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)

We describe a patient with McArdle disease who developed rhabdomyolysis triggered by a bronchial asthmatic attack. A 64-year-old man had chronic pulmonary emphysema with asthma, and an asthmatic attack led to severe rhabdomyolysis that required continuous hemodiafiltration. After 2 years, a physical examination revealed atrophy of the extremities compared with previous examinations, especially of the intercostal muscles. During that time, he suffered two severe bronchial asthmatic attacks. His serum level of creatinine kinase remained between 4,000 and 7,000 IU/l when he did not suffer from asthmatic attacks and rhabdomyolysis had abated. Therefore, we suspected that his recent muscle atrophy was caused by asthmatic attacks, and discussed the possibility of his respiratory muscle weakness due to McArdle disease in relation to his severe bronchial asthmatic attacks as well as chronic obstructive pulmonary disease.
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PMID:Rhabdomyolysis triggered by an asthmatic attack in a patient with McArdle disease. 1130 Jan 46

We reported the case of a 39-year-old man with dermatomyositis (DM) complicated with subcutaneous emphysema and pneumomediastinum during steroid therapy. The patient had complained of muscle weakness, dyspnea and skin eruption on his anterior chest wall 6 months prior to admission. He was diagnosed as having DM on the basis of an elevation in myogenic enzymes, myogenic changes in electromyography, a skin biopsy and a muscle biopsy. Chest roentgenogram revealed interstitial pneumonia (IP) in the lower lobes of the lungs. The administration of prednisolone (60 mg/day) was initiated, which resulted in improvement of DM. Fifteen days after the initiation of the steroid therapy, the patient developed subcutaneous emphysema and pneumomediastinum. Additional administration of cyclosporin A (CsA) enabled us to rapidly taper the dose of prednisolone without aggravating the diseases. Several reports have shown that vasculitis might be involved in the pathogenesis of pneumomediastinum in DM patients. Infection and tissue fragility due to steroid therapy worsen the outcome of those patients. CsA therapy may improve the outcome through the anti-vasculitic- and steroid sparing-effects.
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PMID:[A case of dermatomyositis complicated with pneumomediastinum that was successfully treated with cyclosporin A]. 1150 15

This study sought to analyse the mechanism on the formation of configurations of F-V curve and their transformation rule in COPD and cor pulmonale patients with wave-speed theory. The F-V curves were measured in 90 COPD patients (43 with chronic bronchitis, 47 with emphysema) and 31 complicated with cor pulmonale, all of them were in the ameliorated period. The indices selected were FVC, V75, V50, V25. Both the measured value and the measured value/predicted value (%) of all indices showed chronic bronchitis > emphysema > cor pulmonale. Never was there the concave type of normal humans in the F-V curves of COPD and cor pulmonale patients; however, the convex type was much increased in the curves and the hyperbolic type specific to COPD and cor pulmonale appeared. The mechanisms of formation for plateau, convex and hyperbolic types were analysed with the wave-speed theory. In summary, the unifying rule for the transformation of F-V curve configuration from normal adolescents to old persons, smokers, COPD and cor pulmonale patients in various degrees can be outlined as, concave type normality convex type abnormality hyperbolic type. This implicates a unifying process of pulmonary functions from healthy state to weakness and from slight to serious abnormality.
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PMID:[Configurations of F-V curve and their transformation rule in COPD patients analysed with wave-speed theory]. 1254 42

In a dairy herd of 21 cows which were on pasture during the day at the end of May 2002, four eight years old cows were suddenly inappetent and showed severe diarrhoea consisting of black discolorate feces. A few days after the onset of the disease, three affected cows exhibited neurological disorders. These cows were admitted to the IInd Medical Clinic of the University for Veterinary Medicine in Vienna. Following clinical signs were observed: circulatory weakness, anorexia, atony of the rumen, diarrhoea and in accordance with acute lead poisoning typical signs of the central nervous system. One cow died and the other two animals were euthanized. Results of blood testing were anaemia, basophil spotting of erythrocytes, increase of liver enzymes and CK, hypocalcaemia, decrease of potassium and phosphate. The cerebrospinal fluid of two cows showed increased CK-, LDH- and AST-values. The lead contents of whole blood samples were between 0.486 and 0.928 mg/kg, of liver samples 13.3 to 114.4 mg/kg, of kidney samples 172.2 to 448 mg/kg and of rumen content 59 mg/kg fresh matter. At necropsy, enteritis, liver fluke disease and severe interstitial and alveolar pulmonary emphysema were found. Pathohistologically typical ischaemic necrosis of neurons predominantly at the tips of the gyri, disseminated petechial hemorrhages and moderate diffuse neovascularisation, but no acid-fast intranucleolar inclusion bodies in the renal tubules were observed. As causative agent of the acute lead poisoning a residue on combustion, taken up by the cows on the pasture, was confirmed. The ash residue was formed by combustion of three tires which contained 450 g heavy weights of 96.5% lead for wheel balance. The lead content of the ash residue was between 2.9 and 28 g/kg dry matter.
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PMID:[Acute lead poisoning in cows due to feeding of lead contaminated ash residue]. 1496 24

Lung hyperinflation is a consequence of airway obstruction, increased airway resistance and compliance in patients with chronic obstructive pulmonary disease (COPD) which may result in respiratory muscle fatigue and deterioration of gas transfer. The aim of this study was to investigate the influence of hyperinflation on respiratory muscles, gas transfer and breathing pattern and compare the differences between mild and severe COPD. Twenty-eight COPD patients with radiological and tomographic evidence of emphysema were included in the study and they were divided into two groups according to the severity of COPD. Group I= FEV(1) < or = 49% (n= 16). Group II= FEV(1) > or = 50% (n= 12). Airflow rates were decreased and airway resistance was increased significantly in Group I. Maximal inspiratory pressure (MIP) was significantly reduced in Group I. FRC, RV and RV/TLC ratio were increased above 120% in both groups with more significant increase in Group I. Group I showed moderate hypoxemia (PaO(2) = 54.02 mmHg) with hypercapnia (PaCO(2)= 46.65 mmHg) whereas Group II patients were mildly hypoxemic (PaO(2)= 63.78 mmHg) with normocapnia. Parameters of breathing pattern were similar in both groups. Diaphragm height index (DHI) didn't showed significant difference between groups. But there were significant correlations between DHI and RV, FRC. MIP showed significant positive correlation with airflow rates and DLCO, negative correlation with lung volumes, positive correlation with PaO(2) and negative correlation with PaCO(2). FRC also negatively correlated with Ti and Ti/Ttot. In conclusion, hyperinflation present even in the mild forms of COPD causes inspiratory muscle weakness which in return results in impairment in gas transfer.
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PMID:[The effect of hyperinflation on respiratory muscles and breathing pattern in COPD]. 1514 1

Chronic obstructive pulmonary disease (COPD) is characterized and defined by limitation of expiratory airflow. This can result from several types of anatomical lesions, including loss of lung elastic recoil and fibrosis and narrowing of small airways. Inflammation, edema, and secretions also contribute variably to airflow limitation. Smoking can cause COPD through several mechanisms. First, smoke is a powerful inducer of an inflammatory response. Inflammatory mediators, including oxidants and proteases, are believed to play a major role in causing lung damage. Smoke can also alter lung repair responses in several ways. Inhibition of repair may lead to tissue destruction that characterizes emphysema, whereas abnormal repair can lead to the peribronchiolar fibrosis that causes airflow limitation in small airways. Genetic factors likely play a major role and probably account for much of the heterogeneity susceptibility to smoke and other factors. Many factors may play a role, but to date, only alpha-1 protease inhibitor deficiency has been unambiguously identified. Exposures other than cigarette smoke can contribute to the development of COPD. Inflammation of the lower respiratory tract that results from asthma or other chronic disorders may also contribute to the development of fixed airway obstruction. COPD is not only a disease of the lungs but is also a systemic inflammatory disorder. Muscular weakness, increased risk for atherosclerotic vascular disease, depression, osteoporosis, and abnormalities in fluids and electrolyte balance may all be consequences of COPD. Advances in understanding the pathogenesis of COPD have the potential for identifying new therapeutic targets that could alter the natural history of this devastating disorder.
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PMID:Pathogenesis of COPD. 1608 33

Exertional dyspnea is the leading symptom in patients with COPD. The main causes are progressive weakness of skeletal muscles, reduction of diffusing capacity in emphysema and above all dynamic hyperinflation as a result of the collapsibility of bronchioli with expiratory flow limitation. The exercise-induced hyperinflation leads to a reduction of inspiratory capacity. Therefore, patients are unable to increase the minute volume under exercise. The inadequate ventilatory answer to an increased ventilatory drive is perceived as dyspnea. The inhalation of long-acting bronchodilators reduces hyperinflation and increases exercise capacity.
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PMID:[Importance of air-trapping in patients with COPD. Pathophysiological principle]. 1642 11

Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related diseases caused by the expansion of gas trapped in the lung, or over-pressurization of the lung with subsequent over-expansion and rupture of the alveolar air sacs. This group of disorders includes arterial gas embolism, tension pneumothorax, mediastinal emphysema, subcutaneous emphysema and rarely pneumopericardium. In the case of diving activities, POIS is rarely reported and is frequently related to unsafe diving techniques. We report a classical case of POIS in an underwater logger while cutting trees for logs in Tasik Kenyir, Terengganu. The patient, a 24-year-old worker, made a rapid free ascent to the surface after his breathing equipment malfunctioned while he was working underwater. He suffered from bilateral tension pneumothoraces, arterial gas embolism giving rise to multiple cerebral and cerebellar infarcts, mediastinal and subcutaneous emphysema as well as pneumopericardium. He was treated in a recompression chamber with hyperbaric oxygen therapy and discharged with residual weakness in his right leg.
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PMID:Pulmonary overinflation syndrome in an underwater logger. 1724 32

During chronic obstructive pulmonary disease (COPD) diaphragm and peripheral muscle weakness occur. Muscle remodeling and wasting may be a result of apoptosis and changes in muscle-specific transcription factors, such as MyoD, altering muscle-specific gene transcription and muscle regenerative capacity. To investigate this, we instilled under ketamine/xylazine anesthesia porcine elastase in the lungs of hamsters to induce emphysema. The emphysematous hamster is an accepted model for COPD. In the diaphragm and peripheral muscles we assessed the occurrence of apoptosis, and in the diaphragm and soleus also the expression of MyoD and inhibitor of differentiation protein 2 (Id2). There was no significant muscle atrophy in emphysematous hamsters. The mRNA levels of TNF-alpha and markers of apoptosis were significantly elevated in the diaphragm and soleus muscles during emphysema. This was accompanied by an increased presence of nucleosomes in the cytosol. Caspase 3 activity and the DNA-binding activity of the p65 subunit of NF-kappaB, however, were unaltered in all muscles. The protein expression of MyoD and Id2 were decreased and increased in the diaphragm and the soleus muscle, respectively. Thus, despite the absence of muscle atrophy in emphysematous hamsters, there was evidence of increased TNF-alpha expression, apoptosis, and altered muscle-specific transcriptional regulation as reflected by decreased MyoD and elevated Id2 levels at least in the soleus and diaphragm muscle. These alterations may impair the regenerative capacity of skeletal muscles and ultimately contribute to muscle wasting.
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PMID:Apoptosis and Id2 expression in diaphragm and soleus muscle from the emphysematous hamster. 1739 85

In Canada, endoscopic resection using a CO(2) laser has been generally ignored as a treatment option. In this article, we present an introductory analysis of our clinical experience with the CO(2) laser at the QEII Health Sciences Centre in Halifax, Nova Scotia. Outcomes from a cohort of 36 patients with glottic cancer staged as Cis-T2 (7 Cis, 17 T1, 12 T2) who underwent endoscopic resection using a CO(2) laser between January 2002 and June 2005 were studied retrospectively. The mean follow-up was 16.2 months (range 0-41 months). At the time of the study, no patient had died of laryngeal disease, one patient had died of another disease, and one patient was lost to follow-up. There had been three recurrences in the cohort: two local recurrences and one recurrence in a regional lymph node. After salvage, all patients with recurrences were disease free at the time of the study. There were three postoperative complications in the cohort: one postoperative myocardial infarction, one case of respiratory distress postextubation, and one case of subcutaneous emphysema. The average time for the procedure was 0.97 hours (range 0.25-2.75 hours). The average postoperative length of stay was 1.2 days (range 0-12 days). Of 35 cases with follow-up, 60% had no reported problems with voice in their last visit and 11% reported consistent hoarseness or weakness. Although our oncologic results do require more follow-up, based on our positive experience thus far, we believe that endoscopic management of glottic cancer is a treatment option that may be underused in the Canadian health care system.
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PMID:Endoscopic treatment of cis-T2 glottic cancer with a CO(2) laser: preliminary results from a Canadian centre. 1745 81


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