Histopathology of Explanted Lungs From Patients With a Diagnosis of Pulmonary Sarcoidosis

Background Pathologic features of end-stage pulmonary sarcoidosis (ESPS) are not well defined; anecdotal reports have suggested that ESPS may mimic usual interstitial pneumonia (UIP). We hypothesized that ESPS has distinct histologic features. Methods Twelve patients who received a diagnosis of pulmonary sarcoidosis and underwent lung transplantation were included. Control subjects were 10 age- and sex-matched lung transplant patients with UIP. Hematoxylin and eosin-stained tissue sections were examined for the following features: extent/pattern of fibrosis; presence and quantity (per 10 high-power fields) of fibroblast foci and granulomas; distribution and morphology of granulomas; and presence and extent of honeycomb change. Extent of fibrosis and honeycomb change in lung parenchyma was scored as follows: 1 = 1% to 25%; 2 = 26% to 50%; 3 = 51% to 75%; 4 = 76% to 100% of lung parenchyma. Results Eight of 12 cases demonstrated histologic findings typical of ESPS. All showed well-formed granulomas with associated fibrosis distributed in a distinct lymphangitic fashion. Granulomas were present in hilar or mediastinal lymph nodes from six of six patients with ESPS and none of eight control subjects. The extent of fibrosis, honeycomb change, and fibroblast foci was significantly lower in ESPS cases compared with control cases. Two patients with remote histories of sarcoidosis showed histologic features of diseases other than ESPS (UIP and emphysema) without granulomas. Two patients with atypical clinical findings demonstrated nonnecrotizing granulomas combined with either severe chronic venous hypertension or UIP. Conclusions ESPS and UIP have distinct histopathologic features in the lungs. Patients with a pretransplant diagnosis of sarcoidosis may develop other lung diseases that account for their end-stage fibrosis

Variable-Aperture Reciprocating Reed Valve

A variable-aperture reciprocating reed valve includes a valve body defining a through hole region having a contoured-profile portion. A semi-rigid plate is affixed on one side thereof to the valve body to define a cantilever extending across the through hole region. At least one free edge of the cantilever opposes the contoured-profile portion of the through hole region in a non-contact relationship

X-ray Surface Brightness Profiles of Active Galactic Nuclei in the Extended Groth Strip: Implications for AGN Feedback

Using data from the All Wavelength Extended Groth Strip International Survey (AEGIS) we statistically detect the extended X-ray emission in the interstellar medium (ISM)/intra-cluster medium (ICM) in both active and normal galaxies at 0.3 <= z <= 1.3. For both active galactic nuclei (AGN) host galaxy and normal galaxy samples that are matched in restframe color, luminosity, and redshift distribution, we tentatively detect excess X-ray emission at scales of 1--10 arcsec at a few sigma significance in the surface brightness profiles. The exact significance of this detection is sensitive to the true characterization of Chandra's point spread function. The observed excess in the surface brightness profiles is suggestive of lower extended emission in AGN hosts compared to normal galaxies. This is qualitatively similar to theoretical predictions of the X-ray surface brightness profile from AGN feedback models, where feedback from AGN is likely to evacuate the gas from the center of the galaxy/cluster. We propose that AGN that are intrinsically under-luminous in X-rays, but have equivalent bolometric luminosities to our sources will be the ideal sample to study more robustly the effect of AGN feedback on diffuse ISM/ICM gas.Comment: Accepted in PAS

Diffuse alveolar damage (DAD) resulting from coronavirus disease 2019 Infection is Morphologically Indistinguishable from Other Causes of DAD

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162704/2/his14180.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162704/1/his14180_am.pd

Inter-Examiner Reliability of an Anterior Superior Iliac Spine Compression Test used to Lateralize Pelvic Somatic Dysfunction to the Right Side or Not

BACKGROUND: Osteopathic physicians use a number of palpatory structural examinations to diagnose pelvic somatic dysfunction (SD). They may elect to use the Anterior Superior Iliac Spine (ASIS) Compression Test to lateralize the dysfunctional side. Accurate, reliable tests are crucial to neuromusculoskeletal diagnosis and this study employs the kappa (κ) analysis protocol recommended for assessing interexaminer reliability of manual medicine tests (published by the Fédération Internationale de Médecine Manuelle [FIMM]). κ-values ≥0.40 (moderate agreement) are considered to be acceptable for use in the clinical setting

Effect of Prior Anterior Superior Iliac Spine Compression Testing on Second Assessor Findings: Implications for Inter-Examiner Reliability Testing

BACKGROUND: Osteopathic physicians use palpation to diagnose sacroiliac joint somatic dysfunction (SD) -- including the Anterior Superior Iliac Spine (ASIS) Compression Test for dysfunctional side lateralization. (Literature suggests right-sided lateralization in 80% of asymptomatic individuals). Accurate, reliable tests are crucial however to diagnose SD and kappa (κ) analysis is a gold-standard to determine the degree of interexaminer reliability for tests. Few studies have examined the effect the palpatory examination has on subsequent diagnostic findings and therefore on κ-values

The Use of Objective Data to Improve Interexaminer Reliability

BACKGROUND: In Osteopathic Manipulative Medicine (OMM) and Manual/Musculoskeletal Medicine (MMM), palpatory diagnosis is performed on a regular basis to diagnose somatic dysfunction (SD). This examination requires careful and precise touch coupled with subjective interpretation by individual examiners who may have been trained to evaluate SD through different methods. Interexaminer reliability studies aim to minimize variance by providing quantifiable scientific data to evaluate specific test protocols which can then be taught to practitioners. In a previous PCOM study, two examiners independently diagnosed innominate bone dysfunction lateralized using the ASIS compression test on a large group of subjects. A pressure monitoring system (IsoTOUCH®, Chattanooga TN) has been used in various studies at the PCOM Human Performance & Biomechanics Laboratory (Kuchera, Jean et al 2006 & Kuchera, Vardy et al 2005) to quantify or standardize forces used in palpatory diagnosis or OMM/MMM treatment applications. This study gathered data during the tesing phase of a new and improved model of this system, using the protocol of the previous ASIS interexaminer reliability study. The data collected during standardization of the system was analyzed in the same manner as the previous study to compare the results of interexaminer reliability to results achieved using live data feed for baseline pressure synchronization between examiners

Comparing Inter-Examiner Reliability Levels when Diagnosing Male & Female Innominate Dysfunctions Using a Hemi-Pelvise Compression Lateralization Test and Pelvic Landmark Levels.

BACKGROUND: When diagnosing innominate somatic dysfunctions it may be relevant to recognize that structural, functional, and hormonal differences exist between male and female pelvises. The female pelvis is less massive, ilia are less sloped, and female hormones influence ligamentous tension. Despite these differences, few studies have analyzed gender effects on inter-examiner reliability when using palpatory diagnosis to diagnose innominate dysfunctions. In this study, we hypothesized that interexaminer reliability would be higher in male subjects than in female subjects due cyclic variability of hormonal influence of ligamentous tension in the female pelvis. The kappa (κ) statistic was selected to evaluate inter-examiner reliability as it is designed to eliminate agreement by chance. The agreement scale as proposed by Landis and Koch was used in the evaluation if the κ-value

At the intersection of primary pulmonary myxoid sarcoma and pulmonary angiomatoid fibrous histiocytoma: observations from three new cases

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107555/1/his12354.pd

Landsat-7 ETM+ Radiometric Calibration Status

Now in its 17th year of operation, the Enhanced Thematic Mapper + (ETM+), on board the Landsat-7 satellite, continues to systematically acquire imagery of the Earth to add to the 40+ year archive of Landsat data. Characterization of the ETM+ on-orbit radiometric performance has been on-going since its launch in 1999. The radiometric calibration of the reflective bands is still monitored using on-board calibration devices, though the Pseudo-Invariant Calibration Sites (PICS) method has proven to be an effect tool as well. The calibration gains were updated in April 2013 based primarily on PICS results, which corrected for a change of as much as -0.2%/year degradation in the worst case bands. A new comparison with the SADE database of PICS results indicates no additional degradation in the updated calibration. PICS data are still being tracked though the recent trends are not well understood. The thermal band calibration was updated last in October 2013 based on a continued calibration effort by NASA/Jet Propulsion Lab and Rochester Institute of Technology. The update accounted for a 0.31 W/sq m/ sr/micron bias error. The updated lifetime trend is now stable to within + 0.4K