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Sample records for simultaneous lung ventilation-perfusion

  1. Lung Ventilation/Perfusion Scan

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    ... will recover in the hospital’s intensive care unit (ICU) before moving to a hospital room for one to three weeks. Your doctor may recommend pulmonary rehabilitation after your lung transplant surgery to help you ...

  2. Ventilation-perfusion patterns in lung diseases (with reference to those observed in pulmonary embolism).

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    Ham, H R; Amir, R; Vandevivere, J

    1985-01-01

    The frequency distributions of ventilation-perfusion (V-P) patterns in various lung diseases were compared to those observed in pulmonary embolism in order to determine whether the specific V-P patterns for pulmonary embolism constituted a frequent finding in these disorders. The results showed that a segmental or lobar perfusion defect with normal ventilation, was associated with a high probability of thromboembolic lung disease, and was not present in any of the other lung diseases studied.

  3. Ventilation-perfusion patterns in lung diseases (with reference to those observed in pulmonary embolism)

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    Ham, H.R.; Amir, R.; Vandevivere, J.

    1985-02-01

    The frequency distributions of ventilation-perfusion (V-P) patterns in various lung diseases were compared to those observed in pulmonary embolism in order to determine whether the V-P patterns for pulmonary embolism constituted a frequent finding in these disorders. The results showed that a segmental or labor perfusion defect with normal ventilation, was associated with a high probability of thromboembolic lung disease, and was not present in any of the other lung diseases studied.

  4. Optimizing ventilation-perfusion lung scintigraphy: parting with planar imaging

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    Reinartz, P.; Schirp, U.; Zimny, M.; Sabri, O.; Nowak, B.; Schaefer, W.; Cremerius, U.; Buell, U. [University Hospital, Aachen (Germany). Dept. of Nuclear Medicine

    2001-04-01

    Aim of the study was to introduce and verify a ventilation-perfusion (V/Q) acquisition protocol that incorporates new developments in scinitgraphy in order to allow for a more balanced comparison with other diagnostic procedures. Methods: In 103 patients suspect of having pulmonary embolism, V/Q scans were acquired exclusively with SPECT technique. Ventilation was done with ultrafine aerosol. Planar images in eight directions were reconstructed through addition of three consecutive SPECT projections. Three referees examined the scans in regard to type, localization, and extent of V/Q defects. Results: Using this protocol, significantly more defects, especially of subsegmental size, were detected (p<0.01). Sensitivity, and diagnostic accuracy were also significantly improved (p<0.01) to 0.96, and 0.99, respectively. Furthermore, kappa values were increased up to 0.82 - a relevant enhancement in the ability to precisely localize V/Q defects. Conclusion: In conclusion this protocol provides high-resolution tomographic scans as well as high-quality planar images within a short acquisition time. Due to the significant increase in lesion detection, sensitivity, diagnostic accuracy, and anatomical localization of defects, it is a substantial improvement in the diagnosis of pulmonary embolism that will put V/Q scintigraphy on a par with other tomographic methods. (orig.) [German] Ziel der Studie ist die Einfuehrung und Evaluierung eines Ventilations-Perfusions-Akquisitionsprotokolles (V/Q), das neue technische Entwicklungen beruecksichtigt und auf diese Weise einen ausgewogeneren Vergleich mit anderen tomographischen Verfahren erlaubt. Methodik: Bei 103 Patienten mit Verdacht auf Lungenembolie wurden V/Q-Akquisitionen ausschliesslich in SPECT-Technik angefertigt. Die Ventilationsstudien erfolgten dabei unter Verwendung eines ultrafeinen Aerosols. Durch Addition von jeweils drei aufeinander folgenden SPECT-Projektionen wurden planare Bilder in acht Ansichten rekonstruiert

  5. Applications of Ventilation-Perfusion Scintigraphy in Surgical Management of Chronic Obstructive Lung Disease and Cancer.

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    Tulchinsky, Mark; Fotos, Joseph S; Wechalekar, Kshama; Dadparvar, Simin

    2017-11-01

    Ventilation-perfusion scintigraphy (VPS) depicts the two main physiological processes that are fundamental to oxygen-dependent life. The test has affirmed its critical place in the evaluation of patients with lung cancer preparing for lung resection. The results of the study can differentiate patients who are very likely to survive surgery and the subsequent pulmonary function loss from those who are not. This review presents validated and evolving testing techniques for this critical indication. VPS has long been an integral part of the preoperative evaluation of lung transplant candidates, guiding the single lung grafts to the side with the worst function. New applications are emerging in the rapidly developing surgical and interventional management of severe chronic obstructive lung diseases. Enhanced by the advancements in hybrid imaging and computer processing, the VPS examination continues to be reinvented and updated to keep pace with the needs of modern medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Improvement in Ventilation-Perfusion Mismatch after Bronchoscopic Lung Volume Reduction: Quantitative Image Analysis.

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    Lee, Sei Won; Lee, Sang Min; Shin, So Youn; Park, Tai Sun; Oh, Sang Young; Kim, Namkug; Hong, Yoonki; Lee, Jae Seung; Oh, Yeon-Mok; Lee, Sang-Do; Seo, Joon Beom

    2017-10-01

    Purpose To evaluate whether bronchoscopic lung volume reduction (BLVR) increases ventilation and therefore improves ventilation-perfusion (V/Q) mismatch. Materials and Methods All patients provided written informed consent to be included in this study, which was approved by the Institutional Review Board (2013-0368) of Asan Medical Center. The physiologic changes that occurred after BLVR were measured by using xenon-enhanced ventilation and iodine-enhanced perfusion dual-energy computed tomography (CT). Patients with severe emphysema plus hyperinflation who did not respond to usual treatments were eligible. Pulmonary function tests, the 6-minute walking distance (6MWD) test, quality of life assessment, and dual-energy CT were performed at baseline and 3 months after BLVR. The effect of BLVR was assessed with repeated-measures analysis of variance. Results Twenty-one patients were enrolled in this study (median age, 68 years; mean forced expiratory volume in 1 second [FEV1], 0.75 L ± 0.29). After BLVR, FEV1 (P lung volume (-0.39 L ± 0.44), both ventilation per voxel (P lung volume reduction of 50% or greater had significantly better improvement in FEV1 (P = .02) and ventilation per voxel (P = .03) than patients with lung volume reduction of less than 50%. V/Q mismatch also improved after BLVR (P = .005), mainly owing to the improvement in ventilation. Conclusion The dual-energy CT analyses showed that BLVR improved ventilation and V/Q mismatch. This increased lung efficiency may be the primary mechanism of improvement after BLVR, despite the reduction in lung volume. © RSNA, 2017 Online supplemental material is available for this article.

  7. Ventilation/Perfusion Positron Emission Tomography--Based Assessment of Radiation Injury to Lung.

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    Siva, Shankar; Hardcastle, Nicholas; Kron, Tomas; Bressel, Mathias; Callahan, Jason; MacManus, Michael P; Shaw, Mark; Plumridge, Nikki; Hicks, Rodney J; Steinfort, Daniel; Ball, David L; Hofman, Michael S

    2015-10-01

    To investigate (68)Ga-ventilation/perfusion (V/Q) positron emission tomography (PET)/computed tomography (CT) as a novel imaging modality for assessment of perfusion, ventilation, and lung density changes in the context of radiation therapy (RT). In a prospective clinical trial, 20 patients underwent 4-dimensional (4D)-V/Q PET/CT before, midway through, and 3 months after definitive lung RT. Eligible patients were prescribed 60 Gy in 30 fractions with or without concurrent chemotherapy. Functional images were registered to the RT planning 4D-CT, and isodose volumes were averaged into 10-Gy bins. Within each dose bin, relative loss in standardized uptake value (SUV) was recorded for ventilation and perfusion, and loss in air-filled fraction was recorded to assess RT-induced lung fibrosis. A dose-effect relationship was described using both linear and 2-parameter logistic fit models, and goodness of fit was assessed with Akaike Information Criterion (AIC). A total of 179 imaging datasets were available for analysis (1 scan was unrecoverable). An almost perfectly linear negative dose-response relationship was observed for perfusion and air-filled fraction (r(2)=0.99, Pfit as evaluated by AIC. Perfusion, ventilation, and the air-filled fraction decreased 0.75 ± 0.03%, 0.71 ± 0.06%, and 0.49 ± 0.02%/Gy, respectively. Within high-dose regions, higher baseline perfusion SUV was associated with greater rate of loss. At 50 Gy and 60 Gy, the rate of loss was 1.35% (P=.07) and 1.73% (P=.05) per SUV, respectively. Of 8/20 patients with peritumoral reperfusion/reventilation during treatment, 7/8 did not sustain this effect after treatment. Radiation-induced regional lung functional deficits occur in a dose-dependent manner and can be estimated by simple linear models with 4D-V/Q PET/CT imaging. These findings may inform future studies of functional lung avoidance using V/Q PET/CT. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  8. Lung ventilation-perfusion scintigraphy in children on long-term parenteral nutrition

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    Pifarre, Paloma; Roca, Isabel [Universitat Autonoma de Barcelona, Department of Nuclear Medicine, Hospital de la Vall d' Hebron, Barcelona (Spain); Irastorza, Inaki; Hill, Susan [Great Ormond Street Hospital, Department of Gastroenterology, London (United Kingdom); Simo, Marc [Instituto Universitario Dexeus, Department of Nuclear Medicine, Barcelona (Spain); Biassoni, Lorenzo; Gordon, Isky [Great Ormond Street Hospital, Department of Nuclear Medicine, London (United Kingdom)

    2009-06-15

    Pulmonary emboli (PE) are one of the major complications associated with total parenteral nutrition (TPN). Ventilation-perfusion scintigraphy (V/Q) remains the most used test for the diagnosis of PE and follow-up of patients on TPN. The aim of our study was to demonstrate the high prevalence of undiagnosed PE in children on TPN. The medical and imaging files of 64 patients on TPN who underwent V/Q examinations covering the period of 1986-2004 were reviewed. Children were aged between 3.18 months and 21.6 years. TPN was started at birth (range 0-15 years). All children had a normal chest radiograph and no symptoms at the time of the V/Q scan. A comparative analysis between the prevalence of PE and risk factors number of days per week with lipophilic content of the TPN, bowel inflammation and thrombophilic factors (protein C and S) was performed. Of the 64 patients, 25 (39%) had an abnormal V/Q scan. A total of 29 PE episodes were diagnosed in all patients. Two children had three episodes of PE. The median age at PE diagnosis was 4.6 years. In 17 patients (68%) diagnosis was achieved on the first V/Q scan performed. PE was bilateral in 56% and unilateral in 44%. PE was the main cause of 2 out 15 recorded deaths. All risk factors were associated with an increase in PE prevalence by statistical analysis. PE is underdiagnosed in children on long-term TPN. Lung V/Q scintigraphy is useful in the diagnosis of PE in children with a low pretest probability. (orig.)

  9. Ventilation-perfusion relationships in the lung during head-out water immersion

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    Derion, Toniann; Guy, Harold J. B.; Tsukimoto, Koichi; Schaffartzik, Walter; Prediletto, Renato; Poole, David C.; Knight, Douglas R.; Wagner, Peter D.

    1992-01-01

    Mechanisms of altered pulmonary gas exchange during water immersion were studied in 12 normal males: 6 young (aged 20-29) and 6 older (aged 40-45). It is concluded that, in young subjects with closing volume (CV) less than expiratory reserve volume (ERV), gas exchange was enhanced during immersion, because normal ventilation-perfusion relations were preserved, and by mass balance, the ventilation/O2 uptake changes elevated arterial P(O2). In older males with CV greater than ERV and 52 percent of tidal volume below CV, immersion-induced airways closure during tidal breathing was associated with minimally increased shunt that did not significantly impair gas exchange. It is suggested that airways closure of this degree is of little importance to gas exchange.

  10. Effects of lung ventilation-perfusion and muscle metabolism-perfusion heterogeneities on maximal O2 transport and utilization.

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    Cano, I; Roca, J; Wagner, P D

    2015-04-15

    We expanded a prior model of whole-body O2 transport and utilization based on diffusive O2 exchange in the lungs and tissues to additionally allow for both lung ventilation-perfusion and tissue metabolism-perfusion heterogeneities, in order to estimate V̇O2 and mitochondrial PO2 (PmO2) during maximal exercise. Simulations were performed using data from (a) healthy fit subjects exercising at sea level and at altitudes up to the equivalent of Mount Everest and (b) patients with mild and severe chronic obstructive pulmonary disease (COPD) exercising at sea level. Heterogeneity in skeletal muscle may affect maximal O2 availability more than heterogeneity in lung, especially if mitochondrial metabolic capacity (V̇ MAX ) is only slightly higher than the potential to deliver O2 , but when V̇ MAX is substantially higher than O2 delivery, the effect of muscle heterogeneity is comparable to that of lung heterogeneity. Skeletal muscle heterogeneity may result in a wide range of potential mitochondrial PO 2 values, a range that becomes narrower as V̇ MAX increases; in regions with a low ratio of metabolic capacity to blood flow, PmO2 can exceed that of mixed muscle venous blood. The combined effects of lung and peripheral heterogeneities on the resistance to O2 flow in health decreases with altitude. Previous models of O2 transport and utilization in health considered diffusive exchange of O2 in lung and muscle, but, reasonably, neglected functional heterogeneities in these tissues. However, in disease, disregarding such heterogeneities would not be justified. Here, pulmonary ventilation-perfusion and skeletal muscle metabolism-perfusion mismatching were added to a prior model of only diffusive exchange. Previously ignored O2 exchange in non-exercising tissues was also included. We simulated maximal exercise in (a) healthy subjects at sea level and altitude, and (b) COPD patients at sea level, to assess the separate and combined effects of pulmonary and peripheral

  11. [Ventilation-perfusion ratios].

    Science.gov (United States)

    Schaffartzik, W

    1994-10-01

    Knowledge of normal and impaired pulmonary gas exchange is essential to the anaesthesiologist. Analysis of an arterial blood sample allows evaluation of whether or not pulmonary gas exchange is normal. For this purpose comparison with the oxygenation index or the alveolar-arterial PO2 difference is helpful. Pathological changes of these variables are mainly caused by ventilation-perfusion (VA/Q) mismatch. In daily practice, venous admixture or intrapulmonary shunt can be calculated using arterial and mixed-venous blood. By analysing arterial and expired PCO2, dead-space ventilation can be determined, but extended analyses of VA/Q distribution are not possible in daily practice. However, knowledge of the principles of typical disturbances of pulmonary gas exchange in acute and chronic lung disease allows the use of therapeutic strategies based on the pathophysiological changes.

  12. A technique for lung ventilation-perfusion SPECT in neonates and infants.

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    Sánchez-Crespo, Alejandro; Rohdin, Malin; Carlsson, Charlotta; Bergström, Sten Erik; Larsson, Stig A; Jacobsson, Hans; Lindahl, Sten; Jonsson, Baldvin

    2008-02-01

    Single photon emission tomography (SPECT) of the lung is a well-established non-invasive technique for quantitative assessment of regional lung ventilation and perfusion distribution in children and in adults. However, its application in neonates as well as infants has been scarce because of several practical limitations, such as the trade off between image quality and restricted effective radiation doses and the lack of suitable inhalations agents and administration techniques. In this paper, a new technique for quantitative regional lung SPECT based on a passive Technegas administration procedure is described and clinically applied. The first clinical findings in neonates are reported. This technique overcomes some of the limitations of commercial ventilation systems by making patient compliance unnecessary, avoiding difficult breathing manoeuvres and by minimizing both facemask dead space and inspiratory-expiratory resistance. This technique satisfies requirements for routine applications in neonates, infants and even older patients and has a potential use also for mechanically ventilated patients. It has the potential to allow a more precise functionally oriented diagnosis, which is of importance for treatment and follow-up in patients with severe lung diseases.

  13. The gravitational distribution of ventilation-perfusion ratio is more uniform in prone than supine posture in the normal human lung.

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    Henderson, A Cortney; Sá, Rui Carlos; Theilmann, Rebecca J; Buxton, Richard B; Prisk, G Kim; Hopkins, Susan R

    2013-08-01

    The gravitational gradient of intrapleural pressure is suggested to be less in prone posture than supine. Thus the gravitational distribution of ventilation is expected to be more uniform prone, potentially affecting regional ventilation-perfusion (Va/Q) ratio. Using a novel functional lung magnetic resonance imaging technique to measure regional Va/Q ratio, the gravitational gradients in proton density, ventilation, perfusion, and Va/Q ratio were measured in prone and supine posture. Data were acquired in seven healthy subjects in a single sagittal slice of the right lung at functional residual capacity. Regional specific ventilation images quantified using specific ventilation imaging and proton density images obtained using a fast gradient-echo sequence were registered and smoothed to calculate regional alveolar ventilation. Perfusion was measured using arterial spin labeling. Ventilation (ml·min(-1)·ml(-1)) images were combined on a voxel-by-voxel basis with smoothed perfusion (ml·min(-1)·ml(-1)) images to obtain regional Va/Q ratio. Data were averaged for voxels within 1-cm gravitational planes, starting from the most gravitationally dependent lung. The slope of the relationship between alveolar ventilation and vertical height was less prone than supine (-0.17 ± 0.10 ml·min(-1)·ml(-1)·cm(-1) supine, -0.040 ± 0.03 prone ml·min(-1)·ml(-1)·cm(-1), P = 0.02) as was the slope of the perfusion-height relationship (-0.14 ± 0.05 ml·min(-1)·ml(-1)·cm(-1) supine, -0.08 ± 0.09 prone ml·min(-1)·ml(-1)·cm(-1), P = 0.02). There was a significant gravitational gradient in Va/Q ratio in both postures (P ventilation, perfusion, and regional Va/Q ratio were greater supine than prone, suggesting an interplay between thoracic cavity configuration, airway and vascular tree anatomy, and the effects of gravity on Va/Q matching.

  14. The gravitational distribution of ventilation-perfusion ratio is more uniform in prone than supine posture in the normal human lung

    Science.gov (United States)

    Sá, Rui Carlos; Theilmann, Rebecca J.; Buxton, Richard B.; Prisk, G. Kim; Hopkins, Susan R.

    2013-01-01

    The gravitational gradient of intrapleural pressure is suggested to be less in prone posture than supine. Thus the gravitational distribution of ventilation is expected to be more uniform prone, potentially affecting regional ventilation-perfusion (V̇a/Q̇) ratio. Using a novel functional lung magnetic resonance imaging technique to measure regional V̇a/Q̇ ratio, the gravitational gradients in proton density, ventilation, perfusion, and V̇a/Q̇ ratio were measured in prone and supine posture. Data were acquired in seven healthy subjects in a single sagittal slice of the right lung at functional residual capacity. Regional specific ventilation images quantified using specific ventilation imaging and proton density images obtained using a fast gradient-echo sequence were registered and smoothed to calculate regional alveolar ventilation. Perfusion was measured using arterial spin labeling. Ventilation (ml·min−1·ml−1) images were combined on a voxel-by-voxel basis with smoothed perfusion (ml·min−1·ml−1) images to obtain regional V̇a/Q̇ ratio. Data were averaged for voxels within 1-cm gravitational planes, starting from the most gravitationally dependent lung. The slope of the relationship between alveolar ventilation and vertical height was less prone than supine (−0.17 ± 0.10 ml·min−1·ml−1·cm−1 supine, −0.040 ± 0.03 prone ml·min−1·ml−1·cm−1, P = 0.02) as was the slope of the perfusion-height relationship (−0.14 ± 0.05 ml·min−1·ml−1·cm−1 supine, −0.08 ± 0.09 prone ml·min−1·ml−1·cm−1, P = 0.02). There was a significant gravitational gradient in V̇a/Q̇ ratio in both postures (P < 0.05) that was less in prone (0.09 ± 0.08 cm−1 supine, 0.04 ± 0.03 cm−1 prone, P = 0.04). The gravitational gradients in ventilation, perfusion, and regional V̇a/Q̇ ratio were greater supine than prone, suggesting an interplay between thoracic cavity configuration, airway and vascular tree anatomy, and the effects of

  15. Ventilation/Perfusion SPECT lung scintigraphy and computed tomography pulmonary angiography in patients with clinical suspicion of pulmonary embolism.

    Science.gov (United States)

    Ibáñez-Bravo, S; Banzo, I; Quirce, R; Martínez-Rodríguez, I; Jiménez-Bonilla, J; Martínez-Amador, N; Parra, J A; González-Macías, J; Carril, J M

    2016-01-01

    The aim was to compare ventilation/perfusion SPECT lung scintigraphy (V/Q-SPECT) and computed tomography pulmonary angiography (CTPA) in patients with suspicion of pulmonary embolism (PE). This prospectively designed study included 53 patients with intermediate or high clinical probability of PE. A V/Q-SPECT and CTPA was performed on all patients. The V/Q-SPECT was interpreted according to the European Association of Nuclear Medicine and Molecular Imaging (EANMMI) guidelines. CTPA was reported as positive, negative, or indeterminate. CTPA was positive in 22 cases, negative in 28, and indeterminate in 3. V/Q-SPECT was positive in 27 cases, negative in 24, and non-diagnostic in 2. In the 22 with positive CTPA, V/Q-SPECT was positive in 18, negative in 3, and non-diagnostic in 1. In the 28 with negative CTPA, V/Q-SPECT was positive in 8, negative in 19, and non-diagnostic in 1. In the 3 with indeterminate CTPA, V/Q-SPECT was positive in 1 and negative in 2. In the 2 non-diagnostic cases V/Q-SPECT, CTPA was positive in 1 and negative in one. In the 10 high clinical probabilities, CTPA and V/Q-SPECT were positive in 7, negative in 2, and in 1, CTPA was positive and V/Q-SPECT negative. In the 38 intermediate probability group, CTPA and V/Q-SPECT were positive in 11, negative in 17, with CTPA negative and V/Q-SPECT positive in 8, and in 2 CTPA was positive and V/Q-SPECT negative. The results show that V/Q-SPECT detected PE in 5 patients more than CTPA. Our results show a 77% concordance of both techniques. Overall V/Q-SPECT detected PE in 18% more patients than CTPA in the intermediate group. Both techniques have a complementary role when a diagnosis cannot be made with one of them. Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  16. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas ov...

  17. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT.

    Science.gov (United States)

    Jögi, Jonas; Ekberg, Marie; Jonson, Björn; Bozovic, Gracijela; Bajc, Marika

    2011-07-01

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV(1)). FEV(1) does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV(1), symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be reported. V/P SPECT can also be used to categorize the severity of functional changes in COPD as mild

  18. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Joegi, Jonas; Bajc, Marika [Lund University, Skaane University Hospital, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Ekberg, Marie [Lund University, Skaane University Hospital, Department of Respiratory Medicine and Allergology, Institution of Clinical Sciences, Lund (Sweden); Jonson, Bjoern [Lund University, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Bozovic, Gracijela [Lund University, Skaane University Hospital, Department of Radiology, Institution of Clinical Sciences, Lund (Sweden)

    2011-07-15

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV{sub 1}). FEV{sub 1} does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV{sub 1}, symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be

  19. Measurement of the distribution of ventilation-perfusion ratios in the human lung with proton MRI: comparison with the multiple inert-gas elimination technique.

    Science.gov (United States)

    Sá, Rui Carlos; Henderson, A Cortney; Simonson, Tatum; Arai, Tatsuya J; Wagner, Harrieth; Theilmann, Rebecca J; Wagner, Peter D; Prisk, G Kim; Hopkins, Susan R

    2017-07-01

    We have developed a novel functional proton magnetic resonance imaging (MRI) technique to measure regional ventilation-perfusion (V̇A/Q̇) ratio in the lung. We conducted a comparison study of this technique in healthy subjects (n = 7, age = 42 ± 16 yr, Forced expiratory volume in 1 s = 94% predicted), by comparing data measured using MRI to that obtained from the multiple inert gas elimination technique (MIGET). Regional ventilation measured in a sagittal lung slice using Specific Ventilation Imaging was combined with proton density measured using a fast gradient-echo sequence to calculate regional alveolar ventilation, registered with perfusion images acquired using arterial spin labeling, and divided on a voxel-by-voxel basis to obtain regional V̇A/Q̇ ratio. LogSDV̇ and LogSDQ̇, measures of heterogeneity derived from the standard deviation (log scale) of the ventilation and perfusion vs. V̇A/Q̇ ratio histograms respectively, were calculated. On a separate day, subjects underwent study with MIGET and LogSDV̇ and LogSDQ̇ were calculated from MIGET data using the 50-compartment model. MIGET LogSDV̇ and LogSDQ̇ were normal in all subjects. LogSDQ̇ was highly correlated between MRI and MIGET (R = 0.89, P = 0.007); the intercept was not significantly different from zero (-0.062, P = 0.65) and the slope did not significantly differ from identity (1.29, P = 0.34). MIGET and MRI measures of LogSDV̇ were well correlated (R = 0.83, P = 0.02); the intercept differed from zero (0.20, P = 0.04) and the slope deviated from the line of identity (0.52, P = 0.01). We conclude that in normal subjects, there is a reasonable agreement between MIGET measures of heterogeneity and those from proton MRI measured in a single slice of lung.NEW & NOTEWORTHY We report a comparison of a new proton MRI technique to measure regional V̇A/Q̇ ratio against the multiple inert gas elimination technique (MIGET). The study reports good relationships between

  20. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over...... radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

  1. SPECT/CT imaging of lung perfusion in the diagnosis of pulmonary embolism: Comparison with planar ventilation-perfusion lung scintigraphy; La perfusion pulmonaire en morphoTEMP dans le diagnostic de l'embolie pulmonaire: comparaison a la scintigraphie pulmonaire planaire de ventilation/perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Revel, C.; Poisson, T.; Revel, A.; Daragon, N.; Grandpierre, S.; Netter, F.; Scigliano, S.; Djaballah, W.; Olivier, P.; Karcher, G.; Marie, P.Y. [CHU de Nancy-Brabois, Service de Biophysique et de Medecine Nucleaire, 54 - Vandoeuvre (France)

    2008-06-15

    The aim of this study is to assess a new tool for the diagnosis of acute pulmonary embolism (PE): single-photon emission computed tomography lung perfusion imaging associated with unenhanced computed tomography (SPECT/CT) compared to planar ventilation-perfusion (V.Q.) lung scintigraphy. Methods One hundred and three patients with suspected acute PE underwent V.Q. scintigraphy (two scans were not interpretable) followed by perfusion SPECT/CT. The two types of images were analysed separately: (1) according to the modified P.I.O.P.E.D. scintigraphic criteria for V.Q. lung scan and (2) with regard to SPECT/CT mismatches suggestive acute PE (segmental perfusion defects detected on SPECT images not matched with CT abnormalities). Results On average, the number of segmental perfusion defects per patient was higher with SPECT/CT than with planar scintigraphy (4.3 {+-}3.6 versus 2.8 {+-}2.6; p < 0.001). A mismatch was found with SPECT-CT in 0% (0/18) of normal scintigraphy, and 8% (3/39) for low, 32% (8/25) for intermediate and 74% (14/19) for high probabilities of PE at scintigraphy. The presence of a SPECT/CT mismatch was also associated with higher pretest probability of acute PE (p = 0.001), even for the 25 patients in the intermediate-probability subgroup (p = 0.02). Finally, a SPECT/CT match was found in 29 patients that was not suggestive of acute PE due to the presence, in areas with perfusion defects on SPECT images, of the following CT abnormalities: hypo density and/or emphysema (71%), condensation or atelectasis (38%), pleural disease (7%), extra-pulmonary structure (14%) and/or bronchial obstruction (7%). Conclusion In patients with suspected acute PE, the results obtained with pulmonary SPECT/CT images are consistent with those obtained with V.Q. scintigraphy and the pretest probability of PE. Further studies comparing SPECT/CT imaging with angiographic techniques are now required to evaluate more specifically the diagnostic value of this new tool. (authors)

  2. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

    Science.gov (United States)

    Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.

    2016-08-01

    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

  3. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Krivonogov, Nikolay G., E-mail: kng@cardio-tomsk.ru [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Efimova, Nataliya Y., E-mail: efimova@cardio-tomsk.ru; Zavadovsky, Konstantin W.; Lishmanov, Yuri B. [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation)

    2016-08-02

    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

  4. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used

    Directory of Open Access Journals (Sweden)

    Jögi J

    2014-12-01

    Full Text Available Jonas Jögi,1 Hanna Markstad,2 Ellen Tufvesson,3 Leif Bjermer,3 Marika Bajc1 1Department of Clinical Physiology and Nuclear Medicine, 2Department of Radiology, 3Department of Respiratory Medicine and Allergology, Skåne University Hospital and Lund University, Lund, Sweden Abstract: Ventilation/perfusion (V/P single-photon emission computed tomography (SPECT is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF, pneumonia, and chronic obstructive pulmonary disease (COPD. The development of hybrid SPECT/computed tomography (CT systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT, may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I–IV and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD

  5. Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation.

    Science.gov (United States)

    Spadaro, Savino; Grasso, Salvatore; Karbing, Dan Stieper; Fogagnolo, Alberto; Contoli, Marco; Bollini, Giacomo; Ragazzi, Riccardo; Cinnella, Gilda; Verri, Marco; Cavallesco, Narciso Giorgio; Rees, Stephen Edward; Volta, Carlo Alberto

    2017-12-06

    Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed. Shunt fraction, high V/Q and respiratory mechanics were measured at positive end-expiratory pressure 0 cm H2O during bilateral lung ventilation and one-lung ventilation and, subsequently, during one-lung ventilation at 5 or 10 cm H2O of positive end-expiratory pressure. Shunt fraction and high V/Q were measured using variation of inspired oxygen fraction and measurement of respiratory gas concentration and arterial blood gas. The level of positive end-expiratory pressure was applied in random order and maintained for 15 min before measurements. During one-lung ventilation, increasing positive end-expiratory pressure from 0 cm H2O to 5 cm H2O and 10 cm H2O resulted in a shunt fraction decrease of 5% (0 to 11) and 11% (5 to 16), respectively (P ventilation, high positive end-expiratory pressure levels improve pulmonary function without increasing high V/Q and reduce driving pressure.

  6. Ventilation/perfusion lung scintigraphy: what is still needed? A review considering technetium-99m-labeled macro-aggregates of albumin.

    Science.gov (United States)

    Zöphel, Klaus; Bacher-Stier, Claudia; Pinkert, Jörg; Kropp, Joachim

    2009-01-01

    Lung perfusion scintigraphy (LPS) with technetium-99m-labeled macro-aggregates of albumin (Tc-99m-MAA) is well established in the diagnostic of pulmonary embolism (PE). In the last decade, it was shown that single-photon emission computer tomography (SPECT) acquisition of LPS overcame static scintigraphy. Furthermore, there are rare indications for LPS, such as preoperative quantification of regional lung function prior to lung resection or transplantation, optimization of lung cancer radiation therapy, quantification of right-left shunt, planning of intra-arterial chemotherapy, and several rare indications in pediatrics. Moreover, LPS with Tc-99m-MAA is a safe method with low radiation exposure. PE can also be diagnosed by spiral computer tomography (CT), ultrasound, magnetic resonance angiography, or pulmonary angiography (PA, former gold standard). The present review considers all these methods, especially spiral CT, and compares them with LPS with respect to sensitivity and specificity and gives an overview of established and newer publications. It shows that LPS with Tc-99m-MAA represents a diagnostic method of continuing value for PE. In comparison with spiral CT and/or PA, LPS is not to be defeated as mentioned also by the most actual Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II reports. This applies in particular to chronic or recurring embolisms, whereas currently spiral CT may be of greater value for major or life-threatening embolisms. At present, LPS cannot be replaced by other methods in some applications, such as pediatrics or in the quantification of regional pulmonary function in a preoperative context or prior to radiation therapy. LPS still has a place in the diagnostics of PE and is irreplaceable in several rare indications as described earlier.

  7. To Find a Better Dosimetric Parameter in the Predicting of Radiation-Induced Lung Toxicity Individually: Ventilation, Perfusion or CT based.

    Science.gov (United States)

    Xiao, Lin-Lin; Yang, Guoren; Chen, Jinhu; Wang, Xiaohui; Wu, Qingwei; Huo, Zongwei; Yu, Qingxi; Yu, Jinming; Yuan, Shuanghu

    2017-03-15

    This study aimed to find a better dosimetric parameter in predicting of radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) individually: ventilation(V), perfusion (Q) or computerized tomography (CT) based. V/Q single-photon emission computerized tomography (SPECT) was performed within 1 week prior to radiotherapy (RT). All V/Q imaging data was integrated into RT planning system, generating functional parameters based on V/Q SPECT. Fifty-seven NSCLC patients were enrolled in this prospective study. Fifteen (26.3%) patients underwent grade ≥2 RILT, the remaining forty-two (73.7%) patients didn't. Q-MLD, Q-V20, V-MLD, V-V20 of functional parameters correlated more significantly with the occurrence of RILT compared to V20, MLD of anatomical parameters (r = 0.630; r = 0.644; r = 0.617; r = 0.651 vs. r = 0.424; r = 0.520 p < 0.05, respectively). In patients with chronic obstructive pulmonary diseases (COPD), V functional parameters reflected significant advantage in predicting RILT; while in patients without COPD, Q functional parameters reflected significant advantage. Analogous results were existed in fractimal analysis of global pulmonary function test (PFT). In patients with central-type NSCLC, V parameters were better than Q parameters; while in patients with peripheral-type NSCLC, the results were inverse. Therefore, this study demonstrated that choosing a suitable dosimetric parameter individually can help us predict RILT accurately.

  8. Estimating the ventilation-perfusion distribution: an ill-posed integral equation problem.

    Science.gov (United States)

    Lim, L L; Whitehead, J

    1992-03-01

    The distribution of ventilation-perfusion ratio over the lung is a useful indicator of the efficiency of lung function. Information about this distribution can be obtained by observing the retention in blood of inert gases passed through the lung. These retentions are related to the ventilation-perfusion distribution through an ill-posed integral equation. An unusual feature of this problem of estimating the ventilation-perfusion distribution is the small amount of data available; typically there are just six data points, as only six gases are used in the experiment. A nonparametric smoothing method is compared to a simpler method that models the distribution as a histogram with five classes. Results from the smoothing method are found to be very unstable. In contrast, the simpler method gives stable solutions with parameters that are physiologically meaningful. It is concluded that while such smoothing methods may be useful for solving some ill-posed integral equation problems, the simpler method is preferable when data are scarce.

  9. Kombineret ventilations/perfusions-SPECT/CT er bedst til diagnostik af lungeemboli

    DEFF Research Database (Denmark)

    Gutte Borgwardt, Henrik; Mortensen, Jann; Kristoffersen, Ulrik Sloth

    2012-01-01

    and very limited data comparing these modalities are available. With the use of hybrid scanners, ventilation/perfusion-single-photon-emission-tomography (V/Q-SPECT) in combination with low-dose CT without contrast enhancement is feasible and should probably be considered first-line imaging in diagnosing PE.......The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer test and imaging with either lung scintigraphy or pulmonary multidetector computed tomography angiography (CTA). Which of the two methods to use in PE diagnostic has not been determined...

  10. Pulmonary ventilation/perfusion single photon emission tomography--Initial experience of a Nuclear Medicine Department.

    Science.gov (United States)

    Santos, J G; Carmona, S; Sequeira, J A; Prata, A; Santos, A I

    2016-01-01

    Lung ventilation/perfusion scintigraphy with planar images (V/QS-planar) is very useful for the diagnosis and follow-up of pulmonary thromboembolism (PTE). Acquiring tomographic images (V/QS-SPECT) is a recent development with potential to increase the technique's accuracy. The purpose of this work is to evaluate the added benefits of V/QS-SPECT studies as opposed to traditional planar imaging. We prospectively revised 53 V/QS-planar and V/QS-SPECT exams, performed according to the European Association of Nuclear Medicine guidelines. We evaluated the exams independently, by consensus of two Nuclear Medicine physicians. For both methods, we gave each lung a score expressing the dimension and extension of perfusion defects with normal ventilation. For each lung, we compared the scores with the paired Wilcoxon test, estimating the 95% confidence interval (95 CI) for the respective difference. We performed V/QS-SPECT exams without technical difficulties. The paired Wilcoxon test estimated the score difference to be -0.75 (95 CI of -1.0 to -0.5; p-value=9.6 × 10(-7)), expressing a statistically significant difference of about 1 subsegmental defect between both methods, with V/QS-SPECT detecting more defects. The results demonstrate that V/QS-SPECT identifies a slightly larger number of perfusion defects than V/QS-planar, suggesting a higher sensitivity of this technique. However, more studies are necessary to evaluate the clinical meaning of this fact. V/QS-SPECT demonstrates a higher capability to identify perfusion defects. This method looks promising, allowing for a greater role of this exam in pulmonary thromboembolism diagnosis and follow-up. Copyright © 2015 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  11. Ventilation-perfusion distributions and gas exchange during carbon dioxide-pneumoperitoneum in a porcine model.

    Science.gov (United States)

    Strang, C M; Fredén, F; Maripuu, E; Hachenberg, T; Hedenstierna, G

    2010-11-01

    Carbon dioxide (CO₂)-pneumoperitoneum (PP) of 12 mm Hg increases arterial oxygenation, but it also promotes collapse of dependent lung regions. This seeming paradox prompted the present animal study on the effects of PP on ventilation-perfusion distribution (V/Q) and gas exchange. Fourteen anaesthetized pigs were studied. In seven pigs, single photon emission computed tomography (SPECT) was used for spatial analysis of ventilation and perfusion distributions, and in another seven pigs, multiple inert gas elimination technique (MIGET) was used for detailed analysis of V/Q matching. SPECT/MIGET and central haemodynamics and pulmonary gas exchange were recorded during anaesthesia before and 60 min after induction of PP. SPECT during PP showed no or only poorly ventilated regions in the dependent lung compared with the ventilation distribution during anaesthesia before PP. PP was accompanied by redistribution of blood flow away from the non- or poorly ventilated regions. V/Q analysis by MIGET showed decreased shunt from 9 (sd 2) to 7 (2)% after induction of PP (P<0.05). No regions of low V/Q were seen either before or during PP. Almost no regions of high V/Q developed during PP (1% of total ventilation). Pa(o₂) increased from 33 (1.2) to 35.7 (3.2) kPa (P<0.01) and arterial to end-tidal Pco₂ gradient (Pae'(co₂) increased from 0.3 (0.1) to 0.6 (0.2) kPa (P<0.05). Perfusion was redistributed away from dorsal, collapsed lung regions when PP was established. This resulted in a better V/Q match. A possible mechanism is enhanced hypoxic pulmonary vasoconstriction.

  12. Inhibition of Constitutive Nitric Oxide Synthase Does Not Influence Ventilation-Perfusion Matching in Normal Prone Adult Sheep With Mechanical Ventilation.

    Science.gov (United States)

    Johansson, Mats J; Kvitting, John-Peder Escobar; Flatebø, Torun; Nicolaysen, Anne; Nicolaysen, Gunnar; Walther, Sten M

    2016-12-01

    Local formation of nitric oxide in the lung induces vasodilation in proportion to ventilation and is a putative mechanism behind ventilation-perfusion matching. We hypothesized that regional ventilation-perfusion matching occurs in part due to local constitutive nitric oxide formation. Ventilation and perfusion were analyzed in lung regions (≈1.5 cm) before and after inhibition of constitutive nitric oxide synthase with N-nitro-L-arginine methyl ester (L-NAME) (25 mg/kg) in 7 prone sheep ventilated with 10 cm H2O positive end-expiratory pressure. Ventilation and perfusion were measured by the use of aerosolized fluorescent and infused radiolabeled microspheres, respectively. The animals were exsanguinated while deeply anesthetized; then, lungs were excised, dried at total lung capacity, and divided into cube units. The spatial location for each cube was tracked and fluorescence and radioactivity per unit weight determined. After administration of L-NAME, pulmonary artery pressure increased from a mean of 16.6-23.6 mm Hg, P = .007 but PaO2, PaCO2, and SD log(V/Q) did not change. Distribution of ventilation was not influenced by L-NAME, but a small redistribution of perfusion from ventral to dorsal lung regions was observed. Perfusion to regions with the highest ventilation (fifth quintile of the ventilation distribution) remained unchanged after L-NAME. We found minimal or no influence of constitutive nitric oxide synthase inhibition by L-NAME on the distributions of ventilation and perfusion, and ventilation-perfusion in prone, anesthetized, ventilated, and healthy adult sheep with normal gas exchange.

  13. Improved ventilation-perfusion matching by abdominal insufflation (pneumoperitoneum) with CO2 but not with air.

    Science.gov (United States)

    Strang, C M; Ebmeyer, U; Maripuu, E; Hachenberg, T; Hedenstierna, G

    2013-06-01

    Pneumoperitoneum (PP) by CO2-insufflation causes atelectasis however with maintained or even improved oxygenation. We studied the effect of abdominal insufflation by carbon dioxide (CO2) and air on gas exchange during PP. Twenty-seven anesthetized pigs were studied during PP with insufflations to 12 mmHg by either 1/CO2, 2/ air or 3/CO2 during intravenous nitroprusside infusion (SNP) (N.=9 in each group). In 3 pigs in each group, gamma camera technique (SPECT) was used to study ventilation and perfusion distributions, in another 6 pigs an inert-gas technique (MIGET) was used for assessing ventilation-perfusion matching (VA/Q). Measurements were made during anesthesia before and after 60 minutes of PP. CO2-PP caused a shift of blood flow away from dependent, non-ventilated (atelectatic) to ventilated regions. Air-PP caused smaller, and SNP-PP even less shift of lung blood flow. Shunt decreased during CO2-PP (6 ± 1% compared to baseline 9 ± 2%, P<0.05), did not change during Air-PP (10 ± 2%) and increased during SNP-PP (16 ± 2%, P<0.05). PaO2 increased from baseline 35 ± 2 to 41 ± 3 kPa during CO2-PP and decreased to 32 ± 3 kPa during Air-PP and to 27 ± 3 kPa during SNP-PP (P<0.05 for all three comparisons). PaCO2 increased during CO2- and SNP-PP. CO2-PP enhanced the shift of blood flow towards better ventilated areas of the lung compared to Air-PP and SNP blunted the effects seen with CO2-PP. SNP may thus have blunted and CO2 potentiated vasoconstriction, by hypoxic pulmonary vasoconstriction or another mechanism.

  14. Electrical impedance tomography for assessing ventilation/perfusion mismatch for pulmonary embolism detection without interruptions in respiration.

    Science.gov (United States)

    Nguyen, Doan Trang; Thiagalingam, Aravinda; Bhaskaran, Abhishek; Barry, Michael A; Pouliopoulos, Jim; Jin, Craig; McEwan, Alistair L

    2014-01-01

    Recent studies have shown high correlation between pulmonary perfusion mapping with impedance contrast enhanced Electrical Impedance Tomography (EIT) and standard perfusion imaging methods such as Computed Tomography (CT) and Single Photon Emission Computerized Tomography (SPECT). EIT has many advantages over standard imaging methods as it is highly portable and non-invasive. Contrast enhanced EIT uses hypertonic saline bolus instead of nephrotoxic contrast medium that are utilized by CT and nuclear Ventilation/Perfusion (V/Q) scans. However, current implementation of contrast enhanced EIT requires induction of an apnea period for perfusion measurement, rendering it disadvantageous compared with current gold standard imaging modalities. In the present paper, we propose the use of a wavelet denoising algorithm to separate perfusion signal from ventilation signal such that no interruption in patient's ventilation would be required. Furthermore, right lung to left lung perfusion ratio and ventilation ratio are proposed to assess the mismatch between ventilation and perfusion for detection of Pulmonary Embolism (PE). The proposed methodology was validated on an ovine model (n=3, 83.7±7.7 kg) with artificially induced PE in the right lung. The results showed a difference in right lung to left lung perfusion ratio between baseline and diseased states in all cases with all paired t-tests between baseline and PE yielding p lung to left lung ventilation ratio remained unchanged in two out of three experiments. Statistics were pooled from multiple repetitions of measurements per experiment.

  15. High Probability Ventilation-Perfusion Scan in Primary Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Sat Sharma

    1995-01-01

    Full Text Available The perfusion lung scan is a valuable noninvasive tool in the evaluation of patients with pulmonary arterial hypertension of undetermined cause and for the exclusion of occult large-vessel pulmonary thromboembolism. Peripheral patchy defects have been reported in primary pulmonary hypertension (PPH but there are no well documented reports of segmental or larger perfusion defects. A case of a 55-year-old male with severe pulmonary hypertension of unknown etiology who had persistent high probability perfusion scan patterns over a period of two years is reported. No evidence of thromboembolism was present on pulmonary angiography. A discussion of the case and a review of the literature on the role of lung scan in PPH are presented. Most patients with PPH have normal or low probability perfusion scans; high probability scans occur rarely.

  16. Pulmonary ventilation/perfusion single photon emission tomography – Initial experience of a Nuclear Medicine Department

    Directory of Open Access Journals (Sweden)

    J. G. Santos

    2016-01-01

    Full Text Available Introduction: Lung ventilation/perfusion scintigraphy with planar images (V/QS-planar is very useful for the diagnosis and follow-up of pulmonary thromboembolism (PTE. Acquiring tomographic images (V/QS-SPECT is a recent development with potential to increase the technique's accuracy. The purpose of this work is to evaluate the added benefits of V/QS-SPECT studies as opposed to traditional planar imaging. Patients and methods: We prospectively revised 53 V/QS-planar and V/QS-SPECT exams, performed according to the European Association of Nuclear Medicine guidelines. We evaluated the exams independently, by consensus of two Nuclear Medicine physicians. For both methods, we gave each lung a score expressing the dimension and extension of perfusion defects with normal ventilation. For each lung, we compared the scores with the paired Wilcoxon test, estimating the 95% confidence interval (95CI for the respective difference. Results: We performed V/QS-SPECT exams without technical difficulties. The paired Wilcoxon test estimated the score difference to be −0.75 (95CI of −1.0 to −0.5; p-value = 9.6 × 10−7, expressing a statistically significant difference of about 1 subsegmental defect between both methods, with V/QS-SPECT detecting more defects. Discussion: The results demonstrate that V/QS-SPECT identifies a slightly larger number of perfusion defects than V/QS-planar, suggesting a higher sensitivity of this technique. However, more studies are necessary to evaluate the clinical meaning of this fact. Conclusion: V/QS-SPECT demonstrates a higher capability to identify perfusion defects. This method looks promising, allowing for a greater role of this exam in pulmonary thromboembolism diagnosis and follow-up. Keywords: Pulmonary thromboembolism, Lung, Scintigraphy, Single-photon emission-computed tomography (SPECT

  17. Acute pulmonary embolism detection with ventilation/perfusion SPECT combined with full dose CT: What is the best option?

    Science.gov (United States)

    Milà, M; Bechini, J; Vázquez, A; Vallejos, V; Tenesa, M; Espinal, A; Fraile, M; Monreal, M

    To compare diagnostic accuracy of Ventilation/Perfusion (V/P) single-photon emission computed tomography (SPECT) combined with simultaneous full-dose CT with a hybrid SPECT/CT scanner versus planar ventilation/perfusion (V/P) SPECT and CT angiography (CTA) in patients suspected with acute pulmonary embolism (PE). Between 2009 and 2011, consecutive patients suspected of acute PE were referred for V/P SPECT/CT (reviewed board approved study). A contrast agent was administered to patients who had no contraindications. Non-contrast V/P SPECT/CT was performed on the remaining patients. All patients were followed-up for at least 3 months. A total of 314 patients were available during the study period, with the diagnosis of PE confirmed in 70 (22.29%) of them. The overall population sensitivity and specificity was 90.91% and 92.44%, respectively for V/P SPECT, 80% and 99.15%, respectively, for CTA, and 95.52% and 97.08% for V/P SPECT/CT. SPECT/CT performed better than V/P SPECT (AUC differences=0.0419, P=0.0043, 95% CI; 0.0131-0.0706) and CTA (AUC differences=0.0681, P=0.0208, 95% CI; 0.0103-0.1259)). Comparing imaging modalities when contrast agent could be administered, sensitivity and specificity increased and V/P SPECT/CT was significantly better than CTA (AUC differences=0.0681, P=0.0208, 95% CI; 0.0103-0.1259) and V/P SPECT (AUC differences=0.0659, P=0.0052, 95% CI; 0.0197-0.1121). In case of non-contrast enhancement, there was non-significant increase of specificity. Secondary findings on CT impacted patient management in 14.65% of cases. Our study shows that combined V/P SPECT/CT scanning has a higher diagnostic accuracy for detecting acute PE than V/P SPECT and CTA alone. When feasible, V/P SPECT/CT with contrast enhancement is the best option. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  18. Current Status of Ventilation-Perfusion Scintigraphy for Suspected Pulmonary Embolism.

    Science.gov (United States)

    Metter, Darlene; Tulchinsky, Mark; Freeman, Leonard M

    2017-03-01

    The purpose of this article is to outline recent progress made in ventilation-perfusion (V/Q) scintigraphy imaging techniques and the interpretation systems used for the diagnosis of pulmonary embolism (PE). Various state-of-the-art approaches that can be selected according to the needs dictated by the medical practice environment and specific patient groups are presented. Although advances in tomographic imaging have certainly improved the sensitivity of V/Q scans for the diagnosis of PE, they may lead to overdiagnosis by revealing small and clinically insignificant PEs.

  19. Effect of Bronchoconstriction-induced Ventilation-Perfusion Mismatch on Uptake and Elimination of Isoflurane and Desflurane.

    Science.gov (United States)

    Kretzschmar, Moritz; Kozian, Alf; Baumgardner, James E; Borges, Joao Batista; Hedenstierna, Göran; Larsson, Anders; Hachenberg, Thomas; Schilling, Thomas

    2017-11-01

    Increasing numbers of patients with obstructive lung diseases need anesthesia for surgery. These conditions are associated with pulmonary ventilation/perfusion (VA/Q) mismatch affecting kinetics of volatile anesthetics. Pure shunt might delay uptake of less soluble anesthetic agents but other forms of VA/Q scatter have not yet been examined. Volatile anesthetics with higher blood solubility would be less affected by VA/Q mismatch. We therefore compared uptake and elimination of higher soluble isoflurane and less soluble desflurane in a piglet model. Juvenile piglets (26.7 ± 1.5 kg) received either isoflurane (n = 7) or desflurane (n = 7). Arterial and mixed venous blood samples were obtained during wash-in and wash-out of volatile anesthetics before and during bronchoconstriction by methacholine inhalation (100 μg/ml). Total uptake and elimination were calculated based on partial pressure measurements by micropore membrane inlet mass spectrometry and literature-derived partition coefficients and assumed end-expired to arterial gradients to be negligible. VA/Q distribution was assessed by the multiple inert gas elimination technique. Before methacholine inhalation, isoflurane arterial partial pressures reached 90% of final plateau within 16 min and decreased to 10% after 28 min. By methacholine nebulization, arterial uptake and elimination delayed to 35 and 44 min. Desflurane needed 4 min during wash-in and 6 min during wash-out, but with bronchoconstriction 90% of both uptake and elimination was reached within 15 min. Inhaled methacholine induced bronchoconstriction and inhomogeneous VA/Q distribution. Solubility of inhalational anesthetics significantly influenced pharmacokinetics: higher soluble isoflurane is less affected than fairly insoluble desflurane, indicating different uptake and elimination during bronchoconstriction.

  20. AUTOTRANSPLANTATION OF THE LUNG: EXPERIMENTAL ...

    African Journals Online (AJOL)

    Xenon-l33 ventilation-perfusion studies of the trans- planted lung demonstrated a significant reduction in ... and lungs of a kitten to the neck vessels of an adult cat. The lungs soon became oedematous and distension ... used autotransplantation of the lung in the dog as a control to study the effects of homotransplantation of.

  1. The effect of dopexamine on ventilation perfusion distribution and pulmonary gas exchange in anesthetized, paralyzed patients.

    Science.gov (United States)

    Hachenberg, T; Karmann, S; Pfeiffer, B; Thomas, H; Gründling, M; Wendt, M

    1998-02-01

    We studied the effects of the beta2-adrenoceptor and DA1-receptor agonist dopexamine on ventilation perfusion (V(A)/Q) distribution in anesthetized, paralyzed patients (n = 17) undergoing major abdominal surgery. Intrapulmonary shunt (Q(S)/Q(T)) (percentage of cardiac output [CO]), perfusion of low V(A)/Q areas (percentage of CO), ventilation of high V(A)/Q areas (percentage of total ventilation [V(E)]), and dead space ventilation [percentage of V(E)]) were calculated from the retention/excretion data of six inert gases. In the control state, Q(S)/Q(T) was 11% +/- 9% (mean +/- SD) and little perfusion of low V(A)/Q areas (3% +/- 4%) was observed. Infusion of 1.0 microg kg(-1) x min(-1) dopexamine had no effect on Q(S)/Q(T) and low V(A)/Q areas despite an increased CO (7.7 +/- 2.2 L/min versus 6.2 +/- 1.2 L/min; P < 0.01). Pao2 increased from 15.5 +/- 5.6 kPa (116 +/- 42 mm Hg) to 17.3 +/- 6.3 kPa (130 +/- 47 mm Hg) (P < 0.05). Infusion of 2.0 microg x kg(-1) x min(-1) dopexamine further increased CO to 8.4 +/- 2.7 L/min (P < 0.01) without alterations of Q(S)/Q(T), perfusion of low V(A)/Q areas, and Pao2. We concluded that dopexamine (1.0 microg x kg(-1) x min(-1) and 2.0 microg x kg(-1) x min(-1)) has no adverse effects on V(A)/Q relationships and Q(S)/Q(T) in anesthetized, paralyzed patients. The I.V. administration of vasoactive drugs can improve oxygen delivery to different organ systems but may impair pulmonary gas exchange. In anesthetized, paralyzed patients, we studied the effects of beta2-adrenoceptor and DA1-receptor agonist dopexamine on ventilation perfusion distribution. Dopexamine (1.0 microg x kg(-1) x min(-1) and 2.0 microg x kg(-1) min(-1)) improved cardiac output and oxygenation without alterations of intrapulmonary shunt.

  2. Riociguat versus sildenafil on hypoxic pulmonary vasoconstriction and ventilation/perfusion matching.

    Science.gov (United States)

    Chamorro, Virginia; Morales-Cano, Daniel; Milara, Javier; Barreira, Bianca; Moreno, Laura; Callejo, María; Mondejar-Parreño, Gema; Esquivel-Ruiz, Sergio; Cortijo, Julio; Cogolludo, Ángel; Barberá, Joan A; Perez-Vizcaino, Francisco

    2018-01-01

    Current treatment with vasodilators for pulmonary hypertension associated with respiratory diseases is limited by their inhibitory effect on hypoxic pulmonary vasoconstriction (HPV) and uncoupling effects on ventilation-perfusion (V'/Q'). Hypoxia is also a well-known modulator of the nitric oxide (NO) pathway, and may therefore differentially affect the responses to phosphodiesterase 5 (PDE5) inhibitors and soluble guanylyl cyclase (sGC) stimulators. So far, the effects of the sGC stimulator riociguat on HPV have been poorly characterized. Contraction was recorded in pulmonary arteries (PA) in a wire myograph. Anesthetized rats were catheterized to record PA pressure. Ventilation and perfusion were analyzed by micro-CT-SPECT images in rats with pulmonary fibrosis induced by bleomycin. The PDE5 inhibitor sildenafil and the sGC stimulator riociguat similarly inhibited HPV in vitro and in vivo. Riociguat was more effective as vasodilator in isolated rat and human PA than sildenafil. Riociguat was ≈3-fold more potent under hypoxic conditions and it markedly inhibited HPV in vivo at a dose that barely affected the thromboxane A2 (TXA2) mimetic U46619-induced pressor responses. Pulmonary fibrosis was associated with V'/Q' uncoupling and riociguat did not affect the V'/Q' ratio. PDE5 inhibitors and sGC stimulators show a different vasodilator profile. Riociguat was highly effective and potentiated by hypoxia in rat and human PA. In vivo, riociguat preferentially inhibited hypoxic than non-hypoxic vasoconstriction. However, it did not worsen V'/Q' coupling in a rat model of pulmonary fibrosis.

  3. Safety of ventilation/perfusion single photon emission computed tomography for pulmonary embolism diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Le Roux, Pierre-Yves; Palard, Xavier; Robin, Philippe; Abgral, Ronan; Querellou, Solene; Salaun, Pierre-Yves [Universite Europeenne de Bretagne, Brest (France); Universite de Brest, Brest (France); CHRU de la Cavale Blanche, Service de medecine nucleaire, Brest (France); Delluc, Aurelien; Couturaud, Francis [Universite Europeenne de Bretagne, Brest (France); Universite de Brest, Brest (France); CHRU de la Cavale Blanche, Departement de medecine interne et de pneumologie, Brest (France); Le Gal, Gregoire [Universite Europeenne de Bretagne, Brest (France); University of Ottawa, Ottawa Hospital Research Institute, Ottawa (Canada); CHRU de la Cavale Blanche, Departement de medecine interne et de pneumologie, Brest (France); Universite de Brest, Brest (France)

    2014-10-15

    The aim of this management outcome study was to assess the safety of ventilation/perfusion single photon emission computed tomography (V/Q SPECT) for the diagnosis of pulmonary embolism (PE) using for interpretation the criteria proposed in the European Association of Nuclear Medicine (EANM) guidelines for V/Q scintigraphy. A total of 393 patients with clinically suspected PE referred to the Nuclear Medicine Department of Brest University Hospital from April 2011 to March 2013, with either a high clinical probability or a low or intermediate clinical probability but positive D-dimer, were retrospectively analysed. V/Q SPECT were interpreted by the attending nuclear medicine physician using a diagnostic cut-off of one segmental or two subsegmental mismatches. The final diagnostic conclusion was established by the physician responsible for patient care, based on clinical symptoms, laboratory test, V/Q SPECT and other imaging procedures performed. Patients in whom PE was deemed absent were not treated with anticoagulants and were followed up for 3 months. Of the 393 patients, the prevalence of PE was 28 %. V/Q SPECT was positive for PE in 110 patients (28 %) and negative in 283 patients (72 %). Of the 110 patients with a positive V/Q SPECT, 78 (71 %) had at least one additional imaging test (computed tomography pulmonary angiography or ultrasound) and the diagnosis of PE was eventually excluded in one patient. Of the 283 patients with a negative V/Q SPECT, 74 (26 %) patients had another test. The diagnosis of PE was finally retained in one patient and excluded in 282 patients. The 3-month thromboembolic risk in the patients not treated with anticoagulants was 1/262: 0.38 % (95 % confidence interval 0.07-2.13). A diagnostic management including V/Q SPECT interpreted with a diagnostic cut-off of ''one segmental or two subsegmental mismatches'' appears safe to exclude PE. (orig.)

  4. Ventilation-perfusion scintigraphy for the diagnosis of pulmonary embolism; Pulmonale Perfusions- und Ventilationsszintigraphie in der Diagnostik der Lungenarterienembolie

    Energy Technology Data Exchange (ETDEWEB)

    Poeppel, T.D. [Universitaetsklinikum Essen, Nuklearmedizinische Klinik, Essen (Germany); Krause, B.J. [Universitaetsklinikum rechts der Isar, Technische Universitaet Muenchen, Nuklearmedizinische Klinik und Poliklinik, Muenchen (Germany)

    2007-08-15

    Diagnosis of venous thrombosis and pulmonary embolism is a common clinical problem. Imaging results frequently play a central role in the clinical decision process. This article on nuclear medicine procedures in the diagnosis of suspected pulmonary embolism provides information on pathophysiological basics, commonly used radiopharmaceuticals as well as procedure and interpretation of ventilation-perfusion scintigraphy. (orig.) [German] Die Diagnosestellung einer venoesen Thrombose und Lungenembolie erweist sich klinisch zumeist als schwierig. Die bildgebende Diagnostik stellt dann oftmals die entscheidende Untersuchung im klinischen Entscheidungsprozess dar. Der vorliegende Beitrag zu den nuklearmedizinischen Verfahren in der Diagnostik der Lungenarterienembolie erlaeutert die pathophysiologischen Grundlagen, die verwendeten Radiopharmaka sowie die Durchfuehrung und Interpretation der Perfusions- und Ventilationsszintigraphie. (orig.)

  5. Detection of pulmonary embolism with combined ventilation-perfusion SPECT and low-dose CT: head-to-head comparison with multidetector CT angiography

    DEFF Research Database (Denmark)

    Gutte, Henrik; Mortensen, Jann; Jensen, Claus Verner

    2009-01-01

    The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have...

  6. Kombineret ventilations/perfusions-SPECT/CT er bedst til diagnostik af lungeemboli

    DEFF Research Database (Denmark)

    Gutte Borgwardt, Henrik; Mortensen, Jann; Kristoffersen, Ulrik Sloth

    2012-01-01

    The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer test and imaging with either lung scintigraphy or pulmonary multidetector computed tomography angiography (CTA). Which of the two methods to use in PE diagnostic has not been determined...

  7. Independent lung ventilation in a newborn with asymmetric acute lung injury due to respiratory syncytial virus: a case report

    OpenAIRE

    Di Nardo Matteo; Perrotta Daniela; Stoppa Francesca; Cecchetti Corrado; Marano Marco; Pirozzi Nicola

    2008-01-01

    Abstract Introduction Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weig...

  8. Suspected pulmonary embolism in patients with pulmonary fibrosis: Discordance between ventilation/perfusion SPECT and CT pulmonary angiography.

    Science.gov (United States)

    Leuschner, Gabriela; Wenter, Vera; Milger, Katrin; Zimmermann, Gregor S; Matthes, Sandhya; Meinel, Felix G; Lehner, Sebastian; Neurohr, Claus; Behr, Jürgen; Kneidinger, Nikolaus

    2016-08-01

    Pulmonary embolism (PE) is a common differential diagnosis in patients with pulmonary fibrosis presenting with a clinical deterioration. Both ventilation/perfusion (V/Q)-single photon emission computed tomography (SPECT) and computed tomographic pulmonary angiography (CTPA) are routinely used to detect PE. However, the value of V/Q-SPECT and CTPA in this scenario has not been studied so far. We aimed to investigate the concordance of V/Q-SPECT and CTPA in patients with pulmonary fibrosis and suspicion of pulmonary embolism. A total of 22 consecutive patients with pulmonary fibrosis and clinical deterioration who underwent both V/Q-SPECT and CTPA were included in the study and analyzed for the presence of pulmonary embolism. Nine of 22 patients (41%) had evidence for pulmonary embolism in V/Q-SPECT, and two of these patients had matching evidence for pulmonary embolism in CTPA. In the other seven patients with positive findings in V/Q-SPECT, no evidence of pulmonary embolism was found in CTPA. None of the 13 patients with a negative V/Q-SPECT had evidence for pulmonary embolism in CTPA. In patients with pulmonary fibrosis and suspected pulmonary embolism, pulmonary embolism is detected more frequently by V/Q-SPECT than by CTPA. Thromboembolic disease is identified on CTPA only in a minority of patients with positive findings on V/Q-SPECT. When making treatment decisions, clinicians should be aware of the high rate of discordant findings in V/Q-SPECT and CTPA in this specific patient population. © 2016 Asian Pacific Society of Respirology.

  9. Pulmonary thromboembolism: a retrospective study on the examination of 991 patients by ventilation/perfusion SPECT using Technegas

    Energy Technology Data Exchange (ETDEWEB)

    Lemb, M. [Roentgeninstitut, Bremerhaven (Germany); Pohlabeln, H. [Bremer Inst. fuer Praeventionsforschung und Sozialmedizin (BIPS), Univ. Bremen (Germany)

    2001-12-01

    Purpose: Conventional planar ventilation/perfusion (V/P)-imaging in those patients suspected of suffering from pulmonary thromboembolism (PTE) is of limited diagnostic value. It is the purpose of this retrospective study to determine whether the use of V/P-SPECT using Technegas might reduce the rate of those diagnostic uncertainties and might lead to better results. Methods: 991 patients (660 female, 331 male, age 18-90, mean 60), referred to our laboratory with suspected PTE, were examined as follows: patients inhaled 37 MBq of Technegas in the supine position and a SPECT-acquisition was started. Following SPECT-completion, 185 MBq 99mTc-MAA was injected intravenously. SPECT was then repeated. Coronal and transverse ventilation and perfusion SPECT-slices were reconstructed and compared section by section. 85 patients underwent control scans by the same technique at a mean interval of 22 months after the original scans. Results: As the SPECT images in almost all cases made a clear match/mismatch decision possible, we categorized all patients as embolic (PTE+) if there was at least one mismatching defect, and as non embolic (PTE-) if there were none. Our results were: PTE +: 178 patients (18%), PTE-: 808 patients (81%), uncertain: 5 patients (0.5%), if 34 triple-match defects are included: 39 patients (3.9%). 46 patients, categorized as PTE+ underwent a control V/P scan after anticoagulant therapy. In 44 of these patients, PTE was confirmed by the controls. In a control group of 39 PTE- patients, control scans were unchanged in 38 cases. From these observations we can calculate a sensitivity of 96% and a specificity of 97%. Conclusion: We conclude that V/P imaging can be improved significantly by V/P SPECT using Technegas. (orig.)

  10. 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...

  11. Improved ventilation-perfusion matching with increasing abdominal pressure during CO(2) -pneumoperitoneum in pigs.

    Science.gov (United States)

    Strang, C M; Freden, F; Maripuu, E; Ebmeyer, U; Hachenberg, T; Hedenstierna, Göran

    2011-08-01

    CO(2) -pneumoperitoneum (PP) is performed at varying abdominal pressures. We studied in an animal preparation the effect of increasing abdominal pressures on gas exchange during PP. Eighteen anaesthetized pigs were studied. Three abdominal pressures (8, 12 and 16 mmHg) were randomly selected in each animal. In six pigs, single-photon emission computed tomography (SPECT) was used for the analysis of V/Q distributions; in another six pigs, multiple inert gas elimination technique (MIGET) was used for assessing V/Q matching. In further six pigs, computed tomography (CT) was performed for the analysis of regional aeration. MIGET, CT and central haemodynamics and pulmonary gas exchange were recorded during anaesthesia and after 60 min on each of the three abdominal pressures. SPECT was performed three times, corresponding to each PP level. Atelectasis, as assessed by CT, increased during PP and in proportion to abdominal pressure [from 9 ± 2% (mean ± standard deviation) at 8 mmHg to 15 ± 2% at 16 mmHg, P<0.05]. SPECT during increasing abdominal CO(2) pressures showed a shift of blood flow towards better ventilated areas. V/Q analysis by MIGET showed no change in shunt during 8 mmHg PP (9 ± 1.9% compared with baseline 9 ± 1.2%) but a decrease during 12 mmHg PP (7 ± 0.9%, P<0.05) and 16 mmHg PP (5 ± 1%, P<0.01). PaO(2) increased from 39 ± 10 to 52 ± 9 kPa (baseline to 16 mmHg PP, P<0.01). Arterial carbon dioxide (PCO(2) ) increased during PP and increased further with increasing abdominal pressures. With increasing abdominal pressure during PP perfusion was redistributed more than ventilation away from dorsal, collapsed lung regions. This resulted in a better V/Q match. A possible mechanism is enhanced hypoxic pulmonary vasoconstriction mediated by increasing PCO(2) . © 2011 The Authors. Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  12. [Pulmonary gas exchange model: influence of the heterogeneity of distribution on the ventilation-perfusion and diffusion-perfusion ratios of oxygen transfer].

    Science.gov (United States)

    Beroff, M J; Lelong, F; Cherruault, Y

    1978-07-01

    The purpose of this pulmonary gas exchange model is to study the effect produced by an inhomogeneous distribution of the ventilation-perfusion (V A/Q) and diffusion-perfusion (D/Q) ratios on the oxygen transfer. We calculate partial pressures of oxygen and carbon dioxide in venous blood, in capillary blood and alveolar gas of each element as the unique solution of a non-linear system, the parameters of which are the local values of ventilation, perfusion and diffusion. We show that an inhomogeneous distribution of any ratio leads to a decrease of the mixed arterial concentration of oxygen and that the greater the inhomogeneity, the greater the decrease. We show by numerical stimulation that if two inhomogeneities (V A/Q) and (D/Q) are associated, the oxygen arterial concentration decrease is rather less important if the diffusion-ventilation ratio has a distribution almost homogeneous, i.e. if the V A/Q and D/Q inhomogeneities are almost identical.

  13. Abolished ventilation and perfusion of lung caused by blood clot in the left main bronchus

    DEFF Research Database (Denmark)

    Afzelius, P; Bergmann, A; Henriksen, J H

    2015-01-01

    It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V...

  14. Effect of thoracic epidural anaesthesia on ventilation-perfusion distribution and intrathoracic blood volume before and after induction of general anaesthesia.

    Science.gov (United States)

    Hachenberg, T; Holst, D; Ebel, C; Pfeiffer, B; Thomas, H; Wendt, M; Hedenstierna, G

    1997-10-01

    Gas exchange is impaired during general anaesthesia due to development of shunt and ventilation-perfusion mismatching. Thoracic epidural anaesthesia (TEA) may affect the mechanics of the respiratory system, intrathoracic blood volume and possibly ventilation-perfusion (VA/Q) distribution during general anaesthesia. VA/Q relationships were analyzed in 24 patients undergoing major abdominal surgery. Intrapulmonary shunt (Qs/QT), perfusion of "low" VA/Q areas, ventilation of "high" VA/Q regions, dead space ventilation and mean distribution of ventilation and perfusion were calculated from the retention/excretion data of six inert gases. Intrathoracic blood volume (ITBV) and pulmonary blood volume (PBV) were determined with a double indicator technique. Recordings were made before and after administration of 8.5 +/- 1.5 ml bupivacaine 0.5% (n = 12) or 8.3 +/- 1.8 ml placebo (n = 12) into a thoracic epidural catheter and after induction of general anaesthesia. Before TEA, Qs/QT was normal in the bupivacaine group (2 +/- 2%) and the placebo group (2 +/- 3%). TEA covering the dermatomal segments T 12 to T 4 had no effect on VA/Q relationships, ITBV and PBV. After induction of general anaesthesia Qs/QT increased to 8 +/- 4% (bupivacaine group, P < 0.05 and to 7 +/- 2% (placebo group, P < 0.05). ITBV and PBV decreased significantly to the same extent in the bupivacaine group and the placebo group. TEA has no effect on VA/Q distribution, gas exchange and intrathoracic blood volume in the awake state and does not influence development of Qs/QT and VA/Q inequality after induction of general anaesthesia.

  15. Incidentally diagnosed simultaneous second primary tumor of the sphenoid sinus in a patient with lung cancer

    DEFF Research Database (Denmark)

    Yigit, Ozgur; Taskin, Umit; Demir, Ahmet

    2009-01-01

    Synchronous tumors are described as multiple primary malignancies presenting within 6 months of diagnosis of index tumors. Synchronous tumors of the lung and the head and neck region is frequently seen. However, isolated sphenoid sinus and lung cancers are not reported yet. Here, we reported...... an incidentally diagnosed simultaneous second primary sphenoid sinus tumor in a patient with lung cancer. Radiological evaluation results demonstrated a significant contrast-enhanced mass in the sphenoid sinus extending through the nasopharynx because of the destruction of the sphenoid sinus. The decision...... was made to proceed with chemotherapy and radiotherapy treatment regimens for the sphenoid sinus lesion, and right lobectomy was performed for the lung lesion. Asymptomatic simultaneous, synchronous, or metastatic tumors must always be kept in mind, and histopathologic diagnosis should be done for both...

  16. BILATERAL SIMULTANEOUS VIDEO-ASSISTED LUNG RESECTION USING A UNILATERAL ACCESS IN TUBERCULOSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    V. A. Karnaukhov

    2017-01-01

    Full Text Available Goal of the study: to compare two surgical tactics for the treatment of bilateral pulmonary tuberculosis.Materials and methods: 189 patients with tuberculous lesions in both lungs underwent lung resections: 91 patients had it done simultaneously on both lungs from the unilateral intercostal-mediastinal access by video-assisted thoracoscopy; 98 patients had resections of the left and right lung done one after another, time period between resections made 20.8 ± 9.4 days on the average.Results. When comparing two tactics – simultaneous bilateral lung resection from a unilateral access and bilateral consecutive resections the following results were obtained respectively: 100 and 96.9% of patients had sputum conversion (p = 0.09, χ2; 100 and 93.8% of patients had healing of lung cavities (p = 0.11, χ2 . During simultaneous surgery, the risk of intra-operative blood loss exceeding 300 ml was much lower (OR = 9.94; 95% CI 8.60-11.28 as well as the risk of postoperative complications (OR = 2.11; 95% CI 1.89-2.33. 

  17. Simultaneous occurrence of coronary artery disease and lung cancer: what is the best surgical treatment strategy?

    Science.gov (United States)

    Tourmousoglou, Christos E; Apostolakis, Efstratios; Dougenis, Dimitrios

    2014-10-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether combined surgical procedures in one or two stages are the best surgical treatment strategy in patients with simultaneous coronary artery disease and lung cancer. Altogether, 264 papers were found using the reported search; of which, 15 represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group, study type, outcomes and results of papers are tabulated. The outcomes of the reported studies provided interesting results. All the studies were retrospective. Ten papers reported the results of combined and staged operations. The operative mortality rate of combined procedures was 0-20.8% and of staged procedures was 0-10%. The reoperation rate for bleeding of combined procedures was 0-11% and of staged procedures was 0%. The survival rate of combined procedures at 1 year was 79-100%, at 5 years was 34.9-85% and at 7 years was 61%. The survival rate of staged procedures at 1 year was 72.7% and at 5 years was 53%. Five studies reported the results of off-pump coronary artery bypass grafting (OPCABG) and lung surgery versus on-pump and lung surgery. The operative mortality rate of OPCABG and lung surgery was 0-6.6%. The 2-year survival rate of OPCABG and lung surgery was 47% and the 5-year survival rate was 13-68%. The re-exploration rate for bleeding of OPCABG was 4%. Simultaneous lung surgery and CABG could be safely performed with adequate cancer-free survival in patients with Stage I or II lung cancer. Lung surgery is better performed before institution of cardiopulmonary bypass, avoiding the complications of such a technique. Long-term survival after combined treatment is mostly related to the predicted survival after lung resection. This depends on the T stage and mostly on the patient's nodal status. In certain high-risk groups (if the cardiac procedure is difficult or if the

  18. Bronchopulmonary dysplasia: clinical grading in relation to ventilation/perfusion mismatch measured by single photon emission computed tomography.

    Science.gov (United States)

    Kjellberg, Malin; Björkman, Karin; Rohdin, Malin; Sanchez-Crespo, Alejandro; Jonsson, Baldvin

    2013-12-01

    Bronchopulmonary dysplasia (BPD) is a significant cause of morbidity in the preterm population. Clinical severity grading based on the need for supplemental oxygen and/or need for positive airway pressure at 36 weeks postmenstrual age does not yield reproducible predictive values for later pulmonary morbidity. Single photon emission computed tomography (SPECT) was used to measure the distribution of lung ventilation (V) and perfusion (Q) in 30 BPD preterm infants at a median age of 37 weeks postmenstrual age. The V and Q were traced with 5 MBq Technegas and Technetium-labeled albumin macro aggregates, respectively, and the V/Q match-mismatch was used to quantify the extent of lung function impairment. The latter was then compared with the clinical severity grading at 36 weeks, and time spent on mechanical ventilation, continuous positive airway pressure (CPAP) and supplemental oxygen. Of those with mild and moderate BPD 3/9 and 3/11 patients, respectively, showed significant V/Q mismatches. By contrast, 4/10 patients with severe BPD showed a satisfactory V/Q matching distribution. An unsatisfactory V/Q match was not correlated with time spent on supplemental oxygen or CPAP, but was significantly negatively correlated with time spent on mechanical ventilation. SPECT provides unique additional information about regional lung function. The results suggest that the current clinical severity grading can be improved and/or complemented with SPECT. © 2013 Wiley Periodicals, Inc.

  19. Reduced ventilation-perfusion (V/Q) mismatch following endobronchial valve insertion demonstrated by Gallium-68 V/Q photon emission tomography/computed tomography.

    Science.gov (United States)

    Leong, Paul; Le Roux, Pierre-Yves; Callahan, Jason; Siva, Shankar; Hofman, Michael S; Steinfort, Daniel P

    2017-09-01

    Endobronchial valves (EBVs) are increasingly deployed in the management of severe emphysema. Initial studies focussed on volume reduction as the mechanism, with subsequent improvement in forced expiratory volume in 1 s (FEV1). More recent studies have emphasized importance of perfusion on predicting outcomes, though findings have been inconsistent. Gallium-68 ventilation-perfusion (V/Q) photon emission tomography (PET)/computed tomography (CT) is a novel imaging modality with advantages in spatial resolution, quantitation, and speed over conventional V/Q scintigraphy. We report a pilot case in which V/Q-PET/CT demonstrated discordant findings compared with quantitative CT analysis, and directed left lower lobe EBV placement. The patient experienced a significant improvement in 6-min walk distance (6MWD) without change in spirometry. Post-EBV V/Q-PET/CT demonstrated a marked decrease in unmatched (detrimental) V/Q areas and improvement in overall V/Q matching on post-EBV V/Q-PET/CT. These preliminary novel findings suggest that EBVs improve V/Q matching and may explain the observed functional improvements.

  20. EANM guidelines for ventilation/perfusion scintigraphy : Part 2. Algorithms and clinical considerations for diagnosis of pulmonary emboli with V/P(SPECT) and MDCT.

    Science.gov (United States)

    Bajc, M; Neilly, J B; Miniati, M; Schuemichen, C; Meignan, M; Jonson, B

    2009-09-01

    As emphasized in Part 1 of these guidelines, the diagnosis of pulmonary embolism (PE) is confirmed or refuted using ventilation/perfusion scintigraphy (V/P(SCAN)) or multidetector computed tomography of the pulmonary arteries (MDCT). To reduce the costs, the risks associated with false-negative and false-positive diagnoses, and unnecessary radiation exposure, preimaging assessment of clinical probability is recommended. Diagnostic accuracy is approximately equal for MDCT and planar V/P(SCAN) and better for tomography (V/P(SPECT)). V/P(SPECT) is feasible in about 99% of patients, while MDCT is often contraindicated. As MDCT is more readily available, access to both techniques is vital for the diagnosis of PE. V/P(SPECT) gives an effective radiation dose of 1.2-2 mSv. For V/P(SPECT), the effective dose is about 35-40% and the absorbed dose to the female breast 4% of the dose from MDCT performed with a dose-saving protocol. V/P(SPECT) is recommended as a first-line procedure in patients with suspected PE. It is particularly favoured in young patients, especially females, during pregnancy, and for follow-up and research.

  1. Magnetic Resonance Imaging of Ventilation and Perfusion in the Lung

    Science.gov (United States)

    Prisk, Gordon Kim (Inventor); Hopkins, Susan Roberta (Inventor); Buxton, Richard Bruce (Inventor); Pereira De Sa, Rui Carlos (Inventor); Theilmann, Rebecca Jean (Inventor); Cronin, Matthew Vincent (Inventor)

    2017-01-01

    Methods, devices, and systems are disclosed for implementing a fully quantitative non-injectable contrast proton MRI technique to measure spatial ventilation-perfusion (VA/Q) matching and spatial distribution of ventilation and perfusion. In one aspect, a method using MRI to characterize ventilation and perfusion in a lung includes acquiring an MR image of the lung having MR data in a voxel and obtaining a breathing frequency parameter, determining a water density value, a specific ventilation value, and a perfusion value in at least one voxel of the MR image based on the MR data and using the water density value to determine an air content value, and determining a ventilation-perfusion ratio value that is the product of the specific ventilation value, the air content value, the inverse of the perfusion value, and the breathing frequency.

  2. Scintigraphy at 3 months after single lung transplantation and observations of primary graft dysfunction and lung function

    DEFF Research Database (Denmark)

    Belmaati, Esther Okeke; Iversen, Martin; Kofoed, Klaus F

    2012-01-01

    Scintigraphy has been used as a tool to detect dysfunction of the lung before and after transplantation. The aims of this study were to evaluate the development of the ventilation-perfusion relationships in single lung transplant recipients in the first year, at 3 months after transplantation...... procedure 3 months after single lung transplantation (SLTX). A total of 41 patients were included in the study: 20 women and 21 men with the age span of patients at transplantation being 38-66 years (mean ± SD: 54.2 ± 6.0). Patient records also included lung function tests and chest X-ray images. We found...

  3. Guidelines for lung scintigraphy in children.

    Science.gov (United States)

    Ciofetta, Gianclaudio; Piepsz, Amy; Roca, Isabel; Fisher, Sybille; Hahn, Klaus; Sixt, Rune; Biassoni, Lorenzo; De Palma, Diego; Zucchetta, Pietro

    2007-09-01

    The purpose of this set of guidelines is to help the nuclear medicine practitioner perform a good quality lung isotope scan. The indications for the test are summarised. The different radiopharmaceuticals used for the ventilation and the perfusion studies, the technique for their administration, the dosimetry, the acquisition of the images, the processing and the display of the images are discussed in detail. The issue of whether a perfusion-only lung scan is sufficient or whether a full ventilation-perfusion study is necessary is also addressed. The document contains a comprehensive list of references and some web site addresses which may be of further assistance.

  4. The ventilation-perfusion relation and gas exchange in mitral valve disease and coronary artery disease. Implications for anesthesia, extracorporeal circulation, and cardiac surgery.

    Science.gov (United States)

    Hachenberg, T; Tenling, A; Hansson, H E; Tydén, H; Hedenstierna, G

    1997-04-01

    Patients with mitral valve disease (MVD) are at greater risk for respiratory complications after cardiac surgery compared with patients with coronary artery disease (CAD). The authors hypothesized that ventilation-perfusion (VA/Q) inequality is more pronounced in patients with MVD before and after induction of anesthesia and during and after surgery when extracorporeal circulation (ECC) is used. In patients with MVD (n = 12) or with CAD (n = 12), VA/Q distribution was determined using the multiple inert gas elimination technique. Intrapulmonary shunt (Qs/Qr) defined as regions with VA/Q 100 [% of VE]) were calculated from the retention/excretion data of the inert gases. Recordings were obtained while patients spontaneously breathed air in the awake state, during mechanical ventilation after induction of anesthesia, after separation of patients from ECC, and 4 h after operation. Qs/Qr was low in the awake state (MVD group, 3% +/- 3%; CAD group, 3% +/- 4%) and increased after induction of anesthesia to 10% +/- 8% (MVD group, P < 0.05) and 11% +/- 7% (CAD group, P < 0.01). Qs/Qr increased further after separation from ECC (MVD group, 24% +/- 9%, P < 0.01; CAD group, 23% +/- 7%, P < 0.01). Similarly, alveolar-arterial oxygen tension difference (PA-aO2) increased from 168 +/- 54 mmHg (anesthetized state) to 427 +/- 138 mmHg after ECC (MVD group, P < 0.01) and from 153 +/- 65 mmHg to 377 +/- 101 mmHg (CAD group, P < 0.01). In both groups, PA-aO2 was correlated with Qs/Qr. Four hours after operation, Qs/Qr had decreased significantly to 8% +/- 6% (CAD group) and 10% +/- 6% (MVD group). PA-aO2 and Qs/Qr showed no significant differences between the CAD and MVD groups. Qs/Qr is the main pathophysiologic mechanism of gas exchange impairment during cardiac surgery for MVD or CAD. Impairment of pulmonary gas exchange secondary to general anesthesia, cardiac surgery, and ECC are comparable for patients undergoing myocardial revascularization or mitral valve surgery.

  5. Correlation of Ventilation-Perfusion (V/Q) Scan Results as Compared with Clinical Probability of Pulmonary Embolism in African American Population

    Science.gov (United States)

    Awan, Ahmad; Hunt, Nicole; Tegegn, Nahom; Larbi, Daniel

    2017-01-01

    Introduction Current guidelines suggest the use of the more specific Wells' score could safely reduce the number of unnecessary scans. There is a lack of research to support whether these guidelines apply to the African American population. This study aims to evaluate the correlation of clinical pretest probability of pulmonary embolism (PE) with ventilation-perfusion (V/Q) scan results in a predominantly African American population and to test whether current guidelines based on studies conducted in other populations hold true in this group. Material and Methods A retrospective descriptive study to determine the diagnostic utility of the V/Q scan was conducted among patients who were seen during January 2012 to January 2016. The study population included patients who underwent a V/Q scan for evaluation of PE. One hundred and seventy-five charts were reviewed and 49 were excluded due to poor quality data. A review of the initial history, as well as discharge summaries, was performed. Wells' probability of PE was compared with the results of the scan. Laboratory tests and imaging studies were reviewed and analyzed. Result The median age of the study population was 63.02 ± 16.12 years. The majority of the study population, 121 patients (92.4%), was African American. Sixty-four (48.9%) VQ scans were done for a low clinical probability for pulmonary embolism as defined by the Wells' clinical score. The most common clinical presentations were shortness of breath (SOB) - 74 (58%), leg pain or swelling - 39 (29.8%), chest pain - 36 (27.4%), and syncope - 4 (3.1%). Sixty-two (96.9 %) patients with low clinical probability had low probability VQ scans (P = 0.03). Among the patients who underwent CT angiography and V/Q scanning, a low probability scan was noted in 25 patients with no pulmonary embolism on CT (96.2 %) (P = 0.006). Conclusions This study showed a strong correlation between low clinical probability and low probability V/Q scans and its utility to safely rule

  6. Navigator-triggered oxygen-enhanced MRI with simultaneous cardiac and respiratory synchronization for the assessment of interstitial lung disease.

    Science.gov (United States)

    Molinari, Francesco; Eichinger, Monika; Risse, Frank; Plathow, Christian; Puderbach, Michael; Ley, Sebastian; Herth, Felix; Bonomo, Lorenzo; Kauczor, Hans-Ulrich; Fink, Christian

    2007-12-01

    To evaluate an optimized method for oxygen-enhanced MRI of the lung, using simultaneous electrocardiograph (ECG) and navigator triggering. To correlate oxygen-enhanced MRI with lung function tests assessing alveolar-capillary gas exchange. A total of 12 healthy volunteers (aged 20-32 years) and 10 patients (aged 37-87 years) with interstitial lung diseases (ILD) underwent oxygen-enhanced MRI and pulmonary functional tests (PFTs) assessing alveolar-capillary gas exchange. The paradigm room-air-oxygen-room-air was acquired with a nonselective inversion-recovery half-Fourier single-shot turbo spin-echo sequence (inversion time = 1200 msec; acquisition time = 134.5 msec; slice thickness = 20 mm; matrix size = 128 x 128), using simultaneous double triggering (navigator plus ECG trigger). Cross-correlation was performed in regions of interest (ROIs) encompassing both lungs. The number of oxygen-activated pixels over the total number of pixels in the ROIs (OAP%) of volunteers and patients was compared. OAP%s were correlated with PFTs. The mean OAP% of patients was significantly lower than that of volunteers (36.7 vs. 81.7, P = 0.001). OAP% correlated with the transfer lung factor for carbon monoxide (Tlco) (r = 0.64; P = 0.002), the transfer coefficient (Kco) (r = 0.75; P = 0.001), the arterial partial pressure (r = 0.77; P < 0.001), and the saturation (r = 0.70; P < 0.001) of oxygen. Navigator-triggered oxygen-enhanced MRI of the lung may have a potential role in the quantitative assessment of lung function in ILD. (c) 2007 Wiley-Liss, Inc.

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

    Directory of Open Access Journals (Sweden)

    Yuanhao Fu

    2016-11-01

    Full Text Available 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.

  8. Estimation of lung shunt fraction from simultaneous fluoroscopic and nuclear images

    Science.gov (United States)

    van der Velden, Sandra; Bastiaannet, Remco; Braat, Arthur J. A. T.; Lam, Marnix G. E. H.; Viergever, Max A.; de Jong, Hugo W. A. M.

    2017-11-01

    Radioembolisation with yttrium-90 (90Y) is increasingly used as a treatment of unresectable liver malignancies. For safety, a scout dose of technetium-99m macroaggregated albumin (99mTc-MAA) is used prior to the delivery of the therapeutic activity to mimic the deposition of 90Y. One-day procedures are currently limited by the lack of nuclear images in the intervention room. To cope with this limitation, an interventional simultaneous fluoroscopic and nuclear imaging device is currently being developed. The purpose of this simulation study was to evaluate the accuracy of estimating the lung shunt fraction (LSF) of the scout dose in the intervention room with this device and compare it against current clinical methods. Methods: A male and female XCAT phantom, both with two respiratory profiles, were used to simulate various LSFs resulting from a scout dose of 150 MBq 99mTc-MAA. Hybrid images were Monte Carlo simulated for breath-hold (5 s) and dynamic breathing (10 frames of 0.5 s) acquisitions. Nuclear images were corrected for attenuation with the fluoroscopic image and for organ overlap effects using a pre-treatment CT-scan. For comparison purposes, planar scintigraphy and mobile gamma camera images (both 300 s acquisition time) were simulated. Estimated LSFs were evaluated for all methods and compared to the phantom ground truth. Results: In the clinically relevant range of 10-20% LSF, hybrid imaging overestimated LSF with approximately 2 percentage points (pp) and 3 pp for the normal and irregular breathing phantoms, respectively. After organ overlap correction, LSF was estimated with a more constant error. Errors in planar scintigraphy and mobile gamma camera imaging were more dependent on LSF, body shape and breathing profile. Conclusion: LSF can be estimated with a constant minor error with a hybrid imaging device. Estimated LSF is highly dependent on true LSF, body shape and breathing pattern when estimated with current clinical methods. The hybrid

  9. Three-dimensional x-ray imaging of the anatomy and function of the lungs and pulmonary arteries in dogs following single lung transplant

    Science.gov (United States)

    Wu, Qing-Hua; McGregor, Christopher G. A.; Wu, Xue-Si; Rinaldi, Mauro; Nilsson, Folke N.; Tazelaar, Henry D.; Ritman, Erik L.

    1996-04-01

    It was the goal of this study to see if relatively noninvasive CT studies could provide a quantitative index of acute lung rejection in single lung transplantation. Using volume scanning fast CT, the change in cross-sectional area of the major pulmonary arteries from systole to diastole, regional lung perfusion and ventilation was measured in 12 dogs with left lung allotransplantation before and during rejection and four dogs with left lung autotransplantation. All dogs were anesthetized and scanned in a fast computed tomography scanner (dynamic spatial reconstructor--DSR) during several ventilatory cycles and again during injection of contrast medium into the right atrium. There was significant reduction of regional air content, ventilation, perfusion and pulmonary artery compliance during rejection of the transplanted lung. The severity of these changes related linearly with the histological indices of rejection. It is concluded that minimally invasive dynamic CT imaging of transplanted lung can be used to detect acute rejection and its severity.

  10. Independent lung ventilation in a newborn with asymmetric acute lung injury due to respiratory syncytial virus: a case report

    Directory of Open Access Journals (Sweden)

    Di Nardo Matteo

    2008-06-01

    Full Text Available Abstract Introduction Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weight who had an asymmetric lung injury due to respiratory syncytial virus bronchiolitis. We used independent lung ventilation applying conventional protective pressure controlled ventilation to the less-compromised lung, with a respiratory frequency proportional to the age of the patient, and a pressure controlled high-frequency ventilation to the atelectatic lung. This was done because a single tube conventional ventilation protective strategy would have exposed the less-compromised lung to a high mean airways pressure. The target of independent lung ventilation is to provide adequate gas exchange at a safe mean airways pressure level and to expand the atelectatic lung. Independent lung ventilation was accomplished for 24 hours. Daily chest radiograph and gas exchange were used to evaluate the efficacy of independent lung ventilation. Extubation was performed after 48 hours of conventional single-tube mechanical ventilation following independent lung ventilation. Conclusion This case report demonstrates the feasibility of independent lung ventilation with two separate tubes in neonates as a treatment of an asymmetric acute lung injury.

  11. Exercise-Induced Hypoxemia in Juvenile Thyroid Carcinoma With Lung Metastases.

    Science.gov (United States)

    Segerer, Florian J; Biko, Johannes; Reiners, Christoph; Wirth, Clemens; Hebestreit, Helge

    2017-08-01

    Exercise-induced arterial hypoxemia (EIAH) has been reported in patients with juvenile thyroid cancer treated with radioiodine for lung metastases. This retrospective study tested the hypothesis that EIAH is due to ventilation-perfusion-mismatch in this rare pulmonary condition. 50 patients (age 13-23 years) treated for juvenile thyroid carcinoma and lung metastasis with (131)I and 24 controls with thyroid cancer but without lung metastases and prior (131)I-treatment were assessed in a state of acute hypothyroidism by com-puted tomography of the lungs, pulmonary function testing, cardiopulmonary exercise test with measurements of gas exchange, oxygen saturation, alveolar-arterial difference in pO2 (p(A-a)O2) and pCO2 (p(ET-a)CO2). 10 of the 50 patients with lung metastases showed EIAH. They had more pronounced pulmonary fibrosis on computed tomography, a widened p(A-a)O2, and p(ET-a)CO2, a lower DVE/DVCO2-slope, a lower respiratory rate and no increased dead space ventilation. A more pronounced EIAH was associated with male gender, younger age, lower diffusion capacity, higher p(ET-a)CO2 during exercise and a higher peak exercise tidal volume over vital capacity ratio. EIAH in patients with thyroid carcinoma and pulmonary metastases is not related to ventilation-perfusion mismatch but to alveolar hypoventilation, possibly related to an increased work of breathing with pulmonary fibrosis.

  12. Simultaneous sinus and lung infections in patients with primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Alanin, Mikkel Christian; Johansen, Helle Krogh; Aanaes, Kasper

    2015-01-01

    effect of combined endoscopic sinus surgery (ESS) and concomitant medical treatment. Objectives: The purpose of this research, which is the first study addressing bacteriology in the sinuses of patients with PCD, was to examine the association between sinus and lung infections. Methods: We reviewed...... patients (88%) exhibited intermittent or chronic pulmonary infection with P. aeruginosa. Sinus cultures were obtained during ESS in seven patients. The sinuses were colonized with P. aeruginosa in four of seven patients (57%). Bacterial sinusitis was found in five of seven patients (71%) and the same...... findings of bacterial pathogens from the sinuses obtained during ESS and the lung infection status in eight PCD patients over a 6 year period. Precipitins against P. aeruginosa were used as a marker of severity of chronic infection and effect of treatment. Results: Preoperatively, seven of the eight...

  13. Comparative effects of helium-oxygen and external positive end-expiratory pressure on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in mechanically ventilated patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Jolliet, Philippe; Watremez, Christine; Roeseler, Jean; Ngengiyumva, J C; de Kock, Marc; Clerbaux, Thierry; Tassaux, Didier; Reynaert, Marc; Detry, Bruno; Liistro, Giuseppe

    2003-09-01

    To compare the effects of He/O(2) and external PEEP (PEEPe) on intrinsic PEEP (PEEPi), respiratory mechanics, gas exchange, and ventilation/perfusion (V(A)/Q) in mechanically ventilated COPD patients. Prospective, interventional study in the intensive care unit of a university hospital. Ten intubated, sedated, paralyzed, mechanically ventilated COPD patients studied in the following conditions: (a) baseline settings made by clinician in charge, air/O(2), ZEEP; (b) He/O(2), ZEEP; (c) air/O(2), ZEEP; (d) air/O(2), PEEPe 80% of PEEPi. Measurements at each condition included V(A)/Q by the multiple inert gas elimination technique (MIGET). PEEPi and trapped gas volume were comparably reduced by He/O(2) (4.2+/-4 vs. 7.7+/-4 cmH(2)O and 98+/-82 vs. 217+/-124 ml, respectively) and PEEPe (4.4+/-1.3 vs. 7.8+/-3.6 cmH(2)O and 120+/-107 vs. 216+/-115 ml, respectively). He/O(2) reduced inspiratory and expiratory respiratory system resistance (15.5+/-4.4 vs. 20.7+/-6.9 and 19+/-9 vs. 28.8+/-15 cmH(2)O l(-1)s(-1), respectively) and plateau pressure (13+/-4 vs. 17+/-6 cmH(2)O). PEEPe increased airway pressures, including total PEEP, and elastance. PaO(2)/FIO(2) was slightly reduced by He/O(2) (225+/-83 vs. 245+/-82) without significant V(A)/Q change. He/O(2) and PEEPe comparably reduced PEEPi and trapped gas volume. However, He/O(2) decreased airway resistance and intrathoracic pressures, at a small cost in arterial oxygenation. He/O(2) could offer an attractive option in COPD patients with PEEPi/dynamic hyperinflation.

  14. A novel quantitative dual-isotope method for simultaneous ventilation and perfusion lung SPET.

    Science.gov (United States)

    Sánchez-Crespo, Alejandro; Petersson, Johan; Nyren, Sven; Mure, Margareta; Glenny, Robb W; Thorell, Jan-Olov; Jacobsson, Hans; Lindahl, Sten G E; Larsson, Stig A

    2002-07-01

    A quantitative dual-isotope single-photon emission tomography (SPET) technique for the assessment of lung ventilation (V) and perfusion (Q) using, respectively, technetium-99m labelled Technegas (140 keV) and indium-113m labelled macro-aggregated albumin (392 keV), is presented, validated and clinically tested in a healthy volunteer. In order to assess V, Q and V/Q distributions in quantitative terms, algorithms which correct for down scattering, photon scattering and attenuation, as well as an organ outline algorithm, were implemented. Scatter and down-scatter correction were made in the spatial domain by pixel-wise image subtraction of projection-dependent global scattering factors obtained from the energy domain. The attenuation correction was based on an iterative projection/back-projection method. All studies were made on a three-headed SPET system (Trionix) with medium-energy parallel-hole collimators. The set of input data for quantification was based on SPET acquisition of emission data in four separate energy windows, the associated cumulative energy spectra and transmission data. The attenuation correction routine as well as the edge detection algorithm utilized data from (99m)Tc transmission tomography. Attenuation data for (113m)In were obtained by linear scaling of the (99m)Tc attenuation maps. The correction algorithms were experimentally validated with a stack phantom system and applied on a healthy volunteer. The mean difference between the corrected SPET data of the dense stack lung phantom and those obtained from the corresponding scatter- and attenuation-"free" version was only 1.9% for (99m)Tc and 0.9% for (113m)In. The estimated fractional V/Q distribution in the 3-D lung phantom volume had its peak at V/Q=1, with a width (FWHM) of 0.31 due to noise, particularly in the (113m)In images, and to partial volume effects. For a healthy volunteer, the corresponding values were 0.9 and 0.35, respectively. This method allows accurate assessment of

  15. Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Simultaneous targeting of ATM and Mcl-1 increases cisplatin sensitivity of cisplatin-resistant non-small cell lung cancer.

    Science.gov (United States)

    Zhang, Fuquan; Shen, Mingjing; Yang, Li; Yang, Xiaodong; Tsai, Ying; Keng, Peter C; Chen, Yongbing; Lee, Soo Ok; Chen, Yuhchyau

    2017-08-03

    Development of cisplatin-resistance is an obstacle in non-small cell lung cancer (NSCLC) therapeutics. To investigate which molecules are associated with cisplatin-resistance, we analyzed expression profiles of several DNA repair and anti-apoptosis associated molecules in parental (A549P and H157P) and cisplatin-resistant (A549CisR and H157CisR) NSCLC cells. We detected constitutively upregulated nuclear ATM and cytosolic Mcl-1 molcules in cisplatin-resistant cells compared with parental cells. Increased levels of phosphorylated ATM (p-ATM) and its downstream molecules, CHK2, p-CHK2, p-53, and p-p53 were also detected in cisplatin-resistant cells, suggesting an activation of ATM signaling in these cells. Upon inhibition of ATM and Mcl-1 expression/activity using specific inhibitors of ATM and/or Mcl-1, we found significantly enhanced cisplatin-cytotoxicity and increased apoptosis of A549CisR cells after cisplatin treatment. Several A549CisR-derived cell lines, including ATM knocked down (A549CisR-siATM), Mcl-1 knocked down (A549CisR-shMcl1), ATM/Mcl-1 double knocked down (A549CisR-siATM/shMcl1) as well as scramble control (A549CisR-sc), were then developed. Higher cisplatin-cytotoxicity and increased apoptosis were observed in A549CisR-siATM, A549CisR-shMcl1, and A549CisR-siATM/shMcl1 cells compared with A549CisR-sc cells, and the most significant effect was shown in A549CisR-siATM/shMcl1 cells. In in vivo mice studies using subcutaneous xenograft mouse models developed with A549CisR-sc and A549CisR-siATM/shMcl1 cells, significant tumor regression in A549CisR-siATM/shMcl1 cells-derived xenografts was observed after cisplatin injection, but not in A549CisR-sc cells-derived xenografts. Finally, inhibitor studies revealed activation of Erk signaling pathway was most important in upregulation of ATM and Mcl-1 molcules in cisplatin-resistant cells. These studies suggest that simultaneous blocking of ATM/Mcl-1 molcules or downstream Erk signaling may recover the

  17. Simultaneous in vivo synchrotron radiation computed tomography of regional ventilation and blood volume in rabbit lung using combined K-edge and temporal subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Suhonen, H [Department of Physical Sciences, University of Helsinki (Finland); Porra, L [Department of Physical Sciences, University of Helsinki (Finland); Bayat, S [Universite de Picardie Jules Verne, Faculte de Medecine, PERITOX (EA-INI RIS) and Cardiologie et Pneumo-Allerglogie Pediatriques, CHU Amiens (France); Sovijaervi, A R A [Department of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital, Helsinki (Finland); Suortti, P [Department of Physical Sciences, University of Helsinki (Finland)

    2008-02-07

    In K-edge subtraction (KES) imaging with synchrotron radiation computed tomography (SRCT), two images are taken simultaneously using energies above and below the K-absorption edge of a contrast agent. A logarithmic difference image reveals the contrast agent concentration with good accuracy. Similarly, in temporal subtraction imaging (TSI) the reference image is taken before the introduction of the contrast agent. Quantitative comparisons of in vivo images of rabbit lung indicated that similar results for concentrations of iodine in blood vessels and xenon in airways are obtained by KES and TSI, but the level of noise and artifacts was higher in the latter. A linear fit showed that in the lung parenchyma {rho}{sub TSI} = (0.97 {+-} 0.03){rho}{sub KES} + (0.00 {+-} 0.05) for xenon and {rho}{sub TSI} = (1.21 {+-} 0.15){rho}{sub KES} + (0.0 {+-} 0.1) for iodine. For xenon the calculation of time constant of ventilation gave compatible values for both of the methods. The two methods are combined for the simultaneous determination of the xenon concentration (by KES) and the iodine concentration (by TSI) in lung imaging, which will allow simultaneous in vivo determination of ventilation and perfusion.

  18. Pulmonary blood volume and transit time in cirrhosis: relation to lung function

    DEFF Research Database (Denmark)

    Møller, Søren; Burchardt, H; Øgard, CG

    2006-01-01

    BACKGROUND/AIMS: In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has...... not been determined separately we assessed PBV and pulmonary transit time (PTT) in relation to lung function in patients with cirrhosis and in controls. METHODS: Pulmonary and cardiac haemodynamics and transit times were determined by radionuclide techniques in 22 patients with alcoholic cirrhosis...... and in 12 controls. The lung function including diffusing capacity for carbon monoxide (DL, CO) was determined by conventional single breath technique. RESULTS: In the patients, PTT was shorter, 3.9+/-1.2 vs 5.7+/-1.0 s in the controls, P

  19. MO-AB-BRA-09: Temporally Realistic Manipulation a 4D Biomechanical Lung Phantom for Evaluation of Simultaneous Registration and Segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Markel, D; Levesque, I R.; Larkin, J; Leger, P; El Naqa, I [McGill University, Montreal, QC (Canada)

    2015-06-15

    Purpose: To produce multi-modality compatible, realistic datasets for the joint evaluation of segmentation and registration with a reliable ground truth using a 4D biomechanical lung phantom. The further development of a computer controlled air flow system for recreation of real patient breathing patterns is incorporated for additional evaluation of motion prediction algorithms. Methods: A pair of preserved porcine lungs was pneumatically manipulated using an in-house computer controlled respirator. The respirator consisted of a set of bellows actuated by a 186 W computer controlled industrial motor. Patient breathing traces were recorded using a respiratory bellows belt during CT simulation and input into a control program incorporating a proportional-integral-derivative (PID) feedback controller in LabVIEW. Mock tumors were created using dual compartment vacuum sealed sea sponges. 65% iohexol,a gadolinium-based contrast agent and 18F-FDG were used to produce contrast and thus determine a segmentation ground truth. The intensity distributions of the compartments were then digitally matched for the final dataset. A bifurcation tracking pipeline provided a registration ground truth using the bronchi of the lung. The lungs were scanned using a GE Discovery-ST PET/CT scanner and a Phillips Panorama 0.23T MRI using a T1 weighted 3D fast field echo (FFE) protocol. Results: The standard deviation of the error between the patient breathing trace and the encoder feedback from the respirator was found to be ±4.2%. Bifurcation tracking error using CT (0.97×0.97×3.27 mm{sup 3} resolution) was found to be sub-voxel up to 7.8 cm displacement for human lungs and less than 1.32 voxel widths in any axis up to 2.3 cm for the porcine lungs. Conclusion: An MRI/PET/CT compatible anatomically and temporally realistic swine lung phantom was developed for the evaluation of simultaneous registration and segmentation algorithms. With the addition of custom software and mock tumors, the

  20. 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

  1. YM155 as an inhibitor of cancer stemness simultaneously inhibits autophosphorylation of epidermal growth factor receptor and G9a-mediated stemness in lung cancer cells.

    Directory of Open Access Journals (Sweden)

    Chun-Chia Cheng

    Full Text Available Cancer stem cell survival is the leading factor for tumor recurrence after tumor-suppressive treatments. Therefore, specific and efficient inhibitors of cancer stemness must be discovered for reducing tumor recurrence. YM155 has been indicated to significantly reduce stemness-derived tumorsphere formation. However, the pharmaceutical mechanism of YM155 against cancer stemness is unclear. This study investigated the potential mechanism of YM155 against cancer stemness in lung cancer. Tumorspheres derived from epidermal growth factor receptor (EGFR-mutant HCC827 and EGFR wild-type A549 cells expressing higher cancer stemness markers (CD133, Oct4, and Nanog were used as cancer stemness models. We observed that EGFR autophosphorylation (Y1068 was higher in HCC827- and A549-derived tumorspheres than in parental cells; this autophosphorylation induced tumorsphere formation by activating G9a-mediated stemness. Notably, YM155 inhibited tumorsphere formation by blocking the autophosphorylation of EGFR and the EGFR-G9a-mediated stemness pathway. The chemical and genetic inhibition of EGFR and G9a revealed the significant role of the EGFR-G9a pathway in maintaining the cancer stemness property. In conclusion, this study not only revealed that EGFR could trigger tumorsphere formation by elevating G9a-mediated stemness but also demonstrated that YM155 could inhibit this formation by simultaneously blocking EGFR autophosphorylation and G9a activity, thus acting as a potent agent against lung cancer stemness.

  2. Invasive adenocarcinoma of the lung is associated with the upper lung regions.

    Science.gov (United States)

    Kinsey, C Matthew; Estepar, Raul San Jose; Zhao, Yang; Yu, Xiaojin; Diao, Nancy; Heist, Rebecca Suk; Wain, John C; Mark, Eugene J; Washko, George; Christiani, David C

    2014-05-01

    We postulated that ventilation-perfusion (V/Q) relationships within the lung might influence where lung cancer occurs. To address this hypothesis we evaluated the location of lung adenocarcinoma, by both tumor lobe and superior-inferior regional distribution, and associated variables such as emphysema. One hundred fifty-nine cases of invasive adenocarcinoma and adenocarcinoma with lepidic features were visually evaluated to identify lobar or regional tumor location. Regions were determined by automated division of the lungs into three equal volumes: (upper region, middle region, or lower region). Automated densitometry was used to measure radiographic emphysema. The majority of invasive adenocarcinomas occurred in the upper lobes (69%), with 94% of upper lobe adenocarcinomas occurring in the upper region of the lung. The distribution of adenocarcinoma, when classified as upper or lower lobe, was not different between invasive adenocarcinoma and adenocarcinoma with lepidic features (formerly bronchioloalveolar cell carcinoma, P = 0.08). Regional distribution of tumor was significantly different between invasive adenocarcinoma and adenocarcinoma with lepidic features (P = 0.001). Logistic regression analysis with the outcome of invasive adenocarcinoma histology was used to adjust for confounders. Tumor region continued to be a significant predictor (OR 8.5, P = 0.008, compared to lower region), whereas lobar location of tumor was not (P = 0.09). In stratified analysis, smoking was not associated with region of invasive adenocarcinoma occurrence (P = 0.089). There was no difference in total emphysema scores between invasive adenocarcinoma cases occurring in each of the three regions (P = 0.155). There was also no difference in the distribution of region of adenocarcinoma occurrence between quartiles of emphysema (P = 0.217). Invasive adenocarcinoma of the lung is highly associated with the upper lung regions. This association is not related to smoking, history of COPD

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

    Science.gov (United States)

    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 segmentation on SPECT images are on par with manual segmentation on SPECT images. Relative large volumetric differences between manual delineations of functional SPECT images and anatomical CT images confirms that lung segmentation of functional SPECT images is a challenging task. The current algorithm is a first step towards automatic quantification of wide range of measurements.

  4. Abolished ventilation and perfusion of lung caused by blood clot in the left main bronchus: auto-downregulation of pulmonary arterial blood supply.

    Science.gov (United States)

    Afzelius, P; Bergmann, A; Henriksen, J H

    2015-09-15

    It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V/Q) scintigraphy with single-photon emission CT (SPECT)/CT. V/Q SPECT/CT demonstrated abolished ventilation due to obstruction of the left main bronchus and markedly reduced perfusion of the entire left lung, a condition that was completely reversed after removal of a blood clot. We present the first pictorially documented case of hypoxia-induced pulmonary vasoconstriction and flow shift in a main pulmonary artery due to a complete intrinsic obstruction of the ipsilateral main bronchus. The condition is reversible, contingent on being relieved within a few days. 2015 BMJ Publishing Group Ltd.

  5. Comparison of ventilation-perfusion single-photon emission computed tomography (V/Q SPECT) versus dual-energy CT perfusion and angiography (DECT) after 6 months of pulmonary embolism (PE) treatment

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    Meysman, M., E-mail: marc.meysman@uzbrussel.be [Respiratory Division, Department of Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels (Belgium); Everaert, H., E-mail: nucgeth@gmail.com [Department of Nuclear Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels (Belgium); Buls, N., E-mail: nico.buls@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels (Belgium); Nieboer, K., E-mail: koenraad.nieboer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels (Belgium); Mey, J. de, E-mail: Johan.deMey@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels (Belgium)

    2015-09-15

    Highlights: • Incomplete resolution of pulmonary emboli occurs frequently. • Residual V/Q-SPECT defects correspond in the majority of cases with defects seen on DECT. • Some (11.1%) defects on V/Q-SPECT are not present on comparable DECT images. - Abstract: Background: The natural evolution of treated symptomatic pulmonary embolism shows often incomplete resolution of pulmonary thrombi. The prevalence of perfusion defects depend on the image modality used. This study directly compares V/Q SPECT with DECT. Methods: A single-center prospective observational cohort study of patients with intermediate risk PE, reassessed at the end of treatment with V/Q SPECT. Abnormal V/Q SPECT images were compared with DECT. Results: We compared DECT en V/Q SPECT in 28 consecutive patients with persistent V/Q mismatch on V/Q SPECT, 13 men and 15 woman, mean age 60 (+17), range 23–82 year. One patient was excluded from the final analysis due to inferior quality DECT. In 18/27 (66.7%) the results were concordant between CTPA (persistent embolus visible), DECT (segmentary defects on iodine map) and V/Q SPECT (segmentary ventilation–perfusion mismatch). In 3/18 (11.1% of the total group) the partialy matched V/Q SPECT defect could be explained on DECT lung images by lung infarction. In 6/27 (22.1%) only hypoperfusion was seen on DECT iodine map. In 3/27 (11.1%) results were discordant between V/Q SPECT and DECT images. Conclusion: Six months after diagnosis of first or recurrent PE, residual pulmonary perfusion-defects encountered on V/Q-SPECT corresponds in the majority of patients with chronic thromboembolic disease seen on DECT. In 22.1% of patients V/Q SPECT mismatch only corresponds with hypoperfusion on iodine map DECT scan. Some (11.1%) of the chronic thromboembolic lesions seen on V/Q SPECT can not be explained by DECT results.

  6. Desflurane inhalation before ischemia increases ischemia-reperfusion-induced vascular leakage in isolated rabbit lungs.

    Science.gov (United States)

    Oshima, Yoshiaki; Sakamoto, Seiji; Yamasaki, Kazumasa; Mochida, Shinsuke; Funaki, Kazumi; Moriyama, Naoki; Otsuki, Akihiro; Endo, Ryo; Nakasone, Masato; Takahashi, Shunsaku; Harada, Tomomi; Minami, Yukari; Inagaki, Yoshimi

    2016-01-01

    Isoflurane and sevoflurane protect lungs with ischemia-reperfusion (IR) injury. We examined the influence of desflurane on IR lung injury using isolated rabbit lungs perfused with a physiological salt solution. The isolated lungs were divided into three groups: IR, desflurane-treated ischemia-reperfusion (DES-IR), and ventilation/perfusion-continued control (Cont) groups (n = 6 per group). In the DES-IR group, inhalation of desflurane at 1 minimum alveolar concentration (MAC) was conducted in a stable 30-min phase. In the IR and DES-IR groups, ventilation/perfusion was stopped for 75 min after the stable phase. Subsequently, they were resumed. Each lung was placed on a balance, and weighed. Weight changes were measured serially throughout this experiment. The coefficient of filtration (Kfc) was determined immediately before ischemia and 60 min after reperfusion. Furthermore, bronchoalveolar lavage fluid (BALF) was collected from the right bronchus at the completion of the experiment. After the completion of the experiment, the left lung was dried, and the lung wet-to-dry weight ratio (W/D) was calculated. The Kfc values at 60 min after perfusion were 0.40 ± 0.13 ml/min/mmHg/100 g in the DES-IR group, 0.26 ± 0.07 ml/min/mmHg/100 g in the IR group, and 0.22 ± 0.08 (mean ± SD) ml/mmHg/100 g in the Cont group. In the DES-IR group, the Kfc at 60 min after the start of reperfusion was significantly higher than in the other groups. In the DES-IR group, W/D was significantly higher than in the Cont group. In the DES-IR group, the BALF concentrations of nitric oxide metabolites were significantly higher than in the other groups. In the DES-IR group, the total amount of vascular endothelial growth factor in BALF was significantly higher than in the Cont group. The pre-inhalation of desflurane at 1 MAC exacerbates pulmonary IR injury in isolated/perfused rabbit lungs.

  7. Heart and Lungs Protection Technique for Cardiac Surgery with Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Vladimir Pichugin

    2014-12-01

    Full Text Available Introduction: Cardioplegic cardiac arrest with subsequent ischemic-reperfusion injuries can lead to the development of inflammation of the myocardium, leucocyte activation, and release of cardiac enzymes. Flow reduction to the bronchial arteries, causing low-flow lung ischemia, leads to the development of a pulmonary regional inflammatory response. Hypoventilation during cardiopulmonary bypass (CPB is responsible for development of microatelectasis, hydrostatic pulmonary edema, poor compliance, and a higher incidence of infection. Based on these facts, prevention methods of these complications were developed. The aim of this study was to evaluate constant coronary perfusion (CCP and the “beating heart” in combination with pulmonary artery perfusion (PAP and “ventilated lungs” technique for heart and lung protection in cardiac surgery with CPB.Methods. After ethical approval and written informed consent, 80 patients undergoing cardiac surgery with normothermic CPB were randomized in three groups. In the first group (22 patients, the crystalloid cardioplegia without lung ventilation/perfusion techniques were used. In the second group (30 patients, the CCP and “beating heart” without lung ventilation/perfusion techniques were used. In the third group (28 patients, the CCP with PAP and lung ventilation techniques were used. Clinical, functional parameters, myocardial damage markers (CK MB level, oxygenation index, and lung compliance were investigated.Results. There were higher rates of spontaneous cardiac recovery and lower doses of inotrops in the second and third groups. Myocardial contractility function was better preserved in the second and third groups. The post-operative levels of CK-MB were lower than in control group.  Three hours after surgery CK-MB levels in the second and third  groups were lower by 38.1% and 33.3%, respectively. Eight hours after surgery, CK-MB levels were lower in the second and third groups by 45.9% and

  8. Pulmonary vascular abnormalities in chronic obstructive pulmonary disease undergoing lung transplant.

    Science.gov (United States)

    Peinado, Victor I; Gómez, Federico P; Barberà, Joan Albert; Roman, Antonio; Angels Montero, M; Ramírez, Josep; Roca, Josep; Rodriguez-Roisin, Roberto

    2013-12-01

    Little is known about the structure and function relationships of pulmonary vessels in the most severe chronic obstructive pulmonary disease (COPD) spectrum. We investigated morphometric, cellular, and physiologic characteristics of pulmonary arteries from COPD patients undergoing bilateral lung transplant. Seventeen patients with very severe COPD (forced expiratory volume in 1 second, 24% ± 7%) were assessed using inert gas exchange and pulmonary hemodynamics while breathing ambient air and 100% oxygen. Morphometry, in vitro reactivity to hypoxia, and inflammatory cell counts of pulmonary arteries were measured in explanted lungs. Patients had moderate ventilation-perfusion imbalance along with mild release of hypoxic pulmonary vasoconstriction. Mild pulmonary hypertension was observed in 7 patients. Explanted lungs had predominant emphysema with mild small airway involvement. In vitro reactivity was modestly altered, with relatively preserved endothelium-dependent relaxation, and vascular remodelling was discrete, with intense CD8+ T lymphocytes infiltrate. In vitro reactivity correlated with pulmonary vascular resistance (on ambient air) and oxygen-induced pulmonary artery pressure changes. Patients with pulmonary hypertension had more severe morphologic and physiologic emphysema. In end-stage COPD patients undergoing lung transplant, pulmonary vascular involvement is unexpectedly modest, with low-grade endothelial dysfunction. In this sub-set of COPD patients, pulmonary emphysema may constitute the major determinant of the presence of pulmonary hypertension. © 2013 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.

  9. A hyaluronic acid nanogel for photo-chemo theranostics of lung cancer with simultaneous light-responsive controlled release of doxorubicin

    Science.gov (United States)

    Khatun, Zehedina; Nurunnabi, Md; Nafiujjaman, Md; Reeck, Gerald R.; Khan, Haseeb A.; Cho, Kwang Jae; Lee, Yong-Kyu

    2015-06-01

    The combined delivery of photo- and chemo-therapeutic agents is an emerging strategy to overcome drug resistance in treating cancer, and controlled light-responsive drug release is a proven tactic to produce a continuous therapeutic effect for a prolonged duration. Here, a combination of light-responsive graphene, chemo-agent doxorubicin and pH-sensitive disulfide-bond linked hyaluronic acid form a nanogel (called a graphene-doxorubicin conjugate in a hyaluronic acid nanogel) that exerts an activity with multiple effects: thermo and chemotherapeutic, real-time noninvasive imaging, and light-glutathione-responsive controlled drug release. The nanogel is mono-dispersed with an average diameter of 120 nm as observed by using TEM and a hydrodynamic size analyzer. It has excellent photo-luminescence properties and good stability in buffer and serum solutions. Graphene itself, being photoluminescent, can be considered an optical imaging contrast agent as well as a heat source when excited by laser irradiation. Thus the nanogel shows simultaneous thermo-chemotherapeutic effects on noninvasive optical imaging. We have also found that irradiation enhances the release of doxorubicin in a controlled manner. This release synergizes therapeutic activity of the nanogel in killing tumor cells. Our findings demonstrate that the graphene-doxorubicin conjugate in the hyaluronic acid nanogel is very effective in killing the human lung cancer cell line (A549) with limited toxicity in the non-cancerous cell line (MDCK).The combined delivery of photo- and chemo-therapeutic agents is an emerging strategy to overcome drug resistance in treating cancer, and controlled light-responsive drug release is a proven tactic to produce a continuous therapeutic effect for a prolonged duration. Here, a combination of light-responsive graphene, chemo-agent doxorubicin and pH-sensitive disulfide-bond linked hyaluronic acid form a nanogel (called a graphene-doxorubicin conjugate in a hyaluronic acid

  10. Theoretical Models for the Quantification of Lung Injury Using Ventilation and Perfusion Distributions

    Directory of Open Access Journals (Sweden)

    B. S. Brook

    2009-01-01

    Full Text Available This paper describes two approaches to modelling lung disease: one based on a multi-compartment statistical model with a log normal distribution of ventilation perfusion ratio (V˙/Q˙ values; and the other on a bifurcating tree which emulates the anatomical structure of the lung. In the statistical model, the distribution becomes bimodal, when the V˙/Q˙ values of a randomly selected number of compartments are reduced by 85% to simulate lung disease. For the bifurcating tree model a difference in flow to the left and right branches coupled with a small random variation in flow ratio between generations results in a log normal distribution of flows in the terminal branches. Restricting flow through branches within the tree to simulate lung disease transforms this log normal distribution to a bi-modal one. These results are compatible with those obtained from experiments using the multiple inert gas elimination technique, where log normal distributions of V˙/Q˙ ratio become bimodal in the presence of lung disease.

  11. Hippocampus-Sparing Whole-Brain Radiotherapy and Simultaneous Integrated Boost for Multiple Brain Metastases From Lung Adenocarcinoma: Early Response and Dosimetric Evaluation.

    Science.gov (United States)

    Kim, Kyung Hwan; Cho, Byoung Chul; Lee, Chang Geol; Kim, Hye Ryun; Suh, Yang Gun; Kim, Jun Won; Choi, Chihwan; Baek, Jong Geal; Cho, Jaeho

    2016-02-01

    In this study, the volume response and treatment outcome after hippocampus-sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) using tomotherapy were evaluated. Patients with primary lung adenocarcinoma and multiple brain metastases who had a Karnofsky performance status ≥ 70 and exhibited well-controlled extracranial disease were treated. The prescribed dose was administered in 10 to 14 fractions as 25 to 28 Gy to whole-brain parenchyma, as 40 to 48 Gy to the gross metastatic lesion, and as 30 to 42 Gy to a 5-mm margin to the metastatic lesion. Double-dose gadolinium contrast-enhanced magnetic resonance imaging at 1-mm slice thickness was performed before treatment and at 1, 4, and 7 months post-treatment. The tumor volume reduction ratio was calculated for each follow-up. Between July 2011 and September 2012, 11 patients with 70 lesions were included in this analysis. The median number of lesions per patient was 4 (range, 2-15). The median initial tumor volume was 0.235 cm(3) (range, 0.020-10.140 cm(3)). The treatment plans were evaluated regarding conformation number (CN), target coverage (TC), and homogeneity index (HI). The median follow-up duration was 14 months (range, 3-25 months) and the 1-year intracranial control rate was 67%. The tumor volume reduction was most prominent during the first month with a median reduction rate of 0.717 (range, -0.190 to 1.000). Complete remission was seen in 22 (33%) lesions, and 45 (64%) lesions showed more than 65% reduction in tumor volume. The CN, TC, and HI values were comparable to that of previous studies, and the mean hippocampal dose was 13.65 Gy. No treatment breaks or ≥ G3 acute toxicities were observed during or after treatment. The HS-WBRT with SIB in patients with multiple brain metastases was effective and feasible for volume reduction and showed excellent intracranial control. © The Author(s) 2015.

  12. Fuzzy modeling of electrical impedance tomography images of the lungs.

    Science.gov (United States)

    Tanaka, Harki; Ortega, Neli Regina Siqueira; Galizia, Mauricio Stanzione; Borges, João Batista; Amato, Marcelo Britto Passos

    2008-06-01

    Aiming to improve the anatomical resolution of electrical impedance tomography images, we developed a fuzzy model based on electrical impedance tomography's high temporal resolution and on the functional pulmonary signals of perfusion and ventilation. Electrical impedance tomography images carry information about both ventilation and perfusion. However, these images are difficult to interpret because of insufficient anatomical resolution, such that it becomes almost impossible to distinguish the heart from the lungs. Electrical impedance tomography data from an experimental animal model were collected during normal ventilation and apnea while an injection of hypertonic saline was administered. The fuzzy model was elaborated in three parts: a modeling of the heart, the pulmonary ventilation map and the pulmonary perfusion map. Image segmentation was performed using a threshold method, and a ventilation/perfusion map was generated. Electrical impedance tomography images treated by the fuzzy model were compared with the hypertonic saline injection method and computed tomography scan images, presenting good results. The average accuracy index was 0.80 when comparing the fuzzy modeled lung maps and the computed tomography scan lung mask. The average ROC curve area comparing a saline injection image and a fuzzy modeled pulmonary perfusion image was 0.77. The innovative aspects of our work are the use of temporal information for the delineation of the heart structure and the use of two pulmonary functions for lung structure delineation. However, robustness of the method should be tested for the imaging of abnormal lung conditions. These results showed the adequacy of the fuzzy approach in treating the anatomical resolution uncertainties in electrical impedance tomography images.

  13. Assessing gas exchange in acute lung injury/acute respiratory distress syndrome: diagnostic techniques and prognostic relevance.

    Science.gov (United States)

    Gattinoni, Luciano; Carlesso, Eleonora; Cressoni, Massimo

    2011-02-01

    To provide the most recent insights on the assessment of gas exchange in acute lung injury. Central venous blood may be used as a surrogate of arterial blood to assess carbon dioxide tension and acid-base status. In contrast arterial oxygenation cannot be estimated with confidence from venous blood. However, the use of venous blood associated with pulse oximetry may provide the SvO2 which is useful for monitoring and targeting the resuscitation therapy. Impaired CO2 clearance and increased dead space have been confirmed as useful prognostic indices of structural lung damage and mortality in acute respiratory failure. A simplified technique based on multiple inert gas technique has been described to assess ventilation-perfusion mismatch while a new analysis of pulse oximetry has been suggested to detect lung opening and closing. Finally, new insight has been provided on the relationship between lung anatomy, as detected by computed tomography, oxygenation and CO2 clearance. Although oxygenation assessment is of primary importance during respiratory lung injury, dead space and CO2 retention are more strictly associated with outcome. The association of central venous blood analysis and pulse oximetry may provide more information than arterial blood alone.

  14. First in vivo magnetic particle imaging of lung perfusion in rats

    Science.gov (United States)

    Zhou, Xinyi Y.; Jeffris, Kenneth E.; Yu, Elaine Y.; Zheng, Bo; Goodwill, Patrick W.; Nahid, Payam; Conolly, Steven M.

    2017-05-01

    Pulmonary embolism (PE), along with the closely related condition of deep vein thrombosis, affect an estimated 600 000 patients in the US per year. Untreated, PE carries a mortality rate of 30%. Because many patients experience mild or non-specific symptoms, imaging studies are necessary for definitive diagnosis of PE. Iodinated CT pulmonary angiography is recommended for most patients, while nuclear medicine-based ventilation/perfusion (V/Q) scans are reserved for patients in whom the use of iodine is contraindicated. Magnetic particle imaging (MPI) is an emerging tracer imaging modality with high image contrast (no tissue background signal) and sensitivity to superparamagnetic iron oxide (SPIO) tracer. Importantly, unlike CT or nuclear medicine, MPI uses no ionizing radiation. Further, MPI is not derived from magnetic resonance imaging (MRI); MPI directly images SPIO tracers via their strong electronic magnetization, enabling deep imaging of anatomy including within the lungs, which is very challenging with MRI. Here, the first high-contrast in vivo MPI lung perfusion images of rats are shown using a novel lung perfusion agent, MAA-SPIOs.

  15. Mechanisms of gas exchange response to lung volume reduction surgery in severe emphysema.

    Science.gov (United States)

    Cremona, George; Barberà, Joan A; Barbara, Joan A; Melgosa, Teresa; Appendini, Lorenzo; Roca, Josep; Casadio, Caterina; Donner, Claudio F; Rodriguez-Roisin, Roberto; Wagner, Peter D

    2011-04-01

    Lung volume reduction surgery (LVRS) improves lung function, respiratory symptoms, and exercise tolerance in selected patients with chronic obstructive pulmonary disease, who have heterogeneous emphysema. However, the reported effects of LVRS on gas exchange are variable, even when lung function is improved. To clarify how LVRS affects gas exchange in chronic obstructive pulmonary disease, 23 patients were studied before LVRS, 14 of whom were again studied afterwards. We performed measurements of lung mechanics, pulmonary hemodynamics, and ventilation-perfusion (Va/Q) inequality using the multiple inert-gas elimination technique. LVRS improved arterial Po₂ (Pa(O₂)) by a mean of 6 Torr (P = 0.04), with no significant effect on arterial Pco₂ (Pa(CO₂)), but with great variability in both. Lung mechanical properties improved considerably more than did gas exchange. Post-LVRS Pa(O₂) depended mostly on its pre-LVRS value, whereas improvement in Pa(O(2)) was explained mostly by improved Va/Q inequality, with lesser contributions from both increased ventilation and higher mixed venous Po(2). However, no index of lung mechanical properties correlated with Pa(O₂). Conversely, post-LVRS Pa(CO₂) bore no relationship to its pre-LVRS value, whereas changes in Pa(CO₂) were tightly related (r² = 0.96) to variables, reflecting decrease in static lung hyperinflation (intrinsic positive end-expiratory pressure and residual volume/total lung capacity) and increase in airflow potential (tidal volume and maximal inspiratory pressure), but not to Va/Q distribution changes. Individual gas exchange responses to LVRS vary greatly, but can be explained by changes in combinations of determining variables that are different for oxygen and carbon dioxide.

  16. Long-term Changes in Pulmonary Function After Incidental Lung Irradiation for Breast Cancer: A Prospective Study With 7-Year Follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Jaen, Javier, E-mail: javier.jaen.sspa@juntadeandalucia.es [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain); Vazquez, Gonzalo [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain); Alonso, Enrique; De Las Penas, Maria D.; Diaz, Laura [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain); De Las Heras, Manuel [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain); Perez-Regadera, Jose F. [Servicio de Oncologia Radioterapica, Hospital Universitario Doce de Octubre, Madrid (Spain)

    2012-12-01

    Purpose: To evaluate late pulmonary function changes after incidental pulmonary irradiation for breast cancer. Methods and Materials: Forty-three consecutive female patients diagnosed with breast carcinoma and treated with postoperative radiation therapy (RT) at the same dose (50 Gy) and fractionation (2 Gy/fraction, 5 days/week) were enrolled. Pulmonary function tests (PFT) and ventilation/perfusion scans were performed before RT and 6, 12, 24, and 84 months afterward. Results: Forty-one patients, mean age 55 years, were eligible for the analysis. No differences were found in the baseline PFT values for age, smoking status and previous chemotherapy; women undergoing mastectomy showed baseline spirometric PFT values lower than did women treated with conservative surgery. The mean pulmonary dose was 10.9 Gy, being higher in women who also received lymph node RT (15.8 vs 8.6, P<.01). Only 1 patient experienced symptomatic pneumonitis. All PFT values showed a reduction at 6 months. From then on, the forced vital capacity and forced expiratory volume in 1 second began their recovery until reaching, and even exceeding, their baseline values at 7 years. Diffusing capacity of the lungs for carbon monoxide and ventilation/perfusion scans continued to reduce for 24 months and then partially recovered their baseline values (-3.5%, -3.8%, and -5.5%, respectively). Only the percentage difference at 7 years in the ventilation scan correlated with the dosimetric parameters studied. Other variables, such as age, smoking status, previous chemotherapy, and concomitant tamoxifen showed no significant relation with changes in PFT ({Delta}PFT) values at 7 years. Conclusions: The study of reproducible subclinical parameters, such as PFT values, shows how their figures decrease in the first 2 years but practically recover their baseline values in the long term. The extent of the reduction in PFT values was small, and there was no clear association with several dosimetric and clinical

  17. Imaging lung function in mice using SPECT/CT and per-voxel analysis.

    Directory of Open Access Journals (Sweden)

    Brian N Jobse

    Full Text Available Chronic lung disease is a major worldwide health concern but better tools are required to understand the underlying pathologies. Ventilation/perfusion (V/Q single photon emission computed tomography (SPECT with per-voxel analysis allows for non-invasive measurement of regional lung function. A clinically adapted V/Q methodology was used in healthy mice to investigate V/Q relationships. Twelve week-old mice were imaged to describe normal lung function while 36 week-old mice were imaged to determine how age affects V/Q. Mice were ventilated with Technegas™ and injected with (99mTc-macroaggregated albumin to trace ventilation and perfusion, respectively. For both processes, SPECT and CT images were acquired, co-registered, and quantitatively analyzed. On a per-voxel basis, ventilation and perfusion were moderately correlated (R = 0.58±0.03 in 12 week old animals and a mean log(V/Q ratio of -0.07±0.01 and standard deviation of 0.36±0.02 were found, defining the extent of V/Q matching. In contrast, 36 week old animals had significantly increased levels of V/Q mismatching throughout the periphery of the lung. Measures of V/Q were consistent across healthy animals and differences were observed with age demonstrating the capability of this technique in quantifying lung function. Per-voxel analysis and the ability to non-invasively assess lung function will aid in the investigation of chronic lung disease models and drug efficacy studies.

  18. Simultaneous diagnostic platform of genotyping EGFR, KRAS, and ALK in 510 Korean patients with non-small-cell lung cancer highlights significantly higher ALK rearrangement rate in advanced stage.

    Science.gov (United States)

    Kim, Tae-Jung; Park, Chan Kwon; Yeo, Chang Dong; Park, Kihoon; Rhee, Chin Kook; Kim, Jusang; Kim, Seung Joon; Lee, Sang Haak; Lee, Kyo-Young; Yoon, Hyoung-Kyu

    2014-09-01

    Simultaneous genotyping has advantages in turnaround time and detecting the real mutational prevalence in unresectable non-small-cell lung cancer (NSCLC), a group not previously genetically characterized. We developed simultaneous panel of screening EGFR and KRAS mutations by direct sequencing or PNA clamping, and ALK rearrangement by fluorescent in situ hybridization (FISH) in multicenter manner. Of 510 NSCLC Korean patients, simultaneous genotyping identified mutations of EGFR (29.0%) and KRAS (8.6%) and rearrangement of ALK (9.2%). Seven patients had overlaps in mutations. Although several well-known associations between genotypes and clinical characteristics were identified, we found no relationship between ALK rearrangement and sex or smoking history. Unlike the other genotype mutations, ALK rearrangement was associated with advanced disease. Among the ALK-negative group, patients with 10-15% of ALK FISH split shared characteristics, such as younger age and advanced stage disease, more with the ALK-positive group (>15% ALK FISH split) than smoking history. ALK rearrangement seems to be a marker for aggressive tumor biology and should be assessed in advanced disease. © 2014 Wiley Periodicals, Inc.

  19. [Current approaches to the treatment of severe hypoxic respiratory insufficiency (acute lung injury; acute respiratory distress syndrome)].

    Science.gov (United States)

    Kluge, S; Müller, T; Pfeifer, M

    2011-02-01

    Lung-protective ventilation with a low tidal volume, plateau pressure 90% and permissive hypercapnia results in reduction of the mortality rate in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The level of the positive end-expiratory pressure (PEEP) must be chosen in relation to oxygen requirement. High frequency oscillatory ventilation and neurally adjusted ventilatory assist are promising methods. However, further studies with firm end-points have to be awaited before a final judgment is possible. Veno-venous extracorporeal membrane oxygenation (ECMO) can ensure life-sustaining gas exchange in patients with severe vitally compromised pulmonary failure, to provide time for lung tissue to heal and reduce ventilatory stress. The latest guidelines for analgesia and sedation in intensive care medicine demand consistent monitoring of the level of sedation and the intensity of pain. The sedation should be interrupted daily, with phases of awakenings and, if possible, spontaneous breathing. Methods of supportive treatment: Positional treatment (prone position) and inhalation of vasodilators can improve ventilation/perfusion mismatch and thus oxygenation. However, administration of surfactant is currently not advised in adult respiratory failure. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Novel One Lung Ventilation Strategy (OLV) for a Patient with Complete Unilateral Endobronchial Obstruction Causing Hypoxic Respiratory Failure.

    Science.gov (United States)

    Kanitkar, Amaraja; Lee, Sarah J

    2017-01-27

    BACKGROUND Mechanical ventilation strategies for one lung ventilation (OLV) differ from conventional modalities in that it can adapt to greater degrees of ventilation/perfusion (V/Q) mismatch. We present a case of cancer causing complete unilateral endobronchial obstruction with refractory hypoxia that improved with OLV strategy. CASE REPORT Our patient was an elderly male, admitted to our intensive care unit (ICU) on mechanical ventilation with worsening hypoxic respiratory failure secondary to lung mass and post-obstructive atelectasis. The patient developed refractory hypoxia on high conventional ventilator settings. Chest x-ray (CXR) showed opacification on left lung with ipsilateral mediastinal shift. Bronchoscopy revealed complete obstruction of the left main stem bronchus by a fungating mass. OLV strategy was then implemented. The patient had improved hypoxia despite unchanged CXR. CONCLUSIONS We propose that ventilating a patient with a complete unilateral endobronchial obstruction is physiologically similar to ventilating a patient with OLV. In such cases, OLV strategies may improve refractory hypoxia by minimizing V/Q mismatch and should be considered.

  1. Nuclear medicine pulmonary diagnosis; Nuklearmedizinische Diagnostik der Lunge

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    Schuemichen, C. [Rostock Univ. (Germany). Radiologische Klinik und Poliklinik

    2000-10-01

    Scintigraphic recording of regional ventilation and perfusion with {sup 99m}Tc-Aerosol and {sup 99m}Tc-MAA remain in the foreground of nuclear medicine pulmonary diagnostics. The most important indication for ventilation scintigraphy is the prediction of postoperative pulmonary function, which is still performed in many hospitals with perfusion scintigraphy, and with which, in turn, intrapulmonary right-left shunts can be simply and also semiquantitatively recorded. Combined ventilation/perfusion scintigraphy offers a very high degree of sensitivity in the proof of acute pulmonary embolism, is therefore exceptionally well suited for exclusion diagnostics, while specificity compared to pulmonary angiography and spiral CT still needs some clarification. The self-cleaning mechanism of the lung can be quantitatively examined using mucociliary and resorptive clearance. The clinical areas of application are limited for methodical reasons. Primary diagnostics of bronchial carcinoma and dignity differentiation of solitary pulmonary nodules, preferably with {sup 18}F-FDG PET are gaining steadily in importance. (orig.) [German] Im Vordergrund der nuklearmedizinischen Lungendiagnostik steht nach wie vor die szintigraphische Abbildung der regionalen Ventilation und Perfusion mit {sup 99m}Tc-Aerosol und {sup 99m}Tc-MAA. Wichtigste Indikation fuer die Ventilationsszintigraphie ist die Voraussage der postoperativen Lungenfunktion, die vielerorts noch mit der Perfusionsszintigraphie durchgefuehrt wird, mit der sich wiederum intrapulmonale Rechts-links-Shunts einfach und auch semiquantitativ erfassen lassen. Die kombinierte Ventilations-/Perfusionsszintigraphie bietet ein Hoechstmass an Sensitivitaet beim Nachweis der akuten Lungenembolie, ist deshalb fuer die Ausschlussdiagnostik hervorragend geeignet, die Spezifitaet im Vergleich zur Pulmonalisangiographie und Spiral-CT ist weiterhin klaerungsbeduerftig. Die Selbstreinigungsmechanismen der Lunge lassen sich mit der mukoziliaeren

  2. MRI of interstitial lung diseases. What is possible?; MRT bei interstitiellen Lungenerkrankungen. Was ist moeglich

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J. [Kreisklinik Gross-Gerau, Radiologie Darmstadt, Gross-Gerau (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Deutsches Zentrum fuer Lungenforschung (DZL), Translational Lung Research Center (TLRC) Heidelberg, Heidelberg (Germany); Thoraxklinik, Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Wielpuetz, M.O.; Jobst, B.J.; Dinkel, J. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Deutsches Zentrum fuer Lungenforschung (DZL), Translational Lung Research Center (TLRC) Heidelberg, Heidelberg (Germany); Thoraxklinik, Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany)

    2014-12-15

    Magnetic resonance imaging (MRI) of the lungs is becoming increasingly appreciated as a third diagnostic imaging modality besides chest x-ray and computed tomography (CT). Its value is well acknowledged for pediatric patients or for scientific use particularly when radiation exposure should be strictly avoided. However, the diagnosis of interstitial lung disease is the biggest challenge of all indications. The objective of this article is a summary of the current state of the art for diagnostic MRI of interstitial lung diseases. This article reflects the results of a current search of the literature and discusses them against the background of the authors own experience with lung MRI. Due to its lower spatial resolution and a higher susceptibility to artefacts MRI does not achieve the sensitivity of CT for the detection of small details for pattern recognition (e.g. fine reticulation and micronodules) but larger details (e.g. coarse fibrosis and honeycombing) can be clearly visualized. Moreover, it could be shown that MRI has the capability to add clinically valuable information on regional lung function (e.g. ventilation, perfusion and mechanical properties) and inflammation with native signal and contrast dynamics. In its present state MRI can be used for comprehensive cardiopulmonary imaging in patients with sarcoidosis or for follow-up of lung fibrosis after initial correlation with CT. Far more indications are expected when the capabilities of MRI for the assessment of regional lung function and activity of inflammation can be transferred into robust protocols for clinical use. (orig.) [German] Die MRT der Lunge entwickelt sich zu einer ernstzunehmenden dritten Saeule der Thoraxdiagnostik neben dem Thoraxroentgen und der Computertomographie (CT). Ihr Wert in der paediatrischen Lungendiagnostik oder fuer den wissenschaftlichen Einsatz, insbesondere wenn eine Strahlenexposition vermieden werden soll, ist unbestritten. Von allen Indikationen stellt die Diagnostik

  3. Biological effects of short-term, high-concentration exposure to methyl isocyanate. III. Influence on gas exchange in the guinea pig lung

    Energy Technology Data Exchange (ETDEWEB)

    Fedde, M.R.; Dodd, D.E.; Troup, C.M.; Fowler, E.H.

    1987-06-01

    The influence of methyl isocyanate (MIC) inhalation on the gas exchange function of the lungs in guinea pigs was studied by measuring arterial blood gases, pH, and tracheal pressure during constant-volume, artificial ventilation with air or 100% O/sub 2/ at 40 and 120 min after exposure. A 15 min exposure to MIC at concentrations of 240 to 628 ppm caused a marked reduction in PaO/sub 2/ and pH/sub a/ and an elevated tracheal pressure during artificial ventilation. The low PaO/sub 2/ was only slightly elevated when the animals were ventilated with 100% O/sub 2/. Although the dry-wet lung weight ratio was reduced at the highest exposure concentration, the effect was not severe and no significant increase in lung water was found at the lower concentrations. MIC inhalation caused severe pulmonary blood shunting and ventilation/perfusion imbalance. This, in turn, led to hypoxemia, metabolic acidosis, and tissue hypoxia, which could produce death. The pulmonary gas exchange deficit likely resulted from bronchial and bronchiolar obstruction caused by sloughed epithelium and other debris from intra- and extrapulmonary airways.

  4. Validation of measurements of ventilation-to-perfusion ratio inequality in the lung from expired gas

    Science.gov (United States)

    Prisk, G. Kim; Guy, Harold J B.; West, John B.; Reed, James W.

    2003-01-01

    The analysis of the gas in a single expirate has long been used to estimate the degree of ventilation-perfusion (Va/Q) inequality in the lung. To further validate this estimate, we examined three measures of Va/Q inhomogeneity calculated from a single full exhalation in nine anesthetized mongrel dogs under control conditions and after exposure to aerosolized methacholine. These measurements were then compared with arterial blood gases and with measurements of Va/Q inhomogeneity obtained using the multiple inert gas elimination technique. The slope of the instantaneous respiratory exchange ratio (R slope) vs. expired volume was poorly correlated with independent measures, probably because of the curvilinear nature of the relationship due to continuing gas exchange. When R was converted to the intrabreath Va/Q (iV/Q), the best index was the slope of iV/Q vs. volume over phase III (iV/Q slope). This was strongly correlated with independent measures, especially those relating to inhomogeneity of perfusion. The correlations for iV/Q slope and R slope considerably improved when only the first half of phase III was considered. We conclude that a useful noninvasive measurement of Va/Q inhomogeneity can be derived from the intrabreath respiratory exchange ratio.

  5. Mosaic Pattern of Lung Attenuation on Chest CT in Patients with Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Kamonpun Ussavarungsi

    2015-09-01

    Full Text Available A mosaic pattern of lung attenuation on chest computed tomography (CT may be due to various etiologies. There is limited published data on CT results when used to evaluate pulmonary hypertension (PH. We retrospectively studied the frequency of mosaic pattern in patients with PH and the cause of the PH by diagnostic group, as well as the correlation between the mosaic pattern and the following: demographics, severity of the PH, main pulmonary artery (PA size, PA/aorta (PA/Ao ratio, pulmonary function tests (PFT, and ventilation perfusion scan results. Overall, 18% of the cohort had CT mosaic pattern (34/189. Mosaic pattern was present in 17/113 (15% in Group 1 pulmonary arterial hypertension, 5/13 (28% in Group 2 pulmonary venous hypertension and 8/50 (16% in Group 3 PH. Conversely, Group 4 chronic thromboembolic PH was more prevalent in 4/8 (50%. Main PA size, PA/Ao ratio, and segmental perfusion defect were positively associated with mosaic pattern. In contrast, factors such as age, gender, body mass index, functional class, hemodynamic data, and PFT values were not associated with mosaic pattern. Mosaic pattern is not specific as an isolated finding for distinguishing the subtype of PH.

  6. Grading obstructive lung disease using tomographic pulmonary scintigraphy in patients with chronic obstructive pulmonary disease (COPD) and long-term smokers.

    Science.gov (United States)

    Bajc, Marika; Markstad, Hanna; Jarenbäck, Linnea; Tufvesson, Ellen; Bjermer, Leif; Jögi, Jonas

    2015-01-01

    The severity of chronic obstructive lung disease (COPD) is defined by the degree of flow limitation measured as forced expiratory volume in 1 s, which mainly reflects impairment of large and intermediate airways. However, COPD is primarily a small airways disease. Therefore, better diagnostic tools are needed. Ventilation-Perfusion (V/P) SPECT is a sensitive method to detect obstructive lung changes but criteria for staging airway obstruction are missing. To define and validate criteria to stage COPD using V/P SPECT. 74 subjects (healthy non-smokers, healthy smokers or with stable COPD) were included. All were examined with V/P SPECT in a hybrid SPECT/CT system. Spirometry was performed and patients were evaluated with the clinical COPD questionnaire (CCQ). V/P SPECT was interpreted independently. Preserved lung function (%) was evaluated. The degree of airway obstruction on V/P SPECT was graded according to newly-developed grading criteria. The degree of airway obstruction was graded from normal (0) to severe (3). The airway obstructivity-grade and degree of preserved lung function were compared to GOLD, CCQ and LDCT emphysema extent. Obstructivity-grade (r = 0.66, P obstructivity-grade (P = 0.001) and preserved lung function (P obstructivity-grade and preserved lung function, respectively). However, patients in GOLD 1 differed in obstructivity-grade from non-smoking controls (P = 0.02). Functional imaging with V/P SPECT enables standardized grading of airway obstruction as well as reduced lung function, both of which correlate with GOLD stage. V/P SPECT shows that long-term smokers in most cases have signs of ventilatory impairment and airway obstruction not shown by spirometry.

  7. Simultaneous immunization against tuberculosis.

    Directory of Open Access Journals (Sweden)

    Elma Z Tchilian

    Full Text Available BCG, the only licensed vaccine against tuberculosis, provides some protection against disseminated disease in infants but has little effect on prevention of adult pulmonary disease. Newer parenteral immunization prime boost regimes may provide improved protection in experimental animal models but are unproven in man so that there remains a need for new and improved immunization strategies.Mice were immunized parenterally, intranasally or simultaneously by both routes with BCG or recombinant mycobacterial antigens plus appropriate adjuvants. They were challenged with Mycobacterium tuberculosis (Mtb and the kinetics of Mtb growth in the lungs measured. We show that simultaneous immunization (SIM of mice by the intranasal and parenteral routes is highly effective in increasing protection over parenteral BCG administration alone. Intranasal immunization induces local pulmonary immunity capable of inhibiting the growth of Mtb in the early phase (the first week of infection, while parenteral immunization has a later effect on Mtb growth. Importantly, these two effects are additive and do not depend on priming and boosting the immune response. The best SIM regimes reduce lung Mtb load by up to 2 logs more than BCG given by either route alone.These data establish SIM as a novel and highly effective immunization strategy for Mtb that could be carried out at a single clinic visit. The efficacy of SIM does not depend on priming and boosting an immune response, but SIM is complementary to prime boost strategies and might be combined with them.

  8. Continuous positive airway pressure and body position alter lung ...

    African Journals Online (AJOL)

    uwerhiavwe

    Desenvolvimento Científico e Tecnologia (CNPq) and. Universidade de Santa Cruz do Sulia is acknowledged. REFERENCES. Ashurst S (1995). Oxygen Therapy. Br. J. Nurs. 9:508-516. Bajc M, Jonson B (2011). Ventilation/Perfusion SPECT for diagnosis of pulmonary embolism and other diseases. Int. J. Mol. Imaging pp.

  9. Automatic quantification in lung scintigraphy: functional atlas; Quantification automatique en scintigraphie pulmonaire: elaboration d'atlas fonctionnels

    Energy Technology Data Exchange (ETDEWEB)

    Ledee, R.; Therain, F. [Orleans Univ., Lab. d' Electronique - Signaux - Images (LESI), 45 (France); Debrun, D. [Centre Hospitalier Regional de la Source (CHRO), Medecine Nucleaire, 45 - Orleans (France)

    2003-06-01

    In spite of the development of new techniques, the ventilation perfusion lung scintigraphy keeps a good place for the diagnosis of pulmonary embolism (PE). In the context of an improvement of reliability and reproducibility of the diagnosis, this study proposes to realize an automatic quantification of the distribution of the radioactive tracers by pulmonary segments. Measurements are made following a procedure of non-rigid matching of morphological 2-D charts of the lungs on the scintigraphic images. The adaptation of these charts to the patients' morphology is carried out by exploiting iso-contour information of the images and using Fourier descriptors to determine the parameters of the transformation. The study was performed on a population of 30 patients with a probability of nil of the pulmonary embolism. After a study of the robustness of the quantification, 2-D segmental functional reference charts (according to the conditions of acquisition) were proposed. In the perfusion case and four views, the following lobar distribution, in relative value, is measured: Right Inferior Lobar = 23,39%, Medial Lobar = 10,41 %, Right Superior Lobar = 20,37%, Left Inferior Lobar 20,6% and Left Superior Lobar = 25.6% with culmen = 18,8% and lingula = 6,8%; values comparable with those of the publication. The process of quantification is adaptable to the ventilation lung scans. The segmental quantifications of a patient carried out under the same conditions of acquisition as the functional reference charts, could be compared with the reference data and provide indicators for the diagnosis but also for patient follow-up and preoperative evaluation of lung cancers. (authors)

  10. A case of familial hot tub lung

    Directory of Open Access Journals (Sweden)

    Yoshihiro Kitahara

    2016-01-01

    Full Text Available Hot tub lung is a lung disease caused by Mycobacterium avium complex. We report the first case of familial hot tub lung appearing simultaneously in a husband and wife. Our case supports the consideration that hot tub lung is a hypersensitivity pneumonitis rather than an infectious lung disease. It also suggests that the state of hot tub lung changes seasonally depending on temperature variations, in a manner similar to summer-type hypersensitivity pneumonitis. This case demonstrates similarities between hot tub lung and summer-type hypersensitivity pneumonitis in regards to familial occurrence and seasonal changes in the disease state.

  11. An Official American Thoracic Society/European Respiratory Society Workshop Report: Evaluation of Respiratory Mechanics and Function in the Pediatric and Neonatal Intensive Care Units

    NARCIS (Netherlands)

    Peterson-Carmichael, Stacey; Seddon, Paul C.; Cheifetz, Ira M.; Frerichs, Inéz; Hall, Graham L.; Hammer, Jürg; Hantos, Zoltán; van Kaam, Anton H.; McEvoy, Cindy T.; Newth, Christopher J. L.; Pillow, J. Jane; Rafferty, Gerrard F.; Rosenfeld, Margaret; Stocks, Janet; Ranganathan, Sarath C.

    2016-01-01

    Ready access to physiologic measures, including respiratory mechanics, lung volumes, and ventilation/perfusion inhomogeneity, could optimize the clinical management of the critically ill pediatric or neonatal patient and minimize lung injury. There are many techniques for measuring respiratory

  12. MRI of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, Hans-Ulrich (ed.) [University Clinic Heidelberg (Germany). Diagnostic and Interventional Radiology

    2009-07-01

    For a long time, only chest X-ray and CT were used to image lung structure, while nuclear medicine was employed to assess lung function. During the past decade significant developments have been achieved in the field of magnetic resonance imaging (MRI), enabling MRI to enter the clinical arena of chest imaging. Standard protocols can now be implemented on up-to-date scanners, allowing MRI to be used as a first-line imaging modality for various lung diseases, including cystic fibrosis, pulmonary hypertension and even lung cancer. The diagnostic benefits stem from the ability of MRI to visualize changes in lung structure while simultaneously imaging different aspects of lung function, such as perfusion, respiratory motion, ventilation and gas exchange. On this basis, novel quantitative surrogates for lung function can be obtained. This book provides a comprehensive overview of how to use MRI for imaging of lung disease. Special emphasis is placed on benign diseases requiring regular monitoring, given that it is patients with these diseases who derive the greatest benefit from the avoidance of ionizing radiation. (orig.)

  13. Intensity modulated radiotherapy of non-small-cell lung cancer incorporating SPECT ventilation imaging.

    Science.gov (United States)

    Munawar, Iram; Yaremko, Brian P; Craig, Jeff; Oliver, Michael; Gaede, Stewart; Rodrigues, George; Yu, Edward; Reid, Robert Henderson; Leung, Eugene; Urbain, Jean-Luc; Chen, Jeff; Wong, Eugene

    2010-04-01

    The authors performed this retrospective study to investigate the impact of using ventilation scans obtained from single photon emission computed tomography (SPECT) in selecting beam directions in intensity modulated radiation therapy (IMRT) planning in lung cancer radiotherapy to spare dosimetrically well ventilated lung. For ten consecutive stage III non-small-cell lung cancer patients, the authors obtained both ventilation/perfusion SPECT scans and four-dimensional CT scans for treatment planning purposes. Each ventilation scan was registered with the corresponding planning CT and ventilation volumes corresponding to either > or = 50% (vv50) or > or = 70% (vv70) of the maximum SPECT count were automatically segmented. For each patient, three IMRT plans were generated: One using nine equally spaced beams optimized according to nonfunctional lung based mean lung dose and lung v20; a second using nine equally spaced beams optimized to avoid vv50 and vv70; and a third plan using only three beams with gantry angles chosen based on minimum mean ventilated lung dose calculated for each conformal beam at every 10 degrees gantry angle avoiding vv50 and vv70. Resultant dose volume histogram indices were calculated for each plan and were compared with respect to calculated SPECT-based ventilation parameters in order to quantify the potential utility of ventilation SPECT in this setting. Two patient groups were identified based on (i) the overlap volume between PTV and vv50 and (ii) the average angular mean ventilated lung dose (AAMvLD). The first parameter quantifies the proximity of the PTV to well ventilated lung and the second parameter quantifies the degree of ventilation that surrounds the PTV. For group 1 patients, 5% of the vv50 overlapped the PTV. Group 1 was further classified into subgroups 1A and 1B: For subgroup 1A, AAMvLD is >18 Gy, implying that the functional lung surrounds the PTV; for subgroup 1B, AAMvLD is ventilated lung does not completely surround PTV

  14. Lung cancer

    Science.gov (United States)

    ... it is called metastatic cancer to the lung . Causes Lung cancer is the deadliest type of cancer for both ... under age 45. Cigarette smoking is the leading cause of lung cancer. The more cigarettes you smoke per day and ...

  15. Lung surgery

    Science.gov (United States)

    ... cavity, particularly after trauma Surgery to remove small balloon-like tissues (blebs) that cause lung collapse ( pneumothorax ) ... this surgery include: Failure of the lung to expand Injury to the lungs or blood vessels Need ...

  16. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    NARCIS (Netherlands)

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans; Olsson, Ann

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema,

  17. [Methods of interpreting pulmonary gas exchange].

    Science.gov (United States)

    Schaffartzik, W

    1993-01-01

    When arterial and mixed venous blood gas tensions, inspired and expired O2 and expired CO2 concentrations are known, it is possible to calculate the alveolar-arterial PO2 difference, intrapulmonary right-to-left shunt and dead space ventilation. However, because arterial hypoxemia is caused by ventilation/perfusion mismatching in most cases, a method allowing analysis of ventilation/perfusion ratios is needed. The "multiple inert gas elimination technique" (MIGET) is a powerful method that is useful for this purpose. This technique is based on measurements of arterial, venous and expired levels of inert gases spanning a wide range of solubility and analysis of the lung for the ventilation/perfusion ratios from true shunt to dead space ventilation. True shunt, with ventilation/perfusion ratios of 0, can be differentiated from ventilation/perfusion ratios of 0.005, and dead space ventilation can be distinguished from ventilation/perfusion ratios over 10 and under 100. Ventilation/perfusion ratios between these extremes can also be differentiated. It is not unusual for results yielded by MIGET to differ from those obtained with O2-dependent methods: O2 shunt generally exceeds MIGET shunt, for example, because O2 shunt includes low ventilation/perfusion units.

  18. Improved oxygenation by nitric oxide is enhanced by prior lung reaeration with surfactant, rather than positive end-expiratory pressure, in lung-lavaged rabbits

    NARCIS (Netherlands)

    D.A.M.P.J. Gommers (Diederik); A. Hartog (Arthur); A. van 't Veen (Annemarie); B.F. Lachmann (Burkhard)

    1997-01-01

    textabstractObjectives: The inhalation of nitric oxide increases oxygenation by improving the ventilation/perfusion ratios in neonates with respiratory distress syndrome and those ratios in adults with acute respiratory distress syndrome. There is evidence that inhaled nitric oxide is ineffective

  19. Functionalized synchrotron in-line phase-contrast computed tomography: a novel approach for simultaneous quantification of structural alterations and localization of barium-labelled alveolar macrophages within mouse lung samples.

    Science.gov (United States)

    Dullin, Christian; dal Monego, Simeone; Larsson, Emanuel; Mohammadi, Sara; Krenkel, Martin; Garrovo, Chiara; Biffi, Stefania; Lorenzon, Andrea; Markus, Andrea; Napp, Joanna; Salditt, Tim; Accardo, Agostino; Alves, Frauke; Tromba, Giuliana

    2015-01-01

    Functionalized computed tomography (CT) in combination with labelled cells is virtually non-existent due to the limited sensitivity of X-ray-absorption-based imaging, but would be highly desirable to realise cell tracking studies in entire organisms. In this study we applied in-line free propagation X-ray phase-contrast CT (XPCT) in an allergic asthma mouse model to assess structural changes as well as the biodistribution of barium-labelled macrophages in lung tissue. Alveolar macrophages that were barium-sulfate-loaded and fluorescent-labelled were instilled intratracheally into asthmatic and control mice. Mice were sacrificed after 24 h, lungs were kept in situ, inflated with air and scanned utilizing XPCT at the SYRMEP beamline (Elettra Synchrotron Light Source, Italy). Single-distance phase retrieval was used to generate data sets with ten times greater contrast-to-noise ratio than absorption-based CT (in our setup), thus allowing to depict and quantify structural hallmarks of asthmatic lungs such as reduced air volume, obstruction of airways and increased soft-tissue content. Furthermore, we found a higher concentration as well as a specific accumulation of the barium-labelled macrophages in asthmatic lung tissue. It is believe that XPCT will be beneficial in preclinical asthma research for both the assessment of therapeutic response as well as the analysis of the role of the recruitment of macrophages to inflammatory sites.

  20. Pulmonary blood volume and transit time in cirrhosis: relation to lung function

    DEFF Research Database (Denmark)

    Møller, Søren; Burchardt, H; Øgard, CG

    2006-01-01

    BACKGROUND/AIMS: In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has...

  1. Functional lung MRI in chronic obstructive pulmonary disease: comparison of T1 mapping, oxygen-enhanced T1 mapping and dynamic contrast enhanced perfusion.

    Directory of Open Access Journals (Sweden)

    Bertram J Jobst

    Full Text Available Monitoring of regional lung function in interventional COPD trials requires alternative endpoints beyond global parameters such as FEV1. T1 relaxation times of the lung might allow to draw conclusions on tissue composition, blood volume and oxygen fraction. The aim of this study was to evaluate the potential value of lung Magnetic resonance imaging (MRI with native and oxygen-enhanced T1 mapping for the assessment of COPD patients in comparison with contrast enhanced perfusion MRI.20 COPD patients (GOLD I-IV underwent a coronal 2-dimensional inversion recovery snapshot flash sequence (8 slices/lung at room air and during inhalation of pure oxygen, as well as dynamic contrast-enhanced first-pass perfusion imaging. Regional distribution of T1 at room air (T1, oxygen-induced T1 shortening (ΔT1 and peak enhancement were rated by 2 chest radiologists in consensus using a semi-quantitative 3-point scale in a zone-based approach.Abnormal T1 and ΔT1 were highly prevalent in the patient cohort. T1 and ΔT1 correlated positively with perfusion abnormalities (r = 0.81 and r = 0.80; p&0.001, and with each other (r = 0.80; p<0.001. In GOLD stages I and II ΔT1 was normal in 16/29 lung zones with mildly abnormal perfusion (15/16 with abnormal T1. The extent of T1 (r = 0.45; p<0.05, ΔT1 (r = 0.52; p<0.05 and perfusion abnormalities (r = 0.52; p<0.05 showed a moderate correlation with GOLD stage.Native and oxygen-enhanced T1 mapping correlated with lung perfusion deficits and severity of COPD. Under the assumption that T1 at room air correlates with the regional pulmonary blood pool and that oxygen-enhanced T1 reflects lung ventilation, both techniques in combination are principally suitable to characterize ventilation-perfusion imbalance. This appears valuable for the assessment of regional lung characteristics in COPD trials without administration of i.v. contrast.

  2. Lung density

    DEFF Research Database (Denmark)

    Garnett, E S; Webber, C E; Coates, G

    1977-01-01

    The density of a defined volume of the human lung can be measured in vivo by a new noninvasive technique. A beam of gamma-rays is directed at the lung and, by measuring the scattered gamma-rays, lung density is calculated. The density in the lower lobe of the right lung in normal man during quiet...... breathing in the sitting position ranged from 0.25 to 0.37 g.cm-3. Subnormal values were found in patients with emphsema. In patients with pulmonary congestion and edema, lung density values ranged from 0.33 to 0.93 g.cm-3. The lung density measurement correlated well with the findings in chest radiographs...... but the lung density values were more sensitive indices. This was particularly evident in serial observations of individual patients....

  3. What Is Lung Cancer?

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... starts in the lungs, it is called lung cancer. Lung cancer begins in the lungs and may spread ...

  4. Dynamic Changes in Shunt and Ventilation-Perfusion Mismatch Following Experimental Pulmonary Contusion

    Science.gov (United States)

    2010-04-01

    microcoagulation system (ITC Europe, Rodano, Italy). Fibrinogen; prothrombin time (PT), in seconds; and activated partial thromboplastin time (aPTT...clot formation rate, TEG MA, maximum clot strength, ACT, activated clotting time, PT, prothrombin time, aPTT, activated partial thromboplastin ...times or greater from normal of the international normalized ratio takes place (26, 27), measures derived by TEG may be more sensitive (28, 29). TEG

  5. Ventilation-Perfusion Alterations after Inhalation Injury in an Ovine Model

    Science.gov (United States)

    1996-05-01

    derived from the VA/ VD/VT 41.2% Q distribution. Measured Pa0 2 and estimated Pa0 2 from o the VA/Q distribution for the 47 sheep in this studyC 0.2...partly by using reported increased high VA/Q and dead space ventila- MS as the detector. If this were the case , then with tion soon after smoke exposure...Table 4), in many cases , with hypercapnia. In animals that developed suppurative bronchopneumo- the present study, even though mean values did not nia

  6. Accuracy and Utility of Deformable Image Registration in {sup 68}Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hardcastle, Nicholas, E-mail: nick.hardcastle@gmail.com [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Hofman, Michael S. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Hicks, Rodney J. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Department of Medicine, University of Melbourne, Melbourne (Australia); Callahan, Jason [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Kron, Tomas [Department of Medical Imaging and Radiation Sciences, Monash University, Clayton (Australia); The Sir Peter MacCallum Department of Oncology, Melbourne University, Victoria (Australia); MacManus, Michael P.; Ball, David L. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne (Australia); Jackson, Price [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Siva, Shankar [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia)

    2015-09-01

    Purpose: Measuring changes in lung perfusion resulting from radiation therapy dose requires registration of the functional imaging to the radiation therapy treatment planning scan. This study investigates registration accuracy and utility for positron emission tomography (PET)/computed tomography (CT) perfusion imaging in radiation therapy for non–small cell lung cancer. Methods: {sup 68}Ga 4-dimensional PET/CT ventilation-perfusion imaging was performed before, during, and after radiation therapy for 5 patients. Rigid registration and deformable image registration (DIR) using B-splines and Demons algorithms was performed with the CT data to obtain a deformation map between the functional images and planning CT. Contour propagation accuracy and correspondence of anatomic features were used to assess registration accuracy. Wilcoxon signed-rank test was used to determine statistical significance. Changes in lung perfusion resulting from radiation therapy dose were calculated for each registration method for each patient and averaged over all patients. Results: With B-splines/Demons DIR, median distance to agreement between lung contours reduced modestly by 0.9/1.1 mm, 1.3/1.6 mm, and 1.3/1.6 mm for pretreatment, midtreatment, and posttreatment (P<.01 for all), and median Dice score between lung contours improved by 0.04/0.04, 0.05/0.05, and 0.05/0.05 for pretreatment, midtreatment, and posttreatment (P<.001 for all). Distance between anatomic features reduced with DIR by median 2.5 mm and 2.8 for pretreatment and midtreatment time points, respectively (P=.001) and 1.4 mm for posttreatment (P>.2). Poorer posttreatment results were likely caused by posttreatment pneumonitis and tumor regression. Up to 80% standardized uptake value loss in perfusion scans was observed. There was limited change in the loss in lung perfusion between registration methods; however, Demons resulted in larger interpatient variation compared with rigid and B-splines registration

  7. Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism

    DEFF Research Database (Denmark)

    Borgwardt, Henrik Gutte; Mortensen, Jann; Jensen, Claus Verner

    2010-01-01

    Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography...

  8. Inhaled anticoagulation regimens for the treatment of smoke inhalation-associated acute lung injury: a systematic review.

    Science.gov (United States)

    Miller, Andrew C; Elamin, Elamin M; Suffredini, Anthony F

    2014-02-01

    Inhaled anticoagulation regimens are increasingly being used to manage smoke inhalation-associated acute lung injury. We systematically reviewed published and unpublished preclinical and clinical trial data to elucidate the effects of these regimens on lung injury severity, airway obstruction, ventilation, oxygenation, pulmonary infections, bleeding complications, and survival. PubMed, Scopus, EMBASE, and Web of Science were searched to identify relevant published studies. Relevant unpublished studies were identified by searching the Australian and New Zealand Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform, Cochrane Library, ClinicalTrials.gov, MINDCULL.com, Current Controlled Trials, and Google. Inclusion criteria were any preclinical or clinical study in which 1) animals or subjects experienced smoke inhalation exposure, 2) they were treated with nebulized or aerosolized anticoagulation regimens, including heparin, heparinoids, antithrombins, or fibrinolytics (e.g., tissue plasminogen activator), 3) a control and/or sham group was described for preclinical studies, and 4) a concurrent or historical control group described for clinical studies. Exclusion criteria were 1) the absence of a group treated with a nebulized or aerosolized anticoagulation regimen, 2) the absence of a control or sham group, and 3) case reports. Ninety-nine potentially relevant references were identified. Twenty-seven references met inclusion criteria including 19 preclinical references reporting 18 studies and eight clinical references reporting five clinical studies. A systematic review of the literature is provided. Both clinical and methodological diversity precluded combining these studies in a meta-analysis. The high mortality associated with smoke inhalation-associated acute lung injury results from airway damage, mucosal dysfunction, neutrophil infiltration, airway coagulopathy with cast formation, ventilation-perfusion

  9. Lung Cancer

    Science.gov (United States)

    Lung cancer is one of the most common cancers in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking causes most lung cancers. The more cigarettes you smoke per day and ...

  10. Lung cancer

    OpenAIRE

    Neville, Alan J

    2009-01-01

    Lung cancer is the leading cause of cancer deaths in both men and women, with 80-90% of cases caused by smoking. Small cell lung cancer accounts for 20% of all cases, and is usually treated with chemotherapy. Adenocarcinoma is the main non-small cell pathology, and is treated initially with surgery.

  11. Lung cancer

    OpenAIRE

    Neville, Alan J; Kuruvilla, Mridula Sara

    2010-01-01

    Lung cancer is the leading cause of cancer deaths in both men and women, with 80% to 90% of cases caused by smoking. Small cell lung cancer accounts for 20% of all cases, and is usually treated with chemotherapy. Adenocarcinoma is the main non-small cell pathology, and is treated initially with surgery.

  12. Lung Cancer Screening

    Science.gov (United States)

    ... factors increase or decrease the risk of lung cancer. Lung cancer is a disease in which malignant (cancer) ... following PDQ summaries for more information about lung cancer: Lung Cancer Prevention Non-Small Cell Lung Cancer Treatment ...

  13. Single Stage Transthoracic Approach to the Right Lung and Liver Dome Hydatid Cysts

    Directory of Open Access Journals (Sweden)

    Rasih Yazkan

    2011-09-01

    lung, the hepatic lesions were all of the dome located. Conclusions :Single stage transthoracic approach is prevent the second surgical procedures on simultaneous right lung and liver dome hydatid cyst and it is safe and effective method.

  14. Lung Transplant

    Science.gov (United States)

    ... will recover in the hospital’s intensive care unit (ICU) before moving to a hospital room for one to three weeks. Your doctor may recommend pulmonary rehabilitation after your lung transplant surgery to help you ...

  15. Lung allocation.

    Science.gov (United States)

    Gottlieb, Jens

    2017-08-01

    Shortage of donor lungs in most western countries and broadening of indications for lung transplantation (LTx) has led increased waiting list mortality in the past. Usually donor lungs and recipients are matched by size as measured by total lung capacity and blood type in first order. In some countries regional allocation comes first, in other countries a national wait list exists and some nations are organized in supranational allocation systems. Organ distribution should respect the ethical principles of equity, justice, beneficence and utility. Generally, top priority on the list should be given to patients with the least amount of time to live but outcome is an important factor to consider to avoid futile transplantations. Installation of an urgency status will decrease mortality of the sickest candidates on the waitlist unless the proportion of patients on urgency status will be too high. Urgency can be determined by clinical judgment (so called center decision), an audit process or objectively by a score system. Among the 3,500 transplants performed worldwide annually, approximately 60% are allocated by lung allocation score (LAS) (US, Germany, the Netherlands). With the LAS a model for survival prediction after lung transplantation and wait list survival probability was created. Clinical experience in the US since 2005 and in Germany since 2011 favourable reports regarding effects on waiting list outflow, transplant activity and outcomes have been published. Future perspectives will focus on broader geographic sharing, updating and further development of the LAS.

  16. Horseshoe lung with left lung hypoplasia.

    OpenAIRE

    Ersöz, A; Soncul, H; Gökgöz, L; Kalaycioğlu, S; Tunaoğlu, S; Kaptanoğlu, M; Yener, A

    1992-01-01

    Horseshoe lung is an uncommon congenital malformation in which the bases of the right and the left lungs are fused to each other by a narrow isthmus posterior to the cardiac apex. So far 22 cases have been described: most of these were associated with right lung hypoplasia and the scimitar syndrome. A horseshoe lung anomaly with left lung hypoplasia is described.

  17. Simultaneous Cake Cutting

    DEFF Research Database (Denmark)

    Balkanski, Eric; Branzei, Simina; Kurokawa, David

    2014-01-01

    We introduce the simultaneous model for cake cutting (the fair allocation of a divisible good), in which agents simultaneously send messages containing a sketch of their preferences over the cake. We show that this model enables the computation of divisions that satisfy proportionality — a popular...

  18. Personality and Simultaneous Speech.

    Science.gov (United States)

    Feldstein, Stanley; And Others

    The purpose of the study was to examine the relationship of the limitation and outcome of simultaneous speech to those dimensions of personality indexes by Cattell's 16PF Questionnaire. More than 500 conversations of 24 female college students were computer-analyzed for instances of simultaneous speech, and the frequencies with which they…

  19. Lung Cancer: Glossary

    Science.gov (United States)

    ... professional support team today. Learn More . Find more lung cancer resources. Learn More Donate Today! What is Lung ... to Give How Your Support Helps Events Lung Cancer Awareness © Lung Cancer Alliance. The information presented in this website ...

  20. Tsunami lung.

    Science.gov (United States)

    Inoue, Yoshihiro; Fujino, Yasuhisa; Onodera, Makoto; Kikuchi, Satoshi; Shozushima, Tatsuyori; Ogino, Nobuyoshi; Mori, Kiyoshi; Oikawa, Hirotaka; Koeda, Yorihiko; Ueda, Hironobu; Takahashi, Tomohiro; Terui, Katsutoshi; Nakadate, Toshihide; Aoki, Hidehiko; Endo, Shigeatsu

    2012-04-01

    We encountered three cases of lung disorders caused by drowning in the recent large tsunami that struck following the Great East Japan Earthquake. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within 3 weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Sputum culture for bacteria yielded isolation of Stenotrophomonas maltophilia, Legionella pneumophila, Burkholderia cepacia, and Pseudomonas aeruginosa. The cause of tsunami lung may be a combination of chemical induced pneumonia and bacterial pneumonia.

  1. Semiquantification and classification of local pulmonary function by V/Q single photon emission computed tomography in patients with non-small cell lung cancer: potential indication for radiotherapy planning.

    Science.gov (United States)

    Yuan, Shuanghu Tiger; Frey, Kirk A; Gross, Milton D; Hayman, James A; Arenberg, Doug; Curtis, Jeffrey L; Cai, Xu-Wei; Ramnath, Nithya; Kalemkerian, Gregory P; Ten Haken, Randall K; Eisbruch, Avraham; Kong, Feng-Ming Spring

    2011-01-01

    Perfusion (Q) single photon emission computed tomography (SPECT) has been used to divert dose away from higher-functioning lung during radiation therapy (RT) planning. This study aimed to (1) study regional lung function through coregistered pulmonary ventilation/perfusion (V/Q)-SPECT-CT and (2) classify these defects for its potential value in radiation planning in patients with non-small cell lung cancer (NSCLC). Patients with stages I to III NSCLC requiring radiation-based therapy were eligible for this prospective study. V/Q-SPECT performed within 2 weeks before the start of radiation was interpreted by nuclear medicine physicians and then measured by a semiquantitative score. The potential mechanism of V and Q defects was analyzed; the potential impact of V/Q-SPECT over Q-SPECT alone was completed through classified applications (high-dose RT versus RT avoidance) during planning. Images of 51 consecutive patients were analyzed. The V and Q defects were matched, reverse mismatched (V defect > Q defect), and mismatched (Q defect > V defect) in 61, 31, and 8% of patients, respectively. Tumor was the leading cause of the defects of ipsilateral lung in 73% of patients. The defect scores of the ipsilateral lung were greater in patients with central primaries than those with peripheral primaries for both V-SPECT (2.3 ± 1.1 versus 1.5 ± 0.8, p = 0.017) and Q-SPECT (2.2 ± 0.8 versus 1.4 ± 0.6, p = 0.000). The patients with chronic obstructive pulmonary disease had greater defect scores in contralateral lung for both V-SPECT (1.5 ± 0.7 versus 1.0 ± 0.8, p = 0.006) and Q-SPECT (1.4 ± 0.6 versus 1.0 ± 0.4, p = 0.010). On assessing the potential value of SPECT on RT plan, 39% of patients could have their RT plan when applying V/Q-SPECT rather than Q-SPECT alone. V/Q-SPECT provides a more comprehensive functional assessment, may provide additional value over Q-SPECT alone in assessing local pulmonary function, and guide RT plan decisions in patients with NSCLC.

  2. Suppression in simultaneous masking.

    Science.gov (United States)

    Fastl, H; Bechly, M

    1983-09-01

    Suppression, i.e., the decrease of masked threshold caused by the addition of a second masker M2 to a first masker M1, is measured for the case of simultaneous masking. The magnitude of suppression decreases with increasing test tone duration; pulsed maskers elicit somewhat more suppression than continuous maskers. In comparison to suppression effects obtained in nonsimultaneous masking (post-masking, pulsation threshold) suppression in simultaneous masking is considerably smaller and was found only at the lower slopes of the two maskers. Suppression in simultaneous masking would not be predicted by those models of suppression which require nonsimultaneous presentation of maskers and test sound.

  3. Welders’ lung

    Directory of Open Access Journals (Sweden)

    Izidor Kern

    2010-02-01

    Conclusions: h is study coni rms that longterm welders may have symptoms with no functional disorders, but with prominent morphological changes. h e key to correct diagnosis is an occupational history of the patient. Diagnostic work-up includes funda-mental procedures in suspected interstitial lung disease. h e best therapy is cessation of exposure.

  4. Lung cancer

    DEFF Research Database (Denmark)

    Hansen, H H; Rørth, M

    1999-01-01

    The results of the many clinical trials published in 1997 had only modest impact on the treatment results using either cytostatic agents alone or combined with radiotherapy in lung cancer. In SCLC, combination chemotherapy including platin-compounds (cisplatin, carboplatin) and the podophyllotoxins...

  5. Metasurfaces: Simultaneous Stokes parameters

    Science.gov (United States)

    Lepetit, Thomas; Kanté, Boubacar

    2015-11-01

    Techniques for determining Stokes parameters, which fully define the polarization state of a wave, require multiple measurements, thus potentially leading to inaccuracies. Researchers now show how to simultaneously determine the parameters for visible light using periodic metal structures.

  6. Simultaneous consolidation and creep

    DEFF Research Database (Denmark)

    Krogsbøll, Anette

    1997-01-01

    Materials that exhibit creep under constant effective stress typically also show rate dependent behavior. The creep deformations and the rate sensitive behavior is very important when engineering and geological problems with large time scales are considered. When stress induced compaction (consol...... (consolidation) is retarded by slow drainage of excess pore pressure it is expected that consolidation and creep occur simultaneously. A constitutive model adressing the problems of rate sensitive behavior and simultaneous consolidation and creep is presented....

  7. Simultaneous resection of pulmonary tumor following cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Ryosuke Kaku

    2017-03-01

    Conclusion: The simultaneous resection of pulmonary tumor following cardiovascular surgery is safely performed, and is useful for the pathological diagnosis of the tumor. Further studies are warranted, however, this procedure may contribute to controlling the progression of lung cancer in patients with cardiovascular disease with comorbidities.

  8. Simultaneity, relativity and conventionality

    Science.gov (United States)

    Janis, Allen I.

    2008-01-01

    The view of simultaneity presented by Max Jammer is almost breathtaking, encompassing, as the book's subtitle suggests, the period from antiquity to the 21st century. Many interesting things are to be found along the way. For example, what Jammer (p. 49) says "may well be regarded as probably the earliest recorded example of an operational definition of distant simultaneity" is due to St. Augustine (in his Confessions, written in 397 A.D.; for a modern translation, see Augustine, 2006). He was arguing against astrology by presenting the story of two women, one rich and one poor, who gave birth simultaneously. Although the two children thus had precisely the same horoscopes, their lives followed quite different courses. And how was it determined that the births were simultaneous? A messenger went from each birth site to the other, leaving the instant the child was born (and, presumably, traveling with equal speeds). Since the messengers met at the midpoint between the locations of the two births, the births must have been simultaneous. This is, of course, quite analogous to Albert Einstein's definition of simultaneity (given more than 1500 years later), which will be discussed in Section 2.1.

  9. Two simultaneous autoimmune processes in a patient presenting with respiratory insufficiency.

    Science.gov (United States)

    Troy, Lauren; Hamor, Paul; Bleasel, Jane; Corte, Tamera

    2014-03-01

    The idiopathic inflammatory myopathies, including dermatomyositis, are uncommon acquired autoimmune diseases, sometimes associated with interstitial lung disease. Myasthenia gravis, a separate autoimmune disorder involving the neuromuscular junction, has some overlapping clinical features but has only rarely been reported to occur simultaneously within the same patient. Here we present the first reported case of concomitant dermatomyositis, myasthenia gravis, and interstitial lung disease.

  10. Reporting of perfusion/ventilation lung scintigraphy using an anatomical lung segment chart: a prospective study.

    Science.gov (United States)

    Van Beek, E J; Tiel-Van Buul, M M; Hoefnagel, C A; Jagt, H H; Van Royen, E A

    1994-09-01

    This study prospectively evaluated the effect of the consistent use of a previously described anatomical lung segment chart on the interpretation of lung scans. Simultaneous perfusion/ventilation lung scintigraphy was performed in 221 consecutive patients with clinically suspected pulmonary embolism. Lung scans were immediately reported as normal, high probability or non-diagnostic with the use of an anatomical lung segment chart. After at least 6 months, blinded lung scans were randomly read by a panel of nuclear medicine physicians. Initial lung scan reports were classified as normal, high probability or non-diagnostic in 64, 63 and 94 patients, respectively. Overall observer disagreement was 5.9% (95% confidence interval (CI) 3.2-9.8%), while this was 7.8, 3.2 and 7.9% for lung scans that were initially reported as normal, non-diagnostic and high probability, respectively. Reclassification consisted of normal to non-diagnostic (5), non-diagnostic to normal (1), non-diagnostic to high probability (2), and high probability to non-diagnostic scan results (5). From the literature, an overall disagreement of 20% was expected if no chart had been used. In conclusion, this study confirms that the consistent use of a lung segment chart reduces observer disagreement in the reporting of lung scans.

  11. Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood.

    Science.gov (United States)

    García-de-la-Asunción, José; García-del-Olmo, Eva; Perez-Griera, Jaume; Martí, Francisco; Galan, Genaro; Morcillo, Alfonso; Wins, Richard; Guijarro, Ricardo; Arnau, Antonio; Sarriá, Benjamín; García-Raimundo, Miguel; Belda, Javier

    2015-09-01

    During lung lobectomy, the operated lung is collapsed and hypoperfused; oxygen deprivation is accompanied by reactive hypoxic pulmonary vasoconstriction. After lung lobectomy, ischaemia present in the collapsed state is followed by expansion-reperfusion and lung injury attributed to the production of reactive oxygen species. The primary objective of this study was to investigate the time course of several markers of oxidative stress simultaneously in exhaled breath condensate and blood and to determine the relationship between oxidative stress and one-lung ventilation time in patients undergoing lung lobectomy. This single-centre, observational, prospective study included 28 patients with non-small-cell lung cancer who underwent lung lobectomy. We measured the levels of hydrogen peroxide, 8-iso-PGF2α, nitrites plus nitrates and pH in exhaled breath condensate (n = 25). The levels of 8-iso-PGF2α and nitrites plus nitrates were also measured in blood (n = 28). Blood samples and exhaled breath condensate samples were collected from all patients at five time points: preoperatively; during one-lung ventilation, immediately before resuming two-lung ventilation; immediately after resuming two-lung ventilation; 60 min after resuming two-lung ventilation and 180 min after resuming two-lung ventilation. Both exhaled breath condensate and blood exhibited significant and simultaneous increases in oxidative-stress markers immediately before two-lung ventilation was resumed. However, all these values underwent larger increases immediately after resuming two-lung ventilation. In both exhaled breath condensate and blood, marker levels significantly and directly correlated with the duration of one-lung ventilation immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation. Although pH significantly decreased in exhaled breath condensate immediately after resuming two-lung ventilation, these pH values were inversely correlated with the

  12. Sarcoid lung

    OpenAIRE

    Andrade, Carina; Marinho, Ant��nio

    2015-01-01

    Sarcoidosis is a multisystem disease with a varied clinical presentation. The lung disease is common and is responsible for most of the morbidity and mortality associated with sarcoidosis. Tuberculosis remains a prevalent disease in some countries, such as Portugal. There are reports of sequential occurrence of these identities. The authors present a case of a patient with lymphatic tuberculosis who, some years after treatment of this infection, was diagnosed with sarcoidosis in an atypical p...

  13. How Lungs Work

    Science.gov (United States)

    ... To Quit Help Someone Quit Join Freedom From Smoking GET INVOLVED Events Become An Advocate Volunteer Ways To Give www.lung.org > Lung Health and Diseases > How Lungs Work How Lungs Work The Respiratory System Your lungs are part of the respiratory system, ...

  14. Nutrition for Lung Cancer

    Science.gov (United States)

    ... How Do I Stay Healthy Share this page: Nutrition for Lung Cancer Patients Key Points There is ... lung cancer symptoms, making them worse or better. Nutrition Goals Each person's nutritional needs during lung cancer ...

  15. Lung diffusion testing

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003854.htm Lung diffusion testing To use the sharing features on this page, please enable JavaScript. Lung diffusion testing measures how well the lungs exchange gases. This ...

  16. Lung cancer - small cell

    Science.gov (United States)

    ... carcinoma Small cell carcinoma Squamous cell carcinoma Secondhand smoke and lung cancer Normal lungs and alveoli Respiratory system Smoking hazards Bronchoscope References Horn L, Eisenberg R, ...

  17. Comparison of V/Q SPECT and planar V/Q lung scintigraphy in diagnosing acute pulmonary embolism

    DEFF Research Database (Denmark)

    Borgwardt, Henrik Gutte; Mortensen, Jann; Jensen, Claus Verner

    2010-01-01

    Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography...... (SPECT) in diagnosing PE. This study evaluated the diagnostic performance of three-dimensional V/Q SPECT in comparison with planar V/Q scintigraphy....

  18. Needle Biopsy of the Lung

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Needle Biopsy of the Lung Needle biopsy of the lung ... Needle Biopsy of Lung Nodules? What is Needle Biopsy of the Lung? A lung nodule is relatively ...

  19. Genetics Home Reference: lung cancer

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Lung cancer Lung cancer Printable PDF Open All Close All Enable Javascript ... Lung Cancer Additional NIH Resources (3 links) National Cancer Institute: Lung Cancer Overview National Cancer Institute: Lung Cancer Prevention ...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Screening for lung cancer

    NARCIS (Netherlands)

    Prosch, H.; Schaefer-Prokop, C.M.

    2014-01-01

    The purpose of this review is to provide an update on the current data about low-dose computed tomography (LD-CT) lung cancer screening.The National Lung Screening Trial (NLST) was the first study that provided statistical evidence that LD-CT screening for lung cancer significantly reduces lung

  2. Staging of Lung Cancer

    Science.gov (United States)

    ... LUNG CANCER MINI-SERIES #2 Staging of Lung Cancer Once your lung cancer is diagnosed, staging tells you and your health care provider about ... at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV ...

  3. Lung Cancer Screening

    Science.gov (United States)

    ... experience complications from follow-up tests. For this reason, lung cancer screening is offered to people who are in ... is more likely to be cancerous. For that reason, you might be referred to a lung ... problems. Your lung cancer screening test may detect other lung and heart ...

  4. Simultaneous Inference in Regression

    CERN Document Server

    Liu, Wei

    2010-01-01

    The use of simultaneous confidence bands in linear regression is a vibrant area of research. This book presents an overview of the methodology and applications, including necessary background material on linear models. A special chapter on logistic regression gives readers a glimpse into how these methods can be used for generalized linear models. The appendices provide computational tools for simulating confidence bands. The author also includes MATLAB[registered] programs for all examples on the web. With many numerical examples and software implementation, this text serves the needs of rese

  5. Geodesics of simultaneity in Schwarzschild

    CERN Document Server

    Paiva, F M

    2010-01-01

    Geodesic of simultaneity is a spacelike geodesic in which every pair of neighbour events are simultaneous ($g_{0\\mu}\\dd x^\\mu=0$). These geodesics are studied in the exterior region of \\Sch's metric.

  6. Simultaneous alcohol and cannabis expectancies predict simultaneous use

    Directory of Open Access Journals (Sweden)

    Earleywine Mitch

    2006-10-01

    Full Text Available Abstract Background Simultaneous use of alcohol and cannabis predicts increased negative consequences for users beyond individual or even concurrent use of the two drugs. Given the widespread use of the drugs and common simultaneous consumption, problems unique to simultaneous use may bear important implications for many substance users. Cognitive expectancies offer a template for future drug use behavior based on previous drug experiences, accurately predicting future use and problems. Studies reveal similar mechanisms underlying both alcohol and cannabis expectancies, but little research examines simultaneous expectancies for alcohol and cannabis use. Whereas research has demonstrated unique outcomes associated with simultaneous alcohol and cannabis use, this study hypothesized that unique cognitive expectancies may underlie simultaneous alcohol and cannabis use. Results: This study examined a sample of 2600 (66% male; 34% female Internet survey respondents solicited through advertisements with online cannabis-related organizations. The study employed known measures of drug use and expectancies, as well as a new measure of simultaneous drug use expectancies. Expectancies for simultaneous use of alcohol and cannabis predicted simultaneous use over and above expectancies for each drug individually. Discussion Simultaneous expectancies may provide meaningful information not available with individual drug expectancies. These findings bear potential implications on the assessment and treatment of substance abuse problems, as well as researcher conceptualizations of drug expectancies. Policies directing the treatment of substance abuse and its funding ought to give unique consideration to simultaneous drug use and its cognitive underlying factors.

  7. Note on Magnetism and Simultaneity

    Science.gov (United States)

    Huggins, Elisha

    2009-01-01

    The paper on "Magnetism and Simultaneity" by Adler provides an excellent new thought experiment involving the lack of simultaneity in Einstein's special relativity. Adler uses the lack of simultaneity rather than the Lorentz contraction to derive the formula for the magnetic force on a moving charged particle. Advantages of his derivation are that…

  8. Simultaneous Immersion Mirau Interferometry

    Science.gov (United States)

    Lyulko, Oleksandra

    acquisition challenging. This problem was resolved by integration of polarization optics into the optics of the attachment to enable simultaneous creation and spatial separation of two interferograms, which, combined with the background image, are used to reconstruct the intensity map of the specimen. Giving the name Simultaneous Immersion Mirau Interferometry to this approach, simultaneous acquisition of all interferograms per image has eliminated the issue of vibrations. The designed compound microscope attachment has been manufactured and tested; the system produces images of quality, sufficient to perform targeted cellular irradiation experiments.

  9. Oleic acid vs saline solution lung lavage-induced acute lung injury: effects on lung morphology, pressure-volume relationships, and response to positive end-expiratory pressure.

    Science.gov (United States)

    Luecke, Thomas; Meinhardt, Juergen P; Herrmann, Peter; Weiss, Andreas; Quintel, Michael; Pelosi, Paolo

    2006-08-01

    To compare two lung injury models (oleic acid [OA] and saline solution washout [SW]) regarding lung morphology, regional inflation, and recruitment during static pressure-volume (PV) curves, and the effects of positive end-expiratory pressure (PEEP) below and above the lower inflection point (Pflex). Fourteen adult pigs underwent OA or SW lung injury. Lung volumes were measured using CT. PV curves were obtained with simultaneous CT scanning at lung apex and base. Fractional inflation and recruitment were compared to data on PEEP above and below Pflex. Severity of lung injury was comparable. At zero PEEP, SW showed an increased amount of edema and poorly aerated lung volume, recruitment during inspiration, and a better oxygenation response with PEEP. Whole-lung PV curves were similar in both models, reflecting changes in alveolar inflation or deflation. On the inspiratory PV limb, recruitment and inflation were on the same line, while there was a substantial difference between deflation and derecruitment on the expiratory limb. PEEP-induced recruitment at lung apex and base was at or above the derecruitment line on the expiratory limb and showed no relationship to the whole-lung expiratory PV curve. The following conclusions were made: (1) OA and SW models are comparable in mechanics but not in lung injury characteristics; (2) neither inspiratory nor expiratory whole-lung PV curves are useful to select PEEP in order to optimize recruitment; and (3) after recruitment, there is no difference in derecruitment between the models at high PEEP, while more collapse occurs at lower PEEP in the basal sections of SW lungs.

  10. Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

    Science.gov (United States)

    Ambrosio, Aline M; Luo, Rubin; Fantoni, Denise T; Gutierres, Claudia; Lu, Qin; Gu, Wen-Jie; Otsuki, Denise A; Malbouisson, Luiz M S; Auler, Jose O C; Rouby, Jean-Jacques

    2012-12-01

    In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.

  11. Epidemiology of Lung Cancer

    Science.gov (United States)

    Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

    2013-01-01

    Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

  12. Extravascular Lung Water and Acute Lung Injury

    OpenAIRE

    Ritesh Maharaj

    2012-01-01

    Acute lung injury carries a high burden of morbidity and mortality and is characterised by nonhydrostatic pulmonary oedema. The aim of this paper is to highlight the role of accurate quantification of extravascular lung water in diagnosis, management, and prognosis in “acute lung injury” and “acute respiratory distress syndrome”. Several studies have verified the accuracy of both the single and the double transpulmonary thermal indicator techniques. Both experimental and clinical studies were...

  13. Plasma ADMA concentrations at birth and mechanical ventilation in preterm infants: a prospective pilot study

    NARCIS (Netherlands)

    Richir, M.C.; van Leeuwen, P.A.M.; van den Berg, A.; Wessels, R.; Twisk, J.W.R.; Rauwerda, J.A.; Teerlink, T.; de Vries, T.P.G.M.; van Elburg, R.M.

    2008-01-01

    Rationale Nitric oxide (NO) produced in the lung is an important mediator of normal lung development, vascular smooth muscle relaxation, and ventilation perfusion matching. NO is synthesized from arginine by the action of NO-synthase (NOS). Asymmetric dimethylarginine (ADMA), an endogenous derivate

  14. Plasma ADMA concentrations at birth and mechanical ventilation in preterm infants: a prospective pilot study

    NARCIS (Netherlands)

    Richir, Milan C.; van Leeuwen, Paul A. M.; van den Berg, Anemone; Wessels, Ronni; Twisk, Jos W. R.; Rauwerda, Jan A.; Teerlink, Tom; de Vries, Theo P. G. M.; van Elburg, Ruurd M.

    2008-01-01

    Nitric oxide (NO) produced in the lung is an important mediator of normal lung development, vascular smooth muscle relaxation, and ventilation perfusion matching. NO is synthesized from arginine by the action of NO-synthase (NOS). Asymmetric dimethylarginine (ADMA), an endogenous derivate of

  15. Radiation Therapy for Lung Cancer

    Science.gov (United States)

    ... is almost always due to smoking. TREATING LUNG CANCER Lung cancer treatment depends on several factors, including the ... org TARGETING CANCER CARE Radiation Therapy for Lung Cancer Lung cancer is the second most common cancer in ...

  16. Simultaneity in Emotional Moments

    Science.gov (United States)

    Clore, Gerald L.

    Emotions are described as emergent states, which exist only to the extent that multiple affective reactions to the same object occur at the same time. Emotions are thus the confluence of thoughts, feelings, expressions, desires, and so on. They emerge as meta-cognitive representations of embodied affective reactions. Emotions may be initiated by low-level, automatic, unconscious affective reactions, which are then iteratively re-processed with ever greater cognitive involvement until they become elaborated into emotional states. Affective and emotional reactions act as information about the value of objects of judgment and of accessible cognitions and inclinations during tasks. They influence judgment and thought when they are experienced simultaneously with sensory data about the world. Affective influences thus depend on our inability to disentangle affective from descriptive perceptions. To the extent that affective reactions reflect different, incommensurate sources of value (e.g., utilitarian, moral, aesthetic), perceived persons or objects may be experienced as being transcendently good or evil. Experiments varying people's attributions for their affective experiences allow the separate roles of affective and descriptive information to be examined. However, it is the inability to parse everyday experience into its separate sources of evaluative and descriptive information that gives rise to a colourful and transcendent reality.

  17. Interstitial Lung Disease

    Science.gov (United States)

    ... may include: Silica dust Asbestos fibers Grain dust Bird and animal droppings Radiation treatments Indoor hot tubs ... be at increased risk of interstitial lung disease. Smoking. Some forms of interstitial lung disease are more ...

  18. Lungs and Respiratory System

    Science.gov (United States)

    ... Transplant Vision Facts and Myths Lungs and Respiratory System KidsHealth > For Parents > Lungs and Respiratory System Print ... have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't happen ...

  19. Lung Cancer Prevention

    Science.gov (United States)

    ... that living in areas with higher levels of air pollution increases the risk of lung cancer. Beta carotene supplements in heavy smokers Taking beta carotene supplements (pills) increases the risk of lung cancer, especially in ...

  20. Risks of Lung Cancer Screening

    Science.gov (United States)

    ... Lung Cancer Treatment Small Cell Lung Cancer Treatment Lung cancer is the leading cause of cancer death in the United States. Lung ... which also have risks. A biopsy to diagnose lung cancer can cause part of the lung to collapse. Sometimes surgery ...

  1. Childhood Interstitial Lung Disease

    Science.gov (United States)

    ... doctor may ask whether your child: Has severe breathing problems that occur often. Has had severe lung infections. Had serious lung problems as a newborn. Has been exposed to possible lung irritants in the environment, such as birds, molds, dusts, or chemicals. Has ever had radiation ...

  2. Lung Cancer Trends

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... Cancer Breast Cervical Colorectal (Colon) Ovarian Prostate Skin Cancer Home Lung Cancer Trends Language: English Español (Spanish) Recommend on ...

  3. Transplantation for lung cancer.

    Science.gov (United States)

    Machuca, Tiago N; Keshavjee, Shaf

    2012-10-01

    Recent advances have led to improved outcomes in lung transplantation. The International Society for Heart and Lung Transplantation Registry data have shown a steady increase in the number of cases performed annually. Although somewhat controversial, lung transplantation (LTx) for lung cancer has also slowly increased. The current role of LTx for malignant diseases and the management challenge of incidental lung cancer in the explanted lungs are reviewed herein. For a few particular scenarios (advanced multifocal bronchioloalveolar carcinoma causing chronic respiratory failure, end-stage lung disease concomitant with early stage lung cancer, and metastatic disease restricted to the lungs with the primary site controlled) in which nonsurgical alternatives fail to provide adequate palliation, LTx may be considered. Nevertheless, in order to achieve acceptable results, careful patient selection and staging are paramount. In patients with incidental bronchogenic carcinoma in the explanted lung following transplantation, the prognosis is mainly driven by the malignancy stage. LTx can be performed to treat malignant diseases with results approaching those for nonneoplastic indications, given that patients are carefully selected and staged. Although they have not been widely applied in the reported lung transplant literature, modalities such as endobronchial ultrasound and positron emission tomography scan are strongly encouraged and have the potential to further refine staging in this population.

  4. Diet and lung cancer

    DEFF Research Database (Denmark)

    Fabricius, P; Lange, Peter

    2003-01-01

    Lung cancer is the leading cause of cancer-related deaths worldwide. While cigarette smoking is of key importance, factors such as diet also play a role in the development of lung cancer. MedLine and Embase were searched with diet and lung cancer as the key words. Recently published reviews...... and large well designed original articles were preferred to form the basis for the present article. A diet rich in fruit and vegetables reduces the incidence of lung cancer by approximately 25%. The reduction is of the same magnitude in current smokers, ex-smokers and never smokers. Supplementation...... with vitamins A, C and E and beta-carotene offers no protection against the development of lung cancer. On the contrary, beta-carotene supplementation has, in two major randomised intervention trials, resulted in an increased mortality. Smoking remains the leading cause of lung cancer. The adverse effects...

  5. Lung cancer in women

    Science.gov (United States)

    Barrera-Rodriguez, Raúl; Morales-Fuentes, Jorge

    2012-01-01

    Recent biological advances in tumor research provide clear evidence that lung cancer in females is different from that in males. These differences appear to have a direct impact on the clinical presentation, histology, and outcomes of lung cancer. Women are more likely to present with lung adenocarcinoma, tend to receive a diagnosis at an earlier age, and are more likely to be diagnosed with localized disease. Women may also be more predisposed to molecular aberrations resulting from the carcinogenic effects of tobacco, but do not appear to be more susceptible than men to developing lung cancer. The gender differences found in female lung cancer make it mandatory that gender stratification is used in clinical trials in order to improve the survival rates of patients with lung cancer. PMID:28210127

  6. Bulletin of International Simultaneous Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The publication of the Bulletin of International Simultaneous Observations, began July 1, 1875, with daily maps added in 1877. It was published for distribution...

  7. Advances in lung preservation.

    Science.gov (United States)

    Machuca, Tiago N; Cypel, Marcelo; Keshavjee, Shaf

    2013-12-01

    After a brief review of conventional lung preservation, this article discusses the rationale behind ex vivo lung perfusion and how it has shifted the paradigm of organ preservation from conventional static cold ischemia to the utilization of functional normothermia, restoring the lung's own metabolism and its reparative processes. Technical aspects and previous clinical experience as well as opportunities to address specific donor organ injuries in a personalized medicine approach are also reviewed. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Mycobacterium interjectum Lung Infection

    National Research Council Canada - National Science Library

    Mirant-Borde, M C; Alvarez, S; Johnson, M M

    2013-01-01

    ...). Since his clinical course was atypical for MAI, further investigations were pursued which identified Mycobacterium interjectum in lung specimens, a very rarely described etiology of pulmonary disease...

  9. Diet and lung cancer

    DEFF Research Database (Denmark)

    Fabricius, P; Lange, Peter

    2003-01-01

    Lung cancer is the leading cause of cancer-related deaths worldwide. While cigarette smoking is of key importance, factors such as diet also play a role in the development of lung cancer. MedLine and Embase were searched with diet and lung cancer as the key words. Recently published reviews...... and large well designed original articles were preferred to form the basis for the present article. A diet rich in fruit and vegetables reduces the incidence of lung cancer by approximately 25%. The reduction is of the same magnitude in current smokers, ex-smokers and never smokers. Supplementation...... are only ameliorated to a minor degree by a healthy diet....

  10. 6 Common Cancers - Lung Cancer

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues 6 Common Cancers - Lung Cancer Past Issues / Spring 2007 Table of Contents ... Desperate Housewives. (Photo ©2005 Kathy Hutchins / Hutchins) Lung Cancer Lung cancer causes more deaths than the next three ...

  11. Role of skeletal muscle in lung development.

    Science.gov (United States)

    Baguma-Nibasheka, Mark; Gugic, Dijana; Saraga-Babic, Mirna; Kablar, Boris

    2012-07-01

    Skeletal (striated) muscle is one of the four basic tissue types, together with the epithelium, connective and nervous tissues. Lungs, on the other hand, develop from the foregut and among various cell types contain smooth, but not skeletal muscle. Therefore, during earlier stages of development, it is unlikely that skeletal muscle and lung depend on each other. However, during the later stages of development, respiratory muscle, primarily the diaphragm and the intercostal muscles, execute so called fetal breathing-like movements (FBMs), that are essential for lung growth and cell differentiation. In fact, the absence of FBMs results in pulmonary hypoplasia, the most common cause of death in the first week of human neonatal life. Most knowledge on this topic arises from in vivo experiments on larger animals and from various in vitro experiments. In the current era of mouse mutagenesis and functional genomics, it was our goal to develop a mouse model for pulmonary hypoplasia. We employed various genetically engineered mice lacking different groups of respiratory muscles or lacking all the skeletal muscle and established the criteria for pulmonary hypoplasia in mice, and therefore established a mouse model for this disease. We followed up this discovery with systematic subtractive microarray analysis approach and revealed novel functions in lung development and disease for several molecules. We believe that our approach combines elements of both in vivo and in vitro approaches and allows us to study the function of a series of molecules in the context of lung development and disease and, simultaneously, in the context of lung's dependence on skeletal muscle-executed FBMs.

  12. Familial risk for lung cancer

    OpenAIRE

    Kanwal, Madiha; Ding, Xiao-Ji; Cao, Yi

    2016-01-01

    Lung cancer, which has a low survival rate, is a leading cause of cancer-associated mortality worldwide. Smoking and air pollution are the major causes of lung cancer; however, numerous studies have demonstrated that genetic factors also contribute to the development of lung cancer. A family history of lung cancer increases the risk for the disease in both smokers and never-smokers. This review focuses on familial lung cancer, in particular on the familial aggregation of lung cancer. The deve...

  13. Screening for lung cancer

    DEFF Research Database (Denmark)

    Infante, Maurizio V; Pedersen, Jesper H

    2010-01-01

    In lung cancer screening with low-dose spiral computed tomography (LDCT), the proportion of stage I disease is 50-85%, and the survival rate for resected stage I disease can exceed 90%, but proof of real benefit in terms of lung cancer mortality reduction must come from the several randomized tri...

  14. Screening for lung cancer

    DEFF Research Database (Denmark)

    Infante, Maurizio V; Pedersen, Jesper H

    2010-01-01

    In lung cancer screening with low-dose spiral computed tomography (LDCT), the proportion of stage I disease is 50-85%, and the survival rate for resected stage I disease can exceed 90%, but proof of real benefit in terms of lung cancer mortality reduction must come from the several randomized...

  15. Diet and lung cancer

    DEFF Research Database (Denmark)

    Fabricius, P; Lange, Peter

    2003-01-01

    with vitamins A, C and E and beta-carotene offers no protection against the development of lung cancer. On the contrary, beta-carotene supplementation has, in two major randomised intervention trials, resulted in an increased mortality. Smoking remains the leading cause of lung cancer. The adverse effects...

  16. Lung cancer in women

    Directory of Open Access Journals (Sweden)

    Barrera-Rodriguez R

    2012-12-01

    Full Text Available Raúl Barrera-Rodriguez,1 Jorge Morales-Fuentes2 1Biochemistry and Environmental Medicine Laboratory, National Institute of Respiratory Disease, 2Lung Cancer Medical Service, National Institute of Respiratory Disease, Tlalpan, Mexico City, Distrito Federal, Mexico Both authors contributed equally to this workAbstract: Recent biological advances in tumor research provide clear evidence that lung cancer in females is different from that in males. These differences appear to have a direct impact on the clinical presentation, histology, and outcomes of lung cancer. Women are more likely to present with lung adenocarcinoma, tend to receive a diagnosis at an earlier age, and are more likely to be diagnosed with localized disease. Women may also be more predisposed to molecular aberrations resulting from the carcinogenic effects of tobacco, but do not appear to be more susceptible than men to developing lung cancer. The gender differences found in female lung cancer make it mandatory that gender stratification is used in clinical trials in order to improve the survival rates of patients with lung cancer.Keywords: lung cancer, adenocarcinoma, women, genetic susceptibility, genetic differences, tobacco

  17. Indium lung disease.

    Science.gov (United States)

    Cummings, Kristin J; Nakano, Makiko; Omae, Kazuyuki; Takeuchi, Koichiro; Chonan, Tatsuya; Xiao, Yong-Long; Harley, Russell A; Roggli, Victor L; Hebisawa, Akira; Tallaksen, Robert J; Trapnell, Bruce C; Day, Gregory A; Saito, Rena; Stanton, Marcia L; Suarthana, Eva; Kreiss, Kathleen

    2012-06-01

    Reports of pulmonary fibrosis, emphysema, and, more recently, pulmonary alveolar proteinosis (PAP) in indium workers suggested that workplace exposure to indium compounds caused several different lung diseases. To better understand the pathogenesis and natural history of indium lung disease, a detailed, systematic, multidisciplinary analysis of clinical, histopathologic, radiologic, and epidemiologic data for all reported cases and workplaces was undertaken. Ten men (median age, 35 years) who produced, used, or reclaimed indium compounds were diagnosed with interstitial lung disease 4-13 years after first exposure (n = 7) or PAP 1-2 years after first exposure (n = 3). Common pulmonary histopathologic features in these patients included intraalveolar exudate typical of alveolar proteinosis (n = 9), cholesterol clefts and granulomas (n = 10), and fibrosis (n = 9). Two patients with interstitial lung disease had pneumothoraces. Lung disease progressed following cessation of exposure in most patients and was fatal in two. Radiographic data revealed that two patients with PAP subsequently developed fibrosis and one also developed emphysematous changes. Epidemiologic investigations demonstrated the potential for exposure to respirable particles and an excess of lung abnormalities among coworkers. Occupational exposure to indium compounds was associated with PAP, cholesterol ester crystals and granulomas, pulmonary fibrosis, emphysema, and pneumothoraces. The available evidence suggests exposure to indium compounds causes a novel lung disease that may begin with PAP and progress to include fibrosis and emphysema, and, in some cases, premature death. Prospective studies are needed to better define the natural history and prognosis of this emerging lung disease and identify effective prevention strategies.

  18. Lung Cancer Indicators Recurrence

    Science.gov (United States)

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  19. Lung Cancer: Clinical Presentation and Diagnosis.

    Science.gov (United States)

    Latimer, Kelly M

    2018-01-01

    In the absence of screening, most patients with lung cancer are not diagnosed until later stages, when the prognosis is poor. The most common symptoms are cough and dyspnea, but the most specific symptom is hemoptysis. Digital clubbing, though rare, is highly predictive of lung cancer. Symptoms can be caused by the local tumor, intrathoracic spread, distant metastases, or paraneoplastic syndromes. Clinicians should suspect lung cancer in symptomatic patients with risk factors. The initial study should be chest x-ray, but if results are negative and suspicion remains, the clinician should obtain a computed tomography scan with contrast. The diagnostic evaluation for suspected lung cancer includes tissue diagnosis, staging, and determination of functional capacity, which are completed simultaneously. Tissue samples should be obtained using the least invasive method possible. Management is based on the individual tumor histology, molecular testing results, staging, and performance status. The management plan is determined by a multidisciplinary team consisting of a pulmonology subspecialist, medical oncology subspecialist, radiation oncology subspecialist, and thoracic surgeon. The family physician should remain involved with the patient to ensure that patient priorities are supported and, if necessary, to arrange for end-of-life care. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  20. Interstitial lung edema triggered by marathon running.

    Science.gov (United States)

    Zavorsky, Gerald S; Milne, Eric N C; Lavorini, Federico; Rienzi, Joseph P; Lavin, Kaleen M; Straub, Allison M; Pistolesi, Massimo

    2014-01-01

    The purpose of this study was to determine whether marathon running causes lung edema, and if so, to determine its effects on runners. Posterior/anterior (PA) radiographs were taken one day before the marathon and at 19, 55, and 98min post-marathon in 26 runners. The pre and post exercise radiographs of each runner were collated, and then read simultaneously. Two physicians interpreted the images independently in a blinded fashion. The PA radiographs were viewed together at each time-point and findings suggestive for interstitial lung edema were rated as 'mild,' 'moderate,' or 'severe' based on four different radiological criteria. Forty-six percent of the runners presented radiographic findings suggestive of mild to severe interstitial lung edema. Radiographic findings persisted until 98-min post-marathon, with at least moderate degree increases found more frequently in women (55%) than men (6%) (p<0.01). In conclusion, about half of the runners developed interstitial lung edema of varying degrees post-exercise with the incidence being higher in women compared to men. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Anatomy and physiology of respiratory system relevant to anaesthesia

    OpenAIRE

    Apeksh Patwa; Amit Shah

    2015-01-01

    Clinical application of anatomical and physiological knowledge of respiratory system improves patient's safety during anaesthesia. It also optimises patient's ventilatory condition and airway patency. Such knowledge has influence on airway management, lung isolation during anaesthesia, management of cases with respiratory disorders, respiratory endoluminal procedures and optimising ventilator strategies in the perioperative period. Understanding of ventilation, perfusion and their relation wi...

  2. Teaching Pulmonary Gas Exchange Physiology Using Computer Modeling

    Science.gov (United States)

    Kapitan, Kent S.

    2008-01-01

    Students often have difficulty understanding the relationship of O[subscript 2] consumption, CO[subscript 2] production, cardiac output, and distribution of ventilation-perfusion ratios in the lung to the final arterial blood gas composition. To overcome this difficulty, I have developed an interactive computer simulation of pulmonary gas exchange…

  3. Pulmonary complications in 110 consecutive renal transplant ...

    African Journals Online (AJOL)

    diuretic therapy, treatment of rejection, or dialysis. 2. Acute pulmonary embolism: (I) clinical picture compatible witt; pulmonary embolism, e.g. acute dyspnoea, pleural rub, hypoxia; and (if) a ventilation/perfusion lung scan highly suggestive of pulmonary emboli. 3. Pneumonia: (I) clinical signs and symptoms, e.g. cough ...

  4. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation Back to Your Lung Operation Your Lung Operation DVD Welcome Your Lung ...

  5. Lung cancer - non-small cell

    Science.gov (United States)

    Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma - lung; Squamous cell carcinoma - lung ... Horn L, Eisenberg R, Gius D, et al. Cancer of the lung. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan ...

  6. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    Science.gov (United States)

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R.; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K.; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566

  7. Envisioning Curriculum as Six Simultaneities

    Science.gov (United States)

    Hussain, Hanin; Conner, Lindsey; Mayo, Elaine

    2014-01-01

    This paper uses the discourse of complexity thinking to envision curriculum as six partial and coupled facets that exist simultaneously: curriculum as structure, curriculum as process, curriculum as content, curriculum as teaching, curriculum as learning and curriculum as activity. Such a curriculum is emergent and self-organising. It is emergent…

  8. Simultaneous stabilization using genetic algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Benson, R.W.; Schmitendorf, W.E. (California Univ., Irvine, CA (USA). Dept. of Mechanical Engineering)

    1991-01-01

    This paper considers the problem of simultaneously stabilizing a set of plants using full state feedback. The problem is converted to a simple optimization problem which is solved by a genetic algorithm. Several examples demonstrate the utility of this method. 14 refs., 8 figs.

  9. Simultaneous interpreting: A cognitive perspective.

    NARCIS (Netherlands)

    Christoffels, I.K.; de Groot, A.M.

    2005-01-01

    Simultaneous interpreting (SI) is one of the most complex language tasks imaginable. During SI, one has to listen to and comprehend the input utterance in one language, keep it in working memory until it has been receded and can be produced in the other language, and produce the translation of an

  10. Pulmonary imaging using respiratory motion compensated simultaneous PET/MR.

    Science.gov (United States)

    Dutta, Joyita; Huang, Chuan; Li, Quanzheng; El Fakhri, Georges

    2015-07-01

    Pulmonary positron emission tomography (PET) imaging is confounded by blurring artifacts caused by respiratory motion. These artifacts degrade both image quality and quantitative accuracy. In this paper, the authors present a complete data acquisition and processing framework for respiratory motion compensated image reconstruction (MCIR) using simultaneous whole body PET/magnetic resonance (MR) and validate it through simulation and clinical patient studies. The authors have developed an MCIR framework based on maximum a posteriori or MAP estimation. For fast acquisition of high quality 4D MR images, the authors developed a novel Golden-angle RAdial Navigated Gradient Echo (GRANGE) pulse sequence and used it in conjunction with sparsity-enforcing k-t FOCUSS reconstruction. The authors use a 1D slice-projection navigator signal encapsulated within this pulse sequence along with a histogram-based gate assignment technique to retrospectively sort the MR and PET data into individual gates. The authors compute deformation fields for each gate via nonrigid registration. The deformation fields are incorporated into the PET data model as well as utilized for generating dynamic attenuation maps. The framework was validated using simulation studies on the 4D XCAT phantom and three clinical patient studies that were performed on the Biograph mMR, a simultaneous whole body PET/MR scanner. The authors compared MCIR (MC) results with ungated (UG) and one-gate (OG) reconstruction results. The XCAT study revealed contrast-to-noise ratio (CNR) improvements for MC relative to UG in the range of 21%-107% for 14 mm diameter lung lesions and 39%-120% for 10 mm diameter lung lesions. A strategy for regularization parameter selection was proposed, validated using XCAT simulations, and applied to the clinical studies. The authors' results show that the MC image yields 19%-190% increase in the CNR of high-intensity features of interest affected by respiratory motion relative to UG and a 6

  11. Experimental simulation of simultaneous vision.

    Science.gov (United States)

    de Gracia, Pablo; Dorronsoro, Carlos; Sánchez-González, Álvaro; Sawides, Lucie; Marcos, Susana

    2013-01-17

    To present and validate a prototype of an optical instrument that allows experimental simulation of pure bifocal vision. To evaluate the influence of different power additions on image contrast and visual acuity. The instrument provides the eye with two superimposed images, aligned and with the same magnification, but with different defocus states. Subjects looking through the instrument are able to experience pure simultaneous vision, with adjustable refractive correction and addition power. The instrument is used to investigate the impact of the amount of addition of an ideal bifocal simultaneous vision correction, both on image contrast and on visual performance. the instrument is validated through computer simulations of the letter contrast and by equivalent optical experiments with an artificial eye (camera). Visual acuity (VA) was measured in four subjects (AGE: 34.3 ± 3.4 years; spherical error: -2.1 ± 2.7 diopters [D]) for low and high contrast letters and different amounts of addition. The largest degradation in contrast and visual acuity (∼25%) occurred for additions around ±2 D, while additions of ±4 D produced lower degradation (14%). Low additions (1-2 D) result in lower VA than high additions (3-4 D). A simultaneous vision instrument is an excellent tool to simulate bifocal vision and to gain understanding of multifocal solutions for presbyopia. Simultaneous vision induces a pattern of visual performance degradation, which is well predicted by the degradation found in image quality. Neural effects, claimed to be crucial in the patients' tolerance of simultaneous vision, can be therefore compared with pure optical effects.

  12. Cystic and nodular lung disease.

    Science.gov (United States)

    Richards, J Caleb; Lynch, David A; Chung, Jonathan H

    2015-06-01

    Diffuse cystic and nodular lung diseases have characteristic imaging findings. The most common causes of cystic lung disease are lymphangioleiomyomatosis and Langerhans cell histiocytosis. Other less common cystic lung diseases include Birt-Hogg-Dube syndrome, lymphocytic interstitial pneumonitis, and light chain deposition disease. Computed tomography is used to differentiate cystic lung disease from emphysema, honeycombing, cavities, and bronchiectasis, which mimic cystic lung disease. Diffuse nodular lung disease are categorized as centrilobular, perilymphatic, and random types. In diffuse nodular lung disease, a specific diagnosis is achieved through a combination of history, physical examination, and imaging findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Lung cysts in chronic paracoccidioidomycosis

    Directory of Open Access Journals (Sweden)

    Andre Nathan Costa

    2013-06-01

    Full Text Available On HRCT scans, lung cysts are characterized by rounded areas of low attenuation in the lung parenchyma and a well-defined interface with the normal adjacent lung. The most common cystic lung diseases are lymphangioleiomyomatosis, Langerhans cell histiocytosis, and lymphocytic interstitial pneumonia. In a retrospective analysis of the HRCT findings in 50 patients diagnosed with chronic paracoccidioidomycosis, we found lung cysts in 5 cases (10%, indicating that patients with paracoccidioidomycosis can present with lung cysts on HRCT scans. Therefore, paracoccidioidomycosis should be included in the differential diagnosis of cystic lung diseases.

  14. Genomic Alteration During Metastasis of Lung Adenocarcinoma.

    Science.gov (United States)

    Tan, Qiang; Cui, Jian; Huang, Jia; Ding, Zhengping; Lin, Hao; Niu, Xiaomin; Li, Zhiming; Wang, Guan; Luo, Qingquan; Lu, Shun

    2016-01-01

    Recurrent gene mutation has been identified by the analysis of exonic DNA from lung adenocarcinoma, but its progression has not been extensively profiled. The investigation of the mutational landscape of tumors provides new insights into cancer genome evolution and further discovers the interplay of somatic mutation, adaptation of clones to their environment and natural selection. Cancer development involves cycles of genomic damage, epigenetic deregulation, and increased cellular proliferation that eventually culminate in the carcinoma phenotype. Comparative whole exome sequencing of both primary and metastatic tumor tissues from four patients of stage IV lung adenocarcinoma patients with chest wall metastasis was performed. Both primary and metastatic tumors were diagnosed through biopsy followed by surgical resection. All tumor specimens were cut into several pieces to assess potential heterogenic clones within the tumor tissue. Adjacent normal lung tissue was also obtained to provide germline mutation background. By modeling and analyzing progression of the cancer metastasis based on non-synonymous variants, we defined the extent of heterogeneity of cancer genomes and identified similar cancer evolution pattern in the four patients: metastasis was an early event occurring right after the primary cancer formation and evolution in the metastatic tumor was continuously and simultaneously in progression with that in the primary tumor. By characterizing the clonal hierarchy of genetic lesions, we further charted a pathway of oncogenic events along which genes may drive lung adenocarcinoma metastasis, such as TAS2R31 and UMODL1, involving in G-protein coupled receptor protein signaling pathway. The candidate genes identified in this study may become targets for the treatment of lung adenocarcinoma metastasis. © 2016 S. Karger AG, Basel.

  15. Lung cancer imaging

    CERN Document Server

    Ravenel, James G

    2013-01-01

    This book provides a guide to the diagnosis, staging and overview of the management of lung cancer relevant to practicing radiologists so that they can better understand the decision making issues and provide more useful communication to treating physicians.

  16. [Interstitial lung diseases].

    Science.gov (United States)

    Junker, K; Brasch, F

    2008-11-01

    Interstitial lung diseases comprise a heterogeneous group of about 200 entities. In the classification of these diseases, diffuse parenchymal lung diseases with known cause, granulomatous diseases, and other specific interstitial lung diseases are separated from the important group of idiopathic interstitial pneumonias, which are classified according to the 2002 ATS/ERS consensus classification. Concerning the histological pattern, this classification differentiates between "usual interstitial pneumonia" (UIP), "nonspecific interstitial pneumonia" (NSIP), "organising pneumonia" (COP), "diffuse alveolar damage" (DAD), "respiratory bronchiolitis" (RB), "desquamative interstitial pneumonia" (DIP), "lymphocytic interstitial pneumonia" (LIP) and "unclassifiable interstitial pneumonias". A key message of this classification is that the pathologist will give the diagnosis of a histological pattern, whereas the final clinicopathologic diagnosis can be made only by the clinical pulmonologist after careful correlation with the clinical and radiologic features, which is essential in the diagnosis of interstitial lung diseases.

  17. Bronchoscopic Lung Volume Reduction

    Directory of Open Access Journals (Sweden)

    Armin Ernst

    2011-01-01

    Full Text Available The application of lung volume reduction surgery in clinical practice is limited by high postoperative morbidity and stringent selection criteria. This has been the impetus for the development of bronchoscopic approaches to lung volume reduction. A range of different techniques such as endobronchial blockers, airway bypass, endobronchial valves, thermal vapor ablation, biological sealants, and airway implants have been employed on both homogeneous as well as heterogeneous emphysema. The currently available data on efficacy of bronchoscopic lung volume reduction are not conclusive and subjective benefit in dyspnoea scores is a more frequent finding than improvements on spirometry or exercise tolerance. Safety data are more promising with rare procedure-related mortality, few serious complications, and short hospital length of stay. The field of bronchoscopic lung volume reduction continues to evolve as ongoing prospective randomized trials build on earlier feasibility data to clarify the true efficacy of such techniques.

  18. Lung transplant - slideshow

    Science.gov (United States)

    ... ency/presentations/100120.htm Lung transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  19. Interstitial lung disease

    Science.gov (United States)

    ... scleroderma Lung inflammation due to breathing in a foreign substance such as certain types of dust, fungus, ... problems Using oxygen at home Images Clubbing Coal workers pneumoconiosis - stage II Coal workers pneumoconiosis - stage II ...

  20. What Are the Lungs?

    Science.gov (United States)

    ... vessels, and the muscles that enable breathing. The Respiratory System Figure A shows the location of the respiratory ... your lungs. Over a long period, breathing in cigarette smoke or air pollutants can damage the airways and ...

  1. Lung cysts in chronic paracoccidioidomycosis

    OpenAIRE

    Costa, Andre Nathan; Marchiori, Edson; Benard, Gil; Araujo, Mariana Sponholz; Baldi, Bruno Guedes; Kairalla, Ronaldo Adib; Carvalho, Carlos Roberto Ribeiro

    2013-01-01

    On HRCT scans, lung cysts are characterized by rounded areas of low attenuation in the lung parenchyma and a well-defined interface with the normal adjacent lung. The most common cystic lung diseases are lymphangioleiomyomatosis, Langerhans cell histiocytosis, and lymphocytic interstitial pneumonia. In a retrospective analysis of the HRCT findings in 50 patients diagnosed with chronic paracoccidioidomycosis, we found lung cysts in 5 cases (10%), indicating that patients with paracoccidioidomy...

  2. Lung cysts in chronic paracoccidioidomycosis*

    OpenAIRE

    Costa, André Nathan; Marchiori, Edson; Benard, Gil; Araújo, Mariana Sponholz; Baldi, Bruno Guedes; Kairalla, Ronaldo Adib; Carvalho, Carlos Roberto Ribeiro

    2013-01-01

    On HRCT scans, lung cysts are characterized by rounded areas of low attenuation in the lung parenchyma and a well-defined interface with the normal adjacent lung. The most common cystic lung diseases are lymphangioleiomyomatosis, Langerhans cell histiocytosis, and lymphocytic interstitial pneumonia. In a retrospective analysis of the HRCT findings in 50 patients diagnosed with chronic paracoccidioidomycosis, we found lung cysts in 5 cases (10%), indicating that patients with paracoccidioidomy...

  3. Synchronous, Multiple Primary Lung Cancers: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Baykal Tülek

    2015-04-01

    Full Text Available Multiple primary lung cancers (MPLC are named synchronous if determined simultaneously with the index tumor, and metachronous if the second tumor is diagnosed with an accepted time after the first tumor. It is important for both the rate of survival and treatment alternatives to differentiate synchronous MPLCs from the metastases of the primary lung tumors, and also from the multiple pulmonary metastases of the extra pulmonary tumors. In this study, clinical characteristics, diagnosis and treatment processes of three synchronous MPLC cases diagnosed in our department were assessed.

  4. Effect of lung flooding and high-intensity focused ultrasound on lung tumours: an experimental study in an ex vivo human cancer model and simulated in vivo tumours in pigs.

    Science.gov (United States)

    Wolfram, Frank; Boltze, Carsten; Schubert, Harald; Bischoff, Sabine; Lesser, Thomas Günther

    2014-01-07

    High-intensity focused ultrasound is a valuable tool for minimally invasive tumour ablation. However, due to the air content in ventilated lungs, lung tumours have never been treated with high-intensity focused ultrasound. Lung flooding enables efficient lung sonography and tumour imaging in ex vivo human and in vivo porcine lung cancer models. The current study evaluates the effectiveness of lung flooding and sonography-guided high-intensity focused ultrasound for lung tumour ablation in ex vivo human and in vivo animal models. Lung flooding was performed in four human lung lobes which were resected from non-small cell lung cancers. B-mode imaging and temperature measurements were simultaneously obtained during high-intensity focused ultrasonography of centrally located lung cancers. The tumour was removed immediately following insonation and processed for nicotinamide adenine dinucleotide phosphate-diaphorase and H&E staining. In addition, the left lungs of three pigs were flooded. Purified BSA in glutaraldehyde was injected centrally into the left lower lung lobe to simulate a lung tumour. The ultrasound was focused transthoracically through the flooded lung into the simulated tumour with the guidance of sonography. The temperature of the tumour was simultaneously measured. The vital signs of the animal were monitored during the procedure. A well-demarcated lesion of coagulation necrosis was produced in four of four human lung tumours. There did not appear to be any damage to the surrounding lung parenchyma. After high-intensity focused ultrasound insonation, the mean temperature increase was 7.5-fold higher in the ex vivo human tumour than in the flooded lung tissue (52.1 K ± 8.77 K versus 7.1 K ± 2.5 K). The transthoracic high-intensity focused ultrasound of simulated tumours in the in vivo model resulted in a mean peak temperature increase up to 53.7°C (±4.5). All of the animals survived the procedure without haemodynamic complications. High

  5. Multiple cystic lung disease.

    Science.gov (United States)

    Ferreira Francisco, Flavia Angélica; Soares Souza, Arthur; Zanetti, Gláucia; Marchiori, Edson

    2015-12-01

    Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt-Hogg-Dubé); other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management. Copyright ©ERS 2015.

  6. Simultaneous PET and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yiping Shao; Cherry, Simon R.; Meadors, Ken; Siegel, Stefan; Silverman, Robert W. [Crump Institute for Biological Imaging, Department of Molecular and Medical Pharmacology, 10833 Le Conte Avenue, UCLA School of Medicine, Los Angeles, CA 90095 (United States); Farahani, Keyvan [Department of Radiological Sciences, 10833 Le Conte Avenue, UCLA School of Medicine, Los Angeles, CA 90095 (United States); Marsden, Paul K. [Guy' s and St Thomas' Clinical PET Centre, Division of Radiological Sciences, UMDS, London (United Kingdom)

    1997-10-01

    We have developed a prototype PET detector which is compatible with a clinical MRI system to provide simultaneous PET and MR imaging. This single-slice PET system consists of 48 2x2x10mm{sup 3} LSO crystals in a 38 mm diameter ring configuration that can be placed inside the receiver coil of the MRI system, coupled to three multi-channel photomultipliers housed outside the main magnetic field via 4 m long and 2 mm diameter optical fibres. The PET system exhibits 2 mm spatial resolution, 41% energy resolution at 511 keV and 20 ns timing resolution. Simultaneous PET and MR phantom images were successfully acquired. (author)

  7. From averaged to simultaneous controllability

    OpenAIRE

    Lohéac, Jérôme; Zuazua, Enrique

    2016-01-01

    International audience; We consider a linear finite dimensional control system depending on unknown parameters. We aim to design controls, independent of the parameters, to control the system in some optimal sense. We discuss the notions of averaged control, according to which one aims to control only the average of the states with respect to the unknown parameters, and the notion of simultaneous control in which the goal is to control the system for all values of these parameters. We show ho...

  8. Hyperpolarized Xenon-129 Magnetic Resonance Imaging of Functional Lung Microstructure

    Science.gov (United States)

    Dregely, Isabel

    ) emphysematous tissue destruction in chronic obstructive pulmonary disease (using the tissue density parameter) and 2) parenchymal inflammation or thickening (using the wall thickness parameter). By simultaneously quantifying two lung function parameters, MXTC provides a more comprehensive picture of lung microstructure than existing lung imaging techniques and could become an important non-invasive and quantitative tool to characterize pulmonary disease.

  9. Simultaneous surgery in patients with both cardiac and noncardiac diseases

    Directory of Open Access Journals (Sweden)

    Yang Y

    2016-07-01

    Full Text Available Yang Yang,1 Feng Xiao,1 Jin Wang,1 Bo Song,1 Xi-Hui Li,1 Jian Li,2 Zhi-Song He,3 Huan Zhang,4 Ling Yin5 1Department of Cardiac Surgery, 2Department of Thoracic Surgery, 3Department of Urology Surgery, 4Department of General Surgery, 5Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, People’s Republic of China Background: To investigate the possibility and feasibility of simultaneous cardiac and noncardiac surgery.Methods: From August 2000 to March 2015, 64 patients suffering from cardiac and noncardiac diseases have been treated by simultaneous surgeries.Results: Two patients died after operations in hospital; thus, the hospital mortality rate was 3.1%. One patient with coronary heart disease, acute myocardial infarction, and a recurrence of bladder cancer accepted emergency simultaneous coronary artery bypass grafting (CABG, bladder cystectomy, and ureterostomy. He died of acute cerebral infarction complicated with multiple organ failure on the 153rd day after operation. The other patient with chronic constrictive pericarditis and right lung cancer underwent pericardial stripping and right lung lower lobectomy, which resulted in multiple organ failure, and the patient died on the tenth day postoperatively. The remaining 62 patients recovered and were discharged. The total operative morbidity was 17.2%: postoperative hemorrhage (n, % [1, 1.6%], pulmonary infection and hypoxemia (2, 3.1%, hemorrhage of upper digestive tract (1, 1.6%, incisional infection (3, 4.7%, subphrenic abscess (1, 1.6%, and postoperative acute renal failure and hemofiltration (3, 4.7%. Of the 62 patients discharged, 61 patients were followed up. Eleven patients died with 10 months to 10 years during the follow-up. The mean survival time is 116.2±12.4 months. The cumulative survival rate is 50.8%.Conclusion: Simultaneous surgeries in patients suffering from both cardiac and noncardiac benign or malignant diseases are safe and possible

  10. The Role of Lung Ultrasound in Diagnosis of Respiratory Distress Syndrome in Newborn Infants.

    Science.gov (United States)

    Liu, Jing; Cao, Hai Ying; Wang, Hua-Wei; Kong, Xiang Yong

    2015-02-01

    Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and mortality. The risk of developing RDS decreases with both increasing gestational age and birth weight. The aim of this study was to evaluate the value of lung ultrasound in the diagnosis of respiratory distress syndrome (RDS) in newborn infants. From March 2012 to May 2013, 100 newborn infants were divided into two groups: RDS group (50 cases) and control group (50 cases). According to the findings of chest x-ray, there were 10 cases of grade II RDS, 15 grade III cases, and 25 grade IV cases in RDS group. Lung ultrasound was performed at bedside by a single expert. The ultrasound indexes observed in this study included pleural line, A-line, B-line, lung consolidation, air bronchograms, bilateral white lung, interstitial syndrome, lung sliding, lung pulse etc. In all of the infants with RDS, lung ultrasound consistently showed generalized consolidation with air bronchograms, bilateral white lung or alveolar-interstitial syndrome, pleural line abnormalities, A-line disappearance, pleural effusion, lung pulse, etc. The simultaneous demonstration of lung consolidation, pleural line abnormalities and bilateral white lung, or lung consolidation, pleural line abnormalities and A-line disappearance co-exists with a sensitivity and specificity of 100%. Besides, the sensitivity was 80% and specificity 100% of lung pulse for the diagnosis of neonatal RDS. This study indicates that using an ultrasound to diagnose neonatal RDS is accurate and reliable too. A lung ultrasound has many advantages over other techniques. Ultrasound is non-ionizing, low-cost, easy to operate, and can be performed at bedside, making this technique ideal for use in NICU.

  11. The aging lung

    Directory of Open Access Journals (Sweden)

    Lowery EM

    2013-11-01

    Full Text Available Erin M Lowery,1 Aleah L Brubaker,2 Erica Kuhlmann,1 Elizabeth J Kovacs31Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine at Loyola University Medical Center, 2Loyola University Stritch School of Medicine, 3Department of Surgery, Loyola University Medical Center, Maywood, IL, USAAbstract: There are many age-associated changes in the respiratory and pulmonary immune system. These changes include decreases in the volume of the thoracic cavity, reduced lung volumes, and alterations in the muscles that aid respiration. Muscle function on a cellular level in the aging population is less efficient. The elderly population has less pulmonary reserve, and cough strength is decreased in the elderly population due to anatomic changes and muscle atrophy. Clearance of particles from the lung through the mucociliary elevator is decreased and associated with ciliary dysfunction. Many complex changes in immunity with aging contribute to increased susceptibility to infections including a less robust immune response from both the innate and adaptive immune systems. Considering all of these age-related changes to the lungs, pulmonary disease has significant consequences for the aging population. Chronic lower respiratory tract disease is the third leading cause of death in people aged 65 years and older. With a large and growing aging population, it is critical to understand how the body changes with age and how this impacts the entire respiratory system. Understanding the aging process in the lung is necessary in order to provide optimal care to our aging population. This review focuses on the nonpathologic aging process in the lung, including structural changes, changes in muscle function, and pulmonary immunologic function, with special consideration of obstructive lung disease in the elderly.Keywords: aging, lung, pulmonary immunology, COPD

  12. Screening for Lung Cancer

    Science.gov (United States)

    Mazzone, Peter J.; Naidich, David P.; Bach, Peter B.

    2013-01-01

    Background: Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths. Methods: A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer. Results: Several large randomized controlled trials (RCTs), including a recent one, have demonstrated that screening for lung cancer using a chest radiograph does not reduce the number of deaths from lung cancer. One large RCT involving low-dose CT (LDCT) screening demonstrated a significant reduction in lung cancer deaths, with few harms to individuals at elevated risk when done in the context of a structured program of selection, screening, evaluation, and management of the relatively high number of benign abnormalities. Whether other RCTs involving LDCT screening are consistent is unclear because data are limited or not yet mature. Conclusions: Screening is a complex interplay of selection (a population with sufficient risk and few serious comorbidities), the value of the screening test, the interval between screening tests, the availability of effective treatment, the risk of complications or harms as a result of screening, and the degree with which the screened individuals comply with screening and treatment recommendations. Screening with LDCT of appropriate individuals in the context of a structured process is associated with a significant reduction in the number of lung cancer deaths in the screened population. Given the complex interplay of factors inherent in screening, many questions remain on how to effectively implement screening on a broader scale. PMID:23649455

  13. Diagnostic Value of Transbronchial Lung Biopsy in Peripheral Lung Cancer

    Directory of Open Access Journals (Sweden)

    Wenhui TANG

    2009-03-01

    Full Text Available Background and objective Lung cancer is the leading cause of cancer-related death worldwide. Because the locations of peripheral lung cancer are special, diagnosis of peripheral lung cancer is difficult. The aim of this study was to evaluate diagnostic value of transbronchial lung biopsy (TBLB in peripheral lung cancer. MethodsTransbronchial lung biopsy (TBLB were performed in 78 cases of peripheral lung cancer which could not be observed by bronchoscope, 42 cases among whom were diagnosed by pathology and cytologic examination. Thirty-six cases of peripheral lung cancer were not able to be diagnosed by TBLB, 22 cases among them were diagnosed by percutaneous lung biopsy (PNLB, and 14 cases being left were diagnosed by surgical operation, lymphadenopathy biopsy, pleura biopsy and sputum cytologic examination successively. Results The positive rate produced by transbronchial lung biopsy, brush biopsy were 53.8% and 8.9% respectively. The total positive rate was 57.7%. The positive rate produced by TBLB was higher than that of brush biopsy (P <0.01. Along with tumor's diameter enlarge, the positive rate of diagnosis was higher. The positive rate of right lung was higher than that of left lung. The positive rate of inferior lung was higher than that of upper lung. The lesions near the inner belt and hilus pulmonis, had the higher positive rate. Complicatin frequency in PNLB was much higher than that in TBLB. Conclusion Transbronchial lung biopsy is an important method in diagnosingof peripheral lung cancer. Combination of TBLB can increase the diagnostic positive rate of peripheral lung cancer.

  14. Lung Cancer Statistics.

    Science.gov (United States)

    Torre, Lindsey A; Siegel, Rebecca L; Jemal, Ahmedin

    2016-01-01

    Lung cancer is the leading cause of cancer death among both men and women in the United States. It is also the leading cause of cancer death among men and the second leading cause of cancer death among women worldwide. Lung cancer rates and trends vary substantially by sex, age, race/ethnicity, socioeconomic status, and geography because of differences in historical smoking patterns. Lung cancer mortality rates in the United States are highest among males, blacks, people of lower socioeconomic status, and in the mid-South (e.g., Kentucky, Mississippi, Arkansas, and Tennessee). Globally, rates are highest in countries where smoking uptake began earliest, such as those in North America and Europe. Although rates are now decreasing in most of these countries (e.g., United States, United Kingdom, Australia), especially in men, they are increasing in countries where smoking uptake occurred later. Low- and middle-income countries now account for more than 50% of lung cancer deaths each year. This chapter reviews lung cancer incidence and mortality patterns in the United States and globally.

  15. Lung cancer screening: Update

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyea Young [Dept. of Radiology, Center for Lung Cancer, National Cancer Center, Goyang (Korea, Republic of)

    2015-09-15

    Lung cancer is the leading cause of cancer deaths worldwide as well as in Korea. A recent National Lung Screening Trial in U.S. revealed that low-dose CT (LDCT) screening reduced lung cancer specific mortality by 20% in high risk individuals as compared to chest radiograph screening. Based on this evidence, several expert societies in U.S. and Korean multisociety collaborative committee developed guidelines for recommendation of lung cancer screening using annual LDCT in high risk populations. In most of the societies high risk groups are defined as persons aged 55 to 74 years, who are current smokers with history of smoking of more than 30 packs per year or ex-smokers, who quit smoking up to 15 or more years ago. The benefits of LDCT screening are modestly higher than the harms in high risk individuals. The harms included a high rate of false-positive findings, over-diagnosis and radiation-related deaths. Invasive diagnostic procedure due to false positive findings may lead to complications. LDCT should be performed in qualified hospitals and interpreted by expert radiologists. Recently, the American College of Radiology released the current version of Lung cancer CT screening Reporting and Data Systems. Education and actions to stop smoking must be offered to current smokers.

  16. Inhalational Lung Disease

    Directory of Open Access Journals (Sweden)

    MR Farzaneh

    2010-01-01

    Full Text Available Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become apparent several years after exposure to the particles. However, for certain types of dusts, e.g., silicone dioxide crystal and beryllium, heavy exposure within a short period can cause an acute disease. Pulmonary involvement in asbestosis is usually in the lower lobes. On the contrary, in silicosis and coal worker pneumoconiosis, the upper lobes are involved predominantly. For imaging evaluation of pneumoconiosis, high-resolution computed tomography (CT is superior to conventional chest x-ray. Magnetic resonance imaging (MRI and positron emission tomography (PET scan are helpful in those with suspected tumoral lesions. In this essay, we reviewed the imaging aspects of inhalational lung disease.

  17. Anesthesia Mangement in Simultaneously Coronary Artery By-Pass Grefting and Lobectomy Surgery: Case Report

    Directory of Open Access Journals (Sweden)

    Gokhan Ozkan

    2014-08-01

    Full Text Available Recently, cardio-pulmonary surgical procedures were simultaneously performed in patients with coronary artery disease and lung tumors. There is no complete consensus about the timing of these high rate mortality and morbidity surgery. Similarly, there wasn%u2019t any large number clinical trial related to the anesthetic management of these patients except case reports and clinical experiences. In this case report, we aim to present anesthesia management in a 89-year-old male patient undergoing simultaneous cardio-pulmonary surgery.

  18. Sequential versus simultaneous market delineation

    DEFF Research Database (Denmark)

    Haldrup, Niels; Møllgaard, Peter; Kastberg Nielsen, Claus

    2005-01-01

    and geographical markets. Using a unique data setfor prices of Norwegian and Scottish salmon, we propose a methodologyfor simultaneous market delineation and we demonstrate that comparedto a sequential approach conclusions will be reversed.JEL: C3, K21, L41, Q22Keywords: Relevant market, econometric delineation......Delineation of the relevant market forms a pivotal part of most antitrustcases. The standard approach is sequential. First the product marketis delineated, then the geographical market is defined. Demand andsupply substitution in both the product dimension and the geographicaldimension...

  19. The concept of "baby lung".

    Science.gov (United States)

    Gattinoni, Luciano; Pesenti, Antonio

    2005-06-01

    The "baby lung" concept originated as an offspring of computed tomography examinations which showed in most patients with acute lung injury/acute respiratory distress syndrome that the normally aerated tissue has the dimensions of the lung of a 5- to 6-year-old child (300-500 g aerated tissue). The respiratory system compliance is linearly related to the "baby lung" dimensions, suggesting that the acute respiratory distress syndrome lung is not "stiff" but instead small, with nearly normal intrinsic elasticity. Initially we taught that the "baby lung" is a distinct anatomical structure, in the nondependent lung regions. However, the density redistribution in prone position shows that the "baby lung" is a functional and not an anatomical concept. This provides a rational for "gentle lung treatment" and a background to explain concepts such as baro- and volutrauma. From a physiological perspective the "baby lung" helps to understand ventilator-induced lung injury. In this context, what appears dangerous is not the V(T)/kg ratio but instead the V(T)/"baby lung" ratio. The practical message is straightforward: the smaller the "baby lung," the greater is the potential for unsafe mechanical ventilation.

  20. Unexpandable lung from pleural disease.

    Science.gov (United States)

    Huggins, John T; Maldonado, Fabien; Chopra, Amit; Rahman, Najib; Light, Richard

    2017-10-24

    Unexpandable lung is a common complication of malignant pleural effusions and inflammatory pleural diseases, such as pleural infection (e.g. empyema and complicated parapneumonic effusion) and noninfectious fibrinous pleuritis. Unexpandable lung due to pleural disease may be because of an active pleural process, and is referred to as malignant or inflammatory lung entrapment. An unexpandable lung may also be encountered in the setting of remote pleural inflammation resulting in a mature fibrous membrane overlying the visceral pleura preventing full expansion of the lung. This condition is termed trapped lung and may be understood as a form of defective healing of the pleural space. Trapped lung typically presents as a chronic, stable pleural effusion without evidence of active pleural disease. An unexpandable lung most often manifests itself as an inability of fully expanding the lung with pleural space drainage. Patients will either develop chest pain preventing complete drainage of the pleural space or develop a post-procedure pneumothorax. Pleural manometry and radiological imaging are useful in the assessment of an unexpandable lung. Pleural manometry can demonstrate abnormal lung expansion during drainage and imaging will demonstrate abnormal visceral pleural thickening found in trapped lung or malignant and inflammatory lung entrapment. © 2017 Asian Pacific Society of Respirology.

  1. A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.

    Science.gov (United States)

    Matsuoka, Shunichiro; Miyazawa, Masahisa; Kashimoto, Kentaro; Kobayashi, Hiroaki; Mitsui, Fumihiko; Tsunoda, Hajime; Kunitomo, Kazuyoshi; Chisuwa, Hisanao; Haba, Yoshiaki

    2016-06-01

    We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax.

  2. What Are Asbestos-Related Lung Diseases?

    Science.gov (United States)

    ... Back To Health Topics / Asbestos-Related Lung Diseases Asbestos-Related Lung Diseases What Is Asbestos-related lung ... as the peritoneum (PER-ih-to-NE-um). Asbestos-Related Lung Diseases Figure A shows the location ...

  3. Opioid effect on lungs.

    Science.gov (United States)

    Yamanaka, Travis; Sadikot, Ruxana T

    2013-02-01

    Opioids are widely used for their analgesic properties for the management of acute and chronic pain related to a variety of illnesses. Opioid usage is associated with adverse effects on respiration which are often attributed to depression of the central nervous system. Recent data indicate that opioid use has increased over the last two decades. There is also increasing evidence that opioids have a variety of effects on the lungs besides suppression of respiration. Opioids can affect immune cells function, increase histamine release causing bronchospasm, vaso-constriction and hypersensitivity reactions. Together, these actions have a variety of effects on lung function. Here, we provide a comprehensive review of the effects of opioids on the lungs including the respiratory centre, immune function, airways and pulmonary vasculature. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  4. [Indium lung disease].

    Science.gov (United States)

    Nakano, Makiko; Omae, Kazuyuki

    2014-02-01

    "Indium lung" is a new occupational lung disease. The global demand for indium, the major material used in manufacturing flat-screen display panels, has skyrocketed since the 1990s (Japan comprises 85% of the worldwide demand). The first case was reported in Japan in 2003, followed by seven cases (interstitial pneumonia and emphysema) in Japan. Two pulmonary alveolar proteinosis (PAP) cases in the USA followed in 2011. Indium lung has been described as interstitial pneumonia, pneumothorax, emphysema, and PAP. In 2013, The Japan Ministry of Health, Labor and Welfare issued an "Ordinance on the Prevention of Hazards Due to Specified Chemical Substances" requiring employers to provide regular health checks for employees and measurements of work environment concentrations of respirable indium dust.

  5. Simultaneous optimization of dynamic bioprocesses

    Directory of Open Access Journals (Sweden)

    Riascos C.A.M.

    2002-01-01

    Full Text Available It is known that the optimal control may introduce significant economical benefits into production processes, thus being an important and challenging research area with practical relevance. The modeling and optimization of biotechnological processes has been object of research and their related results have generated improvements in operating conditions and strategies, however, the inherent features of dynamical bioprocesses prevent the application of conventional optimization algorithms, hence making necessary the development of tailored methods and strategies. The objective of this work is to develop mathematical programming strategies for simultaneous optimization of dynamic systems and evaluate their computational performance. Simultaneous optimization with orthogonal collocation is applied to a simplified model for biosynthesis of penicillin from glucose, which was studied by Cuthrell and Biegler (1989. The results show that discretization of differential equations systems (DAE by orthogonal collocation in finite elements efficiently transforms dynamic optimization problems into nonlinear programming (NLP problems, enabling to solve complex problems with several control variables and minimizing the approximation error.

  6. Bronchoscopic lung volume reduction

    Directory of Open Access Journals (Sweden)

    M. I. Polkey

    2006-12-01

    Full Text Available Surgical lung volume reduction can improve exercise performance and forced expiratory volume in one second in patients with emphysema. However, the procedure is associated with a 5% mortality rate and a nonresponse rate of 25%. Accordingly, interest has focused on alternative ways of reducing lung volume. Two principle approaches are used: collapse of the diseased area using blockers placed endobronchially and the creation of extrapulmonary pathways. Preliminary data from the former approach suggest that it can be successful and that the magnitude of success is related to reduction in dynamic hyperinflation.

  7. The lung cancer management guidelines

    Directory of Open Access Journals (Sweden)

    Jazieh Abdul-Rahman

    2008-10-01

    Full Text Available The Lung Cancer Guidelines Committee developed 2008 Lung Cancer Management Guidelines based on available evidences in the literature. These guidelines are stage-dependent and addressing the most common clinical scenarios. They address diagnosis, work-up, treatment, and follow up of lung cancer.

  8. NELSON lung cancer screening study

    NARCIS (Netherlands)

    Y. Zhao (Yingru); X. Xie (Xueqian); H.J. de Koning (Harry); W.P. Mali (Willem); R. Vliegenthart (Rozemarijn); M. Oudkerk (Matthijs)

    2011-01-01

    textabstractThe Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects will lead to a decrease in 10-year lung cancer mortality of at

  9. Radiofrequency Ablation of Lung Tumors

    Science.gov (United States)

    ... to comorbidities or limited lung function. have multiple metastases in your lungs. These are tumors that have spread from a cancer located either in the lung or elsewhere in your body, such as the kidney, intestine or breast. More than one lesion can be treated at ...

  10. Lung Cancer Rates by State

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... Colorectal (Colon) HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by State Language: English (US) Español ( ...

  11. Molecular Determinants of Lung Development

    Science.gov (United States)

    Morrisey, Edward E.; Cardoso, Wellington V.; Lane, Robert H.; Rabinovitch, Marlene; Abman, Steven H.; Ai, Xingbin; Albertine, Kurt H.; Bland, Richard D.; Chapman, Harold A.; Checkley, William; Epstein, Jonathan A.; Kintner, Christopher R.; Kumar, Maya; Minoo, Parviz; Mariani, Thomas J.; McDonald, Donald M.; Mukouyama, Yoh-suke; Prince, Lawrence S.; Reese, Jeff; Rossant, Janet; Shi, Wei; Sun, Xin; Werb, Zena; Whitsett, Jeffrey A.; Gail, Dorothy; Blaisdell, Carol J.

    2013-01-01

    Development of the pulmonary system is essential for terrestrial life. The molecular pathways that regulate this complex process are beginning to be defined, and such knowledge is critical to our understanding of congenital and acquired lung diseases. A recent workshop was convened by the National Heart, Lung, and Blood Institute to discuss the developmental principles that regulate the formation of the pulmonary system. Emerging evidence suggests that key developmental pathways not only regulate proper formation of the pulmonary system but are also reactivated upon postnatal injury and repair and in the pathogenesis of human lung diseases. Molecular understanding of early lung development has also led to new advances in areas such as generation of lung epithelium from pluripotent stem cells. The workshop was organized into four different topics, including early lung cell fate and morphogenesis, mechanisms of lung cell differentiation, tissue interactions in lung development, and environmental impact on early lung development. Critical points were raised, including the importance of epigenetic regulation of lung gene expression, the dearth of knowledge on important mesenchymal lineages within the lung, and the interaction between the developing pulmonary and cardiovascular system. This manuscript describes the summary of the discussion along with general recommendations to overcome the gaps in knowledge in lung developmental biology. PMID:23607856

  12. Your Lungs and Respiratory System

    Science.gov (United States)

    ... Videos for Educators Search English Español Your Lungs & Respiratory System KidsHealth / For Kids / Your Lungs & Respiratory System What's ... your body, and your lungs especially hate it. Cigarette smoke damages the cilia in the trachea so they ...

  13. Semiautomatic assessment of respiratory motion in dynamic MRI. Comparison with simultaneously acquired spirometry

    Energy Technology Data Exchange (ETDEWEB)

    Tetzlaff, R.; Eichinger, M.; Puderbach, M. [Radiologie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Schoebinger, M.; Meinzer, H.P. [Medizinische und Biologische Informatik, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Kauczor, H.U. [Diagnostische Radiologie, Radiologische Universitaetsklinik, Heidelberg (Germany)

    2008-11-15

    Purpose: supplementing global spirometry with regional information could allow for earlier and more specific diagnosis of lung disease. Dynamic magnetic resonance imaging (dMRI) makes it possible to derive functional parameters from the visualization of the pulmonary motion of single lungs. The aim of this study was to compare high temporal resolution measurements of left and right thoracic diameters to simultaneously acquired spirometry. Materials and methods: 10 healthy volunteers underwent 2-dimensional dMRI of both lungs at 1.5 T. Spirometry was performed simultaneously with an MRI-compatible spirometer. Thoracic diameters were measured semiautomatically and compared to simultaneously measured spirometric volumes. A dMRI surrogate for the Tiffeneau Index was compared to the spirometric Tiffeneau. Results: The volume-time and flow-volume curves from dMRI were very similar to the spirometric curves. The semiautomatically measured diameters correlated well with the spirometric volumes (r > = 0.8, p < 10-15). Agreement between the methods at full temporal resolution was not as convincing (width of 95% limits of agreement interval up to 56%). Good agreement was found between the Tiffenau surrogate and spirometry (width of 95% limits of agreement interval of 14.5%). (orig.)

  14. Simultaneous shoulder and elbow dislocation.

    Science.gov (United States)

    Cobanoğlu, Mutlu; Yumrukcal, Feridun; Karataş, Cengiz; Duygun, Fatih

    2014-05-23

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice. 2014 BMJ Publishing Group Ltd.

  15. Innate Immune Landscape in Early Lung Adenocarcinoma by Paired Single-Cell Analyses.

    Science.gov (United States)

    Lavin, Yonit; Kobayashi, Soma; Leader, Andrew; Amir, El-Ad David; Elefant, Naama; Bigenwald, Camille; Remark, Romain; Sweeney, Robert; Becker, Christian D; Levine, Jacob H; Meinhof, Klaus; Chow, Andrew; Kim-Shulze, Seunghee; Wolf, Andrea; Medaglia, Chiara; Li, Hanjie; Rytlewski, Julie A; Emerson, Ryan O; Solovyov, Alexander; Greenbaum, Benjamin D; Sanders, Catherine; Vignali, Marissa; Beasley, Mary Beth; Flores, Raja; Gnjatic, Sacha; Pe'er, Dana; Rahman, Adeeb; Amit, Ido; Merad, Miriam

    2017-05-04

    To guide the design of immunotherapy strategies for patients with early stage lung tumors, we developed a multiscale immune profiling strategy to map the immune landscape of early lung adenocarcinoma lesions to search for tumor-driven immune changes. Utilizing a barcoding method that allows a simultaneous single-cell analysis of the tumor, non-involved lung, and blood cells, we provide a detailed immune cell atlas of early lung tumors. We show that stage I lung adenocarcinoma lesions already harbor significantly altered T cell and NK cell compartments. Moreover, we identified changes in tumor-infiltrating myeloid cell (TIM) subsets that likely compromise anti-tumor T cell immunity. Paired single-cell analyses thus offer valuable knowledge of tumor-driven immune changes, providing a powerful tool for the rational design of immune therapies. VIDEO ABSTRACT. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Role of small colony variants in persistence of Pseudomonas aeruginosa infections in cystic fibrosis lungs

    Directory of Open Access Journals (Sweden)

    Malone JG

    2015-07-01

    Full Text Available Jacob G Malone1,21John Innes Centre, Norwich, UK; 2School of Biological Sciences, University of East Anglia, Norwich, UKAbstract: Pseudomonas aeruginosa is an opportunistic pathogen that predominates during the later stages of cystic fibrosis (CF lung infections. Over many years of chronic lung colonization, P. aeruginosa undergoes extensive adaptation to the lung environment, evolving both toward a persistent, low virulence state and simultaneously diversifying to produce a number of phenotypically distinct morphs. These lung-adapted P. aeruginosa strains include the small colony variants (SCVs, small, autoaggregative isolates that show enhanced biofilm formation, strong attachment to surfaces, and increased production of exopolysaccharides. Their appearance in the sputum of CF patients correlates with increased resistance to antibiotics, poor lung function, and prolonged persistence of infection, increasing their relevance as a subject for clinical investigation. The evolution of SCVs in the CF lung is associated with overproduction of the ubiquitous bacterial signaling molecule cyclic-di-GMP, with increased cyclic-di-GMP levels shown to be responsible for the SCV phenotype in a number of different CF lung isolates. Here, we review the current state of research in clinical P. aeruginosa SCVs. We will discuss the phenotypic characteristics underpinning the SCV morphotype, the clinical implications of lung colonization with SCVs, and the molecular basis and clinical evolution of the SCV phenotype in the CF lung environment.Keywords: small colony variants, cystic fibrosis, cyclic-di-GMP, Pseudomonas aeruginosa, RsmA, antibiotics

  17. Protecting Your Lungs

    Science.gov (United States)

    ... Don't Smoke Cigarette smoking is the major cause of lung cancer and chronic obstructive pulmonary disease ( COPD ), which includes ... air passages and make breathing more difficult. It causes chronic inflammation, ... changes that grow into cancer. If you smoke, it's never too late to ...

  18. Lung Cancer Survivorship

    Centers for Disease Control (CDC) Podcasts

    2016-10-20

    A lung cancer survivor shares her story about diagnosis, treatment, and community support. She also gives advice for other cancer survivors.  Created: 10/20/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/20/2016.

  19. Tuberculosis mimicking lung cancer

    Directory of Open Access Journals (Sweden)

    I. Hammen

    2015-01-01

    Our case report presents two patients, who were referred to the Thorax diagnostic centre at the Department of Respiratory Medicine, Odense University Hospital, with presumptive diagnosis of neoplasm and had proved lung TB with no evidence of malignancy instead. In the first case diagnosis was confirmed after thoracotomy, in the second case after bronchoscopy.

  20. Chemoprevention of Lung Cancer

    Science.gov (United States)

    Szabo, Eva; Mao, Jenny T.; Lam, Stephen; Reid, Mary E.

    2013-01-01

    Background: Lung cancer is the most common cause of cancer death in men and women in the United States. Cigarette smoking is the main risk factor. Former smokers are at a substantially increased risk of developing lung cancer compared with lifetime never smokers. Chemoprevention refers to the use of specific agents to reverse, suppress, or prevent the process of carcinogenesis. This article reviews the major agents that have been studied for chemoprevention. Methods: Articles of primary, secondary, and tertiary prevention trials were reviewed and summarized to obtain recommendations. Results: None of the phase 3 trials with the agents β-carotene, retinol, 13-cis-retinoic acid, α-tocopherol, N-acetylcysteine, acetylsalicylic acid, or selenium has demonstrated beneficial and reproducible results. To facilitate the evaluation of promising agents and to lessen the need for a large sample size, extensive time commitment, and expense, surrogate end point biomarker trials are being conducted to assist in identifying the most promising agents for later-stage chemoprevention trials. With the understanding of important cellular signaling pathways and the expansion of potentially important targets, agents (many of which target inflammation and the arachidonic acid pathway) are being developed and tested which may prevent or reverse lung carcinogenesis. Conclusions: By integrating biologic knowledge, additional early-phase trials can be performed in a reasonable time frame. The future of lung cancer chemoprevention should entail the evaluation of single agents or combinations that target various pathways while working toward identification and validation of intermediate end points. PMID:23649449

  1. Pediatric acute lung injury

    NARCIS (Netherlands)

    Dahlem, P.; van Aalderen, W. M. C.; Bos, A. P.

    2007-01-01

    Among ventilated children, the incidence of acute lung injury (ALI) was 9%; of that latter group 80% developed the acute respiratory distress syndrome (ARDS). The population-based prevalence of pediatric ARDS was 5.5 cases/100.000 inhabitants. Underlying diseases in children were septic shock (34%),

  2. Predicting occupational lung diseases

    NARCIS (Netherlands)

    Suarthana, E.

    2008-01-01

    This thesis aims at demonstrating the development, validation, and application of prediction models for occupational lung diseases. Prediction models are developed to estimate an individual’s probability of the presence or future likelihood of occurrence of an outcome (i.e. disease of interest or

  3. Lung Transplantation for Chronic Humidifier Disinfectant-Associated Lung Injury

    Directory of Open Access Journals (Sweden)

    Won-Young Kim

    2016-05-01

    Full Text Available In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL. However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient’s clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.

  4. Visual anatomical lung CT scan assessment of lung recruitability.

    Science.gov (United States)

    Chiumello, Davide; Marino, Antonella; Brioni, Matteo; Menga, Federica; Cigada, Irene; Lazzerini, Marco; Andrisani, Maria C; Biondetti, Pietro; Cesana, Bruno; Gattinoni, Luciano

    2013-01-01

    The computation of lung recruitability in acute respiratory distress syndrome (ARDS) is advocated to set positive end-expiratory pressure (PEEP) for preventing lung collapse. The quantitative lung CT scan, obtained by manual image processing, is the reference method but it is time consuming. The aim of this study was to evaluate the accuracy of a visual anatomical analysis compared with a quantitative lung CT scan analysis in assessing lung recruitability. Fifty sets of two complete lung CT scans of ALI/ARDS patients computing lung recruitment were analyzed. Lung recruitability computed at an airway pressure of 5 and 45 cm H(2)O was defined as the percentage decrease in the collapsed/consolidated lung parenchyma assessed by two expert radiologists using a visual anatomical analysis and as the decrease in not aerated lung regions using a quantitative analysis computed by dedicated software. Lung recruitability was 11.3 % (interquartile range 7.39-16.41) and 15.5 % (interquartile range 8.18-21.43) with the visual anatomical and quantitative analysis, respectively. In the Bland-Altman analysis, the bias and agreement bands between the visual anatomical and quantitative analysis were -2.9 % (-11.8 to +5.9 %). The ROC curve showed that the optimal cutoff values for the visual anatomical analysis in predicting high versus low lung recruitability was 8.9 % (area under the ROC curve 0.9248, 95 % CI 0.8550-0.9946). Considering this cutoff, the sensitivity, specificity, and diagnostic accuracy were 0.96, 0.76, and 0.86, respectively. Visual anatomical analysis can classify patients into those with high and low lung recruitability allowing more intensivists to get access to lung recruitability assessment.

  5. Developmental defects of the lungs

    Energy Technology Data Exchange (ETDEWEB)

    DaCosta, H.; Pathak, A.; Noronha, O.; Dalal, S.; Shah, K.; Merchant, S.

    1981-06-01

    Poor lung development was first noted on scintigraphy using sup(99m)Tc-phytate in 32 children. They had all been referred for a hepatosplenic scan but the initial circulatory phase of the radiopharmaceutical was also recorded as a routine procedure. In 3 patients it revealed aplasia of an entire lung; bilateral pulmonary hypolplasia was observed in 14 of 16 patients with diaphragmatic herniae. Six patients with congenital heart enlargement showed a poorly developed ipsilateral lung; 5 of 6 patients with dextrocardia without an intracardiac defect had a larger left lung compared with the right lung; both pulmonary beds appeared equal in a patient with mesocardia.

  6. Promoted Delivery of Salinomycin to Lung Cancer Through Epidermal Growth Factor Receptor Aptamers Coupled DSPE-PEG2000 Nanomicelles.

    Science.gov (United States)

    Leng, Dewen; Hu, Jun; Huang, Xiaolong; He, Wei; Wang, Yuan; Liu, Mei

    2018-08-01

    Initiation and recurrence of lung cancer, the most fatal cancer worldwide, are attributed to lung cancer stem cells (CSCs). Evidence suggests that cancer cells can be turned into CSCs in a spontaneous way, and therefore simultaneous elimination of lung CSCs and cancer cells is crucial to achieve effective therapy of lung cancer. In lung cancer, epidermal growth factor receptor (EGFR) is overexpressed in both CSCs and cancer cells. The present study developed salinomycin poly(ethylene glycol) 2000-distearoylphosphatidylethanolamine nanomicelles conjugated with EGFR aptamers (M-SAL-EGFR) to kill lung CSCs and cancer cells. The 24 nm sized M-SAL-EGFR was prepared by a lipid film based method. The EGFR was overexpressed in lung CSCs and cancer cells. Results revealed that the M-SAL-EGFR could efficiently bind to EGFR-overexpressing lung CSCs and cancer cells, and induced enhanced cyotoxic effect than non-targeted M-SAL and salinomycin. Administration of M-SAL-EGFR in mice with lung cancer xenograft inhibited tumor growth more effectively compared with M-SAL and salinomycin. The EGFR aptamers were thus able to promote effective salinomycin delivery to lung cancer. Our results also suggest that the M-SAL-EGFR represents a promising approach for targeting both lung CSCs and cancer cells.

  7. The Danish Lung Cancer Registry

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Rasmussen, Torben Riis

    2016-01-01

    AIM OF DATABASE: The Danish Lung Cancer Registry (DLCR) was established by the Danish Lung Cancer Group. The primary and first goal of the DLCR was to improve survival and the overall clinical management of Danish lung cancer patients. STUDY POPULATION: All Danish primary lung cancer patients since...... 2000 are included into the registry and the database today contains information on more than 50,000 cases of lung cancer. MAIN VARIABLES: The database contains information on patient characteristics such as age, sex, diagnostic procedures, histology, tumor stage, lung function, performance...... the results are commented for local, regional, and national audits. Indicator results are supported by descriptive reports with details on diagnostics and treatment. CONCLUSION: DLCR has since its creation been used to improve the quality of treatment of lung cancer in Denmark and it is increasingly used...

  8. Increased mean lung density: Another independent predictor of lung cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Sverzellati, Nicola, E-mail: nicola.sverzellati@unipr.it [Department of Department of Surgical Sciences, Section of Diagnostic Imaging, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100 Parma (Italy); Randi, Giorgia, E-mail: giorgia.randi@marionegri.it [Department of Epidemiology, Mario Negri Institute, Via La Masa 19, 20156 Milan (Italy); Spagnolo, Paolo, E-mail: paolo.spagnolo@unimore.it [Respiratory Disease Unit, Center for Rare Lung Disease, Department of Oncology, Hematology and Respiratory Disease, University of Modena and Reggio Emilia, Via del Pozzo 71, 44124 Modena (Italy); Marchianò, Alfonso, E-mail: alfonso.marchiano@istitutotumori.mi.it [Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan (Italy); Silva, Mario, E-mail: mac.mario@hotmail.it [Department of Department of Surgical Sciences, Section of Diagnostic Imaging, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100 Parma (Italy); Kuhnigk, Jan-Martin, E-mail: Jan-Martin.Kuhnigk@mevis.fraunhofer.de [Fraunhofer MEVIS, Universitaetsallee 29, 28359 Bremen (Germany); La Vecchia, Carlo, E-mail: carlo.lavecchia@marionegri.it [Department of Occupational Health, University of Milan, Via Venezian 1, 20133 Milan (Italy); Zompatori, Maurizio, E-mail: maurizio.zompatori@unibo.it [Department of Radiology, Cardio-Thoracic Section, S. Orsola-Malpighi Hospital, Via Albertoni 15, 40138 Bologna (Italy); Pastorino, Ugo, E-mail: ugo.pastorino@istitutotumori.mi.it [Department of Surgery, Section of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan (Italy)

    2013-08-15

    Objectives: To investigate the relationship between emphysema phenotype, mean lung density (MLD), lung function and lung cancer by using an automated multiple feature analysis tool on thin-section computed tomography (CT) data. Methods: Both emphysema phenotype and MLD evaluated by automated quantitative CT analysis were compared between outpatients and screening participants with lung cancer (n = 119) and controls (n = 989). Emphysema phenotype was defined by assessing features such as extent, distribution on core/peel of the lung and hole size. Adjusted multiple logistic regression models were used to evaluate independent associations of CT densitometric measurements and pulmonary function test (PFT) with lung cancer risk. Results: No emphysema feature was associated with lung cancer. Lung cancer risk increased with decreasing values of forced expiratory volume in 1 s (FEV{sub 1}) independently of MLD (OR 5.37, 95% CI: 2.63–10.97 for FEV{sub 1} < 60% vs. FEV{sub 1} ≥ 90%), and with increasing MLD independently of FEV{sub 1} (OR 3.00, 95% CI: 1.60–5.63 for MLD > −823 vs. MLD < −857 Hounsfield units). Conclusion: Emphysema per se was not associated with lung cancer whereas decreased FEV{sub 1} was confirmed as being a strong and independent risk factor. The cross-sectional association between increased MLD and lung cancer requires future validations.

  9. Simultaneous seeing measurements at Atacama

    Science.gov (United States)

    Uraguchi, Fumihiro; Motohara, Kentaro; Doi, Mamoru; Takato, Naruhisa; Miyashita, Akihiko; Tanabe, Toshihiko; Oyabu, Shinki; Soyano, Takao

    2004-10-01

    Institute of Astronomy, University of Tokyo is now planning to build a 6.5-m optical-infrared telescope in Atacama, Chile. This project is called "Univ. Tokyo Atacama Observatory (TAO)", and the site evaluation is now under way. As a part of this evaluation process, we started an investigation to compare the astronomical seeing at Atacama with that at Mauna Kea. Here, we report preliminary results of seeing measurements at several sites in Atacama, carried out on October 2003. In order to separate the temporal and site-to-site variation of the seeing, we used two sets of Differential Image Motion Monitors (DIMMs), each of which has two pairs of 7.4 cm sub-apertures with 20.5 cm separation. Three sites were investigated; the point near the TAO weather station (4,950m), the summit of Cello Chico (5,150m) and the point at 5,430m altitude on Cello Toco. Simultaneous measurements were carried out for three half nights out of four half nights measurements. Although the amount of our data is very limited, the results suggest following: 1) Seeing becomes better and more stable as time passing to midnight (eg. From 0."7 to 0."4 at V-band). 2) Higher altitude sites show better seeing than lower altitude sites.

  10. Diffuse parenchymal lung disease

    Directory of Open Access Journals (Sweden)

    Sara Tomassetti

    2017-04-01

    Full Text Available Between September 2015 and August 2016 there were >1500 publications in the field of diffuse parenchymal lung diseases (DPLDs. For the Clinical Year in Review session at the European Respiratory Society Congress that was held in London, UK, in September 2016, we selected only five articles. This selection, made from the enormous number of published papers, does not include all the relevant studies that will significantly impact our knowledge in the field of DPLDs in the near future. This review article provides our personal view on the following topics: early diagnosis of idiopathic pulmonary fibrosis, current knowledge on the multidisciplinary team diagnosis of DPLDs and the diagnostic role of transbronchial cryobiopsy in this diagnostic setting, insights on the new entity of interstitial pneumonia with autoimmune features, and new therapeutic approaches for scleroderma-related interstitial lung disease.

  11. Angiosarcoma of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Grafino, Monica; Alves, Paula; Almeida, Margarida Mendes de; Garrido, Patricia; Hasmucrai, Direndra; Teixeira, Encarnacao; Sotto-Mayor, Renato, E-mail: mgrafino@gmail.com [Centro Hospitalar Lisboa Norte, EPE, Lisboa (Portugal)

    2016-06-01

    Angiosarcoma is a rare malignant vascular tumor. Pulmonary involvement is usually attributable to metastasis from other primary sites, primary pulmonary angiosarcoma therefore being quite uncommon. We report a case of angiosarcoma with pulmonary involvement, probably primary to the lung, which had gone untreated for more than two years. We describe this rare neoplasm and its growth, as well as the extensive local invasion and hematogenous metastasis at presentation. We also discuss its poor prognosis. (author)

  12. Lung donor selection criteria.

    Science.gov (United States)

    Chaney, John; Suzuki, Yoshikazu; Cantu, Edward; van Berkel, Victor

    2014-08-01

    The criteria that define acceptable physiologic and social parameters for lung donation have remained constant since their empiric determination in the 1980s. These criteria include a donor age between 25-40, a arterial partial pressure of oxygen (PaO2)/FiO2 ratio greater than 350, no smoking history, a clear chest X-ray, clean bronchoscopy, and a minimal ischemic time. Due to the paucity of organ donors, and the increasing number of patients requiring lung transplant, finding a donor that meets all of these criteria is quite rare. As such, many transplants have been performed where the donor does not meet these stringent criteria. Over the last decade, numerous reports have been published examining the effects of individual acceptance criteria on lung transplant survival and graft function. These studies suggest that there is little impact of the historical criteria on either short or long term outcomes. For age, donors should be within 18 to 64 years old. Gender may relay benefit to all female recipients especially in male to female transplants, although results are mixed in these studies. Race matched donor/recipients have improved outcomes and African American donors convey worse prognosis. Smoking donors may decrease recipient survival post transplant, but provide a life saving opportunity for recipients that may otherwise remain on the transplant waiting list. No specific gram stain or bronchoscopic findings are reflected in recipient outcomes. Chest radiographs are a poor indicator of lung donor function and should not adversely affect organ usage aside for concerns over malignancy. Ischemic time greater than six hours has no documented adverse effects on recipient mortality and should not limit donor retrieval distances. Brain dead donors and deceased donors have equivalent prognosis. Initial PaO2/FiO2 ratios less than 300 should not dissuade donor organ usage, although recruitment techniques should be implemented with intent to transplant.

  13. Insulin and the Lung

    DEFF Research Database (Denmark)

    Singh, Suchita; Prakash, Y S; Linneberg, Allan

    2013-01-01

    Obesity, metabolic syndrome, and asthma are all rapidly increasing globally. Substantial emerging evidence suggests that these three conditions are epidemiologically and mechanistically linked. Since the link between obesity and asthma appears to extend beyond mechanical pulmonary disadvantage...... and highlights the molecular consequences of insulin-related metabolic signaling cascades that could adversely affect lung structure and function. Examples include airway smooth muscle proliferation and contractility and regulatory signaling networks that are associated with asthma. These aspects of insulin...

  14. Can neural machine translation do simultaneous translation?

    OpenAIRE

    Cho, Kyunghyun; Esipova, Masha

    2016-01-01

    We investigate the potential of attention-based neural machine translation in simultaneous translation. We introduce a novel decoding algorithm, called simultaneous greedy decoding, that allows an existing neural machine translation model to begin translating before a full source sentence is received. This approach is unique from previous works on simultaneous translation in that segmentation and translation are done jointly to maximize the translation quality and that translating each segmen...

  15. Mechanotransduction in the lungs.

    Science.gov (United States)

    Spieth, P M; Bluth, T; Gama De Abreu, M; Bacelis, A; Goetz, A E; Kiefmann, R

    2014-08-01

    Mechanical ventilation may induce or aggravate lung injury, a phenomenon known as ventilator induced lung injury (VILI). On a macroscopic level, the effects of mechanical stress and strain on lung tissue are well described. Increased tidal volumes may lead to volutrauma, raised airway pressures may cause barotrauma and cyclic collapse and reopening of alveolar units contributes to atelectrauma. These three harmful mechanisms may lead to local and systemic pulmonary inflammatory response known as biotrauma. The purpose of this review was to elucidate fundamental mechanisms involved in the mechanotransduction of mechanical stimuli on a cellular level. Bronchial epithelial cells in the distal airways as well as alveolar epithelial cells are exposed to a variety of mechanical forces. These cells are involved in sensing and translation of mechanical stimuli into an inflammatory response. This review provides insight into current knowledge of cellular and molecular pathways during the process of pulmonary epithelial mechanosensation and mechanotransduction under different mechanical conditions. Since evidence for specific pathways is generally lacking in some fields of alveolar epithelial mechanotransduction, this article aims at providing reasonable hypothesis for further investigation.

  16. Parasitic lung infections.

    Science.gov (United States)

    Vijayan, Vannan Kandi

    2009-05-01

    Global climate change and population explosion leading to changes in natural ecosystem and travel across the continents have resulted in an increase in the transmission of parasites to human beings. This review focuses on recent advancements in parasitic lung infections. Invasive parasitic diseases including lung infections are increasingly being reported in patients with immunodeficiency syndromes. A recombinant kinesin-related antigen of Leishmania donovani has been validated with ELISA using urine samples for the diagnosis of visceral leishmaniasis. Pyruvate kinase deficiency has been shown to provide protection against Plasmodium falciparum infection. Intravenous artesunate is an alternative drug for the treatment of severe malaria. The best way to protect from malaria is the use of long-lasting insecticide-treated bednets. Biennial treatment with praziquantel has been found to be cost-effective treatment for control of infection with Schistosoma haematobium. Pulmonary paragonimiasis can be diagnosed by fine needle aspiration biopsy of pulmonary nodules. Strongyloides stercoralis hyperinfection can mimic accelerated idiopathic pulmonary fibrosis. Migratory nodular shadows with halos are important chest computed tomographic findings in human toxocariasis. Patients with immunodeficiency syndromes (HIV infection, organ transplantation and immunosuppressive drugs, including corticosteroids) should be evaluated for early detection of parasitic lung infections.

  17. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  18. Advances in Lung Stem Cells and Lung Cancer Stem Cells

    Directory of Open Access Journals (Sweden)

    Huijing YIN

    2015-10-01

    Full Text Available Cancer stem cells (CSCs are emerging as a hot topic for cancer research. Lung CSCs share many characteristics with normal lung stem cells (SCs, including self-renewal and multi-potency for differentiation. Many molecular markers expressed in various types of CSCs were also found in lung CSCs, such as CD133, CD44, aldehyde dehydrogenase (ALDH and ATP-binding cassette sub-family G member 2 (ABCG2. Similarly, proliferation and expansion of lung CSCs are regulated not only by signal transduction pathways functioning in normal lung SCs, such as Notch, Hedgehog and Wnt pathways, but also by those acting in tumor cells, such as epidermal growth factor receptor (EGFR, signal transducer and activator of transcription 3 (STAT3 and phosphatidylinositol 3 kinase (PI3K pathways. As CSC plays an critical role in tumor recurrence, metastasis and drug-resistance, understanding the difference between lung CSCs and normal lung SCs, identifying and targeting CSC markers or related signaling pathways may increase the efficacy of therapy on lung cancer and improved survival of lung cancer patients.

  19. Lung function; Lungenfunktion

    Energy Technology Data Exchange (ETDEWEB)

    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

  20. Effects of combinations of diesel exhaust and ozone exposure on lung function in human volunteers.

    Science.gov (United States)

    Ozone (03) exposure induces changes in human lung function, typically seen as a decrease in forced expiratory volume in one sec (FEV1) and forced vital capacity (FVC). Because people are usually exposed to other ambient air pollutants simultaneously with 03, there may be interact...

  1. Diagnostic Imaging of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kemal Kara

    2012-12-01

    Full Text Available Lung cancer is the most common cause of cancer related death in men and women. It is frequently seen among men than in women and male-female ratio is 1.5:1. Common epidemiological factors that increase risk of lung cancer is smoking. Early age to start smoking, high number of smoking cigarettes per a day and depth of inhalation increase risk of lung cancer. 25% of patients with lung cancer are nonsmokers that passively exposed to cigarette smoke. Occupational exposure to substances such as asbestos, arsenic, nickel, beryllium, mustard gas increases the risk of lung cancer. The well defined risk factor is exposure to asbestos. In addition advanced age, diffuse pulmonary fibrosis, chronic obstructive pulmonary disease (COPD and genetic predisposition are the risk factors that increases lung cancer. [TAF Prev Med Bull 2012; 11(6.000: 749-756

  2. Evolving Concepts in Lung Carcinogenesis

    Science.gov (United States)

    Gomperts, Brigitte N.; Spira, Avrum; Massion, Pierre P.; Walser, Tonya C.; Wistuba, Ignacio I.; Minna, John D.; Dubinett, Steven M.

    2012-01-01

    Lung carcinogenesis is a complex, stepwise process that involves the acquisition of genetic mutations and epigenetic changes that alter cellular processes, such as proliferation, differentiation, invasion, and metastasis. Here, we review some of the latest concepts in the pathogenesis of lung cancer and highlight the roles of inflammation, the “field of cancerization,” and lung cancer stem cells in the initiation of the disease. Furthermore, we review how high throughput genomics, transcriptomics, epigenomics, and proteomics are advancing the study of lung carcinogenesis. Finally, we reflect on the potential of current in vitro and in vivo models of lung carcinogenesis to advance the field and on the areas of investigation where major breakthroughs will lead to the identification of novel chemoprevention strategies and therapies for lung cancer. PMID:21500122

  3. Lung Cancer Screening and clinical implications

    NARCIS (Netherlands)

    S.C. van 't Westeinde (Susan)

    2012-01-01

    textabstractLung cancer is the most frequently diagnosed major cancer worldwide and the leading cause of death from cancer. Lung cancer is divided into two subgroups: small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC), accounting for 10-20% and 75% of lung cancer cases,

  4. Vagal denervation inhibits the increase in pulmonary blood flow during partial lung aeration at birth.

    Science.gov (United States)

    Lang, Justin A R; Pearson, James T; Binder-Heschl, Corinna; Wallace, Megan J; Siew, Melissa L; Kitchen, Marcus J; Te Pas, Arjan B; Lewis, Robert A; Polglase, Graeme R; Shirai, Mikiyasu; Hooper, Stuart B

    2017-03-01

    Lung aeration at birth significantly increases pulmonary blood flow, which is unrelated to increased oxygenation or other spatial relationships that match ventilation to perfusion. Using simultaneous X-ray imaging and angiography in near-term rabbits, we investigated the relative contributions of the vagus nerve and oxygenation to the increase in pulmonary blood flow at birth. Vagal denervation inhibited the global increase in pulmonary blood flow induced by partial lung aeration, although high inspired oxygen concentrations can partially mitigate this effect. The results of the present study indicate that a vagal reflex may mediate a rapid global increase in pulmonary blood flow in response to partial lung aeration. Air entry into the lungs at birth triggers major cardiovascular changes, including a large increase in pulmonary blood flow (PBF) that is not spatially related to regional lung aeration. To investigate the possible underlying role of a vagally-mediated stimulus, we used simultaneous phase-contrast X-ray imaging and angiography in near-term (30 days of gestation) vagotomized (n = 15) or sham-operated (n = 15) rabbit kittens. Rabbits were imaged before ventilation, when one lung was ventilated (unilateral) with 100% nitrogen (N2 ), air or 100% oxygen (O2 ), and after all kittens were switched to unilateral ventilation in air and then ventilation of both lungs using air. Compared to control kittens, vagotomized kittens had little or no increase in PBF in both lungs following unilateral ventilation when ventilation occurred with 100% N2 or with air. However, relative PBF did increase in vagotomized animals ventilated with 100% O2 , indicating the independent stimulatory effects of local oxygen concentration and autonomic innervation on the changes in PBF at birth. These findings demonstrate that vagal denervation inhibits the previously observed increase in PBF with partial lung aeration, although high inspired oxygen concentrations can partially

  5. Comprehensive evaluation of lung allograft function in infants after lung and heart-lung transplantation.

    Science.gov (United States)

    Hayes, Don; Naguib, Aymen; Kirkby, Stephen; Galantowicz, Mark; McConnell, Patrick I; Baker, Peter B; Kopp, Benjamin T; Lloyd, Eric A; Astor, Todd L

    2014-05-01

    Limited data exist on methods to evaluate allograft function in infant recipients of lung and heart-lung transplants. At our institution, we developed a procedural protocol in coordination with pediatric anesthesia where infants were sedated to perform infant pulmonary function testing, computed tomography imaging of the chest, and flexible fiberoptic bronchoscopy with transbronchial biopsies. A retrospective review was performed of children aged younger than 1 year who underwent lung or heart-lung transplantation at our institution to assess the effect of this procedural protocol in the evaluation of infant lung allografts. Since 2005, 5 infants have undergone thoracic transplantation (3 heart-lung, 2 lung). At time of transplant, the mean ± standard deviation age was 7.2 ± 2.8 months (range, 3-11 months). Of 24 procedural sessions performed to evaluate lung allografts, 83% (20 of 24) were considered surveillance where the patients were completely asymptomatic. Of the surveillance procedures, 80% were performed as an outpatient, whereas 20% were done as inpatients during the lung or heart-lung transplant post-operative period before discharge home. Sedation was performed with propofol alone (23 of 24) or in addition to ketamine (1 of 24) infusion; mean sedation time was 141 ± 39 minutes (range, 70-214) minutes. Of the 16 outpatient procedures, patients were discharged after 14 (88%) on the same day, and after 2 (12%) were admitted for observation, with 1 being due to transportation issues and the other due to fever during the observation period. A comprehensive procedural protocol to evaluate allograft function in infant lung and heart-lung transplant recipients was performed safely as an outpatient. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  6. Pulmonary arterial wall disease in COPD and interstitial lung diseases candidates for lung transplantation.

    Science.gov (United States)

    Domingo, Enric; Grignola, Juan C; Aguilar, Rio; Messeguer, Manuel López; Roman, Antonio

    2017-05-06

    Pulmonary hypertension (PH) associated with lung disease has the worst prognosis of all types of PH. Pulmonary arterial vasculopathy is an early event in the natural history of chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). The present study characterized the alterations in the structure and function of the pulmonary arterial (PA) wall of COPD and ILD candidates for lung transplantation (LTx). A cohort of 73 patients, 63 pre-LTx (30 COPD, 33 ILD), and ten controls underwent simultaneous right heart catheterisation and intravascular ultrasound (IVUS). Total pulmonary resistance (TPR), capacitance (Cp), and the TPR-Cp relationship were assessed. PA stiffness and the relative area of wall thickness were estimated as pulse PA pressure/IVUS pulsatility and as [(external sectional area-intimal area)/external sectional area] × 100, respectively. Twenty-seven percent of patients had pulmonary arterial wedge pressure > 15 mmHg and were not analyzed. PA stiffness and the area of wall thickness were increased in comparison with controls, even in patients without PH (p < 0.05). ILD patients showed a significant higher PA stiffness, and lower Cp beyond mean PA pressure (mPAP) and lower area of wall thickness than COPD patients (p < 0.05). TPR-Cp relationship was shifted downward left for ILD patients. Significant increase of PA stiffness and area of wall thickness were present even in patients without PH and can make the diagnosis of pulmonary vasculopathy at a preclinical stage in PH-lung disease candidates for LTx. ILD patients showed the worst PA stiffness and Cp with respect to COPD.

  7. Radionuclide injury to the lung.

    OpenAIRE

    Dagle, G E; Sanders, C L

    1984-01-01

    Radionuclide injury to the lung has been studied in rats, hamsters, dogs, mice and baboons. Exposure of the lung to high dose levels of radionuclides produces a spectrum of progressively more severe functional and morphological changes, ranging from radiation pneumonitis and fibrosis to lung tumors. These changes are somewhat similar for different species. Their severity can be related to the absorbed radiation dose (measured in rads) produced by alpha, beta or gamma radiation emanating from ...

  8. Interstitial lung diseases in children

    Directory of Open Access Journals (Sweden)

    N. S. Lev

    2014-01-01

    Full Text Available The paper deals with interstitial lung diseases in children. It gives an update and the results of the authors’ observations of different forms of interstitial lung diseases. Particular emphasis is placed on hypersensitive pneumonitis as the most common nosological entity among childhood interstitial lung diseases. The authors followed up 186 children with hypersensitive pneumonitis. They present the most important clinical, functional, radiological, and immunological diagnostic signs of this disease and consider its prognosis. In addition, there is evidence for other rare forms of interstitial lung diseases (idiopathic interstitial pneumonia, idiopathic pulmonary hemosiderosis, etc. in children. 

  9. Lung cancer: principles and practice

    National Research Council Canada - National Science Library

    Pass, Harvey I

    2005-01-01

    "A comprehensive review of lung cancer, from screening, early detection, and prevention, to management strategies including surgery, chemotherapy, radiation therapy, and multimodality therapy, as well...

  10. Loudness estimation of simultaneous sources using beamforming

    DEFF Research Database (Denmark)

    Song, Woo-keun; Ellermeier, Wolfgang; Minnaar, Pauli

    2006-01-01

    An algorithm is proposed for estimating the loudness of several simultaneous sound sources by means of microphone-array beamforming. The algorithm is derived from two listening experiments in which the loudness of two simultaneous sounds (narrow-band noises with 1-kHz and 3.15-kHz center frequenc...

  11. 5 CFR 1651.11 - Simultaneous death.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Simultaneous death. 1651.11 Section 1651.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD DEATH BENEFITS § 1651.11 Simultaneous death. If a beneficiary dies at the same time as the participant, the beneficiary will be treated...

  12. Regeneration of the lung: Lung stem cells and the development of lung mimicking devices

    OpenAIRE

    Schilders, K.; Eenjes, E. (Evelien); Riet, S. van de; Poot, Andreas A.; Stamatialis, Dimitrios; Truckenmüller, R.K.; Hiemstra, P; Rottier, R.

    2016-01-01

    textabstractInspired by the increasing burden of lung associated diseases in society and an growing demand to accommodate patients, great efforts by the scientific community produce an increasing stream of data that are focused on delineating the basic principles of lung development and growth, as well as understanding the biomechanical properties to build artificial lung devices. In addition, the continuing efforts to better define the disease origin, progression and pathology by basic scien...

  13. Size matching in lung transplantation using predicted total lung capacity

    NARCIS (Netherlands)

    Ouwens, JP; van der Mark, TW; van der Bij, W; Koeter, GH

    2002-01-01

    Height is used in allocation of donor lungs as an indirect estimate of thoracic size. Total lung capacity (TLC), determined by both height and sex, could be a more accurate functional estimation of thoracic size. Size-matching criteria based on height versus predicted TLC was retrospectively

  14. Lung dendritic cells imprint T cell lung homing and promote lung immunity through the chemokine receptor CCR4

    OpenAIRE

    Mikhak, Zamaneh; Strassner, James P.; Luster, Andrew D.

    2013-01-01

    T cell trafficking into the lung is critical for lung immunity, but the mechanisms that mediate T cell lung homing are not well understood. Here, we show that lung dendritic cells (DCs) imprint T cell lung homing, as lung DC–activated T cells traffic more efficiently into the lung in response to inhaled antigen and at homeostasis compared with T cells activated by DCs from other tissues. Consequently, lung DC–imprinted T cells protect against influenza more effectively than do gut and skin DC...

  15. Collapsed Lung: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Pneumothorax - infants (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Collapsed Lung updates ... Lung surgery Pneumothorax - slideshow Pneumothorax - infants Related Health Topics Chest Injuries and Disorders Lung Diseases Pleural Disorders ...

  16. Rheumatoid Arthritis: Can It Affect the Lungs?

    Science.gov (United States)

    Rheumatoid arthritis: Can it affect the lungs? Can rheumatoid arthritis affect your lungs? Answers from April Chang-Miller, M.D. Although rheumatoid arthritis primarily affects joints, it sometimes causes lung disease ...

  17. Potential targets for lung squamous cell carcinoma

    Science.gov (United States)

    Researchers have identified potential therapeutic targets in lung squamous cell carcinoma, the second most common form of lung cancer. The Cancer Genome Atlas (TCGA) Research Network study comprehensively characterized the lung squamous cell carcinoma gen

  18. Standardisation of the measurement of lung volumes

    National Research Council Canada - National Science Library

    Wanger, J; Clausen, J. L; Coates, A; Pedersen, O. F; Brusasco, V; Burgos, F; Casaburi, R; Crapo, R; Enright, P; van der Grinten, C. P. M; Gustafsson, P; Hankinson, J; Jensen, R; Johnson, D; MacIntyre, N; McKay, R; Miller, M. R; Navajas, D; Pellegrino, R; Viegi, G

    2005-01-01

    ..., V.le Benedetto XV, 6, I-16132 Genova, Italy. Fax: 39 0103537690. E-mail: vito.brusasco@unige.it Keywords: Helium, lung function, lung physiology, lung volume measurements, nitrogen, radiology Received...

  19. Inflammaging and the Lung.

    Science.gov (United States)

    Kovacs, Elizabeth J; Boe, Devin M; Boule, Lisbeth A; Curtis, Brenda J

    2017-11-01

    With the coming of the "silver tsunami," expanding the knowledge about how various intrinsic and extrinsic factors affect the immune system in the elderly is timely and of immediate clinical need. The global population is increasing in age. By the year 2030, more than 20% of the population of the United States will be older than 65 years of age. This article focuses on how advanced age alters the immune systems and how this, in turn, modulates the ability of the aging lung to deal with infectious challenges from the outside world and from within the host. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Bricklayers and lung cancer risk

    NARCIS (Netherlands)

    Cremers, Jan

    2014-01-01

    The article ‘Lung cancer risk among bricklayers in a pooled analysis of case–control studies’ in the International Journal of Cancer publishes findings of an epidemiological study (in the frame of a SYNERGY-project) dedicated to the lung cancer risk among bricklayers. The authors conclude that a

  1. The epidemiology of lung cancer.

    Science.gov (United States)

    Williams, M D; Sandler, A B

    2001-01-01

    Lung cancer continues to be the leader in cancer deaths in the United States. The incidence of lung cancer in men has slowly decreased since the late 1980s, but has just now begun to plateau in women at the end of this decade. Despite modest advances in chemotherapy for treating lung cancer, it remains a deadly disease with overall 5-yr survival rates having not increased significantly over the last 25 years, remaining at approximately 14%. Tobacco smoking causes approximately 85-90% of bronchogenic carcinoma. Environmental tobacco exposure or a second-hand smoke also may cause lung cancer in life-long non-smokers. Certain occupational agents such as arsenic, asbestos, chromium, nickel and vinyl chloride increase the relative risk for lung cancer. Smoking has an additive or multiplicative effect with some of these agents. Familial predisposition for lung cancer is an area with advancing research. Developments in molecular biology have led to growing interest in investigation of biological markers, which may increase predisposition to smoking-related carcinogenesis. Hopefully, in the future we will be able to screen for lung cancer by using specific biomarkers. Finally, dietary factors have also been proposed as potential risk modulators, with vitamins A, C and E proposed as having a protective effect. Despite the slow decline of smoking in the United States, lung cancer will likely continue its devastation for years to come.

  2. Microbiome overview in swine lungs.

    Science.gov (United States)

    Siqueira, Franciele Maboni; Pérez-Wohlfeil, Esteban; Carvalho, Fabíola Marques; Trelles, Oswaldo; Schrank, Irene Silveira; Vasconcelos, Ana Tereza Ribeiro; Zaha, Arnaldo

    2017-01-01

    Mycoplasma hyopneumoniae is the etiologic agent of swine enzootic pneumonia. However other mycoplasma species and secondary bacteria are found as inhabitants of the swine respiratory tract, which can be also related to disease. In the present study we have performed a total DNA metagenomic analysis from the lungs of pigs kept in a field condition, with suggestive signals of enzootic pneumonia and without any infection signals to evaluate the bacteria variability of the lungs microbiota. Libraries from metagenomic DNA were prepared and sequenced using total DNA shotgun metagenomic pyrosequencing. The metagenomic distribution showed a great abundance of bacteria. The most common microbial families identified from pneumonic swine's lungs were Mycoplasmataceae, Flavobacteriaceae and Pasteurellaceae, whereas in the carrier swine's lungs the most common families were Mycoplasmataceae, Bradyrhizobiaceae and Flavobacteriaceae. Analysis of community composition in both samples confirmed the high prevalence of M. hyopneumoniae. Moreover, the carrier lungs had more diverse family population, which should be related to the lungs normal flora. In summary, we provide a wide view of the bacterial population from lungs with signals of enzootic pneumonia and lungs without signals of enzootic pneumonia in a field situation. These bacteria patterns provide information that may be important for the establishment of disease control measures and to give insights for further studies.

  3. SIV Infection of Lung Macrophages.

    Science.gov (United States)

    Li, Yue; Kang, Guobin; Duan, Lijie; Lu, Wuxun; Katze, Michael G; Lewis, Mark G; Haase, Ashley T; Li, Qingsheng

    2015-01-01

    HIV-1 depletes CD4+ T cells in the blood, lymphatic tissues, gut and lungs. Here we investigated the relationship between depletion and infection of CD4+ T cells in the lung parenchyma. The lungs of 38 Indian rhesus macaques in early to later stages of SIVmac251 infection were examined, and the numbers of CD4+ T cells and macrophages plus the frequency of SIV RNA+ cells were quantified. We showed that SIV infected macrophages in the lung parenchyma, but only in small numbers except in the setting of interstitial inflammation where large numbers of SIV RNA+ macrophages were detected. However, even in this setting, the number of macrophages was not decreased. By contrast, there were few infected CD4+ T cells in lung parenchyma, but CD4+ T cells were nonetheless depleted by unknown mechanisms. The CD4+ T cells in lung parenchyma were depleted even though they were not productively infected, whereas SIV can infect large numbers of macrophages in the setting of interstitial inflammation without depleting them. These observations point to the need for future investigations into mechanisms of CD4+ T cell depletion at this mucosal site, and into mechanisms by which macrophage populations are maintained despite high levels of infection. The large numbers of SIV RNA+ macrophages in lungs in the setting of interstitial inflammation indicates that lung macrophages can be an important source for SIV persistent infection.

  4. SIV Infection of Lung Macrophages.

    Directory of Open Access Journals (Sweden)

    Yue Li

    Full Text Available HIV-1 depletes CD4+ T cells in the blood, lymphatic tissues, gut and lungs. Here we investigated the relationship between depletion and infection of CD4+ T cells in the lung parenchyma. The lungs of 38 Indian rhesus macaques in early to later stages of SIVmac251 infection were examined, and the numbers of CD4+ T cells and macrophages plus the frequency of SIV RNA+ cells were quantified. We showed that SIV infected macrophages in the lung parenchyma, but only in small numbers except in the setting of interstitial inflammation where large numbers of SIV RNA+ macrophages were detected. However, even in this setting, the number of macrophages was not decreased. By contrast, there were few infected CD4+ T cells in lung parenchyma, but CD4+ T cells were nonetheless depleted by unknown mechanisms. The CD4+ T cells in lung parenchyma were depleted even though they were not productively infected, whereas SIV can infect large numbers of macrophages in the setting of interstitial inflammation without depleting them. These observations point to the need for future investigations into mechanisms of CD4+ T cell depletion at this mucosal site, and into mechanisms by which macrophage populations are maintained despite high levels of infection. The large numbers of SIV RNA+ macrophages in lungs in the setting of interstitial inflammation indicates that lung macrophages can be an important source for SIV persistent infection.

  5. Interstitial lung disease

    Directory of Open Access Journals (Sweden)

    Vincent Cottin

    2013-03-01

    Full Text Available This article reviews the most important articles published in interstitial lung disease, as reviewed during the Clinical Year in Review session at the 2012 annual European Respiratory Society Congress in Vienna, Austria. Since the recent international guidelines for the management of idiopathic pulmonary fibrosis (IPF, important new evidence is available. The anti-fibrotic drug pirfenidone has been recently approved in Europe. Other pharmacological agents, especially nintedanib, are still being tested. The so-called triple combination therapy, anticoagulation therapy and endothelin receptor antagonists, especially ambrisentan, are either harmful or ineffective in IPF and are not recommended as treatment. Although the clinical course of IPF is highly variable, novel tools have been developed for individual prediction of prognosis. Acute exacerbations of IPF are associated with increased mortality and may occur with higher frequency in IPF patients with associated pulmonary hypertension. Interstitial lung disease associated with connective tissue disease has been definitely established to have a better long-term survival than IPF. A subset of patients present with symptoms and/or biological autoimmune features, but do not fulfil diagnostic criteria for a given autoimmune disease; this condition is associated with a higher prevalence of nonspecific interstitial pneumonia pattern, female sex and younger age, although survival relevance is unclear.

  6. Polonium and Lung Cancer

    Directory of Open Access Journals (Sweden)

    Vincenzo Zagà

    2011-01-01

    Full Text Available The alpha-radioactive polonium 210 (Po-210 is one of the most powerful carcinogenic agents of tobacco smoke and is responsible for the histotype shift of lung cancer from squamous cell type to adenocarcinoma. According to several studies, the principal source of Po-210 is the fertilizers used in tobacco plants, which are rich in polyphosphates containing radio (Ra-226 and its decay products, lead 210 (Pb-210 and Po-210. Tobacco leaves accumulate Pb-210 and Po-210 through their trichomes, and Pb-210 decays into Po-210 over time. With the combustion of the cigarette smoke becomes radioactive and Pb-210 and Po-210 reach the bronchopulmonary apparatus, especially in bifurcations of segmental bronchi. In this place, combined with other agents, it will manifest its carcinogenic activity, especially in patients with compromised mucous-ciliary clearance. Various studies have confirmed that the radiological risk from Po-210 in a smoker of 20 cigarettes per day for a year is equivalent to the one deriving from 300 chest X-rays, with an autonomous oncogenic capability of 4 lung cancers per 10000 smokers. Po-210 can also be found in passive smoke, since part of Po-210 spreads in the surrounding environment during tobacco combustion. Tobacco manufacturers have been aware of the alpha-radioactivity presence in tobacco smoke since the sixties.

  7. A new design for high stability pressure-controlled ventilation for small animal lung imaging

    Science.gov (United States)

    Kitchen, M. J.; Habib, A.; Fouras, A.; Dubsky, S.; Lewis, R. A.; Wallace, M. J.; Hooper, S. B.

    2010-02-01

    We have developed a custom-designed ventilator to deliver a stable pressure to the lungs of small animals for use in imaging experiments. Our ventilator was designed with independent pressure vessels to separately control the Peak Inspiratory Pressure (PIP) and Positive End Expiratory Pressure (PEEP) to minimise pressure fluctuations during the ventilation process. The ventilator was computer controlled through a LabVIEW interface, enabling experimental manipulations to be performed remotely whilst simultaneously imaging the lungs in situ. Mechanical ventilation was successfully performed on newborn rabbit pups to assess the most effective ventilation strategies for aerating the lungs at birth. Highly stable pressures enabled reliable respiratory gated acquisition of projection radiographs and a stable prolonged (15 minute) breath-hold for high-resolution computed tomography of deceased rabbit pups at different lung volumes.

  8. A new design for high stability pressure-controlled ventilation for small animal lung imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kitchen, M J; Habib, A; Lewis, R A [School of Physics, Monash University, Clayton, Victoria, 3800 (Australia); Fouras, A; Dubsky, S [Division of Biological Engineering, Monash University and Fluids Laboratory for Aeronautical and Industrial Research, Monash University, Clayton, Victoria, 3800 (Australia); Wallace, M J; Hooper, S B, E-mail: Marcus.Kitchen@sci.monash.edu.a [Department of Physiology, Monash University, Clayton, Victoria 3800 (Australia)

    2010-02-15

    We have developed a custom-designed ventilator to deliver a stable pressure to the lungs of small animals for use in imaging experiments. Our ventilator was designed with independent pressure vessels to separately control the Peak Inspiratory Pressure (PIP) and Positive End Expiratory Pressure (PEEP) to minimise pressure fluctuations during the ventilation process. The ventilator was computer controlled through a LabVIEW interface, enabling experimental manipulations to be performed remotely whilst simultaneously imaging the lungs in situ. Mechanical ventilation was successfully performed on newborn rabbit pups to assess the most effective ventilation strategies for aerating the lungs at birth. Highly stable pressures enabled reliable respiratory gated acquisition of projection radiographs and a stable prolonged (15 minute) breath-hold for high-resolution computed tomography of deceased rabbit pups at different lung volumes.

  9. Proteomics as the Tool to Search for Lung Disease Markers in Bronchoalveolar Lavage

    Directory of Open Access Journals (Sweden)

    Isabelle Noël-Georis

    2001-01-01

    Full Text Available Most lung disorders are known to be associated to considerable modifications of surfactant composition. Numerous of these abnormalities have been exploited in the past to diagnose lung diseases, allowing proper treatment and follow-up. Diagnosis was then based on phospholipid content, surface tension and cytological features of the epithelial lining fluid (ELF, sampled by bronchoalveolar lavage (BAL during fiberoscopic bronchoscopy. Today, it appears that the protein content of ELF displays a remarkably high complexity, not only due to the wide variety of the proteins it contains but also because of the great diversity of their cellular origins. The significance of the use of proteome analysis of BAL fluid for the search for new lung disease marker proteins and for their simultaneous display and analysis in patients suffering from lung disorders has been examined.

  10. Gas cooking and reduced lung function in school children

    Science.gov (United States)

    Moshammer, Hanns; Hutter, Hans-Peter; Neuberger, Manfred

    RationaleOutdoor nitrogen dioxide (NO 2) is associated with reduced respiratory health. This could be due to a unique biological effect of this gaseous pollutant or because it serves as a surrogate of fine particles from incineration sources. Cooking with gas in small kitchens produces high concentrations of gaseous irritants (mainly nitrogen dioxide), but not fine particles. ObjectivesTo study the relative impact of cooking with gas on lung function parameters in a cross sectional study of school children. MethodsNearly all elementary school children (2898 children aged 6-10 years) living in the city of Linz (capital of Upper Austria) underwent lung function testing. In a questionnaire administered simultaneously to their parents, information on household conditions including cooking and tobacco smoke exposure was collected. Impact of cooking with gas on lung function controlling for various confounders was analyzed using loglinear multiple regression. ResultsGas cooking reduced lung function parameters ranging from 1.1% (not significant) for MEF 25 up to 3.4% ( p=0.01) for peak expiratory flow (PEF). ConclusionsGas stoves can have an adverse impact on children's respiratory health. Parents and caretakers should be advised to insure good ventilation while and after cooking, especially in small and poorly ventilated rooms. This study adds to the growing evidence that gaseous pollutants from incineration sources affect respiratory health directly.

  11. Cross-sectional changes in lung volume measured by electrical impedance tomography are representative for the whole lung in ventilated preterm infants.

    Science.gov (United States)

    van der Burg, Pauline S; Miedema, Martijn; de Jongh, Frans H; Frerichs, Inez; van Kaam, Anton H

    2014-06-01

    Electrical impedance tomography measures lung volume in a cross-sectional slice of the lung. Whether these cross-sectional volume changes are representative of the whole lung has only been investigated in adults, showing conflicting results. This study aimed to compare cross-sectional and whole lung volume changes using electrical impedance tomography and respiratory inductive plethysmography. A prospective, single-center, observational, nonrandomized study. The study was conducted in a neonatal ICU in the Netherlands. High-frequency ventilated preterm infants with respiratory distress syndrome. Cross-sectional and whole lung volume changes were continuously and simultaneously measured by, respectively, electrical impedance tomography and respiratory inductive plethysmography during a stepwise recruitment procedure. End-expiratory lung volume changes were assessed by mapping the inflation and deflation limbs using both the pressure/impedance and pressure/inductance pairs and characterized by calculating the inflection points. In addition, oscillatory tidal volume changes were assessed at each pressure step. Twenty-three infants were included in the study. Of these, eight infants had to be excluded because the quality of the registration was insufficient for analysis (two electrical impedance tomography and six respiratory inductive plethysmography). In the remaining 15 infants (gestational age 28.0 ± 2.6 wk; birth weight 1,027 ± 514 g), end-expiratory lung volume changes measured by electrical impedance tomography were significantly correlated to respiratory inductive plethysmography measurements in 12 patients (mean r = 0.93 ± 0.05). This was also true for the upper inflection point on the inflation (r = 0.91, p volume/pressure relationships (mean r = 0.81 ± 0.18). This study shows that cross-sectional lung volume changes measured by electrical impedance tomography are representative for the whole lung and that this concept also applies to newborn infants.

  12. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  13. Models with Simultaneous Equations for Local Development

    Directory of Open Access Journals (Sweden)

    Ani MATEI

    2010-01-01

    Full Text Available This paper presents a model based on simultaneous equations with statistical determined parameters for describing the evolution of important issues relating to local development. The main issues considered are public and private business development environment, employment, demography, social comfort, etc. Parameter estimation with simultaneous equations model was done by procedures implemented in EViews using empirical data sets from city Braila, Romania, for the period 2000 to 2005. Applying the Durbin-Watson test, results were compared for the simultaneous equations model where the parameters were estimated by twostage least squares method.

  14. 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

  15. the histological effects of formaldehyde vapour on the lungs

    African Journals Online (AJOL)

    Uwaifoh

    2012-12-31

    Dec 31, 2012 ... lung injury, pulmonary fibrosis, bronchiolar epithelia degeneration, acute purulent bronchitis, cellular pyknosis and chronic lungs injury. Thus, 40% formaldehyde inhalation can induce lungs injury and possibly lung tumors. Keywords: Formaldehyde, Inhalation, Pulmonary histology, Lung injury.

  16. Lung Transplantation for FLNA-Associated Progressive Lung Disease.

    Science.gov (United States)

    Burrage, Lindsay C; Guillerman, R Paul; Das, Shailendra; Singh, Shipra; Schady, Deborah A; Morris, Shaine A; Walkiewicz, Magdalena; Schecter, Marc G; Heinle, Jeffrey S; Lotze, Timothy E; Lalani, Seema R; Mallory, George B

    2017-07-01

    To describe a series of patients with pathogenic variants in FLNA and progressive lung disease necessitating lung transplantation. We conducted a retrospective chart review of 6 female infants with heterozygous presumed loss-of-function pathogenic variants in FLNA whose initial presentation was early and progressive respiratory failure. Each patient received lung transplantation at an average age of 11 months (range, 5-15 months). All patients had pulmonary arterial hypertension and chronic respiratory failure requiring tracheostomy and escalating levels of ventilator support before transplantation. All 6 patients survived initial lung transplantation; however, 1 patient died after a subsequent heart-lung transplant. The remaining 5 patients are living unrestricted lives on chronic immunosuppression at most recent follow-up (range, 19 months to 11.3 years post-transplantation). However, in all patients, severe ascending aortic dilation has been observed with aortic regurgitation. Respiratory failure secondary to progressive obstructive lung disease during infancy may be the presenting phenotype of FLNA-associated periventricular nodular heterotopia. We describe a cohort of patients with progressive respiratory failure related to a pathogenic variant in FLNA and present lung transplantation as a viable therapeutic option for this group of patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Previous Lung Diseases and Lung Cancer Risk: A Pooled Analysis From the International Lung Cancer Consortium

    Science.gov (United States)

    Brenner, Darren R.; Boffetta, Paolo; Duell, Eric J.; Bickeböller, Heike; Rosenberger, Albert; McCormack, Valerie; Muscat, Joshua E.; Yang, Ping; Wichmann, H.-Erich; Brueske-Hohlfeld, Irene; Schwartz, Ann G.; Cote, Michele L.; Tjønneland, Anne; Friis, Søren; Le Marchand, Loic; Zhang, Zuo-Feng; Morgenstern, Hal; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Zaridze, David; Rudnai, Peter; Fabianova, Eleonora; Foretova, Lenka; Janout, Vladimir; Bencko, Vladimir; Schejbalova, Miriam; Brennan, Paul; Mates, Ioan N.; Lazarus, Philip; Field, John K.; Raji, Olaide; McLaughlin, John R.; Liu, Geoffrey; Wiencke, John; Neri, Monica; Ugolini, Donatella; Andrew, Angeline S.; Lan, Qing; Hu, Wei; Orlow, Irene; Park, Bernard J.; Hung, Rayjean J.

    2012-01-01

    To clarify the role of previous lung diseases (chronic bronchitis, emphysema, pneumonia, and tuberculosis) in the development of lung cancer, the authors conducted a pooled analysis of studies in the International Lung Cancer Consortium. Seventeen studies including 24,607 cases and 81,829 controls (noncases), mainly conducted in Europe and North America, were included (1984–2011). Using self-reported data on previous diagnoses of lung diseases, the authors derived study-specific effect estimates by means of logistic regression models or Cox proportional hazards models adjusted for age, sex, and cumulative tobacco smoking. Estimates were pooled using random-effects models. Analyses stratified by smoking status and histology were also conducted. A history of emphysema conferred a 2.44-fold increased risk of lung cancer (95% confidence interval (CI): 1.64, 3.62 (16 studies)). A history of chronic bronchitis conferred a relative risk of 1.47 (95% CI: 1.29, 1.68 (13 studies)). Tuberculosis (relative risk = 1.48, 95% CI: 1.17, 1.87 (16 studies)) and pneumonia (relative risk = 1.57, 95% CI: 1.22, 2.01 (12 studies)) were also associated with lung cancer risk. Among never smokers, elevated risks were observed for emphysema, pneumonia, and tuberculosis. These results suggest that previous lung diseases influence lung cancer risk independently of tobacco use and that these diseases are important for assessing individual risk. PMID:22986146

  18. Advances in lung ultrasound.

    Science.gov (United States)

    Francisco, Miguel José; Rahal, Antonio; Vieira, Fabio Augusto Cardillo; Silva, Paulo Savoia Dias da; Funari, Marcelo Buarque de Gusmão

    2016-01-01

    Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established. Some scanning protocols have been used in patient management. The Blue, FALLS and C.A.U.S.E. protocols are examples of algorithms using artifact combinations to achieve accurate diagnoses. Combined chest ultrasonography and radiography are often sufficient to diagnose and manage lung and chest wall conditions. Chest ultrasonography is a highly valuable diagnostic tool for radiologists, emergency and intensive care physicians. RESUMO O exame ultrassonográfico do tórax avançou nas últimas décadas, sendo utilizado para o diagnóstico de inúmeras condições patológicas, e fornecendo informações qualitativas e quantitativas. Os pulmões aerados e o arcabouço ósseo do tórax representam barreira sonora para o estudo ultrassonográfico, gerando artefatos que, bem conhecidos, são utilizados como ferramentas diagnósticas. Eco pleural normal, linhas A, linhas B, linhas C, linhas E e Z (conhecidas como falsas linhas B) são artefatos com características peculiares. Os padrões de consolidação e de pneumotórax também são bem estabelecidos. Alguns protocolos têm sido utilizados no manuseio dos pacientes: Blue Protocol, Protocolo FALLS e Protocolo C.A.U.S.E são exemplos de três propostas que, por meio da associação entre os artefatos, permitem sugerir diagnósticos precisos. A ultrassonografia de tórax, aliada à radiografia de tórax, muitas vezes é suficiente para o diagn

  19. Simultaneous invention and the patent law

    DEFF Research Database (Denmark)

    Howells, John; Katznelson, Ron D

    inventions they often find this to challenge the idea that patent law (which rewards only the first inventor with exclusive rights) is needed to encourage invention and innovation. We review the empirical evidence alleged to show that simultaneous invention is prevalent for important inventions. In general...... is typical of important pioneer inventions in both survey evidence and alleged illustrative cases of simultaneous invention. We show this in the cases of Edison, the Wright brothers, the Selden automobile patent vis a vis Ford, Watt and the steam engine. We then point out that patent law inherently ensures...... that patent protection is not extended to near simultaneous inventions. There remain a number of simultaneous inventions discovered through interference proceedings but we find the number too small to mount a serious challenge to the general operation of patent law....

  20. Effect of stimulus width on simultaneous contrast

    Directory of Open Access Journals (Sweden)

    Veronica Shi

    2013-09-01

    Full Text Available Perceived brightness of a stimulus depends on the background against which the stimulus is set, a phenomenon known as simultaneous contrast. For instance, the same gray stimulus can look light against a black background or dark against a white background. Here we quantified the perceptual strength of simultaneous contrast as a function of stimulus width. Previous studies have reported that wider stimuli result in weaker simultaneous contrast, whereas narrower stimuli result in stronger simultaneous contrast. However, no previous research has quantified this relationship. Our results show a logarithmic relationship between stimulus width and perceived brightness. This relationship is well matched by the normalized output of a Difference-of-Gaussians (DOG filter applied to stimuli of varied widths.

  1. Ward chest X-rays and extra-vascular lung water estimations in patients in intensive care

    Energy Technology Data Exchange (ETDEWEB)

    Haller, J.; Czembirek, H.; Salomonowitz, E.; Laggner, A.; Sommer, G.; Tscholakoff, D.; Leitner, H.; Kleinberger, G.

    1985-01-01

    Radiological staging of pulmonary oedema was compared with the determination of extra-vascular lung water by means of a double indicator dilution technique. One hundred and forty-six ward chest radiographs were evaluated and compared with the results of simultaneous measurements of lung water. Seventy-seven cases could be evaluated statistically. Chest x-rays regarded as normal corresponded to extra-vascular lung water of 5 to 9 ml./kg. body weight. Interstitial oedema (radiological stage I and II) correspond to extravascular lung water levels of 8 to 12 ml./kg. Differentiation of stages I and II was not possible. During stage III, extra-vascular lung water was 15 to 21 ml./kg. A comparative analysis of these findings revealed a discrepancy of 34%. The reasons for this are discussed.

  2. Synergism between endotoxin priming and exotoxin challenge in provoking severe vascular leakage in rabbit lungs.

    Science.gov (United States)

    Schütte, H; Rosseau, S; Czymek, R; Ermert, L; Walmrath, D; Krämer, H J; Seeger, W; Grimminger, F

    1997-09-01

    Lipopolysaccharides (LPS) of gram-negative bacteria prime rabbit lungs for enhanced thromboxane-mediated vasoconstriction upon subsequent challenge with the exotoxin Escherichia coli hemolysin (HlyA) (Walmrath et al. J. Exp. Med. 1994;180:1437-1443). We investigated the impact of endotoxin priming and subsequent HlyA challenge on lung vascular permeability while maintaining constancy of capillary pressure. Rabbit lungs were perfused in a pressure-controlled mode in the presence of the thromboxane receptor antagonist BM 13.505, with continuous monitoring of flow. Perfusion for 180 min with 10 ng/ml LPS did not provoke vasoconstriction or alteration of capillary filtration coefficient (Kfc) values. HlyA (0.021 hemolytic units/ml) induced thromboxane release and a transient decrease in perfusion flow in the absence of significant changes in Kfc. Similar results were obtained when LPS and HlyA were coapplied simultaneously. However, when the HlyA challenge was undertaken after 180 min of LPS priming, a manifold increase in Kfc values was noted, with concomitant severe lung edema formation, although capillary pressure remained unchanged. Thus, endotoxin primes the lung vasculature to respond with a severe increase in vascular permeability to a subsequent low-dose application of HlyA. Such synergism between endotoxin priming and exotoxin challenge in provoking lung vascular leakage may contribute to the pathogenesis of respiratory failure in sepsis and severe lung infection.

  3. Interaction between Physical Activity and Smoking on Lung, Muscle, and Bone in Mice.

    Science.gov (United States)

    Cielen, Nele; Maes, Karen; Heulens, Nele; Troosters, Thierry; Carmeliet, Geert; Janssens, Wim; Gayan-Ramirez, Ghislaine N

    2016-05-01

    Physical inactivity is an important contributor to skeletal muscle weakness, osteoporosis, and weight loss in chronic obstructive pulmonary disease. However, the effects of physical inactivity, in interaction with smoking, on lung, muscle, and bone are poorly understood. To address this issue, male mice were randomly assigned to an active (daily running), moderately inactive (space restriction), or extremely inactive group (space restriction followed by hindlimb suspension to mimic bed rest) during 24 weeks and simultaneously exposed to either cigarette smoke or room air. The effects of different physical activity levels and smoking status and their respective interaction were examined on lung function, body composition, in vitro limb muscle function, and bone parameters. Smoking caused emphysema, reduced food intake with subsequent loss of body weight, and fat, lean, and muscle mass, but increased trabecular bone volume. Smoking induced muscle fiber atrophy, which did not result in force impairment. Moderate inactivity only affected lung volumes and compliance, whereas extreme inactivity increased lung inflammation, lowered body and fat mass, induced fiber atrophy with soleus muscle dysfunction, and reduced exercise capacity and all bone parameters. When combined with smoking, extreme inactivity also aggravated lung inflammation and emphysema, and accelerated body and muscle weight loss. This study shows that extreme inactivity, especially when imposed by absolute rest, accelerates lung damage and inflammation. When combined with smoking, extreme inactivity is deleterious for muscle bulk, bone, and lungs. These data highlight that the consequences of physical inactivity during the course of chronic obstructive pulmonary disease should not be neglected.

  4. Cryotherapy in Treating Patients With Lung Cancer That Has Spread to the Other Lung or Parts of the Body

    Science.gov (United States)

    2017-05-25

    Advanced Malignant Mesothelioma; Extensive Stage Small Cell Lung Cancer; Lung Metastases; Recurrent Malignant Mesothelioma; Recurrent Non-small Cell Lung Cancer; Recurrent Small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer

  5. Simultaneous vs sequential adjustments in a duopoly

    Science.gov (United States)

    Ibrahim, Adyda; Karim, Sharmila; Zaibidi, Nerda Zura

    2014-12-01

    In a duopoly situation, two firms can move towards the equilibrium point either sequentially or simultaneously. In the case of equal costs and equal initial outputs, numerical results in this paper show the effect of simultaneous adjustment and sequential adjustment on the length of time it takes for a firm to reach the Cournot equilibrium, and the total profit accumulated up until reaching the equilibrium point.

  6. Cancer Genes in Lung Cancer

    Science.gov (United States)

    El-Telbany, Ahmed

    2012-01-01

    Cancer is now known as a disease of genomic alterations. Mutational analysis and genomics profiling in recent years have advanced the field of lung cancer genetics/genomics significantly. It is becoming more accepted now that the identification of genomic alterations in lung cancer can impact therapeutics, especially when the alterations represent “oncogenic drivers” in the processes of tumorigenesis and progression. In this review, we will highlight the key driver oncogenic gene mutations and fusions identified in lung cancer. The review will summarize and report the available demographic and clinicopathological data as well as molecular details behind various lung cancer gene alterations in the context of race. We hope to shed some light into the disparities in the incidence of various genetic mutations among lung cancer patients of different racial backgrounds. As molecularly targeted therapy continues to advance in lung cancer, racial differences in specific genetic/genomic alterations can have an important impact in the choices of therapeutics and in our understanding of the drug sensitivity/resistance profile. The most relevant genes in lung cancer described in this review include the following: EGFR, KRAS, MET, LKB1, BRAF, PIK3CA, ALK, RET, and ROS1. Commonly identified genetic/genomic alterations such as missense or nonsense mutations, small insertions or deletions, alternative splicing, and chromosomal fusion rearrangements were discussed. Relevance in current targeted therapeutic drugs was mentioned when appropriate. We also highlighted various targeted therapeutics that are currently under clinical development, such as the MET inhibitors and antibodies. With the advent of next-generation sequencing, the landscape of genomic alterations in lung cancer is expected to be much transformed and detailed in upcoming years. These genomic landscape differences in the context of racial disparities should be emphasized both in tumorigenesis and in drug

  7. Simultaneous Acute Pulmonary Embolism and Isolated Septal Myocardial Infarction in a Young Patient

    Directory of Open Access Journals (Sweden)

    Claudia Burkhardt

    2016-09-01

    Full Text Available We report here the case of a young patient with a simultaneous isolated septal myocardial infarction (MI and pulmonary embolism (PE. The aim was to describe a rare clinical entity and to explain why these two pathologies were present at the same time in a young patient.
 A review of literature was established. An interventional cardiologist, an interventional radiologist and a lung specialist were consulted. The diagnostic workup revealed only heterozygous Factor Leiden V mutation. This presentation was probably fortuitous, but worth reporting to our opinion.

  8. Palliative procedures in lung cancer.

    Science.gov (United States)

    Masuda, Emi; Sista, Akhilesh K; Pua, Bradley B; Madoff, David C

    2013-06-01

    Palliative care aims to optimize comfort and function when cure is not possible. Image-guided interventions for palliative treatment of lung cancer is aimed at local control of advanced disease in the affected lung, adjacent mediastinal structures, or distant metastatic sites. These procedures include endovascular therapy for superior vena cava syndrome, bronchial artery embolization for hemoptysis associated with lung cancer, and ablation of osseous metastasis. Pathophysiology, clinical presentation, indications of these palliative treatments, procedural techniques, complications, and possible future interventions are discussed in this article.

  9. Scimitar syndrome with horseshoe lung

    Energy Technology Data Exchange (ETDEWEB)

    Beitzke, A.; Gypser, G.; Sager, W.D.

    1982-03-01

    A combination of two rare malformations of the lung was observed in a four-year-old asymptomatic boy. He had typical scimitar syndrome (dextrocardia, hypoplastic right lung and right-sided anomalous pulmonary venous drainage into the v. cava inferior) together with horseshoe lung. Diagnosis was established by angiocardiography and computerized tomography. In the absence of recurrent pulmonary infections operative intervention is not necessary with normal pulmonary arterial pressure and resistance. To the best of our knowledge this case with both malformations seems to be the fourth which is reported in the literature.

  10. Respiratory Effects of Simultaneous Exposure to Respirable Crystalline Silica Dust, Formaldehyde, and Triethylamine of a Group of Foundry Workers.

    Science.gov (United States)

    Zarei, Fatemeh; Rezazadeh Azari, Mansour; Salehpour, Sousan; Khodakarim, Soheila; Omidi, Leila; Tavakol, Elahe

    2017-03-04

    Foundry workers are occupationally exposed to hazardous substances such as silica dusts and toxic gases. The aim of this study was to examine the effects of simultaneous exposure to complex mixtures of silica dust, formaldehyde, and triethylamine on lung function parameters. A cross-sectional study. This study was conducted on 55 male workers of core making unit of a foundry plant (the case group) and 55 workers in a food industry were enrolled as a control group in 2015. Workers were monitored for personal exposure to crystalline silica respirable dust, according the NIOSH method No.7602. The concentrations of formaldehyde and triethylamine were measured using a PID instrument. Lung function tests were performed according to the ERS/ATS standards. The mean concentrations of personal exposure to silica dust, formaldehyde, and triethylamine in the core making workers were 0.23 mg/m3, 2.85 ppm, and 5.55 ppm and respective exposures of control subjects were less than the LOD (limit of detection). There were significant associations between exposure to silica dust and decreases in FVC (Forced vital capacity) values (Psilica dust and triethylamine on FVC values (Psilica dust and triethylamine on some lung function parameters were observed. Simultaneous exposure of foundry workers to silica dust and triethylamine could impair lung function.

  11. Targeting apoptosis pathways in lung cancer

    NARCIS (Netherlands)

    Pore, Milind M.; Hiltermann, T. Jeroen N.; Kruyt, Frank A. E.

    2013-01-01

    Lung cancer is a devastating disease with a poor prognosis. Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) represent different forms of lung cancer that are associated with distinct genetic causes and display different responses to therapy in the clinic. Whereas SCLC is often

  12. Obliterative bronchiolitis after lung and heart-lung transplantation.

    Science.gov (United States)

    Reichenspurner, H; Girgis, R E; Robbins, R C; Conte, J V; Nair, R V; Valentine, V; Berry, G J; Morris, R E; Theodore, J; Reitz, B A

    1995-12-01

    Obliterative bronchiolitis (OB) has emerged as the main cause of morbidity and mortality in the long-term follow-up after lung and heart-lung transplantation. The pathogenesis of OB is multifactorial, with acute rejection and cytomegalovirus infection being the main risk factors for the development of OB. The final common pathway of all inciting events seems to be an alloimmune injury, with subsequent release of immunologic mediators and production of growth factors leading to luminal obliteration and fibrous scarring of the small airways. Analyzing the 14 years of experience in 163 patients at Stanford University, we found a current incidence of bronchiolitis obliterans syndrome or histologically proven OB within the first 3 years after lung and heart-lung transplantation of 36.3%, with an overall prevalence of 58.1% after heart-lung and 51.4% after lung transplantation. Both pulmonary function indices (forced expiratory flow between 25% and 75% of forced vital capacity and forced expiratory volume in 1 second) and transbronchial biopsies have proven helpful in diagnosing bronchiolitis obliterans syndrome or OB at an early stage. Early diagnosis of OB and improved management have achieved survival rates in patients with OB after 1, 3, 5, and 10 years of 83%, 66%, 46%, and 22%, compared with 86%, 83%, 67%, and 67% in patients without OB. Recently, different experimental models have been developed to investigate the cellular and molecular events leading to OB and to evaluate new treatment strategies for this complication, which currently limits the long-term success of heart-lung and lung transplantation.

  13. Anatomy and physiology of respiratory system relevant to anaesthesia.

    Science.gov (United States)

    Patwa, Apeksh; Shah, Amit

    2015-09-01

    Clinical application of anatomical and physiological knowledge of respiratory system improves patient's safety during anaesthesia. It also optimises patient's ventilatory condition and airway patency. Such knowledge has influence on airway management, lung isolation during anaesthesia, management of cases with respiratory disorders, respiratory endoluminal procedures and optimising ventilator strategies in the perioperative period. Understanding of ventilation, perfusion and their relation with each other is important for understanding respiratory physiology. Ventilation to perfusion ratio alters with anaesthesia, body position and with one-lung anaesthesia. Hypoxic pulmonary vasoconstriction, an important safety mechanism, is inhibited by majority of the anaesthetic drugs. Ventilation perfusion mismatch leads to reduced arterial oxygen concentration mainly because of early closure of airway, thus leading to decreased ventilation and atelectasis during anaesthesia. Various anaesthetic drugs alter neuronal control of the breathing and bronchomotor tone.

  14. Anatomy and physiology of respiratory system relevant to anaesthesia

    Directory of Open Access Journals (Sweden)

    Apeksh Patwa

    2015-01-01

    Full Text Available Clinical application of anatomical and physiological knowledge of respiratory system improves patient's safety during anaesthesia. It also optimises patient's ventilatory condition and airway patency. Such knowledge has influence on airway management, lung isolation during anaesthesia, management of cases with respiratory disorders, respiratory endoluminal procedures and optimising ventilator strategies in the perioperative period. Understanding of ventilation, perfusion and their relation with each other is important for understanding respiratory physiology. Ventilation to perfusion ratio alters with anaesthesia, body position and with one-lung anaesthesia. Hypoxic pulmonary vasoconstriction, an important safety mechanism, is inhibited by majority of the anaesthetic drugs. Ventilation perfusion mismatch leads to reduced arterial oxygen concentration mainly because of early closure of airway, thus leading to decreased ventilation and atelectasis during anaesthesia. Various anaesthetic drugs alter neuronal control of the breathing and bronchomotor tone.

  15. The Diagnosis of Acute Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Ebtesam Islam

    2014-10-01

    Full Text Available This paper reviews the most current literature on the diagnosis of pulmonary thromboembolism.  The epidemiology and symptomology of this disorder, including common symptoms such as fever, chest pain, dyspnea, edema, and syncope, are reviewed.  The utility of basic and easily available testing, such as electrocardiography and chest radiography, is evaluated. The literature on determining the pretest probability of venous thromboembolism with scoring systems, such as the Wells Score, the Geneva Scoring System, and the Pulmonary Embolism Rule Out Criteria, is appraised.  As the evaluation of pulmonary embolism has evolved, multiple imaging techniques has been developed and studied.  Ultrasonography, computed tomography with angiography, magnetic resonance angiography, ventilation perfusion lung scanning, and SPECT ventilation-perfusion lung imaging are discussed.  In conclusion, the diagnosis of pulmonary embolism remains complicated.  Clinical suspicion and stratification should guide a diagnostic strategy for the comprehensive evaluation and diagnosis of patients with this disorder.

  16. Assessment of radon equilibrium factor from distribution parameters of simultaneous radon and radon progeny measurements.

    Science.gov (United States)

    Chen, Jing; Marro, Leonora

    2011-11-01

    In Canada, a radon and radon progeny survey was carried out in the 1970s in 19 cities. To the authors' knowledge, this is the only large survey of simultaneous radon and radon progeny measurements up to the present time. However, the survey was carried out for the purpose of establishing geographic variation of radon and radon progeny; therefore, radon equilibrium factors, F, were not assessed at that time. From the summary results of this large simultaneous radon and radon progeny survey, the characteristics of radon equilibrium factor were assessed. The average F factor assessed from this survey in 12,576 houses is 0.54. The current assessment may indicate that the typical F value of 0.4 recommended by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), and the International Commission on Radiological Protection (ICRP) could lead to a downward bias in the estimation of radon doses to the lung.

  17. Lung cancer screening: past, present and future.

    Science.gov (United States)

    Finigan, James H; Kern, Jeffrey A

    2013-09-01

    Lung cancer is the leading cause of cancer death for men and women. Most lung cancer cases are diagnosed at an advanced stage, when cure is no longer an option; this heavily influences mortality. Historically, attempts at lung cancer screening using chest x-rays and sputum cytology have failed to influence lung cancer mortality. However, the recent National Lung Screening Trial demonstrated that low-dose computed tomography screening for lung cancer decreases mortality. This article outlines the history of lung cancer screening, the current state of screening and possible future adjuncts to screening. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Simultaneous identification of multiple driver pathways in cancer.

    Directory of Open Access Journals (Sweden)

    Mark D M Leiserson

    Full Text Available Distinguishing the somatic mutations responsible for cancer (driver mutations from random, passenger mutations is a key challenge in cancer genomics. Driver mutations generally target cellular signaling and regulatory pathways consisting of multiple genes. This heterogeneity complicates the identification of driver mutations by their recurrence across samples, as different combinations of mutations in driver pathways are observed in different samples. We introduce the Multi-Dendrix algorithm for the simultaneous identification of multiple driver pathways de novo in somatic mutation data from a cohort of cancer samples. The algorithm relies on two combinatorial properties of mutations in a driver pathway: high coverage and mutual exclusivity. We derive an integer linear program that finds set of mutations exhibiting these properties. We apply Multi-Dendrix to somatic mutations from glioblastoma, breast cancer, and lung cancer samples. Multi-Dendrix identifies sets of mutations in genes that overlap with known pathways - including Rb, p53, PI(3K, and cell cycle pathways - and also novel sets of mutually exclusive mutations, including mutations in several transcription factors or other genes involved in transcriptional regulation. These sets are discovered directly from mutation data with no prior knowledge of pathways or gene interactions. We show that Multi-Dendrix outperforms other algorithms for identifying combinations of mutations and is also orders of magnitude faster on genome-scale data. Software available at: http://compbio.cs.brown.edu/software.

  19. The Unpredictable Effect of Changing Cardiac Output on Hypoxemia after Acute Pulmonary Thromboembolism

    Directory of Open Access Journals (Sweden)

    John Y. C. Tsang

    2008-01-01

    Full Text Available Previous studies reported that the degree of hypoxemia following acute pulmonary thromboembolism (APTE was highly variable and that its mechanism was mainly due to the creation of many high and low ventilation/perfusion (V/Q units, as a result of the heterogeneous regional blood flow (Q caused by embolic obstruction. We studied the effect of changing cardiac output (Q t on gas exchange after APTE in 5 embolized piglets (23 ± 3 Kg, using Dobutamine intermittently at approximately 20 μg/kg/min for 120 minutes. The distribution of ventilation (V and perfusion (Q at various times was mapped using fluorescent microspheres in 941 ± 60 lung regions. After APTE, increase in Q t by Dobutamine improved venous oxygen tension (PvO 2 but arterial PaO 2 did not change consistently. On the other hand, cluster analysis showed that the V/Q ratio of most lung regions was lowered due to increases in Q at the same time. We concluded that the effect of changing cardiac output on gas exchange following APTE was affected by the simultaneous and varying balance between the changing V/Q mismatch and the concomitantly changing PvO 2 , which might explain the unpredictability of PaO 2 in the clinical setting.

  20. Aging changes in the lungs

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/004011.htm Aging changes in the lungs To use the sharing ... out (exhaled). Watch this video about: Gas exchange AGING CHANGES IN YOUR BODY AND THEIR AFFECTS ON ...

  1. Tuberculosis in the lung (image)

    Science.gov (United States)

    Tuberculosis is caused by a group of organisms: Mycobacterium tuberculosis, M bovis , M africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, ...

  2. Drugs Approved for Lung Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for lung cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  3. Early laparotomy after lung transplantation

    DEFF Research Database (Denmark)

    Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael

    2014-01-01

    BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal...... complications requiring laparotomy after transplantation with outcomes for patients at increased risk. METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after...... transplantation. RESULTS: Lung transplantation was performed in 258 patients, including 51 patients with α1-anti-trypsin deficiency (A1AD). Seventy-eight patients (30%) had an X-ray of the abdomen, and 23 patients (9%) required laparotomy during the first 90 days after transplantation. Patients with A1AD...

  4. Antibody induction therapy for lung transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Møller, Christian H; Penninga, Ida Elisabeth Irene

    2013-01-01

    Lung transplantation has become a valuable and well-accepted treatment option for most end-stage lung diseases. Lung transplant recipients are at risk of transplanted organ rejection, and life-long immunosuppression is necessary. Clear evidence is essential to identify an optimal, safe...... and effective immunosuppressive treatment strategy for lung transplant recipients. Consensus has not yet been achieved concerning use of immunosuppressive antibodies against T-cells for induction following lung transplantation....

  5. Alterations in audiovisual simultaneity perception in amblyopia.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2017-01-01

    Amblyopia is a developmental visual impairment that is increasingly recognized to affect higher-level perceptual and multisensory processes. To further investigate the audiovisual (AV) perceptual impairments associated with this condition, we characterized the temporal interval in which asynchronous auditory and visual stimuli are perceived as simultaneous 50% of the time (i.e., the AV simultaneity window). Adults with unilateral amblyopia (n = 17) and visually normal controls (n = 17) judged the simultaneity of a flash and a click presented with both eyes viewing. The signal onset asynchrony (SOA) varied from 0 ms to 450 ms for auditory-lead and visual-lead conditions. A subset of participants with amblyopia (n = 6) was tested monocularly. Compared to the control group, the auditory-lead side of the AV simultaneity window was widened by 48 ms (36%; p = 0.002), whereas that of the visual-lead side was widened by 86 ms (37%; p = 0.02). The overall mean window width was 500 ms, compared to 366 ms among controls (37% wider; p = 0.002). Among participants with amblyopia, the simultaneity window parameters were unchanged by viewing condition, but subgroup analysis revealed differential effects on the parameters by amblyopia severity, etiology, and foveal suppression status. Possible mechanisms to explain these findings include visual temporal uncertainty, interocular perceptual latency asymmetry, and disruption of normal developmental tuning of sensitivity to audiovisual asynchrony.

  6. Microbiome overview in swine lungs

    OpenAIRE

    Siqueira, Franciele Maboni; P?rez-Wohlfeil, Esteban; de Carvalho, Fab?ola Marques; Trelles, Oswaldo; Schrank, Irene Silveira; Vasconcelos, Ana Tereza Ribeiro de; Zaha, Arnaldo

    2017-01-01

    Mycoplasma hyopneumoniae is the etiologic agent of swine enzootic pneumonia. However other mycoplasma species and secondary bacteria are found as inhabitants of the swine respiratory tract, which can be also related to disease. In the present study we have performed a total DNA metagenomic analysis from the lungs of pigs kept in a field condition, with suggestive signals of enzootic pneumonia and without any infection signals to evaluate the bacteria variability of the lungs microbiota. Libra...

  7. Pentastomids and the tetrapod lung.

    Science.gov (United States)

    Riley, J; Henderson, R J

    1999-01-01

    Pentastomids comprise a highly specialized taxon of arthropod-like parasites that probably became adapted to the lungs of amphibians and reptiles early in their long evolutionary history. Few other macroparasites exploit this particular niche. Pentastomids are often large, long-lived and yet they cause little observable pathology in lungs, despite being haematophagous. The lungs of all tetrapods are lined with pulmonary surfactant, a remarkable biological material consisting of a complex mixture of phospholipids, neutral lipids and proteins that has the unique ability to disperse over the air-liquid lining of the lung. In the lower tetrapods it acts as an anti-glue preventing adhesion of respiratory surfaces when lungs collapse during swallowing prey or upon expiration. In mammals, pulmonary surfactant also plays a critical role regulating the activity of alveolar macrophages, the predominant phagocytes of the lower airways and alveoli. This review outlines the evidence suggesting that lung-dwelling pentastomids, and also nymphs encysted in the tissues of mammalian intermediate hosts, evade immune surveillance and reduce inflammation by coating the chitinous cuticle with a their own stage-specific surfactant. The lipid composition of surfactant derived from lung instars of the pentastomid Porocephalus crotali cultured in vitro is very similar to that recovered from the lung of its snake host. Pentastomid surfactant, visualised as lamellate droplets within sub-parietal cells, is delivered to the cuticle via chitin-lined efferent ducts that erupt at a surface density of < 400 mm(-2). The fidelity of the system, which ensures that every part of the cuticle surface is membrane-coated, testifies to its strategic importance. Two other extensive glands discharge membrane-associated (hydrophobic?) proteins onto the hooks and head; some have been purified and partly characterized but their role in minimising inflammatory responses is, as yet, undetermined.

  8. Lung Oxidative Damage by Hypoxia

    Directory of Open Access Journals (Sweden)

    O. F. Araneda

    2012-01-01

    Full Text Available One of the most important functions of lungs is to maintain an adequate oxygenation in the organism. This organ can be affected by hypoxia facing both physiological and pathological situations. Exposure to this condition favors the increase of reactive oxygen species from mitochondria, as from NADPH oxidase, xanthine oxidase/reductase, and nitric oxide synthase enzymes, as well as establishing an inflammatory process. In lungs, hypoxia also modifies the levels of antioxidant substances causing pulmonary oxidative damage. Imbalance of redox state in lungs induced by hypoxia has been suggested as a participant in the changes observed in lung function in the hypoxic context, such as hypoxic vasoconstriction and pulmonary edema, in addition to vascular remodeling and chronic pulmonary hypertension. In this work, experimental evidence that shows the implied mechanisms in pulmonary redox state by hypoxia is reviewed. Herein, studies of cultures of different lung cells and complete isolated lung and tests conducted in vivo in the different forms of hypoxia, conducted in both animal models and humans, are described.

  9. Main scintigraphic parameters of patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yu. B. Lishmanov

    2012-01-01

    Full Text Available We examined 25 patients with Stage I—II COPD to study diagnostic capabilities of ventilation-perfusion pulmoscintigraphy in relation to the assessment of lung microcirculation and ventilation disorders. Scintigraphic studies were performed by means of the Omega 500 gamma camera (Technicare, USA— Germany. COPD is characterized with the bilateral increase in the apical-basal grade of perfusion and deceleration of the alveolar-capillary permeability. The detected changes of scintigraphic parameters can be used in COPD diagnostics.

  10. Respiratory Strategies and Airway Management in Patients with Pulmonary Alveolar Proteinosis: A Review

    OpenAIRE

    Tomas Vymazal; Martina Krecmerova

    2015-01-01

    Background. Pulmonary alveolar proteinosis is a rare disorder characterized by a large accumulation of lipoproteinaceous material within the alveoli. This causes respiratory failure due to a restriction of gas exchange and changes in the ventilation/perfusion ratio. Treatment methods include noninvasive pharmacological approaches and invasive procedures, such as whole-lung lavage under general anesthesia. Methods. Based on the literature search using free-term key word...

  11. THE GOODNESS OF SIMULTANEOUS FITS IN ISIS

    Directory of Open Access Journals (Sweden)

    Matthias Kühnel

    2016-02-01

    Full Text Available In a previous work, we introduced a tool for analyzing multiple datasets simultaneously, which has been implemented into ISIS. This tool was used to fit many spectra of X-ray binaries. However, the large number of degrees of freedom and individual datasets raise an issue about a good measure for a simultaneous fit quality. We present three ways to check the goodness of these fits: we investigate the goodness of each fit in all datasets, we define a combined goodness exploiting the logical structure of a simultaneous fit, and we stack the fit residuals of all datasets to detect weak features. These tools are applied to all RXTE-spectra from GRO 1008−57, revealing calibration features that are not detected significantly in any single spectrum. Stacking the residuals from the best-fit model for the Vela X-1 and XTE J1859+083 data evidences fluorescent emission lines that would have gone undetected otherwise.

  12. Phase I IGART Study Using Active Breathing Control and Simultaneous Boost for Patients With NSCLC

    Science.gov (United States)

    2015-03-18

    Adenocarcinoma of the Lung; Large Cell Lung Cancer; Squamous Cell Lung Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer

  13. Tracheal reconstruction in children with unilateral lung agenesis or severe hypoplasia.

    Science.gov (United States)

    Backer, Carl Lewis; Kelle, Angela M; Mavroudis, Constantine; Rigsby, Cynthia K; Kaushal, Sunjay; Holinger, Lauren D

    2009-08-01

    Infants with congenital tracheal stenosis may also have unilateral lung agenesis or severe lung hypoplasia. The purpose of this review is to evaluate our results with these patients and compare their presentations and outcomes to those of tracheal stenosis patients with two lungs. Our database was queried for patients undergoing tracheal stenosis repair since 1982. Patients were divided into two groups based on pulmonary anatomy of single lung (SL = unilateral lung agenesis or severe hypoplasia) or two lungs (BL = bilateral lungs) and analyzed to compare presentation and outcomes. From 1982 to 2008, 71 patients had tracheal stenosis repair. Bilateral lungs were present in 60 patients; 9 patients had an absent (4) or severely hypoplastic (5) right lung, and 2 patients had an absent left lung (SL = 11). Age at repair was similar between groups; median age 0.42 years in the SL group (mean 0.80 +/- 1.0 years) versus 0.37 years in the BL group (mean 0.91 +/- 2.1 years, p = not significant [ns]). In the SL group 8 of 11 (73%) were intubated preoperatively versus 15 of 60 (25%) in the BL group (p = 0.004). In the SL group 4 of 11 (36%) patients had pulmonary artery sling versus 20 of 60 (33%) of BL patients (p = ns). In the SL group 2 of 11 (18%) versus 14 of 60 (23%) in the BL group had intracardiac anomalies requiring simultaneous repair (p = ns). Procedures included pericardial tracheoplasty (2 vs 26), tracheal autograft (4 vs 16), slide tracheoplasty (3 vs 8), and tracheal resection (2 vs 10). Overall mortality (operative and late) was 2 of 11 (18%) SL versus 10 of 60 (17%) BL (p = ns). Median postoperative length of stay was 43 days SL (mean 48.6 +/- 40) versus 30 days BL (mean 52.2 +/- 65) (p = ns). The incidence of postoperative tracheostomy (SL group) was 0 of 3 for slide tracheoplasty and 5 of 8 for the other techniques (p = 0.12). Despite the increased severity of pathology and increased critical presentation of tracheal stenosis patients with unilateral lung

  14. Simultaneous wireless electrophysiological and neurochemical monitoring

    Science.gov (United States)

    Murari, Kartikeya; Mollazadeh, Mohsen; Thakor, Nitish; Cauwenberghs, Gert

    2008-08-01

    Information processing and propagation in the central nervous system is mostly electrical in nature. At synapses, electrical signals cause the release of neurotransmitters like dopamine, glutamate etc., that are sensed by post-synaptic neurons resulting in signal propagation or inhibition. It can be very informative to monitor electrical and neurochemical signals simultaneously to understand the mechanisms underlying normal or abnormal brain function. We present an integrated system for the simultaneous wireless acquisition of neurophysiological and neurochemical activity. Applications of the system to neuroscience include monitoring EEG and glutamate in rat somatosensory cortex following global ischemia.

  15. Inflammatory mechanisms in the lung

    Directory of Open Access Journals (Sweden)

    B Moldoveanu

    2008-12-01

    Full Text Available B Moldoveanu1, P Otmishi1, P Jani1, J Walker1,2, X Sarmiento3, J Guardiola1, M Saad1, Jerry Yu11Department of Medicine, University of Louisville, Louisville, KY, USA, 40292; 2Department of Respiratory Therapy, Bellarmine University, Louisville, KY, USA, 40205; 3Intensive Care Medicine Service, University Hospital Germans Trias i Pujol, Badalona, Spain 08916Abstract: Inflammation is the body’s response to insults, which include infection, trauma, and hypersensitivity. The inflammatory response is complex and involves a variety of mechanisms to defend against pathogens and repair tissue. In the lung, inflammation is usually caused by pathogens or by exposure to toxins, pollutants, irritants, and allergens. During inflammation, numerous types of inflammatory cells are activated. Each releases cytokines and mediators to modify activities of other inflammatory cells. Orchestration of these cells and molecules leads to progression of inflammation. Clinically, acute inflammation is seen in pneumonia and acute respiratory distress syndrome (ARDS, whereas chronic inflammation is represented by asthma and chronic obstructive pulmonary disease (COPD. Because the lung is a vital organ for gas exchange, excessive inflammation can be life threatening. Because the lung is constantly exposed to harmful pathogens, an immediate and intense defense action (mainly inflammation is required to eliminate the invaders as early as possible. A delicate balance between inflammation and anti-inflammation is essential for lung homeostasis. A full understanding of the underlying mechanisms is vital in the treatment of patients with lung inflammation. This review focuses on cellular and molecular aspects of lung inflammation during acute and chronic inflammatory states.Keywords: inflammation, lung, inflammatory mediators, cytokines

  16. Electrical impedance tomography compared with thoracic computed tomography during a slow inflation maneuver in experimental models of lung injury.

    Science.gov (United States)

    Wrigge, Hermann; Zinserling, Jörg; Muders, Thomas; Varelmann, Dirk; Günther, Ulf; von der Groeben, Cornelius; Magnusson, Anders; Hedenstierna, Göran; Putensen, Christian

    2008-03-01

    To determine the validity of functional electric impedance tomography to monitor regional ventilation distribution in experimental acute lung injury, and to develop a simple electric impedance tomography index detecting alveolar recruitment. Randomized prospective experimental study. Academic research laboratory. Sixteen anesthetized, tracheotomized, and mechanically ventilated pigs. Acute lung injury was induced either by acid aspiration (direct acute lung injury) or by abdominal hypertension plus oleic acid injection (indirect acute lung injury) in ten pigs. Six pigs with normal lungs were studied as a control group and with endotracheal suction-related atelectasis. After 4 hrs of mechanical ventilation, a slow inflation was performed. During slow inflation, simultaneous measurements of regional ventilation by electric impedance tomography and dynamic computed tomography were highly correlated in quadrants of a transversal thoracic plane (r2 = .63-.88, p Electric impedance tomography indexes to detect alveolar recruitment were determined by mathematical curve analysis of regional impedance time curves. Empirical tests of different methods revealed that regional ventilation delay, that is, time delay of regional impedance time curve to reach a threshold, correlated well with recruited volume as measured by CT (r2 = .63). Correlation coefficients in subgroups were r2 = .71 and r2 = .48 in pigs with normal lungs with and without closed suction related atelectasis and r2 = .79 in pigs subject to indirect acute lung injury, respectively, whereas no significant correlation was found in pigs undergoing direct acute lung injury. Electric impedance tomography allows assessment of regional ventilation distribution and recruitment in experimental models of direct and indirect acute lung injury as well as normal lungs. Except for pigs with direct acute lung injury, regional ventilation delay determined during a slow inflation from impedance time curves appears to be a simple

  17. Lung Density Changes With Growth and Inflation

    Science.gov (United States)

    Kirk, Gregory; Drummond, M. Bradley; Mitzner, Wayne

    2015-01-01

    BACKGROUND: With body growth from childhood, the lungs can enlarge by either increasing the volume of air in the periphery (as would occur with inspiration) or by increasing the number of peripheral acinar units. In the former case, the lung tissue density would decrease with inflation, whereas in the latter case, the lung density would be relatively constant as the lung grows. To address this fundamental structural issue, we measured the CT scan density in human subjects of widely varying size at two different lung volumes. METHODS: Five hundred one subjects were enrolled in the study. They underwent a chest CT scan at full inspiration and another scan at end expiration. Spirometry, body plethysmography, and diffusing capacity of the lung for carbon monoxide were also measured. RESULTS: There was a strong correlation between the size of the lungs measured at full inspiration on CT scan and the mean lung density (r = −0.72, P = .001). People with larger lungs had significantly lower mean lung density. These density changes among different subjects overlapped the density changes within subjects at different lung volumes. CONCLUSIONS: Lung structure in subjects with larger lungs is different from that in subjects with smaller lungs. Tissue volume does not increase in proportion to lung size, as would be required if larger lungs just had more alveoli. These observations suggest that the growth of the lung into adulthood is not accompanied by new alveoli, but rather by enlargement of existing structures. The presence of greater air spaces in larger lungs could impact the occurrence and pathogenesis of spontaneous pneumothorax or COPD. PMID:25996948

  18. Simultaneous Multi-Element Electrothermal Atomic Absorption ...

    African Journals Online (AJOL)

    In the experiments simultaneous determination of 18 elements was performed in the mixed solutions at the mg L–1 to μg L–1 level, within 4–4.5 orders of magnitude linear concentration range. About 1–2 min was needed for the measurement and calculation. Limits of detection (LOD) for individual elements were 1.5–2 ...

  19. Improved derivatization protocol for simultaneous determination of ...

    African Journals Online (AJOL)

    sensitivity and tailing in gas chromatographic analysis (Ding and Tzing, 1998 ... simultaneously. METHODS. Chemicals and standards. The derivatizing agent, HFBA, was of analytical grade, pur- chased from Sigma-Aldrich South Africa. The solvents .... analytes with different chemical structure and polarities were extracted ...

  20. Estimating carrying capacity with simultaneous nutritional constraints.

    Science.gov (United States)

    Thomas A. Hanley; James J. Rogers

    1989-01-01

    A new procedure is presented for estimating carrying capacity (the number of animals of a given species that can be supported per unit area of habitat) on the basis of two simultaneous nutritional constraints. It requires specifying the quantity (bio-mass) and quality (chemical composition or digestibility) of available food and the nutritional requirements of the...

  1. influence of simultaneous infestations of prostephanus truncatus ...

    African Journals Online (AJOL)

    significant differences in the percentage change of adult insect numbers between single and simultaneous infestations at P< 0.01. Further, the grain ... complete development over a wide range of temperatures, 270C to 320C and between ... Aging, sexing and conditioning P. truncatus and S. zeamais. Adults were removed ...

  2. Simultaneous Spectrophotometric Determination of Valsartan and ...

    African Journals Online (AJOL)

    Purpose: To develop a direct, simple and extraction-free spectrophotometric method for the simultaneous estimation of valsartan and ezetimibe in pharmaceuticals. Methods: A spectrophotometric method for the determination of valsartan and ezetimibe was developed using acidic dyes, namely, bromophenol blue (BPB) ...

  3. Problems at simultaneous interpreting education: linguadidactic aspect

    Directory of Open Access Journals (Sweden)

    Pishkova Elena Jurievna

    2015-12-01

    Full Text Available This article is devoted to the problems which students are facing while mastering the skills of a simultaneous interpreting. The article offers a number of exercises to help solve these problems. The authors underline that it is hardly possible to prepare professional simultaneous interpreters among undergraduates for some reasons, and above all because of insufficient time and absence of technical equipment. Nevertheless, the authors conclude by stating the importance of systematic development of students' perceptive skills, attention, memory and reaction required for providing simultaneous interpreting. The main difficulties in simultaneous interpreting training can be connected with three stages of interpreting: listening, comprehension and speaking. Listening challenges deal with a bad speaker’s pronunciation, some technical problems, as well as regional accents or pigeons. As for comprehension problems they are usually connected with the fact that the interpreter isn’t well grounded in the discussion topic, or he isn’t good at topic terminology. It stands to reason that a well-skilled interpreter should prepare to the interpreting topic beforehand. Speaking difficulties can be connected with a poor interpreter’s pronunciation, often caused a stress factor and a lack of topic knowledge. As a rule an excellent pronunciation, a good articulation and a trained voice are necessary for a professional interpreter. The main principal of training exercises given in this article covers all interpreting difficulties mentioned above.

  4. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days re...

  5. Simultaneous Transesterification of Baobab Seed (Adansonia ...

    African Journals Online (AJOL)

    The properties of the Baobab seed methyl ester gave the following: specific gravity, 0.87, pour point, -6 oC, cloud point, 2 oC, flash point, 150 oC, Cetane number , 49, which is comparable with the ASTM D6751 standards for methyl esters. Keywords: Heterogeneous catalyst, Simultaneous transesterification, Baobab seed, ...

  6. Simultaneous Determination of Ciprofloxacin and Tinidazole in ...

    African Journals Online (AJOL)

    Purpose: To develop a simple, sensitive and specific liquid chromatographic method with PDA detection for the simultaneous estimation of ciprofloxacin and tinidazole in tablet dosage form. Methods: Separation was achieved with an Agilent XDB C18, 250 × 4.60 mm 5 μ column, low pressure gradient mode with a ambient ...

  7. Simultaneous determination of naproxen, ibuprofen and diclofenac ...

    African Journals Online (AJOL)

    The occurrence and removal efficiency for naproxen, ibuprofen and diclofenac in two of eThekwini Municipality's wastewater treatment plants (WWTPs), Kingsburgh and Umbilo, were investigated. This paper describes a simple method that can be used routinely for the simultaneous determination of such compounds in the ...

  8. Simultaneous Determination of Seven Constituents in Herbal ...

    African Journals Online (AJOL)

    Simultaneous Determination of Seven Constituents in Herbal Prescription Jaeumganghwa-Tang Using HPLC-PDA. CS Seo, JH Kim, HK Shin. Abstract. A simple and accurate high-performance liquid chromatographic method was applied to the quantitative analysis of seven components of the traditional herbal prescription ...

  9. Simultaneous Visual Discrimination in Asian Elephants

    Science.gov (United States)

    Nissani, Moti; Hoefler-Nissani, Donna; Lay, U. Tin; Htun, U. Wan

    2005-01-01

    Two experiments explored the behavior of 20 Asian elephants ("Elephas aximus") in simultaneous visual discrimination tasks. In Experiment 1, 7 Burmese logging elephants acquired a white+/black- discrimination, reaching criterion in a mean of 2.6 sessions and 117 discrete trials, whereas 4 elephants acquired a black+/white- discrimination in 5.3…

  10. Simultaneous determination of isoniazid and pyrazinamide in ...

    African Journals Online (AJOL)

    Purpose: To develop and validate a new high performance liquid chromatographic (HPLC) method for the simultaneous determination of isoniazid (INH) and pyrazinamide (PZA) in plasma. Methods: A 150 µL aliquot of plasma was mixed with 75 µL of 10 % trichloroacetic acid containing 100 mg/L of acetanilide as the ...

  11. Simultaneous determination of isoniazid and pyrazinamide in ...

    African Journals Online (AJOL)

    Purpose: To develop and validate a new high performance liquid chromatographic (HPLC) method for the simultaneous determination of isoniazid (INH) and pyrazinamide (PZA) in plasma. Methods: A 150 μL aliquot of plasma was mixed with 75 μL of 10 % trichloroacetic acid containing 100 mg/L of acetanilide as the ...

  12. Focusing on Concepts by Covering Them Simultaneously

    Science.gov (United States)

    Shwartz, Pete

    2017-01-01

    "Parallel" pedagogy covers the four mechanics concepts of momentum, energy, forces, and kinematics simultaneously instead of building each concept on an understanding of the previous one. Course content is delivered through interactive videos, allowing class time for group work and student-centered activities. We start with simple…

  13. Simultaneous Quantification of Paracetamol and Meloxicam in ...

    African Journals Online (AJOL)

    Purpose: To develop and validate a simple, rapid and inexpensive RP-HPLC method for the simultaneous estimation of paracetamol and meloxicam in tablets. Methods: For the analysis of the drugs, chromatographic analysis was performed on XTerra symmetry C18 column (100 × 4.6 mm, 5 μ particle size) with mobile ...

  14. Simultaneous estimation of earthquake source parameters and ...

    Indian Academy of Sciences (India)

    This paper presents the simultaneous estimation of source parameters and crustal Q values for small to moderate-size aftershocks (Mw 2.1–5.1) of the Mw 7.7 2001 Bhuj earthquake. The horizontal-component. S-waves of 144 well located earthquakes (2001–2010) recorded at 3–10 broadband seismograph sites in.

  15. Simultaneous estimation of earthquake source parameters and ...

    Indian Academy of Sciences (India)

    This paper presents the simultaneous estimation of source parameters and crustal Q values for small to moderate-size aftershocks ( 2.1–5.1) of the 7.7 2001 Bhuj earthquake. The horizontal-component S-waves of 144 well located earthquakes (2001–2010) recorded at 3–10 broadband seismograph sites in the ...

  16. Optimization of bioethanol production from simultaneous ...

    African Journals Online (AJOL)

    ADOWIE PERE

    ABSTRACT: In this study, bioethanol production from the simultaneous saccharification and fermentation (SSF) of pineapple peels using cellulase and Saccharomyces cerevisiae was investigated. A three-factor Box-behnken design. (BBD) and response surface methodology (RSM) were employed to study the effect of ...

  17. Simultaneous Estimation of Sitagliptin and Metformin in ...

    African Journals Online (AJOL)

    A rapid, simple, specific and precise high-performance thin-layer chromatography (HPTLC) method was developed for the simultaneous estimation of sitagliptin (STG) and metformin (MET) content in a fixed dose pharmaceutical formulation and also in bulk drug. In the developed method, aluminium backed silica gel 60 ...

  18. Development of Three Methods for Simultaneous Quantitative ...

    African Journals Online (AJOL)

    Purpose: To develop new selective, precise, and accurate methods for the simultaneous determination of chlorpheniramine maleate (CHP) and dexamethasone (DX) in the presence of methyl and propyl paraben in phenadone syrup. Methods: In the first two methods, the predictive abilities of principal component ...

  19. Optimization of bioethanol production from simultaneous ...

    African Journals Online (AJOL)

    In this study, bioethanol production from the simultaneous saccharification and fermentation (SSF) of pineapple peels using cellulase and Saccharomyces cerevisiae was investigated. A three-factor Box-behnken design (BBD) and response surface methodology (RSM) were employed to study the effect of broth pH (2-6), ...

  20. Automatic identification of simultaneous equations models

    NARCIS (Netherlands)

    Omtzigt, P.H.

    2003-01-01

    This paper considers within-equation restrictions in simultaneous equation models. It provides an algorithm, which renders them generically identifying. This algorithm works directly on the the restrictions and renders estimation by means of methods that require identification possible. Using this

  1. Simultaneous adsorption and biodegradation of synthetic melanoidin

    African Journals Online (AJOL)

    Being an antioxidant, melanoidin removal through purely biodegradation has been inadequate. Consequently, in the current study, simultaneous adsorption and biodegradation (SAB) was employed in a stirred tank system to remove melanoidin from synthetic wastewater. Mixed microbial consortium was immobilized onto ...

  2. European position statement on lung cancer screening

    DEFF Research Database (Denmark)

    Oudkerk, Matthijs; Devaraj, Anand; Vliegenthart, Rozemarijn

    2017-01-01

    Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified...... specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes...... need to set a timeline for implementing lung cancer screening....

  3. LUNG CANCER INCIDENCE IN OMSK REGION

    Directory of Open Access Journals (Sweden)

    V. K. Kosenok

    2016-01-01

    Full Text Available Lung cancer incidence in the Omsk region was studied. Advanced lung cancer was shown to be commonly detected in patients of the 30 to 49 age group. For this patient group, adenocarcinoma was the most common histological type of lung cancer. The highest incidence of lung cancer was observed in both men and women aged 45–47 years. Thus, to improve early detection of lung cancer, the optimal age for lung cancer screening should be in the age range of 40–50 years.

  4. Lung volume reduction for emphysema.

    Science.gov (United States)

    Shah, Pallav L; Herth, Felix J; van Geffen, Wouter H; Deslee, Gaetan; Slebos, Dirk-Jan

    2017-02-01

    Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction. Alternative minimally invasive approaches using bronchoscopic techniques including valves, coils, vapour thermal ablation, and sclerosant agents have been at the forefront of these developments. Insertion of endobronchial valves in selected patients could have benefits that are comparable with lung volume reduction surgery. Endobronchial coils might have a role in the treatment of patients with emphysema with severe hyperinflation and less parenchymal destruction. Use of vapour thermal energy or a sclerosant might allow focal treatment but the unpredictability of the inflammatory response limits their current use. In this Review, we aim to summarise clinical trial evidence on lung volume reduction and provide guidance on patient selection for available therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Simultaneous tumor and surrogate motion tracking with dynamic MRI for radiation therapy planning

    Science.gov (United States)

    Park, Seyoun; Farah, Rana; Shea, Steven M.; Tryggestad, Erik; Hales, Russell; Lee, Junghoon

    2018-01-01

    Respiration-induced tumor motion is a major obstacle for achieving high-precision radiotherapy of cancers in the thoracic and abdominal regions. Surrogate-based estimation and tracking methods are commonly used in radiotherapy, but with limited understanding of quantified correlation to tumor motion. In this study, we propose a method to simultaneously track the lung tumor and external surrogates to evaluate their spatial correlation in a quantitative way using dynamic MRI, which allows real-time acquisition without ionizing radiation exposure. To capture the lung and whole tumor, four MRI-compatible fiducials are placed on the patient’s chest and upper abdomen. Two different types of acquisitions are performed in the sagittal orientation including multi-slice 2D cine MRIs to reconstruct 4D-MRI and two-slice 2D cine MRIs to simultaneously track the tumor and fiducials. A phase-binned 4D-MRI is first reconstructed from multi-slice MR images using body area as a respiratory surrogate and groupwise registration. The 4D-MRI provides 3D template volumes for different breathing phases. 3D tumor position is calculated by 3D–2D template matching in which 3D tumor templates in the 4D-MRI reconstruction and the 2D cine MRIs from the two-slice tracking dataset are registered. 3D trajectories of the external surrogates are derived via matching a 3D geometrical model of the fiducials to their segmentations on the 2D cine MRIs. We tested our method on ten lung cancer patients. Using a correlation analysis, the 3D tumor trajectory demonstrates a noticeable phase mismatch and significant cycle-to-cycle motion variation, while the external surrogate was not sensitive enough to capture such variations. Additionally, there was significant phase mismatch between surrogate signals obtained from the fiducials at different locations.

  6. Transcendental and interpolation methods in simultaneous stabilization and simultaneous partial pole placement problems

    Science.gov (United States)

    Ghosh, B. K.

    1986-01-01

    The existence of a compensator which simultaneously renders a given r-tuple of multiinput-multioutput p x m linear dynamical systems internally stable is investigated. In particular, a set of simultaneously stabilizable r-tuples of plants is parametrized, and it is shown that, provided r = max(m,p) or less, the above set is semialgebraic and dense in the space Sigma of r-tuples of plants. An extension of the classical pole placement and stabilization problems is considered, and the simultaneous partial pole placement problem is investigated.

  7. How Are Asbestos-Related Lung Diseases Treated?

    Science.gov (United States)

    ... Back To Health Topics / Asbestos-Related Lung Diseases Asbestos-Related Lung Diseases What Is Asbestos-related lung ... as the peritoneum (PER-ih-to-NE-um). Asbestos-Related Lung Diseases Figure A shows the location ...

  8. Proteomic biomarkers in lung cancer.

    Science.gov (United States)

    Pastor, M D; Nogal, A; Molina-Pinelo, S; Carnero, A; Paz-Ares, L

    2013-09-01

    The correct understanding of tumour development relies on the comprehensive study of proteins. They are the main orchestrators of vital processes, such as signalling pathways, which drive the carcinogenic process. Proteomic technologies can be applied to cancer research to detect differential protein expression and to assess different responses to treatment. Lung cancer is the number one cause of cancer-related death in the world. Mostly diagnosed at late stages of the disease, lung cancer has one of the lowest 5-year survival rates at 15 %. The use of different proteomic techniques such as two-dimensional gel electrophoresis (2D-PAGE), isotope labelling (ICAT, SILAC, iTRAQ) and mass spectrometry may yield new knowledge on the underlying biology of lung cancer and also allow the development of new early detection tests and the identification of changes in the cancer protein network that are associated with prognosis and drug resistance.

  9. Drug induced interstitial lung disease.

    Science.gov (United States)

    Schwaiblmair, Martin; Behr, Werner; Haeckel, Thomas; Märkl, Bruno; Foerg, Wolfgang; Berghaus, Thomas

    2012-01-01

    With an increasing number of therapeutic drugs, the list of drugs that is responsible for severe pulmonary disease also grows. Many drugs have been associated with pulmonary complications of various types, including interstitial inflammation and fibrosis, bronchospasm, pulmonary edema, and pleural effusions. Drug-induced interstitial lung disease (DILD) can be caused by chemotherapeutic agents, antibiotics, antiarrhythmic drugs, and immunosuppressive agents. There are no distinct physiologic, radiographic or pathologic patterns of DILD, and the diagnosis is usually made when a patient with interstitial lung disease (ILD) is exposed to a medication known to result in lung disease. Other causes of ILD must be excluded. Treatment is avoidance of further exposure and systemic corticosteroids in patients with progressive or disabling disease.

  10. Aspergillus-Related Lung Disease

    Directory of Open Access Journals (Sweden)

    Alia Al-Alawi

    2005-01-01

    Full Text Available Aspergillus is a ubiquitous dimorphic fungus that causes a variety of human diseases ranging in severity from trivial to life-threatening, depending on the host response. An intact host defence is important to prevent disease, but individuals with pre-existing structural lung disease, atopy, occupational exposure or impaired immunity are susceptible. Three distinctive patterns of aspergillus-related lung disease are recognized: saprophytic infestation of airways, cavities and necrotic tissue; allergic disease including extrinsic allergic alveolitis, asthma, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis and chronic eosinophilic pneumonia; and airway and tissue invasive disease -- pseudomembranous tracheobronchitis, acute bronchopneumonia, angioinvasive aspergillosis, chronic necrotizing aspergillosis and invasive pleural disease. A broad knowledge of these clinical presentations and a high index of suspicion are required to ensure timely diagnosis and treatment of the potentially lethal manifestations of aspergillus-related pulmonary disease. In the present report, the clinical, radiographic and pathological aspects of the various aspergillus-related lung diseases are briefly reviewed.

  11. Cilia dysfunction in lung disease.

    Science.gov (United States)

    Tilley, Ann E; Walters, Matthew S; Shaykhiev, Renat; Crystal, Ronald G

    2015-01-01

    A characteristic feature of the human airway epithelium is the presence of ciliated cells bearing motile cilia, specialized cell surface projections containing axonemes composed of microtubules and dynein arms, which provide ATP-driven motility. In the airways, cilia function in concert with airway mucus to mediate the critical function of mucociliary clearance, cleansing the airways of inhaled particles and pathogens. The prototypical disorder of respiratory cilia is primary ciliary dyskinesia, an inherited disorder that leads to impaired mucociliary clearance, to repeated chest infections, and to the progressive destruction of lung architecture. Numerous acquired lung diseases are also marked by abnormalities in both cilia structure and function. In this review we summarize current knowledge regarding airway ciliated cells and cilia, how they function to maintain a healthy epithelium, and how disorders of cilia structure and function contribute to inherited and acquired lung disease.

  12. Differential metabolism of 4-hydroxynonenal in liver, lung and brain of mice and rats

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Ruijin; Dragomir, Ana-Cristina; Mishin, Vladimir [Pharmacology and Toxicology, Rutgers University-Ernest Mario School of Pharmacy, Piscataway, NJ (United States); Richardson, Jason R. [Environmental and Occupational Medicine, Rutgers University-Robert Wood Johnson Medical School, Piscataway, NJ (United States); Heck, Diane E. [Environmental Science, School of Health Sciences and Practice, New York Medical College, Valhalla, NY (United States); Laskin, Debra L. [Pharmacology and Toxicology, Rutgers University-Ernest Mario School of Pharmacy, Piscataway, NJ (United States); Laskin, Jeffrey D., E-mail: jlaskin@eohsi.rutgers.edu [Environmental and Occupational Medicine, Rutgers University-Robert Wood Johnson Medical School, Piscataway, NJ (United States)

    2014-08-15

    The lipid peroxidation end-product 4-hydroxynonenal (4-HNE) is generated in tissues during oxidative stress. As a reactive aldehyde, it forms Michael adducts with nucleophiles, a process that disrupts cellular functioning. Liver, lung and brain are highly sensitive to xenobiotic-induced oxidative stress and readily generate 4-HNE. In the present studies, we compared 4-HNE metabolism in these tissues, a process that protects against tissue injury. 4-HNE was degraded slowly in total homogenates and S9 fractions of mouse liver, lung and brain. In liver, but not lung or brain, NAD(P)+ and NAD(P)H markedly stimulated 4-HNE metabolism. Similar results were observed in rat S9 fractions from these tissues. In liver, lung and brain S9 fractions, 4-HNE formed protein adducts. When NADH was used to stimulate 4-HNE metabolism, the formation of protein adducts was suppressed in liver, but not lung or brain. In both mouse and rat tissues, 4-HNE was also metabolized by glutathione S-transferases. The greatest activity was noted in livers of mice and in lungs of rats; relatively low glutathione S-transferase activity was detected in brain. In mouse hepatocytes, 4-HNE was rapidly taken up and metabolized. Simultaneously, 4-HNE-protein adducts were formed, suggesting that 4-HNE metabolism in intact cells does not prevent protein modifications. These data demonstrate that, in contrast to liver, lung and brain have a limited capacity to metabolize 4-HNE. The persistence of 4-HNE in these tissues may increase the likelihood of tissue injury during oxidative stress. - Highlights: • Lipid peroxidation generates 4-hydroxynonenal, a highly reactive aldehyde. • Rodent liver, but not lung or brain, is efficient in degrading 4-hydroxynonenal. • 4-hydroxynonenal persists in tissues with low metabolism, causing tissue damage.

  13. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... of Your Lung Operation After Your Operation Your Discharge and Recovery Complete Video After Your Operation Guidance ... Day of Your Lung Operation Read Next Your Discharge and Recovery Back to Top Find A Surgeon ...

  14. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... State Legislation State Advocacy Resources Chapter Advocacy Lobby Day Grant Program State Legislation Tracked by the College ... Your Lung Operation Preparing for Your Operation The Day of Your Lung Operation After Your Operation Your ...

  15. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Liability Reform GME and Workforce Trauma and EMS ... College of Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation ...

  16. Risk Profiling May Improve Lung Cancer Screening

    Science.gov (United States)

    A new modeling study suggests that individualized, risk-based selection of ever-smokers for lung cancer screening may prevent more lung cancer deaths and improve the effectiveness and efficiency of screening compared with current screening recommendations

  17. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Overview ACS-AEI Consortium Quarterly ACS Chapter News Cancer ... American College of Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation ...

  18. Lung attenuation measurements in healthy young adults.

    NARCIS (Netherlands)

    Smit, H.J.M.; Golding, R.P.; Schramel, F.M.N.H.; Devillé, W.L.; Manoliu, R.A.; Postmus, P.E.

    2003-01-01

    Background: High-resolution computed tomography (HRCT) attenuation measurements may be more sensitive in finding early emphysematous changes in relatively young subjects than lung function measurements. Objectives: To define lung attenuation parameters in smokers and never-smokers. Methods: A

  19. Lung function after acute bronchiolitis.

    OpenAIRE

    Henry, R L; Milner, A. D.; Stokes, G M; Hodges, I G; Groggins, R C

    1983-01-01

    We performed 211 lung function measurements on 93 children in the first year after they had been admitted with acute bronchiolitis. During the convalescent phase of the illness, 77% of the infants were hyperinflated with a thoracic gas volume greater than 40 ml/kg and 3 months later 43% were hyperinflated. Twelve months after the initial illness, 17% still had lung function abnormalities and most of these children have had lower respiratory tract symptoms. For the group as a whole about 60% h...

  20. Complement system in lung disease.

    Science.gov (United States)

    Pandya, Pankita H; Wilkes, David S

    2014-10-01

    In addition to its established contribution to innate immunity, recent studies have suggested novel roles for the complement system in the development of various lung diseases. Several studies have demonstrated that complement may serve as a key link between innate and adaptive immunity in a variety of pulmonary conditions. However, the specific contributions of complement to lung diseases based on innate and adaptive immunity are just beginning to emerge. Elucidating the role of complement-mediated immune regulation in these diseases will help to identify new targets for therapeutic interventions.

  1. Related Changes of Autonomic Ganglia and Respiratory Compartments of Lungs in Case of Chronic Alcohol Intoxication in Experiments with Rats

    Directory of Open Access Journals (Sweden)

    Volkov Aleksandr Vladimirovich

    2014-09-01

    Full Text Available The article deals with description of morphological alterations in lungs and their autonomic ganglia due to chronic alcohol intoxication caused by compulsory ethanol ingesting in Wistar rats. Progressive decrease of air content, superficial density of bronchial and alveolar epithelia, and the increase of quantitative density of bronchial and alveolar macrophages became quantitative morphological evidence of chronic lung injury. At the same time, in autonomic ganglia of lungs the volume fraction and quantitative density of neurons decreased dramatically and the characteristics of neurons in radial morphometry were altered. The quantitative density of glial cells and glia/neuron ratio were increased. The total loss of neurons in ganglia reached 7 % to the 60th day of experiment, the signs of compensatory reactions were revealed simultaneously. These peculiarities can particularly explain the mechanisms of chronic lung pathology in late stages of alcohol disease.

  2. Simultaneous Multiagent Hyperpolarized 13C Perfusion Imaging

    DEFF Research Database (Denmark)

    von Morze, Cornelius; Bok, Robert A.; Reed, Galen D.

    2014-01-01

    Purpose: To demonstrate simultaneous hyperpolarization and imaging of three 13C-labeled perfusion MRI contrast agents with dissimilar molecular structures ([13C]urea, [13C]hydroxymethyl cyclopropane, and [13C]t-butanol) and correspondingly variable chemical shifts and physiological characteristics......, and to exploit their varying diffusibility for simultaneous measurement of vascular permeability and perfusion in initial preclinical studies. Methods: Rapid and efficient dynamic multislice imaging was enabled by a novel pulse sequence incorporating balanced steady state free precession excitation and spectral...... in simulations. "Tripolarized" perfusion MRI methods were applied to initial preclinical studies with differential conditions of vascular permeability, in normal mouse tissues and advanced transgenic mouse prostate tumors. Results: Dynamic imaging revealed clear differences among the individual tracer...

  3. The dilemma of simultaneous or successive bilingualism

    Directory of Open Access Journals (Sweden)

    Marina Furlan

    2002-12-01

    Full Text Available The study starts from the definition of bilingualism, according to which a person is considered to be bilingual, if she had started to learn (in natural situations two languages from her birth or from early childhood on. The aim of this research work was to assess the existence of any personality differences among "simultaneous" (children exposed to both languages from birth on or at least before the first birthday and "successive" (children exposed to the first language from birth on and to the second language from the toddler period through early childhood bilingual adolescents. The participants were adolescents from secondary schools from the Slovenian coast and from Trieste. Results show that simultaneousness/successiveness of acquisition of the two languages in question doesn't have any impact on personality traits of tested adolescents.

  4. Hot tub lung: an intriguing diffuse parenchymal lung disease ...

    African Journals Online (AJOL)

    Hot Tub Lung(HTL) is a perplexing pulmonary disease attributed to the Mycobacterium Avium-intracellulare Complex (MAC). MAC is a ubiquitous atypical mycobacterium present in moist environment, and is not considered pathogenic, without the predisposing conditions like immunosuppression. However, HTL is a unique ...

  5. Soluble ICAM-1 activates lung macrophages and enhances lung injury

    DEFF Research Database (Denmark)

    Schmal, H; Czermak, B J; Lentsch, A B

    1998-01-01

    Because of the important role of rat ICAM-1 in the development of lung inflammatory injury, soluble recombinant rat ICAM-1 (sICAM-1) was expressed in bacteria, and its biologic activities were evaluated. Purified sICAM-1 did bind to rat alveolar macrophages in a dose-dependent manner and induced...

  6. CT findings of small bowel metastases from primary lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Wook; Ha, Hyun Kwon; Kim, Ah Young; Kim, Gab Choul; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2002-11-01

    To evaluate the CT findings of small bowel metastases from primary lung cancer. Of the 1468 patients with primary lung cancer between 1990 and 2000, 13 patients who had metastasis to the small intestine were collected. Of these 13 patients, nine who underwent CT scan were included for analysis. The pathologic diagnoses of primary lung cancer in these nine patients were squamous cell carcinoma in six, adenocarcinoma in two, and large cell carcinoma in one. CT scans were analyzed with regard to the site and patterns (intraluminal mass/bowel wall thickening/bowel implants) of metastatic masses, and the presence or absence of complication such as intussusception, obstruction, or perforation of the small bowel. The medical records of the patients were also reviewed retrospectively for evaluation of presenting abdominal symptom and time interval of metastases from initial diagnosis of lung cancer. Metastatic lesions were distributed throughout the small intestine: the duodenum in five, the jejunum in four, the ileum in six, and both jejunum and ileum in one patient. The size of metastatic masses of small bowel ranged from 1.3 cm to 5.0 cm (mean size, 2.6 cm) On CT, the small bowel was involved with intraluminal masses (mean size, 3.4 cm) in eight patients, diffuse wall thickening (mean thickness, 1.6 cm) in five, and bowel implants (mean size, 2.2 cm) in two. Complications occurred in seven patients, including intussusceptions without obstruction in two patients and with obstruction in two, obstruction without intussusceptions in two, and bowel perforation in one. Of 9 patients, 6 had at least one symptom referable to the small bowel including abdominal pain in 4, anemia in 3, vomiting in 1, and jaundice in 1. Lung cancer and small bowel lesions were detected simultaneously in four patients and the time interval of metastases from initial diagnosis of lung cancer ranged from 10 days to 30 months (median interval, 54 days) in patients. CT helps in defining the extent and

  7. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry...... was opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

  8. Recruitment and retention of lung volume

    OpenAIRE

    Lapinsky, Stephen E

    2002-01-01

    Both a reduction in tidal volume and alveolar recruitment may be necessary to prevent ventilator-induced lung injury in the management of patients with acute respiratory distress syndrome. The lung collapse associated with endotracheal suctioning produces hypoxaemia, but it also causes de-recruitment, potentially aggravating lung injury. A study conducted by Dyhr and colleagues demonstrates the benefit of lung recruitment manoeuvres after suctioning, which help to improve oxygenation and rest...

  9. Simultaneous interstitial pneumonitis and cardiomyopathy induced by venlafaxine

    Directory of Open Access Journals (Sweden)

    Pedro Gonçalo Ferreira

    2014-06-01

    Full Text Available Venlafaxine is a serotonin-norepinephrine reuptake inhibitor used as an antidepressant. Interindividual variability and herb-drug interactions can lead to drug-induced toxicity. We report the case of a 35-year-old female patient diagnosed with synchronous pneumonitis and acute cardiomyopathy attributed to venlafaxine. The patient sought medical attention due to dyspnea and dry cough that started three months after initiating treatment with venlafaxine for depression. The patient was concomitantly taking Centella asiatica and Fucus vesiculosus as phytotherapeutic agents. Chest CT angiography and chest X-ray revealed parenchymal lung disease (diffuse micronodules and focal ground-glass opacities and simultaneous dilated cardiomyopathy. Ecocardiography revealed a left ventricular ejection fraction (LVEF of 21%. A thorough investigation was carried out, including BAL, imaging studies, autoimmune testing, right heart catheterization, and myocardial biopsy. After excluding other etiologies and applying the Naranjo Adverse Drug Reaction Probability Scale, a diagnosis of synchronous pneumonitis/cardiomyopathy associated with venlafaxine was assumed. The herbal supplements taken by the patient have a known potential to inhibit cytochrome P450 enzyme complex, which is responsible for the metabolization of venlafaxine. After venlafaxine discontinuation, there was rapid improvement, with regression of the radiological abnormalities and normalization of the LVEF. This was an important case of drug-induced cardiopulmonary toxicity. The circumstantial intake of inhibitors of the CYP2D6 isoenzyme and the presence of a CYP2D6 slow metabolism phenotype might have resulted in the toxic accumulation of venlafaxine and the subsequent clinical manifestations. Here, we also discuss why macrophage-dominant phospholipidosis was the most likely mechanism of toxicity in this case.

  10. Mirror adaptation in sensory-motor simultaneity.

    Directory of Open Access Journals (Sweden)

    Masataka Watanabe

    Full Text Available BACKGROUND: When one watches a sports game, one may feel her/his own muscles moving in synchrony with the player's. Such parallels between observed actions of others and one's own has been well supported in the latest progress in neuroscience, and coined "mirror system." It is likely that due to such phenomena, we are able to learn motor skills just by observing an expert's performance. Yet it is unknown whether such indirect learning occurs only at higher cognitive levels, or also at basic sensorimotor levels where sensorimotor delay is compensated and the timing of sensory feedback is constantly calibrated. METHODOLOGY/PRINCIPAL FINDINGS: Here, we show that the subject's passive observation of an actor manipulating a computer mouse with delayed auditory feedback led to shifts in subjective simultaneity of self mouse manipulation and auditory stimulus in the observing subjects. Likewise, self adaptation to the delayed feedback modulated the simultaneity judgment of the other subjects manipulating a mouse and an auditory stimulus. Meanwhile, subjective simultaneity of a simple visual disc and the auditory stimulus (flash test was not affected by observation of an actor nor self-adaptation. CONCLUSIONS/SIGNIFICANCE: The lack of shift in the flash test for both conditions indicates that the recalibration transfer is specific to the action domain, and is not due to a general sensory adaptation. This points to the involvement of a system for the temporal monitoring of actions, one that processes both one's own actions and those of others.

  11. Freeform object design and simultaneous manufacturing

    Science.gov (United States)

    Zhang, Wei; Zhang, Weihan; Lin, Heng; Leu, Ming C.

    2003-04-01

    Today's product design, especially the consuming product design, focuses more and more on individuation, originality, and the time to market. One way to meet these challenges is using the interactive and creationary product design methods and rapid prototyping/rapid tooling. This paper presents a novel Freeform Object Design and Simultaneous Manufacturing (FODSM) method that combines the natural interaction feature in the design phase and simultaneous manufacturing feature in the prototyping phase. The natural interactive three-dimensional design environment is achieved by adopting virtual reality technology. The geometry of the designed object is defined through the process of "virtual sculpting" during which the designer can touch and visualize the designed object and can hear the virtual manufacturing environment noise. During the designing process, the computer records the sculpting trajectories and automatically translates them into NC codes so as to simultaneously machine the designed part. The paper introduced the principle, implementation process, and key techniques of the new method, and compared it with other popular rapid prototyping methods.

  12. Nicotine transport in lung and non-lung epithelial cells.

    Science.gov (United States)

    Takano, Mikihisa; Kamei, Hidetaka; Nagahiro, Machi; Kawami, Masashi; Yumoto, Ryoko

    2017-11-01

    Nicotine is rapidly absorbed from the lung alveoli into systemic circulation during cigarette smoking. However, mechanism underlying nicotine transport in alveolar epithelial cells is not well understood to date. In the present study, we characterized nicotine uptake in lung epithelial cell lines A549 and NCI-H441 and in non-lung epithelial cell lines HepG2 and MCF-7. Characteristics of [3H]nicotine uptake was studied using these cell lines. Nicotine uptake in A549 cells occurred in a time- and temperature-dependent manner and showed saturation kinetics, with a Km value of 0.31mM. Treatment with some organic cations such as diphenhydramine and pyrilamine inhibited nicotine uptake, whereas treatment with organic cations such as carnitine and tetraethylammonium did not affect nicotine uptake. Extracellular pH markedly affected nicotine uptake, with high nicotine uptake being observed at high pH up to 11.0. Modulation of intracellular pH with ammonium chloride also affected nicotine uptake. Treatment with valinomycin, a potassium ionophore, did not significantly affect nicotine uptake, indicating that nicotine uptake is an electroneutral process. For comparison, we assessed the characteristics of nicotine uptake in another lung epithelial cell line NCI-H441 and in non-lung epithelial cell lines HepG2 and MCF-7. Interestingly, these cell lines showed similar characteristics of nicotine uptake with respect to pH dependency and inhibition by various organic cations. The present findings suggest that a similar or the same pH-dependent transport system is involved in nicotine uptake in these cell lines. A novel molecular mechanism of nicotine transport is proposed. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Optical and Functional Imaging in Lung Cancer

    NARCIS (Netherlands)

    K.H. van der Leest (Cor)

    2010-01-01

    textabstractLung cancer is the second most common cancer in men and women, and is the leading cause of cancer related death. In industrialized countries the mortality rate of lung cancer is higher than the mortality rate of breast, colorectal and prostate cancer combined 1. When lung cancer is

  14. Epidemiology of Lung Disease in Older Persons.

    Science.gov (United States)

    Vaz Fragoso, Carlos A

    2017-11-01

    Older persons frequently report respiratory risk factors and symptoms and have a high prevalence of symptomatic lung disease, most commonly obstructive airway disease, interstitial lung disease, and lung cancer. Notably, coexisting nonrespiratory risk factors are also prevalent and may misidentify or modify respiratory diagnoses and their clinical course. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Myricetin attenuates lung inflammation and provides protection ...

    African Journals Online (AJOL)

    The euthanasia was followed by the collection of lung samples for subsequent experimental analysis. Estimation of 'wet-to-dry' weight ratio. After euthanasia, the extent of pulmonary edema in the experimental groups was assessed by measuring the 'wet-to-dry' weight of the lungs. For this, the left lung was removed and.

  16. Public Preferences for Lung Cancer Screening Policies

    NARCIS (Netherlands)

    Broekhuizen, Henk; Groothuis-Oudshoorn, Catharina G. M.; Vliegenthart, Rozemarijn; Groen, Harry; IJzerman, Maarten J.

    Background: Because early detection of lung cancer can substantially improve survival, there is increasing attention for lung cancer screening.  Objectives: To estimate public preferences for lung cancer screening and to identify subgroups in preferences.  Methods: Seven important attributes were

  17. Comparison of lung ultrasound with transpulmonary thermodilution ...

    African Journals Online (AJOL)

    Background: Increased extra-vascular lung water (EVLW) is common in critical care and correlates with the severity of acute lung injury, length of intensive care unit stay and mortality. Lung ultrasound (LUS) can assess EVLW by determining the amount of. 'B-lines': artefacts signifying alveolar-interstitial oedema.

  18. Lung Cancer Rates by Race and Ethnicity

    Science.gov (United States)

    ... Shareable Graphics Infographics “African-American Men and Lung Cancer” “Lung Cancer Is the Biggest Cancer Killer in Both ... Colorectal (Colon) HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by Race and Ethnicity Language: English ( ...

  19. Stages of Small Cell Lung Cancer

    Science.gov (United States)

    ... inside of the lungs. Enlarge Anatomy of the respiratory system, showing the trachea and both lungs and their ... Cell Lung Cancer Tobacco (includes help with quitting) Cigarette Smoking: Health Risks and How to Quit Secondhand Smoke and Cancer For general cancer information and other ...

  20. Treatment Option Overview (Small Cell Lung Cancer)

    Science.gov (United States)

    ... inside of the lungs. Enlarge Anatomy of the respiratory system, showing the trachea and both lungs and their ... Cell Lung Cancer Tobacco (includes help with quitting) Cigarette Smoking: Health Risks and How to Quit Secondhand Smoke and Cancer For general cancer information and other ...

  1. General Information about Small Cell Lung Cancer

    Science.gov (United States)

    ... inside of the lungs. Enlarge Anatomy of the respiratory system, showing the trachea and both lungs and their ... Cell Lung Cancer Tobacco (includes help with quitting) Cigarette Smoking: Health Risks and How to Quit Secondhand Smoke and Cancer For general cancer information and other ...

  2. Pectus excavatum in children: pulmonary scintigraphy before and after corrective surgery

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G.; Rosen, P.R.; Welch, K.J.; Papanicolaou, N.; Treves, S.T.

    1985-09-01

    Regional distribution of pulmonary function was evaluated preoperatively and postoperatively with xenon-133 perfusion and ventilation scintigraphy in 17 patients with pectus excavatum. Ventilatory preoperative studies were abnormal in 12 of 17 patients, resolving in seven of 12 postoperatively. Perfusion scans were abnormal in ten of 17 patients preoperatively; six of ten showed improvement postoperatively. Ventilation-perfusion ratios were abnormal in ten of 17 patients, normalizing postoperatively in six of ten. Symmetry of ventilation-perfusion ratio images improved in six out of nine in the latter group. The distribution of regional lung function in pectus excavatum can be evaluated preoperatively to support indications for surgery. Postoperative improvement can be documented by physiological changes produced by the surgical correction.

  3. Clinical and laboratory features of acute sulfur dioxide inhalation poisoning: two-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Rabinovitch, S.; Greyson, N.D.; Weiser, W.; Hoffstein, V.

    1989-02-01

    We present clinical and laboratory results (including nuclear imaging) obtained over a period of two years in two nonsmoking miners who were exposed to high concentrations of sulfur dioxide (SO/sub 2/) after a mine explosion. Within 3 wk of the accident, both miners had evidence of severe airways obstruction, hypoxemia, markedly reduced exercise tolerance, ventilation-perfusion mismatch, and evidence of active inflammation as documented by positive gallium lung scan. Serial ventilation-perfusion scans over the first 12 months showed progressive improvement without returning to normal. After the initial recovery, there has been no significant change over the subsequent two years postinjury. Pulmonary function and exercise tests also displayed a similar pattern of initial improvement. We conclude that (1) acute exposure to high concentrations of SO/sub 2/ results in severe airways obstruction, (2) pulmonary function abnormalities are partially reversible, and (3) most of the improvement occurs within 12 months after the initial injury.

  4. CT triage for lung malignancy

    DEFF Research Database (Denmark)

    Kusk, Martin Weber; Karstoft, Jens; Mussmann, Bo

    2015-01-01

    : To assess detection performance using only coronal multiplanar reformations (MPR) when triaging patients for lung malignancies with CT compared to images in three orthogonal planes, and to evaluate performance comparison of novice and experienced readers. Material and Methods: Retrospective study of 63...

  5. LUNG FUNCTION TESTING IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Matjaž Fležar

    2004-03-01

    Full Text Available Background. Lung function testing in children above five years old is standardised similarly as is in adult population (1. Nevertheless bronchial provocation testing can be more hazardous since the calibre and reactivity of childhood airway is different. We analysed the frequency of different lung function testing procedures and addressed the safety issues of bronchial provocation testing in children.Methods. We analysed lung function testing results in 517 children, older than 5 years, tested in our laboratory in threeyear period. Spirometry was done in every patient, metacholine provocation test was used as a part of diagnostic work-up in suspected asthma. In case of airway obstruction, bronchodilator test with salbutamol was used instead of a metacholine provocation test.Results. The most common procedure in children was spirometry with bronchial provocation test as a part of diagnostic work-up of obstructive syndrome (mostly asthma. 291 children required metacholine test and 153 tests were interpreted as positive. The decline in expiratory flows (forced expiratory flow in first second – FEV1 in positive tests was greater than in adult population as was the dose of metacholine, needed to induce bronchoconstriction. The compliance of children was better than in adults.Conclusions. Lung function testing in children is reliable and safe and can be done in a well-standardised laboratory that follows the regulations of such testing in adults.

  6. Obesity, adipokines, and lung disease.

    Science.gov (United States)

    Sood, Akshay

    2010-03-01

    This review summarizes the state of the current literature relating to the associations of lung disease on obesity and adipokines (proteins produced by adipose tissue) in humans. Obesity is an independent risk factor for asthma. Recent studies suggest that obesity is also an independent risk factor for chronic airflow obstruction, as is seen with chronic obstructive pulmonary disease (COPD). The mechanistic basis for these associations in humans is not established, although a possible role for adipokines has been invoked. Leptin, a proinflammatory adipokine, and adiponectin, an anti-inflammatory adipokine, are causally associated with asthma in mice. Although human studies are currently inconclusive, high-serum leptin and low-serum adiponectin concentrations predict asthma, independent of obesity, in select population groups, such as premenopausal women in the United States. In contradistinction, low-serum leptin and high-serum adiponectin concentrations are associated with stable COPD, although these associations are likely confounded by fat mass. Interestingly, leptin may promote systemic and airway inflammation in stable COPD patients. On the other hand, COPD may upregulate systemic and lung adiponectin expression. The precise mechanism and significance of the associations between these adipokines and lung disease at the current stage is confusing and frankly paradoxical in places. This area of research needs additional study that may open up novel therapeutic strategies for these lung diseases.

  7. Smoking Marijuana and the Lungs

    Science.gov (United States)

    ... O P Y PATIENT EDUCATION | INFORMATION SERIES Smoking Marijuana and the Lungs Marijuana, also known as cannabis (can-a-bis) is the second most commonly smoked substance after tobacco. Despite marijuana’s legalization in many states, it may be harmful ...

  8. [Radiotherapy for primary lung carcinoma].

    Science.gov (United States)

    Giraud, P; Lacornerie, T; Mornex, F

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy, for primary lung carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  9. Mucoepidermoid Lung Carcinoma in Child

    African Journals Online (AJOL)

    usually includes asthma, pneumonia, atelectasis, middle lobe syndrome and pleural effusion. Recurrent pneumonia in the same region of the lung should raise clinical suspicion of an endobronchial lesion or mass, such as mucoepidermoid carcinoma.[1] Because MECs are most commonly found in the segmental or lobar ...

  10. Seniors' Lungs Can Tackle Exercise

    Science.gov (United States)

    ... lung's circulation doesn't become limited during vigorous exercise, no matter what your age or fitness level, the researchers said. And, that ... HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of ... Seniors' Health Recent Health News Related ...

  11. in Patients with Mustard Lung

    Directory of Open Access Journals (Sweden)

    ShahrzadM Lari

    2013-05-01

    Full Text Available   Introduction: Chronic Obstructive Pulmonary Disease (COPD secondary to sulfur mustard exposure, known as mustard lung, is an important late pulmonary complication. The BODE (Body mass index, Obstruction, Dyspnea, and Exercise index has been established as a valuable tool for determining the adverse consequences of COPD. The aim of this study was to evaluate the role of the BODE index in patients with mustard lung.   Materials and Methods: Eighty-two consecutively stable patients with mustard lung with all levels of severity were entered this study. The following parameters were recorded in all patients: standard spirometry, pulse oximetry, health-related quality of life, the BODE index. Additionally, the severity of COPD was determined by GOLD (Global initiative for chronic Obstructive Lung Disease staging. The correlation of the BODE index with pulmonary parameters was determined. Results: The mean age of the patients was 47.30±7.08 SD years. The mean BODE index was 3.16±2.25 SD. There was a statistically significant inverse correlation between the BODE index and oxygen saturation (r=-0.30, p=0.007. Also a statistically significant correlation was found between the BODE index and quality of life (r=0.80, p=0.001. The BODE index was not correlated with age of the patients and duration of disease. Conclusions: The results of this study showed that the BODE index is correlated with important clinical parameters and can be used in clinical practice

  12. Lung volume reduction for emphysema

    NARCIS (Netherlands)

    Shah, Pallav L.; Herth, Felix J.; van Geffen, Wouter H.; Deslee, Gaetan; Slebos, Dirk-Jan

    Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited

  13. Glutathione oxidation correlates with one-lung ventilation time and PO2/FiO2 ratio during pulmonary lobectomy.

    Science.gov (United States)

    García-de-la-Asunción, José; García-Del-Olmo, Eva; Galan, Genaro; Guijarro, Ricardo; Martí, Francisco; Badenes, Rafael; Perez-Griera, Jaume; Duca, Alejandro; Delgado, Carlos; Carbonell, Jose; Belda, Javier

    2016-09-01

    During lung lobectomy, the operated lung completely collapses with simultaneous hypoxic pulmonary vasoconstriction, followed by expansion and reperfusion. Here, we investigated glutathione oxidation and lipoperoxidation in patients undergoing lung lobectomy, during one-lung ventilation (OLV) and after resuming two-lung ventilation (TLV), and examined the relationship with OLV duration. We performed a single-centre, observational, prospective study in 32 patients undergoing lung lobectomy. Blood samples were collected at five time-points: T0, pre-operatively; T1, during OLV, 5 minutes before resuming TLV; and T2, T3, and T4, respectively, 5, 60, and 180 minutes after resuming TLV. Samples were tested for reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione redox potential, and malondialdehyde (MDA). GSSG and MDA blood levels increased at T1, and increased further at T2. OLV duration directly correlated with marker levels at T1 and T2. Blood levels of GSH and glutathione redox potential decreased at T1-T3. GSSG, oxidized glutathione/total glutathione ratio, and MDA levels were inversely correlated with arterial blood PO2/FiO2 at T1 and T2. During lung lobectomy and OLV, glutathione oxidation, and lipoperoxidation marker blood levels increase, with further increases after resuming TLV. Oxidative stress degree was directly correlated with OLV duration, and inversely correlated with arterial blood PO2/FiO2.

  14. Epidemiological associations between Mycoplasma hyopneumoniae and Actinobacillus pleuropneumoniae antibody titers and lung lesions in Prince Edward Island swine herds.

    Science.gov (United States)

    Van Til, L D; Dohoo, I R; Morley, R S

    1991-01-01

    A survey of anteroventral (AV) lung lesions, pleuritis and serology for Mycoplasma hyopneumoniae (MH) and Actinobacillus pleuropneumoniae (AP) was conducted on a minimum of 25 slaughter hogs from each of 18 randomly sampled Prince Edward Island farms (producing over 1,000 market hogs per year). The data were analyzed to evaluate the potential role of these two agents as risk factors for the two conditions, using crude and multivariable techniques, as well as individual and herd data. Anteroventral lung lesions were present in 50.5% of hogs at slaughter, and pleuritis was present in 15.4% of the hogs. Least squares multivariable regression was used to analyze the simultaneous ability of MH, AP and MH/AP interaction to predict the herd prevalence of AV lung lesions. Only MH was associated with AV lung lesions (p = 0.035). In spite of this statistical significance, MH accounted for only 53% of the herd variation in prevalence of lung lesions (R2 = 0.529). As well, some herds maintained very low levels of lung lesions despite moderate (up to 30%) prevalence of MH. Discrepancies between the analytic techniques suggested herd-level factors play an important role in the development of lung lesions. Pleuritis did not appear to be associated with either of the agents studied (p = 0.478). PMID:1790490

  15. Lung Cancer and Tobacco: What Is New?

    Science.gov (United States)

    Bialous, Stella Aguinaga; Sarna, Linda

    2017-03-01

    Lung cancer is the leading cause of cancer death worldwide. Tobacco use remains the single most important preventable cause of cancer and is responsible for 80% of all cases of lung cancer. Implementation of tobacco control measures, including preventing initiation and treating dependence, are pivotal to address the lung cancer epidemic. New evidence continues to emerge on the significant positive impact of incorporating tobacco dependence treatment within all lung cancer treatment protocols. Evidence and guidelines on how to implement these strategies exist and present an opportunity for nurses to make a difference in reducing suffering and preventing deaths from lung cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Lung Cancer Screening: Why, When, and How?

    Science.gov (United States)

    Fintelmann, Florian J; Gottumukkala, Ravi V; McDermott, Shaunagh; Gilman, Matthew D; Lennes, Inga T; Shepard, Jo-Anne O

    2017-11-01

    This article explains the rationale of lung cancer screening with low-dose computed tomography and provides a practical approach to all relevant aspects of a lung cancer screening program. Imaging protocols, patient eligibility criteria, facility readiness, and reimbursement criteria are addressed step by step. Diagnostic criteria and Lung-RADS (Lung Computed Tomography Screening Reporting and Data System) nodule management pathways are illustrated with examples. Pearls and pitfalls for interpretation of lung cancer screening low-dose chest computed tomography are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Mass preserving image registration for lung CT

    DEFF Research Database (Denmark)

    Gorbunova, Vladlena; Sporring, Jon; Lo, Pechin Chien Pau

    2012-01-01

    on four groups of data: 44 pairs of longitudinal inspiratory chest CT scans with small difference in lung volume; 44 pairs of longitudinal inspiratory chest CT scans with large difference in lung volume; 16 pairs of expiratory and inspiratory CT scans; and 5 pairs of images extracted at end exhale and end......This paper presents a mass preserving image registration algorithm for lung CT images. To account for the local change in lung tissue intensity during the breathing cycle, a tissue appearance model based on the principle of preservation of total lung mass is proposed. This model is incorporated...

  18. 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.

  19. Quantification of human lung structure and physiology using hyperpolarized 129Xe.

    Science.gov (United States)

    Chang, Yulin V; Quirk, James D; Ruset, Iulian C; Atkinson, Jeffrey J; Hersman, F William; Woods, Jason C

    2014-01-01

    To present in vivo, human validation of a previously proposed method to measure key pulmonary parameters related to lung microstructure and physiology. Some parameters, such as blood-air barrier thickness, cannot be measured readily by any other noninvasive modality. Healthy volunteers (n = 12) were studied in 1.5T and 3T whole body human scanners using hyperpolarized xenon. Xenon uptake by lung parenchyma and blood was measured using a chemical shift saturation recovery sequence. Both dissolved-xenon peaks at 197 ppm and 217-218 ppm were fitted against a model of xenon exchange (MOXE) as functions of exchange time. Parameters related to lung function and structure can be obtained by fitting to this model. The following results were obtained from xenon uptake (averaged over all healthy volunteers): surface-area-to-volume ratio = 210 ± 50 cm(-1) ; total septal wall thickness = 9.2 ± 6.5 μm; blood-air barrier thickness = 1.0 ± 0.3 μm; hematocrit = 27 ± 4%; pulmonary capillary blood transit time = 1.3 ± 0.3 s, in good agreement with literature values from invasive experiments. More detailed fitting results are listed in the text. The initial in vivo human results demonstrate that our proposed methods can be used to noninvasively determine lung physiology by simultaneous quantification of a few important pulmonary parameters. This method is highly promising to become a versatile screening method for lung diseases. Copyright © 2013 Wiley Periodicals, Inc.

  20. Inhibition of metastatic lung cancer in C57BL/6 mice by marine mangrove Rhizophora apiculata.

    Science.gov (United States)

    Prabhu, V Vinod; Guruvayoorappan, C

    2013-01-01

    Metastasis is one of the hallmarks of malignant neoplasms and is the leading cause of death in many cancer patients. A major challenge in cancer treatment is to find better ways to specifically target tumor metastasis. In this study, the anti-metastatic potential of the methanolic extract of Rhizophora apiculata (R.apiculata) was evaluated using the B16F-10 melanoma induced lung metastasis model in C57BL/6 mice. Metastasis was induced in C57BL/6 mice by injecting highly metastatic B16F-10 melanoma cells through the lateral tail vein. Simultaneous treatment with R.apiculata extract (10 mg/kg b.wt (intraperitoneal) significantly (p<0.01) inhibited pulmonary tumor nodule formation (41.1 %) and also increased the life span (survival rate) 107.3 % of metastatic tumor bearing animals. The administration of R.apiculata extract significantly (p<0.01) reduced biochemical parameters such as lung collagen hydroxyproline, hexosamine, uronic acid content, serum nitric oxide (NO), γ-glutamyl transpeptidase (GGT) and sialic acid levels when compared to metastasis controls. These results correlated with lung histopathology analysis of R.apiculata extract treated mice showing reduction in lung metastasis and tumor masses. Taken together, our findings support that R.apiculata extract could be used as a potential anti-metastasis agent against lung cancer.

  1. Simultaneous distribution of AC and DC power

    Science.gov (United States)

    Polese, Luigi Gentile

    2015-09-15

    A system and method for the transport and distribution of both AC (alternating current) power and DC (direct current) power over wiring infrastructure normally used for distributing AC power only, for example, residential and/or commercial buildings' electrical wires is disclosed and taught. The system and method permits the combining of AC and DC power sources and the simultaneous distribution of the resulting power over the same wiring. At the utilization site a complementary device permits the separation of the DC power from the AC power and their reconstruction, for use in conventional AC-only and DC-only devices.

  2. Simultaneous bilateral total hip arthroplasties in nonagenarians.

    Science.gov (United States)

    Power, F R; Cawley, D T; Curtin, P D

    2017-11-01

    Total hip arthroplasty (THA) is an effective and durable treatment option for hip osteoarthritis (OA). As life expectancy continues to increase, so too will the demand for joint arthroplasty in the 10th decade of life, frequently in cases involving osteoarthritis of both hips. Simultaneous bilateral total hip arthroplasty (SBTHA) is a valuable therapeutic option in appropriately selected patients with bilateral degenerative hip disease, although its use in the very elderly is poorly reported on in the literature. A case of bilateral hip OA successfully treated with SBTHA in a nonagenarian is presented and the literature is reviewed.

  3. Resolution enhancement using simultaneous couple illumination

    Science.gov (United States)

    Hussain, Anwar; Martínez Fuentes, José Luis

    2016-10-01

    A super-resolution technique based on structured illumination created by a liquid crystal on silicon spatial light modulator (LCOS-SLM) is presented. Single and simultaneous pairs of tilted beams are generated to illuminate a target object. Resolution enhancement of an optical 4f system is demonstrated by using numerical simulations. The resulting intensity images are recorded at a charged couple device (CCD) and stored in the computer memory for further processing. One dimension enhancement can be performed with only 15 images. Two dimensional complete improvement requires 153 different images. The resolution of the optical system is extended three times compared to the band limited system.

  4. Simultaneous scheduling of machines and mobile robots

    DEFF Research Database (Denmark)

    Dang, Vinh Quang; Nielsen, Izabela Ewa

    2013-01-01

    in terms of their advanced ability to perform tasks at machines by using their manipulation arms. The mobile robots thus have to be scheduled in relation to scheduling of machines so as to increase the efficiency of the overall system. The performance criterion is to minimize time required to complete all......This paper deals with the problem of simultaneously scheduling machines and a number of autonomous mobile robots in a flexible manufacturing system (FMS). Besides capability of transporting materials between machines, the considered mobile robots are different from other material handling devices...

  5. Interstitial lung disease: physiopathology in the context of lung growth.

    Science.gov (United States)

    Nathan, Nadia; Thouvenin, Guillaume; Fauroux, Brigitte; Corvol, Harriet; Clement, Annick

    2011-12-01

    Interstitial lung diseases (ILDs) in children represent a heterogeneous group of respiratory disorders characterized by derangements of the alveolar walls. The key pathologic feature of ILDs is the altered repair of the alveolar surface after injury with a marked disruption in the integrity of the epithelium and, consequently, a dysregulated communication between epithelial and mesenchymal pulmonary components. Concomitant to the loss of cell-cell contact, epithelial cells undergo a process called epithelial to mesenchymal transition and acquire a mesenchymal identity. Among the factors involved in disease progression, transforming growth factor-β has been identified as a master switch in the induction of fibrosis. This article reviews recent advances in the understanding of the mechanisms involved in the pathogenesis of ILDs, and provides information on their adaptation in the context of lung growth. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  6. Lung management during cardiopulmonary bypass: influence on extravascular lung water.

    Science.gov (United States)

    Boldt, J; King, D; Scheld, H H; Hempelmann, G

    1990-02-01

    Progressive respiratory insufficiency secondary to cardiopulmonary bypass (CPB) is still a hazard after cardiac surgery. Pathophysiologically, impaired capillary endothelial integrity seems to be the fundamental lesion, followed by increased interstitial fluid accumulation. The reasons for this pulmonary damage are controversial; however, management of the nonperfused lungs during CPB has been widely neglected and may be partly responsible. In this study, 90 patients undergoing coronary artery bypass grafting were randomly divided into six groups (15 patients each) with different management of the lungs during CPB: group 1, lungs collapsed (0/0); group 2, static inflation with +5 cm H2O and F1O2 1.0 (+5/1.0); group 3, static inflation with +5 cm H2O and F1O2 0.21 (+5/0.21); group 4, static inflation with +15 cm H2O and F1O2 1.0 (+15/1.0); group 5, static inflation with +15 cm H2O and F1O2 0.21 (+15/0.21); and group 6, controlled mechanical ventilation as before start of CPB (positive end-expiratory pressure [PEEP] +5 cm H2O; F1O2 1.0) (ventilation). In addition to hemodynamic monitoring, extravascular lung water (EVLW) was measured by means of a double-indicator dilution technique with heat and indocyanine green. Measurements were performed after induction of anesthesia, before onset of CPB, and immediately after weaning from bypass, as well as 60 minutes and 5 hours after termination of CPB. Pulmonary gas exchange (PaO2) and intrapulmonary shunting (Qs/Qt) were also measured. Starting from comparable, normal baseline values, EVLW was increased in all groups after weaning from CPB, with the most pronounced increase in group 4 (maximum, +35%) and group 5 (+40%).(ABSTRACT TRUNCATED AT 250 WORDS)

  7. [Lung cancer surgery in a single-lung].

    Science.gov (United States)

    Le Pimpec Barthes, F; Rivera, C; Fabre, E; Arame, A; Pricopi, C; Badia, A; Foucault, C; Dujon, A; Riquet, M

    2015-02-01

    The diagnosis of a second lung cancer in a patient with a previous medical history of lung cancer is no longer a rarity. Also, it is possible to observe a new location in a patient who underwent pneumonectomy in the past. Surgery remains the best treatment. Our objective was to overview this subject. Among 5611 patients operated in our institution, 186 (3.3%) had metachronous cancer and 17 had previous pneumonectomy (0.7% of pneumonectomies and 0.2% of NSCLC treated in our department). The procedure was diagnostic and therapeutic in 88% of cases (n=15). There were 16 males and 1 female, mean age was 62.5-years. All were smokers (11 were former smokers) and 6 had other medical history. Mean FEV was 52% (range 35-95%). Types of resection were 2 lobectomies, 4 segmentectomies, and 11 wedge resections. There were no postoperative deaths, but two complications. Histological subtype of the first and second cancer was the same in 11 patients. All patients were pN0 after second surgery. The long-term survival (median 33 months) was 35.3% at 5-years and 14.1% at 10-years. Two patients treated with pneumonectomy for their first cancer were pN2. Patients who underwent upper right lobectomy for treatment of their second cancer survived longer than 5-years. Surgical resection for lung cancer on single-lung is associated with acceptable morbidity and mortality. Prolonged survival can be achieved in selected patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Histologic and biochemical alterations predict pulmonary mechanical dysfunction in aging mice with chronic lung inflammation.

    Science.gov (United States)

    Massa, Christopher B; Groves, Angela M; Jaggernauth, Smita U; Laskin, Debra L; Gow, Andrew J

    2017-08-01

    Both aging and chronic inflammation produce complex structural and biochemical alterations to the lung known to impact work of breathing. Mice deficient in surfactant protein D (Sftpd) develop progressive age-related lung pathology characterized by tissue destruction/remodeling, accumulation of foamy macrophages and alteration in surfactant composition. This study proposes to relate changes in tissue structure seen in normal aging and in chronic inflammation to altered lung mechanics using a computational model. Alterations in lung function in aging and Sftpd -/- mice have been inferred from fitting simple mechanical models to respiratory impedance data (Zrs), however interpretation has been confounded by the simultaneous presence of multiple coexisting pathophysiologic processes. In contrast to the inverse modeling approach, this study uses simulation from experimental measurements to recapitulate how aging and inflammation alter Zrs. Histologic and mechanical measurements were made in C57BL6/J mice and congenic Sftpd-/- mice at 8, 27 and 80 weeks of age (n = 8/group). An anatomic computational model based on published airway morphometry was developed and Zrs was simulated between 0.5 and 20 Hz. End expiratory pressure dependent changes in airway caliber and recruitment were estimated from mechanical measurements. Tissue elements were simulated using the constant phase model of viscoelasticity. Baseline elastance distribution was estimated in 8-week-old wild type mice, and stochastically varied for each condition based on experimentally measured alteration in elastic fiber composition, alveolar geometry and surfactant composition. Weighing reduction in model error against increasing model complexity allowed for identification of essential features underlying mechanical pathology and their contribution to Zrs. Using a maximum likelihood approach, alteration in lung recruitment and diminished elastic fiber density were shown predictive of mechanical alteration at

  9. Histologic and biochemical alterations predict pulmonary mechanical dysfunction in aging mice with chronic lung inflammation.

    Directory of Open Access Journals (Sweden)

    Christopher B Massa

    2017-08-01

    Full Text Available Both aging and chronic inflammation produce complex structural and biochemical alterations to the lung known to impact work of breathing. Mice deficient in surfactant protein D (Sftpd develop progressive age-related lung pathology characterized by tissue destruction/remodeling, accumulation of foamy macrophages and alteration in surfactant composition. This study proposes to relate changes in tissue structure seen in normal aging and in chronic inflammation to altered lung mechanics using a computational model. Alterations in lung function in aging and Sftpd -/- mice have been inferred from fitting simple mechanical models to respiratory impedance data (Zrs, however interpretation has been confounded by the simultaneous presence of multiple coexisting pathophysiologic processes. In contrast to the inverse modeling approach, this study uses simulation from experimental measurements to recapitulate how aging and inflammation alter Zrs. Histologic and mechanical measurements were made in C57BL6/J mice and congenic Sftpd-/- mice at 8, 27 and 80 weeks of age (n = 8/group. An anatomic computational model based on published airway morphometry was developed and Zrs was simulated between 0.5 and 20 Hz. End expiratory pressure dependent changes in airway caliber and recruitment were estimated from mechanical measurements. Tissue elements were simulated using the constant phase model of viscoelasticity. Baseline elastance distribution was estimated in 8-week-old wild type mice, and stochastically varied for each condition based on experimentally measured alteration in elastic fiber composition, alveolar geometry and surfactant composition. Weighing reduction in model error against increasing model complexity allowed for identification of essential features underlying mechanical pathology and their contribution to Zrs. Using a maximum likelihood approach, alteration in lung recruitment and diminished elastic fiber density were shown predictive of mechanical

  10. Sampling for stereology in lungs

    Directory of Open Access Journals (Sweden)

    J. R. Nyengaard

    2006-12-01

    Full Text Available The present article reviews the relevant stereological estimators for obtaining reliable quantitative structural data from the lungs. Stereological sampling achieves reliable, quantitative information either about the whole lung or complete lobes, whilst minimising the workload. Studies have used systematic random sampling, which has fixed and constant sampling probabilities on all blocks, sections and fields of view. For an estimation of total lung or lobe volume, the Cavalieri principle can be used, but it is not useful in estimating individual cell volume due to various effects from over- or underprojection. If the number of certain structures is required, two methods can be used: the disector and the fractionator. The disector method is a three-dimensional stereological probe for sampling objects according to their number. However, it may be affected on tissue deformation and, therefore, the fractionator method is often the preferred sampling principle. In this method, a known and predetermined fraction of an object is sampled in one or more steps, with the final step estimating the number. Both methods can be performed in a physical and optical manner, therefore enabling cells and larger lung structure numbers (e.g. number of alveoli to be estimated. Some estimators also require randomisation of orientation, so that all directions have an equal chance of being chosen. Using such isotropic sections, surface area, length, and diameter can be estimated on a Cavalieri set of sections. Stereology can also illustrate the potential for transport between two compartments by analysing the barrier width. Estimating the individual volume of cells can be achieved by local stereology using a two-step procedure that first samples lung cells using the disector and then introduces individual volume estimation of the sampled cells. The coefficient of error of most unbiased stereological estimators is a combination of variance from blocks, sections, fields

  11. Low-flow venovenous CO₂ removal in association with lung protective ventilation strategy in patients who develop severe progressive respiratory acidosis after lung transplantation.

    Science.gov (United States)

    Ruberto, F; Bergantino, B; Testa, M C; D'Arena, C; Zullino, V; Congi, P; Paglialunga, S G; Diso, D; Venuta, F; Pugliese, F

    2013-09-01

    Primary graft dysfunction (PGD) might occur after lung transplantation. In some severe cases, conventional therapies like ventilatory support, administration of inhaled nitric oxide (iNO), and intravenous prostacyclins are not sufficient to provide an adequate gas exchange. The aim of our study was to evaluate the use of a lung protective ventilation strategy associated with a low-flow venovenous CO2 removal treatment to reduce ventilator-associated injury in patients that develop severe PGD after lung transplantation. From January 2009 to January 2011, 3 patients developed PGD within 24 hours after lung transplantation. In addition to conventional medical treatment, including hemodynamic support, iNO and prostaglandin E1 (PGE1), we initiated a ventilatory protective strategy associated with low-flow venovenous CO2 removal treatment (LFVVECCO2R). Hemodynamic and respiratory parameters were assessed at baseline as well as after 3, 12, 24, and 48 hours. No adverse events were registered. Despite decreased baseline elevated pulmonary positive pressures, application of a protective ventilation strategy with LFVVECCO2R reduced PaCO2 and pulmonary infiltrates as well as increased pH values and PaO2/FiO2 ratios. Every patient showed simultaneous improvement of clinical and hemodynamic conditions. They were weaned from mechanical ventilation and extubated after 24 hours after the use of the low-flow venovenous CO2 removal device. The use of LFVVECCO2R together with a protective lung ventilation strategy during the perioperative period of lung transplantation may be a valid clinical strategy for patients with PGD and severe respiratory acidosis occured despite adequate mechanical ventilation. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Desired Turbulence? Gut-Lung Axis, Immunity, and Lung Cancer.

    Science.gov (United States)

    Bingula, Rea; Filaire, Marc; Radosevic-Robin, Nina; Bey, Mathieu; Berthon, Jean-Yves; Bernalier-Donadille, Annick; Vasson, Marie-Paule; Filaire, Edith

    2017-01-01

    The microbiota includes different microorganisms consisting of bacteria, fungi, viruses, and protozoa distributed over many human body surfaces including the skin, vagina, gut, and airways, with the highest density found in the intestine. The gut microbiota strongly influences our metabolic, endocrine, and immune systems, as well as both the peripheral and central nervous systems. Recently, a dialogue between the gut and lung microbiota has been discovered, suggesting that changes in one compartment could impact the other compartment, whether in relation to microbial composition or function. Further, this bidirectional axis is evidenced in an, either beneficial or malignant, altered immune response in one compartment following changes in the other compartment. Stimulation of the immune system arises from the microbial cells themselves, but also from their metabolites. It can be either direct or mediated by stimulated immune cells in one site impacting the other site. Additionally, this interaction may lead to immunological boost, assisting the innate immune system in its antitumour response. Thus, this review offers an insight into the composition of these sites, the gut and the lung, their role in shaping the immune system, and, finally, their role in the response to lung cancer.

  13. Desired Turbulence? Gut-Lung Axis, Immunity, and Lung Cancer

    Directory of Open Access Journals (Sweden)

    Rea Bingula

    2017-01-01

    Full Text Available The microbiota includes different microorganisms consisting of bacteria, fungi, viruses, and protozoa distributed over many human body surfaces including the skin, vagina, gut, and airways, with the highest density found in the intestine. The gut microbiota strongly influences our metabolic, endocrine, and immune systems, as well as both the peripheral and central nervous systems. Recently, a dialogue between the gut and lung microbiota has been discovered, suggesting that changes in one compartment could impact the other compartment, whether in relation to microbial composition or function. Further, this bidirectional axis is evidenced in an, either beneficial or malignant, altered immune response in one compartment following changes in the other compartment. Stimulation of the immune system arises from the microbial cells themselves, but also from their metabolites. It can be either direct or mediated by stimulated immune cells in one site impacting the other site. Additionally, this interaction may lead to immunological boost, assisting the innate immune system in its antitumour response. Thus, this review offers an insight into the composition of these sites, the gut and the lung, their role in shaping the immune system, and, finally, their role in the response to lung cancer.

  14. Estimating individual listeners’ auditory-filter bandwidth in simultaneous and non-simultaneous masking

    DEFF Research Database (Denmark)

    Buchholz, Jörg; Caminade, Sabine; Strelcyk, Olaf

    2010-01-01

    and assuming a rounded-exponential filter shape. If a forward masking paradigm is used instead of simultaneous masking, filter estimates typically show significantly sharper tuning. This difference in frequency selectivity has commonly been related to spectral suppression mechanisms observed in the cochlea......Frequency selectivity in the human auditory system is often measured using simultaneous masking of tones presented in notched noise. Based on such masking data, the equivalent rectangular bandwidth (ERB) of the auditory filters can be derived by applying the power spectrum model of masking...... the reliability of the individual estimates, a statistical resampling method is applied. It is demonstrated that a rather large set of experimental data is required to reliably estimate auditory filter bandwidth, particularly in the case of simultaneous masking. The poor overall reliability of the filter...

  15. Simultaneous Velocity and Vorticity Measurement in Turbulence

    Science.gov (United States)

    Wu, Huixuan; Xu, Haitao; Bodenschatz, Eberhard

    2013-11-01

    A new paradigm of simultaneous velocity and vorticity measurement is developed to study turbulence. Instead of deducing vorticity from velocities measured at neighboring points, this innovative approach detects the translations and rotations of micro-sized particles directly. These hydrogel particles are spherical, transparent, and encapsulate micro-mirrors. This method outstands conventional ones, e.g., hotwire arrays or PIV because its spatial resolution is much higher. It does not require a non-zero mean flow, and it can provide all three vorticity components, which is not available from planar PIV data. Its principle is to illuminate the mirror and utilize the variation of the reflection directions to deduce the local flow vorticity. Meanwhile, the particle position is recorded as in normal particle tracking. Therefore, the velocity and vorticity of a particle can be obtained simultaneously in Lagrangian framework. The authors have made benchmark experiments to evaluate this novel method in Taylor Couette flows. The results show that the instantaneous vorticity measurement is as accurate as 3%. We are now setting up a von Karman disk pair device to study the turbulent flow. This novel technique will provide unprecedented information of high Reynolds number turbulence. The first author thanks the Alexander von Humboldt Foundation.

  16. Simultaneous structure and texture image inpainting.

    Science.gov (United States)

    Bertalmio, Marcelo; Vese, Luminita; Sapiro, Guillermo; Osher, Stanley

    2003-01-01

    An algorithm for the simultaneous filling-in of texture and structure in regions of missing image information is presented in this paper. The basic idea is to first decompose the image into the sum of two functions with different basic characteristics, and then reconstruct each one of these functions separately with structure and texture filling-in algorithms. The first function used in the decomposition is of bounded variation, representing the underlying image structure, while the second function captures the texture and possible noise. The region of missing information in the bounded variation image is reconstructed using image inpainting algorithms, while the same region in the texture image is filled-in with texture synthesis techniques. The original image is then reconstructed adding back these two sub-images. The novel contribution of this paper is then in the combination of these three previously developed components, image decomposition with inpainting and texture synthesis, which permits the simultaneous use of filling-in algorithms that are suited for different image characteristics. Examples on real images show the advantages of this proposed approach.

  17. Simultaneous optiimisation of nutritional quality and environmental sustainability of diets

    NARCIS (Netherlands)

    van Dooren, C.

    2018-01-01

    Simultaneous optimisation of the nutritional quality and environmental sustainability of diets The purpose of this thesis was to explore how the nutritional quality and environmental sustainability of diets can be optimised simultaneously. This work operationalised and quantified the concept of

  18. Referral Patterns and Diagnostic Yield of Lung Scintigraphy in the Diagnosis of Acute Pulmonary Embolism

    Science.gov (United States)

    Zannier, Erik; Zuckier, Lionel S.

    2017-01-01

    Introduction. The purpose of this study is to assess referral patterns and the yield of ventilation-perfusion (V/Q) scintigraphy in patients referred for acute pulmonary embolism (PE). Methods. We retrospectively reviewed the charts of all patients who underwent V/Q studies between April 1, 2008, and March 31, 2010. Patients were subdivided into 4 groups based on their referral source: emergency department (ED), hospital inpatient ward, outpatient thrombosis clinic, and all other outpatient sources. Results. A total of 1008 patients underwent V/Q scintigraphy to exclude acute PE. The number of ED, inpatient, thrombosis clinic, and outpatient studies was 43 (4.3%), 288 (28.6%), 351 (34.8%), and 326 (32.3%). Proportion of patients with contrast contraindication varied significantly among the different groups. Of the 1,008 studies, 331 (32.8%) were interpreted as normal, 408 (40.5%) as low, 158 (15.7%) as intermediate, and 111 (11.0%) as high probability for PE. 68 (6.7%) patients underwent CTPA within 2 weeks following V/Q. Conclusion. The rate of nondiagnostic studies is lower than that reported in previously published data, with a relatively low rate of intermediate probability studies. Only a small fraction of patients undergoing a V/Q scan will require a CTPA. PMID:28491475

  19. IMAGING TECHNIQUES IN THE DIFFERENTIAL DIAGNOSIS OF PARASITIC LUNG DISEASES AND LUNG CANCER

    Directory of Open Access Journals (Sweden)

    P. M. Kotlyarov

    2016-01-01

    Full Text Available We analyzed imaging findings of 18 patients with atypical manifestations of parasitic diseases of the lung, who were admitted to the hospital with suspected lung cancer or metastatic lung cancer. The common CT, MRT and US findings of parasitic lung disease are fluid-containing lesions, septal structures (echinococcosis, alveolar echinococcosis, cisticercosis, no evidence of bronchial involvement and the absence of contrast agent accumulation in the affected area (paragonimiasis, shistosomiasis, toxoplasmosis, pneumocystis. Realtime monitoring with dynamic CT is often critical for differential diagnosis between atypical manifestations of parasitic lung disease and cancer or secondary lung tumor. 

  20. Lung function measurements in children

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva

    2010-01-01

    syncytial virus (RSV) bronchiolitis may occur in otherwise healthy infants. It is not known whether viral bronchiolitis is causatively related to asthma or simply identifies infants at risk for subsequent wheezing from an atopic predisposition or pre-existing abnormal lung function. First aim...... responsiveness in infants who later develop RSV bronchiolitis with infants who do not develop such severe infection. In a prospective birth cohort study of 411 infants of asthmatic mothers 22 infants developed RSV bronchiolitis. Infants with and without RSV bronchiolitis did not differ significantly in baseline...... was to determine the differential effect within monozygotic twin (MZ) pairs discordant for severe RSV bronchiolitis in infancy on the subsequent development of asthma, pulmonary function and allergy. 37 MZ twin pairs discordant for RSV hospitalization in infancy were compared at the mean age of 7.6 years for lung...

  1. Lung function measurements in children

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva

    2010-01-01

    , there was no effect of the child's history of atopy, parental atopy or smoking. We subsequently pooled these normative data (105 children) with previous data from 121 healthy young children; mean sRaw (SD) 1.27 kPa*s (0.25). Conclusion: Control using biological standards revealed errors in factory setting...... syncytial virus (RSV) bronchiolitis may occur in otherwise healthy infants. It is not known whether viral bronchiolitis is causatively related to asthma or simply identifies infants at risk for subsequent wheezing from an atopic predisposition or pre-existing abnormal lung function. First aim...... was to determine the differential effect within monozygotic twin (MZ) pairs discordant for severe RSV bronchiolitis in infancy on the subsequent development of asthma, pulmonary function and allergy. 37 MZ twin pairs discordant for RSV hospitalization in infancy were compared at the mean age of 7.6 years for lung...

  2. Models of lung branching morphogenesis.

    Science.gov (United States)

    Miura, Takashi

    2015-03-01

    Vertebrate airway has a tree-like-branched structure. This structure is generated by repeated tip splitting, which is called branching morphogenesis. Although this phenomenon is extensively studied in developmental biology, the mechanism of the pattern formation is not well understood. Conversely, there are many tree-like structures in purely physical or chemical systems, and their pattern formation mechanisms are well-understood using mathematical models. Recent studies correlate these biological observations and mathematical models to understand lung branching morphogenesis. These models use slightly different mechanisms. In this article, we will review recent progress in modelling lung branching morphogenesis, and future directions to experimentally verify the models. © The Authors 2015. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

  3. Placental Transmogrification of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woo; Park, Il Hwan; Kwon, Woo Cheol; Eom, Min Seob; Kim, Young Ju; Hwan, Joong Hwan [Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2013-12-15

    Placental transmogrification is a very rare lung disease, where the alveoli resemble the chorionic villi of placenta, and this change is a characteristic finding. A 31-year-old female patient presented with cough and dyspnea that had begun 2 weeks prior to admission. Along with giant bulla found in the left upper lung field, subsegmental consolidation was also identified in the lingular segment on plain chest radiograph and CT scan. Wedge resection was performed to remove the bulla. Pathologic examination of the resected bulla revealed destruction of the normal structures and characteristic villous and papillary changes. These changes led to a diagnosis of placental transmogrification. We made an encounter of an unusual placental transmogrification which had different image findings from other reported transmogrification cases. Thus, we report an atypical placental transmogrification case where both consolidation and giant bulla coexist.

  4. Lung function measurements in children

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva

    2010-01-01

    was to determine the differential effect within monozygotic twin (MZ) pairs discordant for severe RSV bronchiolitis in infancy on the subsequent development of asthma, pulmonary function and allergy. 37 MZ twin pairs discordant for RSV hospitalization in infancy were compared at the mean age of 7.6 years for lung......The Ph.D. thesis is based on studies conducted at 6 pediatric departments in following hospitals: Naestved, Gentofte, Kolding, Skejby, Hvidovre and Rigshospitalet. Study I: Specific airway resistance (sRaw) measured by wholebody plethysmography in preschool children is increasingly used in research...... syncytial virus (RSV) bronchiolitis may occur in otherwise healthy infants. It is not known whether viral bronchiolitis is causatively related to asthma or simply identifies infants at risk for subsequent wheezing from an atopic predisposition or pre-existing abnormal lung function. First aim...

  5. Methylation of the DCLK1 promoter region in circulating free DNA and its prognostic value in lung cancer patients.

    Science.gov (United States)

    Powrózek, T; Krawczyk, P; Nicoś, M; Kuźnar-Kamińska, B; Batura-Gabryel, H; Milanowski, J

    2016-04-01

    The possibility of detection of suppressor genes methylation in circulating free DNA (cf-DNA) of cancer patients and the lack of methylation in healthy individuals makes this epigenetic alternation an ideal diagnostic marker of neoplastic processes. Moreover, hypermethylation in several genes promoter was described as a biomarker of lung cancer. Methylation in the gene encoding doublecortin-like kinase 1 (DCLK1) is observed in patients with colorectal cancer and cholangiocarcinoma. However, there are no studies concerning DCLK1 methylation in lung cancer patients. The aims of the study was to evaluate the frequency of DCLK1 promoter methylation in cf-DNA of lung cancer patients and of healthy persons as well as the usefulness of this test for predicting the lung cancer course. DCLK1 methylation status was evaluated in DNA isolated from peripheral blood plasma from 65 lung cancer patients and 95 healthy individuals. After DNA bisulfitation, DCLK1 methylation was determined using the qMSP-PCR technique. Moreover, the presence of DCLK1 methylation was correlated with the overall survival (OS) probability of lung cancer patients. DCLK1 promoter methylation was detected in 32 lung cancer patients (49.2 %) and 8 healthy individuals (8.4 %). The methylation of the region before transcription start site (TSS) and the region after TSS of DCLK1 gene was detected in 28 and 11 patients, respectively. In seven cases (10.8 %), the DCLK1 promoter methylation in both regions was reported simultaneously. The methylation was observed slightly frequently in patients with small cell lung cancer (75 % of SCLC patients). The median overall survival of patients with DCLK1 promoter methylation was lower than that of patients without DCLK1 gene modification (p = methylation may be useful in both early diagnosis and prediction of the course of lung cancer.

  6. SU-E-T-500: Dose Escalation Strategy for Lung Cancer Patients Using a Biologically- Guided Target Definition

    Energy Technology Data Exchange (ETDEWEB)

    Shusharina, N; Khan, F; Choi, N; Sharp, G [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-01

    Purpose: Dose escalation strategy for lung cancer patients can lead to late symptoms such as pneumonitis and cardiac injury. We propose a strategy to increase radiation dose for improving local tumor control while simultaneously striving to minimize the injury of organs at risk (OAR). Our strategy is based on defining a small, biologically-guided target volume for receiving additional radiation dose. Methods: 106 patients with lung cancer treated with radiotherapy were selected for patients diagnosed with stage II and III disease. Previous research has shown that 50% of the maximum SUV threshold in FDG-PET imaging is appropriate for delineation of the most aggressive part of a tumor. After PET- and CT-derived targets were contoured, an IMRT treatment plan was designed to deliver 60 Gy to the GTV as delineated on a 4D CT (Plan 1). A second plan was designed with additional dose of 18 Gy to the PET-derived volume (Plan 2). A composite plan was generated by the addition of Plan 1 and Plan 2. Results: Plan 1 was compared to the composite plan and increases in OAR dose were assessed. For seven patients on average, lung V5 was increased by 1.4% and V20 by 4.2% for ipsilateral lung and by 13.5% and 7% for contralateral lung. For total lung, V5 and V20 were increased by 4.5% and 4.8% respectively. Mean lung dose was increased by 9.7% for the total lung. The maximum dose to the spinal cord increased by 16% on average. For the heart, V20 increased by 4.2% and V40 by 5.2%. Conclusion: It seems feasible that an additional 18 Gy of radiation dose can be delivered to FDG PET-derived subvolume of the CT-based GTV of the primary tumor without significant increase in total dose to the critical organs such as lungs, spinal cord and heart.

  7. Method of exact lung puncture

    Energy Technology Data Exchange (ETDEWEB)

    Voss, L.

    1986-01-01

    The accuracy can be improved, and the risk of complications can be reduced in the case of cytodiagnostic lung puncture, if one optimises the method whereby the puncture needle is inserted into the lesion. The author describes such a procedure incorporating the use of technical aids for marking the exact puncture point of the cannula. At the same time the procedure results in a reduction of radiation exposure of both doctor and patient.

  8. [Lung cancer surgery and cirrhosis].

    Science.gov (United States)

    Rivera, C; Chevalier, B; Fabre, E; Pricopi, C; Badia, A; Arame, A; Foucault, C; Dujon, A; Le Pimpec Barthes, F; Riquet, M

    2015-02-01

    Lung cancer is the leading cause of death by cancer and cirrhosis is the fourteenth, all causes included. Surgery increases postoperative risks in cirrhotic patients. Our purpose was to analyze this point in lung cancer surgery. We collected, among 7162 patients, the data concerning those operated for lung cancer (n=6105) and compared patients with hepatic disease (n=448) to those presenting other medical disorder (n=2587). We analyzed cirrhotic patients' characteristics (n=49). Five-year survival of patients with hepatic disease was lower (n=5657/6105): 35.3% versus 43.8% for patients with no hepatic disease, P=0.0021. Survival of cirrhotic patients was not statistically different from the one of patients with other hepatic disorder, but none survived beyond 10 years (0% versus 26.4%). Surgery in cirrhotic patients consisted in one explorative thoracotomy, three wedges resections, two segmentectomies, 33 lobectomies and 10 pneumonectomies. Postoperative mortality (8.2%; 4/49) was not different for patients without hepatic disease (4.2%; 239/5657) (P=0.32), as well as the rate of complications (40.8%; 20/49 and 24.8%; 1404/5657, P=0.11). Only one postoperative death was associated to a hepatic failure. Multivariate analysis pointed age, histological subtype of the tumour and stage of disease as independent prognosis factors. When cirrhosis is well compensated, surgical resection of lung cancer can be performed with acceptable postoperative morbidity and satisfactory rates of survival. Progressive potential of this disease is worse after five years. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Variations of Lung Fissures: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Ambali Manoj P

    2014-01-01

    Full Text Available Background: The presence of fissures in the normal lungs enhances uniform expansion and hence facilitates more air intake. Accessory and incomplete fissures of varying depth can be seen in unusual locations of the lung, delimiting abnormal lobes which correspond to the normal bronchopulmonary segments. The knowledge of anatomical variations of lung fissures is essential for clinicians, surgeons, and for radiologist for recognizing various images of related abnormalities because an accessory or anomalous fissure can be mistaken for a lung lesion or an atypical appearance of pleural effusion. Aims and Objectives: The aim of the present study is to observe the variations of lung fissures in Indian population. Fifty pairs (right- 50; left- 50 of lungs were used for this study. Each lung was studied carefully for number of fissures whether complete or incomplete or absent. Presences of accessory fissures were noted. Results: We observed complete absence of fissures in two right and left lungs. Accessory fissures were present in 38% right lungs and 32% in left lungs. Conclusion: Incidence of absence of oblique fissure and accessory fissure was greater in our present work when compared our results with other authors. Considering this we feel that more elaborative study should be done on this topic which will throw more light on this.

  10. Lung ultrasound in the critically ill.

    Science.gov (United States)

    Lichtenstein, Daniel

    2014-06-01

    Lung ultrasound, which allows a bedside visualization of the lungs, is increasingly used in critical care. This review aims at highlighting a simple approach to this new discipline. The 10 basic signs are the bat sign (indicating pleural line), lung sliding (yielding the seashore sign), the A line (horizontal artifact), the quad and sinusoid sign indicating pleural effusion regardless of its echogenicity, the tissue-like and shred sign indicating lung consolidation, the B line and lung rockets (artifacts indicating interstitial syndrome), abolished lung sliding with the stratosphere sign, suggesting pneumothorax, and the lung point, indicating pneumothorax. All these disorders were assessed using computed tomography (CT) as a gold standard with sensitivity and specificity ranging from 90 to 100%, allowing us to consider ultrasound as a reasonable bedside gold standard in the critically ill. We use a simple gray-scale unit (without Doppler) with a microconvex probe. Lung ultrasound can be used for diagnosing acute respiratory failure (BLUE protocol), managing acute circulatory failure (Fluid Administration Limited by Lung Sonography protocol), and decreasing the use of radiograph or CT (the Lung Ultrasound in the Critically Ill Favoring Limitation of Radiation project). This can be extended from sophisticated ICUs to more austere settings, from neonates to bariatric adults without adaptation, trauma and several other disciplines (anesthesiology, emergency medicine, pulmonology, etc.). http://links.lww.com/COCC/A8.

  11. Mechanisms of Enhanced Lung Injury during Sepsis

    Science.gov (United States)

    Czermak, Boris J.; Breckwoldt, Maren; Ravage, Zachary B.; Huber-Lang, Markus; Schmal, Hagen; Bless, Nicolas M.; Friedl, Hans P.; Ward, Peter A.

    1999-01-01

    A major complication in sepsis is progressively impaired lung function and susceptibility to intrapulmonary infection. Why sepsis predisposes the lung to injury is not clear. In the current studies, rats were rendered septic by cecal ligation/puncture and evaluated for increased susceptibility to injury after a direct pulmonary insult (deposition of IgG immune complexes or airway instillation of lipopolysaccharide). By itself, cecal ligation/puncture did not produce evidence of lung injury. However, after a direct pulmonary insult, lung injury in septic animals was significantly enhanced. Enhanced lung injury was associated with increased accumulation of neutrophils in lung, enhanced production of CXC chemokines (but not tumor necrosis factor-α) in bronchoalveolar lavage fluids, and increased expression of lung vascular intercellular adhesion molecule-1 (ICAM-1). Complement depletion or treatment with anti-C5a abolished all evidence of enhanced lung injury in septic animals. When stimulated in vitro, bronchoalveolar lavage macrophages from septic animals had greatly enhanced CXC chemokine responses as compared with macrophages from sham-operated animals or from septic animals that had been complement depleted. These data indicate that the septic state causes priming of lung macrophages and suggest that enhanced lung injury in the septic state is complement dependent and related to increased production of CXC chemokines. PMID:10233844

  12. Intensive-care unit lungs - possibilities to improve the quality

    Energy Technology Data Exchange (ETDEWEB)

    Fund, G.; Fischedick, A.R.; Hartenauer, U.

    1984-06-01

    X-ray lung diagnosis in an intensive-care unit makes special demands on technique, imaging and on the physician's experience. The quality of image interpretation and evaluation is considerably improved by superimposing the technical data on the X-ray image and by using an antiscatter grid cassette. Proper evaluation of the parameters important for diagnosis is improved by registration of the data on the X-ray film; taking a maximum possible score of 100 as reference value, quality of evaluation is improved from 66.5 points to 71.8 points by data registration on the film itself, whereas the simultaneous use of an antiscatter grid cassette improves the score still further, namely, to 84.3 points. The importance of the clinical condition of the patient, and of the type of breathing chosen, for assessing the chest X-ray, is emphasized.

  13. [Epidemiology of interstitial lung diseases].

    Science.gov (United States)

    Valeyre, Dominique; Freynet, Olivia; Dion, Geneviève; Bouvry, Diane; Annesi-Maesano, Isabella; Nunes, Hilario

    2010-01-01

    Diffuse interstitial lung diseases (DILD) cover more than 200 conditions classified in 4 groups: secondary DILD; sarcoidosis; particular DILDs and idiopathic interstitial pneumonias. Overall, these diseases have a prevalence of 60-80/100,000 and an incidence around 30/100,000. Sarcoidosis and idiopathic pulmonary fibrosis are the 2 most frequent diseases, accounting together for more than 50% of all cases, followed by DILD related to connective tissue disease and to immunologic lung diseases. The incidence of different causes of DILD depends on epidemiologic factors: age, sex, race, smoking habits, and history. Mortality is very elevated in idiopathic pulmonary fibrosis, linked in more than 80% of cases to the fibrosis itself, with a median survival between 24 and 36 months. The epidemiologic studies on DILD have substantial limitations, and new studies must be conducted, in particular in France where we lack epidemiologic data beyond one old study of sarcoidosis and one more recent study focused on farmer's lung in the Doubs. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  14. Mechanical ventilation after lung transplantation.

    Science.gov (United States)

    Thakuria, Louit; Davey, Rosada; Romano, Rosalba; Carby, Martin R; Kaul, Sundeep; Griffiths, Mark J; Simon, André R; Reed, Anna K; Marczin, Nandor

    2016-02-01

    To explore the hypothesis that early ventilation strategies influence clinical outcomes in lung transplantation, we have examined our routine ventilation practices in terms of tidal volumes (Vt) and inflation pressures. A total of 124 bilateral lung transplants between 2010 and 2013 were retrospectively assigned to low (8 mL/kg) Vt groups based on ventilation characteristics during the first 6 hours after surgery. Those same 124 patients were also stratified to low-pressure (<25 cm H2O) and high-pressure (≥25 cm H2O) groups. Eighty percent of patients were ventilated using pressure control mode. Low, medium, and high Vt were applied to 10%, 43%, and 47% of patients, respectively. After correcting for patients requiring extracorporeal support, there was no difference in short-term to midterm outcomes among the different Vt groups. Low inflation pressures were applied to 61% of patients, who had a shorter length of intensive care unit stay (5 vs 12 days; P = .012), higher forced expiratory volume in 1 second at 3 months (77.8% vs 60.3%; P < .001), and increased 6-month survival rate (95% vs 77%; P = .008). Low Vt ventilation has not been fully adopted in our practice. Ventilation with higher inflation pressures, but not Vt, was significantly associated with poorer outcomes after lung transplantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Extracellular Vesicles in Lung Disease.

    Science.gov (United States)

    Kubo, Hiroshi

    2018-01-01

    Accumulating evidence suggests that extracellular vesicles (EVs) play a role in the pathogenesis of lung diseases. These vesicles include exosomes, ectosomes (ie, microparticles, extracellular vesicles, microvesicles, and shedding vesicles), and apoptotic bodies. Exosomes are generated by inward budding of the membrane (endocytosis), subsequent forming of multivesicular bodies, and release by exocytosis. Ectosomes are formed by outward blebbing from the plasma membrane and are then released by proteolytic cleavage from the cell surface. Apoptotic bodies are generated on apoptotic cell shrinkage and death. Extracellular vesicles are released when the cells are activated or undergo apoptosis under inflammatory conditions. The number and types of released EVs are different according to the pathophysiological status of the disease. Therefore, EVs can be novel biomarkers for various lung diseases. EVs contain several molecules, including proteins, mRNA, microRNA, and DNA; they transfer these molecules to distant recipient cells. Circulating EVs modify the targeted cells and influence the microenvironment of the lungs. For this unique capability, EVs are expected to be a new drug delivery system and a novel therapeutic target. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. Assessment of gas compression and lung volume during air stacking maneuver.

    Science.gov (United States)

    Sarmento, A; Resqueti, V R; Fregonezi, G A F; Aliverti, A

    2017-01-01

    We reasoned that the application of positive pressure through air stacking (AS) technique could cause gas compression and the absolute lung volumes could be estimated. The aim of this study was to estimate the amount of gas compression (ΔV comp) during AS in healthy subjects positioned at 45° trunk inclination and verify if the simultaneous measurements of chest wall volume changes (ΔV CW), by optoelectronic plethysmography, and changes in lung volume (ΔV ao), by pneumotachograph, combined with pressure variation at the airways opening (ΔP ao) during AS are able to provide reliable data on absolute lung volumes. Twenty healthy subjects (mean age 23.5 ± 3.8 years) were studied during a protocol that included slow vital capacity and AS maneuvers. V comp was calculated by subtracting ΔV ao and ΔV CW occurring during AS and total lung capacity (TLC) was estimated by applying Boyle-Mariote's law using V comp and ΔP ao. During AS, 0.140 ± 0.050 L of gas was compressed with an average ΔP ao of 21.78 ± 6.18 cmH2O. No significant differences between the estimated TLC (-0.03 ± 3.0% difference, p = 0.6020), estimated FRC (-2.0 ± 12.4% difference, p = 0.5172), measured IC (1.2 ± 11.2% difference, p = 0.7627) and predicted values were found. During AS, a significant gas compression occurs and absolute lung volumes can be estimated by simultaneous measurements of ΔV CW, ΔV ao and ΔP ao.

  17. RANK rewires energy homeostasis in lung cancer cells and drives primary lung cancer.

    Science.gov (United States)

    Rao, Shuan; Sigl, Verena; Wimmer, Reiner Alois; Novatchkova, Maria; Jais, Alexander; Wagner, Gabriel; Handschuh, Stephan; Uribesalgo, Iris; Hagelkruys, Astrid; Kozieradzki, Ivona; Tortola, Luigi; Nitsch, Roberto; Cronin, Shane J; Orthofer, Michael; Branstetter, Daniel; Canon, Jude; Rossi, John; D'Arcangelo, Manolo; Botling, Johan; Micke, Patrick; Fleur, Linnea La; Edlund, Karolina; Bergqvist, Michael; Ekman, Simon; Lendl, Thomas; Popper, Helmut; Takayanagi, Hiroshi; Kenner, Lukas; Hirsch, Fred R; Dougall, William; Penninger, Josef M

    2017-10-15

    Lung cancer is the leading cause of cancer deaths. Besides smoking, epidemiological studies have linked female sex hormones to lung cancer in women; however, the underlying mechanisms remain unclear. Here we report that the receptor activator of nuclear factor-kB (RANK), the key regulator of osteoclastogenesis, is frequently expressed in primary lung tumors, an active RANK pathway correlates with decreased survival, and pharmacologic RANK inhibition reduces tumor growth in patient-derived lung cancer xenografts. Clonal genetic inactivation of KRasG12D in mouse lung epithelial cells markedly impairs the progression of KRasG12D -driven lung cancer, resulting in a significant survival advantage. Mechanistically, RANK rewires energy homeostasis in human and murine lung cancer cells and promotes expansion of lung cancer stem-like cells, which is blocked by inhibiting mitochondrial respiration. Our data also indicate survival differences in KRasG12D -driven lung cancer between male and female mice, and we show that female sex hormones can promote lung cancer progression via the RANK pathway. These data uncover a direct role for RANK in lung cancer and may explain why female sex hormones accelerate lung cancer development. Inhibition of RANK using the approved drug denosumab may be a therapeutic drug candidate for primary lung cancer. © 2017 Rao et al.; Published by Cold Spring Harbor Laboratory Press.

  18. Simultaneous covalent and noncovalent hybrid polymerizations

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Zhilin; Tantakitti, Faifan; Yu, Tao; Palmer, Liam C.; Schatz, George C.; Stupp, Samuel I. (NWU)

    2016-01-28

    Covalent and supramolecular polymers are two distinct forms of soft matter, composed of long chains of covalently and noncovalently linked structural units, respectively. We report a hybrid system formed by simultaneous covalent and supramolecular polymerizations of monomers. The process yields cylindrical fibers of uniform diameter that contain covalent and supramolecular compartments, a morphology not observed when the two polymers are formed independently. The covalent polymer has a rigid aromatic imine backbone with helicoidal conformation, and its alkylated peptide side chains are structurally identical to the monomer molecules of supramolecular polymers. In the hybrid system, covalent chains grow to higher average molar mass relative to chains formed via the same polymerization in the absence of a supramolecular compartment. The supramolecular compartments can be reversibly removed and re-formed to reconstitute the hybrid structure, suggesting soft materials with novel delivery or repair functions.

  19. Humanization and simultaneous optimization of monoclonal antibody.

    Science.gov (United States)

    Kuramochi, T; Igawa, T; Tsunoda, H; Hattori, K

    2014-01-01

    Antibody humanization is an essential technology for reducing the potential risk of immunogenicity associated with animal-derived antibodies and has been applied to a majority of the therapeutic antibodies on the market. For developing an antibody molecule as a pharmaceutical at the current biotechnology level, however, other properties also have to be considered in parallel with humanization in antibody generation and optimization. This section describes the critical properties of therapeutic antibodies that should be sufficiently qualified, including immunogenicity, binding affinity, physiochemical stability, expression in host cells and pharmacokinetics, and the basic methodologies of antibody engineering involved. By simultaneously optimizing the antibody molecule in the light of these properties, it should prove possible to shorten the research and development period necessary to identify a highly qualified clinical candidate and consequently accelerate the start of the clinical trial.

  20. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  1. Simultaneous determination of protein structure and dynamics

    DEFF Research Database (Denmark)

    Lindorff-Larsen, Kresten; Best, Robert B.; DePristo, M. A.

    2005-01-01

    at the atomic level about the structural and dynamical features of proteins-with the ability of molecular dynamics simulations to explore a wide range of protein conformations. We illustrate the method for human ubiquitin in solution and find that there is considerable conformational heterogeneity throughout......We present a protocol for the experimental determination of ensembles of protein conformations that represent simultaneously the native structure and its associated dynamics. The procedure combines the strengths of nuclear magnetic resonance spectroscopy-for obtaining experimental information...... the protein structure. The interior atoms of the protein are tightly packed in each individual conformation that contributes to the ensemble but their overall behaviour can be described as having a significant degree of liquid-like character. The protocol is completely general and should lead to significant...

  2. [Expression of a new lung cancer drug resistance-related gene in lung cancer tissues and lung cancer cell strains].

    Science.gov (United States)

    Liu, Ling-Zhi; Qian, Gui-Sheng; Zhou, Xiang-Dong

    2003-02-01

    A new drug resistance-related gene fragment which was 494 bp long was found using suppression subtractive hybridization (SSH) and its full-length cDNA fragment was cloned by the authors. This study was designed to determine the expression of this lung cancer drug resistance-related gene (LCDRG) in lung cancer tissues, juxtacancerous tissues, and five lung cancer cell strains. The expression of LCDRG was determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) method in 38 lung cancer tissues,12 juxtacancerous tissues, and 5 lung cancer cell strains. The expression of LCDRG in cancer tissues was significantly higher than that in juxtacancerous tissue (Pcancer cell strains, the expression levels of LCDRG in adenocarcinoma cell strains SPC-A-1 and A549, big cell lung cancer cell strain H460, small cell lung cancer cell strains H446 and SH77 were decreased gradually. LCDRG is closely related to lung cancer and may be involved in the pathogenesis of lung cancer.

  3. Acute Lung Injury: Making the Injured Lung Perform Better and Rebuilding Healthy Lungs

    Science.gov (United States)

    2014-04-01

    chemotherapeutic agents, themselves, cause a syndrome with features of ALI. The pathology and pathophysiology of ALI are very complex and include features...pediatric lung disease, hypothyroidism , and neurological impairment (Krude et al., 2002). Inability to access the presumed very rare, multipo- tent...Schnabel, D., Neitzel, H., Tönnies, H., Weise, D., Lafferty, A., Schwarz, S., et al. (2002). Choreoathetosis, hypothyroidism , and pulmonary

  4. Acute Lung Injury: Making Injured Lungs Perform Better and Rebuilding Healthy Lungs

    Science.gov (United States)

    2010-07-01

    derived, highly scalable, and since they can be readily derived from individual mice (or humans) they thereby circumvent immune and ethical issues... placentas collected during delivery, and mucosal cells collected by scraping or swab)? N/A Will the research data in this study be gathered through non...is typically depleted in ALI/ARDS, resulting in decreased lung compliance and increased risk of barotrauma. In vivo studies using normal guinea pigs

  5. Hypoxia in models of lung cancer

    DEFF Research Database (Denmark)

    Graves, Edward E; Vilalta, Marta; Cecic, Ivana K

    2010-01-01

    PURPOSE: To efficiently translate experimental methods from bench to bedside, it is imperative that laboratory models of cancer mimic human disease as closely as possible. In this study, we sought to compare patterns of hypoxia in several standard and emerging mouse models of lung cancer...... to establish the appropriateness of each for evaluating the role of oxygen in lung cancer progression and therapeutic response. EXPERIMENTAL DESIGN: Subcutaneous and orthotopic human A549 lung carcinomas growing in nude mice as well as spontaneous K-ras or Myc-induced lung tumors grown in situ......H2AX foci in vitro and in vivo. Finally, our findings were compared with oxygen electrode measurements of human lung cancers. RESULTS: Minimal fluoroazomycin arabinoside and pimonidazole accumulation was seen in tumors growing within the lungs, whereas subcutaneous tumors showed substantial trapping...

  6. MULTIFACTORIAL ASSESSMENT OF POSTMORTEM LUNG DONOR

    Directory of Open Access Journals (Sweden)

    M. S. Khubutiya

    2013-01-01

    Full Text Available The appropriate evaluation and the development of special measures to protect donor lungs are important factors for successful lung transplantation. Aim. To develop and determine the effectiveness of the protocol of morpho- functional assessment of potential lung donor. Methods and results. During the period from May, 2011 to May, 2012, 37 donors with diagnoses of brain death were surveyed. 5 bilateral lung transplantations were performed only in 2 cases donors have been evaluated as «ideal». In the majority of recipients early postoperative period was evaluated as satisfactory. Conclusion. Designed multivariate algorithm of donor with brain death assess- ment, effectively implemented through the selection of donors for lung transplantation with satisfactory results in the early postoperative period. However, compliance with ideal criteria will not allow to effectively provide care for patients with terminal lung disease under conditions of continuous growth of «waiting list». 

  7. Lung herniation: an unusual cause of dysphagia.

    Science.gov (United States)

    Mason, Karen; Riordan, Richard D

    2013-12-01

    Lung herniation is a rare condition that can be classified on the basis of location and etiology. We report an unusual case of right apical lung herniation presenting with dysphagia. Computed tomography of the neck demonstrated an air-containing structure in the root of the right side of the neck, related to but separate from the anteromedial aspect of the right lung apex. The diagnosis of an apical lung hernia was confirmed using high-resolution CT reconstructions. This case highlights that, although uncommon, apical lung hernias should always be considered when investigating abnormalities of swallowing. Identification of an apical lung hernia on plain chest radiographs avoids further unnecessary investigations and surgical intervention. Knowledge of their presentation may avoid complications that could arise from neck interventions such as subclavian central catheter insertion.

  8. Paediatric lung function testing : determinants and reference values

    NARCIS (Netherlands)

    Koopman, Marije

    2011-01-01

    Paediatric lung function tests provide objective measures in diagnosis and follow-up of lung diseases, and give insight in the pathophysiology of lung growth and development. In the first part of the thesis, paediatric lung function tests were used to investigate determinants of lung growth and

  9. Simultaneous reconstruction of activity and attenuation for PET/MR.

    Science.gov (United States)

    Salomon, André; Goedicke, Andreas; Schweizer, Bernd; Aach, Til; Schulz, Volkmar

    2011-03-01

    Medical investigations targeting a quantitative analysis of the position emission tomography (PET) images require the incorporation of additional knowledge about the photon attenuation distribution in the patient. Today, energy range adapted attenuation maps derived from computer tomography (CT) scans are used to effectively compensate for image quality degrading effects, such as attenuation and scatter. Replacing CT by magnetic resonance (MR) is considered as the next evolutionary step in the field of hybrid imaging systems. However, unlike CT, MR does not measure the photon attenuation and thus does not provide an easy access to this valuable information. Hence, many research groups currently investigate different technologies for MR-based attenuation correction (MR-AC). Typically, these approaches are based on techniques such as special acquisition sequences (alone or in combination with subsequent image processing), anatomical atlas registration, or pattern recognition techniques using a data base of MR and corresponding CT images. We propose a generic iterative reconstruction approach to simultaneously estimate the local tracer concentration and the attenuation distribution using the segmented MR image as anatomical reference. Instead of applying predefined attenuation values to specific anatomical regions or tissue types, the gamma attenuation at 511 keV is determined from the PET emission data. In particular, our approach uses a maximum-likelihood estimation for the activity and a gradient-ascent based algorithm for the attenuation distribution. The adverse effects of scattered and accidental gamma coincidences on the quantitative accuracy of PET, as well as artifacts caused by the inherent crosstalk between activity and attenuation estimation are efficiently reduced using enhanced decay event localization provided by time-of-flight PET, accurate correction for accidental coincidences, and a reduced number of unknown attenuation coefficients. First results

  10. Results of total lung irradiation and chemotherapy in comparison with partial lung irradiation in metastatic undifferentiated soft tissue sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Zamboglou, N.; Fuerst, G.; Pape, H.; Bannach, B.; Schmitt, G.; Molls, M.

    1988-07-01

    The poor prognosis of patients with unresectable pulmonary metastases of soft tissue sarcoma is well known. In order to evaluate the beneficial effect of radiotherapy, we have treated 44 patients with pulmonary metastases of grade 3 soft tissue sarcoma from 1980 to 1986. In 36 patients the treatment volume was restricted to the single metastases up to a dose of 50 to 60 (9 to 10 Gy/week). The survival rate at one year was 18% and at two years 6%. Eight patients were treated with a combined regimen, consisting of cisplatin and ifosfamide with simultaneous whole lung irradiation. Irradiation was performed with 8 or 16 MV photons at a hyperfractionation of 2x0,8 Gy/day (8 Gy/week). After a dose of 12 Gy, the single metastases were boosted up to 50 to 60 Gy, with a second course of chemotherapy. In six of eight patients complete remissions were achieved, one patient showed a partial remission. The survival rate at 27 months was 50%. The patients with partial remission died from pulmonary progression at 23 months. One patient died after twelve months from a loco-regional recurrence in the tonsillar fossa without evidence of pulmonary disease. Side effects included alopecia and moderate bone marrow suppression approximately twelve days after each chemotherapy cycle. Pulmonary fibrosis was observed only at the high dose volume without impairment of respiratory function. From these observations the conclusion is drawn that whole lung irradiation simultaneously with cisplatin and ifosfamide chemotherapy provides good palliative results without relevant morbidity in patients with high grade unresectable pulmonary metastases of soft tissue sarcomas.

  11. Local immunotherapy in experimental murine lung inflammation

    OpenAIRE

    sprotocols

    2015-01-01

    Authors: Caroline Uebel, Sonja Koch, Anja Maier, Nina Sopel, Anna Graser, Stephanie Mousset & Susetta Finotto ### Abstract Innovative local immunotherapy for severe lung diseases such as asthma, chronic obstructive pulmonary disease or lung cancer requires a successful delivery to access the desired cellular target in the lung. An important route is the direct instillation into the airways in contrast to delivery through the digestive tract. This protocol details a method to deliver a...

  12. Ultrasound lung comets in extravascular fluid diagnostics

    Directory of Open Access Journals (Sweden)

    М. Н. Алехин

    2015-10-01

    Full Text Available The review is devoted to the analysis of ultrasound lung comets (ULCs that may be observed during ultrasound lung examination in cardiac patients in the case of accumulation of extravascular fluid in the lungs. Recent data on the mechanisms of these artefacts, examination and outcome evaluation methods are discussed. Differential diagnostics problems in patients with cardiac and pulmonary genesis of ULCs are also covered.

  13. Lung-protective perioperative mechanical ventilation

    OpenAIRE

    Hemmes, S.N.T.

    2015-01-01

    Intraoperative ventilation has the potential to cause lung injury and possibly increase risk of pulmonary complications after surgery. Use of large tidal volumes could cause overdistension of lung tissue, which can be aggravated by too high levels of positive end-expiratory pressure (PEEP). Too low levels of PEEP, though, could result in repetitive opening and closing of lung tissue. The main aim of this thesis was to investigate the effect of intraoperative use of higher levels of PEEP and r...

  14. Simultaneous measurement of force and respiratory profiles during chest physiotherapy in ventilated children.

    Science.gov (United States)

    Gregson, R K; Stocks, J; Petley, G W; Shannon, H; Warner, J O; Jagannathan, R; Main, E

    2007-09-01

    There are currently no objective means of quantifying chest wall vibrations during manual physiotherapy. The aims of the study were to (i) develop a method to quantify physiotherapy-applied forces and simultaneous changes in respiratory flow and pressure, (ii) assess the feasibility of using this method in ventilated children and (iii) characterize treatment profiles delivered by physiotherapists in the paediatric intensive care unit. Customized sensing mats were designed and used in combination with a respiratory profile monitor. Software was developed to align force and flow data streams. Force and respiratory data were successfully collected in 55 children (median age 1.6 years (range 0.02-13.7 years)). Physiotherapists demonstrated distinctive variations in the pattern of force applied and manual lung inflations. The maximum applied force ranged from 15 to 172 N, and was correlated with the child's age (r = 0.76). Peak expiratory flow increased significantly during manual inflations both with and without chest wall vibrations (p manual lung inflations as an essential precursor to developing evidence-based practice.

  15. Simultaneous thoracic and abdominal transplantation: can we justify two organs for one recipient?

    Science.gov (United States)

    Wolf, J H; Sulewski, M E; Cassuto, J R; Levine, M H; Naji, A; Olthoff, K M; Shaked, A; Abt, P L

    2013-07-01

    Simultaneous thoracic and abdominal (STA) transplantation is controversial because two organs are allocated to a single individual. We studied wait-list urgency, and whether transplantation led to successful outcomes. Candidates and recipients for heart-kidney (SHK), heart-liver (SHLi), lung-liver (SLuLi) and lung-kidney (SLuK) were identified through the United Network for Organ Sharing (UNOS) and outcomes were compared to single-organ transplantation. Since 1987, there were 1801 STA candidates and 836 recipients. Wait-list survival at 1- and 3 years for SHK (67.4%, 40.8%; N = 1420), SHLi (65.7%, 43.6%; N = 218) and SLuLi (65.7%, 41.0%; N = 122), was lower than controls (p organ candidates. STA outcomes were similar to thoracic transplantation; however, outcomes were similar to abdominal transplantation for SHLi only. Although select patients benefit from STA, risk-exposure variables for decreased survival should be identified, aiming to eliminate futile transplantation. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. An integrated inspection of the somatic mutations in a lung squamous cell carcinoma using next-generation sequencing.

    Directory of Open Access Journals (Sweden)

    Lucy F Stead

    Full Text Available Squamous cell carcinoma (SCC of the lung kills over 350,000 people annually worldwide, and is the main lung cancer histotype with no targeted treatments. High-coverage whole-genome sequencing of the other main subtypes, small-cell and adenocarcinoma, gave insights into carcinogenic mechanisms and disease etiology. The genomic complexity within the lung SCC subtype, as revealed by The Cancer Genome Atlas, means this subtype is likely to benefit from a more integrated approach in which the transcriptional consequences of somatic mutations are simultaneously inspected. Here we present such an approach: the integrated analysis of deep sequencing data from both the whole genome and whole transcriptome (coding and non-coding of LUDLU-1, a SCC lung cell line. Our results show that LUDLU-1 lacks the mutational signature that has been previously associated with tobacco exposure in other lung cancer subtypes, and suggests that DNA-repair efficiency is adversely affected; LUDLU-1 contains somatic mutations in TP53 and BRCA2, allelic imbalance in the expression of two cancer-associated BRCA1 germline polymorphisms and reduced transcription of a potentially endogenous PARP2 inhibitor. Functional assays were performed and compared with a control lung cancer cell line. LUDLU-1 did not exhibit radiosensitisation or an increase in sensitivity to PARP inhibitors. However, LUDLU-1 did exhibit small but significant differences with respect to cisplatin sensitivity. Our research shows how integrated analyses of high-throughput data can generate hypotheses to be tested in the lab.

  17. Prone position ameliorates lung elastance and increases functional residual capacity independently from lung recruitment

    OpenAIRE

    Santini, A.; Protti, A; Langer, T.; Comini, B; Monti, M.; Sparacino, C.C.; Dondossola, D.; Gattinoni, L.

    2015-01-01

    Background Prone position is used to recruit collapsed dependent lung regions during severe acute respiratory distress syndrome, improving lung elastance and lung gas content. We hypothesised that, in the absence of recruitment, prone position would not result in any improvement in lung mechanical properties or gas content compared to supine position. Methods Ten healthy pigs under general anaesthesia and paralysis underwent a pressure?volume curve of the respiratory system, chest wall and lu...

  18. Lung Surfactant and Its Use in Lung Diseases

    Directory of Open Access Journals (Sweden)

    O. A. Rosenberg

    2007-01-01

    Full Text Available The review considers the present views of lung surfactant (LS functions with emphasis on its protective and barrier properties and ability to maintain local and adaptive immunity. The composition of commercial LS formulations is analyzed. Data on qualitative and quantitative LS abnormalities are presented in various diseases in neonates and adults. The results of clinical trials of different LS formulations in the treatment of acute respiratory distress syndrome in adults are analyzed in detail. Recent data on the results of and prospects for surfactant therapy for bronchial asthma, chronic obstructive pulmonary disease and pulmonary tuberculosis are given. 

  19. [Lung transplantation. State of the art].

    Science.gov (United States)

    García-Covarrubias, Lisardo; Salerno, Tomas A; Panos, Anthony L; Pham, Si M

    2007-01-01

    Lung transplantation is currently considered an established treatment for some advanced lung diseases. The beginning of experimental lung transplantation dates back to the 1940's when the Soviet Vladimir P. Demikhov performed the first lung transplants in animals. Two decades later, James Hardy performed the first lung transplant in humans. Unfortunately, the beginning of clinical lung transplantation was hampered by technical complications and the excessive toxicity of immunosuppressive drugs. Improvement in the surgical technique along with the development of more effective and less toxic immunosuppressive drugs has led to a better outcome in lunt transplant recipients. Donor selection and management before organ procurement play a key role in the receptor's outcome. Due to the shortage of donors, some institutions are using more liberal selection criteria, reporting satisfactory outcomes. The approach of the lung and heart-lung transplant patient is multidisciplinary and includes the cardiothoracic transplant surgeon, pulmonologist, anesthesiologist, and intensivist, among others. Herein, we review some relevant historical aspects and recent advances in the management of lung transplant recipients, including indications and contraindications, evaluation of donors and recipients, surgical techniques and peripost-operative care.

  20. American Cancer Society Lung Cancer Screening Guidelines

    Science.gov (United States)

    Wender, Richard; Fontham, Elizabeth T. H.; Barrera, Ermilo; Colditz, Graham A.; Church, Timothy R.; Ettinger, David S.; Etzioni, Ruth; Flowers, Christopher R.; Gazelle, G. Scott; Kelsey, Douglas K.; LaMonte, Samuel J.; Michaelson, James S.; Oeffinger, Kevin C.; Shih, Ya-Chen Tina; Sullivan, Daniel C.; Travis, William; Walter, Louise; Wolf, Andrew M. D.; Brawley, Otis W.; Smith, Robert A.

    2013-01-01

    Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. PMID:23315954