CT-Assisted Improvements in the Accuracy of the Intraoperative Frozen Section Examination of Ground-Glass Density Nodules

Objectives. The intraoperative frozen section examination (IFSE) of pulmonary ground-glass density nodules (GGNs) is a great challenge. In the present study, through comparing the correlation between the computed tomography (CT) findings and pathological diagnosis of GGNs, the CT features as independent risk factors affecting the examination were defined, and their value in the rapid intraoperative examination of GGNs was explored. Methods. The relevant clinical data of 90 patients with GGNs on CT were collected, and all CT findings of GGNs, including the maximum transverse diameter, average CT value, spiculation, solid component, vascular sign, air sign, bronchus sign, lobulation, and pleural indentation, were recorded. All the cases received thoracoscopic surgery, and final pathological results were obtained. The cases were divided into three groups on the basis of pathological diagnosis: benign/atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS)/microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC). The CT findings were analyzed statistically, the independent risk factors were identified through the intergroup bivariate logistic regression analysis on variables with statistically significant differences, and a receiver operating curve (ROC) was plotted to establish a logistic regression model for diagnosing GGNs. A retrospective analysis was conducted on the coincidence rate of the rapid intraoperative and routine postoperative pathological examinations of the 90 cases with GGNs. The relevant clinical data of 49 cases with GGNs were collected. Conventional rapid intraoperative examination and CT-assisted rapid intraoperative examination were performed, and their coincidence rates with routine postoperative pathological examinations were compared. Results. No statistical differences in the onset age, gender, smoking history, and family history of malignant tumors were found among cases with GGNs in the identification of benign/AAH, AIS/MIA, and IAC ( P = 0.158 , P = 0.947 , P = 0.746 , P = 0.566 ). No statistically significant difference was found among the three groups in terms of CT findings, such as lobulation, bronchus sign, pleural indentation, spiculation, vascular sign, and solid component ( P > 0.05 ). The air sign, the maximum transverse diameter of GGNs, and average CT value showed statistically significant differences among the groups ( P < 0.001 , P < 0.05 , P < 0.001 ). Bivariate logistic regression analysis was performed on three risk factors, and the predicted probability value was obtained. A ROC curve was plotted by using the maximum transverse diameter as a predictor for analysis between the groups with benign/AAH and AIS/MIA, and the results demonstrated that the area under the curve (AUC) was 0.692. A ROC curve was plotted by using the predicted probability value, maximum transverse diameter, and average CT value as predictors for distinguishing between the groups with AIS/MIA and IAC, and the results showed that the AUC values of the predicted probability value, maximum transverse diameter, and CT value were 0.920, 0.816, and 0.772, respectively. A regression model Logit P = 2.304 − 2.689 X 1 + 0.302 X 2 + 0.011 X 3 was established to identify GGNs as IAC, obtaining AUC values of up to 0.920 for the groups with AIS/MIA and IAC, the sensitivity of 0.821, and the specificity of 0.894. The coincidence rate of rapid intraoperative and routine postoperative pathological examinations taken for modeling was 79.3%, that of conventional IFSE and postoperative pathological examination in prospective studies was 83.7%, and that of CT-assisted rapid intraoperative and postoperative pathological examinations was 98.0%. The former two were statistically different from the last one ( P = 0.003 and P = 0.031 , respectively). Conclusion. The air sign, maximum transverse diameter, and average CT value of the CT findings of GGNs had superior capabilities to enhance the pathologic classification of GGNs. The auxiliary function of the comprehensive multifactor analysis of GGNs was better than that of single-factor analysis. CT-assisted diagnosis can improve the accuracy of rapid intraoperative examination, thereby increasing the accuracy of the selection of operative approaches in clinical practice.

Natural History of Radiological Changes on CT Chest from COVID-19 Infection Rehabilitation Patients

Object： To investigate the chest CT manifestations of convalescent patients with COVID-19 in recovery phase. Methods: 118 convalescent patients diagnosed as COVID-19 were followed up. According to their medical history, they were divided into 47 cases of severe disease group and 71 cases of mild disease group. Multi-slice spiral CT, high-resolution CT and pulmonary function were examined. Results: 67 rehabilitated cases are normal on CT scan. The other CT findings were: (1) ground glass opacity lesions, including: localized patchy ground glass density lesions; Multi lobes and multi-stage ground glass opacities; Diffuse ground glass opacities lesions in both lungs. (2) The interlobular interstitium and interlobular septum were thickened. (3) Subpleural arc shadow/Subpleural lines. (4) Irregular fiber cord shadow/Irregular lines. (5) Tractive bronchiectasis. (6) Nodular consolidation of air space. (7) Cavitary lesions. No obvious mediastinal lymph node enlargement and pleural effusion were found. Pulmonary imaging and pulmonary function were improved after repeated reexamination. There was significant difference in CT findings and pulmonary function indexes between severe group and mild group (P < 0.05). Conclusion: The pulmonary manifestations of some convalescent patients with COVID-19 are basically normal. Ground glass density lesions are the main CT manifestations of convalescent patients, accompanied by varying degrees of pulmonary interstitial hyperplasia. The severe group had more severe pulmonary manifestations and poor pulmonary function than the mild group. With the extension of time, pulmonary lesions and pulmonary function gradually improved.

Influence of La-impurities and Plasma Treatment on the Structural and Optical Properties of Some Bismuth Calcium Borate Glasses

This research work aims to the estimation of the effect of the addition of La2O3, by different amounts in wt. %, to the matrix of the bismuth calcium borate glass. The fast cooling procedure was used to prepare the suggested compositions. XRD was used to inspecting the internal structural phases of the prepared samples, where XRD patterns confirmed the amorphous natures of all samples. It was found that the La-additives act to increase the glass density, micro hardness, and optical absorption. While the plasma treatment using N2 acted to reduce both the relative intensity of XRD and the optical absorption.

Characteristics of Thoracic CT Findings in Differentiating COVID-19 Pneumonia from Non-COVID-19 Viral Pneumonia

Background: Coronavirus Disease 2019 Reverse-Transcriptase Polymerase Chain Reaction (COVID-19 RT-PCR) positive predictive value is low. COVID-19 RT-PCR negative patients with pneumonia were not rare. It is difficult to distinguish COVID-19 pneumonia between other viral pneumonias radiologically and clinically. We aimed to find whether there was any different radiological finding in COVID-19 pneumonia with the other viral agents that caused pneumonia. Material and Methods: The study was designed retrospectively. 78 patients who underwent Thoracic Computed Tomography (CT) and COVID-19 RT-PCR were included in the study. Other viral Polymerase Chain Reaction (PCR) tests were performed on 33 patients. Results: 22 patients had COVID-19 PCR positive and 11 patients had non-COVID-19 PCR positive. 8 patients had influenza A and B, and 3 patients had adenovirus. In both groups, lung parenchymal lesions were predominantly located in the upper lobes and peripheral. 31 (93.9%) patients had ground-glass density lesions, 24 (72.7%) patients had consolidation, and 5 (15.2%) patients had crazy paving lesions. 1(3.0%) patient had a halo sign. There was no statistical difference between the two groups in terms of the features of the parenchymal lesions, except for vascular enlargement. Vascular enlargement was only seen in patients with COVID-19 pneumonia (p: 0.019). Conclusion: Radiologically, the vascular enlargement sign seems to be specific to COVID-19 disease and it can be used to differentiate COVID-19 pneumonia from other viral pneumonias.

A Rare Infection Factor in a Patient with Multiple Nodules During The COVID-19 Pandemic Period: Actinomycosis Odontoliticus

Pulmonary actinomycosis has been reported to account for 15% of all cases of actinomycosis, and pulmonary Actinomyces odontolyticus is particularly rare. Actinomycosis is a chronic granulomatous infection that often occurs in immunocompromised conditions, but it can also affect healthy people.Here, we present a case in which we diagnosed an immunocompetent 33-year-old female patient with bronchoalveolar lavage (BAL) by bronchoscopy, which is characterized by nodules with ground glass density in bilateral lung caused by A. odontolyticus due to a dental abscess. Bilateral nodular infiltrates made us think of metastatic lung disease; We assessed the patıent in terms of COVID-19 pneumonıa as we are in the perıod of pandemia.

Aerated Concrete Based on Cullet and Liquid Glass

The possibility of using technical glasswork with liquid glass to produce aerated concrete using low-energy technology was considered in the paper. The unsorted technical glass cullet use as a part of aerated concrete will allow the non-decomposing industrial wastes disposal, which makes it possible to speak about the environmental technology development, while reducing the cost of producing effective heat-insulating materials considers its economic efficiency. The optimum liquid glass density was established upon aerated concrete mix receipt, which should be at least 1.23 and not more than 1.35 g / cm3. The technical characteristics of aerated concrete based on cullet and liquid glass obtained in this work are determined. Thermal conductivity of aerated concrete with its density of 150-400 kg / m3 is 0.06 W/m°C. The resulting aerated concrete is recommended for thermal insulation of pipelines both during construction and during their repair.

Physical properties and biocompatibility effects of doping SiO2 and TiO2 into phosphate-based glass for bone tissue engineering

Phosphate glass is continuing to gain more attention as potential bone substitutes. The ternary (P2O5-CaO-Na2O) is investigated in terms of both physical properties and biocompatibility by doping different percentages of SiO2 and TiO2. Two groups were prepared; the first has different percentages of TiO2 and SiO2, whereas the second group compositions have 5 mol% TiO2 and 5 mol% SiO2 being added to compensate the network-forming oxide P2O5 and the network-modifying oxide CaO. Density, mass loss, pH, DTA, XRD, and cation release experiments were performed to study the physicochemical properties of the compositions, while MG63 and hMS cells were used within in vitro cell culture to study their biocompatibility. Results showed that an increase in TiO2 content correlated with an increase in glass density, decreased mass loss, increased trend of Tg and Tm values, and Na+ and Ca2+ release in group 1. There was no improvement in the MG63 viability or the ability of hMSCs to differentiate into osteoblasts where TiO2 decreased in favour of SiO2. Furthermore, in group 2, 50P2O5–25CaO was less dense than 45P2O5–30CaO, degraded dramatically less, had lower Tg and Tm values and released less Na+ and Ca(2+). The synergistic effect of doping 5 mol% TiO2 and 5 mol% SiO2 increased the MG63 viability in both compositions and was found 45P2O5–30CaO to have promising results in terms of the ability of hMSCs to differentiate into osteoblasts. To conclude, substituting TiO2 in place of SiO2 improved the physical properties and the biocompatibility of (P2O5-CaO-Na2O) glass system, whereas doping 5 mol% SiO2 and 5 mol% TiO2 together in place of P2O5 and CaO had a synergistic effect in controlling their degradation rate and improving their biological responses.