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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Asbestos is a fibrous silicate mineral that has been known for decades to cause pulmonary scarring, referred to as asbestosis. The simplest definition of asbestosis is the presence of pulmonary fibrosis as a result of accumulation of airborne asbestos in the lungs. Not infrequently, the terms "asbestos" and "asbestosis" are used incorrectly (interchangeably) by medical personnel, and sometimes pleural fibrosis caused by asbestos is incorrectly referred to as asbestosis. The earliest lesion of asbestosis, as defined by the CAP-NIOSH Committee is peribronchiolar fibrosis, although controversy exists as to how specific this lesion is with respect to causation by asbestos, and whether this lesion progresses to grade 4 asbestosis. In addition, some authorities in the field suggest that the term "asbestosis" be used only for diffuse interstitial fibrosis. The mechanism by which asbestos causes interstitial fibrosis remains poorly understood, and in recent years, pathologic changes such as organizing pneumonitis-bronchiolitis obliterans, and lymphocytic interstitial pneumonitis, have been described in persons occupationally exposed to asbestos, suggesting that the pulmonary lesions caused by asbestos represent a wider spectrum than had previously been appreciated. By defining areas of uncertainty, medical science will eventually clarify areas of disagreement concerning asbestosis which will eventually lead to a better understanding of this disease.
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PMID:Controversies and uncertainties concerning the pathologic features and pathologic diagnosis of asbestosis. 160 52

The disease concept of idiopathic BOOP has emerged from a study of many open lung biopsy cases of diffuse infiltrative lung disease. The histopathologic features of idiopathic BOOP have several components: bronchiolitis obliterans, organizing pneumonia, accumulation of foamy cells in the peripheral air spaces, and interstitial infiltration of mononuclear cells. These pathologic findings are nonspecific and many conditions show such a BOOP pattern. Idiopathic BOOP has been discussed in the context of bronchiolitis obliterans, organizing pneumonia, and interstitial pneumonia. While clinically idiopathic BOOP has a relatively broad spectrum of manifestation, BOOP stands as a clinicopathologic disease entity among diffuse infiltrative lung diseases of unknown etiology.
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PMID:Differential diagnosis of bronchiolitis obliterans organizing pneumonia. 162 10

The reliability of bronchoscopy with transbronchial biopsies for the diagnosis of acute graft rejection has recently been questioned. We present our experience with 59 transbronchial and bronchial biopsies and two open-lung biopsies from 12 patients that underwent lung transplantation. The diagnosis of acute rejection was established in 14 biopsies based on the absence of infection and presence of one or more of the following features: perivascular lymphoid infiltrates, usually associated with endothelial swelling; bronchial "acute on chronic" inflammation; and/or angiitis. Problems and potential pitfalls in the diagnosis of acute graft rejection in lung transplant patients are discussed. The biopsies were also sensitive for the diagnosis of cytomegalovirus pneumonitis and fungal infections but were not helpful for the diagnosis of bacterial pneumonias. Indeed, one patient died with Legionella sp. pneumonia diagnosed only on open-lung biopsy after two negative transbronchial biopsies. The significance of other histologic changes, such as nonspecific interstitial pneumonitis, diffuse alveolar damage, acute alveolitis, goblet cell hyperplasia of the bronchial mucosa, and pulmonary infarction, is discussed.
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PMID:Lung transplantation: the pathologic diagnosis of pulmonary complications. 164 51

Transbronchial lung biopsy is rapidly becoming the procedure of choice for diagnosing lung rejection, and diagnostic criteria are evolving. The presence of perivascular lymphocytic infiltrates has been stated to be sufficient for this diagnosis, although the specificity of this histologic finding has not been determined. In a review of 42 cases of pneumocystis and cytomegalovirus pneumonia diagnosed by open (33 cases) and by transbronchial lung biopsy (nine cases) from immunosuppressed patients (excluding those with underlying non-Hodgkin's lymphoma), perivascular lymphocytic infiltrates similar to those observed in lung rejection were identified in 26% of cases overall, 21% of pneumocystis cases (n = 33), 42% of cytomegalovirus cases (n = 7), and 50% of cases of combined pneumocystis and cytomegalovirus pneumonia (n = 2). The presence of a perivascular infiltrate did not correlate with the pattern of lung histology (diffuse alveolar damage, mononuclear interstitial pneumonia, or organizing pneumonia) or with overall cellularity of the specimens. As cytomegalovirus and pneumocystis are the two most common nonbacterial pathogens in lung transplant recipients, these findings support a multimodal approach to the diagnosis of lung rejection and argue for caution in interpreting the presence of perivascular inflammation on transbronchial biopsies in this setting until a diagnosis of infection is excluded.
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PMID:Perivascular inflammation in pulmonary infections: implications for the diagnosis of lung rejection. 164 36

In a prospective study the efficacy of fiberoptic bronchoscopy was evaluated in the diagnosis of infections with opportunistic pathogens, Kaposi's sarcoma and nonspecific interstitial pneumonitis in 171 episodes of pneumonitis in 151 HIV-infected patients. Samples were collected by suction through the inner aspiration channel of the bronchoscope (n = 164), telescoping plugged catheter (n = 117) and transbronchial lung biopsy (n = 82). A high incidence of infections with pyogenic bacteria (12%), Legionella spp. (5 %) and Mycobacterium tuberculosis were diagnosed (9%). Bronchoalveolar lavage demonstrated a high diagnostic rate in bacterial pneumonia (significance level greater than 10(5) cfu/ml) and a low degree (10%) of contamination (less than 1% squamous epithelial cells). Bronchoalveolar lavage was more effective than the telescoping plugged catheter in yielding a significant number of colonies in patients with bacterial pneumonia previously treated with antibiotics. Nondiagnosed pneumonitis was more frequent in intravenous drug abusers than in homosexual men (p less than 0.001).
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PMID:Fiberoptic bronchoscopic diagnosis of pulmonary disease in 151 HIV-infected patients with pneumonitis. 165 32

Previous research has demonstrated that 4-ipomeanol toxicosis can enhance the severity of para-influenza virus-induced pneumonia in mice. The objectives of this study were to determine whether calves are susceptible to 4-ipomeanol-induced enhancement of parainfluenza type 3 viral pneumonia and to determine whether 4-ipomeanol alters pulmonary replication of parainfluenza virus. Male Holstein calves were injected with either 4-ipomeanol (3 mg/kg) or vehicle (polyethylene glycol) 3 days prior to intratracheal inoculation with either parainfluenza virus or sham inoculum of culture medium. Calves in the four treatment groups (ipomeanol-parainfluenza, ipomeanol-medium, vehicle-parainfluenza, and vehicle-medium) were necropsied at 5 days after inoculation with parainfluenza virus or medium. The lungs were studied by correlated methods of light and electron microscopy, digitizing morphometry and pulmonary lavage to quantitate the severity of pneumonia. Pulmonary viral titers were determined, and viral antigen was identified in the lung by immunoperoxidase technique. The calves in the ipomeanol-virus treatment group had over a 9-fold higher (P less than 0.05) volume density of virus-induced interstitial pneumonia than did the calves in the other three treatment groups. This 4-ipomeanol-enhanced viral pneumonia was associated with significantly greater (P less than 0.05) numbers of pulmonary macrophages and neutrophils in the lavage fluid and higher (P less than 0.05) pulmonary titers of pulmonary infectious parainfluenza virus. Four-ipomeanol-enhanced viral pneumonia was characterized in part by extensive hyperplasia of type II alveolar epithelial cells and by dense aggregates of macrophages and neutrophils in alveolar spaces and interalveolar septa. The results indicate that 4-ipomeanol exacerbates interstitial pneumonia in calves induced by bovine parainfluenza type 3 virus.
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PMID:Effects of 4-ipomeanol on bovine parainfluenza type 3 virus-induced pneumonia in calves. 166 Oct 42

Following intranasal infection with murine cytomegalovirus (MCMV), the levels of viral replication in the lungs of susceptible BALB/c mice were enhanced by treatment with cyclophosphamide (CY), or to a greater extent cyclosporin A (CsA) or the Nu/Nu genotype. Focal inflammation was seen 2-4 days after infection in all groups. This was followed by diffuse interstitial pneumonitis which cleared 12-20 days later in the absence of immunosuppression. Although the initial foci of inflammation were less prominent in infected mice treated with CY or CsA, the most severe interstitial pneumonitis was seen 7 days p.i. in mice given CY, whilst CsA-treatment produced focal and disseminated pneumonitis 7-14 days p.i. and Nu/Nu mice exhibited only the focal response. MCMV-infected mice maintained from weaning on a low protein (4% casein) diet also retained higher titres of virus in their lungs than did normally-fed controls, and displayed more prominent focal pneumonitis.
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PMID:Modulation of immunocompetence by cyclosporin A, cyclophosphamide or protein malnutrition potentiates murine cytomegalovirus pneumonitis. 166 28

The paper reports on a theme of important pediatric interest, pneumonia with Pneumocystis carinii (PC), a more widespread affection lately, due to the progress in pediatric reanimation, on the one hand (that allowed the survival for a long time of several biologically handicapped infants) and as a consequence of the more and more common use of immunosuppressing therapy, on the other hand (malignant diseases, transplant of organs, etc.); another important role in the increase of the PC pneumonia is played, recently, both in the adult and the child, by the infection with HIV (acquired immunodeficiency syndrome). The authors discuss largely on the pathogenic agent, PC, proved to be a fungus by molecular genetic studies, and on the biological field (small age, dystrophy, prematurity, "debilitating" chronic diseases, long diarrheic diseases, congenital malformations, hospitalization, some infections with long evolution: tuberculosis, Cryptococcus, infection with cytomegalic virus). The paper also deals with epidemiology, pathogeny and pathologic anatomy of the disease (characteristic macroscopic aspect: nonaired lung of high consistency, with whitish infiltrations alternating with congestive zones and the microscopic aspect of alveolo-interstitial pneumonia). The clinical picture includes the common form, met in the biologically handicapped infant and hypoergic hypoimmune form, appearing in all ages in immunodeficient subjects. Radiological examination, pulmonary scintigraphy and a series of laboratory data (with evidence of parasitic cysts) complete the clinical examination, making easier the diagnosis. The techniques of seroimmunological diagnosis offers great hope for the future. The positive diagnosis shows the clinical elements that suggest the presence of the disease, the contribution of the radiologic examination and mainly the presence of the parasite in the bronchitic secretions; the therapeutic response is a retroactive element in the positive diagnosis. The differential diagnosis is presented in detail. The paper concludes with a series of treatment schemes used, prophylaxis, evolution, complications and prognosis of the disease.
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PMID:[Pneumocystis carinii pneumonia]. 166 1

Several respiratory complications have been described in patients with ulcerative colitis (UC), and are the subject of this review. Involvement of the bronchial tree is the most frequent of them. Chronic bronchitis (16 patients) and bilateral bronchiectasis (16 patients) are responsible for chronic disabling bronchial suppuration. Symptoms related to the bronchial disease most often develop in patients in whom the diagnosis of ulcerative colitis is already established (88% of cases). Occurrence before the diagnosis of UC is possible, but unusual. Bronchial involvement can develop in patients whose UC is in complete remission, or who have undergone coloproctectomy up to several years earlier. Impressive improvement of cough and sputum production commonly occur following inhaled steroids. This is of great diagnostic and therapeutic significance. Other complications include subacute asphyxiating tracheal obstruction due to intralumenal inflammatory overgrowth (1 patient), small airways disease and panbronchiolitis (2 patients), BOOP (4 patients), pulmonary angiitis (6 patients), desquamative interstitial pneumonitis and granulomatosis (2 and 3 patients respectively), biapical pulmonary infiltrates (2 patients) and serositis. In addition, UC patients can develop less specific pulmonary problems such as pulmonary edema, pulmonary embolism and sulfasalazopyridine-induced pneumonitis and fibrosis.
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PMID:[Respiratory manifestations of hemorrhagic rectocolitis]. 176 14

In this clinical study, one normal subject, one patient with primary interstitial pneumonia, one patient with segmental pneumonia due to Staphylococcus aureus, one patient with post-operative esophageal carcinoma, and two patients with mitral stenosis were studied. Dynamic CT scan images under continuous injection of low osmotic contrast medium were analyzed in series, in an attempt to evaluate vascular permeability quantitatively. The following results were obtained: 1) Subtraction CT scan image 10 minutes after the start of contrast medium injection in two patients with pneumonia, showed a reduction of pulmonary vascular permeability following therapy. 2) Subtraction CT scan image of the patient with post-operative esophageal carcinoma treated with 25 Gy radiation showed a discrepancy between pulmonary vascular permeability and other findings. 3) In hemodynamically stable patients with mitral stenosis, subtraction CT images demonstrated that pulmonary vascular permeability was not affected by pulmonary congestion, irrespective of its severity.
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PMID:[Clinical application of subtraction CT imaging for evaluation of pulmonary vascular permeability]. 177 Jun 85


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