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CT findings of COVID-19 in follow-up: comparison between progression and recovery.

随访新型冠状病毒肺炎的CT表现: 进展与恢复的比较。

  • 影响因子:1.75
  • DOI:10.5152/dir.2019.20176
  • 作者列表:"Guan CS","Wei LG","Xie RM","Lv ZB","Yan S","Zhang ZX","Chen BD
  • 发表时间:2020-07-01
Abstract

PURPOSE:We aimed to retrospectively analyze the imaging changes detected in the follow-up of coronavirus disease 2019 (COVID-19) patients on thin-section computed tomography (CT). METHODS:We included 54 patients diagnosed with COVID-19. The mean interval between the initial and follow-up CT scans was 7.82±3.74 days. Patients were divided into progression and recovery groups according to their outcomes. We evaluated CT images in terms of distribution of lesions and imaging manifestations. The manifestations included ground-glass opacity (GGO), crazy-paving pattern, consolidation, irregular line, and air bronchogram sign. RESULTS:COVID-19 lesions showed mainly subpleural distribution, which was accompanied by bronchovascular bundle distribution in nearly 30% of the patients. The lower lobes of both lungs were the most commonly involved. In the follow-up, the progression group showed more involvement of the upper lobe of the left lung than the recovery group. GGO was the most common sign. As the disease progressed, round GGO decreased and patchy GGO increased. On follow-up CT, consolidation increased in the progression group while decreasing in the recovery group. Air bronchogram sign was more commonly observed at the initial examination (90.9%) than at follow-up (30%) in the recovery group, but there was no significant change in the progression group. Pleural effusion and lymphadenopathy were absent in the initial examination, but pleural effusion was observed in three cases after follow-up. CONCLUSION:As COVID-19 progressed, round GGOs tended to evolve into patchy GGOs, consolidation increased, and pleural effusion could be occasionally observed. As COVID-19 resolved, the crazy-paving pattern and air bronchogram significantly decreased.

摘要

目的: 我们旨在回顾性分析2019例 (新型冠状病毒肺炎) 冠状病毒病患者薄层CT随访中发现的影像学变化。 方法: 我们纳入了54例确诊为新型冠状病毒肺炎的患者。初始ct扫描和随访ct扫描之间的平均间隔为7.82 ± 3.74天。根据患者的预后将其分为进展组和恢复组。我们根据病变的分布和影像学表现评估CT图像。表现包括磨玻璃影 (GGO) 、疯狂铺路、实变、不规则线和空气支气管图征。 结果: 新型冠状病毒肺炎个病灶以胸膜下分布为主,近30% 的患者伴有支气管血管束分布。双肺下叶最常受累。在随访中,进展组显示左肺上叶较恢复组受累更多。GGO是最常见的体征。随着病情进展,圆形GGO减少,片状GGO增加。在随访CT中,进展组的巩固增加,而恢复组的巩固减少。恢复组在初次检查时 (90.9%) 比随访时 (30%) 更常见观察到空气支气管图征,但进展组无显著变化。初次检查无胸腔积液和淋巴结肿大,但随访3例出现胸腔积液。 结论: 随着新型冠状病毒肺炎的进展,圆形gos趋于演变为片状gos,实变增加,偶尔可观察到胸腔积液。当新型冠状病毒肺炎消退时,疯狂铺路模式和空气支气管图显著下降。

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影响因子:6.93
发表时间:2020-01-01
DOI:10.1002/ijc.32419
作者列表:["Milosevic V","Kopecka J","Salaroglio IC","Libener R","Napoli F","Izzo S","Orecchia S","Ananthanarayanan P","Bironzo P","Grosso F","Tabbò F","Comunanza V","Alexa-Stratulat T","Bussolino F","Righi L","Novello S","Scagliotti GV","Riganti C"]

METHODS::Malignant pleural mesothelioma (MPM) is a tumor with high chemoresistance and poor prognosis. MPM-initiating cells (ICs) are known to be drug resistant, but it is unknown if and how stemness-related pathways determine chemoresistance. Moreover, there are no predictive markers of IC-associated chemoresistance. Aim of this work is to clarify if and by which mechanisms the chemoresistant phenotype of MPM IC was due to specific stemness-related pathways. We generated MPM IC from primary MPM samples and compared the gene expression and chemo-sensitivity profile of IC and differentiated/adherent cells (AC) of the same patient. Compared to AC, IC had upregulated the drug efflux transporter ABCB5 that determined resistance to cisplatin and pemetrexed. ABCB5-knocked-out (KO) IC clones were resensitized to the drugs in vitro and in patient-derived xenografts. ABCB5 was transcriptionally activated by the Wnt/GSK3β/β-catenin/c-myc axis that also increased IL-8 and IL-1β production. IL-8 and IL-1β-KO IC clones reduced the c-myc-driven transcription of ABCB5 and reacquired chemosensitivity. ABCB5-KO clones had lower IL-8 and IL-1β secretion, and c-myc transcriptional activity, suggesting that either Wnt/GSK3β/β-catenin and IL-8/IL-1β signaling drive c-myc-mediated transcription of ABCB5. ABCB5 correlated with lower time-to-progression and overall survival in MPM patients treated with cisplatin and pemetrexed. Our work identified multiple autocrine loops linking stemness pathways and resistance to cisplatin and pemetrexed in MPM IC. ABCB5 may represent a new target to chemosensitize MPM IC and a potential biomarker to predict the response to the first-line chemotherapy in MPM patients.

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影响因子:2.09
发表时间:2020-01-01
DOI:10.1016/j.jiph.2019.05.013
作者列表:["Nishimura A","Yamaguchi H","Ito Y","Tokumoto S","Toyoshima D","Kasai M","Maruyama A"]

METHODS::Empyema necessitatis (EN) is a rare complication of empyema in which the pleural infection spreads outside the pleural space. Lower airway infections are common among children with cerebral palsy (CP). Although harmless to healthy individuals, Pseudomonas aeruginosa can cause invasive infections, including CP, in immunocompromised hosts. Mycobacterium tuberculosis and Actinomyces spp. have been reported as common causative organisms of EN. However, EN caused by P. aeruginosa has never been reported. We report the case of an 8-year-old girl with CP without tracheotomy who was admitted to our hospital with complaints of fever and increased epileptic seizures. First, she was diagnosed with pneumonia and treated with antibiotics. However, seven days after admission, a palpable mobile mass overlying the lower part of the shoulder blade was noticed. Enhanced magnetic resonance imaging revealed broad high signal area on T2-weighted and diffusion-weighted images, indicating empyema of the left lower lung that had penetrated the pleural wall and spread to the subcutaneous area of the left back. Thus, she was diagnosed with EN. Twelve days after admission, P. aeruginosa was detected from the pus culture. Patients with CP who have chronic lung diseases, such as pneumonia, atelectasis, or empyema, may need careful follow up.

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胸膜疾病方向

胸膜疾病包括原发于胸膜的疾病,主要指胸膜间皮瘤,也包括胸膜腔内的异常情况,如脓胸、 血胸、胸腔积液等。

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