To evaluate the prognostic implication of ground-glass attenuation at high-resolution computed tomography (HRCT) in assessing response to treatment in fibrosing alveolitis, the authors correlated HRCT findings with the improvement in pulmonary function, as represented by the increase in percentage predicted values on pulmonary function tests after corticosteroid therapy. Nineteen patients underwent HRCT before treatment and pulmonary function testing before and after treatment. The HRCT scans were reviewed by two independent observers. Areas of ground-glass attenuation were quantified subjectively by using a 0%-100% scale with 10% increments. The extent of ground-glass attenuation at HRCT was significantly correlated with improvement in diffusing capacity for carbon monoxide (r = .67, P = .0019), forced vital capacity (r = .71, P = .0007), and forced expiratory volume in 1 second (r = .64, P = .0034) after steroid treatment. These results suggest that ground-glass attenuation at HRCT is a good predictor of response to treatment in fibrosing alveolitis.
Chest radiographic findings of thoracic Behçet syndrome are variable and nonspecific. CT can be helpful in the assessment of the syndrome by showing thrombosis of the superior vena cava and characteristic aneurysms of the pulmonary arteries.
Background: Immobilization with cervical spine worsens endotracheal intubation condition. Though various intubation devices have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning nasotracheal intubation (NTI) in patients with cervical spine immobilization. The present study compared the performance of the C-MAC D-Blade videolaryngoscope with the McCoy laryngoscope for NTI in patients with simulated cervical spine injuries. Methods: This was a prospective, randomized, controlled, study done in a tertiary hospital. Ninety-five patients requiring NTI were included in data analysis: McCoy group (group M, n = 47) or C-MAC D-Blade videolaryngoscope group (group C, n = 48). A Philadelphia neck collar was applied before anesthetic induction to immobilize the cervical spine. Single experienced anesthesiologist performed NTI. The primary outcome was duration of intubation divided by three steps: nose to oropharynx; oropharynx into glottic inlet; and glottic inlet to trachea. Secondary outcomes included glottic view as percentage of glottis opening (POGO) score and Cormack-Lehance (CL) grade, modified nasal intubation-difficulty scale (NIDS) rating, hemodynamic changes before and after intubation, and complications.Results: Total intubation duration was significantly shorter in group C (39.5 ± 11.4 s) compared to group M (48.1 ± 13.9 s). Group C required significantly less time for glottic visualization and endotracheal tube placement in the trachea. More patients in group C had CL grade I and higher POGO scores (P < 0.001, for both measures). No difficulty in NTI (modified NIDS = 0) was more in group C than group M. Hemodynamic changes and incidence of complications were comparable between groups.(Continued on next page)
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