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With the use of metagenomic next-generation sequencing, patients diagnosed with Whipple pneumonia are being increasingly correctly diagnosed. We report a series of 3 cases in China that showed a novel pattern of movable infiltrates and upper lung micronodules. After treatment, the 3 patients recovered, and lung infiltrates resolved.

Idiopathic pulmonary fibrosis (IPF) is the severest form of idiopathic interstitial pneumonia, with a median survival time estimated at 2-5 years from the time of diagnosis. It occurs mainly in elderly adults, suggesting a strong link between the fibrosis process and aging. Although chest high-resolution computed tomography (HRCT) is currently the method of choice in IPF assessment, diagnostic imaging with typical usual interstitial pneumonia (UIP) provides definitive results in only 55%, requiring an invasive surgical procedure such as lung biopsy or cryobiopsy for the final diagnostic analysis. Lung ultrasound (LUS) as a noninvasive, non-radiating examination is very sensitive to detect subtle changes in the subpleural space. The evidence of diffuse, multiple B-lines defined as vertical, hyperechoic artifacts is the hallmark of interstitial syndrome. A thick, irregular, fragmented pleura line is associated with subpleural fibrotic scars. The total numbers of B-lines are correlated with the extension of pulmonary fibrosis on HRCT, being an LUS marker of severity. The average distance between two adjacent B-lines is an indicator of a particular pattern on HRCT. It is used to appreciate a pure reticular fibrotic pattern as in IPF compared with a predominant ground glass pattern seen in fibrotic nonspecific interstitial pattern. The distribution of the LUS artifacts has a diagnostic value. An upper predominance of multiple B-lines associated with the thickening of pleura line is an LUS feature of an inconsistent UIP pattern, excluding the IPF diagnosis. LUS is a repeatable, totally radiation-free procedure, well tolerated by patients, very sensitive in detecting early changes of fibrotic lung, and therefore a useful imaging technique in monitoring disease progression in the natural course or after initiation of treatment.

Severe asthma exhibits heterogeneity in airflow obstruction, driven by airway remodeling and air trapping, which can be noninvasively assessed via quantitative computed tomography (qCT). This study aimed to identify asthma phenotypes by clustering qCT measurements of airway dimensions, lung volumes, and densitometry, and to elucidate the underlying molecular pathways through sputum proteomics. We applied consensus clustering to qCT data from 239 asthma patients (severe and mild/moderate) and 68 healthy controls from the Chinese C‐BIOPRED cohort. Four distinct qCT clusters emerged: cluster 1, characterized by luminal dilation, severe air trapping, and reduced lung density; cluster 2, with thickened airway walls and luminal narrowing without air trapping; cluster 3, showing mild luminal dilation, preserved lung volumes, and optimal spirometry; and cluster 4, featuring airway wall thickening, luminal narrowing, severe air trapping, and profound airflow obstruction. Sputum eosinophilia was elevated in clusters 1 and 4. Proteomics revealed upregulated pathways in apoptosis execution and cornified envelope formation in cluster 1, while clusters 2 and 4 exhibited enhanced complement activation, fibrin formation, plasma lipoprotein assembly, and insulin‐like growth factor (IGF) transport regulation. These findings delineate qCT‐derived phenotypes and their associated underlying mechanisms of airway remodeling and airflow obstruction in severe asthma. Using quantitative computed tomography (qCT) clustering in the C‐BIOPRED asthma cohort of 239 patients, four distinct phenotypes were identified based on airway dimensions, lung volumes, and densitometry, revealing variations in airway remodeling, air trapping, and airflow obstruction compared with healthy controls. Cluster 1 showed airway dilation with severe air trapping and reduced lung density; cluster 2 featured thickened airway walls and luminal narrowing without air trapping; cluster 3 displayed mild airway dilation, preserved lung volumes, and optimal spirometry; and cluster 4 exhibited airway wall thickening, luminal narrowing, severe air trapping, and profound airflow obstruction. Sputum eosinophilia was elevated in clusters 1 and 4. Sputum proteomics linked cluster 1 to upregulated apoptotic execution and cornified envelope formation pathways, while clusters 2 and 4 showed enhanced complement activation, fibrin formation, plasma lipoprotein assembly, and IGF transport regulation, providing insights into underlying molecular mechanisms of severe asthma heterogeneity.

• Premise of the study: Xylem network connections play an important role in water and nutrient transport in plants, but also facilitate the spread of air embolisms and xylem-dwelling pathogens. This study describes the structure and function of vessel relays found in grapevine xylem that form radial and tangential connections between spatially discrete vessels.• Methods: We used high-resolution computed tomography, light microscopy, scanning electron microscopy, and single-vessel dye injections to characterize vessel relays in stems and compare their distributions and structure in two Vitis species.• Key results: Vessel relays were composed of 1–8 narrow diameter (∼25 µm) vessel elements and were oriented radially, connecting vessels via scalariform pitting within a xylem sector delineated by rays. The functional connectedness of vessels linked by vessel relays was confirmed with single-vessel dye injections. In 4.5-cm sections of stem tissue, there were 26% more vessel relays in V. vinifera compared with V. arizonica.• Conclusions: Because of their spatial distribution within Vitis xylem, vessel relays increase the connectivity between vessels that would otherwise remain isolated. Differences in vessel relays between Vitis species suggest these anatomical features could contribute to disease and embolism resistance in some species.

A 41‐year‐old woman who presented with lower back pain, stiff shoulders and fatigue was found to have inflammatory laboratory findings and bilateral ground‐glass opacities on chest x‐ray. High‐resolution computed tomography (HRCT) revealed consolidation, a nodular shadow, multiple mediastinal and hilar lymphadenopathy, liver enlargement, and splenomegaly. Lung biopsy showed lymphoid follicles, plasma cells and lymphocyte infiltration along bronchovascular bundles and interlobular septa, and plasma cells infiltrating the interfollicular area. Lymph node pathology revealed regressed germinal centres and an extended interfollicular area with plasma cell infiltration, as well as capillary proliferation with endothelial hyperplasia. There were no specific findings of lymphoma or immunoglobulin G4 (IgG4)‐related disease and she was diagnosed with idiopathic multicentric Castleman's disease (iMCD). According to consensus diagnostic criteria, lymph node pathology is required for diagnosing iMCD, but this case demonstrates that lung lesions may also provide diagnostic supportive value. Based on the diagnostic criteria, lymph node biopsy is necessary to diagnose idiopathic multicentric Castleman's disease (iMCD). We report a case of iMCD diagnosed using lung and lymph node histopathological findings in a 41‐year‐old woman who presented with inflammatory symptoms and pulmonary lesions.

To assess the perioperative and short-term functional outcomes of robot-assisted partial nephrectomy (RAPN) with intraoperative navigation using an ultra-high-resolution computed tomography (UHR-CT) scanner, we retrospectively analyzed 323 patients who underwent RAPN using an UHR-CT or area-detector CT (ADCT). Perioperative outcomes and the postoperative preservation ratio of estimated glomerular filtration rate (eGFR) were compared. After the propensity score matching, we evaluated 99 patients in each group. Although the median warm ischemia time (WIT) was less than 25 min in both groups, it was significantly shorter in the UHR-CT group than in the ADCT group (15 min vs. 17 min, p = 0.032). Moreover, the estimated blood loss (EBL) was significantly lower in the UHR-CT group than in the ADCT group (33 mL vs. 50 mL, p = 0.028). However, there were no significant intergroup differences in the postoperative preservation ratio of eGFR at 3 or 6 months of follow-up (ADCT 91.8% vs. UHR-CT 93.5%, p = 0.195; and ADCT 91.7% vs. UHR-CT 94.0%, p = 0.160, respectively). Although no differences in short-term renal function were observed in intraoperative navigation for RAPN in this propensity score–matched cohort, this study is the first to demonstrate that UHR-CT resulted in a shorter WIT and lower EBL than ADCT.

Introduction Size‐specific dose estimates (SSDE) are used to assess patient‐specific radiation exposure in Computed Tomography (CT), complementing the volume CT dose index (CTDIvol). This study compared SSDE calculated using patient's lateral size from scan projection radiograph (SPR) with SSDE calculated using water equivalent diameter (Dw) from tomographic images in adult chest high‐resolution CT (HRCT). Methods In a single‐centre study, the CTDIvol and dose‐length product (DLP) were recorded from HRCT dose reports of adult patients. Lateral width (SLat), at the centre of the scan range, from the SPR was measured and the SSDE (SSDER) was calculated using conversion factors related to SLat. Average CT number, area of the slice, and lateral size of the patient (AxLat) were measured on the middle slice. The Dw and SSDE from Dw (SSDEW) were calculated. SSDER and SSDEW were compared using Wilcoxon signed rank test. Correlation between patient size and dosimetry parameters were investigated using Spearman Correlation test with statistical significance at P < 0.05. Bland–Altman plot was also used to test agreement between the two SSDE values. Results Median CTDIvol, DLP, SSDER and SSDEW were 11.0 mGy, 372 mGy.cm, 11.6 mGy and 12.9 mGy, respectively. Small but statistically significant differences (P < 0.03) were found between SLat and AxLat as well as between SSDER and SSDEW. Bland–Altman analysis resulted in borderline agreement between SSDE values. Moderate correlations were observed between dosimetry quantities and patient size measurements (ρ > 0.640; P < 0.001). SSDEw showed statistically significant correlation (ρ = 0.587 and P < 0.001) with SSDER. Conclusion SSDER may be used to assess patients' absorbed radiation dose, before the scan, in adult chest HRCT. The median value of SSDER was about 10% lower than the median value SSDEW. However, the SSDEW should be used after the scan to establish effective dose and radiation risk to the patient. This study established that patient's lateral width measurements made from scanned projection radiograph (SPR) is an overestimate compared to those measured from tomographic slices by about 10%. Size‐specific dose estimates (SSDE) calculated using lateral width measured from SPR correlates well with SSDE calculated using water equivalent diameter of the patient measured from tomographic slice. The 75th percentile of the volume CT Dose index, dose‐length product and SSDE have been established as 12.9 mGy, 453 mGy.cm and 14.4 mGy, respectively, for high‐resolution CT scan of the adult chest.

Determination of pleural dissemination of lung cancer helps define the treatment strategy. Positron emission tomography‐computed tomography imaging could be false‐negative for dry pleural dissemination of lung cancer. Clinicians should consider preoperative thoracoscopy in affected patients showing limited pleural effusion, interlobar fine granular shadows, and no metastasis on high‐resolution computed tomography. Aggressive thoracoscopy can help clinicians diagnose dry pleural dissemination, which leads to the appropriate treatment in lung cancer cases with interlobar granular shadows in HRCT even if PET‐CT shows negative uptake in pleural dissemination.

Colonies are the basic geometric building blocks of coral reefs. However, the forming regulations of both colonies and reefs are still not understood adequately. Therefore, in this study, we reconstructed 25 samples using high‐resolution micro‐computed tomography to investigate coral growth patterns and parameters. Our skeleton and canal reconstructions revealed the characteristics of different coral species, and we further visualized the growth axes and growth rings to understand the coral growth directions. We drew a skeleton grayscale map and calculated the coral skeleton void ratios to ascertain the skeletal diversity, devising a method to quantify coral growth. On the basis of the three‐dimensional (3D) reconstructions and growth parameters, we investigated the growth strategies of different coral species. This research increases the breadth of knowledge on how reef‐building corals grow their colonies, providing information on reef‐forming regulations. The data in this paper contain a large amount of coral growth information, which can be used in further research on reef‐forming patterns under different conditions. The method used in this study can also be applied to animals with porous skeletons. In this study, we use high‐resolution micro‐computed tomography to reconstruct 25 representative coral samples, indicating that there is a polyp network supported by the canal system within coral skeletons, which maintains coral growth. We visualized coral growth regulations to highlight the similarities and differences among different genera, and investigated different growth strategies by their skeleton‐forming patterns. Growth parameters of coral skeletons were obtained being on the gray scale of 3D reconstructions to reveal the mineralizing diversity among species.

Background: Idiopathic pulmonary fibrosis (IPF) is a chronic, interstitial lung disease primarily affecting West Highland White Terriers (WHWTs). Objective: To describe the clinicopathological and diagnostic imaging features in WHWTs with IPF. Animals: Twelve WHWTs with IPF and 14 healthy control WHWTs. Method: Prospective study. Clinical signs and findings of physical examination, blood and arterial blood gas analyses, radiography, high-resolution computed tomography (HRCT), bronchoscopy and bronchoalveolar lavage (BAL) of IPF dogs were obtained and compared with controls. Histopathologic changes in IPF dogs were evaluated. Results: Mean partial pressure of oxygen was significantly lower in IPF (mean ± SD, 65.5 ± 15.4 mmHg) than in controls (99.1 ± 7.8 mmHg, P<.001). The alveolar-arterial oxygen gradient was significantly higher in IPF (50.1 ± 17.3 mmHg) than in controls (17.5 ± 4.9 mmHg, P<.001). In HRCT, ground glass opacity (GGO) was detected in all IPF dogs, traction bronchiectasis in 4, and honeycombing in 1. Bronchoscopic airway changes were noted in all IPF dogs. On BAL fluid (BALF) cytology, the total cell count (TCC) was higher in IPF dogs, and the numbers but not the percentages of macrophages, neutrophils, and mast cells were increased. On histopathology, multifocal or diffuse interstitial fibrosis, type II pneumocyte hyperplasia, prominent intraalveolar macrophages, distortion of alveolar architecture, and emphysematous change were detected. Conclusion and Clinical Importance: IPF causes substantial hypoxemia. In HRCT, GGO is a consistent finding. IPF dogs have concurrent airway changes and an increase in BALF TCC.