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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aetiology of congenital lobar emphysema is not always evident. In the group with demonstrable check-valve mechanism, which allows the air to enter but not to leave the lung, there is either internal stenosis or external compression of the bronchus. When no cause can be found, the condition is called idiopathic, although in some cases alveolar fibrosis has been demonstrated, the check-valve mechanism being in these cases at an alveolar level. In the small group of rare cases of bronchial atresia, air which enters through a collateral ventilation cannot be removed by the same route; in these case too, the check-valve mechanism exists at the alveolar level. Five cases of "congenital lobar emphysema" are presented. One case showed no bronchial anomaly; another case showed an increase in interstitial connective tissue in the lung; tow cases showed hypoplasia or absence of bronchial cartilage; in one case, bronchial atresia was found at operation. Infants show a typical symptomatology of dyspnoea and cyanosis, and a typical chest X-ray with unilateral radiolucency and a delicate lung pattern, collapse of surrounding lung tissue, and mediastinal hernia. In older children, the diagnosis is made either incidently or following a complication. The condition is usually found in the left upper and the right middle lobe. Treatment is surgical and consists of resection of the emphysematous segments.
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PMID:Congenital lobar emphysema. 86 84

Three in-vivo observations stimulated interest in surgical treatment for emphysema: (a) the destructive changes are rarely generalized, (b) the central portions of the lungs are frequently less seriously affected, and (c) marginal folding produces obstructive change in the more normal lung tissue. If destroyed avascular space-occupying areas can be removed, the compressed lung tissue may be stretched to fill pleural space in a functionally effective fashion. Residual elastic tissue will them maintain patency of terminal bronchioles. Preoperatively the extent of the destructive change can be defined most accurately by pulmonary angiography, and zones of functioning capilary circulation can be identified. Forty-seven patients with multifocal space-occupying emphysematous change have been treated surgically. The postoperative mortality was 21% but worthwhile long-term improvement has been obtained in 45% of patients presenting with disabling dyspnea. In these patients, surgical treatment warrants consideration if significant space occupation accompanies the bullous disease, provided alveolar vascularization can be demonstrated in the compressed adjacent normal lung tissue. Limited resections that preserve all vascularized and potentially functioning lung tissue are preferable. It is essential that obliteration of the hemithorax be obtained promptly in view of the high incidence of postoperative complications requiring secondary operative procedures, if 'leaks' and residual spaces are allowed to persist. Postoperative care in a respiratory intensive care unit is mandatory.
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PMID:Surgical treatment for pulmonary emphysema. 87 Jan 55

Two patients with cricotracheal disruption resulting from accidental strangulation of the neck were treated. The first patient had severe respiratory obstruction. In the second patient, a fascial tube maintained airway continuity between the separated larynx and trachea, and she had no difficulty breathing. A preoperative diagnosis of tracheal injury was based on the findings of respiratory obstruction, bloody secretions in the endotracheal tube, and subcutaneous emphysema in the neck. In both cases, an endotracheal tube was easily passed and entered the distal tracheal lumen. This relieved the respiratory obstruction in the first case and allowed administration of general anesthesia and control of ventilation during the operation. Prompt repair with cricotracheal anastomosis was followed by excellent results in both cases.
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PMID:Cricotracheal disruption owing to strangulation. A report of two cases with successful surgical repair. 87 Jul 68

Major fracture of the intrathoracic airway following closed chest trauma is a potentially lethal injury which can be repaired successfully if the diagnosis is made early, Cough, dyspnea cyanosis, hemoptysis, mediastinal emphysema, or pneumothorax not responding to drainage via intercostal tube and a deterioration of the patient's clinical condition out of proportion to the apparent closed chest injury, should alert the clinician to the possiblity of this entity. This report describes the findings in a patient with a longitudinal disruption of the entire intrathoracic trachea and the findings in a second patient with complete transection of the right main bronchus. Each was repaired primarily, with eventual recovery, The principles of management of this difficult group of injuries are reviewed.
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PMID:Major airway injury in closed chest trauma. 87 56

Broken wind is a syndrome characterised by chronic bronchitis and alveolar emphysema. Clinical signs include nasal catarrh, persistent coughing, dyspnoea and poor exercise tolerance. In racehorses, lung haemorrhages may result in epistaxis. Broken wind is a disease of domestication ascribed to pollution of the stable air with fungal spores from hay and straw. Treatment and prevention are based on the provision of fresh air and, if housing is unavoidable, the adoption of a permanent regime of dust-free stable management. If an early diagnosis is made and appropriate treatment instituted, the prognosis is considered to be reasonably good. The disease exemplifies the validity of the Royal Veterinary College motto Venienti occurrite morbo (treat the disease at its first appearance).
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PMID:Chronic bronchitis and alveolar emphysema in the horse. 99 95

Three cases of pulmonary lymphangiomyomatosis are described, with emphasis on the ultrastructural changes. The clinicopathologic features corresponded to those previously described. Each patient was a female in the reproductive years; breathlessness and recurrent pneumothoraces were the predominant clinical features. Histologically, the lungs showed a focal interstitial infiltrate of short, spindle-shaped mononuclear cells compatible with primitive smooth muscle, which was associated with irregular emphysema and hemosiderosis. Electron microscopy confirmed the smooth muscle nature of the pulmonary infiltrate and showed the presence of cells intermediate between smooth muscle and fibroblasts. Abnormalities were also noted in the pulmonary connective tissue that are possibly related to the fragility of the lung in this condition.
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PMID:Pulmonary lymphangiomyomatosis: three new cases studied with electron microscopy. 100 Apr 70

In sixteen patients with upper airway obstruction, breathlessness was a symptom in all with maximum mid vital capacity flow rates in inspiration or expiration of 1-7 litres per second or less. With one exception, all these patients had stridor. The stridor was inspiratory in nine, expiratory in one and both inspiratory and expiratory in two. There was no diagnostic difficulty in the twelve patients with extrathoracic airway obstruction and in this group tests of inspiratory flow (forced inspired volume in one second, peak inspiratory flow or maximum mid inspiratory flow) were of most value in following the progression of the disease and the response to treatment. Flow volume loops were particularly useful where extrathoracic obstruction and diffuse intrapulmonary airway obstruction co-existed. The two patients with intrathoracic upper airway obstruction caused considerable difficulty with diagnosis and both were initially thought to have, and treated unsuccessfully for, asthma. In each patient flow volume loops showed a low flow expiratory plateau, diagnostic of severe intrathoracic airway obstruction but recorded in the absence of any clinical or radiographic features of emphysema. An obstructing lesion of the intrathoracic trachea was therefore suspected and this was confirmed by tracheal tomography. In one patient serial expiratory flow volume curves demonstrated the combination of intrathoracic upper and lower airway obstruction. Two patients had tracheal stenosis in the region of the suprasternal notch. Each showed a characteristic twin humped expiratory flow volume curve and in one patient the stenosis was demonstrated both physiologically and radiologically to move in and out of the thorax. The importance of a standard posture during serial measurements is emphasized. The ratio of forced expired volume in one second measured in millilitres, to the peak expiratory flow measured in litres per minute, was of limited value if differentiating upper from lower airway obstruction in these patients. It is concluded that upper airway obstruction is likely to become more common and that respiratory function tests, in particular the flow volume loop, play an essential part in the recognition and management of this problem.
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PMID:Upper airway obstruction--a report on sixteen patients. 100 57

A prevalence survey on the island of Karkar had previously shown that chronic lung disease was common in both sexes after the age of 35 years and that, in part, this was related to the smoking of home-grown air-cured tobacco. To investigate the nature of this chronic lung disease, 37 nontuberculous subjects with reduced ventilatory capacity (forced expiratory volume in one second less than 75% predicted) underwent clinical and lung function investigations. Ninety-two per cent had adventitiae, 62% had chronic productive cough and 54% had dyspnoea on exertion. Lung function tests showed an irreversible obstructive defect with a variable, but on average, only moderately reduced transfer factor. The chest radiography showed evidence of hyperinflation in 38% of cases but non had narrowing or loss of pulmonary vessels suggestive of emphysema. "Inflammatory changes" occurred in 35% and were associated with a mild but significant element of restriction. The results suggest that chronic bronchitis and chronic bronchiolitis were the main underlying abnormalities and that emphysema was comparatively unimportant. Asthma appeared to be relatively uncommon, especially in children. The clinical and lung function findings in 16 asthmatics were essentially similar to those observed in asthmatics elsewhere and the atopic status of asthmatics and controls was similar to that observed in developed societies. In common with Highland asthmatics however, the age at onset was in early adult life rather than in childhood.
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PMID:A clinical and lung function study of chronic lung disease and asthma in coastal Papua New Guinea. 105 71

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

We experienced three cases of lower respiratory tract infections worsened after Rhinovirus infection. Case 1: A 42-year-old male with diffuse panbronchiolitis was admitted to our hospital with the complaint of dyspnea on November 21, 1988. Rhinovirus was isolated from nasal washing and P. aeruginosa was cultured from transtracheal aspiration (TTA). Case 2: A 67-year-old male, whose underlying disease was pulmonary asbestosis, was admitted to our hospital complaining of pyrexia on June 12, 1990. Rhinovirus was isolated from TTA and H. influenzae and others were cultured from TTA. Case 3: A 64-year-old male with pulmonary emphysema was admitted to our hospital with a complaint of dyspnea on August 11, 1989. On December 17, 1989 the patient developed rhinorrhea and complained of purulent sputum, pyrexia and dyspnea after five days. Rhinovirus was isolated from nasal washing and TTA and S. nonhaemolyticus and others were cultured from TTA. As indicated in this report, it is interesting to study the relationship between viral infection of the upper respiratory tract and bacterial infection of the lower respiratory tract.
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PMID:[Three cases of lower respiratory tract infection worsened after rhinovirus infection]. 133 Dec 64


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