Idiopathic interstitial pneumonias are currently classified into four categories: usual interstitial pneumonia, nonspecific interstitial pneumonia with fibrosis, acute interstitial pneumonia and desquamative interstitial pneumonia. The fibrotic process in interstitial pneumonias appears to result from a complex interaction between fibroblasts, other lung parenchymal cells and macrophages. The complex relationship between the local release of growth-promoting cytokines by alveolar macrophages and resident fibroblasts represents a necessary step for fibrosis or remodeling after lung injury. Injury to the epithelium and basement membranes is likely necessary for the fibrotic process to occur. Usual interstitial pneumonia, most frequent among interstitial pneumonias and has a poor prognosis, appears on high-resolution CT as patchy subpleural areas of ground-glass attenuation, irregular linear opacity, and honeycombing. Nonspecific interstitial pneumonia with fibrosis, the second most frequent and has a better prognosis than usual interstitial pneumonia, appears as subpleural patchy areas of ground-glass attenuation with associated areas of irregular linear opacity on CT. Acute interstitial pneumonia with high mortality rate presents as extensive bilateral airspace consolidation and patchy or diffuse bilateral areas of ground-glass attenuation. Desquamative interstitial pneumonia with good prognosis presents as patchy subpleural areas of ground-glass attenuation in middle and lower lung zones.
Human ; Lung Diseases, Interstitial/radiography ; Lung Diseases, Interstitial/physiopathology ; Lung Diseases, Interstitial/pathology*

The most commonly associated anomalies in patients with extrahepatic biliary atresia are cardiovascular, digestive and splenic defects. Of the cardiovascular anomalies, there are very few reports of biliary atresia with cardiomyopathy. We report the first case of a child with extrahepatic biliary atresia and restrictive cardiomyopathy. The patient was a 13-month-old boy diagnosed with extrahepatic biliary atresia at the age of 2 months, when he underwent laparotomy for definite diagnosis.Hepatic portoenterostomy was performed after confirmative cholangiogram. Recently, he developed severe cough and dyspnea, and his respiratory symptoms worsened. Chest radiograph showed cardiomegaly. Two- dimensional echocardiography showed marked biatrial enlargement. On M- mode echocardiogram, a slight increase in left ventricular dimension was seen in early diastole with a relatively good left ventricular function. Mitral inflow Doppler tracing showed an increased E-velocity (1.1 m/sec) with decreased deceleration time (75 m/sec), and increased E/A ratio (0.33). He was diagnosed as having restrictive cardiomyopathy with characteristic echocardiographic features.
Bile Ducts, Extrahepatic/*abnormalities ; Biliary Atresia/*complications/physiopathology/radiography/ultrasonography ; Cardiomyopathy, Restrictive/*complications/physiopathology/radiography/ultrasonography ; Human ; Infant ; Lung/radiography ; Male ; Radiography, Thoracic

OBJECTIVE: We wanted to demonstrate and compare the serial high-resolution CTs (HRCT) and the pulmonary function test (PFT) findings of the usual interstitial pneumonia (UIP) and the non-specific interstitial pneumonia (NSIP). MATERIALS AND METHODS: The serial HRCT scans and the PFT results were retrospectively analysed and compared for 35 patients having UIP without significant honeycombing (UIP-w/o hc, < 5% of honeycombing at CT), 35 patients having UIP with honeycombing (UIP-w/i hc, > or = 5% of honeycombing), and 25 patients with NSIP. The mortality rates were also compared. Follow-up CT scans were available in 75 patients (29 UIP-w/o hc patients, 22 UIP-w/i hc patients and 24 NSIP patients) and the follow-up periods ranged from 150 to 2, 370 days. The initial and follow-up PFT data were available for 71 patients. RESULTS: On the initial CT, significant differences were present between the UIP-w/i hc patients and both the UIP-w/o hc patients and the NSIP patients in the overall extent, ground-glass opacity (GGO) away from the reticulation, reticulation and honeycombing (all p < 0.05). Improvement was noticed in five (17%) of 29 UIP-w/o hc patients, none of 22 UIP-w/i hc patients, and 9 (37%) of 24 NSIP patients; deterioration was noted in six (21%) UIP-w/o hc patients, two (9%) UIP-w/i hc patients and three (13%) NSIP patients (p = 0.044 between UIP-w/o and UIP-w/i hc; p = 0.637 between UIP-w/o hc and NSIP; p = 0.007 between UIP-w/i hc and NSIP). The serial changes of the pulmonary function in the NSIP patients were different from those noted for the UIP-w/i hc and UIP-w/o hc patients (p = 0.440 between UIP-w/o and UIP-w/i hc; p = 0.022 between UIP-w/o hc and NSIP; p = 0.003 between UIP-w/i hc and NSIP). Five (14%) of the 35 patients with UIP-w/o hc, 16 (46%) of the 35 patients with UIP-w/i hc and three (12%) of the 25 patients with NSIP died (p = 0.002, comparison for the three groups). CONCLUSION: On CT, NSIP and UIP-w/o hc patients have similar patterns of parenchymal abnormalities and a similar likelihood of change in the extent of disease on follow-up. Patients with UIP-w/i hc have distinctive features and a worst prognosis.
*Tomography, X-Ray Computed ; Retrospective Studies ; Lung Diseases, Interstitial/mortality/*physiopathology/*radiography ; Lung/*physiopathology ; Humans ; Follow-Up Studies ; Female ; Aged

OBJECTIVE: We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. MATERIALS AND METHODS: Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfield unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. RESULTS: Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identified in five lesions, mucocele in four, accessory fissure in three and incomplete fissure in two. Either cyst or an accessory fissure was seen in four of the five lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 +/- 0.6 mSv. CONCLUSION: Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung.
Administration, Inhalation ; Child ; Child, Preschool ; Female ; Humans ; Lung/abnormalities/*radiography ; Lung, Hyperlucent/*congenital/physiopathology/*radiography ; Male ; *Pulmonary Ventilation ; *Tomography, X-Ray Computed ; Xenon/administration & dosage/*diagnostic use

OBJECTIVETo study the central modulation mechanism on the relative specificity of the Heart and Lung Meridians and to provide the experimental evidence for deeply study on correlation between meridian-viscera and brain.

METHODSTen healthy students in Anhui College of TCM were chosen and a modified block design was adopted. After 32 time points of resting and 32 of rotation needling, then 48 of resting and 32 stimulating, and 16 resting time points, functional imagings were collected at last. All the process would last for 10 min 44 sec. Acupuncture work was finished by one acupuncturist with extensive experience by acupuncture at the left Shenmen (HT 7) or Taiyuan (LU 8) with the disposable sterile stainless steel needle, and uniform reinforcing-reducing method was used with frequency of 1 Hz and depth of 1.0 cm. After the experiment, the sensation of acupuncture and the other feeling or psychic process were inquired and recorded detailedly. These data were analyzed by AFNI software.

RESULTSAcupuncture at Taiyuan (LU 8) could excite the contralateral frontal lobe, apical lobe, cerebral ganglion, VI, VIII areas and inferior semilunar lobule of cerebellum, and restrain bilateral callosal gyrus and homolateral gyrus rectus. Acupuncture at Shenmen (HT 7) could excite the contralateral IV-VIII areas of cerebellum, and homolateral VI, VII areas of cerebellum, and restrain parts of homolateral apical lobe.

CONCLUSIONAcupuncture at Shenmen (HT 7) of the Heart Meridian and Taiyuan (LU 8) of the Lung Meridian can excite or restrain different brain areas, indicating that there are relatively specific corresponding brain areas for the Heart Meridian and Lung Meridian.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Brain ; diagnostic imaging ; physiopathology ; Female ; Heart ; physiopathology ; Humans ; Lung ; physiopathology ; Magnetic Resonance Imaging ; Male ; Meridians ; Radiography ; Young Adult

OBJECTIVETo study the character of welder's pneumoconiosis on CT, pathology, and lung function.

METHODSTo contrast 185 welder's pneumoconiosis and 115 silicosis on CT, pathology, and clinical characters which were diagnosed between Jan 2008 and Dec 2013. Chest X-ray and lung function of 39 welder's pneumoconiosis patients were followed up after diagnosed 4~6 years later.

RESULTSAverage age and working years of welder's pneumoconiosis were 36.7 and 11.5, less than silicosis patients 58.8 and 22.1, respectively (P<0.05). Of all 185 welder's pneumoconiosis 98.4% were of stage I and no stage III, while in silicosis group stage I, stage II and stage III were 56.5%, 22.6% and 20.9%, respectively. The ratio differences between the two groups were statistically significant,P<0.05. 82.7% of welder's pneumoconiosis patients were observed pathologically moderate or above dust deposition in lung tissue while interstitial fibrosis level was just mild (97.6% patients) or no fibrosis (2.4% patients). By contrast, 60.0% silicosis patients pathologically showed moderate or above dust deposition while 77.8% were of moderate or above fibrosis. CT findings in welder' s pneumoconiosis were diffuse branching linear structure (38.9%), low density consistent size centrilobular micronodules (19.5%), or both (30.8%). Poorly-defined ground-glass attenuation centrilobular micronodules or widely ground glass shadow were observed in 6.4% welder's pneumoconiosis patents. 30.8% patients failed to reach the original stage when 39 welder's pneumoconiosis followed up chest radiograph.

CONCLUSIONChanges in welder's lung caused by welding fume were not only siderosis, but also interstitial fibrosis.

Adult ; Dust ; Fibrosis ; Follow-Up Studies ; Glass ; Humans ; Lung ; pathology ; Middle Aged ; Pneumoconiosis ; physiopathology ; Radiography, Thoracic ; Siderosis ; physiopathology ; Silicosis ; diagnosis ; physiopathology ; Welding

Pulmonary vein (PV) stenosis is a complication of ablation therapy for arrhythmias. We report two cases with chronic lung parenchymal abnormalities showing no improvement and waxing and waning features, which were initially diagnosed as nonspecific pneumonias, and finally confirmed as PV stenosis. When a patient presents for nonspecific respiratory symptoms without evidence of infection after ablation therapy and image findings show chronic and repetitive parenchymal abnormalities confined in localized portion, the possibility of PV stenosis should be considered.
Atrial Fibrillation/surgery ; Catheter Ablation/*adverse effects/methods ; Constriction, Pathologic/diagnosis/*radiography ; *Diagnostic Errors ; Female ; Humans ; Lung/surgery ; Male ; Middle Aged ; Pneumonia/diagnosis ; Pulmonary Infarction/pathology/*radiography ; Pulmonary Veins/physiopathology/radiography ; Tomography, X-Ray Computed/adverse effects ; Vascular Diseases/physiopathology

OBJECTIVE: The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. MATERIALS AND METHODS: Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. RESULTS: Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). CONCLUSION: Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.
Adult ; Aged ; Asthma/*physiopathology ; Exhalation/physiology ; Female ; Healthy Volunteers ; Humans ; Lung/*physiopathology/radiography ; Male ; Middle Aged ; *Respiratory Function Tests ; Tomography, X-Ray Computed/methods

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Oxygen ; blood ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed

OBJECTIVETo explore the features of pulmonary dysfunction in children with Mycoplasma pneumoniae pneumonia (MPP) with different chest imaging findings.

METHODSThe clinical data from 215 children with MPP were reviewed. These patients were grouped based on chest image findings (bronchopneumonia, n=125; lobar pneumonia, n=69; interstitial pneumonia, n=21). Lung function parameters including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and the maximum mid-expiratory flow rate (MMEF 25%-75%) were compared between the groups.

RESULTSIn the acute stage, patients with bronchopneumonia had significantly lower PEF values (measured value and measured value/predicted value) than the other two groups of patients, children with lobar pneumonia had a significant lower MMEF 25%-75% than other patients, and children with interstitial pneumonia had a significantly lower FVC. All patients experienced an improvement in lung function parameters except FEV1 of the lobar pneumonia group in the recovery stage.

CONCLUSIONSVarious features of pulmonary dysfunction can be observed among children with MPP with different chest imaging findings. Patients with bronchopneumonia mainly exhibit large airway dysfunction. The ones with lobar pneumonia mainly suffer small airway dysfunction, and those with interstitial pneumonia demonstrate both airway obstruction and restrictive ventilatory dysfunction.

Adolescent ; Child ; Child, Preschool ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Peak Expiratory Flow Rate ; Pneumonia, Mycoplasma ; physiopathology ; Radiography, Thoracic