Lung Volume Research Articles

Pelvic floor muscle training combined with electroacupuncture for bladder dysfunction after incomplete spinal cord injury: a randomized controlled trial

To observe the efficacy of pelvic floor muscle training combined with electroacupuncture (EA) for bladder dysfunction after incomplete spinal cord injury (SCI). Ninety patients with bladder dysfunction after incomplete SCI were randomly divided into an EA group (30 cases), a pelvic floor muscle training group (30 cases, 1 case dropped out), and a combined group (30 cases, 1 case dropped out). All groups received routine rehabilitation. The EA group received EA at Zhongji (CV 3), Guanyuan (CV 4), Mingmen (GV 4), Yaoyangguan (GV 3), bilateral Shenshu (BL 23), Ciliao (BL 32), and Pangguangshu (BL 28), with continuous waves at frequency of 100 Hz, and the needles were retained for 30 min, once daily, 6 times a week for 6 weeks. The pelvic floor muscle training group underwent pelvic floor muscle training two times a day, for 6 weeks. The combined group received both EA and pelvic floor muscle training. The daily average number of urinations, daily average number of urinary leakages, urodynamic indexes (residual urine volume, maximum bladder capacity, bladder compliance, and maximum urine flow rate), and generic quality of life inventory-74 (GQOLI-74) were compared before and after treatment in each group. Compared before treatment, the daily average number of urinations and urinary leakages were decreased (P<0.05), residual urine volume, maximum bladder capacity, and bladder compliance were reduced (P<0.05), and maximum urine flow rate and GQOLI-74 scores were increased (P<0.05) after treatment in all groups. After treatment, the combined group showed greater differences in the daily average number of urinations, daily average number of urinary leakages, residual urine volume, maximum bladder capacity, bladder compliance, maximum urine flow rate, and GQOLI-74 score compared to the EA group and the pelvic floor muscle training group (P<0.05). There was no statistically significant differences in the changes in these indexes between the EA group and the pelvic floor muscle training group (P>0.05). Pelvic floor muscle training combined with EA can effectively alleviate urination problems in patients with bladder dysfunction after incomplete SCI, improve bladder function, and enhance patients' quality of life.

Long-term consequences of the functional state of the respiratory system after SARS-CoV-2-associated lung damage

Aim. To study the dynamics of respiratory system function in patients without a history of bronchopulmonary pathology after SARS-CoV-2 infection with virus-associated lung damage.Materials and methods. A retrospective study was conducted on 29 patients (median age 46 [43-51] years) at two stages: visit 1 (1-4 months) and visit 2 (8-13 months) from the onset of COVID-19. Data from spirometry, bodyplethysmography, diffusion capacity test, impulse oscillometry (IOS), and chest computed tomography (CT) obtained during the acute phase of the disease (CTmax), as well as dyspnea assessed by the mMRC scale, were analyzed.Results. The median CTmax was 75%, and 66% of patients received treatment in the intensive care unit. At visit 1, dyspnea was of mild or moderate severity. Medians of vital capacity (VC), total lung capacity (TLC), residual volume (RV), and diffusion capacity of the lungs (DLco) were reduced (&lt;80% predicted). The median forced expiratory volume in the first second (FEV1) and IOS parameters were within normal ranges. However, increased reactance area (AX) and absolute frequency dependence of resistance (R5–R20) were found in 59% and 24% of cases, respectively. At visit 2, mild dyspnea persisted. Lung volumes were within normal limits, with statistically significant differences between visits. The median DLco was reduced at visit 1 but increased to normal at visit 2, with statistically significant differences between visits. The median IOS parameters remained within normal limits, with no statistically significant differences between visits. However, in visit 1 increased AX and (R5–R20) were observed in 59% and 24%, in visit 2 – 45% and 17% of cases, respectively, with no statistically significant differences between visits.Conclusions. Among the long-term functional consequences of SARS-CoV-2 infection with virus-associated lung damage, decreased lung diffusion capacity (reduced DLco) and small airway dysfunction (increased AX and/or R5-R20) were noted in some patients. Impulse oscillometry should be included in the comprehensive functional assessment plan for patients after SARS-CoV-2 infection to diagnose small airway dysfunction.

Effects of high-fat, low-carbohydrate enteral nutrition in critically ill patients: A systematic review with meta-analysis

Background & aimsHigh-fat, low-carbohydrate enteral nutrition has gained attention, with expectations of an improved respiratory condition, fewer complications, and lower mortality. The present study performed a systematic review and meta-analysis of randomized controlled trials to examine the effects of high-fat, low-carbohydrate enteral nutrition in critically ill adult patients. MethodsWe searched MEDLINE via Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), and ICHUSHI for randomized controlled trials comparing high-fat, low-carbohydrate enteral nutrition to standard enteral nutrition in critically ill adult patients who received enteral nutrition. The primary outcome was mortality. Secondary outcomes included intensive care unit (ICU) mortality, length of ICU stay, length of mechanical ventilation, and adverse events of diarrhea and gastric residual volume. We examined the risk of bias using the Cochrane risk-of-bias tool for randomized trials version 2. We assessed the overall certainty of evidence based on the Grading of Recommendations Assessment, Development, and Evaluation methodology. Synthesis results were calculated with risk ratios and 95% confidence intervals using a Mantel-Haenszel random-effects model. ResultsEight trials with 607 patients were included. The effects of high-fat, low-carbohydrate enteral nutrition on mortality did not significantly differ from those of standard enteral nutrition (62/280 [22.1%] vs. 39/207 [18.8%], risk ratios=1.14, 95% confidence intervals 0.80 to 1.62, P=0.47). No significant differences were observed in ICU mortality, ICU length of stay, diarrhea, or gastric residual volume between the two groups. However, high-fat, low-carbohydrate enteral nutrition was associated with a significantly shorter duration of mechanical ventilation (mean difference -1.72 days, 95% confidence intervals -2.93 to -0.50, P=0.005). ConclusionHigh-fat, low-carbohydrate enteral nutrition may not affect mortality, but may decrease the duration of mechanical ventilation in critically ill adult patients. Limitations include the small number of studies and potential for bias. Further research is needed to confirm these results and investigate effects on other outcomes and in a subgroup of patients requiring mechanical ventilation.

VNOTES scarless and painless endometrial cancer staging surgery.

Sentinel lymph node dissection is performed in endometrial cancer surgery instead of staging surgery, particularly when the disease is advanced and confined to the uterus. The aim of this study is to share our sentinel lymph node detection rates via the vaginal natural orifice transluminal endoscopic surgery method with the literature and to demonstrate a safer and more comfortable surgical treatment process. The analysis includes the patients who underwent surgery sentinel lymph node dissection for endometrial cancer utilizing indociyanin green in our center between January 2022 and June 2024. In all, of 24 endometrial cancer patients underwent surgery sentinel lymph node dissection, nonendometrioid (serous) pathology was observed in only 1 (4%) patient, our other patients (96%) had endometrioid adenocarcinoma pathology. The rates of our sentinel lymph node dissection bilateral and symmetric are 96% (23/24), 94% (22/24), and 79% (19/24), respectively. We would like to emphasize that we successfully used vaginal natural orifice transluminal endoscopic surgery approach on four of our patients who were unsuitable for laparoscopic and robotic surgery due to pain scores of 2 at the 12th hour after surgery and low lung capacity. Vaginal natural orifice transluminal endoscopic surgery and sentinel lymph node dissection will be considered as surgical options in other gynecological cancers due to the comfort it brings to the patient in endometrial cancer.

The Effect of Respiratory Muscle Stretch Gymnastic (RMSG) on Lung Capacity in The Elderly

The elderly are members of society who must be paid attention to, because in the elderly there will be changes, one of which is in the respiratory system, in this case lung capacity, which is influenced by aging, environmental and lifestyle factors which can be measured with a tool called spirometry. Efforts that can be made to maintain lung function in the elderly are by providing exercise, one of which is Respiratory Muscle Stretch Gymnastics (RMSG). The aim of this research was to determine RMSG on lung capacity in the elderly at the Posyandu for the Meaningful Elderly. The research method used was Quasi Experimental with a Pretest-Posttest Control Group Design research design. The sampling technique was Purposive Random Sampling and a sample of 30 elderly people were obtained which were divided into 2 groups. Data collection was carried out using spirometry, which was then carried out by univariate and bivariate analysis tests. The research results showed that there was an effect of RMSG on the elderly with the results in the intervention group increasing the average value, while in the control group the average value decreased. The conclusion obtained based on the results of data analysis is that there is an effect of giving RMSG on lung capacity in the elderly.

Deep Learning Estimation of Small Airways Disease from Inspiratory Chest CT is Associated with FEV1 Decline in COPD.

Quantifying functional small airways disease (fSAD) requires additional expiratory computed tomography (CT) scan, limiting clinical applicability. Artificial intelligence (AI) could enable fSAD quantification from chest CT scan at total lung capacity (TLC) alone (fSADTLC). To evaluate an AI model for estimating fSADTLC and study its clinical associations in chronic obstructive pulmonary disease (COPD). We analyzed 2513 participants from the SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS). Using a subset (n = 1055), we developed a generative model to produce virtual expiratory CTs for estimating fSADTLC in the remaining 1458 SPIROMICS participants. We compared fSADTLC with dual volume, parametric response mapping fSADPRM. We investigated univariate and multivariable associations of fSADTLC with FEV1, FEV1/FVC, six-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), and FEV1 decline. The results were validated in a subset (n = 458) from COPDGene study. Multivariable models were adjusted for age, race, sex, BMI, baseline FEV1, smoking pack years, smoking status, and percent emphysema. Inspiratory fSADTLC was highly correlated with fSADPRM in SPIROMICS (Pearson's R = 0.895) and COPDGene (R = 0.897) cohorts. In SPIROMICS, fSADTLC was associated with FEV1 (L) (adj.β = -0.034, P < 0.001), FEV1/FVC (adj.β = -0.008, P < 0.001), SGRQ (adj.β = 0.243, P < 0.001), and FEV1 decline (mL / year) (adj.β = -1.156, P < 0.001). fSADTLC was also associated with FEV1 (L) (adj.β = -0.032, P < 0.001), FEV1/FVC (adj.β = -0.007, P < 0.001), SGRQ (adj.β = 0.190, P = 0.02), and FEV1 decline (mL / year) (adj.β = -0.866, P = 0.001) in COPDGene. We found fSADTLC to be more repeatable than fSADPRM with intraclass correlation of 0.99 (95% CI: 0.98, 0.99) vs. 0.83 (95% CI: 0.76, 0.88). Inspiratory fSADTLC captures small airways disease as reliably as fSADPRM and is associated with FEV1 decline.

Same-Day Repeatability and 28-Day Reproducibility of Xenon MRI Ventilation in Children With Cystic Fibrosis in a Multi-Site Trial.

MRI with xenon-129 gas (Xe MRI) can assess airflow obstruction and heterogeneity in lung diseases. Specifically, Xe MRI may represent a sensitive modality for future therapeutic trials of cystic fibrosis (CF) therapies. The reproducibility of Xe MRI has not yet been assessed in the context of a multi-site study. To determine the same-day repeatability and 28-day reproducibility of Xe MRI in children with CF. Four-center prospective, longitudinal. Thirty-eight children (18 females, 47%), median interquartile range (IQR) age 12 (9-14) years old, with mild CF (forced expiratory volume in 1 second (FEV1) ≥85% predicted). 3-T, two-dimensional (2D) gradient-echo (GRE) sequence. Xe MRI, FEV1, and nitrogen multiple-breath wash-out for lung-clearance index (LCI2.5) were performed. To assess same-day reproducibility, Xe MRI was performed twice within the first visit, and procedures were repeated at 28 days. Xe hypoventilation was quantified using ventilation-defect percentage (VDP) and reader-defect volume (RDV). For VDP, hypoventilated voxels from segmented images were identified using a threshold of <60% mean whole-lung signal and expressed as a percentage of the lung volume. For RDV, hypoventilation was identified by two trained readers and expressed as a percentage. Inter-site comparisons were conducted using Kruskal-Wallis nonparametric tests with Dunn's multiple-comparisons tests. Differences for individuals were assessed using Wilcoxon matched-pairs tests. Bland-Altman tests were used to evaluate same-day repeatability, 28-day reproducibility, and inter-reader agreement. A P-value ≤0.05 was considered significant. Median FEV1 %-predicted was 96.8% (86%-106%), and median LCI2.5 was 6.6 (6.3-7.4). Xe MRI had high same-day reproducibility (mean VDP difference 0.12%, 95% limits of agreement [-3.2, 3.4]; mean RDV difference 0.42% [-2.5, 3.3]). At 28 days, 26/31 participants (84%) fell within the same-day 95% limits of agreement. Xe MRI may offer excellent same-day and short-term reproducibility. 2 TECHNICAL EFFICACY: Stage 2.

Multi-pass, single-molecule nanopore reading of long protein strands

The ability to sequence single protein molecules in their native, full-length form would enable a more comprehensive understanding of proteomic diversity. Current technologies, however, are limited in achieving this goal1,2. Here, we establish a method for the long-range, single-molecule reading of intact protein strands on a commercial nanopore sensor array. By using the ClpX unfoldase to ratchet proteins through a CsgG nanopore3,4, we provide single-molecule evidence that ClpX translocates substrates in two-residue steps. This mechanism achieves sensitivity to single amino acids on synthetic protein strands hundreds of amino acids in length, enabling the sequencing of combinations of single-amino-acid substitutions and the mapping of post-translational modifications, such as phosphorylation. To enhance classification accuracy further, we demonstrate the ability to reread individual protein molecules multiple times, and we explore the potential for highly accurate protein barcode sequencing. Furthermore, we develop a biophysical model that can simulate raw nanopore signals a priori on the basis of residue volume and charge, enhancing the interpretation of raw signal data. Finally, we apply these methods to examine full-length, folded protein domains for complete end-to-end analysis. These results provide proof of concept for a platform that has the potential to identify and characterize full-length proteoforms at single-molecule resolution.

Subclinical impairment of the left atrium is associated with MRI-based lung volume but not with parameters from pulmonary function testing

Left atrial (LA) physiology and hemodynamics are intimately connected to cardiac and lung function in health and disease. This study examined the relationship between MRI-based left atrial (LA) size and function with MRI-based lung volume and pulmonary function testing (PFT) parameters in the population-based KORA study cohort of 400 participants without overt cardiovascular disease. MRI quantification assessed LA size/function in sequences with and without ECG synchronization, alongside lung volume. Regression analysis explored the relationship of LA with MRI lung volume and PFT parameters. Among 378 participants (average age 56.3 ± 9.2 years; 42.3% women), non-gated LA size averaged 16.8 cm2, while maximal and minimal LA size from gated measurements were 19.6 cm2 and 11.9 cm2 respectively. The average MRI-derived lung volume was 4.0 L, with PFT showing a total lung capacity of 6.2 L, residual lung volume of 2.1 L, and forced vital capacity of 4.1 L. Multivariate regression analysis, adjusted for age, gender, and cardiovascular risk factors, revealed an inverse association between maximum LA size, non-gated LA, and LA area fraction with lung volume (ß = − 0.03, p = 0.006; ß = − 0.03, p = 0.021; ß = − 0.01, p = 0.012), with no significant association with PFT parameters. This suggests that MRI-based assessment may offer greater sensitivity in detecting subclinical LA impairment than PFT.

Classification methods of pulmonary contusion based on chest CT and the association with in-hospital outcomes: a systematic review of literature.

Patients sustaining pulmonary contusion (PC) have a higher risk of complications and long-term respiratory difficulty. Computed tomography (CT) scans have a high sensitivity for PC. However, since PC develops over time, CT scans made directly post-trauma may underestimate the full extent of PC. This creates a need to better define in which PC-patients complications are more likely. The aim of this systematic review was to identify different classification systems of PC, and investigate the association between amount of PC and in-hospital outcomes. A systematic review was conducted in accordance with PRISMA guidelines. Studies reporting a classification system for PC after blunt thoracic trauma based on a CT scan were included. Outcomes were classification method of PC and the relation between classification and pulmonary complications and in-hospital outcomes. Twenty studies were included. Total number of patients ranged from 49 to 148,140 patients. The most common classification system used was calculating the percentage of contused lung volume. Other classification methods were based on Blunt Pulmonary Contusion score-6 and -18, Abbreviated Injury Score and Thoracic Trauma Severity scores. Worse outcomes were generally associated with between > 18 to > 24% contusion volume. The heterogeneity of currently available literature makes comparing classification methods challenging. The most common classification of PC was based on volumetric analysis. Calculating a percentage of PC as part of the total volume allows for the highest level of segmentation of lung parenchyma as compared to using BPC-6, BPC-18, or AIS. Contusion volume exceeding 18-24% was generally associated with worse outcomes.

The effects of a blended learning model on the physical fitness of Chinese university students: a cluster randomized controlled trial in basketball education

ObjectiveThe university period is a critical stage of personal development, and improving the physical fitness of university students is crucial to their academic performance, quality of life, and future. However, in recent years, the physical fitness level of Chinese university students has shown a decreasing trend. This study aimed to investigate the effects of a blended learning model on the physical fitness of Chinese university students through a 16-week intervention.MethodsA total of 78 first-year students from a public university in Henan Province were recruited for this study via a cluster randomized controlled trial (CRCT) design. The participants were divided into an experimental group (blended learning) and a control group (traditional learning). The intervention lasted for 16 weeks, and physical fitness indices such as body mass index (BMI), lung capacity, sit and reach, pull-ups/sit-ups, standing long jumps, 50-meter runs, and 1000/800-meter runs were measured before and after the intervention. Statistical analyses were conducted via generalized estimating equation (GEE) modeling, with the significance level set at P < 0.05.ResultsBoth learning models significantly improved students’ physical fitness after 16 weeks. However, the blended learning model resulted in more significant improvements in lung capacity, sit and reach, pull-ups/sit-ups, standing long jumps, and 50-meter runs (P < 0.05). No significant differences were found between the two groups in terms of BMI or 1000/800-meter run.ConclusionsThe 16-week blended learning model effectively promoted physical fitness among university students, especially in terms of their lung capacity, flexibility, strength and speed.

Characteristics of lung resistance and elastance associated with tracheal stenosis and intrapulmonary airway narrowing in ex vivo sheep lungs

BackgroundUnderstanding the characteristics of pulmonary resistance and elastance in relation to the location of airway narrowing, e.g., tracheal stenosis vs. intrapulmonary airway obstruction, will help us understand lung function characteristics and mechanisms related to different airway diseases.MethodsIn this study, we used ex vivo sheep lungs as a model to measure lung resistance and elastance across a range of transpulmonary pressures (5–30 cmH2O) and ventilation frequencies (0.125–2 Hz). We established two tracheal stenosis models by inserting plastic tubes into the tracheas, representing mild (71.8% lumen area reduction) and severe (92.1%) obstructions. For intrapulmonary airway obstruction, we induced airway narrowing by challenging the lung with acetylcholine (ACh).ResultsWe found a pattern change in the lung resistance and apparent lung elastance as functions of ventilation frequency that depended on the transpulmonary pressure (or lung volume). At a transpulmonary pressure of 10 cmH2O, lung resistance increased with ventilation frequency in severe tracheal stenosis, whereas in ACh-induced airway narrowing the opposite occurred. Furthermore, apparent lung elastance at 10 cmH2O decreased with increasing ventilation frequency in severe tracheal stenosis whereas in ACh-induced airway narrowing the opposite occurred. Flow-volume analysis revealed that the flow amplitude was much sensitive to ventilation frequency in tracheal stenosis than it was in ACh induced airway constriction.ConclusionsResults from this study suggest that lung resistance and apparent elastance measured at 10 cmH2O over the frequency range of 0.125-2 Hz can differentiate tracheal stenosis vs. intrapulmonary airway narrowing in ex vivo sheep lungs.

Sonothrombolysis Using Microfluidically Produced Microbubbles in a Murine Model of Deep Vein Thrombosis.

The need for safe and effective methods to manage deep vein thrombosis (DVT), given the risks associated with anticoagulants and thrombolytic agents, motivated research into innovative approaches to resolve blood clots. In response to this challenge, sonothrombolysis is being explored as a technique that combines microbubbles, ultrasound, and thrombolytic agents to facilitate the aggressive dissolution of thrombi. Prior studies have indicated that relatively large microbubbles accelerate the dissolution process, either in an in vitro or an arterial model. However, sonothrombolysis using large microbubbles must be evaluated in venous thromboembolism diseases, where blood flow velocity is not comparable. In this study, the efficacy of sonothrombolysis was validated in a murine model of pre-existing DVT. During therapy, microfluidically produced microbubbles of 18 μm diameter and recombinant tissue plasminogen activator (rt-PA) were administered through a tail vein catheter for 30min, while ultrasound was applied to the abdominal region of the mice. Three-dimensional ultrasound scans were performed before and after therapy for quantification. The residual volume of the thrombi was 20% in animals post sonothrombolysis versus 52% without therapy ( ), indicating a significant reduction in DVT volume. Histological analysis of tissue sections confirmed a reduction in DVT volume post-therapy. Therefore, large microbubbles generated from a microfluidic device show promise in ultrasound-assisted therapy to address concerns related to venous thromboembolism.

Ultra-radical surgery versus standard-radical surgery for the primary cytoreduction of advanced epithelial ovarian cancer; long-term tertiary center experiences

ObjectiveTo compare overall survival (OS) and morbidity outcomes in patients with advanced epithelial ovarian/tubal/peritoneal cancer undergoing standard-radical (SR) and ultra-radical (UR) surgical procedures based on NICE classification. Study DesignThis retrospective study analyzed data from 282 patients with 2014 FIGO stage III-IV epithelial ovarian cancer operated on between January 2006 and January 2019. The study compared OS, progression-free survival (PFS), and morbidity between SR and UR surgeries. Parameters influencing OS, including preoperative, postoperative, and post-adjuvant chemotherapy CA-125 values, surgical procedures, post-surgical residual tumor, histopathological grade, and FIGO surgical stage, were assessed. ResultsOut of 282 patients, 256 met the inclusion criteria. SR surgery was performed in 48 %, and UR surgery in 52 %. The mean preoperative CA-125 value was 1200 ± 1914.83, decreasing to 240.32 ± 373.87 postoperatively. The mean follow-up period was 63.01 ± 47.56 months. UR surgery correlated with significantly higher postoperative complications (p < 0.001), histopathological grade (p = 0.023), FIGO stage (p < 0.001), three-year death rates, and overall mortality rates (p = 0.035). FIGO stage and total metastatic lymph nodes emerged as independent prognostic factors for overall and PFS. ConclusionIn the treatment of epithelial ovarian cancer, evaluating the extent of the tumor before the surgery and showing maximal effort to minimize the residual tumor volume instead of applying UR procedures as the first choice seems to be the most important factor that can affect survival.

COMPARISON OF PRE AND POST-TURP EVALUATION IN BPH PATIENTS USING IPSS AND UROFLOWMETRY IN TERTIARY HOSPITAL

Objective: To present the data about LUTS using International Prostatic Symptoms Score (IPSS) and uroflowmetry on BPH patients following TURP. Material &amp; Methods: This retrospective study reviewed patients diagnosed as BPH with LUTS undergone TURP from Dr. Saiful Anwar General Hospital medical records from January 2021 to January 2023. The basic clinical characteristics, IPSS, and uroflowmetry results were collected. Furthermore, the comparison of IPSS score and uroflowmetry prior and 7 days after surgery were analyzed. Results: From a total of 286 patients, 94 patients met the inclusion criteria. Improvement of LUTS and quality of life (QoL) obtained from IPSS were observed before and after TURP (19.13 vs 2.78, p&lt;0.001; 4.38 vs 0.33, p&lt;0.001). Similar improvement was also showed for maximum flow rate (QMax) and post-void residual (PVR) volume obtained from uroflowmetry result (7.90 vs 17.85, p&lt;0.001; 66.25 vs 27.05, p&lt;0.001) with 90.43% patients had Qmax &gt;15 ml/sec after the procedure. Conclusion: This study showed the evidence of early improvement of IPSS and uroflowmetry results in BPH patients after TURP. The indicators were sufficient to evaluate the satisfaction result of patient complaining LUTS. Keywords: BPH, IPSS, uroflowmetry, TURP.

Efficiency of HoLEP in patients with detrusor underactivity and renal dysfunction secondary to BPO

PurposeThe purpose of this study was to assess the bladder and renal functional outcomes of holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic obstruction (BPO) complicated by detrusor underactivity (DU) and secondary renal dysfunction.MethodsThirty-one patients were included in this prospective study. Eligible patients had urinary retention, a bladder outlet obstruction index (BOOI) greater than 40, a bladder contractility index (BCI) less than 100, abnormal renal function at the initial diagnosis (serum creatinine > 132 µmol/L) and a renal pelvis anteroposterior diameter (PRAPD) > 1.5 cm bilaterally. All patients underwent HoLEP in a routine manner and were evaluated preoperatively and at 1, 3 and 6 months after surgery. The baseline characteristics of the patients, perioperative data, postoperative outcomes and complications were assessed.ResultsSignificant improvement was observed in the international prostate symptom score (IPSS), quality of life (QoL) score, maximal urinary flow rate (Qmax), post-void residual volume (PVR), Scr and RPAPD at the 6-month follow-up. Bladder wall thickness (BWT) exhibited a decreasing trend but did not significantly differ from the preoperative values. No grade 3 or higher adverse events occurred, and grade 3 and lower complications were treated conservatively. Three patients required reinsertion of indwelling catheters, and they were able to void spontaneously after two weeks of catheterisation training and medication treatment.ConclusionHoLEP is an effective treatment for men with BPO accompanied by DU and consequent renal function impairment. Patients are able to regain spontaneous voiding. Both bladder and renal functions were preserved and improved.

Quantitative CT analysis of idiopathic pulmonary fibrosis and correlation with lung function study

BackgroundIdiopathic Pulmonary Fibrosis (IPF) is a progressive fibrotic lung disease. However, the field of quantitative CT scan analysis in conjunction with pulmonary function test for IPF patients remains relatively understudied. In this study, we evaluated the diagnostic value of features derived high-resolution computed tomography (HRCT) for patients with IPF and correlated them with pulmonary function tests.MethodsWe retrospectively analyzed the chest HRCT images and pulmonary function test results of 52 patients with IPF during the same period (1 week) and selected 52 healthy individuals, matched for sex, age, and body mass index (BMI) and with normal chest HRCT as controls. HRCT scans were performed using a Philips 256-row Brilliance iCT scanner with standardized parameters. Lung function tests were performed using a Jaeger volumetric tracer for forced vital capacity (FVC), total lung capacity (TLC), forced expiratory volume in first second (FEV1), FEV1/FVC, carbon monoxide diffusing capacity (DLCO), and maximum ventilation volume (MVV) metrics. CT quantitative analysis, including tissue segmentation and threshold-based quantification of lung abnormalities, was performed using 3D-Slicer software to calculate the percentage of normal lung areas (NL%), percentage of ground-glass opacity areas (GGO%), percentage of fibrotic area (F%) and abnormal lesion area percentage (AA%). Semi-quantitative analyses were performed by two experienced radiologists to assess disease progression. The aortic-to-sternal distance (ASD) was measured on axial images as a standardized parameter. Spearman or Pearson correlation analysis and multivariate stepwise linear regression were used to analyze the relationship between the data in each group, and the ROC curve was used to determine the optimal quantitative CT metrics for identifying IPF and controls.ResultsROC curve analysis showed that F% distinguished the IPF patient group from the control group with the largest area under the curve (AUC) of 0.962 (95% confidence interval: 0.85–0.96). Additionally, with F% = 4.05% as the threshold, the Youden’s J statistic was 0.827, with a sensitivity of 92.3% and a specificity of 90.4%. The ASD was significantly lower in the late stage of progression than in the early stage (t = 5.691, P < 0.001), with a mean reduction of 2.45% per month. Quantitative CT indices correlated with all pulmonary function parameters except FEV1/FVC, with the highest correlation coefficients observed for F% and TLC%, FEV1%, FVC%, MVV% (r = − 0.571, − 0.520, − 0.521, − 0.555, respectively, all P-values < 0.001), and GGO% was significantly correlated with DLCO% (r = − 0.600, P < 0.001). Multiple stepwise linear regression analysis showed that F% was the best predictor of TLC%, FEV1%, FVC%, and MVV% (R2 = 0.301, 0.301, 0.300, and 0.302, respectively, all P-values < 0.001), and GGO% was the best predictor of DLCO% (R2 = 0.360, P < 0.001).ConclusionsQuantitative CT analysis can be used to diagnose IPF and assess lung function impairment. A decrease in the ASD may indicate disease progression.

Transurethral balloon dilation safety and efficacy in patients with recurrent bladder neck contracture after transurethral interventions

Introduction. Currently, urologists are divided on which method is most effective for treating bladder neck contracture (BNC) after surgery: transurethral resection (TUR) or incision.Objective. The study aimed to assess the balloon dilation safety and success in patients with recurrent bladder neck contracture (BNC) after endoscopic surgery for benign prostatic hyperplasia (BPH).Materials &amp; Methods. This study involved 110 patients with recurrent BNC after transurethral interventions for BPH. All patients underwent TUR of the bladder neck and were divided into 2 groups: group A (n = 45) included men who, after TUR, additionally underwent repeated balloon dilation, while the control group B (n = 65) included men who were treated with alpha-blockers alone.Results. In 9 months after TUR and 3 months after the fourth balloon dilation procedure in group A, the mean international prostate symptom score (IPSS) decreased from 20.1 ± 8.4 to 17.2 ± 7.4, and the IPSS-quality of life (QoL) was 4.2 ± 1.2 (p &gt; 0.05). In group B, they were 21.7 ± 7.7 and 4.7 ± 1.1 (p &gt; 0.05), respectively. Additionally, the mean flow rate in group A was 13.2 ± 5.4 ml/s, while in group B, it was 8.7 ± 4.9 ml/s (p &lt; 0.05). There was a significant decrease in the post-void residual urine volume (PVR) from 76.2 ± 96.1 ml to 37.6 ± 55.1 ml in group A, whereas, in group B, it increased from 63.0 ± 36.9 ml to 79.4 ± 71.6 ml (p &gt; 0.05). Also, 28.0% of patients of group B, and 13.3% of patients of group A underwent repeated TUR of the bladder neck in 9 months follow-up period (p &lt; 0.05).Conclusion. Balloon dilation procedure is a relatively safe less invasive procedure and can reduce the BNC recurrence rate and consequently the rate of repeated transurethral interventions.

The role of breathing biomechanics and diffusing lung capacity in post-COVID dyspnoea formation

The role of breathing biomechanics and diffusing lung capacity in post-COVID dyspnoea formation

Chest CT Airway and Vascular Measurements in Females with COPD or Long-COVID

Chest CT provides a way to quantify pulmonary airway and vascular tree measurements. In patients with COPD, CT airway measurement differences in females are concomitant with worse quality-of-life and other outcomes. CT total airway count (TAC), airway lumen area (LA), and wall thickness (WT) also differ in females with long-COVID. Our objective was to evaluate CT airway and pulmonary vascular and quality-of-life measurements in females with COPD as compared to ex-smokers and patients with long-COVID. Chest CT was acquired 3-months post-COVID-19 infection in females with long-COVID for comparison with the same inspiratory CT in female ex-smokers and COPD patients. TAC, LA, WT, and pulmonary vascular measurements were quantified. Linear regression models were adjusted for confounders including age, height, body-mass-index, lung volume, pack-years and asthma diagnosis. Twenty-one females (53 ± 14 years) with long-COVID, 17 female ex-smokers (69 ± 9 years) and 13 female COPD (67 ± 6 years) patients were evaluated. In the absence of differences in quality-of-life scores, females with long-COVID reported significantly different LA (p = 0.006) compared to ex-smokers but not COPD (p = 0.7); WT% was also different compared to COPD (p = 0.009) but not ex-smokers (p = 0.5). In addition, there was significantly greater pulmonary small vessel volume (BV5) in long-COVID as compared to female ex-smokers (p = 0.045) and COPD (p = 0.003) patients and different large (BV10) vessel volume as compared to COPD (p = 0.03). In females with long-COVID and highly abnormal quality-of-life scores, there was CT evidence of airway remodelling, similar to ex-smokers and patients with COPD, but there was no evidence of pulmonary vascular remodelling.Clinical Trial Registration: www.clinicaltrials.gov NCT05014516 and NCT02279329