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Robotic-assisted bronchoscopy in the diagnosis of peripheral pulmonary lesions

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2023年第1期1卷 30-35页

作者： Fangfang Xie Ajay Wagh Ruolan Wu Dkyle hogarth Jiayuan Sun Department of Respiratory Endoscopy Shanghai Chest HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200030China Department of Respiratory and Critical Care Medicine Shanghai Chest HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200030China Shanghai Engineering Research Center of Respiratory Endoscopy Shanghai 200030China Department of Medicine Section of Pulmonary and Critical Care MedicineUniversity of ChicagoChicagoIL 60637USA Shanghai Jiao Tong University School of Medicine Shanghai 200001China

More peripheral pulmonary lesions(PPLs)are detected by low-dose helical computed tomography(CT)either in-cidentally or via dedicated lung cancer screening programs.Thus,using methods for safe and accurate diagnosis of these lesions has become increasingly important.Transthoracic needle aspiration(TTNA)and transbronchial lung biopsy(TBLB)are routinely performed during the diagnostic workup for PPLs.However,TTNA often car-ries the risk of pneumothorax,uncontrollable airway hemorrhage,and does not allow mediastinal staging in one procedure.In contrast,traditional TBLB often has a poorer diagnostic yield despite fewer complications.With the ongoing development of technology applied to bronchoscopy,guided bronchoscopy has become widely used and the diagnostic yield of TBLB has improved.Additionally,guided bronchoscopy continues to demonstrate a better safety profile than TTNA.In recent years,robotic-assisted bronchoscopy(RAB)has been introduced and imple-mented in the diagnosis of PPLs.At present,RAB has two platforms that are commercially available:Monarch TM and Ion TM;several other platforms are under development.Both systems differ in characteristics,advantages,and limitations and offer features not seen in previous guided bronchoscopy.Several studies,including cadaveric model studies and clinical trials,have been conducted to examine the feasibility and performance of RAB using these two systems;large multicenter studies are underway.In this review,published experimental results,focus-ing on diagnostic yield and complications of RAB,are analyzed and the potential clinical application of RAB is discussed,which will enable the operators to have a clear overview of RAB.

关键词： Robotic-assisted bronchoscopy Guided bronchoscopy Lung cancer Peripheral pulmonary lesions Diagnosis

Field assessment of bacteria and nutrient removal by vegetative filter strips

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International Journal of Agricultural and Biological Engineering 2011年第2期4卷 43-49页

作者： kyle R.douglas-Mankin Cairo G.Okoren Department of Biological and Agricultural Engineering Kansas State UniversityManhattanKansasKS 66503USA

Strategies are sought to reduce the impact of nonpoint sources of pollution,including fecal bacteria,and meet TMDL criteria.Vegetative filter strips(VFSs)are one such strategy,though the data of VFS function under field conditions,particularly for fecal bacteria,are limited.The objective of this study was to evaluate the efficiencies in removing fecal bacteria,N,and P from VFSs installed to treat contaminated runoff from a working feedlot.VFSs were found to be effective in removing a broad range of constituents from beef feedlot runoff pretreated by a settling basin.The first 30 m provided most or all of the reductions found within the 150 m VFSs studied:reductions average 85%of inflow water,85%of sediment,77%of N,and 84%of P.Fecal bacteria removal by the VFSs was about one order of magnitude:reductions at 30 m ranged from 83.5%for FC and FS to 91%for E.coli.On the site being studied,this provided an important level of protection and reduced surface-flow concentrations of fecal coliforms to below the 200 CFU/100 mL(coliform-forming units,CFU)water-quality standard for Kansas.

关键词： bacteria vegetative filter strips livestock waste management vegetative treatment areas

Early Detection of Lung Cancer Using CT Scan and Bronchoscopy in a High Risk Population

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Journal of Cancer Therapy 2012年第4期3卷 388-396页

作者： Vijayvel Jayaprakash Gregory M. Loewen Samjot S. Dhillon Kirsten B. Moysich Martin C. Mahoney Sai Yendamuri D. kyle hogarth Mary E. Reid Cancer Prevention and Population Sciences Roswell Park Cancer Institute Buffalo USA Department of Medicine Roswell Park Cancer Institute Buffalo USA Department of Social and Preventive Medicine State University of New York at Buffalo Buffalo USA Department of Thoracic Surgery Roswell Park Cancer Institute Buffalo USA Pulmonary Oncology Sacred Heart Medical Center Spokane USA Section of Pulmonary and Critical Care Medicine University of Chicago Chicago USA

Background: Computed tomography (CT) and bronchoscopy have been shown to improve the detection rates of peripheral and central lung cancers (LC), respectively. However, the performance of the combination of CT and bronchoscopy in detecting LC, in high-risk patients, is not clear. Patients & Methods: This prospective study included 205 high-risk patients with a history of at least 2 of the following risk factors: (1) heavy smoking;(2) aero-digestive cancer;(3) pulmonary asbestosis or;(4) chronic obstructive pulmonary disease. Patients were offered chest X-ray, sputum cytology, conventional white-light followed by autofluorescence beonchoscopy (WL/AFB) and low-dose spiral CT both at baseline and follow-up visits. Results: Seven patients (3.4%) were diagnosed with LC or carcinoma in-situ (CIS) at baseline: CT evaluation detected 5 LC/CIS, while WL/AFB evaluation also identified 5 LC/CIS, 2 of which were not detected on CT. Six (85%) of these baseline lesions were early stage (0/IA). The relative-sensitivity of CT with WL/ AFB was 40% better than CT alone. On four year follow-up, 20 patients (9.8%) were diagnosed with an LC/CIS. CT with WL/AFB detected 19 cases (95%), whereas CT alone detected 15 cases (75%). Conclusion: Bimodality surveillance with spiral CT and WL/AFB can improve the detection of early stage LCs among high-risk

关键词： Lung Cancer Screening Surveillance CT Scan Bronchoscopy

Effect of Impaired Lung Function on the Development and Progression of Endobronchial Premalignant Lesions

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Journal of Cancer Therapy 2012年第4期3卷 364-371页

作者： Vijayvel Jayaprakash Gregory M. Loewen Martin C. Mahoney Samjot Dhillon Sai Yendamuri D. kyle hogarth Enrique Machare-Delgado Ravi J. Menezes Sandra M. Jacob Mary E. Reid Cancer Prevention and Population Sciences Roswell Park Cancer Institute Buffalo USA Department of Medical Imaging University Health Network Toronto Canada Department of Medicine Roswell Park Cancer Institute Buffalo USA Department of Social and Preventive Medicine State University of New York at Buffalo Buffalo USA Department of Thoracic Surgery Roswell Park Cancer Institute Buffalo USA Pulmonary Oncology Sacred Heart Medical Center Spokane USA School of Medicine State University of New York at Buffalo Buffalo USA Section of Pulmonary and Critical Care Medicine University of Chicago Chicago USA

Background: Chronic obstructive pulmonary disease (COPD) and presence of endobronchial premalignant lesions (EPL) are individual risk factors for lung cancer (LC). However, effect of impaired lung function (ILF) on the natural history of EPL has not been explored. Patients and Methods: This study included 217 high-risk participants from a hospital-based LC surveillance cohort who underwent pulmonary function testing followed by bronchoscopy with endobronchial biopsies. Baseline histopathology diagnoses included 91 cases (41.9%) with squamous metaplasia (SM), 25 (11.5%) with squamous dysplasia (SD), 1 (0.5%) with in-situ carcinoma and 5 (2.3%) with invasive LC. Follow-up biopsies were obtained for 69 patients, and 16 (23.2%) patients demonstrated progression to a higher grade lesion. Regression models were used to evaluate the relationship between ILF and EPL. All the models were adjusted for age, gender and tobacco smoking. Results: Patients with FEV1% of <50% had 4.5 times greater risk of being diagnosed with an EPL [95% confidence interval: 1.93-10.80] and 8-fold greater risk of SD, compared to patients with FEV1% ≥80. COPD was associated with 2.7 and 4.8 times greater risk of SM and SD, respectively. The mean time to progression to a higher-grade lesion was shorter in COPD patients compared to patients without COPD (27 versus 50 months, p = 0.02). Conclusion: Our results indicate that ILF may be a predictor of prevalence and progression of EPLs among patients at high risk of LC. Therefore, spirometry can be a complementary pre-screening tool for identifying patients with EPL who need more intense LC surveillance.

关键词： COPD Lung Cancer Premalignant Lesions Dysplasia Pulmonary Function Test Spirometry

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110亿年的宇宙图景

环球科学 2021年第11期 30-37页

作者：凯尔·道森威尔·珀西瓦尔刘孝男(译) 犹他大学滑铁卢大学滑铁卢天体物理中心不详

正如道格拉斯·亚当斯(douglas Adams)在《银河系漫游指南》(The Hitchhiker's Gufde fo the Gaiaxy)中所写的:“宇宙太大了……你不敢相信它是那么广阔、巨大,大到令人毛骨悚然。”包括我们在内的众多天文学家都致力于在尽可能大的尺... 详细信息

正如道格拉斯·亚当斯(douglas Adams)在《银河系漫游指南》(The Hitchhiker's Gufde fo the Gaiaxy)中所写的:“宇宙太大了……你不敢相信它是那么广阔、巨大,大到令人毛骨悚然。”包括我们在内的众多天文学家都致力于在尽可能大的尺度上绘制宇宙地图,进而了解宇宙到底有多大,以及它是如何运转的。

关键词：亚当斯宇宙图景道格拉斯天文学家