Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P50583 (asymmetrical)
 12,197 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims of this study were to determine the incidence of typical chest radiography findings - (1) uniform improvement, (2) asymmetrical improvement, (3) no improvement or (4) interstitial emphysema - after therapeutic use of surfactant and to analyse clinical course and outcome. Chest radiographs of 138 infants of very low birth weight treated with surfactant were analysed. Twenty-eight infants with a diagnosis other than typical respiratory distress syndrome (RDS), i. e., sepsis, congenital pneumonia and congenital malformation, were excluded. In 110 patients with clinical and radiological evidence of typical RDS (median gestational age 28 weeks, median birth weight 1070 g) adequate chest radiographs from before and within 72 h after surfactant treatment were available. The time of surfactant application ranged between 1 and 12 h after birth. The most common finding after surfactant treatment was uniform or asymmetrical improvement of pulmonary aeration (80 of 110 patients). Patients with uniform clearing had the best long-term outcome. Asymmetrical clearance was often localised on the right side or in central regions of the lung, and usually disappeared after retreatment with surfactant without clinical significance. In 11 patients no change in aeration was found and retreatment was absolutely ineffective. Development of pulmonary inter- stitial emphysema after surfactant treatment was a grave prognostic sign: 73 % of these infants died within the first 2 weeks of life compared with 10 % of those with uniform or asymmetrical improvement of ventilation.
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PMID:Radiological changes after therapeutic use of surfactant in infants with respiratory distress syndrome. 899 63

After single-lung transplantation for emphysema, the hyperinflated native lung and the graft have different extents and rates of inflation and emptying. This requires that breathing produces asymmetrical expansion of the chest wall, displacement of the mediastinum, or both. In a first study in four seated transplant recipients, we measured the volumes of the two hemithoraces with optoelectronic plethysmography. Functional residual capacity and total lung capacity were identical on the native and transplanted sides, and changes in chest wall volume during CO(2)-induced hyperpnea and FVC maneuvers were similar on both sides. Studies with computerized tomography in three of these patients and in four additional patients in supine posture indicated that the mediastinum was shifted toward the graft at functional residual capacity and total lung capacity. The mediastinum moved toward the native lung during tidal and full inspiration and toward the graft during tidal and forced expiration; additional studies with fluoroscopy showed qualitatively similar changes in upright posture. In summary, the two hemithoraces assume identical static volumes and show similar volume changes during CO(2)-induced hyperpnea and FVC maneuvers in patients with single-lung transplantation for emphysema; displacement of the mediastinum accommodates part, if not all, of the unequal lung volumes and asymmetrical ventilation.
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PMID:Ventilation asymmetry after transplantation for emphysema: role of chest wall and mediastinum. 1533 32

Although normal lungs may be represented satisfactorily by symmetrical architecture, pathological conditions generally require accounting for asymmetrical branching of the bronchial tree, since lung heterogeneity may be significant in respiratory diseases. In the present study, a recently proposed symmetrical dynamic morphometric model of the human lung, based on Weibel's regular dichotomy, was adapted to simulate different physiopathological scenarios of lung heterogeneity. The asymmetrical architecture was mimicked by modeling different conductive airway compartments below the main bronchi, each compartment being characterized by regular branching. The respiratory zone and chest wall were described by a Voigt body and a constant elastance, respectively. Simulation results allowed us to investigate the influence of the main mechanisms involved in expiratory flow limitation and dynamic hyperinflation in mechanically ventilated COPD patients. In brief, they showed that convective gas acceleration plays a key role in reproducing a negative relationship between driving pressure and expiratory flow. Moreover, reduced lung elastance due to emphysema resulted in a remarkable increase in dynamic hyperinflation, although it did not significantly modify expiratory flow limitation. Finally, the presence of a normal lung compartment masked pathological behaviors, preventing standard techniques from revealing expiratory flow limitation in affected compartments.
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PMID:A simulation study of expiratory flow limitation in obstructive patients during mechanical ventilation. 1706 Nov 56

Although right main bronchus intubation is associated with adverse consequences, the optimal endotracheal tube (ETT) tip position above the carina in neonates is not known. The aim of this study was to determine the association between ETT tip position and adverse pulmonary effects as assessed by chest radiographs (CXRs). Lung aeration was examined after masking ETT positions in the first two CXRs taken after birth in 74 consecutive ventilated premature infants <or= 28 weeks. All the CXRs of the infants during the first week were examined for predefined combined adverse pulmonary outcomes by two examiners (right upper lobe collapse, localized pulmonary interstitial emphysema [PIE], and pneumothorax). Infants who had ETT tips below T4 or in the right main bronchus were excluded. The ETT tip was above T1 in 4 (5.4%), at T1 in 11 (14.8%), at T2 in 19 (25.6%), at T3 in 27 (36.5%), and at T4 in 13 (17.6%) infants. The patients were categorized into group A (ETT tips at T1/2) or group B (ETT above T1 or below T2). The combined adverse pulmonary outcome of pneumothorax, localized PIE, and right upper lobe collapse was significantly higher in group B compared with group A ( P=0.03). On logistic regression analysis, the only independent association for adverse pulmonary outcome and asymmetrical lung aeration was the ETT position. The odds ratio for developing nonuniform lung aeration was 6 (95% confidence interval [CI] 1.8, 20) and for adverse pulmonary outcome was 8 (95% CI 1.1, 73) when the ETT tip was at T3/T4 compared with T1/2. We concluded that the ETT tip should be kept at the level of the first or second thoracic vertebrae in extremely premature babies to reduce the incidence of nonuniform lung aeration and adverse pulmonary outcomes.
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PMID:Optimal endotracheal tube tip position in extremely premature infants. 1802 11

Proteus syndrome is a rare, sporadically occurring hamartomatous disorder with complex multisystem involvement and wide clinical variability. Clinical characteristics include craniofacial abnormalities; asymmetrical overgrowth of the trunk, limbs, and digits; lipomas; and vascular malformations. Cystic lung disease is noted in approximately 10 per cent of patients. These cystic malformations may lead to cystic pulmonary emphysema, which may cause significant morbidity for the patient. We describe the case of a 27-year-old woman with known Proteus syndrome who developed acute on chronic respiratory failure. Subsequent CT scan of the chest was significant for extensive bullous disease with nearly complete replacement of the right lung tissue. Our operative management and the patient's clinical course are described.
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PMID:Proteus syndrome: a case report. 1977 61

Giant bullous emphysema is an uncommon condition characterised by large asymmetric bullae with upper lobe predominance. This condition is most frequent in young male smokers. Patients usually present with progressive breathlessness which is secondary to enlargement of the bullae leading to compression of the lung parenchyma. Large asymmetrical bullae may appear as a unilateral hyperlucency on a plain chest radiograph, and may mimic the appearances of pneumothorax. A computed tomography scan is needed to delineate the lung pathology. We describe two cases with this condition that presented acutely and discuss the management of bullous emphysema.
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PMID:The vanishing lung: an important cause of hyperlucency on chest radiograph. 2409 75

Vanishing lung syndrome, also known as idiopathic giant bullous emphysema, is a rare disease characterized by giant emphysematous bullae. The disease is diagnosed by radiological findings of giant bullae in one, or both, of the upper lobes of the lung, occupying at least one-third of the hemithorax. There have been several reports of vanishing lung syndrome, however it remains to be determined whether genetic inheritance is associated with the disease. In the present study, five patients within one family, with vanishing lung syndrome, were reported during a follow-up period of ~ 20 years. All of the patients were diagnosed by radiological findings, which showed diffuse bullae in the lungs, which were of varying size and asymmetrical distribution, and the occurrence of pneumothorax or emphysema. The Medical Ethics Committee of the People's Hospital of Zhangye Municipality (Zhangye, China) approved this study, and all subjects gave their informed consent During the follow-up period of 20 years, bullae in these patients were shown to progressively increase, and no other pulmonary diseases, including lung cancer, tuberculosis, pneumoconiosis and chronic bronchitis were observed. Autosomal dominant inheritance was observed in five cases, and autosomal recessive inheritance was observed in one case. The present study suggests that vanishing lung syndrome may be associated with autosomal dominant and recessive genetic inheritance.
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PMID:Vanishing lung syndrome in one family: five cases with a 20-year follow-up. 2532 95