, there is no accepted non-invasive method to measure lung resistivity. In this study, we presented a method and framework to non-invasively determine lung resistivity using electrical impedance tomography (EIT). By comparing actual measurements from subjects with data from a 3D human thorax model, an EIT image can be reconstructed to show a resistivity difference between the model and the subject. By adjusting the lung resistivity in the model, the resistivity difference in the lung regions can be reduced to near zero. This resistivity value then is the estimation of the lung resistivity of the subject. Using the proposed method, the lung resistivities of four normal adult males (43 +/- 13 years, 78 +/- 10 kg) in the supine position at air volumes starting at functional residual capacity (FRC--end expiration) and increasing in 0.5 l steps to 1.5 l were studied. The averaged lung resistivity changes 12.59%, from 1406 Omega cm to 1583 Omega cm, following the inspiration of 1.5 l air from FRC. The coefficients of variation (CV) of precision for the four subjects are less than 10%. The experiment was repeated five times at each air volume on a subject to test the reproducibility. The CVs are less than 3%. The results show that it is feasible to determine absolute lung resistivity using an EIT-based method.

Re-evaluation of lung to thorax transverse area ratio immediately before birth in predicting postnatal short-term outcomes of fetuses with isolated left-sided congenital diaphragmatic hernia: A single center analysis.

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Kido, Saki; Hidaka, Nobuhiro; Sato, Yuka; Fujita, Yasuyuki; Miyoshi, Kina; Nagata, Kouji; Taguchi, Tomoaki; Kato, Kiyoko

2018-05-01

We aimed to investigate whether the lung-to-thorax transverse area ratio (LTR) immediately before birth is of diagnostic value for the prediction of postnatal short-term outcomes in cases of isolated left-sided congenital diaphragmatic hernia (CDH). We retrospectively reviewed the cases of fetal isolated left-sided CDH managed at our institution between April 2008 and July 2016. We divided the patients into two groups based on LTR immediately before birth, using a cut-off value of 0.08. We compared the proportions of subjects within the two groups who survived until discharge using Fisher's exact test. Further, using Spearman's rank correlation, we assessed whether LTR was correlated with length of stay, duration of mechanical ventilation, and supplemental oxygen. Twenty-nine subjects were included (five with LTR < 0.08, and 24 with LTR ≥ 0.08). The proportion of subjects surviving until discharge was 40% (2/5) for patients with LTR < 0.08, as compared with 96% (23/24) for those with LTR ≥ 0.08. LTR measured immediately before birth was negatively correlated with the postnatal length of stay (Spearman's rank correlation coefficient, rs = -0.486), and the duration of supplemental oxygen (rs = -0.537). Further, the duration of mechanical ventilation was longer in patients with a lower LTR value. LTR immediately before birth is useful for the prediction of postnatal short-term outcomes in fetuses with isolated left-sided CDH. In particular, patients with prenatal LTR value less than 0.08 are at increased risk of postnatal death. © 2017 Japanese Teratology Society.

Different distribution patterns of lymphocytes and microglia in the hippocampus of patients with residual versus paranoid schizophrenia: further evidence for disease course-related immune alterations?

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Busse, Stefan; Busse, Mandy; Schiltz, Kolja; Bielau, Hendrik; Gos, Tomasz; Brisch, Ralf; Mawrin, Christian; Schmitt, Andrea; Jordan, Wolfgang; Müller, Ulf J; Bernstein, Hans-Gert; Bogerts, Bernhard; Steiner, Johann

2012-11-01

Certain cytokines have been identified in the peripheral blood as trait markers of schizophrenia, while others are considered relapse-related state markers. Furthermore, data from peripheral blood, cerebrospinal fluid (CSF) and nuclear imaging studies suggest that (1) blood-brain barrier (BBB) dysfunction (e.g., immigration of lymphocytes into brain tissue and intrathecal antibody production) correlates with the development of negative symptoms, while (2) the brain's mononuclear phagocyte system (microglial cells) is activated during acute psychosis. Based on these neuroinflammatory hypotheses, we have quantified the numerical density of immunostained CD3+ T-lymphocytes, CD20+ B-lymphocytes, and HLA-DR+ microglial cells in the posterior hippocampus of 17 schizophrenia patients and 11 matched controls. Disease course-related immune alterations were considered by a separate analysis of residual (prevailing negative symptoms, n=7) and paranoid (prominent positive symptoms, n=10) schizophrenia cases. Higher densities of CD3+ and CD20+ lymphocytes were observed in residual versus paranoid schizophrenia (CD 3: left: P=0.047, right: P=0.038; CD20: left: P=0.020, right: P=0.010) and controls (CD3: left: P=0.057, right: P=0.069; CD20: left: P=0.008, right: P=0.006). In contrast, HLA-DR+ microglia were increased in paranoid schizophrenia versus residual schizophrenia (left: P=0.030, right: P=0.012). A similar trend emerged when this group was compared to controls (left: P=0.090, right: P=0.090). BBB impairment and infiltration of T cells and B cells may contribute to the pathophysiology of residual schizophrenia, while microglial activation seems to play a role in paranoid schizophrenia. The identification of diverse immune endophenotypes may facilitate the development of distinct anti-inflammatory schizophrenia therapies to normalize BBB function, (auto)antibody production or microglial activity. Copyright © 2012 Elsevier Inc. All rights reserved.

[Gas tamponade following intraoperative pneumothorax on a single lung: A case study].

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El Jaouhari, S D; Mamane Nassirou, O; Meziane, M; Bensghir, M; Haimeur, C

2017-04-01

Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation. Intraoperative pneumothorax can occur due to lesions of the tracheobronchial airway, of the brachial plexus, the placement of a central venous catheter or barotrauma. The diagnosis of pneumothorax during unipulmonary ventilation is posed by the sudden onset of hypoxia associated with increased airway pressures and hypercapnia. The immediate life-saving procedure involves fine needle exsufflation before the placement of a chest tube. Prevention involves reducing the risk of barotrauma by infusing patients with low flow volumes and the proper use of positive airway pressure, knowing that despite protective ventilation, barotraumas risk still exists. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Right and Left Ventricular Volumes in Atrial Septal Defect Studied by Radiocardiography

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Ivancevic, D. [Radioisotope Department, Internal Clinic, Rebro, Zagreb, Yugoslavia (Croatia); Vernejoul, P. de; Kellershohn, C. [CEA, Service Hospitalier Frederic Joliot, Departement de Biologie, Orsay (France)

1971-02-15

Radiocardiography with radioiodinated ({sup 131}I) human serum albumin and barium ({sup 137m}Ba) solution injected into the right subclavian vein has been performed in a group of 43 patients with atrial septal defect and left-to-right shunt. Data on the output and ejection index of each ventricle are essential for the estimation of the diastolic and residual volumes of the right and left ventricle. The systemic flow was therefore calculated according to Veall's formula and the pulmonary flow and the shunt How were determined using the method of de Vernejoul and co-workers. The formulas for the calculation of ventricular volumes were modified. The results show that many cases of atrial septal defect have an enlarged right ventricle whereas the left ventricle remains normal or is diminished. These changes correlate well with the amount of the shunt flow. In both ventricles the ventricular volumes show a good correlation with the stroke volumes. For the regulation of the pulmonary blood volume the right ventricle seems to be more important than the left ventricle. The operative closure of atrial septal defect (in 14 patients) has normalized the size of ventricular volumes. (author)

Using higher doses to compensate for tubing residuals in extended-infusion piperacillin-tazobactam.

Science.gov (United States)

Lam, Wendy J; Bhowmick, Tanaya; Gross, Alan; Vanschooneveld, Trevor C; Weinstein, Melvin P

2013-06-01

To mathematically assess drug losses due to infusion line residuals and evaluate methods to compensate for drug loss due to residual volumes in intravenous pump tubing. Literature was accessed through Ovid MEDLINE (1996-February 2013), using combinations of the search terms tubing residuals, residual volume, residual medication, intravenous infusions, intravenous injections, piperacillin, piperacillin-tazobactam, β-lactams, equipment design, infusion pumps, extended infusion, extended administration, and prolonged infusion. In addition, select reference citations from publications identified were reviewed. All articles that involved extended-infusion piperacillin-tazobactam implementation strategies were included in the review. Infusion pump characteristics and tubing residuals can affect extended-infusion piperacillin-tazobactam dosing strategies. Two studies addressing tubing residuals were identified. Both studies recommended increasing infusion volumes to compensate for tubing residuals. One study also recommended decreasing infusion-line dead space by using alternative infusion pump systems. Study calculations suggest that higher doses of piperacillin-tazobactam may be used to account for medication left in tubing residuals if alternative infusion pump systems cannot be obtained, and increased infusion volumes are not an option. Extended-infusion piperacillin-tazobactam has been used as a method of maximizing pharmacodynamic target attainment. Use of higher doses of piperacillin-tazobactam may be a reasonable method to compensate for drug loss due to residual volumes in large-bore intravenous pump tubing.

Experimental studies of the reimplantation of irradiated lung in dogs

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Kondo, T; Fujimura, S; Sohara, Y; Kawakami, M; Okaniwa, G [Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis and Cancer

1978-02-01

In order to treat the patients with lung cancer who have impaired cardiopulmonary function, a new method is designed, which includes the following steps; 1) pneumonectomy, 2) resection of tumor-bearing lobe, 3) /sup 60/Co irradiation to the remaining lobe, and 4) orthotopic reimplantation of the irradiated lung. The purpose of present study is to clarify the feasibility to use this method clinically. Using adult mongreal dogs, left lung was excised, irradiated and reimplanted. Radiation was carried out from 2,000 rad to 4,000 rad. Viability and function of reimplanted lungs were evaluated by their survival time, serial chest x-ray films, sup(99m)Tc-MAA perfusion scanning, unilateral pulmonary artery occlusion test and histologic examinations. Of 17 animals, 12 survived postoperative period and following results were obtained; 1) no dogs developed pulmonary edema, 2) only one dog was considered to die from acute radiation pneumonitis, 3) serial perfusion scanning showed a gradual decrease in flow distribution to the transplanted lung, 4) the right pulmonary occlusion test done in the dog irradiated with 2,000 rad revealed well reserved pulmonary function 2 months after the operation, and 5) histologically, most irradiated lungs revealed so-called ''late reaction'' of lung fibrosis, but there was the case with nearly normal findings after 6 months from the operation. Although many reports concerning to the radiation pneumonitis are published, there have not been any such reports as the present study. From our experiment, it may be indicated that there is a feasibility to use this new method clinically.

Bronchial Mucus Properties in Lung Cancer: Relationship with Site of Lesion

Directory of Open Access Journals (Sweden)

J Gustavo Zayas

1999-01-01

Full Text Available OBJECTIVE: To compare the biophysical properties of mucus from the left and right mainstem bronchi in patients undergoing diagnostic bronchoscopy because of a unilateral radiological abnormality. It was hypothesized that abnormalities in the properties of mucus would be greater on the side with the lesion and that this would be most obvious in patients with unilateral lung cancer.

Transcatheter interruption of large residual flow after device closure of "Type A" patent ductus arteriosus

Directory of Open Access Journals (Sweden)

Anuradha Sridhar

2012-01-01

Full Text Available We report a case of 3-year-old girl who had persistence of large residual flow following transcatheter closure of a 6 mm ′Type A′ patent ductus arteriosus using a 12 × 10 mm duct occluder. Angiography revealed a large left-to-right shunt coursing through and exiting around the implanted device. Near total abolition of the residual shunt was achieved by initial implantation of an embolization coil within the duct occluder and subsequently an Amplatzer duct occluder (ADO II adjacent to the duct occluder. This challenging case describes an additional technique of abolishing a large residual flow in and around a Nitinol duct occluder device.

Residual fMRI sensitivity for identity changes in acquired prosopagnosia.

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Fox, Christopher J; Iaria, Giuseppe; Duchaine, Bradley C; Barton, Jason J S

2013-01-01

While a network of cortical regions contribute to face processing, the lesions in acquired prosopagnosia are highly variable, and likely result in different combinations of spared and affected regions of this network. To assess the residual functional sensitivities of spared regions in prosopagnosia, we designed a rapid event-related functional magnetic resonance imaging (fMRI) experiment that included pairs of faces with same or different identities and same or different expressions. By measuring the release from adaptation to these facial changes we determined the residual sensitivity of face-selective regions-of-interest. We tested three patients with acquired prosopagnosia, and all three of these patients demonstrated residual sensitivity for facial identity changes in surviving fusiform and occipital face areas of either the right or left hemisphere, but not in the right posterior superior temporal sulcus. The patients also showed some residual capabilities for facial discrimination with normal performance on the Benton Facial Recognition Test, but impaired performance on more complex tasks of facial discrimination. We conclude that fMRI can demonstrate residual processing of facial identity in acquired prosopagnosia, that this adaptation can occur in the same structures that show similar processing in healthy subjects, and further, that this adaptation may be related to behavioral indices of face perception.

Residual fMRI sensitivity for identity changes in acquired prosopagnosia

Directory of Open Access Journals (Sweden)

Christopher J Fox

2013-10-01

Full Text Available While a network of cortical regions contribute to face processing, the lesions in acquired prosopagnosia are highly variable, and likely result in different combinations of spared and affected regions of this network. To assess the residual functional sensitivities of spared regions in prosopagnosia, we designed a rapid event-related functional magnetic resonance imaging (fMRI experiment that included pairs of faces with same or different identities and same or different expressions. By measuring the release from adaptation to these facial changes we determined the residual sensitivity of face-selective regions-of-interest. We tested three patients with acquired prosopagnosia, and all three of these patients demonstrated residual sensitivity for facial identity changes in surviving fusiform and occipital face areas of either the right or left hemisphere, but not in the right posterior superior temporal sulcus. The patients also showed some residual capabilities for facial discrimination with normal performance on the Benton Facial Recognition Test, but impaired performance on more complex tasks of facial discrimination. We conclude that fMRI can demonstrate residual processing of facial identity in acquired prosopagnosia, that this adaptation can occur in the same structures that show similar processing in healthy subjects, and further, that this adaptation may be related to behavioral indices of face perception.

An Ultrasound Surface Wave Technique for Assessing Skin and Lung Diseases.

Science.gov (United States)

Zhang, Xiaoming; Zhou, Boran; Kalra, Sanjay; Bartholmai, Brian; Greenleaf, James; Osborn, Thomas

2018-02-01

Systemic sclerosis (SSc) is a multi-organ connective tissue disease characterized by immune dysregulation and organ fibrosis. Severe organ involvement, especially of the skin and lung, is the cause of morbidity and mortality in SSc. Interstitial lung disease (ILD) includes multiple lung disorders in which the lung tissue is fibrotic and stiffened. The purpose of this study was to translate ultrasound surface wave elastography (USWE) for assessing patients with SSc and/or ILD via measuring surface wave speeds of both skin and superficial lung tissue. Forty-one patients with both SSc and ILD and 30 healthy patients were enrolled in this study. An external harmonic vibration was used to generate the wave propagation on the skin or lung. Three excitation frequencies of 100, 150 and 200 Hz were used. An ultrasound probe was used to measure the wave propagation in the tissue non-invasively. Surface wave speeds were measured on the forearm and upper arm of both left and right arm, as well as the upper and lower lungs, through six intercostal spaces of patients and healthy patients. Viscoelasticity of the skin was calculated by the wave speed dispersion with frequency using the Voigt model. The magnitudes of surface wave speed and viscoelasticity of patients' skin were significantly higher than those of healthy patients (p wave speeds of patients' lung were significantly higher than those of healthy patients (p ionizing technique for measuring both skin and lung surface wave speed and may be useful for quantitative assessment of SSc and/or ILD. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Lung function study and diffusion capacity in anorexia nervosa.

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Pieters, T; Boland, B; Beguin, C; Veriter, C; Stanescu, D; Frans, A; Lambert, M

2000-08-01

In humans, malnutrition alters the respiratory system in different ways. It impairs the ventilatory drive, decreases respiratory muscle strength and reduces immune competence. In addition, typical emphysema-like changes were demonstrated in starved animals. The presence of emphysema has never been demonstrated in starved humans. Our objective was to investigate whether pulmonary emphysema occurs in anorexia nervosa by means of a pulmonary function study. We examined 24 women aged between 14 and 38 years (nine smokers). We studied the lung function including lung volumes, ventilatory capacity, maximal respiratory pressures and transfer factor, as well as PaO2. All respiratory tests were within normal limits with the exception of decreased maximal inspiratory (59% of predicted values) and expiratory pressures (35%), and increased residual volume (162%). Diffusion capacity (98.1 +/- 16.2%) and transfer coefficient (98.4 +/- 16.2%) were also normal. The diffusion coefficient was lower in current smokers than in those who had never smoked (P anorexia nervosa, pulmonary function tests are within normal limits with the exception of maximal pressures and residual volume. Diffusion capacity is not decreased. The present results within the limitations of the used method are not compatible with the hypothesis of starvation-induced pulmonary emphysema.

Prognostic classifications of lymph node involvement in lung cancer and current International Association for the Study of Lung Cancer descriptive classification in zones.

Science.gov (United States)

Riquet, Marc; Arame, Alex; Foucault, Christophe; Le Pimpec Barthes, Françoise

2010-09-01

The lymphatic drainage of solid organ tumors crosses through the lymph nodes (LNs) whose tumoral involvement may still be considered as local disease. Concerning lung cancer, LN involvement may be intrapulmonary (N1), and mediastinal and/or extra-thoracic. More than 30 years ago, mediastinal involved LNs were all considered as N2, and outside the scope of surgery. In 1978, Naruke presented an original article entitled 'Lymph node mapping and curability at various levels of metastasis in resected lung cancer', demonstrating that N2 was not a contraindication to surgery in all patients. The map permitted to localize the favorable N2 on the lung cancer ipsilateral side of the mediastinum. Several maps ensued aiming to discriminate between right and left involvement (1983), and to distinguish N2 (ipsilateral) and N3 (contralateral) mediastinal LN involvement (1983, 1986). The last map (1997 regional LN classification) was recently replaced by a descriptive classification in anatomical zones. This new LN map of the TNM classification for lung cancer is a step toward using anatomical view points which might be the best way to better understand lung cancer lymphatic spread. Nowadays, the LNs are easily identified by current radiological imaging, and their resectability may be anticipated. Each LN chain may be removed by en-bloc lymphadenectomy performed during radical lung resection, a safe procedure which seems to be more oncological based than sampling, and which avoids the source of discrepancies pointed out during the labeling of LN stations by surgeons.

The prevalence and character of crackles (rales) in young women without significant lung disease.

Science.gov (United States)

Workum, P; Holford, S K; Delbono, E A; Murphy, R L

1982-11-01

Although some investigators have reported that crackles are present only in persons with lung disease, others say they also occur in normal persons. In order to clarify this difference of opinion, we determined the prevalence of crackles in 56 women without significant lung disease. The subjects ranged from 19 to 33 yr of age (mean, 21.3). They all had a FVC greater than 80% predicted and a FEV1/FVC ratio greater than 75%. None had a history of acute or chronic lung disease. During slow inspirations from residual volume, midinspiratory fine crackles were heard at the anterior bases in 35 of 56 subjects by a physician using an acoustic stethoscope, whereas a bioengineer using an 800 Hertz high pass filtered stethoscope heard crackles in 53 subjects. Crackles during tidal breathing were heard in 2 subjects. It is postulated that the crackles noted after expiration to residual volume are nonpathologic, and occur when basilar airways, which close at the end of a forced expiration, suddenly open during inspiration. Examination of the quality, timing, and anatomic distribution of the crackles in apparently normal subjects suggests that they can often be distinguished from those resulting from diseases such as bronchitis, interstitial fibrosis, and congestive heart failure.

Assessment of cardiac exposure in left-tangential breast irradiation

International Nuclear Information System (INIS)

Vees, H.; Bigler, R.; Gruber, G.; Bieri, S.

2011-01-01

Purpose. - To assess the value of treatment-planning related parameters namely, the breast volume; the distance of the inferior field border to diaphragm; and the cardio-thoracic ratio for left-tangential breast irradiation. Patients and methods. - Treatment plans of 27 consecutively left-sided breast cancer patients after breast conserving surgery were evaluated for several parameters concerning heart-irradiation. We measured the heart distance respective to the cardio-thoracic ratio and the distance of the inferior field border to diaphragm, as well as the breast volume in correlation with the irradiated heart volume. Results. - The mean heart and left breast volumes were 504 cm 3 and 672.8 cm 3 , respectively. The mean heart diameter was 13.4 cm; the mean cardio-thoracic ratio 0.51 and the mean distance of the inferior field border to diaphragm was 1.4 cm. Cardio-thoracic ratio (p = 0.01), breast volume (p = 0.0002), distance of the inferior field border to diaphragm (p = 0.02) and central lung distance (p = 0.02) were significantly correlated with the measured heart distance. A significant correlation was also found between cardio-thoracic ratio, breast volume and distance of the inferior field border to diaphragm with the irradiated heart volume measured by V10, V20 and V40. Conclusion. - The verification of parameters like cardio-thoracic ratio, distance of the inferior field border to diaphragm and breast volume in left-sided breast cancer patients may help in determining which patients could benefit from more complex planning techniques such as intensity-modulated radiotherapy to reduced risk of late cardiac injury. (authors)

Assessing breathing motion by shape matching of lung and diaphragm surfaces

Science.gov (United States)

Urschler, Martin; Bischof, Horst

2005-04-01

Studying complex thorax breating motion is an important research topic for accurate fusion of functional and anatomical data, radiotherapy planning or reduction of breathing motion artifacts. We investigate segmented CT lung, airway and diaphragm surfaces at several different breathing states between Functional Residual and Total Lung Capacity. In general, it is hard to robustly derive corresponding shape features like curvature maxima from lung and diaphragm surfaces since diaphragm and rib cage muscles tend to deform the elastic lung tissue such that e.g. ridges might disappear. A novel registration method based on the shape context approach for shape matching is presented where we extend shape context to 3D surfaces. The shape context approach was reported as a promising method for matching 2D shapes without relying on extracted shape features. We use the point correspondences for a non-rigid thin-plate-spline registration to get deformation fields that describe the movement of lung and diaphragm. Our validation consists of experiments on phantom and real sheep thorax data sets. Phantom experiments make use of shapes that are manipulated with known transformations that simulate breathing behaviour. Real thorax data experiments use a data set showing lungs and diaphragm at 5 distinct breathing states, where we compare subsets of the data sets and qualitatively and quantitatively asses the registration performance by using manually identified corresponding landmarks.

Esophageal bypass for the treatment of bronchoesophageal fistula in a case of squamous cell carcinoma of the lung

International Nuclear Information System (INIS)

Uchibori, Ken; Suhara, Kozo; Chiba, Sahoko; Tsuchiya, Kimitake; Fujie, Toshihide; Tamaoka, Meiyo; Sakashita, Hiroyuki; Inase, Naohiko

2013-01-01

Bronchoesophageal fistula in lung cancer is very rare. While these cases usually receive an implanted expandable stent in the esophagus or trachea, no standard therapeutic strategy has been developed. Our patient was a 63-year-old woman who had visited a local clinic because of productive cough. Lung cancer was suspected from her chest CT findings and an additional work-up with bronchoscopy and sputum cytology revealed squamous cell cancer of the lung. She also had obstructive pneumonia caused by a severe stricture from the trachea to the left main bronchus. Radiochemotherapy was begun for treatment of the obstruction by the tumor, with concurrent administration of antibiotics. In spite of apparent improvement of the disease by the fifth week of treatment, a large bronchoesophageal fistula appeared at the inlet of the left main bronchus. Stent implantation was judged contraindicated for either the trachea or the esophagus, because of the large size of the fistula. We performed an esophageal bypass procedure in an attempt to restore her dysphagia She regained oral intake ability and she required no antibiotic administration for pneumonia after the procedure. We performed an esophageal bypass for the treatment of a bronchoesophageal fistula that had occurred during radiochemotherapy for lung cancer. The procedure was successful and the patient regained the ability to eat from the mouth. The esophageal bypass procedure might be a viable choice of treatment for tracheo- or bronchoesophageal fistula in lung cancer patients. (author)

Positive pressure ventilation in a patient with a right upper lobar bronchocutaneous fistula: right upper bronchus occlusion using the cuff of a left-sided double lumen endobronchial tube.

Science.gov (United States)

Omori, Chieko; Toyama, Hiroaki; Takei, Yusuke; Ejima, Yutaka; Yamauchi, Masanori

2017-08-01

In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage. After anesthesia induction, mask ventilation was performed with a peak positive pressure of 10 cmH 2 O. A left-sided double lumen endobronchial tube (DLT) was then inserted into the right main bronchus for occluding only the right superior bronchus, and two-lung ventilation was performed to minimize airway pressure and maintain oxygenation, which did not cause air leakage through the fistula. During anesthesia, no ventilation-related difficulty was faced. The method of inserting a left-sided DLT into the right main bronchus and occluding the right upper bronchus selectively by bronchial cuff is considered to be an option for mechanical ventilation in patients with a right upper bronchial fistula, as demonstrated in the present case.

Identification of radiation response genes and proteins from mouse pulmonary tissues after high-dose per fraction irradiation of limited lung volumes.

Science.gov (United States)

Jin, Hee; Jeon, Seulgi; Kang, Ga-Young; Lee, Hae-June; Cho, Jaeho; Lee, Yun-Sil

2017-02-01

The molecular effects of focal exposure of limited lung volumes to high-dose per fraction irradiation (HDFR) such as stereotactic body radiotherapy (SBRT) have not been fully characterized. In this study, we used such an irradiation system and identified the genes and proteins after HDFR to mouse lung, similar to those associated with human therapy. High focal radiation (90 Gy) was applied to a 3-mm volume of the left lung of C57BL6 mice using a small-animal stereotactic irradiator. As well as histological examination for lungs, a cDNA micro array using irradiated lung tissues and a protein array of sera were performed until 4 weeks after irradiation, and radiation-responsive genes and proteins were identified. For comparison, the long-term effects (12 months) of 20 Gy radiation wide-field dose to the left lung were also investigated. The genes ermap, epb4.2, cd200r3 (up regulation) and krt15, hoxc4, gdf2, cst9, cidec, and bnc1 (down-regulation) and the proteins of AIF, laminin, bNOS, HSP27, β-amyloid (upregulation), and calponin (downregulation) were identified as being responsive to 90 Gy HDFR. The gdf2, cst9, and cidec genes also responded to 20 Gy, suggesting that they are universal responsive genes in irradiated lungs. No universal proteins were identified in both 90 Gy and 20 Gy. Calponin, which was downregulated in protein antibody array analysis, showed a similar pattern in microarray data, suggesting a possible HDFR responsive serum biomarker that reflects gene alteration of irradiated lung tissue. These genes and proteins also responded to the lower doses of 20 Gy and 50 Gy HDFR. These results suggest that identified candidate genes and proteins are HDFR-specifically expressed in lung damage induced by HDFR relevant to SBRT in humans.

Long-term survival despite early loss of graft function after single lung transplantation for pulmonary fibrosis

NARCIS (Netherlands)

Ouwens, JP; van den Berg, JWK; van der Bij, W; Koeter, GH

We report a patient who received a single, left lung transplantation for idiopathic pulmonary fibrosis. The effect of the graft on pulmonary improvement was only temporary, because the patient developed obliterative bronchiolitis (OB), resulting in complete destruction of the graft. The patient,

Lung function; Lungenfunktion

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Sorichter, S. [Universitaetsklinikum Freiburg, Abteilung Pneumologie, Freiburg (Germany)

2009-08-15

The term lung function is often restricted to the assessment of volume time curves measured at the mouth. Spirometry includes the assessment of lung volumes which can be mobilised with the corresponding flow-volume curves. In addition, lung volumes that can not be mobilised, such as the residual volume, or only partially as FRC and TLC can be measured by body plethysmography combined with the determination of the airway resistance. Body plethysmography allows the correct positioning of forced breathing manoeuvres on the volume-axis, e.g. before and after pharmacotherapy. Adding the CO single breath transfer factor (T{sub LCO}), which includes the measurement of the ventilated lung volume using He, enables a clear diagnosis of different obstructive, restrictive or mixed ventilatory defects with and without trapped air. Tests of reversibility and provocation, as well as the assessment of inspiratory mouth pressures (PI{sub max}, P{sub 0.1}) help to classify the underlying disorder and to clarify treatment strategies. For further information and to complete the diagnostic of disturbances of the ventilation, diffusion and/or perfusion (capillar-)arterial bloodgases at rest and under physical strain sometimes amended by ergospirometry are recommended. Ideally, lung function measurements are amended by radiological and nuclear medicine techniques. (orig.) [German] Unter dem Begriff Lungenfunktion wird die Bestimmung der Lungenvolumina am Mund verstanden. Dabei werden die mobilisierbaren Lungenvolumina mit den zugehoerigen Fluss-Volumen-Kurven mittels Spirometrie und Ganzkoerperplethysmographie (GKP) und die nicht (RV) und teilweise mobilisierbaren Lungenvolumina (FRC, TLC) einschliesslich der Atemwegswiderstaende bestimmt. Die GKP ermoeglicht zusaetzlich die korrekte (Volumenachsen-)Positionierung der forcierten Atemmanoever. Dieses erlaubt eine uebersichtlichere graphische Darstellung z. B. vor und nach der Applikation pharmakologisch wirksamer Substanzen. Wird die GKP

Lung abscess as a complication of bronchial thermoplasty.

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Balu, Anandh; Ryan, Dorothy; Niven, Robert

2015-09-01

Bronchial thermoplasty (BT) is an emerging treatment modality for patients with difficult to treat asthma. It has been shown to be beneficial for symptom control and improves quality of life and reduces frequency of hospitalization. Safety data from the two major trials of BT indicate that patients who undergo these procedures are most likely to experience adverse respiratory events in the first six weeks post treatment. Lung abscess has never been reported as a direct complication of BT. In this case; we report a lung abscess as an immediate complication of BT, which we believe may be the first case. We describe a forty three year old Caucasian female presented three days post-bronchial thermoplasty with left sided chest pain radiating to the back associated with shortness of breath, wheeze and dry cough. She had also started to feel hot and cold and generally unwell. It remains unclear why this patient developed a lung abscess so acutely post BT treatment. It is important that safety data continues to be collated and published as the procedure becomes more widely available with further long term follow-up in particular.

MRI features of meningeal metastasis from lung cancer

International Nuclear Information System (INIS)

Luo Xuemao; Long Wansheng; Jin Zhifa; Hu Maoqing; Mai Xuyu

2009-01-01

Objective: To investigate the pathway and MRI findings of meningeal metastasis original from lung cancer. Methods: 44 cases with cerebro-spinal meningeal metastasis original from lung cancer proven by clinical and pathology were retrospectively reviewed. All cases undergone plain MRI scan and Gd-DTPA enhanced MRI scan on brain and/or spine. Results: MRI plain scan indicated 28 cases with brain metastases, 3 cases with meningeal nodosity or irregularly patchy abnormal signal, 1 case with nodule in left cavernous sinus, 10 cases with abnormal signal in spine, 2 cases with abnormal signal in spinal dura mater. 34 cases with cerebro meningeal metastases were found in MRI enhancement scan. Among them, 11 cases displayed cerebral dura mater-arachnoid enhancement, 17 cases revealed cerebral pia mater-arachnoid enhancement and 6 cases with mixed typed enhancement. Osteoclasia in skull was found in 4 cases, spinal metastasis was revealed in 17 cases, and patchy abnormal enhancement in spinal dura mater was showed in 12 cases. Conclusion: Hematogenous metastasis is a main route of meningeal metastasis caused by lung cancer and enhanced MRI scan is of important diagnostic value. (authors)

Correlates of lung/heart ratio of thallium-201 in coronary artery disease

International Nuclear Information System (INIS)

Homma, S.; Kaul, S.; Boucher, C.A.

1987-01-01

We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain

Functional evaluation of lung by Xe-133 lung ventilation scintigraphy before and after lung volume reduction surgery (LVRS) in patients with pulmonary emphysema

International Nuclear Information System (INIS)

Kurose, Taichi; Okumura, Yoshihiro; Sato, Shuhei

2004-01-01

We evaluated the respiratory functions of patients with pulmonary emphysema who underwent lung volume reduction surgery (LVRS) by the mean transit time (MTT) with Xe-133 lung ventilation scintigraphy, forced expiration volume in 1 sec (FEV1.0), residual volume (RV), distance walked in 6 min (6-min walk), and the Hugh-Jones classification (H-J classification) before and after LVRS. In 69 patients with pulmonary emphysema (62 men, 7 women; age range, 47-75 years; mean age, 65.4 years±6.1, preoperative H-J classification, III (two were II)-V) who underwent LVRS, all preoperative and postoperative parameters (MTT 3 weeks after LVRS and the others 3 months after LVRS) were judged statistically by the Wilcoxon signed-ranks test and Odds ratio. Every postoperative parameter was improved with a significant difference (P<0.05) compared to preoperative parameters. MTT at 3 weeks after LVRS was not associated with %FEV1.0 and the H-J classification at 3 months after LVRS, but was associated with RV and a 6-min walk at 3 months after LVRS. MTT was useful for the clinical evaluation of aerobic capability after LVRS. (author)

Effects of Sustained Lung Inflation, a lung recruitment maneuver in primary acute respiratory distress syndrome, in respiratory and cerebral outcomes in preterm infants.

Science.gov (United States)

Grasso, Chiara; Sciacca, Pietro; Giacchi, Valentina; Carpinato, Caterina; Mattia, Carmine; Palano, Grazia Maria; Betta, Pasqua

2015-01-01

Sustained Lung Inflation (SLI) is a maneuver of lung recruitment in preterm newborns at birth that can facilitate the achieving of larger inflation volumes, leading to the clearance of lung fluid and formation of functional residual capacity (FRC). To investigate if Sustained Lung Inflation (SLI) reduces the need of invasive procedures and iatrogenic risks. 78 newborns (gestational age≤34 weeks, weighing≤2000 g) who didn't breathe adequately at birth and needed to receive SLI in addition to other resuscitation maneuvers (2010 guidelines). 78 preterm infants born one after the other in our department of Neonatology of Catania University from 2010 to 2012. The need of intubation and surfactant, the ventilation required, radiological signs, the incidence of intraventricular hemorrhage (IVH), periventricular leukomalacia, retinopathy in prematurity from III to IV plus grades, bronchopulmonary dysplasia, patent ductus arteriosus, pneumothorax and necrotizing enterocolitis. In the SLI group infants needed less intubation in the delivery room (6% vs 21%; phemorrhage in the SLI group (23% vs 14%; p=0.15; OR=1.83). SLI is easier to perform even with a single operator, it reduces the necessity of more complicated maneuvers and surfactant without statistically evident adverse effects. Copyright © 2014. Published by Elsevier Ireland Ltd.

Pulmonary function after lobectomy in children under ten years of age

International Nuclear Information System (INIS)

Nonoyama, Akira; Tanaka, Kazuho; Kagawa, Kiyoshi

1985-01-01

Children's ages at the time of the operation ranged from 1 to 4 years in 6 patients and 5 to 10 years in other 6 cases. Their resected lobes were 2 right upper lobes, 1 right middle lobe, 5 right lower lobes, 2 left upper lobes and 2 left lower lobes. At the follow-up period of 4 months to 13 years after surgery, all of the patients were subjectively well with a physical performance equal to those of their peers, and in 11 of them, no apparent residual pulmonary disease was demonstrated. Nine of these 11 patients were over 7 years of age and their course after surgery were more than 6 months. In these nine patients, postoperative forced vital capacity increased over the predicted value calculated from the estimated amount of lung removed. In most of the patients, %VC was about 82% in the upper lobectomized cases and more than 90% in the lower lobectomized patients. Functional residual capacity and total lung capacity generally decreased in proportion to the amount of lung tissue removed. Vital capacity and total lung capacity in the lower lobectomized patients were significantly increased compared with those in the upper lobectomized patients. The ratio of residual volume to total lung capacity decreased in all cases and, conversely, VC/TLC increased over normal value. The ratio of forced expiratory volume in the first second to vital capacity was over 82%. Flow-volume curve and closing volume were within normal limits in all except 2 cases, in whom the follow-up period was about 6 months after surgery. In the other 2 patients, whose ages were under 7 years. Technetium 99m macroaggregated albumin perfusion scan on the operated side showed values corresponding to the estimated amount of removed lung or values higher than the predicted, and the results of radiospirometry coincided with the results of spirometric respiratory function data. (J.P.N.)

Effects of single intratracheal exposure to chlorhexidine gluconate on the rat lung.

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Orito, Kensuke; Hashida, Masaru; Hirata, Kiyotaka; Kurokawa, Akira; Shirai, Mitsuyuki; Akahori, Fumiaki

2006-01-01

Chlorhexidine gluconate (CHX) is an antiseptic that has been widely used for disinfection of cutaneous wound and gingivae. Recently, a patient who inhaled CHX solution died from acute respiratory distress syndrome (ARDS). Although it is highly possible that direct pulmonary damage might be the cause of ARDS, there is no preclinical information about the pulmonary toxicity of CHX. In the current study, the acute direct action of CHX to the lung was evaluated in rats. We successfully exposed the left but not the right lung either to CHX at concentrations of 1%, 0.1%, and 0.01% or to saline using a curved-tip administration tube. At the higher concentrations of CHX (0.1% and 1%), severe congestion to the alveoli and capillaries and perivascular and intra-alveolar hemorrhages were observed 1 day after exposure. Aniline blue-stained collagen fibers with an infiltration of inflammatory cells were present 7 days after exposure. The fibrotic changes and intra-alveolar inflammatory cells had decreased but were still observed sporadically 28 and 84 days after exposure. These detrimental effects were more severe at 1% than at 0.1% CHX. No remarkable effect was observed after exposures to 0.01% CHX and saline. We were able to evaluate the time-course changes in the pulmonary toxicity of CHX by exposures limited to the left lung. It is highly possible that CHX at a concentration of more than 0.1% might directly induce ARDS when aspirated and reaching to the alveoli.

Spontaneous chylothorax complicating small cell lung cancer – Review of aetiology and diagnosis

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S. Hanina

2015-01-01

Full Text Available We report the first case of spontaneous chylothorax complicating small cell lung cancer. A 52 year old female presented with exertional dyspnoea, left-sided chest and neck pain, and dysphagia. The chest X-ray on admission revealed a large left-sided pleural effusion. A subsequent CT chest showed a large anterior mediastinal mass with a left brachiocephalic and jugular vein thrombosis. The patient underwent medical thoracoscopy with chest drain insertion, which drained pleural fluid high in triglycerides, consistent with a chylothorax. Due to its uncommon nature, the management of chylothorax is not well defined. Alongside the case report, we provide a review of aetiology, mechanism and diagnosis with a brief summary of treatment options.

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control

Science.gov (United States)

2010-01-01

Background To study the set-up errors, PTV margin and toxicity of cone beam CT (CBCT) guided hypofractionated radiotherapy with active breathing control (ABC) for patients with non-small cell lung cancer (NSCLC) or metastatic tumors in lung. Methods 32 tumors in 20 patients were treated. Based on the location of tumor, dose per fraction given to tumor was divided into three groups: 12 Gy, 8 Gy and 6 Gy. ABC is applied for every patient. During each treatment, patients receive CBCT scan for online set-up correction. The pre- and post-correction setup errors between fractions, the interfractional and intrafractional, set-up errors, PTV margin as well as toxicity are analyzed. Results The pre-correction systematic and random errors in the left-right (LR), superior-inferior (SI), anterior-posterior (AP) directions were 3.7 mm and 5.3 mm, 3.1 mm and 2.1 mm, 3.7 mm and 2.8 mm, respectively, while the post-correction residual errors were 0.6 mm and 0.8 mm, 0.8 mm and 0.8 mm, 1.2 mm and 1.3 mm, respectively. There was an obvious intrafractional shift of tumor position. The pre-correction PTV margin was 9.5 mm in LR, 14.1 mm in SI and 8.2 mm in AP direction. After CBCT guided online correction, the PTV margin was markedly reduced in all three directions. The post-correction margins ranged 1.5 to 2.1 mm. The treatment was well tolerated by patients, of whom there were 4 (20%) grade1-2 acute pneumonitis, 3 (15%) grade1 acute esophagitis, 2 (10%) grade1 late pneumonitis and 1 (5%) grade 1 late esophagitis. Conclusion The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used. PMID:20187962

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathing control