Bronchial Vessels Research Articles

Extracellular purines in lung endothelial permeability and pulmonary diseases.

The purinergic signaling system is an evolutionarily conserved and critical regulatory circuit that maintains homeostatic balance across various organ systems and cell types by providing compensatory responses to diverse pathologies. Despite cardiovascular diseases taking a leading position in human morbidity and mortality worldwide, pulmonary diseases represent significant health concerns as well. The endothelium of both pulmonary and systemic circulation (bronchial vessels) plays a pivotal role in maintaining lung tissue homeostasis by providing an active barrier and modulating adhesion and infiltration of inflammatory cells. However, investigations into purinergic regulation of lung endothelium have remained limited, despite widespread recognition of the role of extracellular nucleotides and adenosine in hypoxic, inflammatory, and immune responses within the pulmonary microenvironment. In this review, we provide an overview of the basic aspects of purinergic signaling in vascular endothelium and highlight recent studies focusing on pulmonary microvascular endothelial cells and endothelial cells from the pulmonary artery vasa vasorum. Through this compilation of research findings, we aim to shed light on the emerging insights into the purinergic modulation of pulmonary endothelial function and its implications for lung health and disease.

СТРУКТУРА БРОНХИАЛЬНЫХ АРТЕРИЙ КРЫС ПРИ ЧЕРЕПНО-МОЗГОВОЙ ТРАВМЕ И СИСТЕМНОМ ВОСПАЛЕНИИ

Purpose of the study: to present a histochemical and morphometric assessment of the state of the blood vessels of the bronchial tree and lung parenchyma of rats in experimental traumatic brain injury (TBI). and systemic inflammation caused by the administration of pyrogenal. Materials and methods. The experiment was carried out on mature male Wistar rats (200-250 g). Potentially painful interventions in the ongoing experiments and euthanasia were performed under combined injection anesthesia. The model of the falling weight modified by us for rats was used to reproduce TBI. To initiate systemic inflammation (SI), the animals were intramuscularly injected with pyrogenal solution. The study included the following groups: intact rats (n=12); after applying TBI (n=12)-TBI; triple administration (1, 3, 4 days) of pyrogenal without TBI (n=16)-SV; triple administration of pyrogenal (1, 3, 4 days) after TBI (n=12)-TBI+SV. On days 4 and 6 from the beginning of the experiment, under general anesthesia, the animals were dissected, their lungs were removed, after which histological sections were made. Morphological and functional changes in the blood vessels of the bronchial tree and lung parenchyma were analyzed in experimental traumatic brain injury (TBI) and systemic inflammation in rats. It has been established that in injured rats, the administration of pyrogenal has a significant effect on the structure of the bronchial blood vessels of the lungs, while the application of only TBI does not initiate such changes. At the same time, a significant change in the morphometric characteristics of blood vessels is detected, a spasm of arterioles is determined with a decrease in the diameter of the lumen on days 4 and 6 of the study, and an accumulation of segmented leukocytes, macrophages and other bronchial secretion cells in the perivascular space of the vessels is noted. Thus, the results of the study show that with the comorbidity of TBI and SI in the lungs, structural changes occur in the elastic framework of the distal bronchial arteries, which manifests itself changes in the structure of the elastic membranes of these blood vessels.

Structure and Function Adaption of Lung in Phrynocephalus vlangalii by Multiple Mechanisms

Respiration and water-liquid transportation are controlled by many factors in the lung. The aim of this study was to explore the structure and proteins expression in lungs of Phrynocephalus vlangalii by means of gross anatomy, light microscope observation, scanning electron microscope and immunohistochemistry. Results show that there were many alveoli in the lung and the walls of alveoli and capillaries were very thin. The inner surface of the lung was divided into many cystic chambers by reticular diaphragm, and the network of pulmonary capillaries was dense. Immunohistochemistry showed that AQP1 was mainly expressed in the epithelium of interstitial bronchi, parabronchiole endothelium, capillary endothelium and alveolar epithelial cells. VIP positive nerve fibers are mainly distributed in trachea, bronchial smooth muscle layer, the walls of pulmonary vessels and bronchial vessels and around submucosal glands. CECR2 is distributed in peripheral capillaries and small. Investigations of structure and proteins biology could be relevant with the adaptive strategy to drought and hypoxia environment in Phrynocephalus vlangalii.

278 A CASE OF ACCIDENTAL DIAGNOSIS OF ALCAPA SYNDROME IN ASYMPTOMATIC CHILD

Abstract A 7-year-old (y.o.) boy was referred to our center for a specialist evaluation due to alteration of the ventricular repolarization in the anterior and lateral lead on the electrocardiogram at medical evaluation for physical activity. The child was totally asymptomatic, with normal growth and unremarkable past medical history. The physical examination revealed only S4 and a minimal apical systolic murmur. Transthoracic echocardiogram demonstrated a mildly dilated left ventricle (LV) and normal left ventricular ejection fraction. Strain pattern of basal-medium segments of lateral wall was reduced. Right coronary artery (RCA) appeared dilatated and the left coronary artery (LCA) showed an inverse flow at Doppler evaluation. Findings were suspicious for ALCAPA diagnosis (Anomalous Left Coronary Artery Arising from the Pulmonary Artery); a rare congenital heart disease that, if not treated, leads to death in 90% of cases during first year of life. Adult type of ALCAPA (adolescence-60 y.o) is even more rare and can cause heart failure due to a dilatative cardiomyopathy, chronic cardiac ischemia and, in 80-90% of cases, sudden cardiac death. We performed a coronary angiography that confirmed the anomalous origin of LCA from the pulmonary artery. The RCA was dominant, enlarged and supplied an important collateral flow for LCA. Coronary angiography is indicated not only for diagnosis confirmation, but also for coronary tree demonstration, especially in adult type of ALCAPA, because of the presence of not rare anomalies or “adaptation” of peripheral coronary circulation. All these features are important positive prognostic factors that enable survival beyond infancy. LCA ostium stenosis or bronchial artery collateral vessels are also common but weren't seen in this case. In adult type of ALCAPA surgery is usually indicated at the time of diagnosis, so a coronary button transfer and pulmonary Valsalva sinus reconstruction with autologous pericardial patch were performed. This is the preferred surgical technique in adult patients as it is the most anatomic correction. Since before hospitalization heart failure therapy with betablocker was introduced and after surgery aspirin therapy was started too. Post-surgery transthoracic echocardiogram highlighted a moderate pericardial effusion without haemodynamic impact and a pleural effusion, so an anti-inflammatory therapy with ibuprofen, cortisone and then colchicine was started. After discharge anti-inflammatory therapy was under-titrated until suspension based on gradual reduction of pericardial and pleural effusion. Patient was always free of symptoms and with good performance status. ALCAPA or Bland–White–Garland syndrome is an uncommon congenital heart disease. The presence of adequate collateral circulation between RCA and LCA allows to survive beyond infancy (adult type). We described a case of early diagnosis of adult type of ALCAPA in asymptomatic child thanks to a careful examination of basal electrocardiogram for evaluation of non-competitive sport practice.

Abstract 11104: Percutaneous Embolization of Extensive Collateral Vessels for Hemoptysis in Pulmonary Aspergilloma

Introduction: Pulmonary aspergillomas form due to fungal colonization in patients with immunocompromise and underlying cavitary lung disease. They can present with hemoptysis due to erosion of pulmonary vessels and formation of collaterals. Arterial embolization of bronchial vessels is considered first line treatment due to effectiveness and minimal invasiveness. We present one patient with need for extensive embolization treatment for persistent hemoptysis. Case: 53yo woman with pulmonary sarcoidosis and bilateral pulmonary aspergilloma presented to our institution for lung transplant evaluation. She had persistent hemoptysis for years after being diagnosed. She previously had bronchial artery embolization at outside hospital but had persistent symptoms severely limiting her functional status. She continued to have active hemoptysis during the admission, including on arrival to procedure. Angiography demonstrated extensive collateral vessels from systemic arterial to pulmonary circulation including several large branches originating from the subclavian arteries, internal mammary arteries and dorsal scapular arteries. There was leak through multiple previously embolized arteries, with active extravasation of contrast. Initial large collaterals were embolized using Medtronic MVP micro-vascular plugs (3Q, 5Q, 7Q) and smaller collaterals from intercostal arteries embolized using Penumbra Ruby Coil. She had improvement following the first procedure, but had persistent hemoptysis requiring repeat procedures to address more collateral and native vessels prior to resolution of symptoms. Conclusions: This patient with bilateral pulmonary aspergilloma had previous unsuccessful coil embolizations and complex collateral vessel system that resulted in severe recurrent bleeds. We successfully treated this patient’s persistent massive hemoptysis after extensive embolizations during multiple challenging procedures.

Edible algae (Ecklonia cava) bioprocessed with mycelia of shiitake (Lentinula edodes) mushrooms in liquid culture and its isolated fractions protect mice against allergic asthma

BackgroundEcklonia cava is an edible marine brown alga harvested from the ocean that is widely consumed in Asian countries as a health-promoting medicinal food The objective of the present study is to evaluate the anti-asthma mechanism of a new functional food produced by bioprocessing edible algae Ecklonia cava and shiitake Lentinula edodes mushroom mycelia and isolated fractions.MethodsWe used as series of methods, including high performance liquid chromatography, gas chromatography, cell assays, and an in vivo mouse assay to evaluate the asthma-inhibitory effect of Ecklonia cava bioprocessed (fermented) with Lentinula edodes shiitake mushroom mycelium and its isolated fractions in mast cells and in orally fed mice.ResultsThe treatments inhibited the degranulation of RBL-2H3 cells and immunoglobulin E (IgE) production, suggesting anti-asthma effects in vitro. The in vitro anti-asthma effects in cells were confirmed in mice following the induction of asthma by alumina and chicken egg ovalbumin (OVA). Oral administration of the bioprocessed Ecklonia cava and purified fractions suppressed the induction of asthma and was accompanied by the inhibition of inflammation- and immune-related substances, including eotaxin; thymic stromal lymphopoietin (TSLP); OVA-specific IgE; leukotriene C4 (LTC4); prostaglandin D2 (PGD2); and vascular cell adhesion molecule-1 (VCAM-1) in bronchoalveolar lavage fluid (BALF) and other fluids and organs. Th2 cytokines were reduced and Th1 cytokines were restored in serum, suggesting the asthma-induced inhibitory effect is regulated by the balance of the Th1/Th2 immune response. Serum levels of IL-10, a regulatory T cell (Treg) cytokine, were increased, further favoring reduced inflammation. Histology of lung tissues revealed that the treatment also reversed the thickening of the airway wall and the contraction and infiltration of bronchial and blood vessels and perialveolar inflammatory cells. The bioprocessed Ecklonia cava/mushroom mycelia new functional food showed the highest inhibition as compared with commercial algae and the fractions isolated from the bioprocessed product.ConclusionsThe in vitro cell and in vivo mouse assays demonstrate the potential value of the new bioprocessed formulation as an anti-inflammatory and anti-allergic combination of natural compounds against allergic asthma and might also ameliorate allergic manifestations of foods, drugs, and viral infections.

Augmented reality-assisted localization of solitary pulmonary nodules for precise sublobar lung resection: a preliminary study using an animal model.

BackgroundAccurate localization of early lung cancer, manifested as solitary pulmonary nodules (SPNs) on computed tomography (CT), is critical in sublobar lung resection. The AR-assisted localization of SPNs was evaluated using a pig animal model.MethodsA Microsoft HoloLens AR system was used. First, a plastic thoracic model was used for the pilot study. Three female 12 months 45 kg Danish Landrace Pigs were then used for the animal study. Thirty natural pulmonary structures, such as lymphonodus and bifurcated bronchioles or bronchial vessels, were chosen as simulated SPNs. The average angle between the actual puncturing needle and the expected path, the average distance between the puncture point and the plan point, and the difference between the actual puncturing depth and expected depth were recorded, and the accuracy rate was calculated.ResultsThe point selected in the plastic thoracic model could be hit accurately with the assistance from the AR system in the pilot study. Moreover, the average angle between the actual puncturing needle and the expected path was 14.52°±6.04°. Meanwhile, the average distance between the puncture point and the expected point was 8.74±5.07 mm, and the difference between the actual and expected depths was 9.42±7.95 mm. Puncturing within a 1 cm3 area around the SPN using a hook-wire was considered a successful hit. The puncture accuracy was calculated. The average hit rate within a spherical area with a diameter of 1 cm range was 76.67%, and within a diameter of 2 cm range was 100%.ConclusionsThe HoloLens AR-assisted localization of SPNs may become a promising technique to improve the surgical treatment of early-stage lung cancer. Here, we evaluated its feasibility in an animal model. Nevertheless, its safety and effectiveness require further investigation in clinical trials.

Immunohistochemical Staining for Lymphatic and Blood Vessels in Normal Tissues: Comparison between Routinely Paraffin-Embedded Tissues and Frozen Sections.

In the current study, we compared the distribution of blood and lymphatic vessels from paraffin-embedded tissues with those of frozen tissues of normal human and rhesus monkey. We performed immunocytochemical staining for lymphatic and blood vessels using LYVE-1 for lymphatic vessels and von Willebrand factor (F-8) for blood vessels. Normal tissues included spleen, lymph node, liver, pancreas, salivary gland, colon, diaphragm, heart, lung, thyroid, adrenal gland, kidney, ovary, endometrium, and prostate. Splenic sinusoids were stained for LYVE-1 and F-8 in the frozen sections, supporting that the sinusoid is a lymphoreticular system and blood vessel in structure and function. In frozen sections, the lymphatic sinusoids were consistently positive for LYVE-1, while hepatic sinusoids were positive for LYVE-1, but not for F-8. Thus, lymphatic and blood vessels were more readily detected in frozen tissue sections than in the paraffin-embedded sections. In the endometrium, lymphatic vessels were not diffusely immunostained in paraffin-embedded sections. However, frozen sections detected cyclic changes of lymphatic vessels, growing from basalis to functionalis in the menstrual cycle. Lymphatic vessels were immunostained in many organs using frozen sections. Small pulmonary blood vessels were not immunostained by F-8 in the periphery of the bronchial vessel tree most likely these smallest blood vessels were not immunostained due to less F-8 attached to their endothelia. The present findings illustrate the differences in the immunostaining of blood vessels in sections obtained from paraffin-embedded tissues and those from frozen tissue. These new findings may be relevant for the basic histology and histopathology of lymphatic and blood vessels.

The Heart, Bronchi, and Bronchial Vessels.

The Heart, Bronchi, and Bronchial Vessels.

Commentary on The Heart, Bronchi, and Bronchial Vessels.

Commentary on The Heart, Bronchi, and Bronchial Vessels.

Motion Reduction for C-Arm Computed Tomography of the Pulmonary Arteries: Image Quality of a Motion Correction Algorithm in Patients with Chronic Thromboembolic Hypertension During Balloon Pulmonary Angioplasty.

To evaluate the feasibility and image quality of a motion correction algorithm for supra-selective C-arm computed tomography (CACT) of the pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA). CACT raw data acquired during 30consecutive BPAs were used for image reconstruction using either standard (CACTorg) or a motion correction algorithm (CACTmc), using 400 iterations. Two readers independently evaluated 188 segmental and 564 sub-segmental contrast-enhanced pulmonary arteries in each reconstruction. The following categories were assessed: Sharpness of the vessel, motion artifacts, delineation of bronchial structures, vessel geometry, and visibility of treatable lesions. The mentioned criteria were rated from grade 1 to grade 3: grade 1: excellent quality; grade 2: good quality; grade 3: poor/seriously impaired quality. Inter-observer agreement was calculated using Cohen's Kappa. Due to an excellent agreement, the ratings of both readers were merged. Differences in the assessed image quality criteria were evaluated using pairwise Wilcoxon signed-rank test. Inter-observer agreement was excellent for all evaluated image quality criteria (κ > 0.81). For all assessed image quality criteria, the ratings on CACTorg were good but improved significantly for CACTmc to excellent for the whole vascular tree (p < 0.01). When considering segmental and sub-segmental levels individually, all image quality criteria improved significantly for CACTmc on both levels (p < 0.01). While ratings of CACTmc were constant for both levels (segmental and sub-segmental) for all criteria, the ratings of CACTorg were slightly impaired for the sub-segmental arteries. Motion correction for supra-selective contrast-enhanced CACT of the pulmonary arteries is feasible and improves the overall image quality. · Motion artifacts can severely impair the diagnostic accuracy of CACT.. · A motion correction algorithm can significantly improve image quality in CACT of the pulmonary arteries.. · Especially the overall image quality of sub-segmental branches is significantly improved.. · Maschke S, Werncke T, Becker LS et al. Motion Reduction for C-Arm Computed Tomography of the Pulmonary Arteries: Image Quality of a Motion Correction Algorithm in Patients with Chronic Thromboembolic Hypertension During Balloon Pulmonary Angioplasty. Fortschr Röntgenstr 2021; 193: 1074 - 1080.

A Study on the Authenticity of Preoperative Pulmonary Bronchial Angiography by DeepInsight Software

背景与目的精准肺段切除术已成为肺结节及早期肺癌外科治疗的首要选择，而其手术重点及难点则在于对病灶的精准定位与切除。DeepInsight为我中心与东软公司共同研发的精准肺部手术辅助软件，可术前明确肺部精确解剖，定位肺部病灶位置，此次研究即为验证DeepInsight肺部支气管血管成像辅助手术的真实性及可靠性。方法本研究共纳入了2016年8月1日-2019年12月31日江苏省人民医院胸外科收治的1, 020例预行手术治疗患者，所有入组患者肺部结节直径 < 2.0 cm，术前均行肺结节计算机断层血管造影（computed tomographic angiography, CTA）检查，使用DeepInsight软件术前进行术侧肺部支气管血管成像，识别受累肺段、肺动脉及肺静脉，2位胸外科医师采用5分法独立评估受累肺血管的可视性情况，χ2检验评估观察者间的一致性。此外，术侧肺部血管虚拟成像及真实解剖对比，由2名胸外科主任医师最终决定受累肺血管情况。结果1, 020例患者术前运用DeepInsight软件术侧肺部虚拟成像血管与术中受累血管的数量及空间解剖关系之间的差异无明显统计学意义，观察者间的一致性均相当满意。结论Dee术中进行pInsight软件肺部支气管血管虚拟成像可精准具化肺部真实血管情况，辅助肺段切除术的完成。

High-Resolution CT Findings of Leukemia Pulmonary Infiltration and Chemotherapy Outcome and In Vitro Study of Human Lung Tissue

In order to explore the high-resolution CT findings of leukemia pulmonary infiltration and chemotherapy outcomes and the in vitro study of human lung tissue, this paper selected a total of 120 clinically or surgically confirmed leukemia patients at the designated hospital of the study from December 2014 to December 2018, and divided them into three groups according to the random number table method: pulmonary infiltration group, chemotherapy outcome group and in vitro study group, with 40 cases in each group. The CT imaging features of the three groups of patients were observed and summarized respectively; the anomalous evaluation indexes of pulmonary parenchyma tissue abnormalities included CT halo sign, air crescent sign, lung segment consolidation, bronchial vascular bundle and nodules; the CT abnormalities such as thickening of the interlobular septum, bronchial interstitial thickening, nodular shadow, ground glassy change, and air cavity consolidation were selected as observation indicators. The results show that all cases have multiple solid nodules or multiple plaques, varying in number, size and distribution, in which 13 cases have multiple patchy shadows, 9 cases have multiple knots and 11 cases have multiple plaques and nodules; lesions are mainly distributed along the bronchial vessels in 21 cases, and 9 cases are along the center of the small leaves and 5 cases are randomly distributed; there are 13 cases that have frosted glass, in which 4 cases with pleural effusion, 9 cases with mold infection, show multiple patchy shadows with halo signs and layered mold balls. In summary, leukemia pulmonary infiltration has polymorphic high-resolution CT findings and chemotherapy outcomes; high-resolution CT imaging and in vitro studies of human lung tissue have important clinical and pathological research value for leukemia infiltration and chemotherapy outcome. The results of this study provide a reference for the further researches on high-resolution CT findings of pulmonary infiltration and chemotherapy outcomes and in vitro studies of human lung tissue.

A REVIEW ON COMPREHENSIVE UNDERSTANDING OF APASTAMBHA MARMA AND ITS CLINICAL SIGNIFICANCE

The word Marma denotes the vital spots of the body. Marma Shareera is widely discussed in Ayurveda. The structural entity of these spots is not clearly explained in the classical texts so we cannot rule out the exact structural components involved. Apastambha Marma is one among 107 Marma explained in Classical textbooks. According to Sushruta, it is classified under Sira variety and it is an Urogata Kalantara Pranahara Marma. But Vagbhata has mentioned it as a type of Dhamani Marma on the basis of its structural entity. It measures about 1/2 Angula Pramana. Acharya Sushruta mentions its location as Uras, bilaterally where two Vatavaha Sira (tubular structures carrying air) are seen. Vagbhata says that it is situated in the Uras on both sides of the Parshwa. The Viddha Lakshana of this Marma as per Sushruta is Vatapoornakoshtataya, Kasa, Shwasa and Marana. However, there is a difference of opinion with Vagbhata; he has explained Raktena Poornakoshta instead of Vatapoornakoshtataya. Result: The marked area for the Apastambha Marma is at the level of 3rd costal cartilage on both the sides of the chest just lateral to the midline. As the measurement in Angula (1 cm) is not apparent so it is taken as the lengthwise, breadth wise and depth-wise. Conclusion: The area of about 2 cm lateral to carina which is the common site of injury in the bronchus can be taken as the site of Apastambha Marma as rupture of the bronchus leads to pneumothorax and the individual will show symptoms of breathing difficulty such as Kasa, Shwasa and in severe cases it may lead to the death. This explanation holds true for the Viddha Lakshana mentioned by Sushruta. Taking Shonitapoornakoshta this into consideration, pulmonary and bronchial vessels can be taken as the structures involved in Apastambha Marma which also holds good for the explanation of structural composition as per Vagbhata also i.e., it is a Dhamani Marma. Thus, we can conclude that the two Principal Bronchus along with the pulmonary vessels and bronchial vessels should be considered as the site of Apastambha Marma.

Small airway remodeling in a sheep model of bleomycin-induced pulmonary fibrosis

Background Although IPF is described traditionally as a disease affecting lung parenchyma, there is renewed interest in the alterations in the structure and function of the small airways in both IPF patients, and animal models of pulmonary fibrosis. Small airway remodeling may contribute to the pathophysiology of pulmonary fibrosis. Given the dearth of knowledge of small airway changes in pulmonary fibrosis, this study aims to assess the structural remodeling, as well as functional changes associated with bleomycin-injured small airways in a sheep model of pulmonary fibrosis. Materials and Methods Two separate lung segments in ten sheep received two challenges of either 3 IU bleomycin, or saline (control), two weeks apart. The animals were euthanized seven weeks after the final bleomycin injury. Airflow resistance in the infused segments was measured with a wedged-bronchoscope procedure. This parameter was measured at baseline before bleomycin/saline-infusion, and at 2-, 4-, and 7-weeks after the final bleomycin-infusion. Inflammation and fibrosis in the airways were assessed by semi-quantitative morphological parameters. The density of blood vessels in the small airway walls was assessed in lung tissue sections immuno-stained with antibodies against collagen type IV. Results There were a number of changes in the distal airways of bleomycin-infused lung segments. Bleomycin exposure significantly elevated airway resistance in these lung segments when compared to saline-infused control lung segments. In the peribronchial and peribronchiolar regions of the small airways, there were significantly increased levels of inflammation, fibrosis, airway wall area, and collagen deposition in bleomycin-infused airways when compared to saline-infused airways. Bronchial blood vessel density was not significantly different between bleomycin-and saline-infused lung segments. Conclusions In summary, our results indicate that the distal airways are involved in the pathology induced by bleomycin in this sheep model. This suggests that the sheep model may be useful for studying small airway remodeling in pulmonary fibrosis.

CT imaging features and image evolution characteristics of coronavirus disease 2019.

To analyze the imaging features of coronavirus disease 2019 (COVID-19) in different periods, and summarize the characteristics with itsdevelopment. We retrospectively analyzed the CT image data of COVID-19 patients diagnosed by nucleic acid test and CT examination in 57 patients in Zhuzhou Central Hospital and Zhuzhou First People's Hospital, and summarized the characteristics of CT imaging and the development of lesions. Most of the cases were characterized by peripheral distribution of lesions. A total of 37 cases (64.91%) were purely peripherally distributed, 16 cases (28.07%) coexisted with peripheral and mid-internal distribution, and 4 cases (7.02%) had simple mid-inner band distribution. In peripherally distributed cases, the long axis of the lesion was mostly parallel to the pleura in 36 cases (63.16%). In the case of inner-middle zone distribution, the long axis of the lesion was mostly parallel and surrounded the bronchial vascular bundle, or distributed along the lung lobules (31.58%). All cases had ground-glass-density foci, 31 cases (54.38%) had fine grid shadows in the lesions, 46 cases (80.70%) had thick vascular shadows in the lesions, and 23 cases (40.35%) showed signs of bronchial inflation. Among the 10 cases of "wrinkling shape" lesions in the first CT examination, except for 1 case without reexamination, the remaining 9 cases had different degrees of absorption in the second CT examination. Among the 26 cases of "wrinkling shape" lesions in the second CT examination, except for 11 cases without reexamination, the other 15 patients had different degrees of absorption in the third CT examination. The early CT manifestations of COVID-19 are mostly ground-glass-density foci distributed in the subpleural region, some of which are distributed near the bronchial blood vessel bundle and in the central area of the lobule. As the course of the disease progresses, there may be varying degrees of solid components in the lesion. When the lesions show a "wrinkling shape", it is often suggested that the lesions will evolve towards the direction of absorption. These characteristics are of great value in assisting clinical diagnosis and dynamically observing changes undersuch condition.

Lung Segmentation and Iterative Weighted Averaging Smoothing Technique on Chest Ct Images

Computed Tomography (CT) is one of the most commonly used imaging modalities for tumour detection and diagnosis, due to its high spatial resolution, fast imaging speed and wide availability. Nodules of the lungs and pathological residues with varied diameter can be comfortably viewed by computed tomography and can be categorized as benign or malignant. The key intention of this segmentation and smoothing is to develop an efficient methodology for an automated lung tumour diagnosis. Segmentation is the quantitative pre- processing step used in the chest CT analysis. The iterative weighted averaging technique is used in addressing the issues related to the segmentation and smoothing method employed in this paper. The methodology incorporates the accurate Lung Segmentation, enclosure of Juxtapleural nodules, the proper insertion of the bronchial vessels for enhancing the smoothness of the segmented Lung area. The steps involved in this paper include Image preprocessing by nonlinear anisotropic diffusion filtering, Thorax Extraction, Lung segmentation and iterative weighted averaging technique for smoothing the contours. The main feature in choosing the nonlinear anisotropic diffusion filtering is for properly preserving the regions unaffected with cancer and also to differentiate the artefacts involved due to the subject movements. In the fuzzy c- means clustering algorithm, the lung parenchyma is identified from the thorax region based on the fuzzy membership value and the affected regions are attached. The standard execution time for segmentation process of one dataset is 1.91s, it is the more rapid process than the manual segmentation.

Postoperative Haemothorax Following Thoracic Surgery

Postoperative haemothorax following thoracic surgery is a rare complication, but associated with a high mortality. In the literature, this complication occurs in 0.6 to 4.6% of patients and with a mortality of 5.1 to 17.8%. In minor cases, chest tube placement, application of fresh frozen plasma (FFP) or transfusion can be sufficient to control the situation. In severe cases, re-thoracotomy is mandatory. The most frequent origin of bleeding is a bronchial or intercostal vessel (21 and 16%) or the area of pleural adhesions that were separated (10.5%). The pulmonal artery or vein were the origin of bleeding in 16% of cases while in most cases (37%) active bleeding could no longer be detected. A positive effect on postoperative outcome is observed after an early reoperation.

Three-Dimensional Quantitative Co-Mapping of Pulmonary Morphology and Nanoparticle Distribution with Cellular Resolution in Nondissected Murine Lungs.

Deciphering biodistribution, biokinetics, and biological effects of nanoparticles (NPs) in entire organs with cellular resolution remains largely elusive due to the lack of effective imaging tools. Here, light sheet fluorescence microscopy in combination with optical tissue clearing was validated for concomitant three-dimensional mapping of lung morphology and NP biodistribution with cellular resolution in nondissected ex vivo murine lungs. Tissue autofluorescence allowed for label-free, quantitative morphometry of the entire bronchial tree, acinar structure, and blood vessels. Co-registration of fluorescent NPs with lung morphology revealed significant differences in pulmonary NP distribution depending on the means of application (intratracheal instillation and ventilator-assisted aerosol inhalation under anesthetized conditions). Inhalation exhibited a more homogeneous NP distribution in conducting airways and acini indicated by a central-to-peripheral (C/P) NP deposition ratio of unity (0.98 ± 0.13) as compared to a 2-fold enhanced central deposition (C/P = 1.98 ± 0.37) for instillation. After inhalation most NPs were observed in the proximal part of the acini as predicted by computational fluid dynamics simulations. At cellular resolution patchy NP deposition was visualized in bronchioles and acini, but more pronounced for instillation. Excellent linearity of the fluorescence intensity-dose response curve allowed for accurate NP dosimetry and revealed ca. 5% of the inhaled aerosol was deposited in the lungs. This single-modality imaging technique allows for quantitative co-registration of tissue architecture and NP biodistribution, which could accelerate elucidation of NP biokinetics and bioactivity within intact tissues, facilitating both nanotoxicology studies and the development of nanomedicines.

Primary pulmonary sarcoma - treatment outcomes depending on the different types of radical operation.

IntroductionPrimary pulmonary sarcomas (PPS) are rare types of non-epithelial malignant tumors of the lungs (0.013–1.1% of all malignant lung tumors). The PPS can originate from mesenchymal elements of the bronchial wall, vessels or pulmonary stroma. Since the introduction of immunohistochemical and molecular diagnosis, a significant improvement in description and classification of sarcomas has been achieved. Nonetheless, sarcomas still remain a diagnostic and clinical problem.AimTo estimate factors which could have an influence on the overall survival (OS) and progression-free survival (PFS) of different types of radical operations (R0) for PPS.Material and methodsFourteen patients who underwent surgical radical treatment between 1994 and 2009 with a final diagnosis of PPS were analyzed.ResultsA group of 14 patients, treated with R0 operations (pneumonectomies, lobectomies, non-anatomical resections), were included in the analysis. Median OS of patients undergoing R0 operations was respectively: for pneumonectomy 7 months, lobectomy 20 months, non-anatomic resections 213 months. Patients subjected to non-anatomical resections had better prognosis than the others treated radically (p < 0.05); however, this group of patients had the most local recurrences (3 patients – 50%). Statistical analysis did not show the influence of prognostic factors characteristic of PPS and soft tissue sarcoma (STS) on OS in the types of surgery performed.ConclusionsThere are no unambiguous factors affecting OS and PFS of patients who have undergone anatomical and non-anatomical resections. A large number of local recurrences in non-anatomical operations may indicate that PPS spread like lung cancer.