43 results on '"Pulmonary Fibrosis diagnosis"'
Search Results
2. [Sarcoidosis as prime example of a granulomatous disease].
- Author
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Oqueka T, Galow S, Simon M, Weidmann A, Stübiger N, Zengin-Sahm E, Sinning C, Krusche M, Ruffer N, Steurer S, Schick-Bengardt X, Sebode M, Horst LJ, Steinmetz OM, Melderis S, Rosenkranz SC, Möller K, Jantke H, and Klose H
- Subjects
- Diagnosis, Differential, Granuloma diagnosis, Granuloma therapy, Humans, Lung, Quality of Life, Pulmonary Fibrosis diagnosis, Sarcoidosis diagnosis, Sarcoidosis therapy
- Abstract
Sarcoidosis is the most frequent immunologically related granulomatous disease and can serve as a model for understanding diseases within this category. The evidence on the diagnostics and treatment is so far limited. It is therefore all the more important that two new and significant guidelines on diagnosis and treatment of sarcoidosis were published during the last 2 years. Additionally, there were more new publications, which were considered for this review article. In this context, this review article provides a current update and overview of sarcoidosis. Pathophysiologically, there is an increasing understanding of the complex processes and interactions involved in the inflammatory processes and granuloma formation. The probability of a diagnosis of sarcoidosis is determined by compatible histology, the exclusion of differential diagnoses and if possible evidence of a multiorgan manifestation. The clinical course is variable and ranges from an asymptomatic manifestation to severe life-threatening organ failure. The most frequently affected organ are the lungs. Pulmonary fibrosis is the most severe form and is also decisive for mortality. An increasing focus is on the extrapulmonary organ manifestations, in particular, cardiac, hepatosplenic, gastrointestinal, renal, ocular and neurological involvement. Treatment, which consists primarily of immunosuppression, should be initiated in cases of organ-threatening or quality of life-impairing activity of the disease. Additional organ-specific management must also be evaluated. In cases of organ failure transplantation should be considered. Due to the limited evidence especially for the treatment of multiorgan sarcoidosis, when possible, patients with this disease should be included in clinical trials., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2022
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3. [Treatment of lung fibrosis in systemic rheumatic diseases (new treatment)].
- Author
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Buschulte K, Hoffmann-Vold AM, Dobrota RD, Höger P, Krause A, and Kreuter M
- Subjects
- Humans, Connective Tissue Diseases, Lung Diseases, Interstitial diagnosis, Lung Diseases, Interstitial drug therapy, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis drug therapy, Rheumatic Diseases complications, Rheumatic Diseases diagnosis, Rheumatic Diseases drug therapy, Scleroderma, Systemic complications, Scleroderma, Systemic diagnosis, Scleroderma, Systemic drug therapy
- Abstract
An interstitial lung disease represents a relevant organ manifestation in many systemic rheumatic diseases (connective tissue disease-interstitial lung disease, CTD-ILD). In 10% of the cases pulmonary fibrosis even results in an underlying systemic disease. The CTD-ILDs are frequently associated with a poor prognosis. Therefore, it is important to test patients with systemic rheumatic diseases timely and regularly for the presence of an ILD. Treatment decisions should be made together with pneumologists and rheumatologists, particularly with respect to the initiation of a specific treatment. Treatment is based on randomized studies only in a few cases and can mostly be derived from case control studies. For systemic sclerosis-associated ILD (SSc-ILD) antifibrotic treatment with nintedanib has also now been approved in addition to an immunosuppressive treatment. For other CTD-ILDs an antifibrotic treatment should be discussed in an interdisciplinary approach depending on the underlying disease corresponding to a progressively fibrosing ILD., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2021
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4. Impact of concomitant obstructive sleep apnea on pulmonary involvement and main pulmonary artery diameter in adults with scleroderma.
- Author
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Yakut T, Balcan B, Karakurt S, Direskeneli H, Yalcinkaya Y, and Peker Y
- Subjects
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Pulmonary Artery diagnostic imaging, Respiratory Function Tests, Skin Diseases diagnosis, Tomography, X-Ray Computed, Young Adult, Hypertension, Pulmonary diagnosis, Pulmonary Artery pathology, Pulmonary Fibrosis diagnosis, Scleroderma, Diffuse diagnosis, Scleroderma, Limited diagnosis, Sleep Apnea, Obstructive diagnosis
- Abstract
Purpose: Pulmonary involvement is common in adults with scleroderma. The effect of concomitant obstructive sleep apnea (OSA) on risk for pulmonary hypertension in scleroderma is unknown. An enlarged main pulmonary artery diameter (mPAD) derived from chest computer tomography (CT) is a useful predictor of pulmonary hypertension. We addressed the effect of OSA on pulmonary involvement and enlarged mPAD in adults with scleroderma., Methods: All participants underwent pulmonary function testing, carbon monoxide diffusion capacity, chest CT, and overnight sleep recording with home sleep apnea testing. OSA diagnosis was based on an apnea-hypopnea index (AHI) ≥ 15/h. Oxygen desaturation index (ODI) was also recorded. Scleroderma involvement of the lungs was defined as the Warrick score ≥ 7 based on the CT findings. Enlarged mPAD was defined as an mPAD ≥ 29 mm in men and ≥ 27 mm in women., Results: After exclusions, 62 patients (58 women) were included. OSA was found among 20 (32%), 17/42 (38%) in the limited cutaneous type, and 3/20 (15%) in the diffuse cutaneous type (p = 0.08). Scleroderma involvement of the lungs was observed in 40 participants (65% in OSA vs 64% in no-OSA; n.s.). Enlarged mPAD was measured in 16 participants, 10 of 20 (50%) in the OSA group and 6 of 17 (14%) in the no-OSA group (p = 0.003). OSA was associated with enlarged mPAD (odds ratio 4.7, 95% confidence interval 1.1-20.9; p = 0.042) independent of age, body mass index, and pulmonary involvement. There was a linear relationship between mPAD and AHI (r = 0.37; p = 0.003) as well as ODI (r = 0.41; p < 0.001)., Conclusions: In this cohort, OSA was associated with risk for pulmonary hypertension independent of pulmonary involvement. These findings suggest that assessing the effect of therapy for concomitant OSA in patients with scleroderma is warranted., Trial Registration: NCT02740569.
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- 2021
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5. [Pulmonary fibrosis in rheumatic diseases].
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Grund D and Siegert E
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- Diagnosis, Differential, Evidence-Based Medicine, Germany, Humans, Pulmonary Fibrosis etiology, Rheumatic Diseases complications, Risk Assessment methods, Treatment Outcome, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis therapy, Rheumatic Diseases diagnosis, Rheumatic Diseases therapy
- Abstract
Rheumatic diseases are frequently complicated by secondary pulmonary diseases, which often impair the quality of life and increase the mortality of patients. A correct classification of such pulmonary complications is important to ensure appropriate treatment and optimal prognosis. The diagnostic and therapeutic challenge is to find the precise diagnosis and appropriate therapy among the multitude of potential causes for respiratory symptoms. It is important to maintain a cautious approach to invasive diagnostics, even though the differential diagnostics of infections or toxic lung disease might be crucial. The situation is further complicated by the frequent lack of evidence for therapies. Especially in the case of pulmonary fibrosis which is comparable to cancer in its complexity and high mortality, the diagnostics and therapy should be discussed in appropriate interdisciplinary boards.
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- 2016
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6. Sleep-disordered breathing and idiopathic pulmonary fibrosis--is there an association?
- Author
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Reid T, Vennelle M, McKinley M, MacFarlane PA, Hirani N, Simpson AJ, and Riha RL
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- Aged, Aged, 80 and over, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Polysomnography, Pulmonary Diffusing Capacity physiology, Pulmonary Fibrosis mortality, Pulmonary Fibrosis physiopathology, Sleep Apnea, Obstructive mortality, Sleep Apnea, Obstructive physiopathology, Statistics as Topic, Survival Rate, Total Lung Capacity physiology, Pulmonary Fibrosis diagnosis, Sleep Apnea, Obstructive diagnosis
- Abstract
Background: Very little data exists on the prevalence and impact of sleep-disordered breathing (SDB) in patients with idiopathic pulmonary fibrosis (IPF). The aim of this study was to examine the impact of SDB on newly diagnosed IPF patients and explore associations with lung function parameters., Methods: From 2005 to 2009, a cohort of 27 newly diagnosed patients with IPF underwent unattended polygraphy. All patients were diagnosed according to ATS 2000 diagnostic criteria and were not on supplemental oxygen or other treatment. Standard statistical analysis was undertaken using SPSS v. 19 (IBM)., Results: Of the 27 patients, 19 were men. There was no correlation at baseline of apnoea + hypopnoea per time in bed (AH), oxygen desaturation index, or 4% desaturations with any lung function variables, age, or body mass index. Six patients had significant SDB (AH >20). Two patients were started on CPAP following polygraphy. No variables from the original sleep studies at baseline predicted eventual long-term oxygen therapy (LTOT) use. At 5-year follow-up, 18 of 27 patients had died (67%). Cox regression analysis showed no association of time spent at SpO2 <90% on baseline polygraphy with survival (p = 0.39). There was no association with survival for AH >20 (p = 0.4) or LTOT use (p = 0.19)., Conclusion: Our results do not support the contention that nocturnal upper airway obstruction in steroid-free patients with IPF is a common problem or correlated with lung function. In this cohort of patients, there was no evidence that significant SDB at baseline was a predictor of survival.
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- 2015
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7. CPAP therapy in patients with idiopathic pulmonary fibrosis and obstructive sleep apnea: does it offer a better quality of life and sleep?
- Author
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Mermigkis C, Bouloukaki I, Antoniou KM, Mermigkis D, Psathakis K, Giannarakis I, Varouchakis G, Siafakas N, and Schiza SE
- Subjects
- Activities of Daily Living classification, Aged, Disorders of Excessive Somnolence diagnosis, Disorders of Excessive Somnolence therapy, Female, Greece, Humans, Male, Middle Aged, Surveys and Questionnaires, Treatment Outcome, Continuous Positive Airway Pressure, Polysomnography, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis therapy, Quality of Life, Sleep Apnea, Obstructive diagnosis, Sleep Apnea, Obstructive therapy
- Abstract
Background: The recent literature shows an increased incidence of obstructive sleep apnea (OSA) in patients with idiopathic pulmonary fibrosis (IPF). On the other hand, there are no published studies related to continuous positive airway pressure (CPAP) treatment in this patient group. Our aim was to assess the effect of CPAP on sleep and overall life quality parameters in IPF patients with OSA and to recognize and overcome possible difficulties in CPAP initiation and acceptance by these patients., Methods: Twelve patients (ten males and two females, age 67.1 ± 7.2 years) with newly diagnosed IPF and moderate to severe OSA, confirmed by overnight attended polysomnography, were included. Therapy with CPAP was initiated after a formal in-lab CPAP titration study. The patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Functional Outcomes in Sleep Questionnaire (FOSQ), the Fatigue Severity Scale (FSS), the SF-36 quality of life questionnaire, and the Beck Depression Inventory (BDI) at CPAP initiation and after 1, 3, and 6 months of effective CPAP therapy., Results: A statistically significant improvement was observed in the FOSQ at 1, 3, and 6 months after CPAP initiation (baseline 12.9 ± 2.9 vs. 14.7 ± 2.6 vs. 15.8 ± 2.1 vs. 16.9 ± 1.9, respectively, p = 0.02). Improvement, although not statistically significant, was noted in ESS score (9.2 ± 5.6 vs. 7.6 ± 4.9 vs. 7.5 ± 5.3 vs. 7.7 ± 5.2, p = 0.84), PSQI (10.7 ± 4.4 vs. 10.1 ± 4.3 vs. 9.4 ± 4.7 vs. 8.6 ± 5.2, p = 0.66), FSS (39.5 ± 10.2 vs. 34.8 ± 8.5 vs. 33.6 ± 10.7 vs. 33.4 ± 10.9, p = 0.44), SF-36 (63.2 ± 13.9 vs. 68.9 ± 13.5 vs. 72.1 ± 12.9 vs. 74.4 ± 11.3, p = 0.27), and BDI (12.9 ± 5.5 vs. 10.7 ± 4.3 vs. 9.4 ± 4.8 vs. 9.6 ± 4.5, p = 0.40). Two patients had difficulty complying with CPAP for a variety of reasons (nocturnal cough, claustrophobia, insomnia) and stopped CPAP use after the first month, despite intense follow-up by the CPAP clinic staff. Heated humidification was added for all patients in order to improve the common complaint of disabling nocturnal cough., Conclusion: Effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities based on the FOSQ, namely an OSA-specific follow-up instrument. Improvement was also noted in other questionnaires assessing quality of life, though not to a statistically significant degree, probably because of the multifactorial influences of IPF on physical and mental health. The probability of poor CPAP compliance was high and could only be eliminated with intense follow-up by the CPAP clinic staff.
- Published
- 2013
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8. Enteric-coated mycophenolate sodium for progressive systemic sclerosis--a prospective open-label study with CT histography for monitoring of pulmonary fibrosis.
- Author
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Henes JC, Horger M, Amberger C, Schmalzing M, Fierlbeck G, Kanz L, and Koetter I
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- Adult, Aged, Carbon Monoxide analysis, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mycophenolic Acid administration & dosage, Mycophenolic Acid therapeutic use, Prospective Studies, Pulmonary Fibrosis complications, Pulmonary Fibrosis drug therapy, Respiratory Function Tests, Scleroderma, Diffuse complications, Skin pathology, Time Factors, Tomography, X-Ray Computed, Mycophenolic Acid analogs & derivatives, Pulmonary Fibrosis diagnosis, Scleroderma, Diffuse drug therapy, Tablets, Enteric-Coated therapeutic use
- Abstract
The purpose of this study was to assess the impact of enteric-coated mycophenolate sodium (EC-MPS) on skin and pulmonary manifestations of patients with progressive systemic sclerosis (Ssc). A prospective, open-label single-centre trial with EC-MPS 2 × 720 mg/day over 12 months and a long-term follow-up of 50 months were conducted. Modified Rodnan skin score (mRSS) was used to assess the skin and pulmonary function tests to assess the pulmonary involvement. In order to quantify the extent of alveolitis/fibrosis via densitometry, the high attenuation value, median lung density and percentiles of lung tissue densities were obtained by high-resolution computed tomography. Eleven patients were included. Three patients had to stop medication before month 6 (2× side effects, 1× progression). For the remaining eight patients, the median mRSS was non-significantly reduced from 13.5 at baseline to 11 at month 12. According to the CT histography, median lung density and high attenuation values remained stable. However, the course of percentiles -200 to -300 and particularly -300 to -400 Hounsfield units slightly increased in seven of eight patients after 12 months, suggesting worsening of pulmonary involvement. Accordingly, median diffusing capacity for carbon monoxide showed a tendency to decline (75.1 % vs. 70.2) while forced vital capacity non-significantly improved (78.0 vs. 85.5 %) during the study. Four patients are still on EC-MPS without clinical signs of progression after 50 months follow-up. EC-MPS showed non-significant improvement of the skin. Pulmonary fibrosis remained stable with only a slight tendency towards progression which might be ascribed to the medication as well as the natural course of the disease. CT histography appears to be a sensitive method for the detection of progression of pulmonary fibrosis and therefore should be considered for further studies in Ssc.
- Published
- 2013
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9. Enhancing image analytic tools by fusing quantitative physiological values with image features.
- Author
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Caban JJ, Yao J, and Mollura DJ
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- Analysis of Variance, Echocardiography methods, Humans, Lung diagnostic imaging, Lung physiopathology, Pulmonary Fibrosis blood, Reproducibility of Results, Respiratory Function Tests methods, Severity of Illness Index, Diagnosis, Computer-Assisted methods, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis physiopathology, Tomography, X-Ray Computed methods
- Abstract
Computer-aided diagnosis systems (CADs) can quantify the severity of diseases by analyzing a set of images and employing prior statistical models. In general, CADs have proven to be effective at providing quantitative measurements of the extent of a particular disease, thus helping physicians to better monitor the progression of cancer, infectious diseases, and other health conditions. Electronic Health Records frequently include a large amount of clinical data and medical history that can provide critical information about the underlying condition of a patient. We hypothesize that the fusion of image and clinical-physiological features can be used to enhance the accuracy of automatic image classification models. In particular, this paper shows how image analytic tools can move beyond classical image interpretation models to broader systems where image and physiological measurements are fused and used to create more generic detection models. To test our hypothesis, a CAD system capable of quantifying the severity of patients with pulmonary fibrosis has been developed. Results show that CAD systems augmented with multimodal physiological values are more robust and accurate at determining the severity of the disease.
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- 2012
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10. Estimation of pulmonary vascular resistance in patients with pulmonary fibrosis by phase-contrast magnetic resonance imaging.
- Author
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Ayukawa Y, Murayama S, Tsuchiya N, Yara S, and Fujita J
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- Adult, Aged, Area Under Curve, Case-Control Studies, Female, Humans, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Respiratory Function Tests, Sensitivity and Specificity, Tomography, X-Ray Computed, Magnetic Resonance Imaging methods, Pulmonary Artery physiopathology, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis physiopathology, Vascular Resistance physiology
- Abstract
Purpose: The aim of this study was to assess pulmonary vascular resistance (PVR) in patients with pulmonary fibrosis (PF) by phase-contrast magnetic resonance imaging (MRI)., Materials and Methods: Subjects were 11 healthy volunteers and 11 patients with PF. Using phase-contrast MRI, we measured pulmonary arterial blood flow and calculated the parameters of PVR. Parameters were compared between volunteers and patients using unpaired t-tests. The diagnostic capability of the parameters was evaluated by receiver operating characteristic (ROC) curve analysis. Patients underwent respiratory function tests (RFTs) and chest computed tomography (CT), and they were correlated with MRI parameters., Results: Most MRI parameters were significantly different between volunteers and patients (t-test P values were <0.05 in 9 of 10 parameters). Regarding the RFT and CT visual score, only the %DLco/VA and acceleration time and the CT visual score and average flow volume had significant correlation [r = -0.667 (P = 0.024) and r = -0.6 (P = 0.031)], respectively., Conclusion: Our findings suggest that PVR derived from phase-contrast MRI is significantly higher in patients with PF than in volunteers. However, all but two of these parameters may not correlate with the severity of PF.
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- 2011
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11. Methotrexate-induced pulmonary toxicity in psoriatic arthritis (PsA): case presentation and literature review.
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Rondon F, Mendez O, Spinel N, Ochoa C, Saavedra C, Penaranda E, Garcia-Valladares I, Espinoza LR, and Iglesias-Gamarra A
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- Acute Disease, Arthritis, Psoriatic complications, Fatal Outcome, Female, Humans, Middle Aged, Pulmonary Fibrosis diagnosis, Antirheumatic Agents adverse effects, Arthritis, Psoriatic drug therapy, Methotrexate adverse effects, Pulmonary Fibrosis chemically induced
- Abstract
A 45-year-old female with a 4-week history of psoriatic arthritis developed cough, fever, and progressive shortness of breath 2 weeks following initiation of methotrexate therapy. High resolution CT of chest revealed bilateral basal interstitial involvement and diffuse ground glass opacities. Patient, though, died despite immediate discontinuation of methotrexate and initiation of treatment with IV methylprednisolone and cyclophosphamide. Post-mortem examination showed diffuse interstitial pulmonary fibrosis. Methotrexate-induced pulmonary toxicity is a serious event, unpredictable, and unusual, especially in patients with psoriatic arthritis, and although reversible, it may be fatal.
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- 2011
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12. [Dyspnea in the hypertensive patient. Why was diuretic therapy not effective?].
- Author
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Stiefelhagen P
- Subjects
- Aged, Diagnosis, Differential, Diuretics therapeutic use, Heart Failure, Diastolic drug therapy, Humans, Male, Pulmonary Edema drug therapy, Treatment Failure, Dyspnea etiology, Heart Failure, Diastolic diagnosis, Pulmonary Edema diagnosis, Pulmonary Fibrosis diagnosis
- Published
- 2011
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13. Lung texture classification using locally-oriented Riesz components.
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Depeursinge A, Foncubierta-Rodriguez A, Van de Ville D, and Müller H
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- Algorithms, Computer Simulation, Diagnosis, Computer-Assisted, Humans, Models, Statistical, Normal Distribution, Principal Component Analysis, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis pathology, Radiology methods, Lung pathology, Radiographic Image Interpretation, Computer-Assisted methods, Tomography, X-Ray Computed methods
- Abstract
We develop a texture analysis framework to assist radiologists in interpreting high-resolution computed tomography (HRCT) images of the lungs of patients affected with interstitial lung diseases (ILD). Novel texture descriptors based on the Riesz transform are proposed to analyze lung texture without any assumption on prevailing scales and orientations. A global classification accuracy of 78.3% among five lung tissue types is achieved using locally-oriented Riesz components. Comparative performance analysis with features derived from optimized grey-level co-occurrence matrices showed an absolute gain of 6.1% in classification accuracy. The adaptability of the Riesz features is demonstrated by reconstructing templates according to the first principal components of the lung textures. The balanced performance achieved among the various lung textures suggest that the proposed methods can complement human observers in HRCT interpretation, and opens interesting perspectives for future research.
- Published
- 2011
14. Referenceless stratification of parenchymal lung abnormalities.
- Author
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Raghunath S, Rajagopalan S, Karwoski RA, Bartholmai BJ, and Robb RA
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- Algorithms, Databases, Factual, Diagnostic Imaging methods, Emphysema diagnosis, Emphysema pathology, Humans, Lung pathology, Models, Statistical, Pulmonary Fibrosis pathology, Reproducibility of Results, Lung Diseases diagnosis, Lung Diseases, Interstitial diagnosis, Pulmonary Fibrosis diagnosis, Radiographic Image Interpretation, Computer-Assisted methods, Tomography, X-Ray Computed methods
- Abstract
This paper introduces computational tools that could enable personalized, predictive, preemptive, and participatory (P4) Pulmonary medicine. We demonstrate approaches to (a) stratify lungs from different subjects based on the spatial distribution of parenchymal abnormality and (b) visualize the stratification through glyphs that convey both the grouping efficacy and an iconic overview of an individual's lung wellness. Affinity propagation based on regional parenchymal abnormalities is used in the referenceless stratification. Abnormalities are computed using supervised classification based on Earth Mover's distance. Twenty natural clusters were detected from 372 CT lung scans. The computed clusters correlated with clinical consensus of 9 disease types. The quality of inter- and intra-cluster stratification as assessed by ANOSIM R was 0.887 +/- 0.18 (pval < 0.0005). The proposed tools could serve as biomarkers to objectively diagnose pathology, track progression and assess pharmacologic response within and across patients.
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- 2011
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15. [Myocardial infarct, pulmonary fibrosis and osteoporosis encumber the prognosis].
- Author
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Stiefelhagen P
- Subjects
- Arthritis, Rheumatoid diagnosis, Arthritis, Rheumatoid therapy, Comorbidity, Early Diagnosis, Humans, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Osteoporosis diagnosis, Osteoporosis therapy, Prognosis, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis therapy, Arthritis, Rheumatoid mortality, Cause of Death, Myocardial Infarction mortality, Osteoporosis mortality, Pulmonary Fibrosis mortality
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- 2010
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16. Anti-cyclic citrullinated peptide-2 (CCP2) autoantibodies and extra-articular manifestations in Greek patients with rheumatoid arthritis.
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Alexiou I, Germenis A, Koutroumpas A, Kontogianni A, Theodoridou K, and Sakkas LI
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- Aged, Arthritis, Rheumatoid ethnology, Felty Syndrome diagnosis, Felty Syndrome etiology, Felty Syndrome immunology, Greece ethnology, Humans, Middle Aged, Prognosis, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis immunology, Raynaud Disease diagnosis, Raynaud Disease etiology, Raynaud Disease immunology, Retrospective Studies, Rheumatoid Factor immunology, Rheumatoid Nodule diagnosis, Rheumatoid Nodule etiology, Rheumatoid Nodule immunology, Serositis diagnosis, Serositis immunology, Sjogren's Syndrome diagnosis, Sjogren's Syndrome etiology, Sjogren's Syndrome immunology, Vasculitis diagnosis, Vasculitis etiology, Vasculitis immunology, Arthritis, Rheumatoid complications, Arthritis, Rheumatoid immunology, Autoantibodies blood, Peptides, Cyclic immunology, Pulmonary Fibrosis etiology, Serositis etiology
- Abstract
The objective of our study was to establish whether there is an association between rheumatoid arthritis with extra-articular manifestations (exRA) and anti-cyclic citrullinated peptide 2 (anti-CCP2) antibodies in Greeks. A retrospective study of 220 Greek patients with RA, 95 with exRA and 125 without extra-articular manifestations (cRA). Serum anti-CCP2 antibodies and IgM rheumatoid factor (RF) were measured. CCP2(+) were 65.3% of exRA and 58.4% of cRA patients. RF(+) were 69.5% of exRA and 60.0% of cRA patients. Among exRA patients, 37.9% had high serum anti-CCP2 antibody levels (>100 IU/ml) compared to 21.6% cRA patients (p = 0.008). Serositis and pulmonary fibrosis were found to be associated with high levels of anti-CCP2 antibodies (52.9 vs 26.6%, p = 0.02 and 63.6 vs 26.8%, p = 0.008, respectively). Serum RF levels were 265.0 +/- 52.0 IU/ml (mean +/- SEM) in exRA and 205.1 +/- 40.6 (mean +/- SEM) in cRA (NS). High serum RF levels (>268 IU/ml) were more likely to have sicca syndrome. In Greek patients with rheumatoid arthritis (RA), high serum anti-CCP2 antibodies are associated with serositis and pulmonary fibrosis. Therefore, anti-CCP2 antibodies have prognostic significance in patients with RA.
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- 2008
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17. [Systemic sclerosis--a challenge in rheumatology].
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Saar P and Müller-Ladner U
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- Antibodies, Antinuclear blood, Gastrointestinal Diseases diagnosis, Gastrointestinal Diseases drug therapy, Gastrointestinal Diseases immunology, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary immunology, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic drug therapy, Kidney Failure, Chronic immunology, Penicillamine administration & dosage, Penicillamine adverse effects, Prognosis, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis drug therapy, Pulmonary Fibrosis immunology, Raynaud Disease diagnosis, Raynaud Disease drug therapy, Raynaud Disease immunology, Risk Factors, Scleroderma, Systemic drug therapy, Scleroderma, Systemic immunology, Tomography, X-Ray Computed, Vasodilator Agents administration & dosage, Vasodilator Agents adverse effects, Scleroderma, Systemic diagnosis
- Abstract
The connective tissue disease systemic sclerosis (SSc) is still a challenge to every rheumatologist. SSc is characterized by progressing fibrosis of the skin and internal organs, abnormal activation of the immune system and distinct changes in microcirculation. Although it is a rare disease with a prevalence of about 20:100,000 one may come across it in daily practice. SSc is classified into limited and diffuse forms. Both entities usually involve internal organs. Life expectancy is limited and depends predominantly on the extent of the organs involved. Therefore, it is essential to diagnose SSc early and to identify and closely monitor the organs involved.
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- 2006
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18. [Farmer with blue lips].
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Palm HG
- Subjects
- Aged, Cyanosis etiology, Diagnosis, Differential, Farmer's Lung complications, Humans, Male, Pulmonary Fibrosis complications, Pulmonary Fibrosis etiology, Cyanosis diagnosis, Farmer's Lung diagnosis, Pulmonary Fibrosis diagnosis
- Published
- 2006
19. Systemic sclerosis sine scleroderma presenting as pulmonary intersticial fibrosis.
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Vañó Sanchis D, Arranz Garcia G, and Yglesias PJ
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- Aged, 80 and over, Diagnosis, Differential, Female, Humans, Pulmonary Fibrosis etiology, Pulmonary Fibrosis physiopathology, Radiography, Thoracic, Respiratory Function Tests, Scleroderma, Systemic complications, Scleroderma, Systemic physiopathology, Tomography, X-Ray Computed, Pulmonary Fibrosis diagnosis, Scleroderma, Systemic diagnosis, Skin pathology
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- 2006
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20. A study on vascular endothelial growth factor and endothelin-1 in patients with extra-articular involvement of rheumatoid arthritis.
- Author
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Kuryliszyn-Moskal A, Klimiuk PA, Sierakowski S, and Ciolkiewicz M
- Subjects
- Amyloidosis blood, Amyloidosis diagnosis, Amyloidosis etiology, Arthritis, Rheumatoid complications, Arthritis, Rheumatoid physiopathology, Blood Sedimentation, Enzyme-Linked Immunosorbent Assay, Female, Glomerulonephritis blood, Glomerulonephritis diagnosis, Glomerulonephritis etiology, Health Status, Humans, Male, Middle Aged, Neovascularization, Pathologic etiology, Neovascularization, Pathologic physiopathology, Pulmonary Fibrosis blood, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis etiology, Severity of Illness Index, Arthritis, Rheumatoid blood, Endothelin-1 blood, Neovascularization, Pathologic blood, Vascular Endothelial Growth Factor A blood
- Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease associated with a wide range of extra-articular manifestations. Recent studies emphasise a key inflammatory role of the endothelial cells, either by overexpression of inflammatory mediators or by the proliferation of new blood vessels, in the disease process leading to the systemic organ involvement. To evaluate the relationship between internal organ manifestations and immunological markers of endothelial activation, serum levels of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were determined by an enzyme-linked immunosorbent assay in 64 RA patients and in 32 healthy controls. In comparison with a control group, higher serum concentrations of VEGF and ET-1 (p<0.001) in RA patients were demonstrated. A comparison between both RA groups with (20 patients) and without systemic involvement (44 patients) showed significantly higher concentrations of VEGF (p<0.05) and ET-1 (p<0.01) in the sera of patients with systemic manifestation. Moreover, a significant positive correlation between VEGF and ET-1 (r=0.475, p<0.001) in RA patients was found. A positive correlation between VEGF and Disease Activity Score (DAS) 28 index (r=0.39, p<0.005) as well as erythrocyte sedimentation rate (ESR) (r=0.564, p<0.0001) and C-reactive protein was found. ET-1 serum level correlated significantly with ESR (r=0.326, p<0.05) and DAS 28 index (r=0.307, p<0.05). These results suggest that the elevated serum levels of VEGF and ET-1 are associated with systemic organ involvement in RA patients and may play a key role in the pathogenesis of extra-articular manifestation of the disease.
- Published
- 2006
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21. [Increasing dyspnea: myocardial infarction anamnesis led to wrong track].
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Stiefelhagen P
- Subjects
- Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones therapeutic use, Aged, Azathioprine administration & dosage, Azathioprine therapeutic use, Diagnosis, Differential, Female, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents therapeutic use, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis drug therapy, Dyspnea etiology, Pulmonary Fibrosis complications, Pulmonary Fibrosis diagnostic imaging, Radiography, Thoracic, Tomography, X-Ray Computed
- Published
- 2005
22. [Mold fungi as disease agents. Sick people in sick houses?].
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Stiefelhagen P
- Subjects
- Alveolitis, Extrinsic Allergic diagnosis, Animals, Asthma diagnosis, Bronchial Provocation Tests, Bronchoalveolar Lavage Fluid, Columbidae, Humans, Intestines microbiology, Pulmonary Fibrosis diagnosis, Radiography, Thoracic, Alveolitis, Extrinsic Allergic etiology, Asthma etiology, Fungi isolation & purification, Pulmonary Fibrosis etiology, Sick Building Syndrome diagnosis
- Published
- 2004
23. Static lung compliance as an index of early pulmonary disease in systemic sclerosis.
- Author
-
Sud A, Gupta D, Wanchu A, Jindal SK, and Bambery P
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Pulmonary Diffusing Capacity, Pulmonary Fibrosis etiology, Spirometry, Lung Compliance, Pulmonary Fibrosis diagnosis, Scleroderma, Systemic physiopathology
- Abstract
Pulmonary function abnormalities constitute the most important cause of morbidity and mortality in patients with systemic sclerosis (SSc). A restrictive ventilatory defect with a reduction in pulmonary carbon monoxide diffusion capacity (DLCO) is the commonest finding. Static lung compliance (Cst) is perhaps the most sensitive parameter for the detection of abnormal pulmonary mechanics. We compared the results of Cst and DLCO in patients with SSc and normal spirometry to identify early pulmonary disease. Sixteen of 50 patients had normal spirometry, eight of whom had abnormal Cst. Four of them also had a reduced DLCO. Two patients had abnormal DLCO but their Cst was normal. One of them had pulmonary hypertension on echocardiography. We conclude that Cst was helpful in diagnosing early pulmonary abnormality in 50% of patients with normal spirometry. Among these patients Cst was a better index of abnormality than DLCO.
- Published
- 2001
- Full Text
- View/download PDF
24. Amyopathic dermatomyositis and pulmonary fibrosis.
- Author
-
Chow SK and Yeap SS
- Subjects
- Dermatomyositis drug therapy, Disease Progression, Female, Humans, Middle Aged, Pulmonary Fibrosis drug therapy, Treatment Failure, Dermatomyositis complications, Dermatomyositis diagnosis, Pulmonary Fibrosis complications, Pulmonary Fibrosis diagnosis
- Abstract
'Amyotrophic dermatomyositis' (ADM) is used to describe a small subgroup of patients with the typical skin rash associated with dermatomyositis but without muscle involvement. Lung involvement in ADM is rare. We report on the management of a patient with ADM associated with pulmonary fibrosis at presentation, and her response to corticosteroid treatment.
- Published
- 2000
- Full Text
- View/download PDF
25. Clinical, laboratory and radiological findings in pulmonary fibrosis with and without connective tissue disease.
- Author
-
Renzoni E, Rottoli P, Coviello G, Perari MG, Galeazzi M, and Vagliasindi M
- Subjects
- Antibodies, Antinuclear analysis, Bronchoalveolar Lavage Fluid cytology, Connective Tissue Diseases drug therapy, Connective Tissue Diseases mortality, Diagnosis, Differential, Fluorescent Antibody Technique, Indirect, Humans, Middle Aged, Peptidyl-Dipeptidase A analysis, Prednisone therapeutic use, Pulmonary Fibrosis mortality, Pulmonary Fibrosis therapy, Respiratory Function Tests, Retrospective Studies, Scleroderma, Systemic diagnosis, Survival Rate, Treatment Outcome, Connective Tissue Diseases diagnosis, Pulmonary Fibrosis diagnosis
- Abstract
Uncertainty exists over whether to consider "lone" idiopathic pulmonary fibrosis (LIPF) and pulmonary fibrosis associated with connective tissue disorders (PFCTD) as significantly different entities. We retrospectively analysed data collected at the time of first diagnosis in 17 patients with LIPF and in 14 patients with PFCTD and compared survival in the two groups. At first evaluation, the time from onset of respiratory symptoms, spirometric volumes and the diffusing capacity for carbon monoxide were not significantly different between the two groups. However, arterial oxygen tension was significantly lower in LIPF than in PFCTD (63 +/- 3 vs 88 +/- 3 mmHg, p < 0.001). The radiological profusion scores relative to the upper and middle lung fields were significantly higher in LIPF than in PFCTD (upper regions: 6.9 +/- 0.6 vs 3.4 +/- 0.6, p < 0.005 - middle regions: 7.1 +/- 0.5 vs 4.8 +/- 0.7, p < 0.025), whereas the scores relative to the lower fields were similar (7.4 +/- 0.4 in LIPF and 8.4 +/- 0.6 in PFCTD). Survival since onset of respiratory symptoms was significantly better in the PFCTD than in LIPF patients, with a hazard ratio of 4.16 (95% CI 1.12-15.58, p=0.034). Thus, in our series of patients, those with LIPF had a more severe disease than those with PFCTD as shown by the higher frequency of hypoxaemia, the more diffuse pulmonary involvement demonstrated by the chest X-ray and the decreased survival.
- Published
- 1997
- Full Text
- View/download PDF
26. Case report and review of the literature. Fatal pulmonary complication in ankylosing spondylitis.
- Author
-
Strobel ES and Fritschka E
- Subjects
- Adult, Fatal Outcome, Humans, Pulmonary Fibrosis complications, Pulmonary Fibrosis diagnostic imaging, Tomography, X-Ray Computed, Pulmonary Fibrosis diagnosis, Spondylitis, Ankylosing complications
- Abstract
A 44-year-old non-smoking patient with longstanding ankylosing spondylitis presented in marked respiratory distress with tachypnea, fever, cough, greenish sputum, night sweats, dyspnea and weight loss. Computed tomography showed traction bronchiectases and cavities associated with scarring. The findings were most pronounced in the upper lobes which contained multiple cavities up to 8 cm in diameter harboring fungus balls. The superior segment of the left lower lobe showed two additional cavities. Tuberculosis and atypical mycobacteria were ruled out. Antibiotic therapy resulted in transient improvement. Five months after this acute exacerbation the patient expired from massive haemoptysis. Pulmonary fibrosis is a rare manifestation of ankylosing spondylitis, may be complicated by infection and haemorrhage and determine the dismal prognosis of these patients.
- Published
- 1997
- Full Text
- View/download PDF
27. [Case report and discussion of a patient with polymyositis, fibrosing alveolitis and scleroderma-like involvement of the right hand].
- Author
-
Wunderlin B, Knüsel O, and Kummer H
- Subjects
- Adult, Antibodies, Antinuclear blood, Biopsy, Combined Modality Therapy, Cyclosporine administration & dosage, Cyclosporine adverse effects, Diagnosis, Differential, Drug Administration Schedule, Follow-Up Studies, Hand Dermatoses drug therapy, Hand Dermatoses immunology, Humans, Immunization, Passive, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Lung pathology, Male, Muscle, Skeletal pathology, Neurologic Examination, Polymyositis drug therapy, Polymyositis immunology, Pulmonary Fibrosis drug therapy, Pulmonary Fibrosis immunology, Scleroderma, Systemic drug therapy, Scleroderma, Systemic immunology, Treatment Outcome, Hand Dermatoses diagnosis, Polymyositis diagnosis, Pulmonary Fibrosis diagnosis, Scleroderma, Systemic diagnosis
- Abstract
It is important to know the diagnostic procedure and therapy of polymyositis (PM) inspite of its rare incidence. We describe a case with PM, interstitial lung disease, high titers of anti-Jo-1-antibodies and affection of the right hand, that could be followed over 11 years. The differentiation of PM from neurologic diseases and toxic myopathies is mentioned. The patient was successfully treated with cyclosporin over a period of 20 months, but he is now in remission while receiving steroids alone. We emphasize the importance of early treatment of PM with high-dose steroids and the addition of immunosuppressive drugs (azathioprin, methotrexate, cyclophosphamid) in cases with high disease activity or resistance to steroids. In the treatment of PM/DM immunoglobulins play an increasingly important role. The problems of long-term treatment with steroids are of special interest.
- Published
- 1996
28. [Anti-Jo-1 antibodies: specific autoantibodies for polymyositis with interstitial pulmonary fibrosis. 2 case reports].
- Author
-
Fischer E, Thiele A, Stierle HE, and Lang B
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Antibody Specificity immunology, Cyclophosphamide therapeutic use, Drug Therapy, Combination, Female, Humans, Male, Methotrexate therapeutic use, Polymyositis diagnosis, Polymyositis drug therapy, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis drug therapy, Antibodies, Antinuclear immunology, Polymyositis immunology, Pulmonary Fibrosis immunology
- Abstract
Anti-Jo-1 antibodies are rare autoantibodies, which bind and inhibit the activity of histidyl-tRNA-synthetase. They are predominantly found in a genetically and clinically distinct subset of myositis patients, presenting with interstitial alveolitis. We describe the case of a 22-year-old woman with Jo-1-syndrome with typical features of myositis, pulmonary fibrosis, nonerosive symmetric polyarthritis, Gottron's papules at the metacarpophalangeal joints and classic heliotrope discoloration of the periorbital area with edema. The patient did not respond to chloroquine, azathioprine, intravenous immunoglobulins or cyclophosphamide. Remission was finally achieved with oral methotrexate plus corticosteroids. The second case describes a 34-year-old man with myositis, who rapidly developed respiratory insufficiency after suffering from joint pain and stiffness for about 10 weeks. He responded well to cyclophosphamide pulse therapy and high-dose corticosteroids. The second case demonstrates that control of the interstitial alveolitis is most important for long-term outcome. Therefore, immunosuppressive drugs should be used along with corticosteroids as early as possible.
- Published
- 1995
29. Interstitial alveolitis as early manifestation of anti-Jo-1 positive polymyositis.
- Author
-
Löhr HF, Böcher WO, Hermann E, Müller-Quernheim J, Schwickert H, Meyer zum Büschenfelde KH, and Gerken G
- Subjects
- Aged, Bronchoscopy, Humans, Immunosuppressive Agents therapeutic use, Male, Polymyositis drug therapy, Polymyositis immunology, Pulmonary Fibrosis drug therapy, Pulmonary Fibrosis immunology, Tomography, X-Ray Computed, Antibodies, Antinuclear analysis, Polymyositis diagnosis, Pulmonary Fibrosis diagnosis
- Abstract
Polymyositis (PM), dermatomyositis (DM) and inclusion-body myositis belong to a heterogenous group of inflammatory myopathies. Pulmonary manifestations occur in a minority of PM patients due to infiltration of diaphragmatic and thoracic muscles or more rarely due to interstitial lung disease. Here, we report on the case of a 67-year-old patient who developed an interstitial idiopathic alveolitis as an early and rare manifestation of anti-Jo-1-positive polymyositis. Clinical and pathogenetical features of the PM associated interstitial alveolitis are discussed.
- Published
- 1993
30. [Polymyositis and Jo-1 syndrome].
- Author
-
Treher E, Niederhoff A, Gellissen U, Schmidt P, Dornberg M, and Peter HH
- Subjects
- Adult, Amyloidosis diagnosis, Amyloidosis drug therapy, Amyloidosis immunology, Colchicine administration & dosage, Cyclophosphamide administration & dosage, Diclofenac administration & dosage, Drug Therapy, Combination, Female, Fluorescent Antibody Technique, Histidine-tRNA Ligase immunology, Humans, Methotrexate administration & dosage, Nifedipine administration & dosage, Polymyositis drug therapy, Polymyositis immunology, Prednisolone administration & dosage, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis drug therapy, Pulmonary Fibrosis immunology, Raynaud Disease diagnosis, Raynaud Disease drug therapy, Raynaud Disease immunology, Syndrome, Antibodies, Antinuclear analysis, Polymyositis diagnosis
- Abstract
Polymyositis is a primarily clinical diagnosis. In 30-40% of patients, however, the specific anti-Jo-1 antibody (anti-histidyl-tRNA-synthetase) can be found. These cases are often associated with interstitial lung disease and other typical clinical manifestations. This symptomatology is called Jo-1-syndrome. Prognosis depends on early diagnosis, since Jo-1 associated interstitial lung disease resulting in pulmonary fibrosis is favorably influenced by immunosuppressive therapy, especially with corticosteroids. The present report concerns a patient with Jo-1-syndrome and beginning pulmonary fibrosis who was treated with methotrexate and prednisolone with good initial response. After 1 year the patient's condition had deteriorated, so that the therapy was changed to cyclophosphamide. Longterm results under this therapy remain to be evaluated.
- Published
- 1993
31. Validated method for automatic detection of lung sound crackles.
- Author
-
Kaisla T, Sovijärvi A, Piirilä P, Rajala HM, Haltsonen S, and Rosqvist T
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Bronchiectasis diagnosis, Pulmonary Fibrosis diagnosis, Respiratory Sounds diagnosis, Signal Processing, Computer-Assisted
- Abstract
Crackling lung sounds are associated with many pulmonary diseases. Their occurrence reflects the quality and the severity of the disease. An automatic method for crackle detection is developed, based on analysing the spectral stationarity of the lung sound. The method is validated by studying the crackles of 20 adult patients; 10 with fibrosing alveolitis (FA) and 10 with bronchiectasis (BE). The number of crackles detected by the automatic method in inspiratory cycles is compared to the number of crackles counted from time-expanded waveforms by two expert observers. The total number of inspiratory cycles studied is 117 and that of crackles 1064. The method has a sensitivity of 89 per cent and a positive predictivity of 88 per cent for patients with FA, and 80 per cent and 83 per cent respectively, for patients with BE. The linear correlation coefficients between the numbers of crackles counted by the automatic method and by the observers is 0.86 (p less than 0.001) for the patients with FA and 0.93 (p less than 0.001) for the patients with BE. The values refer to whole inspiratory cycles. The new automatic method seems reliable enough for clinical and scientific purposes. It enables a rapid and objective analysis of large materials with crackling lung sounds.
- Published
- 1991
- Full Text
- View/download PDF
32. Fiberoptic bronchoscopic diagnosis of pulmonary disease in 151 HIV-infected patients with pneumonitis.
- Author
-
Jiménez ML, Aspa J, Padilla B, Ancochea J, González A, Fraga J, Santos I, Martínez R, Gómez Herruz P, and López-Brea M
- Subjects
- Adult, Bacterial Infections complications, Bacterial Infections diagnosis, Bronchoalveolar Lavage Fluid microbiology, Bronchoscopy, Cytomegalovirus Infections complications, Cytomegalovirus Infections diagnosis, Female, Fiber Optic Technology, Homosexuality, Humans, Lung Diseases, Fungal complications, Lung Diseases, Fungal diagnosis, Male, Middle Aged, Opportunistic Infections complications, Pneumonia, Pneumocystis complications, Pneumonia, Pneumocystis diagnosis, Prospective Studies, Pulmonary Fibrosis complications, Sarcoma, Kaposi complications, Substance Abuse, Intravenous complications, HIV Infections complications, Opportunistic Infections diagnosis, Pulmonary Fibrosis diagnosis, Sarcoma, Kaposi diagnosis
- Abstract
In a prospective study the efficacy of fiberoptic bronchoscopy was evaluated in the diagnosis of infections with opportunistic pathogens, Kaposi's sarcoma and nonspecific interstitial pneumonitis in 171 episodes of pneumonitis in 151 HIV-infected patients. Samples were collected by suction through the inner aspiration channel of the bronchoscope (n = 164), telescoping plugged catheter (n = 117) and transbronchial lung biopsy (n = 82). A high incidence of infections with pyogenic bacteria (12%), Legionella spp. (5 %) and Mycobacterium tuberculosis were diagnosed (9%). Bronchoalveolar lavage demonstrated a high diagnostic rate in bacterial pneumonia (significance level greater than 10(5) cfu/ml) and a low degree (10%) of contamination (less than 1% squamous epithelial cells). Bronchoalveolar lavage was more effective than the telescoping plugged catheter in yielding a significant number of colonies in patients with bacterial pneumonia previously treated with antibiotics. Nondiagnosed pneumonitis was more frequent in intravenous drug abusers than in homosexual men (p less than 0.001).
- Published
- 1991
- Full Text
- View/download PDF
33. [Bronchoalveolar lavage in diseases of rheumatic origin].
- Author
-
Petermann W
- Subjects
- Humans, Leukocyte Count, Bronchoalveolar Lavage Fluid cytology, Pulmonary Fibrosis diagnosis, Rheumatic Diseases diagnosis
- Abstract
The cells recovered by bronchoalveolar lavage reflect the cellular composition of the interstitial lung tissue. Inflammatory and fibrosing interstitial lung disorders, often accompanying rheumatic diseases, can be detected by this diagnostic procedure.
- Published
- 1990
34. [New knowledge on the diagnosis and prognosis of interstitial lung disease in scleroderma].
- Author
-
König G, Behr J, and Luderschmidt C
- Subjects
- Bronchoalveolar Lavage Fluid cytology, Humans, Leukocyte Count, Prognosis, Pulmonary Fibrosis diagnosis, Scleroderma, Systemic diagnosis
- Abstract
According to their clinical manifestation 101 patients with scleroderma were separated in morphea (n = 17) and progressive systemic sclerosis (PSS) (n = 84). PSS was divided into Type I (Acrosclerosis, n = 19), Type II (proximal ascending scleroderma, n = 61), and Type III (trunk scleroderma, n = 4). Lung function testing was done, including vital capacity, total capacity, FEV1.0, airway resistance, CO-transfer factor, lung compliance, blood gases at rest and during exercise. Patients suffering from Type-II or -III PSS, especially when displaying signs of inflammation in blood and serum (Form A) carry a much higher risk of developing severe life-limiting lung involvement compared to patients with morphea or Type-I PSS, or those without signs of inflammation (Form B). Lung function indicates the severity of functional involvement and inables to differentiate from obstructive bronchopulmonary disease. Bronchoalveolar lavage (BAL) showed a normal cell pattern in all Type-I patients (n = 5). In contrast, only six out of 33 Type-II patients had a normal BAL. PSS patients showing signs of inflammation in blood and serum (Form A) had, compared to those without inflammation (Form B), significantly elevated numbers of inflammatory cells in BAL. These results show that in patients with a high incidence of pulmonary manifestation in PSS (Type II, III, Form A) an inflammatory cell pattern in BAL was found significantly more frequently than in those patients without this risk factor (Type I, Form B). In the course of disease lung function of patients without inflammatory activity in BAL remained unchanged irrespective of whether there was an immunosuppressive treatment or not.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1990
35. [The status of standardization of oscillatory parameters for assessment of respiratory technic].
- Author
-
Pfleger E
- Subjects
- Humans, Inspiratory Capacity, Lung Compliance, Pulmonary Emphysema diagnosis, Pulmonary Fibrosis diagnosis, Reference Values, Software, Airway Resistance, Lung Diseases, Obstructive diagnosis, Oscillometry instrumentation, Signal Processing, Computer-Assisted
- Published
- 1989
36. Severe spirometric defects in systemic lupus erythematosus. A possible role for bronchoalveolar lavage and gallium scanning.
- Author
-
Lin RY
- Subjects
- Adolescent, Female, Humans, Pulmonary Fibrosis diagnosis, Therapeutic Irrigation, Ventilation-Perfusion Ratio, Gallium Radioisotopes, Lung Diseases, Obstructive diagnosis, Lupus Erythematosus, Systemic diagnosis, Pulmonary Alveoli pathology, Spirometry
- Abstract
Two patients with systemic lupus erythematosus (SLE) developed progressive chronic pulmonary disease. Pulmonary bronchoalveolar lavage (BAL) and Gallium-67 scanning were performed and were consistent with alveolitis. In one patient, an open lung biopsy was performed and showed the presence of several immunoreactants as well as interstitial pneumonitis. Although mild pulmonary function abnormalities are common in SLE, some patients such as the two described in this report develop progressive and incapacitating pulmonary impairment. The need for developing standardized indices of pulmonary inflammation such as BAL and gallium scanning for the purposes of diagnosis, prognostication, and monitoring treatment responses in systemic lupus erythematosus is stressed.
- Published
- 1987
- Full Text
- View/download PDF
37. Interstitial lung disease as the presentation of anti-Jo-1 positive polymyositis.
- Author
-
Nash P, Schrieber L, and Webb J
- Subjects
- Aged, Female, Humans, Myositis diagnosis, Osteoarthritis immunology, Pulmonary Fibrosis diagnosis, Antibodies, Antinuclear analysis, Myositis immunology, Pulmonary Fibrosis immunology
- Abstract
A patient presenting with interstitial lung disease was predicted to have underlying polymyositis when found to be anti-Jo-1 antibody positive. When myopathy developed later with elevated serum creatine phosphokinase and myoglobin levels, the electromyogram was nonmyopathic, and polymyositis was confirmed by muscle biopsy. The case illustrates the value of anti-Jo-1 as a 'marker' autoantibody for polymyositis, and the need for thorough investigation of patients with interstitial lung disease of uncertain etiology. This should include indirect immunofluorescence using a dividing cell substrate and tests for antibodies to extractable tissue antigens. The need to completely evaluate patients with dermatopolymyositis is also emphasised.
- Published
- 1987
- Full Text
- View/download PDF
38. [Treatment of interstitial pulmonary fibrosis with D-penicillamine in progressive scleroderma: a long-term study (author's transl)].
- Author
-
Bröll H, Tausch G, and Eberl R
- Subjects
- Aged, Drug Evaluation, Female, Follow-Up Studies, Humans, Immunosuppressive Agents therapeutic use, Male, Middle Aged, Pulmonary Fibrosis diagnosis, Scleroderma, Systemic drug therapy, Penicillamine therapeutic use, Pulmonary Fibrosis drug therapy, Scleroderma, Systemic complications
- Abstract
5 patients suffering from progressive scleroderma with interstitial pulmonary fibrosis have been treated since 1971 with D-penicillamine (Artamin) as basic therapeutic agent. All patients showed a significant tendency towards normalization of the pathological findings in regard to functional capacity of the lungs and scintigraphic and radiological assessment. These results, in our opinion, justify the recommendation of a new indication for D-penicillamine therapy, namely in cases of progressive scleroderma with interstitial pulmonary fibrosis.
- Published
- 1976
39. [Early detection of fibrosing alveolitis in collagenoses].
- Author
-
Petermann W
- Subjects
- Airway Resistance, Humans, Lung Compliance, Oxygen blood, Plethysmography, Whole Body, Pulmonary Diffusing Capacity, Total Lung Capacity, Vital Capacity, Collagen Diseases diagnosis, Pulmonary Fibrosis diagnosis
- Abstract
Lung function tests during a five-year follow-up were performed on 29 patients with various collagen diseases. At the beginning of the study none of the patients had signs of any pulmonary dysfunction. The onset of fibrosing alveolitis was accompanied by a marked reduction of the diffusing capacity for CO and a more minor alteration of the static specific compliance. The vital capacity and the pO2 at rest changed only in cases of advanced pulmonary fibrosis.
- Published
- 1986
40. Systemic lupus erythematosus and pulmonary hypertension.
- Author
-
Scherak O and Kolarz G
- Subjects
- Adult, Female, Hemodynamics, Humans, Lung Volume Measurements, Lupus Erythematosus, Systemic diagnosis, Male, Middle Aged, Pulmonary Fibrosis diagnosis, Hypertension, Pulmonary diagnosis, Lupus Erythematosus, Systemic complications
- Abstract
Pulmonary hypertension is one of the complications in the pulmonary manifestation of SLE. Following a two year SLE history a patient developed pulmonary hypertension although his chest radiograph showed neither pulmonary changes nor signs of hypertension. In two other patients, interstitial fibrosis, pleurisy and pulmonary hypertension were the initial manifestations of SLE. They all complained of dyspnoea and respiratory chest pain. Lung function studies showed restrictive changes, reduced lung compliance and, by two patients, reduced diffusion capacity. Lung biopsy performed in one patient revealed interstitial fibrosis, focal lymphocyte infiltrations and intima proliferation of the arterioles. All three patients were treated with anticoagulants in addition to steroids and cytotoxic drugs. After a period of 8 to 42 months examinations were repeated and all three patients showed improved hypertension and less physical ailment. The radiographs from two patients even revealed an improvement of their pulmonary changes.
- Published
- 1981
41. [Diffuse interstitial lung processes: differencial diagnosis, by the physiologic respiratory studies].
- Author
-
Witek F
- Subjects
- Adult, Aged, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Cystic Fibrosis diagnosis, Lung Diseases diagnosis, Lung Neoplasms diagnosis, Pulmonary Fibrosis diagnosis, Pulmonary Heart Disease diagnosis, Respiratory Function Tests
- Published
- 1966
42. [Pulmonary fibrosis].
- Author
-
Mlczoch F
- Subjects
- Autoantibodies analysis, Autoimmune Diseases, Bronchoscopy, Electrocardiography, Humans, Hyperventilation, Oxygen Consumption, Pulmonary Diffusing Capacity, Respiratory Function Tests, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis etiology
- Published
- 1971
43. [Lung fibrss].
- Author
-
Morawetz F
- Subjects
- Acute Disease, Adult, Aged, Anti-Glomerular Basement Membrane Disease complications, Antigen-Antibody Reactions, Biopsy, Diagnosis, Differential, Farmer's Lung diagnosis, Farmer's Lung etiology, Female, Hemosiderosis, Histiocytosis, Langerhans-Cell complications, Humans, Lung radiation effects, Lupus Erythematosus, Systemic complications, Male, Middle Aged, Pneumonia, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis etiology, Respiratory Function Tests, Rheumatic Diseases complications, Scleroderma, Systemic complications, Pulmonary Fibrosis classification
- Published
- 1967
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