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)

We measured PT, TT, KPTT, Fg, vWF, AT-IIIAg, AT-IIIA, alpha 2M, TXB2, 6-keto-PGF1 alpha, PLg, tPAAg, tPAA and PAI of patients with acute onset of chronic bronchitis, pulmonary emphysema, and cor pulmonale. The results were that many above parameter had a worsening tendency along with deterioration of COPD, and Fg, vWF, TXB2, 6-keto-PGF1 alpha, tPAA and PAI were more sensitive than others. The analysis of multiple liner regression of 22 blood items in patients with cor pulmonale showed that pH, PaO2, PaCO2 had correlation with many items of prethrombotic state. We consider that in the progress of COPD, prethrombotic state gradually appeared and aggravated. The causes may be related with repeatedly infections, low O2, high CO2 and imbalance of acid-base equilibrium.
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PMID:[The study on prethrombotic state in patients with chronic obstructive pulmonary disease and cor pulmonale]. 822 62

In a prospective study during the period January-May 1992, 362 consecutive out-patients above 65 years of age, attending the pulmonary department for chronic obstructive airways disease (COPD), were ultrasonographically screened for an aneurysm of the abdominal aorta (AAA). Data from pulmonary function tests together with history of cardiac disease, diabetes mellitus, hypertension, hypercholesterolaemia, peripheral arterial obstructive disease, smoking and corticosteroid medication were collected. 30/282 men and 6/80 women with COPD had an AAA > or = 30 mm in diameter, which equals a prevalence of 9.9% (95% confidence limits: 6.8-13.0%). COPD patients with severe emphysema, having a decreased forced expiratory volume/vital capacity ratio (FEV/VC) of < 55%, have a significantly higher prevalence of aortic dilatation or AAA compared to COPD patients with mild or moderate decreased FEV/VC (chi-squared test: p < 0.05, alpha = 0.05). In the group of patients with AAA, significantly more smokers were seen compared to the group with normal and dilated aortas (chi-squared test: p < 0.05).
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PMID:Chronic obstructive pulmonary disease and abdominal aortic aneurysms. 835 93

Long-term oxygen therapy (LTOT) has a significant effect on the survival of patients with chronic obstructive bronchitis and/or emphysema (COPD). The rationale for this therapy is based on prevention of the increase in pulmonary arterial tension resulting from chronic hypoxia. There are several problems in the application of this treatment to individual patients, and they are reviewed in this paper. Indication for LTOT depends on precise criteria. Information to the patients and to the medical community is essential for the success of this therapy.
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PMID:[Continuous home oxygen therapy in chronic obstructive bronchopneumopathy]. 850 36

Antileucoprotease (ALP) is a natural occurring anti-elastase, and is produced in the epithelium of the conducting airways. It is a small protein, consisting of 107 amino-acids arranged in 2 domains. The second domain carries the antiproteolytic active site, the first is responsible for antimicrobial activity. In hamsters, intratracheal installation of ALP prevents the development of emphysema after administration of elastase. The daily production of ALP is remarkably constant, even during exacerbations of COPD. In the human lung a positive correlation was found between the number of ALP-producing bronchiolar cells and small airway's disease and emphysema. ALP is able to penetrate the alveolar-capillary membrane and has a tendency to associate with elastic fibers.
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PMID:Antileucoprotease in the airways and emphysema. 854 23

The most frequent form of lung emphysema leading to respiratory failure is the tobacco bronchitis-induced type of emphysema the so called chronic obstructive pulmonary (lung) disease (COPD). Histologically the centrilobular or centriacinar emphysema is believed to develop due to elastase and oxidant overload with concomitant antiprotease deficiency. The alpha1-antitrypsin deficiency is a rare genetic defect leading also in non-smoking patients to early death due to panlobular or panacinar emphysema. The functional pattern of both emphysema types shows irreversible lung overinflation with severe mainly expiratory bronchial obstruction with various degrees of pulmonary hypertension alpha1-proteinaseNinhibitor deficiency emphysema is prophylactically treated with prolastine and if hypoxia (PaO2 > 55 mm/Hg) is present with long term oxygen therapy. If hypercapnia develops O2 Therapy is combined with non invasive pressure supported ventilation. Volume reducing surgery may precede. In nonsmoking emphysema patients long term oxygen therapy and later unilateral lung transplantation improves quality of life as well as life expectancy.
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PMID:[Pulmonary emphysema--lung transplantation]. 857 95

In summary, emphysema in smokers should not be considered a single entity with predictable clinical and functional abnormalities. Decreases in flow are the ultimate abnormalities seen in COPD with emphysema; however, the pathophysiology of the flow alterations are vastly different in CLE and PLE. Based on the present understanding of emphysema, it could be predicted that the short-term results of pneumonectomy might produce some improvement in flows in CLE but not in PLE. Any improvement, however, may be short-lived, because the new mechanical conditions resulting from the removal of emphysematous lung would destroy the remaining lung at an accelerated rate, thus returning to the prior emphysematous state.
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PMID:Overview of the pathology of emphysema in humans. 857 52

Although many factors have been shown to relate to survival in patients with emphysema and COPD, age and baseline post-bronchodilator FEV1 are the best predictors of mortality. It is important to note that mortality in patients presenting with a baseline FEV1 of 50% or greater is only slightly greater than in a group of healthy smokers. Moreover, the wide variability in survival in patients with severe airflow obstruction should cause clinicians to be cautious when attempting to estimate and discuss prognosis with patients.
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PMID:Quality of life and predictions of survival in patients with advanced emphysema. 857 55

The possibility of a difference between the amount of elastic and collagenous connective tissues in normal and emphysematous lungs is controversial. I used an equation (MIN, 1995, reference 2) to compute the total amount of connective tissue in the pulmonary parenchyma from static pressure-volume relationships in 44 subjects divided into four groups. For normal nonsmokers, normal smokers, smokers with COPD, and subjects with emphysema, there was a unique relationship between the total, amount of connective tissues (sigma 0 = -0.82 Log(a) + 3.02 r2 = 0.201, p = 0.0029). Age was also significantly related to the modulus of elasticity: it appeared to increase 0.4% per year in nonsmokers and 5.4% per year in smokers with COPD. The ratio of collagen-to-elastin content in the lung parenchyma was taken to be 1.3 (from the results of recent studies), and little difference was found between normal smokers and emphysematous smokers in regard to collagen-elastin catabolism. In both groups the apparent yearly decrease in elastin content was about 1.6%, and the apparent yearly increase in collagen content was about 0.6%. Therefore, the damaging effects of emphysema on parenchymal connective tissues may be analogous to accelerated catabolism of parenchymal connective tissues in normal aging lungs.
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PMID:[Changes in the amounts of elastic and collagenous elements of normal aged and emphysematous lung: use of a model of static pressure-volume relationships]. 858 4

Opioids, benzodiazepines and hypnotics all affect central respiratory drive, muscular activity of the oropharynx, thoracic wall and diaphragm, bronchomotor tone and pulmonary vascular resistance (PVR), and may thus influence respiratory function during sedation and weaning. Opioids and benzodiazepines will attenuate hypercapnic and hypoxic stimulation of the respiratory centres. Compromise of respiratory drive must also be anticipated with ketamine, in view of recent evidence contradicting earlier findings of central respiratory stimulation. Coordinated muscular activity of the oropharynx is important for airway patency. Since this mechanism is impaired more by benzodiazepines than by ketamine the latter may be advantageous during weaning. Respiratory frequency and tidal volume are both diminished by opioids, benzodiazepines and propofol. The differential impact on intercostal and diaphragmatic muscle activity may prove important in COPD and emphysema. With ketamine spontaneous respiration is increased. Gas distribution and airway pressures are influenced by bronchomotor tone. Bronchodilator effects are well known to arise with ketamine, but have also been demonstrated with benzodiazepines, propofol and some opioids. PVR is a critical factor in respiratory insufficiency. An increase in PVR with ketamine has been found during spontaneous respiration. Since evidence for pulmonary vasodilation during controlled ventilation has been recorded in humans and in vitro experiments, sedation regimens applied in respiratory insufficiency can also include ketamine.
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PMID:[The effect of sedation on pulmonary function]. 859 71

In November 1990, a lung transplantation program began at the University Hospital in Groningen, the Netherlands. As of April 1994, 300 patients were referred for lung transplantation and we investigated the decisions that have been made concerning these referrals up to January 1, 1995. The patients were evaluated according to a stepwise procedure. In stage 1, written information about the referred patients was discussed during the weekly, multidisciplinary lung transplantation meeting. In this stage, 14% of the patients were rejected and 2% were postponed. If no major objections for transplantation were identified, the patient was invited for a visit to the outpatient clinic, stage 2. The newly acquired information from that visit was discussed again at the transplantation meeting. In this stage, 11% of the patients were rejected and 18% postponed. The remaining patients underwent an (partial or complete) inpatient evaluation, stage 3. From all patients about whom a decision was made in this stage, only 5% were rejected, respectively 35% after partial evaluation and only 1.5% after complete evaluation. A total of 110 patients (37% of all referred patients) were listed for lung transplantation, stage 4. Of the listed patients, 20% died while awaiting an appropriate donor. The group of patients with COPD/emphysema had by far the lowest death rate on the waiting list. Patients with short stature (< or = 1.65 m) had a much higher risk to die on the waiting list compared with patients with longer stature, 42% vs 13%. As of January 1, 1995, 55 patients have undergone transplantation, which is 50% of all patients on the waiting list and 18% of all referred patients. The stepwise selection procedure identifies patients with potential contraindications at an early stage. In this way, unrealistic expectations and unnecessary examinations, expense, and/or hospital admissions may be prevented. Donor shortage, and thus waiting list problems, still remains a significant drawback in the further development of lung transplantation.
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PMID:Three hundred patients referred for lung transplantation. Experiences of the Dutch Lung Transplantation Program. Groningen Lung Transplantation Group. 862 Jul 14


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