Automated detection, segmentation and measurement of major vessels and the trachea in CT pulmonary angiography.

Mediastinal structure measurements are important for the radiologist's review of computed tomography pulmonary angiography (CTPA) examinations. In the reporting process, radiologists make measurements of diameters, volumes, and organ densities for image quality assessment and risk stratification. However, manual measurement of these features is time consuming. Here, we sought to develop a time-saving automated algorithm that can accurately detect, segment and measure mediastinal structures in routine clinical CTPA examinations. In this study, 700 CTPA examinations collected and annotated. Of these, a training set of 180 examinations were used to develop a fully automated deterministic algorithm. On the test set of 520 examinations, two radiologists validated the detection and segmentation performance quantitatively, and ground truth was annotated to validate the measurement performance. External validation was performed in 47 CTPAs from two independent datasets. The system had 86-100% detection and segmentation accuracy in the different tasks. The automatic measurements correlated well to those of the radiologist (Pearson's r 0.68-0.99). Taken together, the fully automated algorithm accurately detected, segmented, and measured mediastinal structures in routine CTPA examinations having an adequate representation of common artifacts and medical conditions.

Serum paraoxonase-1 enzyme activities and oxidative stress levels in patients with esophageal squamous cell carcinoma.

OBJECTIVES: Oxidative stress is well recognized to play a role in the pathogenesis of many diseases, including cancers. Paraoxonase-1 (PON1) is implicated in the elimination of carcinogenic lipid-soluble radicals produced by lipid peroxidation. Reports on PON1 activities in patients with cancer are conflicting. The aim of this study was to investigate serum antioxidant enzyme activities and oxidative stress levels in patients with esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS: Thirty-two patients with ESCC and 33 healthy controls were enrolled. Serum malondialdehyde (MDA) levels and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GR), paraoxonase, and arylesterase activities were measured spectrophotometrically. RESULTS: Serum paraoxonase, arylesterase, SOD, activities, GSH-Px, and GR activities were significantly lower in patients with ESCC than in controls (all, P < 0.05), whereas serum MDA levels were significantly higher (P < 0.05). Serum MDA levels were significantly correlated with paraoxonase (r = -0.572, P < 0.001) and arylesterase activities (r = -0.597, P < 0.001) in patients with ESCC. CONCLUSIONS: This study indicated that ESCC is associated with increased oxidative stress and decreased antioxidant enzyme activities. Decreased serum PON1 enzyme activities may play a role in the progression and/or development of ESCC. Further studies are required to clarify these results.

A long-term study assessing the factors influencing survival and morbidity in the surgical management of bronchiectasis.

BACKGROUND: Although the prevalence of bronchiectasis decreased significantly in developed countries, in less developed and in developing countries, it still represents a significant cause of morbidity and mortality. The aim of this retrospective study is to present our surgical experiences, the morbidity and mortality rates and outcome of surgical treatment for bronchiectasis. METHODS: We reviewed the medical records of 129 patients who underwent surgical resection for bronchiectasis between April 2002 and April 2010, at Van Training and Research Hospital, Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and surgical procedures, mortality, morbidity and the result of surgical therapy were analyzed retrospectively. RESULTS: Mean age was 21.8 year (the eldest was 67 year, the youngest was 4 years-old). Male/female ratio was 1.86 and 75% of all patients were young population under the age of 40. Bilateral involvement was 14.7%, left/right side ratio according to localization was 2.1/1. The most common reason for bronchiectasis was recurrent infection. Surgical indications were as follows: recurrent infection (54%), hemoptysis (35%), empyema (6%), and lung abscess (5%). There was no operative mortality. Complications occurred in 29 patients and the morbidity rate was 22.4%. Complete resection was achieved in 110 (85.2%) patients. Follow-up data were obtained for 123 (95%) of the patients. One patient died during follow-up. The mean follow-up of this patient was 9 months. Mean postoperative hospitalization time was 9.15 ± 6.25 days. Significantly better results were obtained in patients who had undergone a complete resection. CONCLUSIONS: Surgical treatment of bronchiectasis can be performed with acceptable morbidity and mortality at any age. The involved bronchiectatic sites should be resected completely for the optimum control of symptoms.

Arytenoid dislocation related to an uneventful endotracheal intubation: a case report.

INTRODUCTION: Invasive methods currently applied to the respiratory tract may result in impaired movement of the cricoarytenoid joint with hoarseness and immobility of the vocal ligament. Hoarseness after tracheal intubation is reported as a high incidence in patients who receive general anaesthesia. In most cases, the symptoms are temporary and improve within several days. We report this case for emphasizing that early diagnosis of arytenoid cartilage dislocation is important even in nontraumatic cases. CASE PRESENTATION: We present the case of a 19-year-old Caucasian male who developed arytenoid cartilage dislocation associated with uneventful endotracheal intubation and anesthesia. CONCLUSION: Arytenoid subluxation should be considered whenever any of the symptoms mentioned occur following endolaryngeal manipulation, and they become persistent, as recovery becomes difficult if appropriate treatment is not started immediately.