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

Eleven autopsied cases of bronchiolar emphysema are reported. In all, both lungs were involved. Their pleural surfaces were finely bosselated, presenting an appearance resembling that of the liver in Laennec's cirrhosis. The lungs were firm, they cut with increased fibrous resistance, and the cut surfaces were honeycombed with cysts.Microscopically, the cysts originated in terminal bronchioles. Their walls were thickened with fibrous tissue, elastic fibres and prominent smooth muscle. Areas of lung parenchyma were replaced by fibrous tissue rich in elastic fibres.The etiology of this disease is unknown. Inherent weakness of the myoelastic wall of the respiratory bronchiole, hypoplasia of the distal segment of the respiratory unit, and superimposed recurrent respiratory infections probably are essential in its pathogenesis. The pulmonary changes cause interference with hemorespiratory gaseous exchange.Death was due to respiratory failure in seven cases, to cardiac failure in three and to superimposed staphylococcal pneumonia in one.
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PMID:Bronchiolar emphysema (diffuse bronchiolectasis)--so-called muscular cirrhosis of the lungs. 582 39

A patient with both muscle weakness and progressively degenerating respiratory function became increasingly less responsive to therapeutic intervention. The diagnosis of the muscle disease was made through biopsy samples and confirmed as rod myopathy. Through autopsy samples, the patient was found to have had extensive centriacinar emphysema and widespread involvement of rod disease in the skeletal muscles. The most involved of the muscles sampled (anterior tibial, brachioradialis, rectus femoris, psoas, diaphragm, biceps) was the diaphragm. While the influence on diaphragmatic function has been reported in the juvenile form of rod disease, this is the first known report of the extensiveness of involvement in adult-onset disease. The diseased state of the diaphragm was appreciated as a contributing factor to the respiratory insufficiency.
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PMID:Rod myopathy with extensive systemic and respiratory muscular involvement. 668 95

A 70-year-old man died of alcoholic cirrhosis and long-standing pulmonary emphysema. Multiple independent dissecting aneurysms involved the distal epicardial branches of the right and left coronary arteries, but spared their proximal trunks. These dissections extended distally from vascular branch points in association with acute and chronic medionecrosis. Iatrogenic trauma superimposed on preexisting medial weakness may have accounted for what is, to our knowledge, a unique presentation of a rare condition.
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PMID:Multiple coronary artery dissections in old age. A unique case. 689 35

We describe a 41-year-old patient with adult-onset dermatomyositis who developed persistent pneumomediastinum and severe subcutaneous emphysema due to end-stage interstitial lung disease. The diagnosis of dermatomyositis was based on proximal muscle weakness, electromyographic findings of inflammatory myopathy, and positive findings on muscle biopsy. Low levels of creatine kinase elevation were found at the time of diagnosis (a form of dermatomyositis which has been associated with a poor prognosis). The patient had no signs of cutaneous vasculitis. Despite treatment with prednisone and azathioprine, she died of intercurrent gram-negative sepsis 15 months after the diagnosis of dermatomyositis.
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PMID:Chronic pneumomediastinum and subcutaneous emphysema: association with dermatomyositis. 771 58

A 17-year-old female with anorexia nervosa developed pneumomediastinum, subcutaneous emphysema, retroperitoneal emphysema, interstitial pulmonary emphysema and epidural emphysema (epidural emphysema; air between the dura mater and the vertebral arch). She had no history of bronchial asthma. The mechanism was presumed to be weakness of the alveolar wall due to malnutrition, leading to rupture of alveoli, followed by air entering the interstitium and dissecting along perivascular sheaths (interstitial pulmonary emphysema) into the mediastinum. A further increase in mediastinal pressure may bring about opening of the fascial planes along great vessels and allow air to penetrate into subcutaneous tissues and the spinal canal. These types of emphysema have been reported in bronchial asthma cases and in those on positive pressure breathing. To our knowledge, there are no previous reports of anorexia nervosa associated with these phenomena.
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PMID:[anorexia nervosa; an association with certain types of soft tissue emphysema]. 796 45

To assess the hemodynamic effects of pulmonary microvasculature disruption in emphysema, we examined resting pulmonary hemodynamics and lung function in 12 carefully identified patients with type A chronic obstructive pulmonary disease. Individuals with respiratory muscle weakness and intercurrent infection were excluded. Standard spirometry, helium dilution lung volumes, and single-breath carbon monoxide diffusing capacity (DCOSB) were obtained within 24 h of right heart catheterization. Resistance to pulmonary blood flow was assessed using the difference between pulmonary arterial (PA) diastolic and mean wedge pressures, and expressed as the pulmonary diastolic gradient (PDG). Mean FEV1/FVC was 51 +/- 8 percent, RV/TLC was 48 +/- 11 percent, DCOSB percent predicted was 62 +/- 29 percent, PaO2 was 72 +/- 11 mm Hg (FIO2, 0.21), and PaCO2 was 39 +/- 5 mm Hg. Mean PDG was 5 +/- 3 mm Hg (normal < or = 3 mm Hg) with normal PA pressures, indicating mildly elevated resistance to pulmonary blood flow. The PDG correlated most closely with DCOSB, rising in curvilinear fashion as DCOSB fell (r = -0.869, p < 0.001). These observations were compared with our previous report of analogous findings in patients with chronic, diffuse interstitial lung disease (ILD). In that group, PDG also increased curvilinearly as DCOSB fell (r = -0.839, p < 0.001). Subjects with FVC greater than 50 percent predicted had elevated PDG with normal pressures, while those with FVC less than 50 percent had pulmonary hypertension. The regression of PDG on DCOSB was strikingly similar to emphysema, although the slope in emphysema was less than that in ILD (p < 0.001). These observations suggest that elevated pulmonary vascular resistance in emphysema stems from disruption of the microcirculation in a fashion similar to that encountered in mild-moderate ILD. However, the magnitude of increase is not sufficient to generate resting pulmonary hypertension in the absence of disturbed gas exchange.
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PMID:Pulmonary vascular resistance in emphysema. 813 43

Pneumomediastinum (spontaneous, iatrogenic and traumatic) is a relatively uncommon infrequently reported entity. The most common cause is the rupture of marginal pulmonary alveoli, allowing bubbles of air to dissect along the vascular sheaths and connective tissue planes to the mediastinum. Rupture of the trachea or thoracic traumas are other causes of pneumomediastinum. The most common presenting complaint was retrosternal pain, dyspnea, dysphagia, weakness and neck pain. Physical finding revealed: subcutaneous emphysema extended to face, chest or neck, and Hamman's sign. Chest X-ray was made in all cases and diagnosis was completed with chest CT scan and tracheoscopy. We present our series of 34 PM between January 1.1993 to July 31.1995 and discuss about etiology, diagnosis and treatment of this entity.
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PMID:[Spontaneous and traumatic pneumomediastinum. Analysis of 34 cases]. 941 Dec 92

The toxicity of Rhazya stricta leaves for Najdi sheep is described in 9 sheep assigned as untreated controls, Rhazya-treated at 0.25 g/kg/d and Rhazya-treated at 1 g/kg/d. The oral use of 1 g/kg/d caused body weight depression, ruminal bloat, diarrhea, dyspnea and weakness of the hind limbs. Enterohepatonephropathy, pulmonary congestion, hemorrhage and emphysema, lymphocytes in vital organs, and congestion of the blood vessels of the heart were associated with increases in serum AST and LDH, in elevated bilirubin and urea concentrations, and decreased total protein, albumin and calcium concentrations, and leucopenia and anemia.
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PMID:Toxicity of Rhazya stricta to sheep. 955 56

Measurement of airflow limitation and assessment of its reversibility are essential in estimating the correct diagnosis of asthma. The presence of at least 15% reversibility in FEV1 or PEF after inhalation of a short-acting beta 2-agonist favours the diagnosis, but lack of a short-term reversibility does not exclude asthma. Advanced emphysema, upper airway stenosis and respiratory muscle weakness can, usually, be differentiated from asthma solely by their lung function characteristics. Monitoring of parameters (e.g. PEF) reflecting daily variation of airways' calibre, measurement of bronchial responsiveness to exercise, and to certain bronchospasmogenic mediators, non-isosmolar solutions may help in the differential diagnosis of asthma in a symptom-free condition. Cutoff values, sensitivity and specificity for asthma of these tests are discussed.
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PMID:The significance of lung function tests in the differential diagnosis of bronchial asthma. 959 57

Bronchial rupture is a rare but severe complication of intubation with a double-lumen tube. Cardinal symptoms are mediastinal and subcutaneous emphysema as well as pneumothorax. Larger injuries result in an air leak and the endtidal carbon dioxide decreases. The gas exchange may worsen drastically when mucosal prolapse or bronchial haemorrhagia lead to bronchial occlusion. Mediastinitis or sepsis can be the sequel of the opened mediastinum. If bronchial injury is suspected probably fibreoptic bronchoscopy is indicated. We report on a case of bronchial rupture due to overinflation of the endobronchial cuff or movement of the inflated cuff when repositioning the patient. The conservative therapy was successful in spite of the fact that surgical intervention is recommended in the literature following bronchial rupture. To avoid tracheobronchial injuries an adequate tubus size must be selected. The more flexible polyvinylchloride (PVC) tubes without a carinal hook should be preferred to the Carlens tube. An atraumatic intubation is promoted by leaving the stylet inside after the tip of the tube has passed the vocal cords. To identify the minimum occlusive pressure of the endobronchial cuff for lung isolation different methods are described and should be used. The cuff has to be deflated when the patient is repositioned and when one-lung-ventilation is not required. Tumours of the tracheobronchial tree and weakness of the bronchial wall caused by steroid hormone therapy or COPD may increase the risk of tracheobronchial laceration.
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PMID:[Diagnosis, procedures and conservative therapy of a bronchial rupture after intubation with double-lumen tube]. 1007 58


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