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)

An analysis of the situation in respect of the activity of the Working Group "Patient Training" of the German Society of Pneumology reveals that the development has been a positive one. During the period under scrutiny (1988-1990) the patient training measures were markedly broadened for patients suffering from obstructive airway diseases. A significant increase took place in specialised hospitals and in the medical practices of physicians. Patients suffering from asthma, chronic obstructive bronchitis and pulmonary emphysema were trained both for coping with their individual diseases and with subsequent and concomitant diseases. On the whole, about 18,000 patients were trained in Germany. Both own material and in an increasing measure material supplied by the pharmaceutical industry was successfully employed. Although most of the trainers are physicians, these are being increasingly joined by nurses and physiotherapists. In the consulting-rooms of practising physicians, patient training is performed mainly up to two hours after consulting hours, especially in the evening. Preferred subjects are technique of inhalation, problems of therapy and causes of airway diseases. Second in importance after the individual talk with the patient is the group discussion. To spread patient training it will be necessary to set up pilot units: however, the medical professional organisations should also help in translating the project into reality. Standardisation of training measures for clinic and practice is planned and will be a future target for the working group. The aim is to officially integrate training measures into the therapeutic concept in obstructive airway disease also for practising physicians.
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PMID:[Patient training in obstructive respiratory tract diseases--the status in Germany]. 843 75

In a 50-year old patient with a long history of chronic obstructive airway disease and pulmonary emphysema, unusual solid spongious areas adjacent to bullous tissue were detected by bullectomia because of mediastinal displacement and dyspnoea on exertion. Pathological anatomical diagnosis showed villous framework in the marginal regions of bullous transformed parenchyma. According to pathognomonic histological finding the lesion is known as placentoid malformation or placentoid bullous transmogrification, respectively. This disease must be differentiated against rare cystic tumours such as alveolar adenoma or sclerosing haemangioma as well as congenital lesions e.g. adenomatoid cystic malformation. The lesion presented here includes hamartomatous features, such as the presence of leiomyomatoid proliferations of smooth muscle cells and fatty tissue embedded in the villous stroma. The clinically predominant emphysematous transformation of the adjacent lung tissue is pathogenetically the result of a valve formation in combination with unphysiological traction forces. The ectatic lymphatic vessels in peripheral tissue may perhaps be of etiological importance. According to former studies this may be an congenital malformation with progressive development. Resection of affected lung parenchyma seems to be curative: so far, no recurrences have been noticed.
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PMID:[Placentoid malformation of the lung as differential diagnosis of localized emphysema]. 933 86

Flow-volume curves in patients with obstructive airway disease differs from that observed in healthy subjects. Two types of pathological curves can be differentiated: these with clear sharp bend and intermediate forms characterised by the different grade of concavity of the descending segments plotted against X-axis. The aim of our present investigation is to elucidate the mechanisms which determines the forced expiratory airflow course in patients with obstructive airway diseases. Patients with sharp bend curves show changes of the several lung function data which are more advanced than in subjects with the intermediate forms of the flow-volume curves. In cases of bend curves the volume of the forced expiration can be differentiated on the two parts: circumferential and serial. Circumferential volume exhaled on the very beginning of the expiration (above the bend) amounts 0.118L in average. This volume depends on the expiratory narrowing of the bronchi from the 1-st to 9-th generation. The serial volume contained between the bend and the end of expiration amounts about 95% of the expired volume. Flow limitation occurs in 5-th to 9-th generations which is manifested by the strong increase of the flow resistance. The intermediate types of the flow-volume curves is caused by the inhomogenous emptying of the lung together with corresponding volume dependent narrowing of the bronchi. The same mechanisms can be detected even on the bodypletysmographic tidal breathing resistance curves. The concave and particularly bend flow-volume curves has been attributed to the pulmonary emphysema. This is not entirely truth. Other conditions leading to inhomogenic emptying of the lung due to airway and parenchymal changes (such as lung cicatrisation) can influence expiratory flow course resulting in concave or even bend flow-volume relationships.
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PMID:The flow-volume curve in patients with obstructive airway diseases partial analysis and functional importance. 937 90

Low single-breath diffusing capacity (DL(CO)) values are associated with anatomic emphysema, but the predictors of longitudinal change in DL(CO) over many years are unknown. Study subjects were adult participants in the longitudinal Tucson Epidemiology Study of Obstructive Lung Disease who had at least one DL(CO) measurement during either of two surveys 8 yr apart (n = 543). Smoking status was determined at each examination (current, former, or never smoker). Quitters were defined as those currently smoking at the baseline DL(CO) examination (1982-1983) and self-reported as no longer smoking at the follow-up exam (1990-1991). The longitudinal DL(CO) data were analyzed using repeated measures analysis; because of missing observations this was done using a saturated random effects model. The results showed that males had higher levels of DL(CO) than females, current smokers had significantly lower levels of DL(CO) than never smokers, but there was no difference in their mean slopes over time. Smoking history, assessed using pack-years of smoking, was associated with reduced DL(CO) levels, independent of whether current or ex-smokers. Males and females demonstrated equivalent rates of decline in DL(CO) that accelerated with increasing age, and mean DL(CO) declines were associated with declines in FEV(1) between surveys.
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PMID:Predictors of longitudinal change in diffusing capacity over 8 years. 1058 1

Chronic graft-versus-host disease occurring in the setting of allogeneic bone marrow transplantation (BMT) can affect many organ systems, is a cause of significant morbidity, and contributes to late deaths. Bronchiolitis obliterans is a form of obstructive airway disease; when seen in the post-BMT setting, it is considered a manifestation of chronic graft-versus-host disease. Air-leak syndromes including pneumothoraces, pneumomediastinum and subcutaneous emphysema are rare complications of bronchiolitis obliterans. Here we describe a patient who developed pneumomediastinum, pneumopericardium, subcutaneous emphysema and pneumothorax secondary to severe bronchiolitis obliterans complicating the post bone marrow transplantation course.
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PMID:Spontaneous pneumomediastinum and subcutaneous emphysema complicating bronchiolitis obliterans after allogeneic bone marrow transplantation--case report and review of literature. 1152 71

Chronic obstructive pulmonary disease (COPD) is a progressive disease with alveolar destruction (emphysema) and bronchiolar fibrosis (obstructive bronchitis) in variable proportions. Reducing disease progression, as assessed by forced expiratory volume in I second (FEV1) decline, health-related quality of life, exacerbation rate and mortality, is a more realistic outcome than physiological improvement. This paper reviews all the published studies of at least 100 patients followed for at least 2 years. Studies have included patients with mild COPD (Copenhagen City Lung Study) to advanced symptomatic disease [Inhaled Steroids in Obstructive Lung Disease (ISOLDE)], with 2 studies of those with relatively early symptoms [European Respiratory Society Study on Chronic Obstructive Pulmonary Disease (EUROSCOP) and Lung Health-21. Exacerbation frequency, and probably severity, are reduced by high dose inhaled corticosteroids. Exacerbations are only frequent in more advanced disease, limiting the use of this outcome in EUROSCOP and Lung Health-2. Exacerbations are associated with reduced health-related quality of life. ISOLDE clearly showed a reduced rate in decline of the disease-specific St George's Respiratory Questionnaire with fluticasone propionate, partly related to the reduced exacerbations. The symptom component of the score showed the greatest difference between placebo and fluticasone propionate. None of the larger studies were able to reproduce the statistically significant reduction in the rate of decline in FEV1 suggested by the smaller, earlier studies. This might at least in part be as a result of the statistical modelling used which cannot adequately compensate for those with more rapidly progressive disease dropping out earlier. The equivalent doses of inhaled corticosteroids differed approximately fivefold between the major studies. The more positive results were obtained with higher doses. Oropharyngeal adverse effects were similar to those seen in patients with asthma; bruising was increased in one study with budesonide, otherwise adverse effects were similar to placebo. Bone loss was specifically studied in subgroups of patients in EUROSCOP and Lung Health-2. Budesonide 800 microg/day was associated with less bone loss than placebo, whereas triamcinolone 1200 microg/day was associated with excess bone loss. High dose inhaled corticosteroids have a favourable risk/benefit ratio in patients with advanced disease, particularly those with frequent exacerbations, and no benefit for those with very mild disease. It is not possible from the data to make firm recommendations for the important intermediate group where delaying progression is likely to lead to greatest benefit. I believe high dose inhaled steroids are warranted for those with intermediate severity COPD, who have frequent exacerbations or significant COPD-related symptoms.
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PMID:Should inhaled corticosteroids be used in the long term treatment of chronic obstructive pulmonary disease? 1157 91

Acute viral respiratory tract infections are well known to precipitate asthma attacks and acute exacerbations of chronic obstructive pulmonary disease, but their role in the pathogenesis of chronic disease is poorly defined. Double-stranded DNA viruses have the ability to persist in airway epithelial cells long after the acute infection has cleared. During these latent infections, viral genes are expressed at the protein level without replication of a complete virus. The expression of the adenoviral trans-activating protein has been demonstrated in the airway epithelium of both human and animal lungs and is associated with an amplification of the cigarette smoke-induced inflammatory response. Studies of cultured human airway epithelial cells have also shown that transfection with this viral gene upregulates the expression of intercellular adhesion molecule 1 and interleukin 8 by these cells when they are challenged with endotoxin. In guinea pigs, cigarette smoke-induced emphysema is amplified by latent adenoviral infection. Furthermore, this infection independently increased the number of CD-8 cells, whereas the cigarette smoke independently increased the number of CD-4 cells in the inflammatory infiltrate. On the other hand, allergen-induced lung inflammation was uninfluenced by latent adenoviral infection in the guinea pig, but the latent infection caused the eosinophilic component of this response to become steroid resistant. These studies suggest that latent adenoviral infections may have a role in the pathogenesis of obstructive airway disease by amplifying the response to cigarette smoke and inducing steroid resistance.
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PMID:Role of latent viral infections in chronic obstructive pulmonary disease and asthma. 1173 71

There is currently no consensus on the criteria for diagnosing chronic obstructive pulmonary disease. This study evaluated the impact of different definitions of airway obstruction on the estimated prevalence of obstruction in a population-based sample. Using the Third National Health and Nutrition Examination Survey, obstructive airway disease was defined using the following criteria: 1) self-reported diagnosis of chronic bronchitis or emphysema; 2) forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) <0.70 and FEV1 <80% predicted (Global Initiative for Chronic Obstructive Lung Disease (GOLD) Stage IIA); 3) FEV1/FVC below the lower limit of normal; 4) FEV1/FVC <88% pred in males and <89% pred in females; 5) FEV1/FVC <0.70 ("fixed ratio"). Spirometry in this dataset did not include reversibility testing, making it impossible to distinguish reversible from irreversible obstruction. Rates in adults varied from 77 per 1,000 (self-report) to 168 per 1,000 (fixed ratio). For persons aged >50 yrs, the fixed ratio criteria produced the highest rate estimates. For all subgroups tested, the GOLD Stage II criteria produced lower estimates than other spirometry-based definitions. Different definitions of obstruction may produce prevalence estimates that vary by >200%. International opinion leaders should agree upon a clear definition of chronic obstructive pulmonary disease that can serve as a population-based measurement criterion as well as a guide to clinicians.
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PMID:Population impact of different definitions of airway obstruction. 1295 59

Cadmium is an important toxic environmental heavy metal. Occupational and environmental pollution with cadmium results mainly from mining, metallurgy industry and manufactures of nickel-cadmium batteries, pigments and plastic stabilizers. Important sources of human intoxication are cigarette smoke as well as food, water and air contaminations. In humans, cadmium exposures have been associated with cancers of the prostate, lungs and testes. Acute exposures are responsible for damage to these organs. Chronic intoxication is associated with obstructive airway disease, emphysema, irreversible renal failure, bone disorders and immuno-suppression. At the cellular level, cadmium affects proliferation, differentiation and causes apoptosis. It has been classified as a carcinogen by the International Agency for Research on Cancer (IARC). However, it is weakly genotoxic. Indirect effects of cadmium provoke generation of reactive oxygen species (ROS) and DNA damage. Cadmium modulates also gene expression and signal transduction, reduces activities of proteins involved in antioxidant defenses. Several studies have shown that it interferes with DNA repair. The present review focuses on the effects of cadmium in mammalian cells with special emphasis on the induction of damage to DNA, membranes and proteins, the inhibition of different types of DNA repair and the induction of apoptosis. Current data and hypotheses on the mechanisms involved in cadmium genotoxicity and carcinogenesis are outlined.
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PMID:Cadmium: cellular effects, modifications of biomolecules, modulation of DNA repair and genotoxic consequences (a review). 1707 Sep 79

The pulse sequences for hyperpolarized (3)He lung MRI that have made the most clinical impact to date are 1) those that supply regional apparent diffusion coefficient (ADC) measurements, which provide insight into early emphysematous destruction of the alveoli in the lungs, and 2) high-resolution ventilation images that provide regional indicators of airway obstruction in obstructive airway disease, such as asthma, cystic fibrosis, and chronic obstructive pulmonary disease (COPD). In this work a hybrid 2D ADC-ventilation sequence was used with low flip angles to acquire both sets of data in the same breath-hold. The performance of the sequence was investigated in vivo in a healthy subject and a subject with mild emphysema, and compared with conventional 2D gradient-echo (GRE) (3)He ventilation and ADC imaging sequences. Acquisition of the ADC and ventilation images in one breath-hold provides ventilation images with equal or better SNR (approximately 20) and the same spatial resolution (3.75 mm x 3.3 mm in plane) with simultaneous accurate, high-resolution ADC images. The hybrid sequence offers a means of conserving gas by using two-thirds of the (3)He gas needed for separate ADC and ventilation exams, and saves the subject from having to perform an extra breath-hold. The data are inherently spatially and temporally registered, allowing quantitative cross-correlation between high-spatial-resolution ADC and ventilation data.
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PMID:Single-scan acquisition of registered hyperpolarized (3)He ventilation and ADC images using a hybrid 2D gradient-echo sequence. 1753 18


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