Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT

<p>Bronchial diverticula have been described as a common radiological finding in smoker patients with COPD, but the specificity of this sign should be further investigated. Thus, the aim of our study was to evaluate the prevalence of diverticula in a cohort of non-smoker subjects. Between February and July 2012, 2438 patients were admitted to our Radiology Unit to undergo a chest CT. Among them, we enrolled 121 non-smoking patients (78/121-64.5% females, 43/121-35.5% males), of different age (57.0±20.7 years-range: 12-88), without any respiratory symptoms, submitted to chest CT for several reasons (oncologic evaluation: 59/121-48.8%; follow up of lung nodules: 27/121-22.3%; screening in connectivitis: 12/121-9.9%; others: 23/121-19.0%). We considered thin-section CT scan on axial, coronal and sagittal plans to evaluate prevalence, numbers and level of bronchial diverticula. Diverticula were found in 41/121-33.9% patients, with a slight major prevalence in males (p=0.048), but no significant difference on age. In 31/41-75.6% the number was <3, whereof 17/31-54.8% with just one diverticulum assessed. Regarding the level, in 30/41-73.2% they were subcarinal, but they were also detected in mainstem (2/41-4.9%) and lobar bronchi (with the right upper lobe bronchus most frequently involved- 12/41-29.3%). Bronchial diverticula can be observed in non-smokers, as well as in smoker patients with COPD. However, their prevalence seems to be lower than in smokers and they tend to be isolated and subcarinal. The age of patients does not influence their finding. More studies should be proposed to better define a cut-off between smokers and healthy subjects.</p>

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Comparison of Bone-Conducted Vibration for Eliciting Ocular Vestibular-Evoked Myogenic Potentials

Otolaryngology ◽

10.1177/0194599811425884 ◽

2011 ◽

Vol 146 (2) ◽

pp. 289-294 ◽

Cited By ~ 33

Author(s):

Chia-Chen Tseng ◽

Shou-Jen Wang ◽

Yi-Ho Young

Keyword(s):

Prospective Study ◽

Study Design ◽

Healthy Subjects ◽

University Hospital ◽

Vestibular Evoked Myogenic Potentials ◽

Ménière’S Disease ◽

Asymmetry Ratio ◽

Significant Difference ◽

The Asymmetry ◽

The Right

Objective. This study compared bone-conducted vibration (BCV) stimuli at forehead (Fz) and mastoid sites for eliciting ocular vestibular-evoked myogenic potentials (oVEMPs). Study Design. Prospective study. Setting. University hospital. Methods. Twenty healthy subjects underwent oVEMP testing via BCV stimuli at Fz and mastoid sites. Another 50 patients with unilateral Meniere’s disease also underwent oVEMP testing. Results. All healthy subjects showed clear oVEMPs via BCV stimulation regardless of the tapping sites. The right oVEMPs stimulated by tapping at the right mastoid had earlier nI and pI latencies and a larger nI-pI amplitude compared with those stimulated by tapping at the Fz and left mastoid. Similar trends were also observed in left oVEMPs. However, the asymmetry ratio did not differ significantly between the ipsilateral mastoid and Fz sites. Clinically, tapping at the Fz revealed absent oVEMPs in 28% of Meniere’s ears, which decreased to 16% when tapping at the ipsilesional (hydropic) mastoid site, exhibiting a significant difference. Conclusion. Tapping at the ipsilateral mastoid site elicits earlier oVEMP latencies and larger oVEMP amplitudes when compared with tapping at the Fz site. Thus, tapping at the Fz site is suggested to screen for the otolithic function, whereas tapping at the ipsilesional mastoid site is suitable for evaluating residual otolithic function.

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SUN-932 Successful Response of Temozolomide (TMZ) in two Patients with Metastatic Pheochromocytoma/Paragangliomas (PPGLs)

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1949 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Tobias Skrebsky de Almeida ◽

Roberta P Borges ◽

Janeczko Laís ◽

Giovana Caroline Marx Becker ◽

Ticiana Costa Rodrigues ◽

...

Keyword(s):

Lung Metastases ◽

Left Lung ◽

Vena Cava ◽

Lung Lesion ◽

Chest Ct ◽

Complete Regression ◽

Lung Lesions ◽

The Right ◽

Urinary Metanephrines

Abstract Introduction: PPGLs are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla or their neural crest progenitors, being able to secrete catecholamines. Its treatment is primarily surgical; however, for metastatic/inoperable tumors, effective treatments are lacking. The use of TMZ, an oral alkylating agent, has been scarcely reported with variable response rates. We report 2 patients with reasonable clinical, biochemical and structural responses. Case Reports: Case 1) A 14-year old girl presented with neck pain, sweating, hypertension and tachycardia. Urinary hormonal profile revealed metanephrines 80 (up to 320 ug/24h) and normetanephrines 2983 (up to 390 ug/24h). Abdominal MRI showed a 10x6x5 cm retroperitoneal lesion in close contact with celiac trunk, superior mesenteric artery, renal arteries, aorta, left renal vein and vertebral bodies of T10, T11 and T12. A chest CT revealed multiple lung metastases. After 11 months, both the primary abdominal lesion and lung metastases increased in size.. Due to disease severity, after excluding surgical possibilities and confirming diagnosis by lesion biopsy, rescue treatment with TMZ was started for 5 days on a 28-day cycle. After 11 cycles, lung and abdominal lesions decreased more than 30% in size, and urinary metanephrines decreased 53.4%. After 21 cycles, there is no evidence of disease progression. Case 2) A 44-year old female was first diagnosed at the age of 31 with a right adrenal mass invading the kidney and the inferior vena cava associated with hypertension, sweating, headaches and palpitations. She underwent right adrenalectomy and nephrectomy. Immunohistochemistry confirmed the diagnosis of pheochromocytoma. Seven years later, follow-up CT`s showed a 3 x 2 cm liver metastasis, which was resected, and two lung lesions, one located at the right inferior lobe (1.6 cm) and the other at the left superior lobe (0.9 cm), which initially were just followed-up. At this time, a 7-month sorafenib trial was performed but the drug was stopped due to intolerable side effects. After 3 years of follow-up, the lung lesions increased in size and the right lesion was resected, but the patient refused surgery for the remainder left lung lesion. After 1 year, left lung lesion increased to 2.4 cm and mediastinal and paratracheal lymphadenomegaly developed. TMZ in the same aforementioned schedule was prescribed and after 7 cycles a new chest CT revealed complete regression of the lung and lymph node metastases.. Urinary metanephrines were 2.1 times the upper limit of normal before TMZ and decreased to normal range. Conclusion: These cases highlight the promising role of a well-tolerated single drug chemotherapy regimen in severe cases of metastatic and inoperable PPGLs. TMZ could be considered an alternative strategy for the treatment of these cases and, if possible, should be tested in adequate clinical trials.

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PULMONARY AGENESIS

PEDIATRICS ◽

10.1542/peds.15.6.761 ◽

1955 ◽

Vol 15 (6) ◽

pp. 761-767

Author(s):

Harriette Clark ◽

Roland B. Scott ◽

John B. Johnson

Keyword(s):

Urinary Tract ◽

Respiratory Symptoms ◽

Interatrial Septum ◽

Post Mortem ◽

Associated Anomalies ◽

Ventilatory Function ◽

Pulmonary Agenesis ◽

Follow Up Study ◽

The Right

Two cases of agenesis of the lung, both with anomalies of the urinary tract, have been presented. In 1 patient the diagnosis was made at post-mortem examination at the age of 5 weeks. Associated anomalies in this patient included defect of the interatrial septum, anomalous drainage of the pulmonary vein into the right atrium, and congenital bilateral ureterovesicle obstruction with dilatation of the ureters and kidney pelves. In the second patient, the diagnosis was made at the age of 3 years. A follow-up study 12 years later substantiated the diagnosis and revealed pelvic location of fused kidneys with short ureters bilaterally. In the latter case, the lung anomaly has not resulted in any dysfunction of the heart or pulmonary circulation. There has been some decrease in ventilatory function but not sufficiently severe to result in respiratory symptoms. This patient is living and well at the time of this report.

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Radiation Pneumonitis Risk after Bleomycin Toxicity in Hodgkin Lymphoma Patients

Blood ◽

10.1182/blood.v126.23.1511.1511 ◽

2015 ◽

Vol 126 (23) ◽

pp. 1511-1511

Author(s):

Zeinab A Abou Yehia ◽

George Mikhaeel ◽

Grace Smith ◽

Chelsea C Pinnix ◽

Sarah A Milgrom ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Respiratory Symptoms ◽

Cox Regression ◽

Radiation Pneumonitis ◽

Radiation Treatment ◽

Cox Regression Analysis ◽

Significant Difference ◽

To Receive ◽

Median Interval

Abstract Introduction: Combined modality treatment with Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) chemotherapy followed by consolidative radiation to start within 3-4 weeks is the current accepted approach in the treatment of patients with early stage Hodgkin lymphoma (HL). Bleomycin pulmonary toxicity (BPT) is a well-known complication of treatment in HL patients. We undertook this study to investigate the risk of radiation pneumonitis (RP) in the setting of BPT and to determine the need for delay or omission of radiation in these patients. Methods: We reviewed the records of all HL patients treated with ABVD followed by radiation therapy (RT) to the chest between January 2009 and December 2014. We defined bleomycin toxicity as: the occurrence of clinical respiratory symptoms leading to discontinuation of bleomycin and/or bilateral opacities noted on computed tomography (CT) imaging and/or drop in diffusing capacity of the lung for carbon monoxide (DLCO) by 25%, in the absence of infection. We identified 129 patients, 100 of which received consolidation RT as part of combined modality and are the subject of this report, 29 patients were excluded because they developed relapse before getting RT. We compared patients with and without bleomycin toxicity for the following outcomes:Frequency of RP using the Pearson chi-square test.Interval between BPT and Radiation using Mann-Whitney U test (MWT)Interval between end of chemotherapy and radiation using MWT. We used univariate Cox regression analysis to assess the risk of RP by looking at the time-interval in weeks from end of bleomycin to start of RT. Results: Median follow up was 23 months (6 - 69), Median age was 31 years (18-77), and 60% were females. Per our criteria, 28 patients developed BPT (25.5%). All patients received intensity modulated radiation therapy, radiation dose median was 30.60 Gy (20-42Gy). Mean lung dose (MLD) was a median of 9.4 Gy (2.6- 13.9 Gy). The median interval between chemotherapy and RT was 3 weeks (1- 8 weeks). Median interval from stopping bleomycin, either as a precaution or because of toxicity, to the start of RT was 5 weeks (1-20 weeks). Interval between documented bleomycin toxicity to start of radiation was a median of 8.5 weeks (2-20 weeks). We had 10 cases of RP (10%), 5 of which were ≥ Grade 2. There was no significant difference in RP risk in patients with or without BPT; 10.7% (3/28) versus 9.6% (7/72) respectively, P= 0.82. Patients with BPT versus those without BPT had no significant difference in baseline characteristics. The interval time from chemotherapy to radiation was a median of 3 weeks in both groups with or without BPT showing no difference; P= 0.83. However, Patients with BPT had a significantly longer interval from last bleomycin cycle to start of radiation compared to those without BPT (median 8.5 vs. 5 weeks, p =0.014). The intervals from chemotherapy to radiation treatment and from bleomycin to radiation treatment showed no significant correlation with RP on univariate Cox regression analysis (P= 0.41 and P= 0.12, respectively). This was maintained when adjusted for the number of bleomycin cycles. Treatment of BPT Of the 28 patients, 17 were managed by stopping bleomycin and observation only; 10 patients required a 2 week course of steroids. One patient went into severe respiratory compromise, was started on continuous oxygen and eventually recovered 48 hours later and went on to receive RT beginning 2 weeks after completing his steroid treatment. This patient did not have pulmonary complications after RT. All 28 BPT patients eventually completed their planned course of radiation. At last follow up, all 28 patients were alive and free of respiratory symptoms. Conclusion: In our cohort of Hodgkin lymphoma patients, those patients with bleomycin toxicity who received standard RT had no excess risk of subsequent RP. Moreover, patients were able to receive complete courses of RT to intended conventional radiation doses. Our findings suggest that RT does not need to be delayed following chemotherapy, except to allow for the completion of steroids or clinical recovery from BPT. Table 1. BPT_clinical BPT _imaging BPT_DLCO≥25% Clinical+(CTorDLCO≥25%) BPT per criteria All patients n=100 25 17 10 13 28 RP No n=90 22 15 9 12 25 Yes n=10 3 2 1 1 3 Disclosures No relevant conflicts of interest to declare.

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Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

10.21203/rs.3.rs-25791/v1 ◽

2020 ◽

Author(s):

Nian Liu ◽

Guanghong He ◽

Xiongxiong Yang ◽

Jianxin Chen ◽

Jie Wu ◽

...

Keyword(s):

Severity Score ◽

Ground Glass Opacity ◽

Chest Ct ◽

Critical Group ◽

Occurrence Rate ◽

Dynamic Changes ◽

Pleural Thickening ◽

The Third ◽

The Right

Abstract Background To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p < 0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2 = 0.137, p = 0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p > 0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p > 0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p < 0.05). Conclusions The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

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Right-sided lateralization of skin temperature in healthy young persons

Clinical & Investigative Medicine ◽

10.25011/cim.v39i6.27515 ◽

2016 ◽

Vol 39 (6) ◽

pp. 121 ◽

Cited By ~ 4

Author(s):

Havva Demirel ◽

Arzu Bahar ◽

Nurcan Gokgoz ◽

Muzeyyen Arslan ◽

Senol Dane

Keyword(s):

Lymph Node ◽

Immune System ◽

Skin Temperature ◽

Healthy Subjects ◽

The Body ◽

Node Distribution ◽

Significant Difference ◽

Close Relationship ◽

The Right ◽

Relationship Of

Purpose: Previous studies reported a peripheral immune asymmetry and lateralization of different paired organ cancers. Because of the close relationship of immune system with body temperature, the aim of the study was to test the possible lateralization of skin temperature. Materials and Methods: Four hundred sixty three healthy subjects (325 women, 138 men) with an average age of 23.62 years (SD = 8.65) participated in this study. All skin temperature measurements were done 8:00-9:00 a.m. Skin temperature was assessed for three different points in skin: axillary, thumb and external auditory. Results: Skin temperature was statistically significantly higher on the right side of the body than on the left side, when measured by axillary and thumb temperatures. But there was no statistically significant difference in external auditory temperature. Conclusion: The asymmetry of skin temperature may result from the peripheral immune asymmetry or the asymmetric lymph node distribution.

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Benefits of breast milk for prevention of sore nipple & association with their demographic variables: A quasi-experimental study

IP Journal of Paediatrics and Nursing Science ◽

10.18231/j.ijpns.2021.027 ◽

2022 ◽

Vol 4 (4) ◽

pp. 127-131

Author(s):

Javaid Ahmad Mir ◽

Nadiya Rashid

Keyword(s):

Experimental Study ◽

Breast Milk ◽

Comparison Group ◽

Significant Difference ◽

Postnatal Mothers ◽

Quasi Experimental ◽

Sample Characteristics ◽

The Right ◽

Experimental Group

A newborn baby has only three demands. They are warmth in the arms of his mother, food from her breasts and security in the knowledge of her presence. Breastfeeding satisfies all three. While breastfeeding may not seem the right choice for every parent, it is the choice for every baby because it fulfills the physical needs as well as psychotic complementary of the child. The study aimedto find out the association of nipple soreness in experimental group and comparison group in terms of sample characteristics of postnatal mothers. A quasi experimental study was conducted on 70 postnatal mothers, (35 in experimental group and 35 in the comparison group) who breast feeds their babies were selected conveniently. Feeding pattern was assessed by LATCH scale four times in a day followed by the application of hind milk minimum four times in a day for three or four days as per discharge day of mother. The mother was asked to rub hind milk on nipples after feeding the baby and letting it air dry in front of researcher and nipple soreness scale was used to check the sore nipple at third and fifth day or at the day of discharge. Follow up of postnatal mothers was done telephonically by using interview questionnaire on day 15 in both groups. Study findings revealed that on 3rd day, the mean nipple soreness score was higher in comparison group (1.45) than experimental group (0.10) and thus there was significant difference (t value = 3.87) in nipple soreness score.Study concluded that breast milk application was effective in preventing sore nipples among postnatal mothers. Hence, it can be recommended to use breast milk for the prevention of sore nipple.

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Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

10.21203/rs.3.rs-25791/v2 ◽

2020 ◽

Author(s):

Nian Liu ◽

Guanghong He ◽

Xiongxiong Yang ◽

Jianxin Chen ◽

Jie Wu ◽

...

Keyword(s):

Severity Score ◽

Ground Glass Opacity ◽

Chest Ct ◽

Critical Group ◽

Occurrence Rate ◽

Dynamic Changes ◽

Pleural Thickening ◽

The Third ◽

The Right

Abstract Background: To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods: This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results: There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p <0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p >0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p >0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p <0.05). Conclusions: The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

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Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature

Case Reports in Pathology ◽

10.1155/2012/319434 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Farzana Arif ◽

Susan Wu ◽

Shahriyour Andaz ◽

Stewart Fox

Keyword(s):

Incidental Finding ◽

Lower Lobe ◽

Final Diagnosis ◽

Myoepithelial Cells ◽

Myoepithelial Carcinoma ◽

Rare Entity ◽

Lobe Bronchus ◽

Epithelial Myoepithelial Carcinoma ◽

Bronchial Glands ◽

The Right

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

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Diagnostic performances of leucine-rich α-2-glycoprotein 1 and stem cell factor for diagnosis and follow-up of colorectal cancer

Journal of Genetic Engineering and Biotechnology ◽

10.1186/s43141-021-00116-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Manar S. Fouda ◽

Rokaia M. Aljarwani ◽

Khaled Aboul-Enein ◽

Mohamed M. Omran

Keyword(s):

Colorectal Cancer ◽

Stem Cell ◽

Tumor Markers ◽

Stem Cell Factor ◽

Healthy Subjects ◽

Multivariate Logistic Regression Analysis ◽

Characteristic Analysis ◽

Lymphocyte Ratio ◽

Significant Difference

Abstract Background Colorectal cancer (CRC) is one of the most frequently diagnosed tumors worldwide with high mortality and morbidity. There is an urgent need for biomarkers to improve the outcomes and early detection of CRC. The sensitivity of traditional CRC tumor markers (carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)) is not ideal. The levels of leucine-rich-alpha-2-glycoprotein 1 (LRG1) and stem cell factor (SCF) were evaluated, but the combined value of both markers is unclear. This case-control study included four groups: CRC patients before treatments (n = 22), CRC patients after treatments (n = 26), 20 patients with benign tumor, and 20 healthy subjects. Levels of routine biochemical and hematological markers, traditional tumor markers (CA19.9 and CEA), and candidate markers (LRG1 and SCF) were determined. Univariate and multivariate logistic regression analysis and area receiver-operating characteristic analysis (ROC) were used for evaluation the diagnostic performances of single and combined markers. Results No significance difference in traditional tumor markers CEA, CA 19.9, and neutrophil–lymphocyte ratio (NLR) were found among study groups. SCF, LRG1, and platelet–lymphocyte ratio (PLR) were significantly decreased (p < 0.05) in non-treated CRC patients than after treated CRC. The combination between SCF and LRG1 showed highly significant difference in CRC patients compared with benign, healthy subjects, and among CRC groups (treated and non-treated) (p < 0.0001). The highest areas under curve (AUCs) were observed when LRG1 was used as a single predictor for discriminating CRC from healthy (0.87), benign (0.84), and non-treated CRC vs treated CRC (0.82). AUCs were jumped to 0.90, 0.84, and 0.84 when LRG1 and SCF were combined. Conclusion Our study revealed that LRG1 and SCF were potential diagnostic and follow-up markers for CRC.

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