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Journal of Comparative Pathology Aug 2021Mineralizing pulmonary elastosis (MPE) is a rare and unique phenomenon that has been reported in humans, typically secondary to recurrent pulmonary haemorrhage. MPE has...
Mineralizing pulmonary elastosis (MPE) is a rare and unique phenomenon that has been reported in humans, typically secondary to recurrent pulmonary haemorrhage. MPE has a complex histopathological appearance, often containing iron-calcium deposits that can be mistaken as fungal organisms or other inorganic material. This report documents the first case of MPE in an animal species. A 10-year-old female domestic cat with respiratory failure was submitted for necropsy. The lungs were consolidated with severe pulmonary haemosiderosis, and widely disseminated granulomas surrounded large aggregates of hyphae-like structures. The pulmonary vasculature and airway smooth muscle were partially mineralized and fragmented. Histochemical stains revealed that the fungus-like material stained strongly with Prussian blue and alizarin red but only sparingly with von Kossa and negative with Gomori's methenamine silver stain. These findings are similar to those of MPE in humans. As most veterinary pathologists may not be familiar with MPE, it is important to avoid possible misinterpretation by recognizing its distinct features and the ancillary testing that may be required.
Topics: Animals; Cat Diseases; Cats; Fatal Outcome; Female; Hemorrhage; Hemosiderosis; Lung; Lung Diseases; Staining and Labeling
PubMed: 34503649
DOI: 10.1016/j.jcpa.2021.06.007 -
Comparative Biochemistry and... Apr 2021Anurans have an exceptional capacity for maintaining vascular volume compared with other groups of vertebrates. They can mobilize interstitial fluids via lymphatic... (Comparative Study)
Comparative Study Review
Anurans have an exceptional capacity for maintaining vascular volume compared with other groups of vertebrates. They can mobilize interstitial fluids via lymphatic return at rates that are ten-fold higher than mammals. This extraordinary capacity is the result of coordination of specialized skeletal muscles and pulmonary ventilation that vary volume and pressure of subcutaneous lymph sacs, thus moving lymph to dorsally located lymph hearts that return lymph to the vascular space. Variation in the capacity to mobilize lymph within anurans varies with the degree of terrestriality, development of skeletal muscles, lung volume and lung compliance, and lymph heart pressure development. This ability enable anurans, which have the highest rates of evaporative water loss among terrestrial vertebrates, to withstand levels of dehydration far exceeding that of other vertebrates, and to successfully occupy virtually all terrestrial environments during their evolution. Maintenance of vascular fluid volume for all vertebrates can be achieved primarily by moving fluid from the interstitial space to the vascular space by transcapillary uptake and mobilization of interstitial (lymphatic) fluid. Transcapillary fluid uptake at the capillary level has been analyzed historically by Krogh and others from a Starling perspective and involves a balance of hydrostatic and oncotic forces. A complete evaluation of blood volume homeostasis also incorporates pressures and compliances of the vascular and interstitial spaces, but has been applied to only a few species. In this review we outline the current understanding of how anurans and other vertebrates maintain blood volume during hypovolemic challenges such as dehydration and hemorrhage which is crucial for maintaining cardiac output.
Topics: Amphibians; Animals; Anura; Biological Transport; Blood Volume; Capillaries; Fishes; Hemorrhage; Humans; Hypovolemia; Lung; Lymph; Lymphatic System; Muscle, Skeletal; Pulmonary Ventilation; Ranidae; Species Specificity; Vertebrates; Viscosity
PubMed: 33358925
DOI: 10.1016/j.cbpa.2020.110878 -
Frontiers in Immunology 2023Up to 30% of hospitalized COVID-19 patients experience persistent sequelae, including pulmonary fibrosis (PF).
INTRODUCTION
Up to 30% of hospitalized COVID-19 patients experience persistent sequelae, including pulmonary fibrosis (PF).
METHODS
We examined COVID-19 survivors with impaired lung function and imaging worrisome for developing PF and found within six months, symptoms, restriction and PF improved in some (Early-Resolving COVID-PF), but persisted in others (Late-Resolving COVID-PF). To evaluate immune mechanisms associated with recovery versus persistent PF, we performed single-cell RNA-sequencing and multiplex immunostaining on peripheral blood mononuclear cells from patients with Early- and Late-Resolving COVID-PF and compared them to age-matched controls without respiratory disease.
RESULTS AND DISCUSSION
Our analysis showed circulating monocytes were significantly reduced in Late-Resolving COVID-PF patients compared to Early-Resolving COVID-PF and non-diseased controls. Monocyte abundance correlated with pulmonary function forced vital capacity and diffusion capacity. Differential expression analysis revealed MHC-II class molecules were upregulated on the CD8 T cells of Late-Resolving COVID-PF patients but downregulated in monocytes. To determine whether these immune signatures resembled other interstitial lung diseases, we analyzed samples from Idiopathic Pulmonary Fibrosis (IPF) patients. IPF patients had a similar marked decrease in monocyte HLA-DR protein expression compared to Late-Resolving COVID-PF patients. Our findings indicate decreased circulating monocytes are associated with decreased lung function and uniquely distinguish Late-Resolving COVID-PF from Early-Resolving COVID-PF, IPF, and non-diseased controls.
Topics: Humans; Monocytes; Leukocytes, Mononuclear; COVID-19; Idiopathic Pulmonary Fibrosis; Lung
PubMed: 38292490
DOI: 10.3389/fimmu.2023.1308594 -
Age and Comorbidities Impact Medical Complications and Mortality Following Free Flap Reconstruction.The Laryngoscope Apr 2022Determine if age correlated with surgical or medical complications following head and neck free flap reconstruction.
OBJECTIVE
Determine if age correlated with surgical or medical complications following head and neck free flap reconstruction.
STUDY DESIGN
Retrospective review of prospectively collected databases.
METHODS
Patients undergoing head and neck free flap reconstruction at three tertiary care institutions were included (n = 1972). Cohorts were based on age (<65, 65-75, 75-85, and >85). Outcomes reviewed operative duration, length of stay, surgical complications (free flap failure, fistula, hematoma, dehiscence, and infection), and medical complications (thromboembolism, stroke, cardiac, and pulmonary).
RESULTS
Anatomic site (P < .0001) and donor site varied by age (P < .0001). There was no difference in operative duration (P = .3) or length of hospitalization (P = .8) by age. The incidence of medical complications increased with increasing age. Pulmonary complication rates: <65 (3.9%), 65 to 75 (4.8%), 75 to 85 (7.1%), and >85 (11%) (P = .02). Cardiac complication rates: <65 (2.0%), 65 to 75 (7.3%), 75 to 85 (6.1%), and >85 (16.4%) (P < .0001). Mortality increased with age: <65 (0.4%), 65 to 75 (0.8%), 75 to 85 (1.1%), and >85 (4.1%) (P < .003). Medical complications correlated with mortality rates: pulmonary (3.5% vs. 0.6%; OR: 5.5; 95% CI: 1.5-20.0; P = .004); cardiac (3.3% vs. 0.6%; OR: 6.0; 95% CI: 1.6-21.8; P = .002); thromboembolism (4.6% vs. 0.7%; OR: 7.3; 95% CI: 1.6-33.6; P = .003); stroke (42% vs. 0.5%; OR: 149; 95% CI: 40-558; P < .0001); and sepsis (5% vs. 0.7%; OR 7.5; 95% CI: 1.0-60.5; P = .03). Age did not correlate with free flap success (P = .5), surgical complications (hematoma, P = .33; fistula, P = .23; infection, P = .07; and dehiscence, P = .37), or thirty-day readmission (P = .3).
CONCLUSION
Following free flap reconstruction, patient age did not correlate with development of a surgical complication. Patient age did correlate with development of a medical complication. Postoperative medical complications were found to correlate with perioperative mortality.
LEVEL OF EVIDENCE
4 Laryngoscope, 132:772-780, 2022.
Topics: Free Tissue Flaps; Head and Neck Neoplasms; Hematoma; Humans; Postoperative Complications; Plastic Surgery Procedures; Retrospective Studies; Stroke; Thromboembolism
PubMed: 34415067
DOI: 10.1002/lary.29828 -
Revue Des Maladies Respiratoires Apr 2024In France, even though it occurs only exceptionally in cases of hemopathy, severe hemoptysis in cancer is the leading cause of hemoptysis. Without adequate treatment,... (Review)
Review
In France, even though it occurs only exceptionally in cases of hemopathy, severe hemoptysis in cancer is the leading cause of hemoptysis. Without adequate treatment, in-hospital mortality exceeds 60%, even reaching 100% at 6 months. The management of severe hemoptysis should be discussed with the oncologist. Aside from situations of threatening hemoptysis, in which bronchoscopy should be performed immediately, CT angiography is an essential means of localizing the bleeding and determining the causes and the vascular mechanisms involved. In more than 90% of cases, hemoptysis is linked to systemic bronchial or non-bronchial hypervascularization, whereas in fewer than 5%, it is associated with pulmonary arterial origin or, exceptionally, with damage to the alveolar-capillary barrier. The most severely ill patients must be treated in intensive care in centers equipped with interventional radiology, thoracic surgery and, ideally, with interventional bronchoscopy. Interventional radiology is the first-line symptomatic treatment. In over 80% of cases, bronchial arteriography with embolization allows immediate control. Emergency surgery should be avoided, as it is associated with significant mortality. Appropriate and adequate care reduces hospital mortality to 30%, enabling patients to benefit from the most recent, survival-prolonging treatments.
Topics: Humans; Hemoptysis; Embolization, Therapeutic; Bronchoscopy; Bronchi; Hematology
PubMed: 38155073
DOI: 10.1016/j.rmr.2023.11.004 -
The Journal of Surgical Research Jan 2020Phosphatidylserine (PS) is a key cell membrane phospholipid normally maintained on the inner cell surface but externalizes to the outer surface in response to cellular...
BACKGROUND
Phosphatidylserine (PS) is a key cell membrane phospholipid normally maintained on the inner cell surface but externalizes to the outer surface in response to cellular stress. We hypothesized that PS exposure mediates organ dysfunction in hemorrhagic shock. Our aims were to evaluate PS blockade on (1) pulmonary, (2) renal, and (3) gut function, as well as (4) serum lysophosphatidic acid (LPA), an inflammatory mediator generated by PS externalization, as a possible mechanism mediating organ dysfunction.
MATERIALS AND METHODS
Rats were either (1) monitored for 130 min (controls, n = 3), (2) hemorrhaged then resuscitated (hemorrhage only group, n = 3), or (3) treated with Diannexin (DA), a PS blocking agent, followed by hemorrhage and resuscitation (DA + hemorrhage group, n = 4). Pulmonary dysfunction was assessed by arterial partial pressure of oxygen, renal dysfunction by serum creatinine, and gut dysfunction by mesenteric endothelial permeability (L). LPA levels were measured in all groups.
RESULTS
Pulmonary: there was no difference in arterial partial pressure of oxygen between groups. Renal: after resuscitation, creatinine levels were lower after PS blockade with DA versus hemorrhage only group (P = 0.01). Gut: L was decreased after PS blockade with DA versus hemorrhage only group (P < 0.01). Finally, LPA levels were also lower after PS blockade with DA versus the hemorrhage only group but higher than the control group (P < 0.01).
CONCLUSIONS
PS blockade with DA decreased renal and gut dysfunction associated with hemorrhagic shock and attenuated the magnitude of LPA generation. Our findings suggest potential for therapeutic targets in the future that could prevent organ dysfunction associated with hemorrhagic shock.
Topics: Animals; Annexin A5; Disease Models, Animal; Female; Humans; Infusions, Intravenous; Intestinal Mucosa; Kidney; Lung; Lysophospholipids; Organ Dysfunction Scores; Phosphatidylserines; Rats; Resuscitation; Shock, Hemorrhagic; Treatment Outcome
PubMed: 31499368
DOI: 10.1016/j.jss.2019.07.050 -
Cell Communication and Signaling : CCS Nov 2020Vascular leakage is an important pathophysiological process of critical conditions such as shock and ischemia-reperfusion (I/R)-induced lung injury. Microparticles...
BACKGROUND
Vascular leakage is an important pathophysiological process of critical conditions such as shock and ischemia-reperfusion (I/R)-induced lung injury. Microparticles (MPs), including endothelial cell-derived microparticles (EMPs), platelet-derived microparticles (PMPs) and leukocyte-derived microparticles (LMPs), have been shown to participate in many diseases. Whether and which of these MPs take part in pulmonary vascular leakage and lung injury after I/R and whether these MPs have synergistic effect and the underlying mechanism are not known.
METHODS
Using hemorrhage/transfusion (Hemo/Trans) and aorta abdominalis occlusion-induced I/R rat models, the role of EMPs, PMPs and LMPs and the mechanisms in pulmonary vascular leakage and lung injury were observed.
RESULTS
The concentrations of EMPs, PMPs and LMPs were significantly increased after I/R. Intravenous administration of EMPs and PMPs but not LMPs induced pulmonary vascular leakage and lung injury. Furthermore, EMPs induced pulmonary sequestration of platelets and promoted more PMPs production, and played a synergistic effect on pulmonary vascular leakage. MiR-1, miR-155 and miR-542 in EMPs, and miR-126 and miR-29 in PMPs, were significantly increased after hypoxia/reoxygenation (H/R). Of which, inhibition of miR-155 in EMPs and miR-126 in PMPs alleviated the detrimental effects of EMPs and PMPs on vascular barrier function and lung injury. Overexpression of miR-155 in EMPs down-regulated the expression of tight junction related proteins such as ZO-1 and claudin-5, while overexpression of miR-126 up-regulated the expression of caveolin-1 (Cav-1), the trans-cellular transportation related protein such as caveolin-1 (Cav-1). Inhibiting EMPs and PMPs production with blebbistatin (BLE) and amitriptyline (AMI) alleviated I/R induced pulmonary vascular leakage and lung injury.
CONCLUSIONS
EMPs and PMPs contribute to the pulmonary vascular leakage and lung injury after I/R. EMPs mediate pulmonary sequestration of platelets, producing more PMPs to play synergistic effect. Mechanically, EMPs carrying miR-155 that down-regulates ZO-1 and claudin-5 and PMPs carrying miR-126 that up-regulates Cav-1, synergistically mediate pulmonary vascular leakage and lung injury after I/R. Video Abstract.
Topics: Amitriptyline; Animals; Blood Platelets; Capillary Permeability; Caveolin 1; Cell-Derived Microparticles; Claudin-5; Endothelial Cells; Heterocyclic Compounds, 4 or More Rings; Leukocytes; Lung; Lung Injury; MicroRNAs; Rats, Sprague-Dawley; Reperfusion Injury; Zonula Occludens-1 Protein
PubMed: 33225929
DOI: 10.1186/s12964-020-00672-0 -
Canadian Respiratory Journal 2022The aim of this study was to analyze the differences in risk factors for pulmonary hemorrhage in elderly and young patients with percutaneous computed tomography-guided...
PURPOSE
The aim of this study was to analyze the differences in risk factors for pulmonary hemorrhage in elderly and young patients with percutaneous computed tomography-guided needle biopsies (PCNBs). The correlations between the incidence of pulmonary hemorrhage and pulmonary function indicators before CT-guided PCNB were also discussed.
METHODS
Between January 2018 and December 2019, 1,100 consecutive patients underwent CT-guided PCNBs at Qilu Hospital. Both univariate and multivariate logistic regression analyses identified risk factors for hemorrhage.
RESULTS
The occurrence of pulmonary hemorrhage was 22.1% in elderly patients and was 22.6% in young patients. In elderly patients, pulmonary hemorrhage was significantly influenced by needle depth to the lesion and dwell time, while in young patients, pulmonary hemorrhage was independently associated with lesion size, needle depth to the lesion, and dwell time. However, pulmonary function parameters, including FVC (% pred), FEV (% pred), FEV/FVC ratio (%), small airway function parameters (FEF, FEF, and FEF), and large airway function parameters (MVV, PEF, and FEF), were not risk factors for hemorrhage. Furthermore, the incidence of pulmonary hemorrhage was not associated with different types of pulmonary dysfunctions. The risk of pulmonary hemorrhage did not increase with the severity of pulmonary dysfunctions.
CONCLUSIONS
In this study, age is no longer a risk factor in evaluating pulmonary hemorrhage. Longer needle depth to the lesion and longer dwell time were significantly high risk factors of hemorrhage in both elderly patients and young patients. Patients with severe pulmonary dysfunctions did not show increased risks of pulmonary hemorrhage here.
Topics: Aged; Biopsy, Large-Core Needle; Hemorrhage; Humans; Lung; Lung Diseases; Pneumothorax; Pulmonary Ventilation; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 36033344
DOI: 10.1155/2022/5238177 -
Radiologic Clinics of North America Jul 2019Cardiovascular injuries represent the second most common cause of death among trauma victims in the United States. Motor vehicle collisions account for more than 80% of... (Review)
Review
Cardiovascular injuries represent the second most common cause of death among trauma victims in the United States. Motor vehicle collisions account for more than 80% of all blunt thoracic trauma. Given the nonspecific nature and variable severity of presenting symptoms, such as chest pain and shortness of breath, as well as confounding and overlapping clinical presentations in the setting of additional injuries, diagnosis of cardiovascular injuries can be challenging. This article reviews the clinical entities of acute aortic syndrome and pulmonary embolism, their imaging findings, and diagnostic challenges.
Topics: Aortic Dissection; Aorta; Computed Tomography Angiography; Emergencies; Hematoma; Humans; Pulmonary Artery; Pulmonary Embolism; Syndrome; Ulcer; Wounds, Nonpenetrating
PubMed: 31076032
DOI: 10.1016/j.rcl.2019.02.012 -
Clinical and Translational Medicine Dec 2021scRNA-seq is on track for use as a routine measurement of clinical biochemistry and to assist in clinical decision-making and guide the performance of molecular...
scRNA-seq is on track for use as a routine measurement of clinical biochemistry and to assist in clinical decision-making and guide the performance of molecular medicine, but there are still a large number of challenges to be overcome. In conclusion, scRNA-seq-based clusters and differentiation of circulating blood cells have been examined and informative in patients with various diseases, although the information generated from scRNA-seq varies between different conditions, technologies, and diseases. Most of the clinical studies published have focused on the landscape of circulating immune cells, disease-specific patterns of new clusters, understanding of potential mechanisms, and potential correlation between cell clusters, differentiations, cell interactions, and circulating and migrated cells. It is clear that the information from scRNA-seq advances the understanding of the disease, identifies disease-specific target panels, and suggests new therapeutic strategies. The adaptation of scRNA-seq as a routine clinical measurement will require standardization and normalization of scRNA-seq-based comprehensive information and validation in a large population of healthy and diseased patients. The integration of public databases on human circulating cell clusters and differentiations with an application of artificial intelligence and computational science will accelerate the application of scRNA-seq for clinical practice. Thus, we call special attention from scientists and clinicians to the clinical and translational discovery, validation, and medicine opportunities of scRNA-seq development.
Topics: Artificial Intelligence; Chemistry, Clinical; Hematology; Humans; Single-Cell Analysis
PubMed: 34898038
DOI: 10.1002/ctm2.671