Management Of Emphysema Research Articles

AUTOMATED CLASSIFICATION OF EMPHYSEMA USING CONVOLUTIONAL NEURAL NETWORKS

The analysis of CT scans for emphysema diagnosis can be formulated as a computer vision problem, where predefined patterns are used to automatically classify the images. This paper investigates a method for classifying emphysema subtypes in High-Resolution Computed Tomography (HRCT) scans using convolutional neural networks (CNNs). This classification is crucial for accurate diagnosis and management of emphysema, a chronic lung disease causing shortness of breath. Our approach leverages transfer learning to extract informative features from HRCT images labeled as centrilobular (CLE), paraseptal (PLE), panlobular (PSE), and non-emphysematous (NT). We evaluate various CNN architectures, with InceptionV3 demonstrating exceptional performance, achieving an accuracy of 98% while effectively distinguishing between all subtypes. The trained InceptionV3 model is then integrated into a user-friendly front-end application developed using Streamlit and ngrok. This application allows real-time emphysema classification from HRCT scans, potentially aiding clinicians in diagnosis and treatment decisions. Keywords:- Emphysema classification ,Transfer Learning,CNN,InceptionV3,Streamlit , Ngrok

Endobronchial valves for emphysema and persistent air-leak: 10-year experience in an Asian country

BackgroundEndobronchial valve (EBV) therapy, a validated method for bronchoscopic lung volume reduction (BLVR) in severe emphysema, has been explored for persistent air-leak (PAL) management. However, its effectiveness and safety in the Asian population require further real-world evaluation. In this study, we assessed the outcomes of treatment with EBV within this demographic.MethodsWe conducted a retrospective analysis of medical records from 11 Korean centers. For the emphysema cohort, inclusion criteria were patients diagnosed with emphysema who underwent bronchoscopy intended for BLVR. We assessed these patients for clinical outcomes of chronic obstructive pulmonary disease. All patients with PAL who underwent treatment with EBV were included. We identified the underlying causes of PAL and evaluated clinical outcomes after the procedure.ResultsThe severe emphysema cohort comprised 192 patients with an average age of 70.3 years, and 95.8% of them were men. Ultimately, 137 underwent treatment with EBV. Three months after the procedure, the BLVR group demonstrated a significant improvement in forced expiratory volume in 1 s (+160 mL vs. +30 mL; P = 0.009). Radiographic evidence of lung volume reduction 6 months after BLVR was significantly associated with improved survival (adjusted hazard ratio 0.020; 95% confidence interval 0.038–0.650; P = 0.010). Although pneumothorax was more common in the BLVR group (18.9% vs. 3.8%; P = 0.018), death was higher in the no-BLVR group (38.5% vs. 54.5%, P = 0.001), whereas other adverse events were comparable between the groups. Within the subset of 18 patients with PAL, the predominant causes of air-leak included spontaneous secondary pneumothorax (44.0%), parapneumonic effusion/empyema (22.2%), and post-lung resection surgery (16.7%). Following the treatment, the majority (77.8%) successfully had their chest tubes removed. Post-procedural complications were minimal, with two incidences of hemoptysis and one of empyema, all of which were effectively managed.ConclusionsTreatment with EBV provides substantial clinical benefits in the management of emphysema and PAL in the Asian population, suggesting a favorable outcome for this therapeutic approach.

Targeted delivery of pentagalloyl glucose inhibits matrix metalloproteinase activity and preserves elastin in emphysematous lungs

BackgroundElastin degradation has been established as one of the driving factors of emphysema. Elastin-derived peptides (EDPs) are shown to act as a chemoattractant for monocytes. Effectively shielding elastin from elastolytic damage and regenerating lost elastin are two important steps in improving the mechanical function of damaged lungs. Pentagalloyl glucose (PGG) has been shown to preserve elastin in vascular tissues from elastolytic damage in vivo and aid in elastin deposition in vitro.MethodsWe created emphysema by elastase inhalation challenge in mice. Albumin nanoparticles loaded with PGG, conjugated with elastin antibody, were delivered to target degraded elastin in lungs. We investigated matrix metalloproteinase-12 activity and lung damage by measuring dynamic compliance and tidal volume changes.ResultsEx-vivo experiments demonstrated elastin preservation in PGG treated samples compared to controls. Inhaled nanoparticles conjugated with elastin antibody retained for extended periods in lungs. Further, mice treated with PGG nanoparticles showed a significant suppression of MMP-12 activity measured in the lungs. We observed suppression of emphysema in terms of dynamic lung compliance and tidal volume change compared to the control group. The histological examination further confirmed elastin preservation in the lungs.ConclusionThese results demonstrate successful targeted delivery of nanoparticles loaded with PGG to inhibit MMP-12 activity and preserve elastin in the lungs. Such targeted PGG therapy has potential therapeutic use in the management of emphysema.

Myths and Legends: Do Bronchial Valves Have a Role in the Management of Emphysema?

Myths and Legends: Do Bronchial Valves Have a Role in the Management of Emphysema?

Lung Volume Reduction in Chronic Obstructive Pulmonary Disease (COPD) and #8211; An Updated Review of Surgical and Endoscopic Procedures

The conventional medical management of emphysema using bronchodilators and anti-inflammatory agents has a limited benefit in patients having advanced hyperinflation of lungs due to destruction of elastic tissue. The natural course of Chronic Obstructive Pulmonary Disease (COPD) has been shown to be altered by only smoking cessation and oxygen therapy so far. The lung volume reduction surgery is viewed as another modality to change the natural history of emphysema in recent years. For patients with more generalized emphysema, resection of lung parenchyma improves elastic recoil and chest wall mechanics. An extensive literature search has demonstrated that carefully selected patients of emphysema (i.e. upper lobe predominant disease, low exercise capacity and Forced Expiratory Volume in First Second (FEV1) and DLco ≤ 20% of predicted) receive benefits in terms of symptomatic improvement and physiologic response following Lung Volume Reduction Surgery (LVRS). The resurgent interest in LVRS and National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative methods, to improve the outcome and reduce complications associated with current LVRS techniques. These novel approaches include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices & valves and endobronchial bronchial bypass approaches. Experimental data and preliminary results are becoming available for some of these approaches. Most of the published studies so far have been uncontrolled and unblinded. Overall, extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms.

Assessing the Cost of Illness of Emphysema

An extensive MEDLINE search revealed a paucity of studies assessing economic outcomes associated with managing emphysema. Consequently, we estimated the annual levels of National Health Service (NHS) resource use and corresponding costs (at 1995/96 prices), by performing a subgroup analysis of a prevalence-based burden of illness analysis that measured the annual NHS cost of managing all community-acquired lower respiratory tract infections (LRTIs) during 1992/93 in the UK. As there have been few therapeutic innovations in the management of emphysema over the last 5 years, we consider that this sub-analysis offers a robust indication of the order of magnitude of resource use and corresponding costs. To the best of our knowledge, this is the first estimate assessing the costs of emphysema.

Pathophysiology and treatment of alpha 1-antitrypsin deficiency.

The pathophysiology of alpha 1-antitrypsin (AAT) deficiency and the use of alpha 1-proteinase inhibitor therapy in the management of emphysema caused by AAT deficiency are described. AAT deficiency is the most common genetic cause of liver disease in children and emphysema in adults. However, not all patients with AAT deficiency develop hepatic or pulmonary involvement. Changes in the composition of the AAT molecule have been associated with AAT dysfunction in liver disease, whereas lung disease occurs when AAT concentrations are reduced. A definitive diagnosis can be made through serum AAT phenotype determination. Therapy for liver disease induced by AAT deficiency consists of supportive measures. Therapy for pulmonary disease due to AAT deficiency includes AAT augmentation therapy along with supportive measures. The available product, alpha 1-proteinase inhibitor, is derived from fractionated plasma and has similar biological activity to native serum AAT. Clinical trials have demonstrated a positive effect on serum and lung concentrations of AAT with few adverse events. Two recombinant forms of AAT have also been developed; however, few trials have been published evaluating their safety and efficacy in AAT-deficient patients. Many questions remain unanswered concerning AAT deficiency and replacement therapy. AAT augmentation therapy appears to reduce the progression of emphysema in some AAT-deficient patients.

Soft tissue emphysema

Many cases of soft tissue emphysema have been reported; it is recognized as a common surgical and dental complication. This report adds to the number of recorded cases and emphasizes the potential for emphysema with the use of high pressure dental instruments. It also shows that the point of entry of air may be overlooked and will therefore delay diagnosis. Proper diagnosis and recognition of the potential for widespread secondary infection dictate the management of emphysema. If any doubt should exist, consultation should be obtained without hesitation.