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

The clinical conditions, roentgenographic findings, and pulmonary function tests of 6 children (mean age, 10.9 years) with surgically treated congenital lobar emphysema (group 1) were compared with those of 5 children (mean age, 10.3 years) with congenital lobar emphysema who had been treated conservatively, i.e., nonsurgically (group 2). At the time of this study, patients in both groups were asymptomatic. Patients in group 1 were surgically treated because of severe respiratory distress in the newborn period, with the exception of one patient, who was eupneic as a newborn and was not operated on until the age of 9 years. Patients in group 2 were eupneic or mildly distressed in the neonatal period and received only conservative treatment. Two patients in group 1 had occasional wheezing and labored breathing, but no patient in group 2 had recurrent respiratory distress. Roentgenographically, at the time of the study, patients in group 1 had generalized overinflation, whereas those in group 2 had only localized overinflation of the involved lobe and minimal compression of remaining lung tissue. Pulmonary function studies in both groups were not significantly different (P greater than 0.05). Both groups had reduced forced vital capacities, large trapped gas volumes, and reduced forced expiratory flows at low lung volumes. Reductions in forced vital capacity were proportional to the unventilated volumes of lung either excised because of congenital lobar emphysema (group 1) or chronically obstructed by congenital lobar emphysema (group 2). These studies suggest that lung growth was not different in these 2 groups and that asymptomatic or midly symptomatic patients do not benefit from surgical treatment.
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PMID:Congenital lobar emphysema: long-term evaluation of surgically and conservatively treated children. 93 22

The objectives of this study were to use pulmonary function tests, blood gas measurements and bronchoalveolar lung lavage (BAL) to characterize lesions in the respiratory tract of young adult male Wistar rats as a result of a 5-day exposure (6 h/day) to 0, 1.1, 6.2, 15 or 26 mg n-butyl isocyanate (n-BIC)/m3 air. Further objectives were to probe the diagnostic sensitivities of these procedures in comparison with more traditional evaluations (clinical observation, lung weight, histopathology). Measurements were performed during post-exposure weeks 2 and 5. Most rats exposed to 26 mg/m3 died or were sacrificed in a moribund state during post-exposure week 2. All other rats survived the exposure regimen. In rats exposed to 15 and 26 mg/m3 a significant decrease in body weight, laboured breathing, hypoactivity, nasal discharge, cyanosis, and hypothermia were observed. Pulmonary function measurements revealed increased total lung capacity (TLC) and residual volume (RV), decreased forced expiratory flow rates and quasi-static compliance in rats exposed to 26 mg/m3. At the end of the observation period rats exposed to 6.2 and 15 mg/m3 air were hyperresponsive to an acetylcholine bronchoprovocation aerosol. Arterial blood gas measurements revealed an arterial hypoxia and an increase in venous admixture, suggesting a severe mismatch of the ventilation-perfusion relationship. Biochemical and cellular components in BAL fluid (BALF) indicated a concentration dependent and protracted increase of polymorphonuclear leucocytes and further inflammatory parameters. In the 1.1 mg/m3 group BALF parameters were not significantly elevated. The major histopathological lesions of the lung were thickening of septa, emphysema, and intra-alveolar oedema in rats exposed to 26 mg/m3.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Altered lung function in rats after subacute exposure to n-butyl isocyanate. 160 26

Lung volume reduction surgery (LVRS) was developed as a means of surgical treatment for severe pulmonary emphysema. To date, various studies have been designed to explain the mechanisms involved in pathophysiological changes after treatment, to define criteria for patient selection, to identify the surgical technique of choice and to propose appropriate follow-up care. Preliminary results of follow-up studies (up to five years) have already been published, indicating improved pulmonary function and quality of life after surgical treatment. However, the alarming results from the National Emphysema Treatment Trial (NETT) Research Group indicated a considerable risk for death in patients with homogenous emphysema and low forced expiratory volume in one second (FEV1) undergoing LVRS. This brief review summarizes the results of currently published studies to supply evidence for selection criteria in order to better define the subset of patients for which LVRS offers an effective and safe means of palliation from the symptoms of advanced COPD. Due to acceptable morbidity and mortality rates, stapler device wedge excision and closure has become the standard procedure for removing non-functioning, hyperinflated lung areas in heterogeneously affected organs. LVRS is carried out in two ways - using video-assisted thoracoscopic surgery (VATS) as well as thoracotomy/sternotomy-and performed in unilateral and bilateral procedures. In contrast, most clinics have found laser resection of emphysematous parenchyma to be unsuccessful. In some patients, LVRS was carried out as an alternative to lung transplantation, whereas in others, it served as a bridge-to-transplant procedure. LVRS has proven effective in the reduction of dyspnea, especially in patients with recovery options in both the circulatory and pulmonary system. In responders, recovery from labored breathing and O(2) dependency and increased physical capacity are usually accompanied by improved spirometric data. These results are mainly explained by a more regular breathing pattern and an increase in the maximum volume of ventilation in the affected lung. In most cases, functional improvement is maximized during the first six months postoperatively and decreases steadily thereafter indicating the need for a systematic postoperative patient care after surgical treatment. After indicating at-risk patients who should not be considered for LVRS, long-term results from the multicenter NETT research group will hopefully help clarify the impact of this treatment on survival of patients further.
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PMID:Evidence-based medicine: lung volume reduction surgery (LVRS). 1237 93

We report the case of a patient with severe chronic obstructive pulmonary disease (COPD) for whom gastrectomy was successfully performed with the use of noninvasive positive pressure ventilation (NPPV). A 63-year-old man who had been suffering from chronic pulmonary emphysema for 12 years and receiving home oxygen therapy (HOT) for 9 years was diagnosed with gastric carcinoma. The patient required supplemental oxygen via nasal cannulae even at rest, and had labored breathing through pursed lips after a short conversation. The forced expiratory volume in 1 s was 400 ml. He underwent conventional gastrectomy under general anesthesia, and was extubated 90 min after surgery and given NPPV support. He was successfully weaned from NPPV on postoperative day (POD) 10 and discharged from our hospital on POD 28. Noninvasive positive pressure ventilation is useful for the perioperative management of patients with severe COPD and for extending the possibilities of surgery for patients on HOT.
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PMID:Gastrectomy performed with noninvasive positive pressure ventilation for a patient with severe chronic obstructive pulmonary disease: report of a case. 1603 54

Pneumomediastinum is a condition in which air is present in the mediastinum. This condition can result from physical trauma or other situations that lead to air escaping from the lungs, airways or bowel into the chest cavity. Pneumomediastinum is a rare situation and occurs when air leaks into the mediastinum. The diagnosis can be confirmed via chest X-ray or CT scanning of the thorax. The main symptom is usually severe central chest pain. Other symptoms include laboured breathing, voice distortion (as with helium) and subcutaneous emphysema, specifically affecting the face, neck, and chest. Pneumomediastinum can also be characterized by the shortness of breath that is typical of a respiratory system problem. It is often recognized on auscultation by a "crunching" sound timed with the cardiac cycle (Hamman's crunch). Pnemomediastinum may also present with symptoms mimicking cardiac tamponade as a result of the increased intrapulmonary pressure on venous flow to the heart. The tissues in the mediastinum will slowly resorb the air in the cavity so most pneumomediastinums are treated conservatively.
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PMID:Pneumomediastinum. 2577 7