Number Of Lung Lobes Research Articles

Pseudomonas aeruginosa mucinous phenotypes and algUmucABD operon mutant characteristics obtained from inpatients with bronchiectasis and their correlation with acute aggravation.

Although the mechanism is unclear, Pseudomonas aeruginosa (PA) infection directly affects the frequency of acute exacerbations in patients with bronchiectasis. The aims of this article are to analyze the genetic mutation characteristics of the algUmucABD operon in PA, isolated from hospitalized patients with bronchiectasis, and to explore independent risk factors for frequent acute exacerbations of bronchiectasis. Based on the number of acute exacerbations that occurred in the past year, these patients with bronchiectasis were divided into those with frequent acute exacerbations (Group A) and those with non-frequent acute exacerbations (Group B). We identified the distribution of mucoid phenotypes (MPs) and alginate morphotypes (AMs) in PA, and classified them into I-IV categories based on their different AMs; otherwise, the gene mutation types (GMTs) of the algUmucABD operon were tested. Subsequently, the relationship between GMT, MP, and AM and the independent risk factors for frequent acute exacerbations in patients with bronchiectasis were explored. A total of 93 patients and 75 PA strains, from January 2019 to August 2023, were included in this study. The MP and AM distributions of PA were as follows: 64 strains (85.33%) of mucoid (the AMs were 38 strains of type I, 3 strains of type II, and 23 strains of type IV) and 11 strains of non-mucoid (the AM was type III only). Mucoid PA with algU, mucA, mucB, and mucD mutations accounted for 19.61%, 74.51%, 31.37%, and 50.98%, respectively. GMT was divided into the following: mucA mutations only, mucA combined with other gene mutations, other gene mutations without mucA mutations, and without gene mutations. In 91.7% of PA with type I of AM, only mucA mutations occurred, and in both separate MP and AM, the GMT differences were statistically significant. Lastly, the number of lung lobes with bronchiectasis and the number of PA with mucA mutations only were the independent risk factors for frequent acute exacerbations. The mucA mutation was primarily responsible for the mucoid of MP and type I of AM in PA, and it was also an independent risk factor for frequent exacerbations of bronchiectasis.

Analysis of blood samples from 42 patients with varying degrees of infection during the epidemic of COVID-19: a retrospective study.

Blood samples from 42 patients with coronavirus disease 2019 (COVID-19) with varying degrees of infection were examined to further explore the relationship between clinical features, immune factors and COVID-19, as well as the diagnostic and predictive values of clinical features and immune factors in severe disease progression. This study included 42 nucleic acid-positive COVID-19 patients admitted to the First Hospital of Jiaxing from January 26, 2020 to February 21, 2020, who were divided into mild-moderate group and severe group based on respiratory rate, resting oxygen saturation and alveolar oxygen partial pressure/O2 inhalation. On February 21, 2020, clinical data including sex, age, body mass index (BMI), past medical history, clinical symptoms, hematology indexes [white blood cell (WBC); neutrophil (NEUT); lymphocyte (LYM); C-reactive protein (CRP)] were collected. The chi-square test was used to compare the clinical data differences between the two groups, so as to perform comparative analysis in the context of serious disease development. There were 8 cases of severe disease, and 34 cases of mild and moderate symptoms. Comparative analysis showed that patients with advanced age (≥60 years, OR =5.800, P=0.0286), history of hypertension (OR =5.800, P=0.0286) and pulmonary lobe lesions (≥4, OR =6.273, P=0.0270) were more likely to develop serious diseases. In addition, according to clinical symptoms, chest pain was more prominent in patients with severe disease. Laboratory tests showed that levels of WBC (severe 4.96±1.76 vs. mild-moderate 5.45±2.01, P=0.5300), NEUT (severe 3.56±1.44 vs. mild-moderate 3.94±1.87, P=0.5945) and LYM (severe 0.91±0.25 vs. mild-moderate 1.11±0.51, P=0.2903) were normal or decreased, but CRP level (severe 31.03±9.38 vs. mild-moderate 12.53±15.73, P=0.0029) was obviously increased, especially in patients with severe disease, with statistically significant difference between groups. Patients with hypertension and advanced age are more likely to develop deteriorate with COVID-19, and the number of lung lobes with lesions and chest pain may indicate disease progression. Notably, CRP level is significantly elevated in severe disease and it may be closely related to COVID-19 progression.

Clinical characteristics and laboratory indicator analysis of 67 COVID-19 pneumonia patients in Suzhou, China

BackgroundSudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking.MethodsA retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People’s Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed.ResultsThe study found that fibrinogen (FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100 and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P < 0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19.ConclusionsBased on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.

Comparison of four ventilatory protocols for computed tomography of the thorax in healthy cats

To identify ventilatory protocols that yielded good image quality for thoracic CT and hemodynamic stability in cats. Animals-7 healthy cats. Cats were anesthetized and ventilated via 4 randomized protocols (hyperventilation, 20 seconds [protocol 1]; single deep inspiration, positive inspiratory pressure of 15 cm H(2)O [protocol 2]; recruitment maneuver [protocol 3]; and hyperventilation, 20 seconds with a positive end-expiratory pressure of 5 cm H(2)O [protocol 4]). Thoracic CT was performed for each protocol; images were acquired during apnea for protocols 1 and 3 and during positive airway pressure for protocols 2 and 4. Heart rate; systolic, mean, and diastolic arterial blood pressures; blood gas values; end-tidal isoflurane concentration; rectal temperature; and measures of atelectasis, total lung volume (TLV), and lung density were determined before and after each protocol. None of the protocols eliminated atelectasis; the number of lung lobes with atelectasis was significantly greater during protocol 1 than during the other protocols. Lung density and TLV differed significantly among protocols, except between protocols 1 and 3. Protocol 2 TLV exceeded reference values. Arterial blood pressure after each protocol was lower than before the protocols. Mean and diastolic arterial blood pressure were higher after protocol 3 and diastolic arterial blood pressure was higher after protocol 4 than after protocol 2. Standardization of ventilatory protocols may minimize effects on thoracic CT images and hemodynamic variables. Although atelectasis was still present, ventilatory protocols 3 and 4 provided the best compromise between image quality and hemodynamic stability.

Pulmonary Embolism Detection with Dual-Energy CT: Experimental Study of Dual-Source CT in Rabbits

To evaluate feasibility and added value of dual-energy computed tomography (CT) in diagnosis of pulmonary embolism (PE). This institutional animal experimental committee-approved study was performed in accordance with animal care guidelines. Eight New Zealand rabbits underwent standard unenhanced and contrast material-enhanced dual-source CT. Gelatin sponge particles were injected into the pulmonary artery, and rabbits underwent contrast-enhanced dual-source CT pulmonary angiography, from which blood-flow (BF) and fusion images were created. Immediately after dual-source CT, rabbits were sacrificed, their lungs were removed and fixed in 10% formalin, and detailed pathologic determination of location and number of lung lobes with PE was performed. Two rabbits were excluded: One died during the procedure. In the other, the catheter tip was retained in the left inferior pulmonary artery. This caused marked postembolization CT image artifacts in adjacent regions. Six rabbits were included in final analysis. Two radiologists without knowledge of pathologic results evaluated five pulmonary lobes in each rabbit and recorded whether PE was present. Pathologic results served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the techniques were calculated. Weighted kappa values were calculated to evaluate agreement between modalities. Pathologic analysis revealed PE in 18 of 30 pulmonary lobes. Conventional CT angiography was used to correctly identify PE in 12 lobes and absence of emboli in 18 lobes, which corresponded to sensitivity, specificity, PPV, and NPV of 67%, 100%, 100%, and 67%, respectively. A kappa value of 0.65 indicated good correlation with pathologic findings. On BF images, segments with an embolic region showed low perfusion compared with segments with a normal pulmonary region. BF images and fused images correctly showed PE in 16 of 18 pulmonary lobes and absence of emboli in 11 of 12 lobes, which corresponded to sensitivity, specificity, PPV, and NPV of 89%, 92%, 94%, and 85%, respectively, in detection of PE. A kappa value of 0.80 indicated good correlation with pathologic findings. Dual-source CT can depict normal and abnormal blood perfusion distribution in a rabbit's lung. Abnormal pulmonary blood distribution, as shown at dual-source CT, improves detection of acute PE in rabbits.

Late Respiratory Complications of Mustard Gas Poisoning in Iranian Veterans

Mustard gas or sulfur mustard (SM) is an alkylating chemical warfare agent that was widely used during the World War I and in the Iran-Iraq conflict. We aimed to study late toxic effects of SM on the respiratory system of severely intoxicated Iranian veterans. Respiratory examination, spirometry, arterial blood gas (ABG) analysis, and high resolution computed tomograpghy (HRCT) of the chest were performed on all severely SM-poisoned veterans in the province of Khorasan, Iran. HRCT abnormalities were classified into four grades based on the number of lung lobes involved. ABG and spirometric results were compared with each other, as well as, with the severity grades of HRCT abnormalities, using Spearman's rank correlation test. Forty male subjects with confirmed SM poisoning 16 to 20 years ago, were studied. Main respiratory complications were diagnosed as chronic obstructive pulmonary disease (COPD) (35%), bronchiectasis (32.5%), asthma (25%), large airway narrowing (15%), pulmonary fibrosis (7.5%), and simple chronic bronchitis (5%) patients. While there was a significant correlation (p<0.05) between ABG and spirometric results, the severity grades of HRCT abnormalities revealed a significant correlation (p<0.05) only with PaO2. We concluded that SM-induced respiratory complications tend to progress over the years. While spirometry is a valuable diagnostic tool for evaluation of pulmonary impairment during regular follow-ups, ABG and HRCT are more objective and should be more considered for evaluation of the severity and for diagnosis of the respiratory complications.