Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The morphological concept of an end-stage lung implies a pathologically and radiologically nonspecific appearance of diffuse lung disease which can be caused by many different disease processes. The lung can respond to injury in only a limited and stereotyped fashion; with persistent injury, these pathological changes telescope toward a common appearance, the end-stage lung, which is characterized by cystic spaces of variable size and extent throughout both lungs caused by alveolar septal dissolution, bronchiolectasia, and obstructive emphysema. The most important radiological manifestation is cystic spaces, a sign of severe, irreversible damage to that portion of the lung. Pleural thickening, cor pulmonale, spontaneous pneumothorax, calcific nodules, or scar carcinoma may also be seen.
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PMID:The end-stage lung: pathogenesis, pathology, and radiology. 115 28

A report is presented of a newborn baby who developed a pneumothorax and extensive surgical emphysema after being delivered by Caesarean section for fetal distress soon after the mother had an amniocentesis.
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PMID:Pneumothorax and surgical emphysema in a newborn baby caused by amniocentesis. 116 82

Clinical and roentgenographic findings were compared in patients 40 years of age and over and in those under 40 who were treated for acute unilateral pneumothorax. Dyspnea and anxiety were pominent in the older individuals, although pneumothoraces were usually small. Because physical findings were often unreliable, roentgenograms were required. In the presence of pulmonary emphysema, loss of retractility prevented total collapse of the underlying lung. Increased intrapleural pressure caused over-expansion of the chest wall and the depression of the diaphragm without much mediastinal shifting. Partial collapse of emphysematous lobes demonstrated bullae that were not previously obvious. Respiratory failure developed in five patients over 40 years of age, but four of them recovered after relief of the pneumothorax. Mortality for the group was low and related to associated pulmonary diseases.
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PMID:Pneumothorax complicating pulmonary emphysema. 117 69

Report on successful post-drowning cardiopulmonary resuscitation of a 2-year-old boy who had lain for 20 min in cold water at 5-7 degrees C. Because of severe pulmonary complications after primary resuscitation--e.g. pulmonary edema, repeated mediastinal and subcutaneous emphysema, pneumoperitoneum and bilateral pneumothorax--spontaneous respiration remained insufficient for 36 days. Under appropriate treatment the patient recovered completely except for slight muscular hypotrophy of the left thigh. 14 months after the submersion no other neurological or pulmonary sequelae could be detected.
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PMID:[Successful treatment of a severe drowning accident after 20 minutes submersion]. 121 45

Natural surfactant (Surfactant TA, Survanta, CLSE, SF-RI 1, Curosurf and human surfactant obtained from amniotic fluid) therapy for RDS in very premature infants has been evaluated in 17 controlled clinical trials. Uniformly intratracheal surfactant administration caused a decreased intensity of mechanical ventilation during the first hours (reduced inspiratory pressure, reduced oxygen requirements) as an immediate effect of surfactant administration. Metanalysis reveals barotraumatic pulmonary complications mainly, pneumothorax and pulmonary interstitial emphysema to occur less frequently in surfactant-treated infants in virtually all trials; an increased incidence of survival without bronchopulmonary dysplasia following surfactant treatment was observed in 10 controlled clinical trials. The incidence of other complications of prematurity (intracranial hemorrhage, patent ductus arteriosus and necrotizing enterocolitis) was unchanged following natural surfactant treatment. Dosing of natural surfactant is still under investigation, however recent data indicate that the initial dose should not be less than 100 mg/kg b.w. and retreatment should be given to infants with unsatisfactory response (i.e. fraction of inspired oxygen (FiO2) > 40%). Timing of surfactant treatment still remains controversial. Prophylactic treatment shortly following birth has been compared with rescue-treatment, i.e. surfactant administration to infants suffering from manifest RDS in most studies 4-8 h after birth. Conflicting data from 5 controlled trials may be interpreted as follows: prophylactic treatment seems to be favourable for extremely premature infants (GA < or = 26 weeks) and rescue treatment seems to be adequate for infants of 27-30 weeks of gestation. Intratracheal surfactant instillation in very premature infants did not result in an improved lung function for 24 h to 48 h in all patients. Ten--25% of study infants were reported to be "non-responders", i.e. infants without sustained decrease in oxygen requirements (i.e. FiO2 > 40%). Various factors may be operative including congenital bacterial infections (sepsis or pneumonia), lung hypoplasia and cardiac failure. Inactivation of surface properties of natural surfactant caused by a leakage of proteins across the alveolar-capillary membrane was observed in experimental and clinical studies. Current investigations focus on a combination of postnatal steroids and surfactant treatment to improve lung function and outcome in "non-responders". As long as any controlled clinical studies are being published, this approach remains experimental. Up to now, any controlled clinical trials have been performed to assess different modes of artificial ventilation (e.g. high frequency oscillating ventilation versus conventional ventilation) combined with surfactant therapy. Data obtained from premature animals given natural surfactant indicate any advantage with respect to gas exchange and lung histology to result from high frequency ventilation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Natural surfactant for neonatal respiratory distress syndrome in very premature infants: a 1992 update. 129 66

We present 81 patients with diagnosis of air leaks in a Neonatal Intensive Care Unit (NICU). During 6 and a half year period. Air leaks were present in a 7.3% of overall admissions and in 18% in those whom received mechanical ventilation. We observed pneumothorax in all the patients, accompanied by pneumomediastinum in 12% and with interstitial emphysema in 7%. Other forms of air leak were present only rarely. Eighty percent of our patients were managed with intrapleural drainage. Almost 40% of events happened after resuscitation of tracheal aspiration management. The concomitant disease most often seen was respiratory distress syndrome (RDS) during it's convalescent period. Most of them had been previously placed in mechanical ventilation. We had a very high death rate, most significant in the group with weight less than 2,500 g in which 80% died. An analysis between our findings and those in literature was made.
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PMID:[Barotrauma in newborns. Study of 81 cases at a neonatal intensive care unit of a province]. 130 96

The procedure and results of thoracoscopy by using a fiberoptic bronchoscope and rigid cold-light thoracoscope in 76 cases with chest diseases of unknown causes were reported. The positive diagnostic rate was 89.5% (68/76). The histologic diagnosis following thoracoscopic biopsy in 65 patients was compared with the findings at follow-up, the results showed the sensitivity being 87.7%, specificity 100% and diagnostic accuracy 89.2%. 3 cases with persistent or recurrent spontaneous pneumothorax were cured by Nd-YAG laser transendoscopically. 5 patients with malignant pleural effusion were treated with intrapleural talcum powder under thoracoscopic control, 4 of them obtained complete pleurodesis. There were only minor complications: transient fever in 40 cases and local subcutaneous emphysema in 7. It was concluded that thoracoscopy is simple, safe, reliable and practical in the diagnosis and treatment of chest diseases. It should be popularized clinically.
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PMID:[The use of thoracoscopy in the diagnosis and treatment of chest diseases]. 130 81

Rupture of the trachea is an exceptional obstetrical lesion. The infant reported in this paper, at 1 hour of age, developed respiratory distress with pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema. This resulted from the fact that the trachea had ruptured, within 1 cm of the carina, during the difficult delivery. When the child was 23 days old, operation proved necessary because extubation was not feasible. The stenotic portion of the trachea was resected and continuity restored by end-to-end anastomosis. The tracheal lumen at the site of the anastomosis proved normal by bronchoscopic examination 4 months after the operation. There is only one similar case in the literature. The etiology of this rupture is discussed.
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PMID:Tracheal rupture in a newborn during a complicated delivery. Diagnosis and surgical repair. 139 May 52

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.
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PMID:Management of an unusual presentation of foreign body aspiration. 140 75

There were 34 episodes of pneumothorax out of 400 episodes of COPD (i.e. 8.5% of the total) among patients who were admitted to Chulalongkorn Hospital during the period 1982 to 1986; the episodes of pneumothorax occurred among 22 males and one female, with the average age on admission being 64.0 +/- 8.5 years. All patients had a long history of smoking (average 40 years) with a history of recurrent pneumothorax (47.8%) and two episodes of pneumothorax per patient. Since only about one third of our patients had chest pain or positive signs of pneumothorax on physical examination, the possibility of pneumothorax should be considered in every patient who develops sudden and increasing shortness of breath, especially during mechanical ventilation, or even in association with other obvious precipitating factors, e.g. URI. With regard to complications, there were eight, four, two, two and five episodes of severe respiratory failure requiring assisted ventilation, tension pneumothorax, bilateral simultaneous pneumothorax, pneumomediastinum with subcutaneous emphysema, and plural effusion, respectively. The death rate was 23.5 per cent. Patients who had a pneumothorax requiring assisted ventilation or who developed a pneumothorax during assisted ventilation had a grave prognosis because of multiple complications from mechanical ventilation. Two episodes with minimal pneumothoraxes achieved re-expansion after conservative treatment. The treatment required 3.3 days for the lung to fully expand, 9.6 days when the air-leak stopped and the duration of tube drainage was 10.8 days. Our study indicates that the longer the duration of lung collapse the longer the time required for re-expansion of the lung.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spontaneous pneumothorax in chronic obstructive pulmonary disease. 140 43


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