Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report six observations of pneumomediastinum, due to dental extraction and use of high speed air turbine drill, aspiration of a nut with air trapping, labor in delivery, status asthmaticus, mechanical ventilation, and rectal perforation. Some patients showed widespread extension of dissecting air presenting as subcutaneous emphysema, pneumopericardium or pneumoretroperitoneum. The mediastinum is thought to be a central pump, the diaphragm and the lung acting like bellows, which distribute interstitial air from and into communicating layers on both sides of the diaphragm. Pneumomediastinum does not prove an air leak in the thoracic cage nor does pneumoretroperitoneum absolutely indicate bowel rupture. Review of the literature.
 ...
PMID:[Dissecting emphysema]. 194 55

The effects of overinflation of the lung in obstructive lung disease on the function of chest wall (rib cage, diaphragm) were studied. Concerning the function of the rib cage, the lateral motion of the lower lateral rib cage was evaluated using several experimental models. The results showed that the lower lateral rib cage was moved by many factors, including the force of the diaphragm, rib cage, compliance of abdominal wall, zone of apposition and angle of the diaphragm at the part of its insertion into the rib cage with respect to the transverse section of the trunk. The inward motion of the lower lateral rib cage due to overinflation of the lung occurred by participation of these factors. Concerning the function of the diaphragm, the diaphragm at high lung volume in healthy subjects and patients with pulmonary emphysema was evaluated by the three-dimensional stereoscopic method. The radius of the portion of the dome in the diaphragm decreased at higher lung volume, and changes in lung volume at that lung volume were caused by changes in the shape in the posterior of the diaphragm.
 ...
PMID:[Chest wall mechanics in obstructive lung disease]. 206 49

Transthoracic two-dimensional echocardiography (TTE) has been an accepted noninvasive procedure used to diagnose infective endocarditis by demonstrating the presence of vegetations and other complications such as ring abcess, mycotic lesions or sinus of valsalva aneurysm. Moreover, complementary Doppler and Color Flow imaging are very useful in detecting early valvular regurgitation and in evaluating the severity of such regurgitant lesions. Occasionally, TTE fails to provide an adequate quality of imaging because of the patient's obesity, chest deformity or emphysema. Transesophageal echocardiography (TEE) on the other hand, a relatively new technique, allows ultrasonic imaging of the heart through the esophagus and provides a clear visualization of all cardiac structures without any interference from the lungs, chest wall or rib cage. We present a case of aortic valve endocarditis diagnosed by TEE.
 ...
PMID:Transesophageal echocardiography (TEE): its diagnostic value in endocarditis. 227 24

The response of breathing patterns to increased expiratory resistance is not only of physiologic interest, with respect to the control of breathing, but also of clinical interest because of its clinical relevance to obstructive diseases such as asthma and emphysema. To elucidate the response of breathing patterns to increased expiratory resistance during anesthesia, the respiratory effects of expiratory flow-resistive loading on breathing patterns were studied in 15 conscious and 10 lightly anesthetized subjects. Inspiratory time, expiratory time, respiratory frequency, inspiratory duty cycle, tidal volume, minute ventilation, and mean inspiratory flow rate were determined from a respiratory inductive plethysmograph. End-tidal CO2 was continuously recorded. In awake subjects, respiratory frequency was reduced without change in tidal volume or mean inspiratory flow rate, and minute ventilation was significantly decreased; the synchrony between rib cage and abdomen wall motion was well maintained during the loads. In contrast, in anesthetized subjects, respiratory frequency was reduced with remarkable increases in tidal volume, mean inspiratory flow rate, and minute ventilation, whereas coordination between rib cage and abdomen compartments was disturbed. End-tidal CO2 did not change in conscious subjects, but it increased in anesthetized subjects during the loads. These results indicate that there are differences between conscious and anesthetized subjects in breathing patterns during expiratory loading, and suggest that the ability to coordinate rib cage-abdomen wall motion is easily disturbed during anesthesia in patients with expiratory flow limitation.
 ...
PMID:Respiratory effects of expiratory flow-resistive loading in conscious and anesthetized humans. 234 54

The present study examined the effects of elastase-induced emphysema on the structure and elasticity of the chest wall. Specifically, we examined the passive pressure-volume relationship of the intact chest wall in anesthetized animals and the stress-strain relationship of the isolated rib cage devoid of respiratory musculature. The structure of the isolated rib cage was assessed by measuring its circumferential, anterior-posterior, and transverse dimensions, the angles of articulation of the ribs at the costovertebral and sternochondral joints, and the length of the sternum and individual ribs. Studies were performed in 10 Syrian Golden hamsters, 26-27 wk after intratracheal injection of elastase, and 9 saline-injected hamsters that served as controls. Mean functional residual capacity of emphysematous animals was 239% of the value obtained in control animals. In emphysematous animals, the pressure-volume curve of the chest wall was shifted parallel and to the left of the curve obtained in controls. That is, at any given esophageal pressure, lung volume was significantly greater in emphysematous animals compared with controls, but the slope of the pressure-volume relationship was similar in the two groups. In the relaxed position, the circumference, anterior-posterior, transverse, and rostral-caudal dimensions of the thorax were significantly greater in emphysematous than control animals. Although the length of the thoracic spinal column was the same in both groups, the length of the ribs and sternum were greater in emphysematous animals and the angles of articulation of the ribs with the vertebrae and sternum were altered.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Changes in chest wall structure and elasticity in elastase-induced emphysema. 364 Jul 62

Lung volume reduction surgery (LVRS) is performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. Removing diseased and functionless lung may improve the function of remaining, less diseased lung by (1) increasing elastic recoil pressure, thereby increasing expiratory airflow rates, (2) decreasing the degree of hyperinflation resulting in improved diaphragm and chest wall mechanics, and (3) decreasing inhomogeneity resulting in decreased work of breathing and improved alveolar gas exchange. The guidelines used for patient assessment were (1) airflow limitation with a forced expiratory volume in 1 second (FEV1) less than 35%, (2) hyperinflation and air trapping with total lung capacity more than 125% and respiratory volume more than 250% predicted, and (3) regional heterogeneity of the emphysematous process providing target areas for resection. We sought to exclude patients with the following: (1) obliteration of the pleural space by previous disease or surgery, (2) severe structural abnormalities of the thoracic cage, (3) PaCo2 greater than 55 mm Hg. (4) mean pulmonary artery pressure greater than 35 mm Hg. (5) predominant airway disease such as asthma, bronchiectasis, or chronic bronchitis with persistent excessive purulent secretions, (6) significant coexisting disease, and (7) maintenance corticosteroid therapy in excess of 10 mg prednisone per day. The assessment process continues to be evaluated by analysis of patient outcome.
 ...
PMID:Evaluation of patients with emphysema for lung volume reduction surgery. Washington University Emphysema Surgery Group. 867 53

We discovered a unique case of complete cartilaginous duplication of the rib cage in a cadaver, never previously described in the literature. A retrospective review of the patient's medical records revealed an antecedent history of progressive tobacco-related emphysema leading to death from end stage respiratory failure. Prior imaging studies consisting of plain radiographs and computed tomograms of the chest had failed to show several underlying cartilaginous duplications of the rib cage. The clinical significance and the potential contribution of this entity to this patient's clinical course remains unanswered.
 ...
PMID:Complete cartilaginous duplication of the rib cage found in a cadaver: a first reported case. 889 26

To evaluate the effects of pulmonary rehabilitation on pulmonary function, 15 patients with chronic pulmonary emphysema underwent pulmonary rehabilitation for six weeks as inpatients. Pulmonary rehabilitation consisted of relaxation techniques, breathing retraining, thoracic massage, physical exercise, and walking. In 8 of the 15 patients vital capacity increased by more than 200 ml (over 10%), and in 7 of the 15 patients the load of maximal exercise increased by more than 5 watts (over 10%). Increases in vital capacity were not associated with increases in maximal exercise load. The percent change in vital capacity associated with pulmonary rehabilitation correlated significantly with the percent change in tidal volume and the percent change in expiratory minute ventilation at the maximal load. The percent change in tidal volume at the maximal load correlated significantly with the percent change in maximum oxygen uptake. We attribute the increase in vital capacity to an improvement in thoracic cage movement. These findings suggest that pulmonary rehabilitation can increase vital capacity in some patients with chronic pulmonary emphysema, and that such an increase is not directly connected to increases in exercise capacity.
 ...
PMID:[Effects of pulmonary rehabilitation on vital capacity in patients with chronic pulmonary emphysema]. 897 71

Volume reduction surgery is based on the removal of volume-occupying but nonfunctioning emphysematous lung, which is thought to improve pulmonary elastic recoil. The reduction in thoracic volume may also improve thoracic cage and inspiratory muscle function. In addition, dyspnea is lessened, exercise tolerance is increased, and measured pulmonary function is improved. Alveolar gas exchange may also be improved. Selection criteria include marked airway obstruction secondary to emphysema, marked hyperinflation of the chest wall, and regional heterogeneity in the distribution of the emphysema. The best results are obtained with a bilateral procedure utilizing stapling resection. The two surgical approaches are median sternotomy and video-assisted thoracic surgery.
 ...
PMID:Recent advances in surgery for emphysema. 904 70

Acute hyperinflation causes the inspiratory muscles to operate at shorter than normal lengths. The ability of these muscles, in particular the diaphragm, to lower intrathoracic pressure is therefore reduced. Skeletal muscles, however, adapt to chronic shortening, and animals models of emphysema have shown that with chronic hyperinflation, the diaphragmatic muscle fibres lose sacromeres. As a result, the force-generating ability of these fibres is relatively preserved. In patients with hyperinflation due to chronic obstructive pulmonary disease, the ability of the diaphragm to generate pressure is also better than anticipated on the basis of hyperinflation alone. However, the diaphragm in these patients is also lower in the chest wall than in healthy subjects. Consequently, even though the neural drive to the muscle is greater than normal, its ability to descend during inspiration is impaired. Its rib cage expanding action is also reduced; in patients with severe hyperinflation, contraction of the diaphragm even produces deflation, rather than expansion, of the rib cage. In such patients, therefore, the ability of the diaphragm to increase lung volume is reduced, and hence the act of breathing is more dependent on the rib cage inspiratory muscles.
 ...
PMID:Effect of hyperinflation on the diaphragm. 907 10


1 2 3 Next >>