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

Intensive care after lung, and heart-lung transplantation may have simple post operative course specially after preventive procedures of reperfusion injury, nosocomial infections during mechanical ventilation and immunosuppression risks. Nevertheless a severe mediastinal shift may occurred after single lung transplantation in emphysema. Rapid changes in ventilation/perfusion ratio during lung infection or rejection specially in pulmonary hypertension are responsible of dramatic respiratory failure. Knowledge of multiorgan dysfunction and multidisciplinary experience encourage to future development.
Rev Mal Respir 1996 Nov
PMID:[Intensive care in lung and heart-lung transplantation]. 901 8

The matrix metalloproteinases (MMP) are a multigenic family involving 14 enzymes which can cleave most, if not all, the components of the extracellular matrix (interstitium and basement membranes). The present work reports on the main structural characteristics, the substrate preference and the site synthesis of these proteinases and their inhibitors (TIMP). Human MMPs are produced by various cell types and are involved in the remodelling of the extracellular matrix in many physiological and pathophysiological circumstances. Elastolytic MMPs produced by monocytes and/or macrophages (matrilysin, gelatinases, macrophage elastase) are likely to be implicated in the development of acquired pulmonary emphysema.
Rev Mal Respir 1997 Jan
PMID:[Metalloproteinases in the extracellular matrix: structure and activity]. 908

Lung volume reduction surgery in emphysema has, as an objective, the reduction of dyspnoea and an increase in the exercise tolerance in patients with respiratory insufficiency suffering from diffuse emphysema. In principle the resection of the most diseased areas of emphysema leads to improvement in the mechanical properties of the emphysematous lung and correct pulmonary hyperinflation. The respiratory function benefits both objective and subjective, produced by surgery are real but transitory and inconstant depending in particular on the evolutionary profile of the emphysematous disease. The indications should be further refined and an objective comparison of different surgical techniques has not been achieved. The impact on the quality of life for these patients is unknown.
Rev Mal Respir 1997 Sep
PMID:[Lung volume reduction surgery in emphysema]. 941 8

We report a case of 33 year old man who consulted us in 1994 for recurrent bronchitis sometimes with haemoptysis. The physical examination was unremarkable. At consultation abnormal fascicular sounds were noted at the left base. A chest x-ray showed hyperlucency of the left lung associated with a very small left hilar shadow. We considered the diagnosis of Mac Leod's syndrome after eliminating a proximal obstructive pathology and pulmonary embolus. Mac Leod's syndrome or Swyer James' syndrome was described in 1954 and is suggested on the standard radiograph above all if the expiratory films have confirmed the presence of air trapping. Angiography shows a slender and fine pulmonary network. Computer tomographic examination of the chest rules out a bronchial tumour, excludes bullous emphysema and reveals hyperlucent zones. Scintigraphy with ventilation perfusion supplies the essentials to understanding the mechanism (a syndrome of aerated lung which is neither directly ventilated nor perfused). The expiratory function tests most often show a restrictive syndrome but sometimes an obstructive syndrome is found with associated air trapping. The disorder does not progress and the prognosis is good.
Rev Mal Respir 1997 Dec
PMID:[Unilateral hyperlucent lung]. 949 8

We report three cases of volume reduction surgery in three single lung transplant recipients with emphysema. Each patient had a late decline in lung function with hyper-inflation of the native lung. Lung function was improved post-operatively for two patients. The relief of thoracic overdistension may be considered in single lung transplant recipients who exhibit clinical significant functional deterioration.
Rev Mal Respir 1998 Oct
PMID:[Reduction of native lung volume after single-lung transplantation for emphysema]. 983 96

Computed tomography, and particularly high-resolution computed tomography, allows a detailed exploration of the pulmonary parenchyma. We discuss here work on the use of this technique in the diagnosis and quantification of pulmonary emphysema. We stress first the subjective quantification then the objective approach based on specific software. We summarize our work which has demonstrated. 1) that the relative surface with density below -950 Hounsfield units and measured on millimetric tomographic slices obtained at the end of maximal inspiration is a valuable measurement of the extent of the macroscopic emphysema and reflects the microscopic emphysema; 2) that subjective quantification overestimates minimally extensive emphysema and shows important intra- and inter-operator variability; 3) that indexes derived from computed tomographic images acquired at the end of expiration reflect more the obstructive syndrome than emphysematous destruction; 4) that age and the size of the lungs influence computed tomographic measurements while hyperinflation appears to have no effect. Finally, we present an example of recent work applying the computed tomographic technique.
Rev Mal Respir 1999 Sep
PMID:[Quantitative computed tomography of pulmonary emphysema]. 1054 56

A 42-year-old patient with emphysema was hospitalized in the intensive care unit for an episode of acute respiratory failure. The patient became dependent on invasive mechanical ventilation and surgical lung volume reduction was performed. The indication of lung volume reduction in this pathological situation but was followed by rapid weaning 48 hours postoperatively. The patient was discharged without ventilatory assistance and has not required further ventilatory assistance after more than 2 years follow-up.
Rev Mal Respir 1999 Sep
PMID:[Lung volume reduction in patients with emphysema after prolonged ventilatory assistance]. 1054 65

Besides increasing the work of ventilation, emphysema increases lung volume which in itself has a deleterious effect on the inspiratory muscles. We review here the effects of an acute change in lung volume on the configuration of the rib cage and muscle function. We also discuss the effects of the chronic distension associated with emphysema. The effects produced by changes in muscle length and configuration on the mechanical force and action of inspiratory muscles is detailed with particular focus on the diaphragm and its structural adaptations to experimental emphysema. We also analyze the activation pattern of inspiratory and expiratory muscles during the breathing process in patients with emphysema. Finally, we discuss the effects of single-lung transplantation and reduction surgery on chest distension and improved inspiratory muscle function.
Rev Mal Respir 2000 Apr
PMID:[The respiratory muscles in emphysema. The effects of thoracic distension]. 1085 63

The diagnosis and early extraction of a respiratory foreign body (FB) in a child requires a rapid bronchoscopy. Thus, the possibility of a foreign body requires an endoscopy even in the absence of clinical or radiological signs. While the sensitivity of "the foreign body syndrome" is important (79-85%) its specificity is low (21-46%) which results in numerous endoscopies which do not show FB. This justifies the promotion of flexible fibroscopy, under a simple local anaesthesia of the upper airways and some sedation, each time that the foreign body is not obvious. That is when there is an absence of a radio-opaque foreign body (2-20% of cases) or an absence of associated unilateral diminution in breath sounds or ipsilateral obstructive emphysema (a positive predicted value of 94%, 95% confidence interval: 71-100%). The complications of flexible fibroscopy are rare but still justify its performance in an environment where there is resuscitation equipment and the possibility of rapidly performing a rigid bronchoscopy. Rigid bronchoscopy, which requires a general anaesthesia, remains the best technique to remove a foreign body in a child. It is also indicated initially in cases of respiratory distress where there is a fear of a foreign body in the trachea. The extraction of the CE by flexible fibroscopy under general anaesthesia has been reported in children but it is more difficult and more risky.
Rev Mal Respir 1999 Nov
PMID:[Indications of bronchial endoscopy in suspected tracheo-bronchial foreign body in children]. 1089 30

A triad of signs constitutes Boerhaave syndrome: forceful vomiting, chest pain and subcutaneous emphysema. The syndrome results from spontaneous rupture of the oesophageal wall leading to an oeso-pleural or oeso-mediastinal fistula. Positive diagnosis is established with a water-soluble swallow, sometimes coupled with computed tomography of the thorax. Boerhaave syndrome is a surgical emergency. We report three cases of spontaneous rupture of the oesophagus and analyze the importance of emergency surgery as well as emergency treatment of the sepsis, an important prognosis factor.
Rev Mal Respir 2001 Oct
PMID:[Spontaneous rupture of the esophagus or Boerhaave syndrome. Report of 3 cases and review of the literature]. 1188 72


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