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)

Experimental research in animals have demonstrated that pulmonary development continues after birth. This happens in man as well: alveolar proliferation and enlargement go on until the eighth year of age, furthermore complete pulmonary development is achieved until the 20-22 years of age. It is therefore possible to hypothesise that respiratory deficit following pulmonary exeresis in children would regress with time. In the Pediatric Surgery of IRCCS Policlinico S. Matteo of Pavia eight children, 4 days to 8 years of age, underwent lobectomy for pulmonary hypertensive emphysema (3), lung abscess (2), bronchogenic cysts (2) and hystiocytoma (1). One of them was lost to follow-up; the remainders were controlled from 3 to 25 years after surgery: all of them enjoy a normal active life. Respiratory function was evaluated through blood chemistry, blood gas analysis, basal and after strain ECG, chest X-ray, spirometry, basal and after strain pulmonary scintigraphy. Basal and after strain ECG, chest X-ray, and arterial blood gas were normal in every examined subjects; spirometry, although results are quite variable, did not show serious respiratory deficits; basal after strain pulmonary scintigraphies weren't homogeneous. These results, although they aren't univocally interpretable, positively confirmed that the residual lung after lobectomy has a satisfactory possibility of functional recovery.
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PMID:[Follow-up study of pulmonary function in individuals subjected to lobectomy in infancy and childhood]. 779 11

The transplantation of the lung is a therapeutical option in the treatment of patients with terminal lung emphysema. In the presence of limiting prognostic factors, like severe obstruction without massive air trapping and pulmonary hypertension, the results are superior to lung volume reduction. Guidelines for indications, perioperative course and functional development are discussed. Bilateral transplantation provides early rehabilitation due to excellent functional recovery of the lungs.
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PMID:[Lung transplantation in obstructive diseases]. 906 21

Although the annual number of lung transplant operation performed in the United States and Europe is over 1000, five year survival rate is under 50%, mainly because of obstructive bronchiolitis that is considered chronic rejection. Lung transplantation may be difficult to justify on the ground of survival consideration alone for the certain disease, such as emphysema and pulmonary hypertension. But functional recovery after lung transplantation especially, bilateral is reported very good. Among the diseases of indication of lung transplant, Cystic Fibrosis and alpha antitrypsin deficiency are very rare disease in Japan and emphysema that is most frequently reported indication in the United States, is also rare disease in the age group of lung transplantation candidate. So, idiopathic interstitial pneumonitis, pulmonary vascular disease and other miscellaneous disease are most possible indications for lung transplantation in Japan. These disease have different prognosis, we discussed the timing of registration and operation of lung transplantation in each disease.
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PMID:[Indications for lung transplantation and its selection of the candidates in Japan]. 1049 11

Surgery is an important therapeutic option for emphysema patients with invalidating dyspnea and poor quality-of-life. Preoperative tests must determine the degree of functional impairment (dyspnea score, walking test, quality-of-life) and evaluate lesion reversibility (imaging, function tests, TLCO, blood gases, scintigraphy, right microcatheterism) and assess the patient's general health status. Besides lung transplantation, the only surgical alternative is resection which, depending on the type of parenchymal damage, can involve excision of bullae or volume reduction. Several modalities can be proposed: atypical resection of the apexes via sternotomy, multiple unilateral atypical resection, simple lobectomy. The choice depends on the distribution of the parenchymal destruction and also on the severity of the emphysema and the patient's age. Operative mortality is now well below 10%. Volume reduction provides significant functional improvement in 80% of patients but with a temporary effect (4-5 years). Bullae excision is particularly important since functional recovery is achieved early and persists.
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PMID:[Surgical management of emphysema]. 1513 48

Lung volume reduction surgery improves exercise tolerance, lung function, and quality of life for selected patients with emphysema. Lung volume reduction surgery is well established for patients in a highly elective setting. It is, however, contraindicated in cases of acute cardiorespiratory failure. We present the case of a patient with severe emphysema who had acute respiratory failure and decompensated cor pulmonale requiring life-saving venovenoarterial extracorporeal life support after admission to the emergency unit. He underwent lung volume reduction surgery with intent to wean from extracorporeal life support. He had complete functional recovery after 4 months.
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PMID:Lung Volume Reduction Surgery on Extracorporeal Life Support. 2810 66