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Pulmonary capillary hemangiomatosis/veno-occlusive disease diagnosed by transbronchial cryobiopsy 经支气管冷冻活检诊断的肺毛细血管血管瘤病/静脉闭塞性疾病。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-05-01 DOI: 10.1016/j.pulmoe.2023.08.009
Venerino Poletti , Davide Femia , Simone Petrarulo , Alessandro Marinelli , Claudia Ravaglia , Sara Piciucchi
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引用次数: 0
Lung cancer and breast metastasis: A rare and atypical presentation 癌症和乳腺转移:一种罕见和非典型的表现。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-05-01 DOI: 10.1016/j.pulmoe.2023.08.001
H. Guedes , A. Barroso , D. João , A. Furtado , T. Costa
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引用次数: 0
Differential immunohistochemical expression of hTERT in lung cancer patients with and without idiopathic pulmonary fibrosis 有特发性肺纤维化和无特发性肺纤维化的肺癌患者中 hTERT 的免疫组化表达差异。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-05-01 DOI: 10.1016/j.pulmoe.2021.12.001
G. Gomatou , C. Masaoutis , I. Vamvakaris , E. Kotteas , E. Bouros , V. Tzilas , D. Bouros

Background

Human telomerase reverse transcriptase (hTERT) is the catalytic subunit of telomerase enzyme, which adds nucleotides to telomeres and counteracts their length shortening. The development of a telomere maintenance mechanism represents a hallmark of cancer. On the other hand, idiopathic pulmonary fibrosis (IPF) is associated with mutations in telomerase genes and shorter telomeres. IPF is frequently complicated with lung cancer.

Aim

To investigate the expression of hTERT in lung cancer with co-existing IPF and to compare with lung cancer without fibrosis.

Methods

Diagnostic lung cancerous biopsies were retrieved from 18 patients with lung cancer and concomitant IPF, as well as 18 age and gender matched controls with lung cancer without pulmonary fibrosis. The expression of hTERT was studied with immunohistochemistry. ImajeJ software was used to quantitate subcellular stain intensity. Immunohistochemical investigation of two senescence-associated markers, p16 and p21, was also performed in all 36 cases.

Results

Both groups highly expressed hTERT, without significant difference (100% vs 95%, p = 0.521). Evaluation of p16 and p21 immunostaining revealed negative to minimal immunoreactivity in both groups. hTERT localization exhibited higher median nuclear intensity in the group of lung cancer with IPF (0.62 vs 0.45, p = 0.016), while cytoplasmic intensity did not differ significantly (0.17 vs 0.15, p = 0.463). Higher median nuclear intensity was also correlated with small cell lung cancer subtype in the whole study sample (0.69 vs 0.45, p = 0.09).

Conclusion

hTERT is highly expressed in lung cancer with concomitant IPF, but with differential localization compared to lung cancer without IPF, implying differences in pathogenicity and requiring further investigation.

背景:人类端粒酶逆转录酶(hTERT)是端粒酶的催化亚基,它能为端粒添加核苷酸,抵消端粒长度的缩短。端粒维持机制的发展是癌症的标志。另一方面,特发性肺纤维化(IPF)与端粒酶基因突变和端粒缩短有关。目的:研究 hTERT 在合并有 IPF 的肺癌中的表达,并与无纤维化的肺癌进行比较:方法:从18例肺癌并发IPF患者以及18例年龄和性别匹配的无肺纤维化的肺癌对照组中提取诊断性肺癌活检组织。用免疫组化方法研究了 hTERT 的表达。使用 ImajeJ 软件对亚细胞染色强度进行量化。此外,还对所有 36 个病例的两个衰老相关标记物 p16 和 p21 进行了免疫组化检测:结果:两组病例均高表达 hTERT,无显著差异(100% vs 95%,p = 0.521)。两组患者的 p16 和 p21 免疫染色均为阴性或极弱。hTERT 定位在 IPF 肺癌组的中位核强度更高(0.62 vs 0.45,p = 0.016),而胞质强度无显著差异(0.17 vs 0.15,p = 0.463)。结论:hTERT在伴有IPF的肺癌中高表达,但与无IPF的肺癌相比,其定位不同,这意味着致病性不同,需要进一步研究。
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引用次数: 0
Main bronchus fistula: An open window to the lung parenchyma 主支气管瘘:通往肺实质的开放窗口
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-05-01 DOI: 10.1016/j.pulmoe.2023.07.007
N. Faria, M. Sucena, J. Gomes
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引用次数: 0
COPD phenotypes by computed tomography and ventilatory response to exercise 计算机断层扫描的慢性阻塞性肺病表型和运动时的通气反应。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-05-01 DOI: 10.1016/j.pulmoe.2022.01.002
S. Rodrigues Sousa, J. Nunes Caldeira, C. Rodrigues

Introduction

Computed tomographic (CT) phenotypic patterns of chronic obstructive pulmonary disease (COPD) identify different clinical features of disease. The impact of these variables on the physiological response to exercise has been the focus of a great deal of research as it allows more individualized clinical approaches. The aim of our study was to evaluate the relationships between CT phenotyping of subjects with COPD and the ventilatory response during cardiopulmonary exercise testing (CPET).

Methods

Subjects with COPD were classified into four phenotypes based on CT metrics of emphysema (low attenuation area less than a threshold of -950 Hounsfield [%LAA-950]) and airwall thickness (bronchial wall area percentage [%WA]).

Results

Eighty COPD patients (78.8% males, median age 65±11.3 years) were enrolled in the study. Based on CT phenotype, 25 (31.3%) patients were classified as normal, 27 (33.8%) air dominant, 17 (21.3%) emphysema dominant and 11 (13.8%) mixed type. The emphysema and mixed phenotypes showed the highest ventilatory equivalent for carbon dioxide (VE/VCO2) and VE/VCO2 slope (p<0,05). In all phenotypes, %LAA was positive correlated with VE/VCO2 and VE/VCO2 slope (r = 0.437, p = 0.006 and r = 0.503, p<0.001, respectively). %WA also showed a positive correlation with VE/VCO2 and VE/VCO2 slope (r = 0.541, p<0.001 and r = 0.299, p = 0.033, respectively). In multivariate regression models, after adjustment for age, BMI, sex and FEV1, %LAA was the only independent predictor of VE/VCO2 and VE/VCO2 slope (β 0.343, SE 0.147, 95% CI 0.009/0.610, p = 0.044 and β 0.496, SE 0.081, 95% CI 0.130/0.455, p = 0.001, respectively).

Conclusion

Emphysema (%LAA) and airways metrics (%WA) had strong relationships with the different characteristics of ventilatory response to exercise in subjects with mild to moderate COPD. In particular, %LAA seemed to play an important role as an independent predictor of VE/VCO2 and VE/VCO2 slope. These results suggested that CT phenotyping may help predicting ventilatory response to exercise in subjects with COPD.

简介:慢性阻塞性肺病(COPD)的计算机断层扫描(CT)表型模式可确定疾病的不同临床特征。这些变量对运动生理反应的影响一直是大量研究的焦点,因为它可以使临床方法更加个体化。我们的研究旨在评估慢性阻塞性肺病受试者的 CT 表型与心肺运动测试(CPET)期间通气反应之间的关系:根据肺气肿(低衰减面积小于-950 Hounsfield[%LAA-950]阈值)和气壁厚度(支气管壁面积百分比[%WA])的 CT 指标,将慢性阻塞性肺病受试者分为四种表型:80 名慢性阻塞性肺病患者(78.8% 为男性,中位年龄为 65±11.3 岁)参加了研究。根据 CT 表型,25 例(31.3%)患者被归类为正常型,27 例(33.8%)为空气优势型,17 例(21.3%)为肺气肿优势型,11 例(13.8%)为混合型。肺气肿和混合表型的二氧化碳通气当量(VE/VCO2)和 VE/VCO2 斜率(pE/VCO2 和 VE/VCO2 斜率(r = 0.437,p = 0.006 和 r = 0.503, pE/VCO2 and VE/VCO2 slope (r = 0.541, pE/VCO2 and VE/VCO2 slope (β 0.343, SE 0.147, 95% CI 0.009/0.610, p = 0.044 and β 0.496, SE 0.081, 95% CI 0.130/0.455, p = 0.001, respectively).结论:肺气肿(%LAA)和气道指标(%WA)与轻度至中度慢性阻塞性肺疾病患者运动时通气反应的不同特征有密切关系。尤其是,肺气肿%LAA似乎是VE/VCO2和VE/VCO2斜率的独立预测因子。这些结果表明,CT 表型可能有助于预测慢性阻塞性肺病患者运动时的通气反应。
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引用次数: 0
Phenotyping exercise limitation of patients with Interstitial Fibrosing Lung Disease: the importance of exercise hemodynamics 间质性纤维化肺病患者运动受限的表型分析:运动血流动力学的重要性。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-03-01 DOI: 10.1016/j.pulmoe.2022.03.012
E. Panagiotidou , A. Βoutou , E. Fouka , D. Papakosta , E. Chatzopoulos , E. Sourla , A. Markopoulou , I. Kioumis , I. Stanopoulos , G. Pitsiou
<div><h3>Introduction and objective</h3><p>Left-heart dysfunction and pulmonary vasculopathy are increasingly recognized as contributing factors of exercise capacity limitation in interstitial fibrosing lung disease (IFLD). Moreover, the clinical significance of exercise pulmonary hypertension (ePH) in pulmonary and cardiac diseases has been documented, representing a risk factor for decreased exercise capacity and survival, progression to resting pulmonary hypertension (PH) and overall clinical worsening.</p><p>We conducted a prospective study aiming at: (a) assessing the prevalence of PH and ePH in a cohort of 40 functionally limited patients with IFLD, (b) determining the post-capillary (postC) or pre-capillary (preC) etiology of either PH or ePH in this cohort, and (c) examining the correlations between invasively and non-invasively measured exercise variables among hemodynamic groups.</p></div><div><h3>Patients and methods</h3><p>40 IFLD patients underwent cardiopulmonary evaluation, including: clinical examination, lung function tests, 6-minute walking test, heart ultrasonography, cardiopulmonary exercise test and, finally, right heart catheterization (RHC). Resting hemodynamic evaluation was followed by the exercise protocol proposed by Herve et al, using a bedside cycle ergometer in the supine position. Abnormal elevation of mean pulmonary artery pressure (mPAP) above 30mmHg during exercise, with respect to abnormal elevation of cardiac output (CO) below 10 L/min (mPAP–CO ratio ⩾3 mmHg·min·L<sup>−1</sup>) was used to define ePH (Herve et al, 2015). Secondary hemodynamic evaluation involved detection of abnormal pulmonary arterial wedge pressure (PAWP) increase at peak exercise in relation to CO. Specifically, ΔPAWP/ΔCO >2 mmHg/L per minute determined an abnormal PAWP elevation (Bentley et al, 2020).</p></div><div><h3>Results</h3><p>Among the 40-patient cohort, 25% presented postC PH, 37.5% preC PH, 27.5% ePH, with the remaining 10% recording normal hemodynamics. PAWP evaluation during exercise revealed a postC etiology in 4 out of the 11 patients presenting ePH, and a postC etiology in 6 out of the 15 patients presenting resting preC PH. Mean values of non-invasive variables did not display statistically significant differences among hemodynamic groups, except for: diffusing capacity for carbon monoxide (DLCO), carbon monoxide transfer coefficient (KCO) and the ratio of functional vital capacity to DLCO (FVC%/DLCO%), which were lower in both ePH and PH groups (<em>p</em> < 0.05). Resting values of CO, cardiac index (CI), stroke volume (SV) and pulmonary vascular compliance (PVC) were significantly impaired in ePH, preC-PH and postC-PH groups when compared to the normal group.</p></div><div><h3>Conclusions</h3><p>Both PH and ePH were highly prevalent within the IFLD patient group, suggesting that RHC should be offered more frequently in functionally limited patients. Diffusion capacity markers must thus guide decision making, in para
导言和目的:人们日益认识到,左心功能不全和肺血管病变是导致间质性纤维化肺病(IFLD)运动能力受限的因素。此外,运动性肺动脉高压(ePH)在肺部和心脏疾病中的临床意义也已得到证实,它是运动能力和存活率下降、发展为静息肺动脉高压(PH)和整体临床恶化的危险因素。我们进行了一项前瞻性研究,旨在(a) 评估 40 名功能受限的 IFLD 患者中 PH 和 ePH 的患病率;(b) 确定该组患者中 PH 或 ePH 的病因是毛细血管后(postC)还是毛细血管前(preC);(c) 检查血液动力学组间有创和无创测量的运动变量之间的相关性。患者和方法:40 名 IFLD 患者接受了心肺评估,包括临床检查、肺功能测试、6 分钟步行测试、心脏超声波检查、心肺运动测试,最后还进行了右心导管检查(RHC)。在进行静息血流动力学评估后,再按照 Herve 等人提出的运动方案,使用床边循环测力计进行仰卧位运动。运动时平均肺动脉压(mPAP)异常升高超过30mmHg,而心输出量(CO)异常升高低于10 L/min(mPAP-CO比值⩾3 mmHg-min-L-1)被用来定义ePH(Herve等人,2015年)。二次血液动力学评估包括检测峰值运动时肺动脉楔压(PAWP)的异常升高与 CO 的关系。具体来说,ΔPAWP/ΔCO >2毫米汞柱/升/分钟即为PAWP异常升高(Bentley等人,2020年):结果:在 40 名患者中,25% 的患者表现为中风后 PH,37.5% 的患者表现为中风前 PH,27.5% 的患者表现为 ePH,其余 10%的患者血液动力学正常。在 11 名出现 ePH 的患者中,有 4 人在运动时进行 PAWP 评估,而在 15 名出现静息先心病 PH 的患者中,有 6 人的病因是先心病后遗症。除一氧化碳弥散容量(DLCO)、一氧化碳传递系数(KCO)和功能生命容量与 DLCO 的比值(FVC%/DLCO%)在 ePH 组和 PH 组均较低外,其他非侵入性变量的平均值在血液动力学组间无显著统计学差异(P 结论):在 IFLD 患者组中,PH 和 ePH 的发病率都很高,这表明应更频繁地为功能受限的患者提供 RHC。ePH与静息CO和PVC较低有关,与静息PH相似,表明心肺功能与运动受限有关。最后,ΔPAWP/ΔCO>2标准的使用进一步揭示了毛细血管后病因的PH,凸显了IFLD血液动力学的复杂性:NCT03706820。
{"title":"Phenotyping exercise limitation of patients with Interstitial Fibrosing Lung Disease: the importance of exercise hemodynamics","authors":"E. Panagiotidou ,&nbsp;A. Βoutou ,&nbsp;E. Fouka ,&nbsp;D. Papakosta ,&nbsp;E. Chatzopoulos ,&nbsp;E. Sourla ,&nbsp;A. Markopoulou ,&nbsp;I. Kioumis ,&nbsp;I. Stanopoulos ,&nbsp;G. Pitsiou","doi":"10.1016/j.pulmoe.2022.03.012","DOIUrl":"10.1016/j.pulmoe.2022.03.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and objective&lt;/h3&gt;&lt;p&gt;Left-heart dysfunction and pulmonary vasculopathy are increasingly recognized as contributing factors of exercise capacity limitation in interstitial fibrosing lung disease (IFLD). Moreover, the clinical significance of exercise pulmonary hypertension (ePH) in pulmonary and cardiac diseases has been documented, representing a risk factor for decreased exercise capacity and survival, progression to resting pulmonary hypertension (PH) and overall clinical worsening.&lt;/p&gt;&lt;p&gt;We conducted a prospective study aiming at: (a) assessing the prevalence of PH and ePH in a cohort of 40 functionally limited patients with IFLD, (b) determining the post-capillary (postC) or pre-capillary (preC) etiology of either PH or ePH in this cohort, and (c) examining the correlations between invasively and non-invasively measured exercise variables among hemodynamic groups.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients and methods&lt;/h3&gt;&lt;p&gt;40 IFLD patients underwent cardiopulmonary evaluation, including: clinical examination, lung function tests, 6-minute walking test, heart ultrasonography, cardiopulmonary exercise test and, finally, right heart catheterization (RHC). Resting hemodynamic evaluation was followed by the exercise protocol proposed by Herve et al, using a bedside cycle ergometer in the supine position. Abnormal elevation of mean pulmonary artery pressure (mPAP) above 30mmHg during exercise, with respect to abnormal elevation of cardiac output (CO) below 10 L/min (mPAP–CO ratio ⩾3 mmHg·min·L&lt;sup&gt;−1&lt;/sup&gt;) was used to define ePH (Herve et al, 2015). Secondary hemodynamic evaluation involved detection of abnormal pulmonary arterial wedge pressure (PAWP) increase at peak exercise in relation to CO. Specifically, ΔPAWP/ΔCO &gt;2 mmHg/L per minute determined an abnormal PAWP elevation (Bentley et al, 2020).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Among the 40-patient cohort, 25% presented postC PH, 37.5% preC PH, 27.5% ePH, with the remaining 10% recording normal hemodynamics. PAWP evaluation during exercise revealed a postC etiology in 4 out of the 11 patients presenting ePH, and a postC etiology in 6 out of the 15 patients presenting resting preC PH. Mean values of non-invasive variables did not display statistically significant differences among hemodynamic groups, except for: diffusing capacity for carbon monoxide (DLCO), carbon monoxide transfer coefficient (KCO) and the ratio of functional vital capacity to DLCO (FVC%/DLCO%), which were lower in both ePH and PH groups (&lt;em&gt;p&lt;/em&gt; &lt; 0.05). Resting values of CO, cardiac index (CI), stroke volume (SV) and pulmonary vascular compliance (PVC) were significantly impaired in ePH, preC-PH and postC-PH groups when compared to the normal group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Both PH and ePH were highly prevalent within the IFLD patient group, suggesting that RHC should be offered more frequently in functionally limited patients. Diffusion capacity markers must thus guide decision making, in para","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"30 2","pages":"Pages 104-112"},"PeriodicalIF":11.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2531043722001052/pdfft?md5=f9b8adb1e540e5e0e9a6842374b108d2&pid=1-s2.0-S2531043722001052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80070575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postural lung volume reduction, expiratory flow limitation, and orthopnoea in diaphragmatic weakness: Preliminary observations 膈肌无力时体位性肺容量减少、呼气流量限制和正呼吸:初步观察。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-03-01 DOI: 10.1016/j.pulmoe.2023.08.007
S. Redolfi , C. Straus , V. Ninane , T. Similowski
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引用次数: 0
Subpleural curvilinear lines as an early indicator of silicosis in artificial stone workers 胸膜下曲线是人工结石工人矽肺的早期指标。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-03-01 DOI: 10.1016/j.pulmoe.2023.08.006
C.H. Chen , P.J. Tsai , W.W. Chang , C.Y. Chen , C.Y. Chen , Y.L. Guo
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引用次数: 0
Thoracic endometriosis presenting as diffuse cystic lung disease: a rare case report 以弥漫性肺囊性疾病为表现的胸部子宫内膜异位症:罕见病例报告
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-03-01 DOI: 10.1016/j.pulmoe.2023.04.005
G. das Posses Bridi , M.R. de Oliveira , C.R.R. Carvalho , E.C.T. do Nascimento , B.G. Baldi
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引用次数: 0
Open-source, low-cost App-driven Internet of Things approach to facilitate respiratory oscillometry at home and in developing countries 开源、低成本的应用程序驱动的物联网方法,促进国内和发展中国家的呼吸振荡测量。
IF 11.7 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-03-01 DOI: 10.1016/j.pulmoe.2023.10.004
J.-E. González , M.A. Rodríguez , E. Caballero , A. Pardo , S. Marco , R. Farré
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引用次数: 0
期刊
Pulmonology
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