The class is still in service, now operated by Great Western Railway and by Chiltern Railways. When operated originally by Network SouthEast, along with that operator's Class 166 trains, the Paddington suburban units were initially known as Thames Turbos, while the units operated on the Marylebone suburban network were known as Chiltern Turbos. These conditions are rare and few physicians have substantial experience with their diagnosis and management. Table 3. RADIOLOGIC FEATURES AND DIFFERENTIAL DIAGNOSIS OF IDIOPATHIC INTERSTITIAL PNEUMONIAS Clinical Diagnosis In more recent publications the term NSIP has evolved from its original use, which was intended to indicate a histologic pattern with a variety of etiologies ( 17). Now it is almost exclusively used to identify a form of IIP ( 18, 20, 21, 35, 36, 40, 90, 94-96). However, the concept of an idiopathic form of NSIP presents a problem for the clinician because there is no recognized and distinctive clinical description for patients presenting with this histologic pattern on lung biopsy. Although these patients have a better prognosis than those with IPF, the clinician does not know this in advance. This improved prognosis has been observed in several studies and appears to correlate with differences in the dominant pathology, whether a cellular or fibrotic pattern of NSIP is present and dominates ( 17, 18, 20, 21, 23, 36, 40, 94, 95). Further subclassification may become necessary, but this remains an issue for further study. It is possible that specific occupational exposures may give rise to this pattern.

Chapple, James (16 November 2015). "Passengers 'standing around in country lane' after train fire". Surrey Live.It is recommended that the term pattern be added to the IIP designations when referring to the lung biopsy pathologic pattern, to distinguish it from the clinico–radiologic– pathologic diagnosis (e.g., NSIP, DIP, or LIP).

A new depot was built at Aylesbury in 1990/1991 for the maintenance of these trains and has been enlarged since British Rail days, with the addition of a wheel lathe. Light maintenance and refuelling is carried out at Wembley LMD and Tyseley TMD, and units can occasionally be found at Stourbridge LMD. Units are also regularly stabled in the Marylebone station environs, Aylesbury South Sidings and at Banbury, where a further depot is currently under construction at the south end of the station on the western side of the line. Each unit was formed of two outer driving motors, with an additional intermediate motor in the 3-car units. The technical description of the formation is DMOSL+MOS+DMOS. Individual carriages are numbered as follows: [1]Chiltern Railways refurbished three car Class 165/0 No. 165032 at London Marylebone. 165039 in revised Chiltern Railways livery at London Marylebone. Definition of abbreviations: AIP = acute interstitial pneumonia; CFA = cryptogenic fibrosing alveolitis; COP = cryptogenic OP; DAD = diffuse alveolar damage; DIP = desquamative interstitial pneumonia; IPF = idiopathic pulmonary fibrosis; LIP = lymphoid interstitial pneumonia; NSIP = nonspecific interstitial pneumonia; OP = organizing pneumonia; PCP = Pneumocystis carinii pneumonia; RB-ILD = respiratory bronchiolitis-associated interstitial lung disease; UIP = usual interstitial pneumonia. The Class 165/1 fleet were built for local services from London Paddington along the Great Western Main Line; their main destinations included local trains to Reading, Greenford, Newbury, Bedwyn, Oxford, and Banbury, and services along the branch lines to Windsor & Eton Central, Henley-on-Thames, Marlow and Bicester Town.

AIP occurs over a wide age range, with a mean age of approximately 50 yr, and there is no sex predominance, nor association with smoking ( 19, 39, 40, 119, 120). Most case series fail to distinguish between those patients with a putative cause and idiopathic cases.On 16 June 2016, unit 165124 was derailed by a set of trap points at Paddington after passing a signal at danger, causing significant disruption to services. The driver's assistant's side of the cab was destroyed after the train hit a stanchion that holds up the overhead catenary after derailing. The vehicle was moved after two days in position at Paddington to Old Oak Common Depot to be taken away by road for assessment and repair work. [10] New timetable for South Wales launched by Great Western Railway". RailAdvent. 5 October 2019 . Retrieved 30 March 2021. Transbronchial biopsies are not useful in the diagnosis of most of the IIPs, with the exception of DAD/AIP, and occasionally organizing pneumonia (OP)/COP. The primary role of transbronchial biopsies is to exclude sarcoidosis and certain infections. Bronchoalveolar lavage is not always required in the assessment of the IIPs.

The British Rail Class 165 Networker Turbo is a fleet of suburban diesel multiple unit passenger trains (DMUs), originally specified by and built for the British Rail Thames and Chiltern Division of Network SouthEast. They were built by BREL York Works between 1990 and 1992. [6] An express version was subsequently built in the form of the Class 166 Networker Turbo Express trains. Both classes are now sometimes referred to as " Networker Turbos", a name derived some three years later for the project that resulted in the visually similar Class 365 and Class 465 EMUs. Each unit was formed of two outer driving motors, with an additional intermediate motor in the 3-car units. The technical description of the formation is DMOCL+MOS+DMOS. Although still listed on the vehicle data sheets at DMCL vehicles, the first-class area has been removed from 2-car 165s operated by GWR. As such these vehicles are now technically DMOSL vehicles. The 3-car units were similarly de-classified, but the first-class accommodation has now been re-instated on these. Individual carriages are numbered as follows: [1] It was reported in September 2018 that Angel Trains was to convert class 165 units for Chiltern Railways to hybrid diesel and battery-powered trains. [21] a b c d e f Colin J Marsden. "Technical Data: Class 165". Archived from the original on 27 October 2007 . Retrieved 17 March 2010. {{ cite web}}: CS1 maint: unfit URL ( link)

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Almost all of the current treatments for the IIPs have potentially serious risks and side effects, and it is not reasonable to expose patients to these risks in the presence of diagnostic uncertainty. Establishment of a firm clinicopathologic diagnosis allows the patient and clinician to make more informed decisions about therapy. The majority of patients recover completely on administration of oral corticosteroids, but a significant number relapse within 1 to 3 mo when the corticosteroids are reduced (usually to below 15 mg/d) or stopped ( 37, 106). Prolonged treatment for 6 mo or longer is advised. A small proportion of patients recovers spontaneously ( 37). Rare cases previously classified as COP are reported to progress to respiratory failure and death. In some of these cases, additional features of diffuse interstitial fibrosis have been present, suggesting an alternative diagnosis including organizing pneumonia superimposed on a UIP lesion (acute exacerbation or accelerated decline of IPF) ( 107, 109-111). a b "About us - Our train fleet". Chiltern Railways. Archived from the original on 3 July 2010 . Retrieved 26 August 2008.