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The Journal of International Medical... Jul 2018Objective Diagnosis of pulmonary cryptococcosis is difficult. In this study, we examined the clinical and radiological features that increase the diagnostic accuracy for...
Objective Diagnosis of pulmonary cryptococcosis is difficult. In this study, we examined the clinical and radiological features that increase the diagnostic accuracy for pulmonary cryptococcosis. Methods This retrospective study included clinical data from 68 patients with pulmonary cryptococcosis from 2012 to 2016 in 3 tertiary hospitals. Results Among the 68 patients, 39 (57.35%) had no complications, 39 (57.35%) had clinical symptoms, 6 (8.82%) had a history of occupational exposure, 27 (39.71%) had a single nodule/mass (the most common type of pulmonary cryptococcosis) on chest computed tomography images, 21 (30.88%) had multiple nodules/masses, 16 (23.53%) had ground glass opacity with or without nodules, 2 (2.94%) had miliary nodules, and 2 (2.94%) had enlarged mediastinal lymph nodes. Fifty-three (77.94%) patients had lesions with irregular margins, 33 (48.53%) had spiculated lesions, 32 (47.06%) had air bronchograms, 9 (13.24%) had cavities, and 4 (5.88%) had calcifications. Twenty-four patients underwent surgery, 35 received antifungal treatment, and 9 received both treatments. Conclusion The clinical features and computed tomography signs found in this study are not specific for a diagnosis of pulmonary cryptococcosis. Therefore, an increased awareness of pulmonary cryptococcosis is needed among clinicians.
Topics: Adolescent; Adult; Antifungal Agents; Biopsy; Child; Child, Preschool; Cryptococcosis; Female; Humans; Infant; Infant, Newborn; Lung; Lung Diseases, Fungal; Male; Middle Aged; Pneumonectomy; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 29848126
DOI: 10.1177/0300060518769541 -
Journal of the Mechanical Behavior of... Apr 2020The Hounsfield unit (HU) obtained from high resolution computed tomography (HRCT) has been used to assess lung pathology. However, lung mass density has not been...
The Hounsfield unit (HU) obtained from high resolution computed tomography (HRCT) has been used to assess lung pathology. However, lung mass density has not been quantified in vivo noninvasively. The objective of this study was to develop a method for analyzing lung mass density of superficial lung tissue of patients with interstitial lung disease (ILD) and healthy subjects using a deep neural network (DNN) and lung ultrasound surface wave elastography (LUSWE). Surface wave speeds at three vibration frequencies (100, 150 and 200 Hz) from LUSWE and a pulmonary function test (PFT) including predicted forced expiratory volume (FEV1% pre) and ratio of forced expiratory volume to forced vital capacity (FEV1%/FVC%) were used. Predefined lung mass densities based on the HU for ILD patients and healthy subjects (77 in total) were also used to train the DNN model. The DNN was composed of four hidden layers of 1024 neurons for each layer and trained for 80 epochs with a batch size of 20. The learning rate was 0.001. Performances of two types of activation functions in the DNN, rectified linear activation unit (ReLU) and exponential linear unit (ELU), as well as, machine learning models (support vector regression, random forest, Adaboost) were evaluated. The test dataset of wave speeds, FEV1% pre and FEV%/FVC%, was used to predict lung mass density. The results showed that predictions using a DNN with ELU obtained a comparatively better performance in the testing dataset (accuracy = 0.89) than those of DNN with ReLU or machine learning models. This method may be useful to noninvasively analyze lung mass density by using the DNN model together with the measurements from LUSWE and PFT.
Topics: Elasticity Imaging Techniques; Healthy Volunteers; Humans; Lung; Lung Diseases, Interstitial; Neural Networks, Computer
PubMed: 32174432
DOI: 10.1016/j.jmbbm.2020.103682 -
Carbohydrate Research Jul 2021The viral infection caused by SARS-CoV-2 has increased the mortality rate and engaged several adverse effects on the affected individuals. Currently available antiviral... (Review)
Review
The viral infection caused by SARS-CoV-2 has increased the mortality rate and engaged several adverse effects on the affected individuals. Currently available antiviral drugs have found to be unsuccessful in the treatment of COVID-19 patients. The demand for efficient antiviral drugs has created a huge burden on physicians and health workers. Plasma therapy seems to be less accomplishable due to insufficient donors to donate plasma and low recovery rate from viral infection. Repurposing of antivirals has been evolved as a suitable strategy in the current treatment and preventive measures. The concept of drug repurposing represents new experimental approaches for effective therapeutic benefits. Besides, SARS-CoV-2 exhibits several complications such as lung damage, blood clot formation, respiratory illness and organ failures in most of the patients. Based on the accumulation of data, sulfated marine polysaccharides have exerted successful inhibition of virus entry, attachment and replication with known or unknown possible mechanisms against deadly animal and human viruses so far. Since the virus entry into the host cells is the key process, the prevention of such entry mechanism makes any antiviral strategy effective. Enveloped viruses are more sensitive to polyanions than non-enveloped viruses. Besides, the viral infection caused by RNA virus types embarks severe oxidative stress in the human body that leads to malfunction of tissues and organs. In this context, polysaccharides play a very significant role in providing shielding effect against the virus due to their polyanionic rich features and a molecular weight that hinders their reactive surface glycoproteins. Significantly the functional groups especially sulfate, sulfate pattern and addition, uronic acids, monosaccharides, glycosidic linkage and high molecular weight have greater influence in the antiviral activity. Moreover, they are very good antioxidants that can reduce the free radical generation and provokes intracellular antioxidant enzymes. Additionally, polysaccharides enable a host-virus immune response, activate phagocytosis and stimulate interferon systems. Therefore, polysaccharides can be used as candidate drugs, adjuvants in vaccines or combination with other antivirals, antioxidants and immune-activating nutritional supplements and antiviral materials in healthcare products to prevent SARS-CoV-2 infection.
Topics: Anticoagulants; Antiviral Agents; Blood Platelets; COVID-19; Humans; Immunologic Factors; Lung; Phaeophyceae; Polysaccharides; Pulmonary Embolism; Respiratory Insufficiency; Rhodophyta; SARS-CoV-2; Sulfuric Acid Esters; Virus Attachment; Virus Internalization; COVID-19 Drug Treatment
PubMed: 34015720
DOI: 10.1016/j.carres.2021.108326 -
Nanotoxicology 2015We evaluated and compared the pulmonary clearance kinetics and extrapulmonary translocations of seven titanium dioxide (TiO2) nano- and submicron particles with...
We evaluated and compared the pulmonary clearance kinetics and extrapulmonary translocations of seven titanium dioxide (TiO2) nano- and submicron particles with different characteristics, including size, shape and surface coating. Varying doses of TiO2 nano- and submicron particles dispersed in 0.2% disodium phosphate solution were intratracheally administered to male F344 rats. The rats were euthanized under anesthesia for 3, 28 and 91 days after administration. Ti levels in pulmonary and various extrapulmonary organs were determined using inductively coupled plasma-sector field mass spectrometry (ICP-SFMS). The lungs, including bronchoalveolar lavage fluid (BALF), contained 55-89% of the administered TiO2 dose at 3 days after administration. The pulmonary clearance rate constants, estimated using a one-compartment model, were higher after administration of 0.375-2.0 mg/kg body weight (bw) (0.016-0.020/day) than after administration of 3.0-6.0 mg/kg bw (0.0073-0.013/day) for six uncoated TiO2. In contrast, the clearance rate constant was 0.011, 0.0046 and 0.00018/day following administration of 0.67, 2.0 and 6.0 mg/kg bw TiO2 nanoparticle with Al(OH)3 coating, respectively. Translocation of TiO2 from the lungs to the thoracic lymph nodes increased in a time- and dose-dependent manner. Furthermore, the translocation of TiO2 from the lungs to the thoracic lymph nodes after 91 days was higher when Al(OH)3 coated TiO2 was administered (0.93-6.4%), as compared to uncoated TiO2 (0.016-1.8%). Slight liver translocation was observed (<0.11%), although there was no clear trend related to dose or elapsed time. No significant translocation was observed in other organs including the kidney, spleen and brain.
Topics: Animals; Lung; Male; Metabolic Clearance Rate; Nanoparticles; Rats; Tissue Distribution; Titanium; Trachea
PubMed: 25938280
DOI: 10.3109/17435390.2015.1015644 -
Thoracic Surgery Clinics Nov 2023Current lung cancer screening protocols use low-dose computed tomography scans in selected high-risk individuals. Unfortunately, utilization is low, and the rate of... (Review)
Review
Current lung cancer screening protocols use low-dose computed tomography scans in selected high-risk individuals. Unfortunately, utilization is low, and the rate of false-positive screens is high. Peripheral biomarkers carry meaningful promise in diagnosing and monitoring cancer with added potential advantages reducing invasive procedures and improving turnaround time. Herein, the use of such blood-based assays is considered as an adjunct to further utilization and accuracy of lung cancer screening.
Topics: Humans; Lung Neoplasms; Early Detection of Cancer; Tomography, X-Ray Computed; Lung; Liquid Biopsy; Mass Screening
PubMed: 37806743
DOI: 10.1016/j.thorsurg.2023.04.004 -
MBio Apr 2019Tuberculosis (TB), caused by infection, remains a major cause of mortality and morbidity worldwide. One-third of the world population is infected with , and about 15...
Tuberculosis (TB), caused by infection, remains a major cause of mortality and morbidity worldwide. One-third of the world population is infected with , and about 15 million people with latent tuberculosis infection (LTBI) reside in the United States. An estimated 10% of individuals with LTBI are at risk of progressing to active disease. Loss of body mass, or wasting, accompanied by a significant reduction of body fat is often associated with active TB disease and is considered to be immunosuppressive and a major determinant of severity and outcome of disease. While the lungs are the primary site of infection and TB manifestation, recent reports have shown that adipose tissue serves as an important reservoir for In this article, we investigated the association between infection, adipose tissue, and TB disease progression using a transgenic inducible "fatless" model system, the FAT-ATTAC (fat apoptosis through targeted activation of caspase 8) mouse. By selectively ablating fat tissue during infection, we directly tested the role of fat cell loss and adipose tissue physiology in regulating pulmonary pathology, bacterial burden, and immune status. Our results confirm the presence of in fat tissue after aerosol infection of mice and show that loss of fat cells is associated with an increase in pulmonary burden and pathology. We conclude that acute loss of adipose tissue during LTBI may predispose the host to active TB disease. Although the lungs are the port of entry and the predominant site of TB disease manifestation, we and others have demonstrated that also persists in adipose tissue of aerosol-infected animals and directly or indirectly alters adipose tissue physiology, which in turn alters whole-body immuno-metabolic homeostasis. Our present report demonstrates a direct effect of loss of adipocytes (fat cells) on promoting the severity of pulmonary pathogenesis during TB, advancing our understanding of the pathogenic interactions between wasting and TB activation/reactivation.
Topics: Ablation Techniques; Adipose Tissue; Animals; Animals, Genetically Modified; Disease Progression; Female; Host-Pathogen Interactions; Latent Tuberculosis; Lung; Male; Mice; Mycobacterium tuberculosis; Tuberculosis, Pulmonary
PubMed: 30992360
DOI: 10.1128/mBio.02771-18 -
Clinical Laboratory Jun 2024Invasive pulmonary aspergillosis (IPA) is a deep fungal infection caused by invasion of Aspergillus mycelium into the lung parenchyma resulting in tissue destruction and...
BACKGROUND
Invasive pulmonary aspergillosis (IPA) is a deep fungal infection caused by invasion of Aspergillus mycelium into the lung parenchyma resulting in tissue destruction and necrosis, which occurs more often in im-munosuppressed populations. The severity of the disease and the rapid progression of the lung lesions puts pa¬tients at high risk of death and poor prognosis if the correct therapeutic intervention is not given as early as possible.
METHODS
Here we report a case of IPA, which was initially diagnosed as community-acquired pneumonia in a local hospital. The symptoms did not improve after receiving anti-infective treatment. The patient was diagnosed with IPA after completing a chest CT examination and an electronic bronchoscopy, as well as pathogenetic examination of the bronchoalveolar lavage fluid and pathological examination of the left bronchial mass in the respiratory department of our hospital, which was finally diagnosed as IPA. After one week of administration of voriconazole for anti-fungal infection treatment, the patient's symptoms improved significantly, and a repeat chest CT suggested that the lung lesions were better than before. In order to raise clinicians' awareness of this disease, we also conducted a literature analysis.
RESULTS
The final diagnosis of IPA was made by analyzing the patient's history, symptoms, signs, and relevant findings.
CONCLUSIONS
When the patient's clinical symptoms and imaging manifestations are consistent with IPA, electronic bronchoscopy and pathogenetic and pathological examinations may be appropriately performed to clarify the na-ture of the lesion. More consideration should be given to the possibility of disease diagnosis to avoid misdiagnosis and underdiagnosis. Appropriate treatment should be given at an early stage.
Topics: Humans; Invasive Pulmonary Aspergillosis; Antifungal Agents; Voriconazole; Tomography, X-Ray Computed; Bronchoscopy; Male; Bronchoalveolar Lavage Fluid; Middle Aged; Lung
PubMed: 38868875
DOI: 10.7754/Clin.Lab.2024.240106 -
The Turkish Journal of Pediatrics 2016Inflammation is a central contributor to the pathogenesis of cystic fibrosis (CF) pulmonary disease; so limiting the excessive production of inflammatory mediators...
Inflammation is a central contributor to the pathogenesis of cystic fibrosis (CF) pulmonary disease; so limiting the excessive production of inflammatory mediators represents a major therapeutic strategy for slowing the decline in lung function and improving survival. The macrolide antibiotic azithromycin (AZM) has anti-inflammatory properties and immunomodulatory effects that may be beneficial in CF. The aim of this study was to document the long term use of AZM effect on pulmonary function, nutritional status and number of pulmonary exacerbations in patients with CF. Twenty four patients with CF aged 4-23 years followed at Hacettepe University Department of Pediatric Pulmonology between May 2007- December 2014 enrolled in the study from 630 CF patients. They received 10 mg/kg/day of AZM three times a week. Pulmonary function parameters, sputum cultures, body mass index (BMI) Z scores and number of pulmonary exacerbations were analyzed at different time intervals (at the visits at months 6, 9 and 12). Median age of the patients was 14.7 (range 4-23 years) years and median treatment duration was 14 months (range 6-60 months). Initially, median FEV1% was found 68% (range 30%-100%), BMI was found 17.05 (range 13.3-26.5) and oxygen saturation was found 95% (range 84%-99%). At the end of the 6th, 9th and 12th months of the AZM therapy; no significant differences in FEV1% and oxygen saturation parameters were found compared to the initial time, however BMI increased significantly (p=0.03), also the number of pulmonary exacerbations (p < 0.001) and severe exacerbations (p < 0.001) needing intravenous antibiotic treatment were significantly reduced at the 6th and 12th month. At the end of the 12th month of AZM; Methicillin sensitive S. aureus (MSSA) colonization was significantly increased (p=0.005) and increased macrolide resistance was detected (p=0.008). Although, this study could not be designed as a placebo controlled study, the results showed that at least 6 months of AZM treatment led to a significiant reduction in the number of pulmonary exacerbations requiring antibiotics and improvement on nutritional status. Despite increased P. aeruginosa antibiotic resistance and MSSA colonization rates, the lower incidence of acute exacerbations in patients receiving AZM is an important and clinically relevant measure of beneficial effect. Therefore, long term use of AZM may be considered to slow pulmonary deterioration in CF patients with P. aeruginosa colonization.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Child, Preschool; Cystic Fibrosis; Female; Humans; Inflammation; Lung; Male; Nutritional Status; Respiratory Function Tests; Young Adult
PubMed: 27922234
DOI: 10.24953/turkjped.2016.01.005 -
Computers in Biology and Medicine Mar 2024Pulmonary airflow simulation is a valuable tool for studying respiratory function and disease. However, the respiratory system is a complex multiscale system that...
Pulmonary airflow simulation is a valuable tool for studying respiratory function and disease. However, the respiratory system is a complex multiscale system that involves various physical and biological processes across different spatial and temporal scales. In this study, we propose a 3D-1D-0D multiscale method for simulating pulmonary airflow, which integrates different levels of detail and complexity of the respiratory system. The method consists of three components: a 3D computational fluid dynamics model for the airflow in the trachea and bronchus, a 1D pipe model for the airflow in the terminal bronchioles, and a 0D biphasic mixture model for the airflow in the respiratory bronchioles and alveoli coupled with the lung deformation. The coupling between the different components is achieved by satisfying the mass and momentum conservation law and the pressure continuity condition at the interfaces. We demonstrate the validity and applicability of our method by comparing the results with data of previous models. We also investigate the reduction in inhaled air volume due to the pulmonary fibrosis using the developed multiscale model. Our method provides a comprehensive and realistic framework for simulating pulmonary airflow and can potentially facilitate the diagnosis and treatment of respiratory diseases.
Topics: Models, Biological; Lung; Respiration; Pulmonary Alveoli; Computer Simulation
PubMed: 38367450
DOI: 10.1016/j.compbiomed.2024.108150 -
Shock (Augusta, Ga.) May 2024Background: Sepsis is a type of life-threatening organ dysfunction that is caused by a dysregulated host response to infection. The lung is the most vulnerable target...
Background: Sepsis is a type of life-threatening organ dysfunction that is caused by a dysregulated host response to infection. The lung is the most vulnerable target organ under septic conditions. Pulmonary microvascular endothelial cells (PMVECs) play a critical role in acute lung injury (ALI) caused by severe sepsis. The impairment of PMVECs during sepsis is a complex regulatory process involving multiple mechanisms, in which the imbalance of calcium (Ca 2+ ) homeostasis of endothelial cells is a key factor in its functional impairment. Our preliminary results indicated that hydrogen gas (H 2 ) treatment significantly alleviates lung injury in sepsis, protects PMVECs from hyperpermeability, and decreases the expression of plasma membrane stromal interaction molecule 1 (STIM1), but the underlying mechanism by which H 2 maintains Ca 2+ homeostasis in endothelial cells in septic models remains unclear. Thus, the purpose of the present study was to investigate the molecular mechanism of STIM1 and Ca 2+ release-activated Ca 2+ channel protein1 (Orai1) regulation by H 2 treatment and explore the effect of H 2 treatment on Ca 2+ homeostasis in lipopolysaccharide (LPS)-induced PMVECs and LPS-challenged mice. Methods: We observed the role of H 2 on LPS-induced ALI of mice in vivo . The lung wet/dry weight ratio, total protein in the bronchoalveolar lavage fluid, and Evans blue dye assay were used to evaluate the pulmonary endothelial barrier damage of LPS-challenged mice. The expression of STIM1 and Orai1 was also detected using epifluorescence microscopy. Moreover, we also investigated the role of H 2 -rich medium in regulating PMVECs under LPS treatment, which induced injury similar to sepsis in vitro . The expression of STIM1 and Orai1 as well as the Ca 2+ concentration in PMVECs was examined. Results:In vivo , we found that H 2 alleviated ALI of mice through decreasing lung wet/dry weight ratio, total protein in the bronchoalveolar lavage fluid and permeability of lung. In addition, H 2 also decreased the expression of STIM1 and Orai1 in pulmonary microvascular endothelium. In vitro , LPS treatment increased the expression levels of STIM1 and Orai1 in PMVECs, while H 2 reversed these changes. Furthermore, H 2 ameliorated Ca 2+ influx under sepsis-mimicking conditions. Treatment with the sarco/endoplasmic reticulum Ca 2+ adenosine triphosphatase inhibitor, thapsigargin, resulted in a significant reduction in cell viability as well as a reduction in the expression of junctional proteins, including vascular endothelial-cadherin and occludin. Treatment with the store-operated Ca 2+ entry inhibitor, YM-58483 (BTP2), increased the cell viability and expression of junctional proteins. Conclusions: The present study suggested that H 2 treatment alleviates LPS-induced PMVEC dysfunction by inhibiting store-operated Ca 2+ entry mediated by STIM1 and Orai1 in vitro and in vivo .
Topics: Animals; Male; Mice; Acute Lung Injury; Calcium; Endothelial Cells; Hydrogen; Lipopolysaccharides; Lung; Mice, Inbred C57BL; ORAI1 Protein; Sepsis; Stromal Interaction Molecule 1; Microvessels
PubMed: 38010088
DOI: 10.1097/SHK.0000000000002279