CNN-Based Deformable Registration Facilitates Fast and Accurate Air Trapping Measurements on Inspiratory-Expiratory CT

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder involving lungs, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT) also called proteinase inhibitor (PI). Asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. Objectives: The aim of the study was to evaluate lung function in asthmatic outpatients with mutation in the SERPINA1 gene coding for AAT versus asthmatic subjects without mutation. Methods: We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently; they were subdivided into mutated and non-mutated subjects. All the mutated patients had a heterozygous genotype, except 1 (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airway parameters through an impulse oscillometry system. Results: The values of forced vital capacity (% predicted) and those of the residual volume to total lung capacity ratio (%) were, respectively, lower and higher in patients mutated versus patients without mutation, showing a significantly greater air trapping (p = 0.014 and p = 0.017, respectively). Moreover, patients with mutation in comparison to patients without mutation showed lower forced expiratory volume in 3 s (% predicted) and forced expiratory volume in 6 s (L) spirometric values, reflecting a smaller airways contribution. Conclusions: In asthmatic patients, heterozygosity for AAT with PI*MZ and PI*MS genotypes was associated with small airway dysfunction and with lung air trapping.

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Quantitative Assessment of Shape Deformation of Regional Cranial Bone for Evaluation of Surgical Effect in Patients with Craniosynostosis

Applied Sciences ◽

10.3390/app11030990 ◽

2021 ◽

Vol 11 (3) ◽

pp. 990

Author(s):

Min Jin Lee ◽

Helen Hong ◽

Kyu Won Shim

Keyword(s):

Quantitative Assessment ◽

Deformable Registration ◽

Occipital Bone ◽

Cranial Bone ◽

Shape Deformation ◽

Surface Model ◽

Cephalic Index ◽

Skull Shape ◽

Quantification Method ◽

Parietal Bones

Surgery in patients with craniosynostosis is a common treatment to correct the deformed skull shape, and it is necessary to verify the surgical effect of correction on the regional cranial bone. We propose a quantification method for evaluating surgical effects on regional cranial bones by comparing preoperative and postoperative skull shapes. To divide preoperative and postoperative skulls into two frontal bones, two parietal bones, and the occipital bone, and to estimate the shape deformation of regional cranial bones between the preoperative and postoperative skulls, an age-matched mean-normal skull surface model already divided into five bones is deformed into a preoperative skull, and a deformed mean-normal skull surface model is redeformed into a postoperative skull. To quantify the degree of the expansion and reduction of regional cranial bones after surgery, expansion and reduction indices of the five cranial bones are calculated using the deformable registration as deformation information. The proposed quantification method overcomes the quantification difficulty when using the traditional cephalic index(CI) by analyzing regional cranial bones and provides useful information for quantifying the surgical effects of craniosynostosis patients with symmetric and asymmetric deformities.

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Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping

Respiratory Research ◽

10.1186/s12931-021-01619-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

F. Schleich ◽

S. Graff ◽

F. Guissard ◽

M. Henket ◽

V. Paulus ◽

...

Keyword(s):

Bronchial Hyperresponsiveness ◽

Forced Expiratory Volume ◽

Lower Airway ◽

Low Grade ◽

Sputum Induction ◽

Air Trapping ◽

Cell Counts ◽

Airway Caliber ◽

Significant Difference ◽

Long Acting

Abstract Background Elderly asthmatics represent an important group that is often excluded from clinical studies. In this study we wanted to present characteristics of asthmatics older than 70 years old as compared to younger patients. Methods We conducted a retrospective analysis on a series of 758 asthmatics subdivided in three groups: lower than 40, between 40 and 70 and older than 70. All the patients who had a successful sputum induction were included in the study. Results Older patients had a higher Body Mass Index, had less active smokers and were more often treated with Long Acting anti-Muscarinic Agents. We found a significant increase in sputum neutrophil counts with ageing. There was no significant difference in blood inflammatory cell counts whatever the age group. Forced expiratory volume in one second (FEV1) and FEV1/FVC values were significantly lower in elderly who had lower bronchial hyperresponsiveness and signs of air trapping. We found a lower occurrence of the allergic component in advanced ages. Asthmatics older than 70 years old had later onset of the disease and a significant longer disease duration. Conclusion Our study highlights that asthmatics older than 70 years old have higher bronchial neutrophilic inflammation, a poorer lung function, signs of air trapping and lower airway variability. The role of immunosenescence inducing chronic low-grade inflammation in this asthma subtype remains to be elucidated.

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