The Experts below are selected from a list of 681 Experts worldwide ranked by ideXlab platform
Sumit Gupta - One of the best experts on this subject based on the ideXlab platform.
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quantitative computed tomography derived clusters redefining airway remodeling in asthmatic patients
The Journal of Allergy and Clinical Immunology, 2014Co-Authors: Ruth Hartley, Umair T Khan, Amisha Singapuri, Beverley Hargadon, W Monteiro, Ana R Sousa, Sumit Gupta, Richard P MarshallAbstract:Background Asthma heterogeneity is multidimensional and requires additional tools to unravel its complexity. Computed tomography (CT)–assessed proximal airway remodeling and air trapping in asthmatic patients might provide new insights into underlying disease mechanisms. Objectives The aim of this study was to explore novel, quantitative, CT-determined asthma phenotypes. Methods Sixty-five asthmatic patients and 30 healthy subjects underwent detailed clinical, physiologic characterization and quantitative CT analysis. Factor and cluster analysis techniques were used to determine 3 novel, quantitative, CT-based asthma phenotypes. Results Patients with severe and mild-to-moderate asthma demonstrated smaller mean right upper lobe apical Segmental Bronchus (RB1) lumen volume (LV) in comparison with healthy control subjects (272.3 mm 3 [SD, 112.6 mm 3 ], 259.0 mm 3 [SD, 53.3 mm 3 ], 366.4 mm 3 [SD, 195.3 mm 3 ], respectively; P = .007) but no difference in RB1 wall volume (WV). Air trapping measured based on mean lung density expiratory/inspiratory ratio was greater in patients with severe and mild-to-moderate asthma compared with that seen in healthy control subjects (0.861 [SD, 0.05)], 0.866 [SD, 0.07], and 0.830 [SD, 0.06], respectively; P = .04). The fractal dimension of the segmented airway tree was less in asthmatic patients compared with that seen in control subjects ( P = .007). Three novel, quantitative, CT-based asthma clusters were identified, all of which demonstrated air trapping. Cluster 1 demonstrates increased RB1 WV and RB1 LV but decreased RB1 percentage WV. On the contrary, cluster 3 subjects have the smallest RB1 WV and LV values but the highest RB1 percentage WV values. There is a lack of proximal airway remodeling in cluster 2 subjects. Conclusions Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies.
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Quantitative analysis of high-resolution computed tomography scans in severe asthma subphenotypes
2010Co-Authors: Sumit Gupta, Salman Siddiqui, Pranab Haldar, James J. Entwisle, Dean Mawby, Andrew J. Wardlaw, Peter Bradding, Ian D. Pavord, Ruth H. Green, Christopher E. BrightlingAbstract:Background: Severe asthma is a heterogeneous condition. Airway remodelling is a feature of severe asthma and can be determined by the assessment of high-resolution computed tomography (HRCT) scans. The aim of this study was to assess whether airway remodelling is restricted to specific subphenotypes of severe asthma. Methods: A retrospective analysis was performed of HRCT scans from subjects who had attended a singlecentre severe asthma clinic between 2003 and 2008. The right upper lobe apical Segmental Bronchus (RB1) dimensions were measured and the clinical and sputum inflammatory characteristics associated with RB1 geometry were assessed by univariate and multivariate regression analyses. Longitudinal sputum data were available and were described as area under the time curve (AUC). Comparisons were made in RB1 geometry across subjects in four subphenotypes determined by cluster analysis, smokers and non-smokers, and subjects with and without persistent airflow obstruction. Results: Ninety-nine subjects with severe asthma and 16 healthy controls were recruited. In the subjects with severe asthma the RB1 percentage wall area (%WA) was increased (p¼0.009) and lumen area (LA)/body surface area (BSA) was decreased (p¼0.008) compared with controls but was not different across the four subphenotypes. Airway geometry was not different between smokers and non-smokers and RB1 %WA was increased in those with persistent airflow obstruction. RB1 %WA in severe asthma was best associated with airflow limitation and persistent neutrophilic airway inflammation (model R2¼0.27, p¼0.001). Conclusions: Airway remodelling of proximal airways occurs in severe asthma and is associated with impaired lung function and neutrophilic airway inflammation
Richard P Marshall - One of the best experts on this subject based on the ideXlab platform.
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quantitative computed tomography derived clusters redefining airway remodeling in asthmatic patients
The Journal of Allergy and Clinical Immunology, 2014Co-Authors: Ruth Hartley, Umair T Khan, Amisha Singapuri, Beverley Hargadon, W Monteiro, Ana R Sousa, Sumit Gupta, Richard P MarshallAbstract:Background Asthma heterogeneity is multidimensional and requires additional tools to unravel its complexity. Computed tomography (CT)–assessed proximal airway remodeling and air trapping in asthmatic patients might provide new insights into underlying disease mechanisms. Objectives The aim of this study was to explore novel, quantitative, CT-determined asthma phenotypes. Methods Sixty-five asthmatic patients and 30 healthy subjects underwent detailed clinical, physiologic characterization and quantitative CT analysis. Factor and cluster analysis techniques were used to determine 3 novel, quantitative, CT-based asthma phenotypes. Results Patients with severe and mild-to-moderate asthma demonstrated smaller mean right upper lobe apical Segmental Bronchus (RB1) lumen volume (LV) in comparison with healthy control subjects (272.3 mm 3 [SD, 112.6 mm 3 ], 259.0 mm 3 [SD, 53.3 mm 3 ], 366.4 mm 3 [SD, 195.3 mm 3 ], respectively; P = .007) but no difference in RB1 wall volume (WV). Air trapping measured based on mean lung density expiratory/inspiratory ratio was greater in patients with severe and mild-to-moderate asthma compared with that seen in healthy control subjects (0.861 [SD, 0.05)], 0.866 [SD, 0.07], and 0.830 [SD, 0.06], respectively; P = .04). The fractal dimension of the segmented airway tree was less in asthmatic patients compared with that seen in control subjects ( P = .007). Three novel, quantitative, CT-based asthma clusters were identified, all of which demonstrated air trapping. Cluster 1 demonstrates increased RB1 WV and RB1 LV but decreased RB1 percentage WV. On the contrary, cluster 3 subjects have the smallest RB1 WV and LV values but the highest RB1 percentage WV values. There is a lack of proximal airway remodeling in cluster 2 subjects. Conclusions Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies.
Hiroyasu Yokomise - One of the best experts on this subject based on the ideXlab platform.
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Bronchoplastic Operation Using a Continuous Anastomosis for Mucous Gland Adenoma
The Annals of thoracic surgery, 2011Co-Authors: Natsumi Matsuura, Naoya Yokota, Hiroyasu YokomiseAbstract:Mucous gland adenoma is an uncommon tumor that seems to be truly benign, and parenchyma-saving bronchoplastic operations are feasible. We applied a continuous anastomosis using an absorbable monofilament suture for bronchoplasty to treat mucous gland adenoma in the Segmental Bronchus. Continuous anastomosis is easy, quick, and safe, needing fewer knots. Continuous anastomosis for Segmental bronchi is an efficient technique, and no stenosis or stricture occurred in this case.
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a novel method for determining adjacent lung segments with infrared thoracoscopy
The Journal of Thoracic and Cardiovascular Surgery, 2009Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Yasumichi Yamamoto, K Satoh, Hiroyasu YokomiseAbstract:Objectives We investigated a new technique for identifying the lung interSegmental line using infrared thoracoscopy with intravenous injection of indocyanine green. Methods This was an experimental animal study, and target segments were established preoperatively. Six adult beagle dogs underwent thoracotomy. After the corresponding pulmonary artery of the target segment had been ligated, indocyanine green was administered intravenously during infrared thoracoscopy. The lung was separated into 2 areas, white and blue, according to the blood flow on the monitor. We marked the visceral pleura with electrocautery along the transition zone showing a change in color from blue to white. The experimental lung was removed and subjected to pathologic and radiologic analysis. Results After injection of indocyanine green, infrared thoracoscopy showed that the area of normal perfusion changed to blue, whereas the area at which perfusion was absent remained white. The transition zone between colors was distinct, and the blue stain remained visible during the marking procedure. Three-dimensional computed tomographic analysis indicated that the marking separated the target Segmental Bronchus from the adjacent one. Detailed macroscopic and microscopic study confirmed that the marking corresponded to the interSegmental line. Conclusion By using infrared thoracoscopy with indocyanine green, it is possible to detect the interSegmental line without inflating the lung.
Amisha Singapuri - One of the best experts on this subject based on the ideXlab platform.
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quantitative computed tomography derived clusters redefining airway remodeling in asthmatic patients
The Journal of Allergy and Clinical Immunology, 2014Co-Authors: Ruth Hartley, Umair T Khan, Amisha Singapuri, Beverley Hargadon, W Monteiro, Ana R Sousa, Sumit Gupta, Richard P MarshallAbstract:Background Asthma heterogeneity is multidimensional and requires additional tools to unravel its complexity. Computed tomography (CT)–assessed proximal airway remodeling and air trapping in asthmatic patients might provide new insights into underlying disease mechanisms. Objectives The aim of this study was to explore novel, quantitative, CT-determined asthma phenotypes. Methods Sixty-five asthmatic patients and 30 healthy subjects underwent detailed clinical, physiologic characterization and quantitative CT analysis. Factor and cluster analysis techniques were used to determine 3 novel, quantitative, CT-based asthma phenotypes. Results Patients with severe and mild-to-moderate asthma demonstrated smaller mean right upper lobe apical Segmental Bronchus (RB1) lumen volume (LV) in comparison with healthy control subjects (272.3 mm 3 [SD, 112.6 mm 3 ], 259.0 mm 3 [SD, 53.3 mm 3 ], 366.4 mm 3 [SD, 195.3 mm 3 ], respectively; P = .007) but no difference in RB1 wall volume (WV). Air trapping measured based on mean lung density expiratory/inspiratory ratio was greater in patients with severe and mild-to-moderate asthma compared with that seen in healthy control subjects (0.861 [SD, 0.05)], 0.866 [SD, 0.07], and 0.830 [SD, 0.06], respectively; P = .04). The fractal dimension of the segmented airway tree was less in asthmatic patients compared with that seen in control subjects ( P = .007). Three novel, quantitative, CT-based asthma clusters were identified, all of which demonstrated air trapping. Cluster 1 demonstrates increased RB1 WV and RB1 LV but decreased RB1 percentage WV. On the contrary, cluster 3 subjects have the smallest RB1 WV and LV values but the highest RB1 percentage WV values. There is a lack of proximal airway remodeling in cluster 2 subjects. Conclusions Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies.
Ana R Sousa - One of the best experts on this subject based on the ideXlab platform.
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quantitative computed tomography derived clusters redefining airway remodeling in asthmatic patients
The Journal of Allergy and Clinical Immunology, 2014Co-Authors: Ruth Hartley, Umair T Khan, Amisha Singapuri, Beverley Hargadon, W Monteiro, Ana R Sousa, Sumit Gupta, Richard P MarshallAbstract:Background Asthma heterogeneity is multidimensional and requires additional tools to unravel its complexity. Computed tomography (CT)–assessed proximal airway remodeling and air trapping in asthmatic patients might provide new insights into underlying disease mechanisms. Objectives The aim of this study was to explore novel, quantitative, CT-determined asthma phenotypes. Methods Sixty-five asthmatic patients and 30 healthy subjects underwent detailed clinical, physiologic characterization and quantitative CT analysis. Factor and cluster analysis techniques were used to determine 3 novel, quantitative, CT-based asthma phenotypes. Results Patients with severe and mild-to-moderate asthma demonstrated smaller mean right upper lobe apical Segmental Bronchus (RB1) lumen volume (LV) in comparison with healthy control subjects (272.3 mm 3 [SD, 112.6 mm 3 ], 259.0 mm 3 [SD, 53.3 mm 3 ], 366.4 mm 3 [SD, 195.3 mm 3 ], respectively; P = .007) but no difference in RB1 wall volume (WV). Air trapping measured based on mean lung density expiratory/inspiratory ratio was greater in patients with severe and mild-to-moderate asthma compared with that seen in healthy control subjects (0.861 [SD, 0.05)], 0.866 [SD, 0.07], and 0.830 [SD, 0.06], respectively; P = .04). The fractal dimension of the segmented airway tree was less in asthmatic patients compared with that seen in control subjects ( P = .007). Three novel, quantitative, CT-based asthma clusters were identified, all of which demonstrated air trapping. Cluster 1 demonstrates increased RB1 WV and RB1 LV but decreased RB1 percentage WV. On the contrary, cluster 3 subjects have the smallest RB1 WV and LV values but the highest RB1 percentage WV values. There is a lack of proximal airway remodeling in cluster 2 subjects. Conclusions Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies.