Reexpansion pulmonary edema after treatment of primary spontaneous pneumothorax.

A 24-year-old male patient, without further symptoms or comorbidities presented to the emergency room with acute dyspnea after heavy lifting two days before. On auscultation an attenuated vesicular breath was noticed on the right lung. In the initial chest radiograph a right-sided primary spontaneous pneumothorax with minor mediastinal shift was diagnosed. After insertion of a 12-French chest tube the patient's clinical condition deteriorated. The following chest radiograph and computed tomography of the thorax showed a reexpansion pulmonary edema in the right lung. The patient was admitted to the ICU and supportive treatment was initiated. Pulmonary reexpansion edema after drainage of a pneumothorax is a very rare complication with mortality rates reaching up to 20%. The exact pathophysiology remains unknown. Typical Symptoms include dyspnea, hypotension, and tachycardia. To minimize the risk of a pulmonary reexpansion edema, not more than 1200-1800 ml of air should be drained at once and the drainage should be stopped when the patient starts coughing.

[Computed tomographic imaging in chronic obstructive pulmonary disease : What pulmonologists and thoracic surgeons want to know]. / Computertomographie bei chronisch-obstruktiver Lungenerkrankung : Was Pneumologen und Thoraxchirurgen wissen wollen.

Chronic obstructive pulmonary disease (COPD) begins with chronic inflammation of the bronchial system and leads to the development of emphysema in many patients. COPD patients are characterized by reduced performance, dyspnea in the context of an obstructive respiratory disorder and increased susceptibility to infections. COPD has a major impact on public health, as it is very common and many patients die from it. The most important preventable cause of COPD is tobacco smoke inhalation, which is why consistent smoking cessation is the most important component of any COPD treatment. There is no causal therapy, but in severely symptomatic patients with advanced emphysema, respiratory mechanics can be improved by lung volume reduction if all conservative treatment options have been exhausted. Diagnostic imaging is of great importance in the care of COPD patients. This article summarizes which indications warrant the performance of computed tomography (CT) and what we should pay special attention to during image analysis in order to provide optimal advice to our clinical partners.

Narrowband organic photodetectors - towards miniaturized, spectroscopic sensing.

Omnipresent quality monitoring in food products, blood-oxygen measurement in lightweight conformal wrist bands, or data-driven automated industrial production: Innovation in many fields is being empowered by sensor technology. Specifically, organic photodetectors (OPDs) promise great advances due to their beneficial properties and low-cost production. Recent research has led to rapid improvement in all performance parameters of OPDs, which are now on-par or better than their inorganic counterparts, such as silicon or indium gallium arsenide photodetectors, in several aspects. In particular, it is possible to directly design OPDs for specific wavelengths. This makes expensive and bulky optical filters obsolete and allows for miniature detector devices. In this review, recent progress of such narrowband OPDs is systematically summarized covering all aspects from narrow-photo-absorbing materials to device architecture engineering. The recent challenges for narrowband OPDs, like achieving high responsivity, low dark current, high response speed, and good dynamic range are carefully addressed. Finally, application demonstrations covering broadband and narrowband OPDs are discussed. Importantly, several exciting research perspectives, which will stimulate further research on organic-semiconductor-based photodetectors, are pointed out at the very end of this review.

Joint Statement of the German Respiratory Society and German Society of Thoracic Surgery in Cooperation with the German Radiological Society: Structural Prerequisites of Centres for Interventional Treatment of Emphysema.

Interventional treatment of emphysema offers a wide range of surgical and endoscopic options for patients with advanced disease. Multidisciplinary collaboration of pulmonology, thoracic surgery, and imaging disciplines in patient selection, therapy, and follow-up ensures treatment quality. The present joint statement describes the required structural and quality prerequisites of treatment centres. This is a translation of the German article "Positionspapier der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin und der Deutschen Gesellschaft für Thoraxchirurgie in Kooperation mit der Deutschen Röntgengesellschaft: Strukturvoraussetzungen von Zentren für die interventionelle Emphysemtherapie" Pneumologie. 2020;74:17-23.

Submillisievert chest CT in patients with COVID-19 - experiences of a German Level-I center.

PURPOSE: Computed tomography (CT) is used for initial diagnosis and therapy monitoring of patients with coronavirus disease 2019 (COVID-19). As patients of all ages are affected, radiation dose is a concern. While follow-up CT examinations lead to high cumulative radiation doses, the ALARA principle states that the applied dose should be as low as possible while maintaining adequate image quality. The aim of this study was to evaluate parameter settings for two commonly used CT scanners to ensure sufficient image quality/diagnostic confidence at a submillisievert dose. MATERIALS AND METHODS: We retrospectively analyzed 36 proven COVID-19 cases examined on two different scanners. Image quality was evaluated objectively as signal-to-noise ratio (SNR)/contrast-to-noise ratio (CNR) measurement and subjectively by two experienced, independent readers using 3-point Likert scales. CT dose index volume (CTDIvol) and dose-length product (DLP) were extracted from dose reports, and effective dose was calculated. RESULTS: With the tested parameter settings we achieved effective doses below 1 mSv (median 0.5 mSv, IQR: 0.2 mSv, range: 0.3-0.9 mSv) in all 36 patients. Thirty-four patients had typical COVID-19 findings. Both readers were confident regarding the typical COVID-19 CT-characteristics in all cases (3 ± 0). Objective image quality parameters were: SNRnormal lung: 17.0 ± 5.9, CNRGGO/normal lung: 7.5 ± 5.0, and CNRconsolidation/normal lung: 15.3 ± 6.1. CONCLUSION: With the tested parameters, we achieved applied doses in the submillisievert range, on two different CT scanners without sacrificing diagnostic confidence regarding COVID-19 findings.

Advantages of a T1-Weighted Gradient-Recalled Echo (GRE) Sequence With a Radial 3D Sampling Approach Versus 2D Turbo Spin-Echo and Cartesian 3D GRE Sequences in Head and Neck MRI.

OBJECTIVE. The purpose of this study is to compare the image quality, including artifacts, of a T1-weighted gradient-recalled echo (GRE) MRI sequence with a radial sampling approach to that of both 2D turbo spin-echo (TSE) and cartesian 3D GRE MRI sequences performed in the head and neck region. MATERIALS AND METHODS. The retrospective study included 26 datasets of patients who underwent MRI examination for inflammatory or neoplastic diseases of the head and neck region performed using a 1.5-T system. All examination protocols comprised three fat-saturated T1-weighted sequences performed in the axial plane after contrast agent administration. Axial FOV and spatial resolution in plane and along the z-axis were recorded. Sequences were evaluated independently by two readers for qualitative and quantitative parameters, including homogeneity of fat saturation and discrimination of pharyngeal wall structures. Qualitative parameters were evaluated using a 5-point Likert scale. RESULTS. For comparison, mean values of Likert scale scores were generated from the two readers' data. Fat saturation was significantly better on the radial GRE sequences (1.942) than on the TSE (2.346; p = 0.002) and cartesian GRE (2.365; p = 0.008) sequences. The overall impact of foreign material artifacts was comparable among sequences (radial GRE, 1.731; TSE, 1.731 [p = 1.000]; cartesian GRE, 1.769 [p = 0.414]); however, on direct comparison, the mean area that was not evaluable because of susceptibility was smaller on radial GRE sequences (53.8 mm) than on TSE sequences (59.8 mm; p = 0.062) and cartesian GRE sequences (59.6 mm; p = 0.079). Overall image quality was 1.635 with the use of radial GRE, 2.423 with TSE (p = 0.000), and 2.500 with cartesian GRE (p = 0.000). CONCLUSION. For imaging of the head and neck region, radial GRE has several advantages, including improved fat saturation and reduced extent of susceptibility artifacts, compared with TSE and cartesian GRE, leading to improved overall image quality.

Vertical Organic Thin-Film Transistors with an Anodized Permeable Base for Very Low Leakage Current.

The organic permeable base transistor (OPBT) is currently the fastest organic transistor with a transition frequency of 40 MHz. It relies on a thin aluminum base electrode to control the transistor current. This electrode is surrounded by a native oxide layer for passivation, currently created by oxidation in air. However, this process is not reliable and leads to large performance variations between samples, slow production, and relatively high leakage currents. Here, for the first time it is demonstrated that electrochemical anodization can be conveniently employed for the fabrication of high-performance OPBTs with vastly reduced leakage currents and more controlled process parameters. Very large transmission factors of 99.9996% are achieved, while excellent on/off ratios of 5 × 105 and high on-currents greater than 300 mA cm-2 show that the C60 semiconductor layer can withstand the electrochemical anodization. These results make anodization an intriguing option for innovative organic transistor design.

Importance of Interface Diffusion and Climate in Defect Dominated Moisture Ultrabarrier Applications.

OLEDs and organic photovoltaic (OPV) devices require encapsulation from water vapor using a permeation barrier system. As a benchmark for barrier quality, often only a single number is provided as water vapor transmission rate. However, this value is highly dependent on the aging climate. So far, little scientific effort has been undertaken to characterize ultrahigh moisture barriers at different temperatures and relative humidities. We present Ca-test studies on sputtered Zinc-Tin-Oxide and atomic layer deposited AlOx barriers in extensively varied climates. Relative humidities are changed at constant temperatures, and temperatures are changed at constant absolute humidity. We find Henry's law to apply for sorption and discover a fundamental change of the diffusion regime with time related to the interface between the test and the barrier thin-film.