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

Poisoning with the plant Lasiospermum bipinnatum was studied in 9 lambs at various dose levels. Dyspnoea and tachypnoea, which were dose-related, were observed in 4 of the lambs. Gross and microscopic pulmonary lesions were found in all the lambs receiving plant material originating from one source but not in those given plant from another locality. The severity of the lesions appeared to be dose-dependent. Macroscopic lesions included pulmonary and mediastinal emphysema, congestion and oedema. Microscopically Clara cell hypertrophy and hyperplasia, and interstitial pneumonia were the most outstanding findings. It is speculated that the pulmonary lesions were induced by a furanosesquiterpene or tryptophan or a combination of both of these toxins in the dosed plant material. Miscellaneous and inconsistent lesions observed in the experimental animals included widespread haemorrhage (1 lamb), transudations into the body cavities and adrenocortical hyperplasia.
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PMID:The pathology of experimental Lasiospermum bipinnatum (Thunb.) Druce (Asteraceae) poisoning in sheep. II. Pulmonary and miscellaneous lesions. 229 35

With use of a qualitative research approach, a study was conducted to explore the phenomenon of dyspnea from the point of view of patients with chronic obstructive pulmonary disease. During a nonacute phase of their illness, 96 adults with chronic bronchitis or emphysema were asked in semistructured interviews to recall their feelings associated with sensations of shortness of breath during hospitalizations for the acute phase. Through content analysis, accounts of different subjects were compared, and several themes were isolated that dominated the dyspneic experience. The themes were fear, helplessness, loss of vitality, preoccupation, and legitimacy. Each theme was expanded by integrating accounts of dyspnea previously reported in the literature with the field study data. Substantiated descriptions of the five themes are presented to sensitize nurses to patients' perceptions of dyspnea and nursing behaviors during hospitalization for the acute phase of chronic obstructive pulmonary disease.
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PMID:Dyspnea during hospitalizations for acute phase of illness as recalled by patients with chronic obstructive pulmonary disease. 231 59

A case of pneumatic esophageal rupture secondary to distension from compressed air was reported. The patient, a 69-year-old man who was repairing an automobile tire suddenly exploded. The blast was directed into the open mouth. He was admitted to our hospital 12 hours after the onset with the complaint of chest pain and dyspnea. Subcutaneous emphysema was seen in the neck. The chest roentgenogram revealed a partial right hydropneumothorax. The diagnosis of esophageal rupture was established by Gastrographin swallowing study. Operation was performed 46 hours after the onset. Primary closure of the middle thoracic esophagus was judged to be impossible because of a 6 cm longitudinal laceration with contaminated pyothorax. Thereafter, total esophagectomy was indicated. Esophageal reconstruction using the pediculated gastric tube was performed throughout the retrosternal route. The leakage of esophagogastrostomy in the cervical area occurred in early postoperative stage. Re-esophagogastrostomy was successfully carried out 6 weeks after the first surgery. He is uneventful 6 months after the operation. We have not found any reports of surgical cases with pneumatic esophageal rupture treated by this approach in the literature.
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PMID:[A case of accidental pneumatic rupture of the esophagus]. 232 88

A 22 year-old man was brought to our hospital about twenty-three minutes following a high-speed motorbicycle accident in which he had blunt chest trauma. He was in severe respiratory distress with marked dyspnea and restless with extensive subcutaneous emphysema involving anterior chest wall, cervical and bilateral inguinal regions. A chest X-ray revealed bilateral pneumothorax involving mediastinal emphysema and also fracture of right submandibular and clavicula. In spite of orotracheal intubation and insertion of bilateral chest tube, continuous air leak and pneumothorax did not improve. Bronchoscopy revealed the disruption of mucosa of the right main bronchus at the bifurcation. Emergency right thoracotomy was performed and there was the complete disruption of the right main bronchus. Anastomosis of the right main bronchus with circumferential resection was undertaken on May 30, 1987 about two hours after trauma. About three months after reconstruction, bronchoscopic examination revealed stomal stenosis with deformation of tracheobronchial cartilage and granulation. The stenosis showed severe irregularity by deformed cartilage and thickened scar, so widening by Nd-YAG laser vaporization was inadequate in effect. Seven months after first reconstruction, we performed re-reconstructive operation, right upper sleeve lobectomy with partial resection of carcina and right wall of trachea for scar with severe deformation of cartilage. Following the operation, the patient suffered from sepsis with pneumonitis accompanied by lung edema. This complication was treated successfully. We considered that acute pneumonitis was caused by reventilation with increase of perfusion after tracheobronchial reconstruction. Consequently, we thought it important to treat such patients with long term IPPB postoperatively with adequate medication for respiratory system.
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PMID:[Successful re-reconstruction for complete disruption of the right main bronchus by blunt chest trauma]. 232 99

The toxicity of sodium selenite was studied in 28 Nubian goats, 20 of which died or were killed in extremis 2 h to 21 d after dosing. Single or repeated daily oral doses of 160, 80, 40, 20 and 5 mg sodium selenite/kg were toxic to goats while daily doses of selenite ranging from 0.25 to 1 mg/kg/d for 225 d were not toxic to this species of animals. The main signs of poisoning were uneasiness, inappetence, dyspnea, salivation, diarhea, paresis of the hind limbs, arching of the back, and recumbency. The main lesions were hemorrhages in the rumen, reticulum, osmasum and abomasum, hemorrhagic or catarrhal abomasitis and enteritis, fatty change and necrosis of the centrilobular hepatocytes and of the cells of the renal convoluted tubules, splenic hemosiderosis, pulmonary congestion, haemorrhage, edema and emphysema, accumulation of lymphocytes in the vital organs, and straw-colored fluid in the serous cavities.
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PMID:Experimental selenium poisoning in Nubian goats. 235 37

Two cases of spontaneous pneumomediastinum and subcutaneous emphysema were reported. The first cases was a 21-year-old man who had a past history of recurrent spontaneous pneumothorax. The second was a healthy 20-year-old man. They were admitted to our hospital because of dyspnea and chest pain, which occurred at or after vocal exercise for Xiao-lin Temple boxing. Physically, a mediastinal crunch on auscultation heard over the cardiac apex and the left sternal border (Hamman's sign) was recognized in the first case, and subcutaneous emphysema was palpated in both cases. The chest X-ray films revealed intramediastinal air and subcutaneous emphysema in both cases. We diagnosed these patients as spontaneous pneumomediastinum because of no underlying disease. This is a report of rare cases of spontaneous pneumomediastinum occurring at the same time, and one of the mechanism causing them was considered to be a sudden increase in intrathoracic pressure due to the vocal exercise of chinese boxing.
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PMID:[Two cases of spontaneous pneumomediastinum due to Xiao-lin Temple boxing vocal exercise]. 235 76

A 70-year-old woman developed increasing dyspnoea and hoarseness without stridor. Bronchoscopy revealed the characteristic picture of a "rock-garden" with multiple whitish irregularly shaped nodules in the distal two third of the trachea, except the pars membranacea, involving the right-sided bronchial system to the origin of the lower-lobe bronchus, and the left main bronchus. The diagnosis of tracheobronchopathia osteochondroplastica was confirmed histologically: primary tracheobronchial amyloidosis was excluded. Tomography of the tracheobronchial tree demonstrated the findings, but a plain chest X-ray did not. The symptoms in this patient were not, however, caused by tracheobronchopathia osteochondroplastica but by concomitant pulmonary emphysema and acute laryngitis and were improved after symptomatic treatment of the laryngitis.
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PMID:[Tracheobronchopathia osteochondroplastica]. 236 84

The fifth leading cause of death in the United States, chronic obstructive respiratory conditions, cannot be cured but can be considerably ameliorated by appropriate management. Many patients with COPD have a combination of chronic bronchitis, asthma, and emphysema. While the damage due to emphysema is permanent, many of the pathophysiologic changes of asthma and bronchitis can be reversed to some extent, and such reversal should be a goal of therapy. Smoking cessation will help the patient more than any other medical treatment. Bronchodilator therapy is best given by inhalation from a metered dose inhaler and on a maintenance basis. Be sure to check inhaler technique. An anticholinergic agent, eg, ipratropium bromide, is probably most effective, but many patients prefer a beta 2-selective adrenergic agent. Xanthines are currently third choice but are very useful to cover nocturnal dyspnea. Corticosteroids are usually only used in acute exacerbations and then only for short courses. If prolonged use is required, however, the inhalation route minimizes side effects to which these patients are particularly prone. Antibiotics are also usually only used in exacerbations, but one can be liberal with them. Use the less expensive broad-spectrum options for ten days. Some clinicians believe that hydration is an effective expectorant. Mucolytic therapy is extensively used outside the United States. The appropriate role of mucolytic therapy in the treatment of bronchitis remains to be more fully explored. Low-flow oxygen is only used in the prevention or treatment of cor pulmonale when the PaO2 is persistently at or below 55, or with a rising hematocrit and right-sided cardiac changes. If used, oxygen is helpful only when given long term for at least 18 h per day, not on a prn basis. Cardiac glycosides are probably of little benefit, but diuretics have an important role in treatment of fluid retention. Pulmonary vasodilator therapy is still experimental, as is almitrine. Prophylaxis with pneumococcal vaccine and annual influenza vaccine is rational but has not been proven to be of value. Exercise and activity should be encouraged for all except those with frank congestive heart failure. The role of "breathing exercises" is currently being reevaluated. Surgery has almost no place in the management of COPD. Anesthesia often results in postoperative complications in this disease. Avoid all sedatives and tranquilizers.
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PMID:Chronic obstructive pulmonary disease. Current concepts and therapeutic approaches. 240 8

Fourteen employees of a pharmaceutical company, who had been exposed to porcine pancreatic and other organic dusts for 1-18 years were examined because of exercise dyspnea and asthmatic attacks. Airway obstruction or bronchial hyperreactivity and disturbance of oxygen diffusion were present in all cases. Two patients showed evidence of acute alveolitis and 3 had radiological signs of mild fibrosis, whilst emphysema dominated in 7 others. Skin tests and bronchial provocation revealed hyperreactivity to pancreatic extracts. Pancreatic alpha-amylase was determined as a causative allergen for Type I allergy symptoms by means of RAST. Three pathomechanisms of the lung diseases are discussed: 1) Type I allergy of the airways to pancreatic enzymes, 2) broncho-alveolar Type III reaction to porcine proteins; and 3) proteolytic damage of the lung tissue and an increase of non-specific bronchial reactivity.
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PMID:Occupational lung disease following long-term inhalation of pancreatic extracts. 257 40

The authors present the results of a preliminary study designed to define the surgical indications in diffuse pulmonary emphysema based on the data of haemodynamic investigations. This series consists of 10 patients identified for disabling dyspnoea, diffuse emphysema and dynamic expiratory compression documented by the data of right micro-catheterisation by a DEP/DIP ratio greater than 2. The surgical operation consisted of reduction in the lung volume, the results of which were defined by pre- and postoperative examinations. In this way, it is possible to distinguish 3 groups of patients: one group was markedly improved, another was moderately improved and the third group continued to deteriorate analysis of the results suggests the determinant role of dynamic factors, in particular haemodynamic factors. The role of the diaphragm is demonstrated by modifications in its radius or curvature.
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PMID:[Value of hemodynamics in the surgical indications of emphysema]. 258 2


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