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

A retrospective review of 400 Chinese children who had inhaled foreign bodies was undertaken. There has been a yearly increase in the total number of cases of airway foreign bodies removed in our hospital. Fifty-eight percent of the children presenting were from the countryside; 42% were townspeople. Approximately 90% of the patients were under 3 years of age, with the peak incidence of foreign body inhalation occurring between 1 and 2 years of age (57.8%). The male-female ratio was about 1.2:1. About 95% of the removed foreign bodies were organic in origin. The majority of the foreign bodies were found most often in the right bronchial tree (46%). A positive history of foreign body inhalation was obtained in 98% of the cases. Twenty-eight percent of the children presented at the hospital within 24 hours, 71% within 1 week, and 29% more than 1 week after inhaling the foreign body. The most common presenting symptoms of laryngotracheal foreign bodies were cough, wheezing, dyspnea, and hoarseness; those of bronchial foreign bodies were cough, wheezing, decreased air entry, and rhonchi. More than two-thirds of the children with larygotracheal foreign bodies had normal x-ray findings. The most common fluoroscopic findings in those children with bronchial foreign bodies were mediastinal shift (36.8%), obstructive emphysema (35.7%), and normal findings (35%). A total of 348 (87%) bronchial foreign bodies were removed by rigid bronchoscopy (81%), rod-lens bronchoscopy (5%), and spontaneous expulsion (1%); 52 (13%) laryngeal and tracheal foreign bodies were removed by direct laryngoscopy (12%) and tracheotomy (1%). A single endoscopic procedure successfully removed 92.5% of 400 foreign bodies detected in the airways. One child died during bronchoscopy, for a mortality rate of 0.25%.
 ...
PMID:Inhalation of foreign bodies in Chinese children: a review of 400 cases. 204 47

Information gathered in the Zutphen Study, the Dutch contribution to the Seven Countries Study that started in the 1960s, was used for the present study. In 1960 878 men participated in the physical examination and they were followed for 25 years until 1 July 1985. During this follow-up, their morbidity status was verified regularly. With this information the occurrence of chronic non-specific lung disease (CNSLD) at a specific time was coded by one physician, using strict criteria. The CNSLD diagnosis was based on the following criteria: episodes of respiratory symptoms such as regular cough and phlegm for longer than three months or episodes of wheezing and shortness of breath reported to the survey physician, or: diagnosis of CNSLD, including chronic bronchitis or emphysema by a clinical specialist. Occupation in 1960 was coded and used to generate specific occupational exposures with a Job Exposure Matrix. Because the exact time of diagnosis of CNSLD was known, incidence densities could be calculated. For 804 men a complete set of data was available. A Poisson regression analysis was used to analyse the relationships between the incidence density and independent variables like age, calendar period, occupation and specific occupational exposures. Blue collar workers had a significantly elevated incidence density ratio (IDR) compared to white collar workers (1.82, 95% confidence limits (CL): 1.35, 2.46). Subgroups of blue collar workers, wood and paper workers, textile workers, and tailors, construction workers and transport workers had significantly elevated IDRs also. Of the specific exposures heavy metals, mineral dust and adhesives had a significantly elevated IDR.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Occupational exposure and 25-year incidence rate of non-specific lung disease: the Zutphen Study. 208 26

Chronic irreversible obstructive airways disease (COAD) is the end result of a number of disorders: airway damage from tobacco smoke, atmospheric pollution and occupational dust and fume, bronchiectasis, cystic fibrosis, bronchial asthma and a number of congenital disorders of defective airway defence. The clinical features include sputum, wheeze, breathlessness and infective and noninfective airway inflammation. The pathological consequences are airways obstruction, emphysema and respiratory failure. Except in bronchiectasis, the volume of daily sputum and bronchial infection is less than 20-30 years ago. At autopsy, bronchial gland hypertrophy is now an inconstant feature. Bronchial infection probably contributes little to airways obstruction, but the load of activated neutrophils in bronchiectasis is an important feature. Wheeze comes late to many patients with COAD. It is associated with less reversibility to bronchodilator drugs and more fixed airways obstruction compared to the conventional asthmatic and is probably of different aetiology. Breathlessness is of variable severity when the forced expiratory volume (FEV1) falls below 1.0 liters resulting in disability ranging from manageable to severe. The FEV1 declines an average by 70-80 ml/year (normal approx. 25 ml/year) until the value falls below 1.0 liters, then the rate of decline slows to a plateau which can persist for several years. During this period, hyperinflation, breathlessness and respiratory failure continue to worsen. Significant respiratory failure may be a terminal event or be present for many years. Arterial oxygen tension (PaO2) slowly declines in most patients--"pink puffers" generally have a minimal rate of fall until weeks or months before death, "blue bloaters," by contrast, several times as great.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Natural history of obstructive airways disease and hypoxia: implications for therapy. 211 87

Five-week-old Wistar/Ms rats were inoculated intranasally with a lung homogenate containing a strain of cilia-associated respiratory (CAR) bacillus and were examined on days 4, 7, 14, 21, 28 and 56 postinoculation (PI). Some rats showed clinical signs with wheezing and considerable body weight loss from day 21 PI. Gross lesions, including enlargement of lungs with focal atelectasis, bronchiectasis and emphysema, were observed from day 21 PI. Histologically, round cell infiltration was first present in the lamina propria of the nasal respiratory mucosa on day 7 PI. From day 14 PI, colonization of the CAR bacillus (4-8 micron in length), associated with round cell infiltration in the lamina propria and the peripheral regions, was observed in the ciliated mucosa of the bronchioles, bronchi, trachea and nasal cavities. Generally, the lesions progressed and expanded from upper to lower airways with time. Sporadic mucopurulent bronchopneumonia was observed from day 21 PI in some rats. The CAR bacilli (0.2-0.25 micron in diameter) were also demonstrated electron-microscopically in the ciliated epithelium of the intrapulmonary airways. The CAR bacillus antigen was demonstrated on the ciliated mucosa of the affected airways by the indirect immunofluorescence assay technique. Microbiological examination revealed that the rats used in this study were free from other known respiratory pathogens throughout the experimental period. Thus, it is suggested that the CAR bacillus alone can produce a murine respiratory disease. Fourteen days were needed for pathological lesions to develop.
 ...
PMID:Pathology of rats intranasally inoculated with the cilia-associated respiratory bacillus. 252 2

Twenty one patients with bronchial adenoma, treated surgically in our hospital, include three different neoplasms: carcinoid, cylindroma and mucoepidermoid adenoma. In this series, clinical characteristics were: bronchial obstruction when the tumor protrudes into the lumen and infection, first in the bronchus (bronchitis or bronchiectasis) then in the parenchyma (acute, recurrent or chronic pneumonia, tension abscess). Ball-valve action of the tumor may result in lobar or segmental emphysema. Preoperatively, most of the patients had been misdiagnosed as bronchitis, carcinoma of lung, bronchiectasis or acute tension abscess. In our series, all the patients were alive in a follow up of 2-8 years. Yet one patient is living with local recurrence and distant metastasis. To our experience, pneumonia recurring in the same area of the lung, localized wheezing, with or without endocrine symptoms, lobar or segmental emphysema may suggest bronchial adenoma. Tomography and endoscopy are important for diagnosis. For the treatment, sleeve resection of the main bronchus was done in 2, bronchoplastic lobectomy in 7, lobectomy in 10, and pneumonectomy in 2. Sleeve resection of the main bronchus or bronchoplastic lobectomy is recommended as a reliable procedure for this disease.
 ...
PMID:[Diagnosis and surgical treatment of bronchial adenoma]. 282 Jun 82

We studied 149 children aged seven months to 13 years (mean age 2.9 +/- 0.2 years) who had aspirated foreign bodies for age, sex, and type of foreign body. Symptoms, physical findings, chest x-ray, and fluoroscopy were compared with different sites of enlodgement. Positive history was obtained in 135 (91%). In 133 children, the diagnosis was made on admission. Frequent symptoms were cough (80%) and cyanosis (27%) following aspiration, while prevalent emergency department symptoms were cough (33%) and dyspnea (30%). Common physical findings on admission were decreased breath sounds (65%), tachypnea (43%), and fever (36%). Admission chest radiographs revealed emphysema (43%) and infiltrates or atelectasis (29%). Forty-one children (27%) were asymptomatic, and 43 children had normal chest x-ray. Fluoroscopy showed inspiratory mediastinal shift in 57%. Bronchoscopy performed within 48 hours of admission was successful in removing the foreign material in 88% of the children. Food particles were the most common type of foreign body. Hoarseness and stridor were significantly more common in upper airway enlodgement (P less than 0.01). Decreased breath sounds were significantly more common among children with lower airway enlodgement (P less than 0.001). A delay in diagnosis of longer than three weeks was associated with equivocal history of aspiration (P less than 0.05), and with significantly more wheezing (P less than 0.02) and atelectasis (P less than 0.01). Our study reemphasizes the importance of integrating various diagnostic tools in order to accurately evaluate and manage these children.
 ...
PMID:Foreign body aspiration in childhood. 338 Jul 39

The history holds the central role in distinguishing among asthma, chronic bronchitis, and emphysema. A personal or family history of atopy, a history of seasonal worsening of disease in response to a known environmental agent, perhaps seasonal, and marked variability in the severity of airflow obstruction, often with dramatic responsiveness to bronchodilator drugs, strongly support the diagnosis of asthma. Exacerbation of wheezing by exposure to cold air or following the ingestion of a drug, and asthma variants, such as nocturnal cough responsive to bronchodilator agents or exercise-induced asthma, all support the diagnosis of asthma. Peripheral blood eosinophilia or sputum eosinophilia support the diagnosis of asthma providing other known causes of eosinophilia can be excluded. Positive skin tests are helpful in establishing the atopic state and indicating its possible etiology. An elevated serum IgE level supports the diagnosis of asthma; a normal one does not exclude it. Cigarette smoking is a common background factor in both chronic bronchitis and emphysema, and both diseases are infrequently observed in the absence of this history. Long-standing mucous hypersecretion preceding airflow obstruction suggests the presence of chronic bronchitis. Progressive dyspnea on effort as the predominant symptom suggests the possibility of emphysema. Reversibility of airflow obstruction suggesting the presence of asthma can be obtained either from physical examination or serial pulmonary function studies. Apart from this, neither of these techniques is very useful in differential diagnosis. Evidence of emphysema in the chest roentgenogram and a low value of the Dco/VA are sensitive tests for the presence of emphysema but are not highly specific. The main value of making the differentiation among these three conditions now lies in establishing a prognosis and guiding the use of corticosteroid therapy. As new information accumulates on the pathogenesis, prevention, and treatment of asthma, chronic bronchitis, and emphysema, precise diagnosis is likely to acquire increased significance.
 ...
PMID:Distinguishing among asthma, chronic bronchitis, and emphysema. 396 40

The effects on ventilation of the non-selective beta-blocker propranolol, and the relatively cardioselective beta-blocker, metoprolol, were compared in a randomized single-blind crossover study in 16 patients with asthma, bronchitis and emphysema (American Thoracic Society criteria). Group I had "fixed" airways disease with less than 20% improvement in FEV1 following inhaled salbutamol 5 mg by nebuliser. Group II had "reversible" obstruction, greater than 20% improvement. Bronchodilator therapy was withheld for 24 h with the exception of aerosols which were permitted until 12 h before study. After control observations on each of 2 study days, each patient received cumulative doses of propranolol (maximum 170 mg) and metoprolol (maximum 187.5 mg). Ventilatory function (FEV1, FVC, FEV1%) was assessed at 0, 2, 4, 6 and 8 h. In Group I, 2 patients were unable to complete the study. One patient became dizzy with propranolol 70 mg but tolerated metoprolol 187.5 mg. One patient developed wheeze with propranolol 15 mg but tolerated metoprolol 187.5 mg. Metoprolol was tolerated in all 8 patients with "fixed" disease, although FEV1 was reduced by more than 30% in 1 patient. Three patients in Group II did not complete the study because of wheezing following propranolol 10 mg, metoprolol 37.5 mg; propranolol 17.5 mg, metoprolol 37.5 mg; propranolol 45 mg, tolerated metoprolol 187.5 mg respectively. Wheezing responded in all cases to inhaled isoprenaline. The response to either propranolol or metoprolol was unpredictable in patients with "reversible" disease. When wheezing occurred in this group, it developed following small, potentially subtherapeutic doses of each drug. Although metoprolol was better tolerated, the practical benefit of cardioselectivity in those patients with reversible airways disease was negligible.
 ...
PMID:Influence of cardioselectivity and respiratory disease on pulmonary responsiveness to beta-blockade. 615 5

Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation exclusively located in the region of respiratory bronchioles. The pathologic features of the disease are characterized by thickening of the wall of the respiratory bronchiole with infiltration of lymphocytes, plasma cells and histiocytes, and extension of the inflammatory changes toward peribronchiolar tissues. In the advanced stage, secondary ectasia of proximal bronchioli may occur. These changes appear as diffusely disseminated small nodular shadows throughout both lungs on the chest roentgenogram. Obstructive respiratory functional impairment, occasional symptoms of wheezing, and also cough and sputum resemble the feature of emphysema, bronchial asthma, or chronic bronchitis, respectively. In the advanced stage, large amounts of purulent sputum and dilatation of proximal terminal conducting bronchioli resemble bronchiectasis. However, diffuse panbronchiolitis belongs to a distinctly different category from these diseases, and should be distinguished from them, because it may often show rapid progression with fatal outcome. The disease is dominant in males and the onset is unrelated to age. More than 1,000 cases of probable diffuse panbronchiolitis and 82 histologically-confirmed cases have been collected in Japan.
 ...
PMID:Diffuse panbronchiolitis. A disease of the transitional zone of the lung. 684 35

Nine patients with severe chronic airway obstruction secondary to chronic bronchitis and emphysema all preferred nebulised salbutamol solution to placebo in a double-blind controlled trial. Four of the patients who had previously received domiciliary nebulised salbutamol failed to complete the placebo period, though all completed the active period. Five others improved subjectively on active therapy, and showed a significant improvement in morning and evening peak flows. Symptom scores for breathlessness, wheezing, and sputum production were lower in the active treatment period and standard aerosol usage fell, although these changes might have been due to chance. Patients with severe chronic airway obstruction who do not respond to conventional bronchodilator therapy should be considered for this form of treatment.
 ...
PMID:Domiciliary nebulised salbutamol solution in severe chronic airway obstruction. 701 50


<< Previous 1 2 3 4 5 6 7 8 Next >>