Chest X-ray Classification Research Articles

The correlation between the chest X-ray classifications and the pathogens of hand–foot–mouth disease

ObjectiveTo study the correlation between the chest X-ray classifications and different pathogens in patients with hand–foot–mouth disease. MethodsThe images and the results of laboratory examination of patients with HFMD and positive chest X-ray were analyzed retrospectively. ResultsThere were 83 cases (21.013%) with positive chest X-ray in this group, including 19 cases of type 1, 19 cases of type 2, 28 cases of type 3, 13 cases of type 4, 4 cases of type 5. The distribution of pathogens had significantly statistical difference between mild and severe HFMD group, critical HFMD group respectively (mild HFMD group VS severe HFMD group, χ2 = 78.523, P = 0.000; mild HFMD group VS critical HFMD group, χ2 = 30.222, P = 0.000). The distribution of pathogens in different the chest X-ray classifications had no statistical difference (P > 0.05), but the proportion of the EV71 was more than that of CVA16 in type 1and 2 chest X-ray (P = 0.029 and 0.001). ConclusionsThere was some relativity between clinical grade and pathogens. The severe and critical HFMD were caused mainly by EV71, and the mild HFMD was caused mainly by other pathogens except EV71. There was no significant correlation between chest X-ray classification and pathogens, but in the same chest X-ray classification, the distribution of pathogens was not identical. For the limitations of this study, we will do more research in the future work.

A study on far-advanced cavitary pulmonary tuberculosis cases

In cases with far-advanced cavitary pulmonary tuberculosis, the most serious lesions according to the chest X-ray classification by the Japanese Society of Tuberculosis (b I 3), their prognosis is believed to be poor due to their emaciated general conditions, and a retrospective clinical study was made on these cases admitted to our hospital. The subjects consisted of 95 cases, and among them 87 were male and 8 were female, and their mean age was 49.5 +/- 13.0 years. Eighty four cases were detected by symptomatic visits to clinics, 10 cases during their treatment for other diseases, and 1 case was discovered accidentally. Sputum examination for acid fast bacilli was all smear positive. As to their social background, the majority were occupied by socially vulnerable groups; 31 cases (32.6%) were jobless on admission, 24 cases (25.3%) were day laborers, and 25 cases (26.3%) were receiving poor relief. Regarding their general condition on admission, 40 cases were very serious and they could not stand by themselves, and their nutritional conditions were poor, and 19 cases (20%) died during hospitalization. All of them were male, and they were found by symptomatic visit to clinics. The period from hospital admission to death was short, the average was 35.0 +/- 39.8 days, and the median was 11.0 days. Among 84 patients detected by symptomatic visit, the patient's delay was 5.5 +/- 5.0 months, while the doctor's delay was 0.3 +/- 0.9 months. Major cause of late detection at advanced stage of these cases was patient's delay which caused poor prognosis of these cases, and various measures to shorten the delay in case-detection must be taken.

A study of chest X-ray classification of farmer's lung--correlation between X-ray pattern and background factors

Patients with farmer's lung were classified into five groups according to their chest X-ray pattern, and the background of each group was studied with respect to stage, severity, and prognosis. Type I group, which has fine nodular shadows on chest X-ray, showed a significantly high percentage of lymphocytes in BAL cells (p less than 0.01). Type V group, which has irregular patchy shadows on chest X-ray, showed increased peripheral WBC counts, increased CRP score, and decreased PaO2 compared to the other groups. Type II, III, and IV groups, which are characterized by combined X-ray patterns such as nodular shadows, ring-like shadows, and irregular pulmonary markings, had no specific background features according to our study. Our results suggest that type I and type V groups are likely to represent acute phase and severe phase, respectively. We could not identify any significant factors indicative of chronic disease in terms of restrictive and diffusion impairment of pulmonary function tests and pathologic findings obtained by TBLB. The chest X-ray classification we proposed is useful for the diagnosis of the acute and severe stages of farmer's lung.

An epidemiological study of talc-related respiratory morbidity among employees of a rubber industry in Shiraz-Iran

The main purpose of this study was to assess and characterize the pulmonary reactions associated with occupational exposure to talc dust. Ninety-seven talc workers and 110 unexposed employees as the reference group were randomly selected from a local rubber industry. Standardized respiratory questionnaires were administered to the subjects, they underwent chest X-ray and were examined by a specialist for any possible respiratory abnormality to be diagnosed. Furthermore, pulmonary function tests (PFTs) were measured just before and after the work shift. Moreover, to assess the extent to which workers had been exposed to talc dust, using standard methods, inhalable and respirable dust concentrations were measured in different dusty worksites. The average (mean +/- SD) age (years), weight (kg), height (cm) and duration of exposure to talc dust (years) for the exposed group were 35.8 +/- 6.75, 73.1 +/- 9.2, 172.3 +/- 5.9 and 11.79 +/- 5.3, respectively. The corresponding values for the non-exposed group were 36.1 +/- 6.87, 73.36 +/- 8.1, 173.2 +/- 5.7 and 0 +/- 0, respectively. Atmospheric concentrations of inhalable and respirable talc dust were estimated to be 41.8 +/- 23.52 and 19.8 +/- 8.04 mg/m(3) (mean +/- SD), respectively. Talc exposed subjects had a significantly higher prevalence of respiratory symptoms. Similarly, PFTs revealed that exposure to this lubricating agent was associated with significant decreases in the mean percentage predicted of vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)). Likewise, there was a general tendency for VC, FVC and FEV(1) to decrease as estimated cumulative exposure (years worked) increased. Moreover, there was an acute reduction in some parameters of pulmonary function such as VC, FVC and FEV(1), over the work shift. Chest radiographs of exposed workers showed that pneumoconiosis profusions were between p 0/0 and p 2/1 according to the ILO 1980 chest X-ray classification. These results that are in full agreement with our preliminary observations, support the notion that occupational inhalation exposure to talc is associated with both acute and chronic respiratory disorders and induces bronchitis and interstitial lung disease.

Presence and HRCT quantification of bronchiectasis in coal workers

Purpose: The purpose of this study was to evaluate the presence of bronchiectasis in coal workers with or without coal worker pneumoconiosis (CWP) and to assess the extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high resolution computed tomography (HRCT). Materials and methods: The retrospective study consisted of HRCT archieves of 93 coal workers. The coal workers with previous diagnosis of COPD (six), asthma (one) and tuberculosis (three) were excluded. Five coal workers with progressive massive fibrosis were not included into the study. The resulting patient group consisted of 78 patients (43 CWP; 35 non-CWP). Pneumoconiosis profusions of CWP workers were between p0/1 and p2/2 according to ILO 1980 chest X-ray classification. HRCT examinations of all subjects were evaluated for the presence, extent, dilatation and thickness of bronchiectasis. Analysis of extent, dilatation and thickness were performed according to established criteria. Results: The diagnosis of bronchiectasis was put on 19 of 43 CWP (44.1%) and 7 of 35 non-CWP workers (20.0%). There were statistically significant differences between bronchiectasis positive and negative coal workers with CWP concerning age and exposure duration ( P = 0.012 and 0.009, respectively). Then, multiple logistic regression analysis was performed to define exact risk factors. Exposure duration was only found to be related with presence of bronchiectasis [(odds ratio) OR = 1.494, 95% confidence interval 1.168–1.912]. Conclusions: The data from the present study shows that bronchiectasis is frequent and severe in CWP workers than without. Bronchiectasis is influenced by coal dust exposure. Thus, coal dust protection measures must be controlled efficiently to prevent bronchiectasis in coal workers.

Antioxidant response at early stages and low grades of simple coal worker's pneumoconiosis diagnosed by high resolution computed tomography

In miners exposed to coal dusts, coal worker's pneumoconiosis (CWP) can occur. The purpose of the present study is to better understand the relations between coal dust exposure and activities of blood plasma antioxidant enzymes, namely, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and lipid peroxidation end product malondialdehyde (MDA) concentration in coal workers with early and low grade simple CWP diagnosed by high resolution computed tomography (HRCT). Forty-three coal workers who had profusions of 0/1-2/2 according to ILO 1980 chest X-ray (CXR) classification, 43 coal workers without CWP (control group 1) and 44 healthy subjects (control group 2) who were randomly selected from the population register or recruited from the hospital staff were enrolled. Coal workers were reevaluated by HRCT (Hosoda-Shida classification) due to its higher sensitivity than standard CXR. Then, blood plasma SOD and GSH-Px activities and MDA plasma levels were measured. CWP was found positive in 46 of 89 coal workers by HRCT evaluation. Profusion 0 (P0, CWP not present), profusion 1 (P1, early CWP) and profusion 2 (P2, low grade CWP) were found in 43, 23 and 19 of patients found to have CWP by HRCT, respectively. We had no worker with profusion 3 (P3). Complicated CWP was shown in four of 46 patients and thesecases were excluded as the study was restricted to early and low-grade pneumoconiosis. In respect to the plasma levels of MDA and plasma activities of SOD and GSH-Px, statistically significant differences were found between CWP cases and control groups (p < 0.01, p < 0.01, p < 0.001 respectively). Statistical differences were also obtained for the plasma activities of SOD and GSH-Px and levels of MDA in relation to HRCT profusions (p < 0.05). In conclusion, these findings suggest an oxidative stress due to increased free radicals and reactive oxygen metabolite production in early stages and low grades of simple CWP diagnosed by HRCT.