Drug delivery in pulmonary aspergillosis
Anthony J. Hickey, Heidi M. Mansour in Inhalation Aerosols, 2019
Aspergilloma is diagnosed by radiography. A computerized tomography (CT) scan of an aspergilloma presents as an ovoid or round opacity within the lung cavity and a thickening of localized pleura (20). A solid, round, or oval mass is separated from the wall of the cavity by a crescent of air. This is called an air crescent sign or monod sign (Figure 10.2) (21,22). In addition, this change of intracavitary mass from images taken in different positions determines the mobility of the mass within the cavity (22). This solid mass within the lung cavity changes lung physiology, causing poor drug penetration into the mycetomal cavities. Consequently, systemic antifungal drugs are not effective enough for the treatment of the disease (22,23). Definitive surgical therapy is often not possible secondary to severe underlying lung disease, and bronchial embolization may be required to treat significant hemoptysis (24,25). However, alternative therapies are currently needed for this disorder (25).
The Extra-Pleural and Pleural Spaces, including Plombages, Pleural Tumours and the Effects of Asbestos.
Fred W Wright in Radiology of the Chest and Related Conditions, 2022
A simple clinical test to prove the presence of a fistula is to inject methylene blue into the pleural cavity, and to note if it becomes coughed up. Large fistulae may be confirmed by bronchoscopy or be demonstrated by tomography, including CT. CT may also be useful in some cases for studying the position of a drainage tube and its track after removal. This latter may sometimes mimic an air-filled lung cavity - up to three to four weeks after removal.
Dictionary
Mario P. Iturralde in Dictionary and Handbook of Nuclear Medicine and Clinical Imaging, 1990
Diaphragmatic breathing. Breathing caused by contraction and relaxation of the diaphragm. As the diaphragm contracts during inhalation, it moves toward the abdomen, enlarging the lung cavity and drawing air into the lungs. The abdominal contents are simultaneously pushed outward and down. As the diaphragm relaxes, it moves upward, reducing the volume of the lungs and expelled air from them (exhalation).
Experimental protocol to evaluate lung parenchyma properties under inflation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
T. Pallière, A. Lanel, A. Bel-Brunon, K. Bruyère-Garnier, N. Biboulet, T. Lubrecht
Lung parenchyma is a multiscale foam-like tissue with several intricate phenomena. During inspiration, the diaphragm creates a depression on the lung cavity forcing air to enter; alveoli dilatation is favored by the presence of surfactant, a biofilm which decreases the surface tension on the inner surface of the alveoli. Lung parenchyma is composed of vasculature, air ducts, alveolar walls, surfactant; a loss of equilibrium between these components can lead to pathologies, such as fibrosis or emphysema, causing a mechanical vicious circle (Hinz and Suki 2016). Understanding how lung parenchyma behaves mechanically with its different components is still a challenge. Experimental characterization has been performed at the organ scale (Richardson et al. 2017) or on tissue strips (Bel-Brunon et al. 2014) but the former includes structural effects while the latter does not allow for realistic loading (inflation), leading to a poor identification of the constitutive law. The aim of the presented protocol is to acquire experimental data related to lung parenchyma inflation to build and identify a component-based constitutive law for this tissue, focusing on small scales (from alveoli to sub-segment). So to reach a sufficient imaging resolution, the protocol is designed for sub-segment lobules.
Emerging and potential treatment options for sarcoidosis
Published in Expert Opinion on Orphan Drugs, 2018
Debabrata Bandyopadhyay, Marc A. Judson
Mycetoma – Pulmonary mycetomas are conglomerations of intertwined fungal hyphae matted together with mucus, fibrin, and cellular debris [108]. Mycetoma tend to develop in areas of devitalized lung with a poor blood supply [108]. Aspergillus fumigatus is the overwhelming most common fungus that forms mycetoma. Although worldwide, a residual lung cavity related to previous tuberculosis is the most common underlying lung disease in which pulmonary mycetoma develop; in the United States, fibrocystic sarcoidosis is the probably the most common underlying lung disease associated with pulmonary mycetoma [109]. Mycetoma may cause life threating hemoptysis, and are a significant clinical problem in patients with end-stage fibrocystic sarcoidosis [110,111]. Although the presence of a mycetoma does not mandate treatment, sarcoidosis is associated with a particularly poor outcome if pulmonary mycetoma develop [112]. They are most commonly found in the upper lobes of sarcoidosis patients as that is where fibrocystic sarcoidosis is most common. Mycetoma were identified in 2% of patients in a US sarcoidosis specialty clinic, and, as expected, they were seen exclusively in patients with stage 4 fibrocystic disease [113].
Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging
Published in Expert Review of Respiratory Medicine, 2019
Ana Luiza Di Mango, Gláucia Zanetti, Diana Penha, Miriam Menna Barreto, Edson Marchiori
Plain radiographs of typical aspergillomas are characterized by the presence of a solid, round or oval soft-tissue mass within a lung cavity, with a ‘“ball-in-hole”’ aspect (Figure 8). The mass is separated from the wall of the cavity by airspace resulting in the ‘air crescent’ sign that usually moves when the patient changes position. CT accurately characterizes the heterogeneous soft tissue mass, which may contain some internal flecks of gas. The filling aspect of the lung cavity ranges from very solid forms (pseudo-tumoral) to very cavitating forms. CT may also depict pericavitary infiltrates, adjacent bronchiectasis, pleural thickening, and effusions or new satellite cavities in development [63,67,69,72,73].
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