Early and accurate diagnosis of emphysema is said to be invaluable for identification of clinically silent and mild emphysema. Recently, computed tomography (CT) has been much advocated for its efficacy in detailed diagnosis of emphysema, and the results have been compared with the pathology grade of emphysema in resected lung specimens. To assess the ability of high resolution CT scan in detecting and grading mild emphysema, we correlated the high resolution CT scan with the pathology grade of emphysema and the destructive index (DI) of lung specimens from 42 patients undergoing thoracotomy for a solitary pulmonary nodule. The high resolution CT scan and the cut surface of the lung, corresponding exactly to the same plane of the CT scan image, were assessed using the picture-grading system of Thurlbeck and coworkers on a scale of zero to 100. The CT scores for all patients ranged from 12 to 57, with a mean +/- SD of 22.1 +/- 9.6 using 1-mm collimation (n = 35), and from 7 to 46 with a mean +/- SD of 16.5 +/- 8.3 using 5-mm collimation (n = 33). The pathology scores ranged from 10 to 57, with a mean +/- SD of 23.2 +/- 9.8 (n = 42). The DI ranged from 15.4 to 67.1, with a mean +/- SD of 31.4 +/- 10.8 (n = 42). The CT scores using 1-mm and 5-mm collimation correlated significantly with the pathology scores (r = 0.68 and 0.76, respectively, p less than 0.001), and with the DI (r = 0.62 and 0.74, respectively, p less than 0.001). The pathology scores correlated significantly with the DI (r = 0.72, p less than 0.001). We therefore concluded that high resolution CT can help to identify the presence and grading of mild emphysema.
A high prevalence of advanced hepatic fibrosis was observed in patients with hypertension. Hypertension was an independent risk factor, and creatinine level and SGLT2i were divergence variables for advanced hepatic fibrosis. Thus, hypertension with chronic kidney injury may exacerbate hepatic fibrosis, while SGLT2i treatment may ameliorate hepatic fibrosis.
Despite the morphological diversity of organisms, they only occupy a fraction of the theoretically possible spectrum (i.e., morphospace) and have been studied on several taxa. Such morphospace occupation patterns are formed through evolutionary processes under multiple constraints. In this study, we discovered a differential morphospace occupation pattern between terrestrial and aquatic gastropods, and subsequently attempted to quantitatively understand these differences through morphospace analysis. These differential occupation patterns between terrestrial and aquatic species were observed in the morphospace of spire height and aperture inclination, including a bimodal distribution of shell height in terrestrial species alongside an absence of high-spired shells with high aperture inclination. Although terrestrial species were distributed along optimal lines of shell instability and shell hindrance to locomotion, aquatic species were distributed not only along this line but also within a suboptimal region of the low spire with low inclination. Based on numerical simulation and biometric analysis, here we propose the hypothesis that this difference was caused by the aquatic species being able to adopt a posture with the growth direction perpendicular to the substrate due to reduced functional demands. Our results provided an ultimate explanation for the differential occupation patterns between habitats alongside an overview of the morphospace.
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