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Query: UMLS:C0034069 (pulmonary fibrosis)
7,050 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regional lung density (g lung/ml thoracic volume) and fractional pulmonary blood volume (ml blood/ml thoracic volume) have been measured by positron tomography in 10 patients with interstitial disease. From the measurements regional extravascular lung density (g tissue and interstitial water/ml thoracic volume) was derived, providing a non-invasive measurement of the interstitial reaction. Extravascular lung density was increased and large regional variations were observed. Fractional blood volume was reduced in patients with pulmonary fibrosis. In two patients with sarcoidosis, a reduction in extravascular lung density occurred after treatment with oral prednisone. Abnormalities in extravascular lung density and fractional blood volume correlated with abnormalities shown by tests of overall pulmonary function.
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PMID:Regional extravascular density and fractional blood volume of the lung in interstitial disease. 660 48

High-frequency jet ventilation is an experimental method of mechanical support, which achieves satisfactory alveolar ventilation and oxygenation at low peak-inspiratory pressures of 5 to 8 cm H2O and low end-expiratory pressures of 3 to 5 cm H2O. This characteristic was used to advantage in 23 patients with cancer, 12 of whom had tracheal or bronchial disruption complicated by pneumonia. Eight patients who could not be supported by conventional means were salvaged. Barotrauma complicated the very high peak airway pressures required to ventilate 8 of 11 patients with respiratory failure associated with diffuse interstitial pneumonia or pulmonary fibrosis. There were only 2 survivors despite temporary normalization of arterial blood gas values in 7 patients. Earlier use of high-frequency jet ventilation in patients with poor compliance may prevent pulmonary disruption in addition to deleterious hemodynamic and systemic effects of conventional high-pressure ventilation. Other applications under study include the role of jet ventilation in resection of the trachea or carina, and in major airway trauma.
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PMID:High-frequency jet ventilation in major airway or pulmonary disruption. 694 29

Breathing air from a humidifier or an air conditioning unit contaminated by various microorganisms can cause an acute lung disease involving fever, cough and dyspnea, termed "humidifier fever". This type of hypersensitivity pneumonitis was first described in 1959 by PESTALOZZI in the Swiss literature and subsequently by BANASZAK et al. in the Anglo-American. Here a chronic form of this disease which led to pulmonary fibrosis is described: A 37-year-old woman who works in a cheese shop presented with dyspnea which had been progressive over two years, weight loss, a diffuse reticular pattern radiographically and a severe restrictive defect in lung function tests. Open lung biopsy revealed chronic interstitial and alveolar inflammation with non-caseating granulomas and fibrotic changes. Circulating immune complexes and precipitins against the contaminated humidifier water and cheese mites were found, but no antibodies suggesting legionnaires' disease. Two out of five otherwise healthy employees of this cheese shop, where a new humidifying system had been installed 7 years earlier, also had precipitins against the contaminated water from the humidifier and the cheese mites. Despite ending of exposure and longterm steroid and immunosuppressive therapy, the signs and symptoms of pulmonary fibrosis persisted. Contrary to the acute disease, this chronic form is termed "humidifier lung". The importance is stressed of investigating the possibility of exposure to contaminated humidifiers or air conditioning units in all cases of newly detected pulmonary fibrosis.
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PMID:[Humidifier lung]. 722 22

All available workers engaged in bagging an artificial crystalline aluminium silicate--the kiln-dried residue from the calcining and water extraction of alunite (a hydrated sulphate of aluminium and potassium) that is currently classified as a nuisance dust--were studied after a complaint of respiratory and systemic symptoms, including arthritis, by an employee of the factory, who showed physiological and radiographic evidence of diffuse pulmonary fibrosis and in whom lung biopsy showed diffuse fibrosis with granulomas. Inhalation challenge produced a transient decrease in transfer factor and transfer factor standardised for alveolar volume. Twenty-five subjects were known to have been exposed at some time to the dust of alunite-residue. Of the 17 who could be contacted, all agreed to attend for respiratory questionnaire and occupational history, pulmonary function testing (spirometry, lung volumes, gas transfer), and posteroanterior chest radiograph. Six subjects considered that occupational exposure to the dust was responsible for respiratory symptoms. Three subjects had abnormality of the chest radiograph consistent with pulmonary fibrosis. The mean percentage of predicted transfer factor standardised for effective alveolar volume was 71.1% in subjects with abnormal chest radiographs and 86.6% in subjects with normal radiographs (p = 0.10). There was a trend in the correlation between the percentage of predicted transfer factor standardised for effective alveolar volume and total dust exposure (sum of the products of grade of severity of each exposure period and duration of each exposure period in months) (r = 0.40 p = 0.10). This study suggests that there may be a relation between inhalation of the dust of this form of aluminium silicate and pulmonary fibrosis.
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PMID:Pulmonary disease from occupational exposure to an artificial aluminium silicate used for cat litter. 744 31

The pulmonary interstitium acts as an important safety factor against alveolar flooding. To test the hypothesis that in advanced fibrosis, edema is redistributed away from a less compliant interstitium to flood alveoli, we induced severe left lung fibrosis in six dogs with radiation and intratracheal bleomycin. Twenty-four months later, edema was induced by infusing 20% body weight lactated Ringer's solution over 30 min, preceded and followed by computed tomography (CT) scanning. Lower lobes were frozen, and samples were taken for extravascular lung water measurements (Qwl/dQl), regional blood volume, and light microscopic grading of interstitial and alveolar edema. The total volumes of the control and fibrotic lungs were 800 +/- 63 and 45 +/- 10 ml (SE), respectively, indicative of severe fibrosis. Before edema, the fibrotic carinal and basal slices had CT densities 3.5 and 2.2 times greater than respective control slices. After edema, the densities of all control lung slices rose 2.5 times and that of fibrotic carinal and basal slices rose 1.5 times. Edema significantly accentuated the small gravity-dependent gradient in CT density of control lungs, but it had minimal effect on this gradient in fibrotic lungs. The Qwl/dQl for control and fibrotic lower lobes were 8.7 +/- 0.8 and 6.8 +/- 0.7 g H2O/g dry lung, respectively, but the amounts of water per lung volume were similar, and there was no gravity-dependent gradient in Qwl/dQl or in regional blood contents. By light microscopy, we found significantly less interstitial and more alveolar edema in the fibrotic lobes. We conclude that in severe pulmonary fibrosis, similar amounts of water accumulate per lung volume as in controls, and that there is predominant alveolar flooding over interstitial edema. We also conclude that the gravity-dependent gradients in CT densities postedema in the control lungs are not accounted for by edema fluid or congestion, but probably by atelectasis.
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PMID:Effects of pulmonary fibrosis on the distribution of edema. Computed tomographic scanning and morphology. 817 69

We tested the hypothesis that in advanced pulmonary fibrosis, edema is redistributed away from the relatively noncompliant interstitium and predominantly floods alveoli. Severe left lung fibrosis was produced in six dogs with radiation and intratracheal bleomycin and, 24 mo later, hydrostatic edema was induced by infusing 20% body weight Ringer's lactate. Previously we had found, by computed tomography scanning and gravimetry, that similar amounts of water per unit volume accumulated in control and fibrotic lungs; semiquantitative light microscopic grading showed less interstitial and more alveolar edema in the fibrotic lungs. In the present study, we extended these observations with detailed morphometric assessment of volume fractions and absolute volumes of the pulmonary compartments, and we examined the lungs with electron microscopy. We found a twofold rise in the volume fractions of connective tissue and alveolar edema (p < 0.05) and a 50% reduction of air and of interstitial edema in fibrotic lobes (p < 0.05). There was a marked reduction in the absolute volume of edema, paralleling the reduction in lung volume in fibrosis, and minimal gravity-dependent edema gradients in both control and fibrotic lungs. In the latter, evidenced by electron microscopy, the interstitial edema was randomly distributed, whereas in the control lungs, it was found primarily around extra-alveolar vessels and airways, not in the alveolo-capillary septa. We conclude that fibrosis profoundly affects the distribution of edema in the lung.
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PMID:Effects of pulmonary fibrosis on the distribution of edema. Morphometric analysis. 817 70

It is well known that there is a close correlation between blood viscosity and blood flow. To clarify any relationship between blood viscosity and regional cerebral blood flow (rCBF) in the elderly, we simultaneously studied both CBF with PET (positron emission tomography) and blood viscosity with viscosimeter before and after phlebotomy in the elderly with various kinds of polycythemia. These subjects consisted of five male cases of secondary polycythemia due to pulmonary fibrosis, one male case of essential erythrocytosis (average age 66.6 +/- 4.6 years old) and one female case of stress polycythemia (47 years old). Before phlebotomy an increase in blood viscosity, decrease in rCBF and regional cerebral metabolic rate of oxygen (rCMRO2) were observed in all cases. After phlebotomy (total amount of 800 to 1,000 ml) blood viscosity rapidly decreased, and both rCBF and rCMRO2 tended to increase. There was a significant negative or positive correlation between CBF and blood viscosity or rCMRO2, respectively. However, no increase in cerebral oxygen transport was observed in any subject after phlebotomy. It was noted that cerebral infarction is not infrequent among elderly visitors to Kusatsu spa, which is characterized by high temperature hot spring water. From the authors' observation of 23 cases of cerebral infarction encountered during the last five years, it is noteworthy that the disease tended to occur more frequently during midnight to morning, specially 3:00 to 6:00. Thus, to clarify the pathogenetic mechanism of the cerebral infarction occurring after bathing in hot spring water, we studied the changes in blood viscosity, blood pressure and coagulation-fibrinolytic system after bathing in hot spring water.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Blood viscosity and cerebral blood flow in aged]. 833 18

Amiodarone is a potent antiarrhythmic agent with a number of side-effects, the most serious being the development of pulmonary toxicity. The purpose of the study was to determine if a single intratracheal instillation of amiodarone would induce pulmonary fibrosis and associated functional changes in rats. Female Fischer 344 rats were given a single intratracheal instillation of 200 microliters containing 1.25 mg amiodarone (n = 9) while the control group received an equivalent volume of sterile water (n = 8). After 6 weeks, pulmonary function tests, lung hydroxyproline measurements and lung histology were performed. The amiodarone-treated animals showed a significant reduction in the coefficient of diffusion (kCO) and a significant increase in lung hydroxyproline levels as compared to the control group. The treated group had abnormal histology including areas of septal thickening with cellular infiltration of the interstitial and alveolar spaces, whereas the control group had normal histology. These observations suggest that the intratracheal instillation route of amiodarone treatment produces a fibrotic response in rats that can be measured physiologically, biochemically and histologically. This model may aid in the elucidation of the mechanism of amiodarone-induced pulmonary toxicity (AIPT)./ABS.
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PMID:Amiodarone-induced pulmonary fibrosis in Fischer 344 rats. 865 64

The normal functional state of the vasculature and the events leading to the development of significant arterial disease involve the interaction of important vasoactive substances, which play important modulating or initiating roles in the development of hypertension and arteriosclerosis. Three endothelins have now been identified, of which ET-1 is the best characterized. ET-1 is produced by epithelial, mesangial, neuronal and glial, and liver cells, and is the most potent vasoconstrictor yet found. Each endothelin is derived from a different gene on separate chromosomes, and each binds to at least 2 types of receptor. The plasma half-life of ET-1 is about 7 min, and this provides a rapid mechanism for adjusting vascular resistance or blood pressure. The actions of endothelin are mediated through several pathways of postreceptor signaling, including activation of the mitogen-activated protein kinase cascade, which give rise to its growth-stimulating properties. Secretion of ET-1 from cultured endothelial cells is stimulated by a wide range of substances, and is inhibited by some prostaglandins. Endothelin in turn stimulates secretion of nitric oxide, arginine vasopressin and atrial natriuretic peptide, and participates in the hormonal control of salt and water balance. Hypoxia and ischemia augment ET-1 secretion, as does insulin, and this could play a role in the accelerated vascular disease of diabetes. ET-1 also causes bronchoconstriction and has been implicated in the development of acute asthma, primary pulmonary hypertension and pulmonary fibrosis. Its role in hypertension is still debatable, though most of the manifestations of congestive heart failure can theoretically be explained by the actions of ET-1. Endothelin also has extensive renovascular and parenchymal effects in the kidney. It is hoped that a fuller understanding of the role of endothelins in normal or pathologic vasculature will lead to effective therapy based on antagonism or augmentation of specific functions.
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PMID:Endothelins as cardiovascular peptides. 873 84

In 16 patients with pulmonary fibrosis, an artificial pneumothorax was introduced using the Veress cannula and the Saugman water manometer. Atmospheric air was introduced by fractionated insufflation to a total volume of 800 ml (median). The interpleural space was found on the first attempt, and in all cases, fractionated insufflation of atmospheric air was conducted while the intrapleural pressure was controlled with the water manometer. In one case, the procedure was stopped because of a rise in the pleural pressure after insufflation of only 50 ml air. This was undoubtedly caused by pleural adhesions not visible on chest X-ray. The main concern with air insufflation is air embolism but this was not observed clinically in any of the present cases. The patients in the present study all suffered from pulmonary fibrosis judged by clinical examination, chest X-ray and pulmonary function tests. Despite a diffusion capacity (DCO/VA) with a median value of 48% expected, the procedure was well tolerated. It has previously been shown that artificial pneumothorax preceding thoracoscopy is well tolerated due to hyperventilation, with an increase in respiratory frequency and a fall in arterial CO2 concentration (PaCO2), while pH and arterial O2 concentration (PO2) remain constant. This probably also explains the tolerance of the patients in this material. Insufflation of air as described here should be restricted to senior pulmonologists because it is an infrequent procedure. The present authors found the procedure to be uncomplicated and easy to perform with little discomfort to the patients.
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PMID:Artificial pneumothorax by the Veress cannula: efficacy and safety. 932 40


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