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International Journal of Surgical... Feb 2021A 46-year-old man presented with nonproductive cough and lower limb swelling. Chest radiograph showed a left lower lobe lung mass and multiple subpleural nodules. Other...
A 46-year-old man presented with nonproductive cough and lower limb swelling. Chest radiograph showed a left lower lobe lung mass and multiple subpleural nodules. Other investigations revealed that he had nephrotic syndrome. Core biopsies of the left lower lobe lung mass showed features of inflammatory pseudotumor with endarteritis obliterans and a lymphoplasmacytic infiltrate. Immunohistochemical stain for was positive. Resolution of the lung mass and nephrotic syndrome was achieved after treatment with intramuscular benzathine benzylpenicillin. The differential diagnosis of pulmonary inflammatory pseudotumor, manifestations of pulmonary syphilis, and a literature review of secondary syphilis of the lung are discussed.
Topics: Biopsy; Humans; Immunohistochemistry; Injections, Intramuscular; Lung; Lung Neoplasms; Male; Middle Aged; Penicillin G Benzathine; Plasma Cell Granuloma, Pulmonary; Sarcoma; Syphilis; Syphilis Serodiagnosis; Treponema pallidum
PubMed: 32486870
DOI: 10.1177/1066896920928584 -
Pediatric Research Nov 2019Outcomes of infants with congenital diaphragmatic hernia (CDH) are primarily dependent on the severity of pulmonary hypoplasia. It is previously unknown whether...
BACKGROUND
Outcomes of infants with congenital diaphragmatic hernia (CDH) are primarily dependent on the severity of pulmonary hypoplasia. It is previously unknown whether postnatal lung growth in infants with CDH represents true parenchymal lung growth or merely an expansion in volume of the existing tissue. We hypothesized that lung volume growth in CDH infants will be accompanied by an increase in lung mass and that CDH infants will demonstrate accelerated catch-up growth of the more hypoplastic lung.
METHODS
We used fetal and post-CDH repair MRI of 12 infants to measure lung volume and density, which was used to calculate lung mass.
RESULTS
The average increase in right lung mass was 1.1 ± 1.1 g/week (p = 0.003) and the average increase in left lung mass was 1.8 ± 0.7 g/week (p < 0.001). When the ratio of left-to-right lung mass of the prenatal MRI was compared to post-repair MRI, the ratio significantly increased in all infants with average prenatal and post-repair ratios of 0.30 and 0.73, respectively (p = 0.002).
CONCLUSION
Lung growth in infants with CDH is indeed growth in lung mass (i.e. parenchyma), and the lungs demonstrate catch-up growth (i.e., increased rate of growth in the more hypoplastic ipsilateral lung).
Topics: Female; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Lung; Magnetic Resonance Imaging; Male
PubMed: 31238333
DOI: 10.1038/s41390-019-0480-y -
Spine Deformity Jan 2021Retrospective review of prospective multi-center cohort.
STUDY DESIGN
Retrospective review of prospective multi-center cohort.
OBJECTIVE
To investigate the impact of thoracoplasty on pulmonary function at 2-year follow-up among complex pediatric spine deformity patients. Complex pediatric spine deformities may be associated with significant rib prominence causing body image concerns. Surgical correction of spine deformity may include thoracoplasty to correct the rotational prominence. Some surgeons refrain from performing thoracoplasty due to its purported negative effect on pulmonary function. There is paucity of literature on the effect of thoracoplasty on pulmonary function at 2-year follow-up in pediatric patients with complex spine deformity.
METHODS
We reviewed data of 312 patients (> 100°, with or without vertebral column resection (VCR)) or (< 100° with VCR)) from an international multicenter database. Data of 106 patients with complete radiographic and pulmonary function test (PFT) assessment with a minimum of 2-year follow-up was analyzed. Paired t test was performed to compare pre-op and 2-year PFT results. PFT comparison was stratified based on thoracoplasty status (thoracoplasty: Group 1 vs. no thoracoplasty: Group 2).
RESULTS
106 patients (61 patients Group 1 vs. 45 in Group 2). The average age and gender ratio were similar in both groups (p > 0.05). Group 1 had significantly lower body mass index (BMI) compared to Group 2 (18.4 kg m ± 2.8 vs. 19.9 kg m ± 4.8, p = 0.0351). The average baseline coronal and sagittal Cobbs were larger for Group 1 relative to Group 2 (p < 0.05). The distribution of deformity etiology and curve types, and apices were similar between the two groups (p > 0.05). The rate of pre-op utilization of halo gravity traction (HGT) was 52.5% vs. 26.7% (p = 0.008), at an average duration of 103 days vs. 47 days, p = 0.0001. The rate of surgical osteotomies was similar in both groups. Estimated blood volume (EBV) loss was greater in Group 1 (63.1% vs. 43.1%, p = 0.0012). Post-op coronal and sagittal Cobb correction was similar in both groups. The incidence of post-op pulmonary complication was similar in both groups (8.2% vs. 8.9%, p = 0.899). Baseline and 2-year follow-up PFT did not differ significantly between and within the groups. Vertebral column resection (VCR) did not negatively affect PFT in both groups.
CONCLUSION
Despite higher curve magnitudes in patients undergoing surgical correction and thoracoplasty for complex pediatric spine deformity, our findings revealed that thoracoplasty does not negatively affect pulmonary function at 2-year follow-up.
Topics: Child; Follow-Up Studies; Humans; Lung; Prospective Studies; Retrospective Studies; Scoliosis; Thoracoplasty
PubMed: 32812164
DOI: 10.1007/s43390-020-00188-0 -
Respiratory Research Nov 2017Emphysema is a progressive disease characterized by irreversible airspace enlargement followed by a decline in lung function. It also causes extrapulmonary effects, such...
BACKGROUND
Emphysema is a progressive disease characterized by irreversible airspace enlargement followed by a decline in lung function. It also causes extrapulmonary effects, such as loss of body mass and cor pulmonale, which are associated with shorter survival and worse clinical outcomes. Ghrelin, a growth-hormone secretagogue, stimulates muscle anabolism, has anti-inflammatory effects, promotes vasodilation, and improves cardiac performance. Therefore, we hypothesized that ghrelin might reduce lung inflammation and remodelling as well as improve lung mechanics and cardiac function in experimental emphysema.
METHODS
Forty female C57BL/6 mice were randomly assigned into two main groups: control (C) and emphysema (ELA). In the ELA group (n=20), animals received four intratracheal instillations of pancreatic porcine elastase (PPE) at 1-week intervals. C animals (n=20) received saline alone (50 μL) using the same protocol. Two weeks after the last instillation of saline or PPE, C and ELA animals received ghrelin or saline (n=10/group) intraperitoneally (i.p.) daily, during 3 weeks. Dual-energy X-ray absorptiometry (DEXA), echocardiography, lung mechanics, histology, and molecular biology were analysed.
RESULTS
In elastase-induced emphysema, ghrelin treatment decreased alveolar hyperinflation and mean linear intercept, neutrophil infiltration, and collagen fibre content in the alveolar septa and pulmonary vessel wall; increased elastic fibre content; reduced M1-macrophage populations and increased M2 polarization; decreased levels of keratinocyte-derived chemokine (KC, a mouse analogue of interleukin-8), tumour necrosis factor-α, and transforming growth factor-β, but increased interleukin-10 in lung tissue; augmented static lung elastance; reduced arterial pulmonary hypertension and right ventricular hypertrophy on echocardiography; and increased lean mass.
CONCLUSION
In the elastase-induced emphysema model used herein, ghrelin not only reduced lung damage but also improved cardiac function and increased lean mass. These findings should prompt further studies to evaluate ghrelin as a potential therapy for emphysema.
Topics: Animals; Female; Ghrelin; Hypertrophy, Right Ventricular; Lung; Mice; Mice, Inbred C57BL; Pulmonary Emphysema; Swine
PubMed: 29100513
DOI: 10.1186/s12931-017-0668-9 -
The Malaysian Journal of Pathology Dec 2022Hyalinising clear cell carcinoma (HCCC) of the lung is an extremely rare tumour that is just recently recognised as one of the salivary gland-type tumours (SGTT) in the... (Review)
Review
Hyalinising clear cell carcinoma (HCCC) of the lung is an extremely rare tumour that is just recently recognised as one of the salivary gland-type tumours (SGTT) in the latest WHO classification of thoracic tumours. Eleven cases have been reported in English literature since Joaquín et al. reported the first case. Given the very limited number of cases, the clinical and histological features of pulmonary HCCC are equivocal. Herein, we present two cases of pulmonary HCCC. The patients were a 66-year-old man and a 48-year-old woman. The mass was located on the right main bronchus and right middle lobar bronchus separately. One was 2 cm and the other was 3.3 cm in the greatest dimension. The tumours were comprised of small monomorphic cells with clear or eosinophilic cytoplasm and infiltrated in a hyalinising stroma arranged in nests, cords, sheets and trabeculae. Their morphology resembled their head and neck counterparts. Immunohistochemically, the tumour cells were positive for AE1/AE3, P63, while negative for TTF1, Calponin, S-100, HMB45 and PAX8. Ki-67 labeling ranges from 3% to 10%. Fluorescence in situ hybridisation (FISH) demonstrated EWSR1 rearrangement and Next-generation sequencing (NGS) demonstrated EWSR1- ATF1 (exon 11: exon 3) fusion in case one and EWSR1- ATF1 (exon 2: exon 12) fusion in case two. This is the first time to report the EWSR1-ATF1fusion point other than exon 11: exon 3 in pulmonary HCCC. Case one recurred two years after local resection but didn't metastasise during follow-up 36 months. Case two is alive without disease after lobectomy during follow-up 14 months.
Topics: Humans; Salivary Gland Neoplasms; Lung; Carcinoma
PubMed: 36591718
DOI: No ID Found -
The Thoracic and Cardiovascular Surgeon Jan 2019Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to... (Comparative Study)
Comparative Study
BACKGROUND
Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to review the effect of lung resection on longitudinal growth, clinical course of patients depending on annual exacerbation rates, and pulmonary function tests (PFTs) and compare them with the results of only medically treated children with non-cystic fibrosis (non-CF) bronchiectasis.
METHODS
The medical records of patients with non-CF bronchiectasis were retrospectively analyzed. Patients who underwent lobectomy/segmentectomy/pneumonectomy were categorized as "surgery group" ( = 29). Age- and gender-matched patients who were only medically treated were selected as "medical group" ( = 33). Annual data of patients were included till the end of postoperative second year in the surgery group and third year of medical treatment in the medical group.
RESULTS
Mean baseline height -score was lower in the surgery group, and mean baseline PFT values were all lower in the surgery group than those in the medical group ( < 0.05). In the surgery group, mean values of height -score were -1.68 ± 0.92 at the time of surgery and improved to -1.42 ± 1.22 and -1.34 ± 1.05 in the first and second postoperative years, respectively, and annual intravenous antibiotic requirements decreased significantly ( < 0.05); however, mean body mass index (BMI) -score values and PFT parameters did not change significantly. In the medical group, height -score mean values and PFT parameters showed nonsignificant improvement but annual exacerbation frequency, annual intravenous, and oral antibiotic requirements decreased significantly.
CONCLUSION
Surgical management of non-CF bronchiectasis has no significant effect on BMI -scores, annual exacerbation frequencies, oral antibiotic requirements and lung function tests; but can lead to significant improvement on height -scores and decrease need of annual intravenous antibiotic requirements for acute severe exacerbations despite small number of patients in this study.
Topics: Adolescent; Adolescent Development; Age Factors; Anti-Bacterial Agents; Body Mass Index; Bronchiectasis; Bronchodilator Agents; Child; Child Development; Child, Preschool; Disease Progression; Female; Forced Expiratory Volume; Humans; Lung; Male; Maximal Midexpiratory Flow Rate; Physical Therapy Modalities; Pneumonectomy; Recovery of Function; Retrospective Studies; Risk Factors; Steroids; Time Factors; Treatment Outcome; Vital Capacity
PubMed: 29232734
DOI: 10.1055/s-0037-1608922 -
Paediatric Respiratory Reviews Jun 2017Bronchopulmonary dysplasia (BPD) is a common complication of extreme prematurity, which has increased over the last 20 years. BPD is associated with increased... (Review)
Review
Bronchopulmonary dysplasia (BPD) is a common complication of extreme prematurity, which has increased over the last 20 years. BPD is associated with increased morbidities and mortality. It has been increasingly recognized that BPD affects overall lung development including the pulmonary vasculature. More recent studies have demonstrated an increased awareness of pulmonary arterial hypertension (PH) in BPD patients and recent international guidelines have advocated for better screening. This review will describe the current understanding of the pathophysiology of PH in infants with BPD, the in-depth assessment of the available literature linking PH and BPD, and propose an approach of screening and diagnosis of PH in infants with BPD.
Topics: Bronchopulmonary Dysplasia; Humans; Hypertension, Pulmonary; Infant, Extremely Premature; Infant, Newborn; Lung; Mass Screening
PubMed: 27986502
DOI: 10.1016/j.prrv.2016.11.002 -
Journal of Anatomy Jul 2020We examined the morphology of the lungs of five species of high-altitude resident ducks from Lake Titicaca in the Peruvian Andes (yellow-billed pintail [Anas georgica],...
We examined the morphology of the lungs of five species of high-altitude resident ducks from Lake Titicaca in the Peruvian Andes (yellow-billed pintail [Anas georgica], cinnamon teal [Anas cyanoptera orinomus], puna teal [Anas puna], speckled teal [Anas flavirostris oxyptera], and ruddy duck [Oxyura jamaicensis ferruginea]) and compared them with those of the high-altitude migratory bar-headed goose (Anser indicus) and the low-altitude migratory barnacle goose (Branta leucopsis). We then determined the relationship between mass-specific lung volume, the volume densities of the component parts of the lung, and previously reported hypoxia-induced increases in pulmonary O extraction. We found that the mass-specific lung volumes and the mass-specific volume of the exchange tissue were larger in the lungs of high-altitude resident birds. The bar-headed goose had a mass-specific lung volume that fell between those of the low-altitude species and the high-altitude residents, but a mass-specific volume of exchange tissue that was not significantly different than that of the high-altitude residents. The data suggest that the mass-specific volume of the lung may increase with evolutionary time spent at altitude. We found an inverse relationship between the percentage increase in pulmonary O extraction and the percentage increase in ventilation across species that was independent of the volume density of the exchange tissue, at least for the resident Andean birds.
Topics: Altitude; Animals; Ducks; Flight, Animal; Geese; Lung; Oxygen Consumption; Respiration
PubMed: 32173858
DOI: 10.1111/joa.13180 -
European Journal of Pharmaceutical... Jun 2024Orally marketed products nintedanib (NDNB) and pirfenidone (PFD) for pulmonary fibrosis (PF) are administered in high doses and have been shown to have serious toxic and...
Orally marketed products nintedanib (NDNB) and pirfenidone (PFD) for pulmonary fibrosis (PF) are administered in high doses and have been shown to have serious toxic and side effects. NDNB can cause the elevation of galectin-3, which activates the NF-κB signaling pathway and causes the inflammatory response. S-allylmercapto-N-acetylcysteine (ASSNAC) can alleviate the inflammation response by inhibiting the TLR-4/NF-κB signaling pathway. Therefore, we designed and prepared inhalable ASSNAC and NDNB co-loaded liposomes for the treatment of pulmonary fibrosis. The yellow, spheroidal co-loaded liposomes with a particle size of 98.32±1.98 nm and zeta potential of -22.5 ± 1.58 mV were produced. The aerodynamic fine particle fraction (FPF) and mass median aerodynamic diameter (MMAD) of NDNB were >50 % (81.14 %±0.22 %) and <5 μm (1.79 μm±0.06 μm) in the nebulized liposome solution, respectively. The results showed that inhalation improved the lung deposition and retention times of both drugs. DSPE-PEG 2000 in the liposome formulation enhanced the mucus permeability and reduced phagocytic efflux mediated by macrophages. ASSNAC reduced the mRNA over-expressions of TLR-4, MyD88 and NF-κB caused by NDNB, which could reduce the NDNB's side effects. The Masson's trichrome staining of lung tissues and the levels of CAT, TGF-β1, HYP, collagen III and mRNA expressions of Collagen I, Collagen III and α-SMA in lung tissues revealed that NDNB/Lip inhalation was more beneficial to alleviate fibrosis than oral NDNB. Although the dose of NDNB/Lip was 30 times lower than that in the oral group, the inhaled NDNB/Lip group had better or comparable anti-fibrotic effects to those in the oral group. According to the expressions of Collagen I, Collagen III and α-SMA in vivo and in vitro, the combination of ASSNAC and NDNB was more effective than the single drugs for pulmonary fibrosis. Therefore, this study provided a new scheme for the treatment of pulmonary fibrosis.
Topics: Animals; Liposomes; Indoles; Acetylcysteine; Pulmonary Fibrosis; Administration, Inhalation; Lung; Mice; Male; Particle Size
PubMed: 38670294
DOI: 10.1016/j.ejps.2024.106779 -
The Journal of International Medical... May 2021Each pulmonary segment is an anatomical and functional unit. However, it is fundamentally difficult to precisely distinguish every pulmonary segment using the...
OBJECTIVE
Each pulmonary segment is an anatomical and functional unit. However, it is fundamentally difficult to precisely distinguish every pulmonary segment using the conventional pulmonary intersegmental planes from computed tomography images. Building arteriopulmonary segments is likely to be an effective way to identify pulmonary segments.
METHODS
The thoracic computed tomography images of 40 patients were collected. The anatomic structures of interest were extracted in the transverse, sagittal, and coronal planes using the semi-automated segmentation tools provided by Amira software. The intrapulmonary vessels were subsequently segmented and reconstructed. The distributions of the pulmonary arteries, veins, and bronchi were observed. In patients with pulmonary masses, the mass was also reconstructed.
RESULTS
The three-dimensional reconstructed images showed the branches of the pulmonary artery ramified up to their eighth order covering the entire lung as well as evident intersegmental gaps without pulmonary arteries. The segmental artery was closely accompanied by the segmental bronchi in 486 pulmonary segments (90% of total number of segments). The size and spatial location of the pulmonary mass within a pulmonary segment were also clearly visible.
CONCLUSIONS
Demarcation of arteriopulmonary segments can be used to precisely distinguish every pulmonary segment and provide its detailed anatomical structure before pulmonary segmentectomy.
Topics: Humans; Lung; Pneumonectomy; Pulmonary Artery; Tomography, X-Ray Computed
PubMed: 33990153
DOI: 10.1177/03000605211014383