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2.
Phys Rev Lett ; 120(16): 163001, 2018 Apr 20.
Article in English | MEDLINE | ID: mdl-29756934

ABSTRACT

Size-selected dianionic lead clusters Pb_{n}^{2-}, n=34-56, are stored in a Penning trap and studied with respect to their decay products upon photoexcitation. Contrary to the decay of other dianionic metal clusters, these lead clusters show a variety of decay channels. The mass spectra of the fragments are compared to the corresponding spectra of the monoanionic precursors. This comparison leads to the conclusion that, in the cluster size region below about n=48, the fission reaction Pb_{n}^{2-}→Pb_{n-10}^{-}+Pb_{10}^{-} is the major decay process. Its disappearance at larger cluster sizes may be an indication of a nonmetal to metal transition. Recently, the pair of Pb_{10}^{-} and Pb_{n-10}^{-} were observed as pronounced fragments in electron-attachment studies [S. König et al., Int. J. Mass Spectrom. 421, 129 (2017)IMSPF81387-380610.1016/j.ijms.2017.06.009]. The present findings suggest that this combination is the fingerprint of the decay of doubly charged lead clusters. With this assumption, the dianion clusters have been traced down to Pb_{21}^{2-}, whereas the smallest size for the direct observation was as high as n=28.

3.
Diagn Interv Imaging ; 99(5): 291-299, 2018 May.
Article in English | MEDLINE | ID: mdl-29477490

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the usefulness of computed tomography-texture analysis (CTTA) in differentiating between in-situ and minimally-invasive from invasive adenocarcinomas in subsolid lung nodules (SSLNs). MATERIAL AND METHODS: Two radiologists retrospectively reviewed 49 SSLNs in 44 patients. There were 27 men and 17 women with a mean age of 63±7 (SD) years (range: 47-78years). For each SSLN, type (pure ground-glass or part-solid) was assessed by consensus and CTTA was conducted independently by each observer using a filtration-histogram technique. Different filters were used before histogram quantification: no filtration, fine, medium and coarse, followed by histogram quantification using mean intensity, standard deviation (SD), entropy, mean positive pixels (MPP), skewness and kurtosis. RESULTS: We analyzed 13 pure ground-glass and 36 part-solid nodules corresponding to 16 adenocarcinomas in-situ (AIS), 5 minimally invasive adenocarcinomas (MIA) and 28 invasive adenocarcinomas (IVA). At uni- and multivariate analysis CTTA allowed discriminating between IVAs and AIS/MIA (P<0.05 and P=0.025, respectively) with the following histogram parameters: skewness using fine textures and kurtosis using coarse filtration for pure ground-glass nodules, and SD without filtration for part-solid nodules. CONCLUSION: CTTA has the potential to differentiate AIS and MIA from IVA among SSLNs. However, our results require further validation on a larger cohort.


Subject(s)
Adenocarcinoma in Situ/diagnostic imaging , Adenocarcinoma in Situ/pathology , Adenocarcinoma of Lung/diagnostic imaging , Adenocarcinoma of Lung/pathology , Tomography, X-Ray Computed , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness/diagnostic imaging , Retrospective Studies
4.
Int J Cosmet Sci ; 39(4): 442-449, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28267214

ABSTRACT

OBJECTIVE: To assess the effect of two different additives (propylene glycol (PG) and polyethylene glycol 400 (PEG 400)) on release and in vitro skin retention of quercetin and chrysin from semisolid bases (amphiphilic creams and acidic carbomer gels). METHODS: For obtaining semisolid formulations, flavonoids were pre-dissolved in the liquid (PG or PEG 400) or directly suspended in the semisolid base. Three chrysin formulations ('cream 0', 'PG-cream' and 'PEG 400-cream') and five quercetin formulations ('cream 0', 'PG cream', 'PEG 400 cream', 'gel 0' and 'PG gel') were prepared. The release studies were carried out in Franz diffusion cells by means of a cellulose membrane. The porcine ear skin was used in in vitro skin retention studies. RESULTS: The dissolution was a prerequisite to increase the release rates of tested flavonoids from obtained semisolid formulations. The cumulative amount of chrysin released after 6 h from 'PEG 400 cream' containing partly dissolved form of that flavonoid was higher than that from 'cream 0' or 'PG cream' containing its suspended form. The formulations containing quercetin dissolved in PG ('PG cream', 'PG gel') or PEG 400 ('PEG 400 cream') exhibited higher release rates of that flavonoid than corresponding semisolid suspensions ('cream 0' or 'gel 0'). The effects of both liquid additives (PG and PEG 400) on the cumulative amount of quercetin released after 6 h were comparable. However, there was no correlation between the release rate and the skin retention. The amounts of the flavonoids found in the skin were strongly affected by the type of the used solvent. While PG increased the skin retention of both flavonoids, PEG 400 had no effect on chrysin skin retention and delayed quercetin skin absorption. CONCLUSION: The proper choice of the solvent added to the semisolid base is crucial for enhanced skin delivery of the tested flavonoids. PG is more efficient absorption promoter than PEG 400 of both chrysin and quercetin.


Subject(s)
Flavonoids/administration & dosage , Skin/metabolism , Animals , Chromatography, High Pressure Liquid , Emulsions , Flavonoids/metabolism , Gels , In Vitro Techniques , Spectrophotometry, Ultraviolet , Swine
5.
Diagn Interv Imaging ; 97(10): 955-963, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27639313

ABSTRACT

Adenocarcinoma is the most common histologic type of lung cancer. Recent lung adenocarcinoma classifications from the International Association for the Study of Lung cancer, the American Thoracic Society and the European Respiratory Society (IASLC/ETS/ERS, 2011) and World Health Organization (WHO, 2015) define a wide range of adenocarcinoma types and subtypes featuring different prognosis and management. This spectrum of lesions translates into various CT presentations and features, which generally show good correlation with histopathology, stressing the key role of the radiologist in the diagnosis and management of those patients. This review aims at helping radiologists to understand the basics of the up-to-date adenocarcinoma pathological classifications, radio-pathological correlations and how to use them in the clinical setting, as well as other imaging-related correlations (radiogenomics, quantitative analysis, PET-CT).


Subject(s)
Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Tomography, X-Ray Computed/methods , Adenocarcinoma/classification , Diagnosis, Differential , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Neoplasms/classification , Sensitivity and Specificity , Solitary Pulmonary Nodule/classification , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/pathology , Statistics as Topic
6.
Rev Mal Respir ; 33(9): 794-798, 2016 Nov.
Article in French | MEDLINE | ID: mdl-27444697

ABSTRACT

INTRODUCTION: In severe emphysema, endoscopic lung volume reduction with valves is an alternative to surgery with less morbidity and mortality. In 2015, selection of patients who will respond to this technique is based on emphysema heterogeneity, a complete fissure visible on the CT-scan and absence of collateral ventilation between lobes. Our case report highlights that individualized prediction is possible. CASE REPORT: A 58-year-old woman had severe, disabling pulmonary emphysema. A high resolution thoracic computed tomography scan showed that the emphysema was heterogeneous, predominantly in the upper lobes, integrity of the left greater fissure and no collateral ventilation with the left lower lobe. A valve was inserted in the left upper lobe bronchus. At one year, clinical and functional benefits were significant with complete atelectasis of the treated lobe. CONCLUSION: The success of endoscopic lung volume reduction with a valve can be predicted, an example of personalized medicine.


Subject(s)
Bronchoscopy , Lung/surgery , Pneumonectomy/methods , Pulmonary Emphysema/diagnosis , Pulmonary Emphysema/surgery , Bronchoscopy/methods , Female , Humans , Lung/pathology , Middle Aged , Organ Size , Prognosis , Pulmonary Emphysema/pathology , Severity of Illness Index , Treatment Outcome
7.
Diagn Interv Imaging ; 97(3): 287-96, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26857787

ABSTRACT

Lung cancer is the leading cause of deaths due to cancer in France. More than half of lung cancers are discovered at an advanced-stage. New anticancer treatment strategies (i.e., the so-called personalized or targeted therapy) have recently been introduced and validated for non-small-cell lung cancer (NSCLC), in addition to or in association with standard chemotherapy. Personalized therapy includes tyrosine kinase inhibitors (TKIs), antiangiogenic treatments and immunotherapy. Because these treatments may be responsible for atypical thoracic adverse effects and responses as compared to standard chemotherapy, RECIST 1.1 criteria may be inadequate to evaluate the responses to these agents. The goal of this article was to review personalized treatment strategies for NSCLC, to consider the therapy-specific responses and thoracic complications induced by these new therapeutic agents and finally to discuss future directions for the personalized assessment of tumor response.


Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Precision Medicine , Radiology , Humans , Immunotherapy , Lung Neoplasms/genetics , Protein-Tyrosine Kinases/antagonists & inhibitors
8.
Diagn Interv Imaging ; 96(7-8): 707-15, 2015.
Article in English | MEDLINE | ID: mdl-26206744

ABSTRACT

In multiple injuries, features of bleeding from solid organs mostly involve the liver, spleen and kidneys and may be treated by embolization. The indications and techniques for embolization vary between organs and depend on the pathophysiology of the injuries, type of vascularization (anastomotic or terminal) and type of embolization (curative or preventative). Interventional radiologists should have a full understanding of these indications and techniques and management algorithms should be produced within each facility in order to define the respective place of the different treatment options.


Subject(s)
Acute Kidney Injury/diagnosis , Acute Kidney Injury/therapy , Embolization, Therapeutic/methods , Emergency Medical Services , Endovascular Procedures/methods , Hemorrhage/diagnosis , Hemorrhage/therapy , Liver/injuries , Multiple Trauma/diagnosis , Multiple Trauma/therapy , Splenic Rupture/diagnosis , Splenic Rupture/therapy , Angiography , Cooperative Behavior , Humans , Interdisciplinary Communication , Syndrome
10.
Occup Environ Med ; 71(12): 865-70, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25286915

ABSTRACT

OBJECTIVES: To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos. METHODS: The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading. RESULTS: κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. CONCLUSIONS: Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers.


Subject(s)
Asbestos/adverse effects , Asbestosis/diagnosis , Diagnostic Errors/prevention & control , Occupational Exposure/adverse effects , Pleura/diagnostic imaging , Pleural Diseases/diagnosis , Tomography, X-Ray Computed/methods , Aged , Asbestosis/diagnostic imaging , Cross-Sectional Studies , Fibrosis , Health Personnel/standards , Humans , Middle Aged , Pleural Diseases/diagnostic imaging
11.
Rev Med Interne ; 35(11): 742-51, 2014 Nov.
Article in French | MEDLINE | ID: mdl-25023720

ABSTRACT

Technological advances have enabled the rapid development of cardiovascular imaging techniques. Cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) have become diagnostic and prognostic tools for the management of patients in routine clinical practice. This review gives the main indications and describes the performance of both techniques.


Subject(s)
Heart Diseases/diagnosis , Heart/anatomy & histology , Heart/diagnostic imaging , Magnetic Resonance Imaging, Cine , Tomography, X-Ray Computed , Cardiology , Humans , Patient Care Team , Radiology
12.
Diagn Interv Imaging ; 93(7-8): 604-11, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22771372

ABSTRACT

OBJECTIVE: To study endobronchial cancers occurring in a population at high risk of bronchial cancer (history of surgically treated bronchial or ENT cancer in complete remission, and symptoms due to smoking) detected by annual volume CT scans and biannual fibroscopy. MATERIAL AND METHODS: Two hundred and sixty-six patients were included in this single centre prospective study; 27 bronchopulmonary cancers were detected. Ten endobronchial cancers (37%) were identified by fibroscopy (nine invasive cancers and one carcinoma in situ) in 10 patients (nine men) (51-78 years old) nine of whom were smokers (dark tobacco: seven). The screening CTs were reappraised by two radiologists. RESULTS: Three cancers out of 10 were detected by CT during the initial reading. The sensitivity of the reappraised CT was 80% with seven false positives. In five cases, the mean period between the first CT scan where the lesion was visible retrospectively, but not described, and the diagnostic fibroscopy was 463 days (213-808 days); two cancers were not visible in the CT scan. Seven curative treatments were undertaken. CONCLUSION: In this population, the sensitivity of the initial reading of the CT scan for detecting endobronchial tumours was 30%, while 80% of the tumours were visible retrospectively, underlining the importance of careful analysis of the proximal bronchial tree.


Subject(s)
Bronchial Neoplasms/diagnostic imaging , Bronchial Neoplasms/pathology , Bronchoscopy , Early Detection of Cancer/methods , Tomography, X-Ray Computed , Aged , Female , Fiber Optic Technology , Humans , Male , Middle Aged , Prospective Studies
13.
Case Rep Radiol ; 2011: 687203, 2011.
Article in English | MEDLINE | ID: mdl-22606554

ABSTRACT

We describe a case of extramedullary tracheal plasmacytoma that was incidentally discovered in a 73-year-old man on a PET scan performed for assessing the extent of colon cancer. CT scan showed the tumor; multiplanar reformation coupled with virtual bronchoscopy allowed proper treatment planning. The tracheal tumor was resected during rigid bronchoscopy. Relevant investigations excluded multiple myeloma. Follow-up CT showed persistent thickening of the tracheal wall, but there has been no recurrence after one-year followup.

14.
J Investig Allergol Clin Immunol ; 21(7): 507-13, 2011.
Article in English | MEDLINE | ID: mdl-22312933

ABSTRACT

BACKGROUND: The mechanism of aspirin sensitivity in patients with asthma and rhinosinusitis has been attributed to arachidonic acid metabolism abnormalities. OBJECTIVE: We aimed to test whether aspirin-triggered generation of 15-hydroxyeicosatetraenoic acid (15-HETE) in nasal polyp dispersed cells (NPDCs) from aspirin-sensitive patients is associated with activation of inflammatory cells. METHODS: Polyps were obtained from 11 aspirin-sensitive and 19 aspirin-tolerant patients with chronic rhinosinusitis. NPDCs were stimulated by aspirin or calcium ionophore. Levels of 15-HETE, leukotriene (LT) C4, eosinophil cationic protein (ECP), and tryptase were measured in NPDC supernatant. RESULTS: NPDCs from aspirin-sensitive patients contained more eosinophils (14% vs 9%, P < .05) and released 2.4-fold more ECP (P < .01) at baseline. Stimulation with aspirin (200 microM) resulted in a significant increase in 15-HETE generation only in tissue from aspirin-sensitive patients (mean increase, 82%) but did not induce any increase in the release of LTC4, ECP, or tryptase. Preincubation with calcium ionophore resulted in significantly enhanced generation of 15-HETE, ECP, tryptase, and LTC4 in patients from both groups. Incubation of NPDCs with misoprostol inhibited aspirin-induced 15-HETE generation in aspirin-sensitive patients and calcium ionophore-induced 15-HETE, ECP, and tryptase release in both aspirin-sensitive and aspirin-tolerant patients. CONCLUSION: Our study demonstrated that aspirin-induced 15-HETE generation in nasal polyps from aspirin-sensitive patients is not associated with activation of mast cells and eosinophils. Misoprostol has a potent inhibitory effect on the activation of cells derived from the site of nasal mucosal inflammation, regardless of sensitivity to aspirin.


Subject(s)
Aspirin/adverse effects , Drug Hypersensitivity/metabolism , Eosinophils/drug effects , Hydroxyeicosatetraenoic Acids/metabolism , Mast Cells/drug effects , Nasal Polyps/immunology , Adult , Aged , Aged, 80 and over , Arachidonate 15-Lipoxygenase/physiology , Calcium Ionophores/pharmacology , Eosinophils/physiology , Female , Humans , Male , Mast Cells/physiology , Middle Aged , Misoprostol/pharmacology
15.
Eur J Clin Nutr ; 65(2): 191-5, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21048771

ABSTRACT

BACKGROUND/OBJECTIVES: Vegetarian diet has become an increasing trend in western world and in Poland. The frequency of allergies is growing, and the effectiveness of vegetarian diet in allergic diseases is a concern for research. We aimed to study an effect of vegetarian diet on lipid profile in serum in a group of Polish children in Poland and to investigate lipid parameters in healthy vegetarian children and in omnivorous children with diagnosed atopic disease. SUBJECTS/METHODS: Serum lipid profiles (triglycerides, total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, fatty acids) were assessed in groups of children: healthy vegetarians (n=24) and children with diagnosed atopic diseases (n=16), with control group of healthy omnivores (n=18). Diet classification was assessed by a questionnaire. RESULTS: No differences were observed in serum triglycerides, LDL cholesterol and saturated and monounsaturated fatty acids level in all groups. In the group of Polish vegetarian children, we recorded high consumption of vegetable oils rich in monounsaturated fatty acid, and sunflower oil containing linoleic acid. This observation was associated with higher content of linoleic acid in serum in this group. Among polyunsaturated n-6 fatty acids, linoleic acid revealed significantly (P<0.05) lower levels in allergy vs vegetarian groups. In case of eicosapentaenoic acid (n-3 fatty acid), the allergy group showed higher levels of this compound in comparison to vegetarians. CONCLUSIONS: Significantly higher concentration of linoleic acid in vegetarian children in comparison to allergy group indicated possible alternative path of lipid metabolism in studied groups, and in consequence, some elements of vegetarian diet may promote protection against allergy.


Subject(s)
Diet, Vegetarian , Dietary Fats/administration & dosage , Fatty Acids/blood , Hypersensitivity, Immediate/epidemiology , Lipids/blood , Adolescent , Case-Control Studies , Child , Child, Preschool , Diet , Female , Humans , Hypersensitivity, Immediate/blood , Hypersensitivity, Immediate/prevention & control , Lipid Metabolism/physiology , Male , Poland
16.
Rev Mal Respir ; 27(10): 1267-74, 2010 Dec.
Article in French | MEDLINE | ID: mdl-21163402

ABSTRACT

This review aims to present the 2D and 3D reconstructions derived from high-resolution volume CT acquisitions and to illustrate their thoracic applications, as well as showing the interest and limitations of these techniques. We present new applications for computer-assisted detection (CAD) and tools for quantification of pulmonary lesions.


Subject(s)
Imaging, Three-Dimensional/methods , Lung/diagnostic imaging , Tomography, X-Ray Computed/methods , Bronchi/pathology , Bronchography , Bronchoscopy , Humans , Lung/pathology , Lung Neoplasms/diagnostic imaging , Organ Size , User-Computer Interface
17.
Rev Mal Respir ; 27(8): 964-9, 2010 Oct.
Article in French | MEDLINE | ID: mdl-20965411

ABSTRACT

CT has become the chest imaging technique of reference after chest radiograph performed on the frontline. Technological developments have resulted in shortening the duration of image acquisition to a few seconds, and allow imaging the entire chest in patients unable to take a long breath. This fact-sheet aims to present the basic principles of formation of the CT image, the various embodiments of this imaging technique, and its main pitfalls and constraints.


Subject(s)
Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods , Artifacts , Contrast Media/administration & dosage , Equipment Design , Exhalation , Gravitation , Humans , Posture , Radiography, Thoracic/instrumentation , Tomography, Spiral Computed/instrumentation , Tomography, Spiral Computed/methods , Tomography, X-Ray Computed/instrumentation
18.
Rev Mal Respir ; 27(6): 644-50, 2010 Jun.
Article in French | MEDLINE | ID: mdl-20610079

ABSTRACT

Thoracic imaging plays a major role in the non-invasive approach to the diagnosis and management of thoracic disease. Techniques that use ionizing radiation (radiography, computed tomography, nuclear medicine) are the most useful approaches for imaging the thorax. Both the availability and the clinical indications of these imaging procedures are growing rapidly, which means that the radiation dose that patients may receive is increasing. The goal of this paper is to review briefly the factors that determine the radiation dose, to highlight the risks associated with radiation exposure, and to describe the techniques that can be used to reduce the radiation dose that patients with respiratory disease are exposed to.


Subject(s)
Radiation Dosage , Radiography, Thoracic/adverse effects , Radiography, Thoracic/standards , Humans
19.
Thorac Surg Clin ; 20(1): 31-45, xiii, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20378059

ABSTRACT

Tumors of the trachea and central bronchi can be benign or malignant. Clinical presentation may be confusing, particularly in benign tumors that can be misdiagnosed as asthma or chronic bronchitis. Chest radiography has many limitations and is often considered unremarkable in patients with tumors of the central airways; therefore, multidetector CT (MDCT) has become the most useful noninvasive method for diagnosing and assessing the central airways. The purpose of this article is to provide a review of imaging of the tumors of the trachea and central bronchi. We emphasize the crucial role of MDCT and postprocessing techniques in assessing neoplasms of the central airways.

20.
J Radiol ; 90(11 Pt 2): 1869-92, 2009 Nov.
Article in French | MEDLINE | ID: mdl-19953078

ABSTRACT

Localized ground-glass opacities (GGOs) have been recently individualized and account for between 2.9% and 19% of all pulmonary nodules detected in high-risk patients included in CT screening series for lung cancer. These opacities, nodular, lobular or flat, correspond to benign lesions (localised infectious and inflammatory diseases, focal interstitial fibrosis, and atypical alveolar hyperplasia) or malignant lesions (bronchioloalveolar carcinoma, early-stage adenocarcinoma and sometimes metastases). Localized GGOs are more likely to be malignant than solid nodules and prognosis is related to the percentage of the ground-glass component. However, doubling time of pure localized malignant GGOs is longer than mixed localized malignant GGOs and even longer than the doubling time of solid malignant nodules. Therefore, localized GGOs warrant a dedicated diagnostic workup.


Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/diagnostic imaging , Adenocarcinoma/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Radiography, Thoracic/methods , Solitary Pulmonary Nodule/diagnostic imaging , Tomography, X-Ray Computed/methods , Adenocarcinoma/classification , Adenocarcinoma/pathology , Algorithms , Biopsy , Clinical Trials as Topic , Diagnosis, Differential , Female , Humans , Hyperplasia , Lung/pathology , Lung Neoplasms/etiology , Lung Neoplasms/pathology , Lung Neoplasms/secondary , Middle Aged , Neoplasm Staging , Prognosis , Pulmonary Alveoli/pathology , Risk Factors , Smoking/adverse effects , Solitary Pulmonary Nodule/etiology , Solitary Pulmonary Nodule/pathology
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