Objective To assess the spectrum of causes, clinical features, differences between disease phases, and prognosis of extrinsic allergic alveolitis （EAA）. Methods Patients with EAA diagnosed at Peking Union Medical C...Objective To assess the spectrum of causes, clinical features, differences between disease phases, and prognosis of extrinsic allergic alveolitis （EAA）. Methods Patients with EAA diagnosed at Peking Union Medical College Hospital from August 1983 to May 2007 were analyzed retrospectively. Their medical records were examined to gather clinical, laboratorial, radiological, and histopathological data. Patients were divided to three phases （acute, subacute, and chronic） according to clinical presentations. Follow-up data regarding treatment response, subsequent radio- logical and pulmonary function studies, and clinical outcomes were collected. Results A total of 21 cases were enrolled. Among them, 11 were subacute, 10 were chronic. The most common exposure was pet birds （6 cases, 28.6%）. The primary abnormality of pulmonary function was restriction and/or reduction in diffusing capacity （12 cases, 63.2%）. The most common findings on high-resolution computed tomography （HRCT） were ground-glass opacities （13 cases, 68.4%） and centri- lobular nodules （8 cases, 42.1%）. Airway obstruction in pulmonary function test, emphysema, hmg cysts, and fibrosis on HRCT were more frequently seen in chronic than in subacute patients, though the differences were not statistically significant. Bronchoalveolar lavage fluid （BALF） showed lymphocytosis. The total＇cell count and the percentage of neutrophils were significantly higher in subacute than in chronic patients （P〈0.05）. Nonnecrotizing granulomas were seen in 8 （47.1%） cases. Improvement or normalization in symptoms, radiography, and pulmonary function test after treatment were seen in all 18 patients with avail- able follow-up data. Five patients recurred. Conclusions The characteristic abnormalities of pulmonary function, findings on HRCT, and pa- thology are essential for all phases of EAA, and the atypical manifestations such as obstruction and fibrosis can also be present frequently, particularly in chronic cases. Differential cell counts of BALF are related to the phase of the disease. The treatment response and prognosis of EAA are good.展开更多
Objective： To evaluate the pelvic lymph node coverage of conventional pelvic fields based on bony landmarks in Chinese patients with cervical cancer by using computed tomography （CT） simulation images to contour pe...Objective： To evaluate the pelvic lymph node coverage of conventional pelvic fields based on bony landmarks in Chinese patients with cervical cancer by using computed tomography （CT） simulation images to contour pelvic vessels as substitutes for lymph nodes location. Methods： A retrospective review of CT simulation images and conventional pelvic radiation planning data sets was performed in 100 patients with cervical cancer at the International Federation of Gynecology and Obstetrics （FIGO） Stage liB to IIIB in our hospital. Pelvic arteries were contoured on CT simulation images, and the outlines of conventional pelvic fields were drawn as defined by the gynecologic oncology group （GOG） after hiding the contours. The distances between the following vessel contours and field borders were measured： D1, the superior border of the anterior/posterior （AP） field and the bifurcation of abdominal aorta; D2, the ipsilateral border of the AP field and the distal end of external iliac artery; and D3, the anterior border of the lateral （LAT） field and the distal end of the external iliac artery. The distances were recorded as positive values if the measuring point was within the conventional pelvic fields, or they were recorded as negative values. Lymph nodes coverage was considered adequate when D1≥0 mm, D2〉17 mm or D3≥7 mm. Results： All patients had at least 1 inadequate margin, 97 patients （97.0%） had 2, and 22 patients （22.0%） had all the 3. On the AP field, 95 patients （95%） had the measuring point, the bifurcation of the abdominal aorta, out of the field （D1〈0 mm）, and all the patients had a distance less than 17.0 mm between the distal end of the external iliac artery and ipsilateral border （D2〈1 7.0 mm）. On the LAT field, 24 patients （24%） had a distance less than 7.0 mm between the distal end of the external iliac artery and anterior border （D3〈7.0 mm）. Conclusion： We observed that conventional pelvic fields based on bony landmarks provided inadequate coverage of pelvic lymph nodes in our patients with cervical cancer. CT simulation may be a feasible technique for planning pelvic fields optimally and individually.展开更多
Objective： To demonstrate the validity and reliability of volumetric quantitative computed tomography （vQCT） with multi-slice computed tomography （MSCT） and dual energy X-ray absorptiometry （DXA） for hip bone m...Objective： To demonstrate the validity and reliability of volumetric quantitative computed tomography （vQCT） with multi-slice computed tomography （MSCT） and dual energy X-ray absorptiometry （DXA） for hip bone mineral density （BMD） measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods： Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes 〈-2SD, with and without radiographically confirmed vertebral fracture （n= 11 and 33, respectively）. Group 3 comprised normal controls with BMD changes 〉-ISD （n-46）. Post-MSCT （GE, LightSpeed16） scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters： volumetric BMD values of trabecular bone （TRAB）, cortical bone （CORT）, and integral bone （INTGL） of the left femoral neck, femoral neck axis length （NAL）, and minimum cross-section area （mCSA）. DXA BMD measurements of the lumbar spine （AP-SPINE） and the left femoral neck （NECK） also were performed for each subject. Results： The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women （P〈0.05, respectively）. Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture（s） [（109.8±9.61） and （243.3±33.0） mg/cm^3, respectively] than in those without [（148.9±7.47） and （285.4±17.8） mg/cm^3, respectively] （P〈0.05, respectively）, but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion： the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from those without, vQCT might be useful to evaluate the effect of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck.展开更多
文摘Objective To assess the spectrum of causes, clinical features, differences between disease phases, and prognosis of extrinsic allergic alveolitis （EAA）. Methods Patients with EAA diagnosed at Peking Union Medical College Hospital from August 1983 to May 2007 were analyzed retrospectively. Their medical records were examined to gather clinical, laboratorial, radiological, and histopathological data. Patients were divided to three phases （acute, subacute, and chronic） according to clinical presentations. Follow-up data regarding treatment response, subsequent radio- logical and pulmonary function studies, and clinical outcomes were collected. Results A total of 21 cases were enrolled. Among them, 11 were subacute, 10 were chronic. The most common exposure was pet birds （6 cases, 28.6%）. The primary abnormality of pulmonary function was restriction and/or reduction in diffusing capacity （12 cases, 63.2%）. The most common findings on high-resolution computed tomography （HRCT） were ground-glass opacities （13 cases, 68.4%） and centri- lobular nodules （8 cases, 42.1%）. Airway obstruction in pulmonary function test, emphysema, hmg cysts, and fibrosis on HRCT were more frequently seen in chronic than in subacute patients, though the differences were not statistically significant. Bronchoalveolar lavage fluid （BALF） showed lymphocytosis. The total＇cell count and the percentage of neutrophils were significantly higher in subacute than in chronic patients （P〈0.05）. Nonnecrotizing granulomas were seen in 8 （47.1%） cases. Improvement or normalization in symptoms, radiography, and pulmonary function test after treatment were seen in all 18 patients with avail- able follow-up data. Five patients recurred. Conclusions The characteristic abnormalities of pulmonary function, findings on HRCT, and pa- thology are essential for all phases of EAA, and the atypical manifestations such as obstruction and fibrosis can also be present frequently, particularly in chronic cases. Differential cell counts of BALF are related to the phase of the disease. The treatment response and prognosis of EAA are good.
文摘Objective： To evaluate the pelvic lymph node coverage of conventional pelvic fields based on bony landmarks in Chinese patients with cervical cancer by using computed tomography （CT） simulation images to contour pelvic vessels as substitutes for lymph nodes location. Methods： A retrospective review of CT simulation images and conventional pelvic radiation planning data sets was performed in 100 patients with cervical cancer at the International Federation of Gynecology and Obstetrics （FIGO） Stage liB to IIIB in our hospital. Pelvic arteries were contoured on CT simulation images, and the outlines of conventional pelvic fields were drawn as defined by the gynecologic oncology group （GOG） after hiding the contours. The distances between the following vessel contours and field borders were measured： D1, the superior border of the anterior/posterior （AP） field and the bifurcation of abdominal aorta; D2, the ipsilateral border of the AP field and the distal end of external iliac artery; and D3, the anterior border of the lateral （LAT） field and the distal end of the external iliac artery. The distances were recorded as positive values if the measuring point was within the conventional pelvic fields, or they were recorded as negative values. Lymph nodes coverage was considered adequate when D1≥0 mm, D2〉17 mm or D3≥7 mm. Results： All patients had at least 1 inadequate margin, 97 patients （97.0%） had 2, and 22 patients （22.0%） had all the 3. On the AP field, 95 patients （95%） had the measuring point, the bifurcation of the abdominal aorta, out of the field （D1〈0 mm）, and all the patients had a distance less than 17.0 mm between the distal end of the external iliac artery and ipsilateral border （D2〈1 7.0 mm）. On the LAT field, 24 patients （24%） had a distance less than 7.0 mm between the distal end of the external iliac artery and anterior border （D3〈7.0 mm）. Conclusion： We observed that conventional pelvic fields based on bony landmarks provided inadequate coverage of pelvic lymph nodes in our patients with cervical cancer. CT simulation may be a feasible technique for planning pelvic fields optimally and individually.
文摘Objective： To demonstrate the validity and reliability of volumetric quantitative computed tomography （vQCT） with multi-slice computed tomography （MSCT） and dual energy X-ray absorptiometry （DXA） for hip bone mineral density （BMD） measurements, and to compare the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures from those without. Methods： Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes 〈-2SD, with and without radiographically confirmed vertebral fracture （n= 11 and 33, respectively）. Group 3 comprised normal controls with BMD changes 〉-ISD （n-46）. Post-MSCT （GE, LightSpeed16） scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were processed by OsteoCAD software to calculate the following parameters： volumetric BMD values of trabecular bone （TRAB）, cortical bone （CORT）, and integral bone （INTGL） of the left femoral neck, femoral neck axis length （NAL）, and minimum cross-section area （mCSA）. DXA BMD measurements of the lumbar spine （AP-SPINE） and the left femoral neck （NECK） also were performed for each subject. Results： The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women （P〈0.05, respectively）. Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with vertebral fracture（s） [（109.8±9.61） and （243.3±33.0） mg/cm^3, respectively] than in those without [（148.9±7.47） and （285.4±17.8） mg/cm^3, respectively] （P〈0.05, respectively）, but no significant differences were evident in AP-SPINE or NECK BMD. Conclusion： the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating osteoporotic postmenopausal women with vertebral fractures from those without, vQCT might be useful to evaluate the effect of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck.
