Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty eight patients with the acquired immunedeficiency syndrome (AIDS) presented to the Mount Sinai Hospital in New York with persistent cough and dyspnoea or an abnormal chest radiograph, or both. Thirty two (67%) were found to have Pneumocystis carinii pneumonia, either alone or in combination with another pathogen. Of these patients, eight (25%) had a normal chest radiograph. Abnormalities in the single breath carbon monoxide diffusing capacity and alveolar-arterial oxygen gradient [A-a) DO2) suggested infection with Pneumocystis carinii. Fibreoptic bronchoscopy with transbronchial biopsy was 100% sensitive in the diagnosis of pneumocytis pneumonia. Fibreoptic bronchoscopy should be undertaken in patients suspected of having a pulmonary complication of AIDS, even if the chest radiograph is normal.
 ...
PMID:Diagnosis of pulmonary complications of the acquired immune deficiency syndrome. 387 10

Controlled mechanical ventilation is an accepted therapy for acute respiratory failure but by virtue of the increase in intrathoracic pressure has a large number of disadvantages. It is to overcome these disadvantages that alternative modes of ventilation have been introduced. These aim to reduce the effects of abnormally high airway pressure on the lung whilst recruiting solid alveoli and at the same time maintaining effective blood volume. Intermittent mandatory ventilation is a mode of ventilation first introduced to aid weaning which may reduce the need for sedation, permit better tolerance of high levels of PEEP and maintain urine osmolar output. High frequency ventilation utilising low airway pressures can maintain pulmonary gas exchange whilst reducing the effects of stretch on the lung. Its major role would seem to be in cases of bronchopleural fistula and necrotising pneumonia where a low mean airway pressure is essential. Low frequency positive pressure ventilation with extra corporeal CO2 removal, whilst a very labour intensive technique, has produced a favourable outcome in patients with terminal respiratory failure. Use of PEEP is associated with further deleterious haemodynamic effects which are largely overcome with use of continuous positive airway pressure during spontaneous respiration. PEEP is widely used. Its effect on pulmonary compliance, dead space and oxygen delivery are unpredictable making haemodynamic monitoring mandatory. Inversed ratio ventilation requires further evaluation whereas differential lung ventilation is logical, complicated but very valuable where the time constants for each lung are significantly different.
 ...
PMID:Alternative modes of ventilation. Part I. Disadvantages of controlled mechanical ventilation: intermittent mandatory ventilation. 388 40

Human alveolar macrophages were lavaged from surgically resected lungs and from lungs of normal subjects. Macrophages that had been purified by glass adherence were maintained in tissue culture for as long as 54 days. After 3-4 wk in vitro they underwent transformation into multinucleated giant cells. These aged cells had more than 30 times the phagocytic capacity that the same group of cells had had after 1 day in vitro. Phagocytosis of heat-killed Candida albicans was inhibited by iodoacetate, sodium fluoride, potassium cyanide, and low partial pressures of oxygen, suggesting that these cells require both oxidative and glycolytic energy sources for maximal particle ingestion. Alveolar macrophages and monocyte-derived macrophages killed Listeria monocytogenes with similar efficiency, but neutrophils were more efficient than either of the other cell types. Bacterial killing is probably not dependent upon myeloperoxidase in the monocyte-derived macrophage or in the alveolar macrophage since histochemical stains for peroxidase do not stain either cell type. C. albicans blastospores, which are killed by neutrophils and monocytes that contain myeloperoxidase, were not killed by human alveolar macrophages during the 4 hr of observation. Large cells with supernormal phagocytic capacity were recovered from patients with postobstructive pheumonia and from one patient with recurrent bacterial pneumonia, indicating that macrophage function can be altered in certain disease states. Human alveolar macrophages are unique human phagocytes in their dependence on an oxygen tension greater than 25 mm HG for maximal phagocytosis. Carbon dioxide tensions as high as 70 mm Hg did not alter phagocytosis when the pH of the medium was held constant. These data suggest that the increased susceptibility to pneumonia of patients with chronic bronchitis or atelectasis may be in part related to suboptimal phagocytosis by macrophages in areas of the lung with depressed oxygen tension.
 ...
PMID:The human alveolar macrophage: isolation, cultivation in vitro, and studies of morphologic and functional characteristics. 499 83

Five pulmonary function tests (transfer factor for carbon monoxide, diffusing capacity of the alveolar-capillary membrane, pulmonary capillary blood volume, alveolar volume, vital capacity) were performed, and creatinine clearance was measured in 39 patients with disseminated testicular nonseminomatous tumor treated with a combination chemotherapy containing bleomycin. Eight of these patients (20.5%) developed bleomycin-induced pneumonitis (BIP). To investigate which parameter has value in predicting BIP, a discriminant analysis was performed. The combination of a low normal creatinine clearance, a decrease in vital capacity and alveolar volume without a decrease in pulmonary capillary blood volume, pointed to an increased risk. We concluded that it is worthwhile to monitor these parameters and, if necessary, to adapt the chemotherapy of a patient at risk.
 ...
PMID:Predictive factors for bleomycin-induced pneumonitis. 621 2

The arterial pH and partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2) were evaluated in LAF 1 mice 15 and 38 weeks after localized irradiation of the animals' thoraxes. Graded radiation doses of 900 to 1200 rad were administered. These doses resulted in 0 to 100% lethality by 26 weeks (180 days) after irradiation. At 15 weeks after treatment mice receiving radiation doses which would subsequently result in lethality (by 180 days) exhibited significant reductions in their PaO2 and elevations in their PaCO2 values, respectively. However, there was no clear dose-response relationship between blood gas values and radiation dose, which may reflect the animals' ability to compensate for their poor blood gas exchange by an increased breathing frequency. At 38 weeks after irradiation the blood gas values were abnormal in mice from groups which had normal blood gas values at Week 15 (and no fatalities by Week 26) but in which animal deaths had occurred between Weeks 26 and 38. These data therefore indicated (i) that abnormal blood gas values occurred in the mice prior to fatalities resulting from the acute radiation pneumonitis syndrome and (ii) that mice surviving the initial radiation pneumonitis phase could still succumb to progressive pulmonary toxicity which was reflected by the increasing levels of animal lethality and altered blood gas tensions at the later times.
 ...
PMID:Quantitative changes in the arterial blood gases of mice following localized irradiation of the lungs. 640 58

We studied 53 patients with proximal myopathy to determine at what level of muscle weakness hypercapnic respiratory failure is likely, and which tests of pulmonary function or respiratory muscle strength would best suggest this development. Respiratory muscle strength was determined from maximal static efforts and in half the patients, both inspiratory and expiratory muscle strengths were less than 50% of normal. In the 37 patients without lung disease respiratory muscle weakness was accompanied by significant decreases in vital capacity, total lung capacity, and maximum voluntary ventilation; by significant increases in residual volume and arterial carbon dioxide tension (PaCO2); and greater likelihood of dependence on ventilators, atelectasis, and pneumonia. Hypercapnia was particularly likely when respiratory muscle strength was less than 30% of normal in uncomplicated myopathy, and when vital capacity was less than 55% of the predicted value in any patient.
 ...
PMID:Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies. 641 85

Three further patients are presented who developed evidence of a parenchymal pulmonary disturbance in the course of treatment with amiodarone. In one case the progress of the condition was rapid and ended fatally. Histological examination of the lungs showed evidence of diffuse alveolar damage. The concentration of amiodarone was from four to seven times higher in the lungs than in other organs studied. The concentration of the metabolite desethylamiodarone in the lungs was even higher in relation to other organs studied. The remaining two patients showed a more insidious onset and improvement after withdrawal of amiodarone and treatment with corticosteroids. Gallium 67 scintigraphy appeared to be a sensitive indicator of this adverse effect. Review of published reports revealed 35 cases of amiodarone pneumonitis, including the cases reported in this study. In 11 instances the dose of amiodarone was 400 mg or less. The onset was either insidious or rapidly progressive. Exertional dyspnoea was always present and a nonproductive cough, hypoxaemia, a raised erythrocyte sedimentation rate and diminished carbon monoxide diffusing capacity (transfer factor) were usually noted. Chest radiographs showed either a reticular pattern or diffuse patchy alveolar infiltrates. Discontinuation of amiodarone and an institution of corticosteroid treatment was usually followed by improvement or resolution.
 ...
PMID:Amiodarone pneumonitis: three further cases with a review of published reports. 669 54

The biological activity of materials produced in the direct liquefaction of coal is being assessed by a variety of test systems. In this study, the pulmonary toxicity of process solvent (PS) from the solvent refined coal-I (SRC-I) process was determined by histamine aerosol challenge tests and pulmonary function and morphologic evaluations. Guinea pigs inhaled aerosols of PS (boiling range, 230 to 450 degrees C) for 6 hr/day, 5 day/week, for up to 12 days in three different experiments. In the first experiment, 8-week-old animals inhaled 0 (controls), 0.15, or 0.60 mg/liter PS aerosols with a mass median aerodynamic diameter (MMAD) of 1.3 micrometer. Exposure to 0.15 mg/liter PS for 12 days resulted in depressed weight gain and marked hypersensitivity to inhaled histamine compared with sham-exposed control animals. Four of five animals exposed to 0.6 mg/liter PS died of respiratory failure during exposure. During the second experiment, 14-week-old animals inhaled 0 (controls) or 0.19 mg/liter PS (MMAD, 1.3 microns) for 1, 3, or 12 days. Hypersensitivity to aerosolized histamine occurred only after 12 days exposure to PS aerosols. At that time, morphologic lung evaluations showed mild to moderate pneumonitis and accumulation of exudate in bronchioles of PS-exposed animals. In the third experiment, pulmonary function evaluations were conducted on 4-week-old animals exposed to 0 (controls) or 0.19 mg/liter PS for 8 days. Functional changes measured in these animals (compared to controls) included increased gas trapping at low lung volumes, decreased quasi-static compliance, and decreased diffusion capacity of the lung for carbon monoxide. These studies showed that measurable changes in lung function were produced in guinea pigs after 8 to 12 days exposure to 0.15 or 0.19 mg/liter PS and that exposure to PS affected weight gain only in younger animals (4 and 8 weeks old) but not in 14-week-old animals.
 ...
PMID:Pulmonary toxicity of inhaled coal liquid aerosols (boiling range 230-450 degrees C). 684 64

Continuous positive airway pressure (CPAP) is used frequently to improve gas exchange in acute pulmonary failure. We investigated clinical and respiratory variables in 98 patients presenting with two or more of the classical criteria for endotracheal intubation and mechanical ventilation. CPAP applied by a face mask was efficient in 60 cases. Posttraumatic and postoperative pulmonary problems responded better to this therapy than lung dysfunction secondary to left heart failure, sepsis or pneumonia. Abundant expectorations, discoordination of respiratory movements and an increase in arterial carbon dioxide were frequently associated with failure of CPAP by mask and the necessity of endotracheal intubation and mechanical ventilation.
 ...
PMID:Treatment of acute pulmonary failure by CPAP via face mask: when can intubation be avoided? 701 62

Idiopathic pneumonitis is a major cause of morbidity and mortality in patients with leukaemia undergoing total body irradiation (TBI) and bone marrow transplantation (BMT). The effect of variation in dose relate of TBI on the development of lethal and sublethal lung damage has been investigated in mice by measuring changes in carbon monoxide uptake. CBA mice were irradiated using a 60Co source at 0.02, 0.05, 0.1, 0.2, 0.5 and 1.0 Gy min -1 to a total dose of 15.5 Gy. A log-linear relationship between the severity of impairment of carbon monoxide uptake (Vco) and dose rate was found. Ventilatory requirement (ventilation rate/Vco) was raised 20 to 40 weeks after TBI at dose rates above 0.1 Gy min -1. Time of onset and extent of elevation of ventilatory requirement were also dose-rate dependent. The implications of these findings for clinical practice are discussed.
 ...
PMID:Dose-rate dependence of lung damage after total body irradiation in mice. 704 Feb 73


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>