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

As part of an evaluation of the effects of left lung transplantation in dogs with papain emphysema of the right lung, differential lung blood flows were estimated by in vivo scintiscan of 99Mc-macroaggregated albumin (99mTc-MAA) and, after sacrifice, by direct counting of isotopically labeled carbonized microspheres. In six dogs, percentage flow to the right lung was calculated at the following four times: before and after induction of papain emphysema and 2 and 6 weeks after left lung autotransplantation. After the induction of right lung emphysema, the right lung in four of six animals continued to receive more than 50 percent of the total pulmonary blood flow. No correlation could be established between right lung blood flow determined by carbonized microsphere distribution (true right lung blood flow) and the flow determined by anterior and posterior scintiscans (apparent right lung blood flow). This discrepancy was caused by gross distortion of the right, emphysematous lungs, which had herniated into the left hemithoraces. This herniation was demonstrated by coronal slices taken through the thoraces of two additional dogs with right lung emphysema that were given radiolabeled carbonized microspheres and 99Tc-MAA and frozen after sacrifice. These results indicate that external scintiscans for which the particulate distribution technique are used are invalid in circumstances of altered lung geometry.
J Thorac Cardiovasc Surg 1979 Jul
PMID:Differential lung blood flows in experimental unilateral emphysema: nonvalidity of perfusion scans. 37 52

Perforation of the cervical esophagus in the course of attempted intubation of the trachea is a very rare accident, or at least rarely reported. Over the past 11 years, 12 patients ranging in age from 44 to 72 years were treated in our unit. If suspected, esophageal perforation is easy to diagnose when intubation has been difficult or when the patient complains of dysphagia and neck pain. Subcutaneous cervical emphysema appears early. All the patients who were operated upon early made an uneventful and prompt recovery. In those subjected to delayed operation (more than 12 hours) or nonoperative treatment, the mortality rate was 56 percent and recovery was achieved only after long and difficult treatment.
J Thorac Cardiovasc Surg 1979 Jul
PMID:Esophageal perforation during attempted endotracheal intubation. 44 86

Two patients with cricotracheal disruption resulting from accidental strangulation of the neck were treated. The first patient had severe respiratory obstruction. In the second patient, a fascial tube maintained airway continuity between the separated larynx and trachea, and she had no difficulty breathing. A preoperative diagnosis of tracheal injury was based on the findings of respiratory obstruction, bloody secretions in the endotracheal tube, and subcutaneous emphysema in the neck. In both cases, an endotracheal tube was easily passed and entered the distal tracheal lumen. This relieved the respiratory obstruction in the first case and allowed administration of general anesthesia and control of ventilation during the operation. Prompt repair with cricotracheal anastomosis was followed by excellent results in both cases.
J Thorac Cardiovasc Surg 1977 Jun
PMID:Cricotracheal disruption owing to strangulation. A report of two cases with successful surgical repair. 87 Jul 68

A 5-month-old female infant was transferred to our institution for evaluation of recurrent upper respiratory tract symptoms and chest x-ray films showing hyperaeration of the right upper lobe. Preoperative studies including chest fluoroscopy, lung scan, and bronchoscopy suggested congenital lobar emphysema. At thoracotomy, an anomalous right upper lobe bronchus which bifurcated around the main pulmonary artery in a sling fashion was found. This anatomic abnormality has not been described previously and is a unique cause of congenital lobar emphysema.
J Thorac Cardiovasc Surg 1977 Jul
PMID:Congenital lobar emphysema resulting from bronchial sling around a normal right main pulmonary artery. 87 29

Barotrauma has been used to describe several specific complications related to mechanical ventilation. These include tension lung cyst, pneumothorax, pneumomediastinum, pneumoperitoneum, and subcutaneous emphysema. Pulmonary hyperinflation, another such complication, occurred in 6 patients, being fatal in 3. Two pathophysiologic mechanisms are discussed. The simpler, and well-recognized, ball-valve airway obstruction allows inspiration of air delivered by the mechanical ventilator but prevents expiration. A more complex circumstance exists when pulmonary contusion or infiltration produces differential lung compliances. This allows extreme hyperinflation of areas of normal lung during attempts to ventilate abnormal lung of low compliance. This mechanism is particularly evident when positive end-expiratory pressure (PEEP) is used in an attempt to open collapsed ventilatory units. Functional complications of lung hyperinflation include decreased alveolar ventilation and compression effects on adjacent structures. Interference with and shifts of regional lung perfusion may worsen gas exchange. Proper treatment includes airway clearance by bronchoscopy, the judicious use of bronchodilators, the discontinuance of PEEP, and adjustments of mechanical ventilators to prevent high airway pressures.
J Thorac Cardiovasc Surg 1975 Nov
PMID:Pulmonary hyperinflation. A form of barotrauma during mechanical ventilation. 110 9

A left upper lobectomy in a 5-month-old infant revealed a specimen whose tissue, both grossly and microscopically, was characteristic of intr- and extrapulmonary swquestration, bronchial atresia, and adenomatoid cystic malformation. This case may be considered the missing link between the various congenital lung malformations, for it illustrates their interrelationship or their common origin. Atresia or malformation of the main bronchus seems to be the defect shared by all these anomalies. A similar bronchial abnormality probably is responsible for congenital lobar emphysema and isolated congenital lung cysts.
J Thorac Cardiovasc Surg 1975 Aug
PMID:Congenital lung malformations: a unified concept and a case report. 115 10

Seven single lung transplants are reported. The patients were severely disabled and oxygen dependent below sixty years of age with a poor prognosis. Diagnosis were alfa 1-antitrypsin deficiency (3), sarcoidosis (3) and idiopathic emphysema (1). Multiorgan-harvesting including six hearts, was performed in local or distant hospitals (3). Partial cardiopulmonary bypass simplified transplantation. The surgical procedure was modified with a direct transpericardial approach. Soft tissue wrapping by a vascularized pedicle secured the bronchial anastomosis. The four drug immunosuppressive regimen included cyclosporin A, azathioprine, steroids and antithymocyte globulin. Primary graft function was excellent. Six patients survived the postoperative period and are alive 5-19 months post transplant. Transbronchial biopsies and lung function studies have been helpful in detecting pulmonary rejections. Patient rehabilitation is satisfactory in most patients with improvement in physiologic parameters.
Scand J Thorac Cardiovasc Surg 1992
PMID:Single lung transplantation. Surgical experiences with the first seven patients. 128 30

In the truly elderly, a complex balance between compensatory processes and impaired organ function allows reasonably normal physical function. It is argued that beta blockade should have certain desirable qualities to minimize any impairment of organ function, thereby upsetting the quality of life. Thus a simple pharmacokinetic pattern without hepatic metabolism is less likely to cause unexpected variation in blood levels of the beta blocking agents and to have fewer risks of interactions with other drugs including nicotine. Renal-excreted beta blockers--such as atenolol, nadolol, and celiprolol--do, however, need downward dose adjustment when the glomerular filtration rates fall. The elderly are frequently categorized as having a low renin profile, which in the view of some workers may make a vasodilatory beta blocker more desirable. Hemodynamic advantages of such agents include the prime site of attack in hypertension on the increased peripheral vascular resistance, increasingly fundamental with a prolonged duration of hypertension and therefore with the aging process. Furthermore, a normal heart rate with a sustained cardiac output may avoid symptomatic bradycardia. In the elderly, respiratory function may be impaired so that loss of elastic recoil causes elderly emphysema. A highly cardioselective beta blocker should be an advantage. Finally, minimal interference with glucose and lipid metabolism should also be desirable goals.
Cardiovasc Drugs Ther 1991 Jan
PMID:Required beta blocker profile in the elderly. 167 3

Classic transplantation dogma mandated bilateral lung replacement for lung transplant candidates with end-stage emphysema to avoid air trapping in the native lung and subsequent crowding of the newly transplanted lung. During a recent 12-month period 11 patients with emphysema received a single lung transplant. There was no hospital mortality and only one patient had any notable degree of air trapping in the native lung. Substantial improvement in pulmonary function was seen as early as 2 weeks after transplantation, with significant functional improvement seen by 6 weeks, despite some residual ventilation-perfusion mismatch. We have demonstrated the utility and safety of single lung transplantation for patients with end-stage emphysema, and it is our operation of choice in recipients more than 50 years of age.
J Thorac Cardiovasc Surg 1991 Sep
PMID:The evolution of single lung transplantation for emphysema. The Washington University Lung Transplant Group. 188 Nov 73

From 1971 to 1990, 315 thoracoscopies were performed. Recent advances in optic/video systems and endoscopic operating instruments have made thoracoscopy easier and more accurate than 20 years ago. The operative mortality rate was low (1%) and the diagnostic accuracy high (99%). Thoracoscopy has been performed at an increasing frequency in recent years because of its expanded applications, especially in the areas of therapeutic or operative procedures such as carbon dioxide laser treatment of spontaneous pneumothorax or diffuse bullous emphysema, neodymium:yttrium-aluminum-garnet laser vaporization of pleural malignant tumors, and thoracoscope/laser-aided pleurectomy, pericardiectomy, or lung resection. Further technologic advancement in thoracoscopy will have a considerable impact on the future of thoracic surgery.
J Thorac Cardiovasc Surg 1991 Nov
PMID:Expanded applications of diagnostic and therapeutic thoracoscopy. 194 91


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