Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LUNGS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMed2006

Lung injury after thoracic surgery and one-lung ventilation.

PURPOSE OF REVIEW: An update is provided for anaesthetists, on recent work investigating the incidence and cause of lung injury following thoracic surgery. Pulmonary damage is also discussed in relation to the management of one-lung ventilation. RECENT FINDINGS: The extent of recent original literature on lung injury, following thoracic surgery, is limited for the review period (2004-2005). Increasing evidence that pulmonary oxidative stress and an increase in proinflammatory cytokines are significant contributors to lung injury following thoracic surgery, however, exists. This is particularly the case in patients with lung or oesophageal carcinoma. Animal experiments confirm the above and also indicate that anaesthetic agents may offer some protection against the ischaemia-reperfusion injury sustained as a result of one-lung ventilation. SUMMARY: Pulmonary damage in the form of acute lung injury and adult respiratory distress syndrome is a major cause of morbidity and mortality after thoracic surgery. An understanding of the pathogenesis of lung damage, following thoracic surgery, may enable anaesthetists to modify this process and decrease the incidence and severity of the problem.

Anesthetics↗
PubMed1975

Effect of shape and size of lung and chest wall on stresses in the lung.

Conflicting results have been reported on the changes in the distribution of pleural pressures caused by alterations of chest shape. To understand better the effect of shape and size of lung and chest wall on the distribution of stresses, strains, and surface pressures, we analyzed a theoretical model using the technique of finite elements. The study was in two parts. First we investigated the effects of changing the chest wall shape during expansion, and second we studied lungs of a variety of inherent shapes and sizes. We found that, in general, the distributions of alveolar size, mechanical stresses, and surface pressures in the lungs were dominated by the weight of the lung and that changing the shape of the lung or chest wall had relatively little effect. Only at high states of expansion where the lung was very stiff did changing the shape of the chest wall cause substantial changes. Altering the inherent shape of the lung generally had little effect but the topographical differences in stresses and surface pressures were approximately proportional to lung height. The results are generally consistent with those found in dog by Hoppin et al. (J. Appl. Physiol. 27: 863-873, 1969).

Animals↗
PubMed1978

Static lung mechanics of intact and excised rhesus monkey lungs and lobes.

Subdivisions of lung volume and pressure-volume (PV) curves of the lung and chest wall (CW) were measured in 12 rhesus monkeys (Macacca mulatta) under pentobarbital anesthesia. In addition, volumes and PV curves were obtained on the excised lungs and lobes of 12 cynomolgus monkeys (M. fasicularis). Boyle's law was used to determine functional residual capacity (FRC) in the intact animals and water displacement to determine minimal volume (MV) in the excised lungs. Total lung capacity (TLC = lung volume at a transpulmonary pressure of 30 cmH2O) was similar in vivo and in vitro (90 + 83 ml/kg) but residual volume (RV = volume at airway pressure of -50 cmH2O) and MV differed markedly (16.5 + 5.9 ml/kg). In the intact animals a very stiff CW appeared to determine RV, whereas airway closure determined MV in excised lungs. PV curves of upper and lower lobes were not different when expressed as %TLC but when expressed as milliliters of gas per gram of lung, the upper lobes contained significantly more gas per unit weight.

Animals↗
PubMed1981

Mechanical properties of mouse lungs: effects of degassing on normal, hyperoxic, and irradiated lungs.

We critically examined conventional techniques for studying static mechanical properties of the lungs using normal mice, mice exposed to high O2 concentrations, and mice with radiation pneumonitis and radiation fibrosis. Successive pressure-volume (PV) curves were performed in situ both before and after degassing the lungs in vacuo. In both hyperoxia and radiation pneumonitis the deflation limbs of the curves were shifted to the right compared with their corresponding controls. However, the curves were further shifted rightward and downward after degassing the lung, as compared with the curve obtained before degassing. This effect of degassing was most marked in abnormal lungs and was not corrected by repeating inflation-deflation cycles nor by inflating to higher pressures and allowing time for units to open. Histology showed that abnormal lungs fixed in inflation after degassing were unevenly reinflated. It is speculated that, in conditions such as hyperoxia and radiation pneumonitis, altered surface tension properties may result in uneven reinflation of the lungs after degassing and that nonuniform reinflation may produce spurious shifts in the shape as well as the amplitude of PV curves. Thus PV curves performed with air after degassing the lung may not correctly represent the mechanical properties of abnormal lungs.

Air Pressure↗
PubMed1999

Lung elastic recoil during breathing at increased lung volume.

During dynamic hyperinflation with induced bronchoconstriction, there is a reduction in lung elastic recoil at constant lung volume (R. Pellegrino, O. Wilson, G. Jenouri, and J. R. Rodarte. J. Appl. Physiol. 81: 964-975, 1996). In the present study, lung elastic recoil at control end inspiration was measured in normal subjects in a volume displacement plethysmograph before and after voluntary increases in mean lung volume, which were achieved by one tidal volume increase in functional residual capacity (FRC) with constant tidal volume and by doubling tidal volume with constant FRC. Lung elastic recoil at control end inspiration was significantly decreased by approximately 10% within four breaths of increasing FRC. When tidal volume was doubled, the decrease in computed lung recoil at control end inspiration was not significant. Because voluntary increases of lung volume should not produce airway closure, we conclude that stress relaxation was responsible for the decrease in lung recoil.

Adult↗
PubMed1993

Evidence that granulocyte macrophage-colony-stimulating factor regulates the distribution and differentiated state of dendritic cells/Langerhans cells in human lung and lung cancers.

GM-CSF has been shown to be important for the survival and function of cells of dendritic cell/Langerhans cell (LC) lineage in vitro. Since these cells have been demonstrated to infiltrate human lung and some lung carcinomas, we hypothesized that the production of GM-CSF in the lung could be important in their recruitment and differentiation. Using both immunohistochemistry and in situ hybridization, we have shown that: (a) GM-CSF was produced by normal bronchiolar epithelium, the only site were CD1a+ LC are observed in the normal lung, whereas neither GM-CSF production nor LC were identified in normal alveolar epithelium. (b) In inflamed pulmonary tissue, hyperplastic alveolar cells produced GM-CSF, and CD1a+ LC accumulated adjacent to these cells. (c) Some, but not all, lung carcinomas produced this cytokine, and a close correlation was found between the production of GM-CSF and the number of CD1a+ LC infiltrating these tumors. Since GM-CSF was produced at all sites where CD1a+ LC are known to accumulate, but not at other locations within the lung, these data suggest that the local production of GM-CSF by certain lung cells may play an important role in determining the distribution and differentiated state of dendritic cell/LC in the human lung.

Adenocarcinoma↗
PubMed1989

Submaximal invasive exercise testing and quantitative lung scanning in the evaluation for tolerance of lung resection.

Lung resection in patients with cardiopulmonary dysfunction is associated with increased risk. We studied 52 elderly male patients with airflow obstruction and a lung mass. Studies were performed at rest with routine ventilatory tests and lung scan quantitation of right-left lung function. Cycle ergometry exercise was then performed at 2 submaximal work loads (25 and 40 watts). Data were obtained using systemic and pulmonary artery catheterization for blood pressures, thermal dilution cardiac output, and blood gases. Twenty-nine patients underwent lung resection and seven failed to tolerate the procedure (death within 60 days or prolonged ventilator dependence). Those parameters most clearly separating the group tolerating surgery (n = 22) from the intolerant group (n = 7) were obtained during exercise and included: cardiac index (tolerant 5.5 +/- 1.3 vs intolerant 3.9 +/- 0.3 L/min/m2, p less than .01), O2 delivery (p less than .01) and calculated VO2 ml/kg/min (tolerant 11.3 +/- 2.1 vs intolerant 7.8 +/- 1.5 ml/kg/min, p less than .001). Pulmonary vascular pressures and calculated resistance did not predict intolerance. Calculated VO2 at 40 watts did not separate those patients who had survivable complications from those who did not (p much greater than .05). Multivariate analysis suggests that exercise VO2 is an important predictor of tolerance of lung resection because it reflects the effects of cardiac function and O2 transport. In our patients with COPD, submaximal exercise testing predicted intolerance of lung resection better than calculation using quantitative lung scanning. Exercise testing may accomplish this goal by uncovering deficits in O2 transport.

Aged↗
PubMed2002

Systemic sclerosis and interstitial lung disease: a pilot study using pulse intravenous methylprednisolone and cyclophosphamide to assess the effect on high resolution computed tomography scan and lung function.

OBJECTIVE: To document the effectiveness, including the longterm effect, of a course of intravenous (IV) pulses of methylprednisolone (MP) and cyclophosphamide (CYC) in patients with scleroderma (SSc) who had evidence of lung inflammation on high resolution computer tomographic (HRCT) scan of the chest. METHODS: Fourteen consecutive patients with SSc and lung involvement were treated with 6 pulses of IV MP (10 mg/kg) and IV CYC (15 mg/kg) given at 3-4 weekly intervals. HRCT scans and lung function tests were performed at baseline and after the 6th pulse. Further lung function tests were repeated at 12 months and annually thereafter. RESULTS: Modified Rodnan skin scores improved significantly by 35% from a median baseline score of 17 (IQR 14-26.5) to a posttreatment score of 13 (IQR 10.5-18.5; p = 0.0058). HRCT scan scores improved significantly (p = 0.04). Twelve of 13 patients experienced either improvement or stabilization of the HRCT score. Median DLCO and lung volumes remained stable during the first 12 months. After a median followup of 26 months (IQR 19-43), 67% of patients experienced deterioration in DLCO. Median deterioration was 23% (IQR 44-0.6), with the median rate of deterioration of the predicted value of the DLCO/month being 0.87% (IQR 1.24-0.02). The treatment was safe and well tolerated. CONCLUSION: This IV regimen stabilized lung disease in patients with SSc. When treatment was stopped, or reduced in intensity, a deterioration in lung function occurred in the majority of patients. Rate of deterioration of DLCO may be a useful marker for determining the intensity of treatment. These findings have implications for treating lung disease and designing clinical trials in patients with SSc.

Adult↗
PubMed1990

[Diagnostic value of transbronchial lung biopsy in diffuse or peripheral lung lesions].

The results of 102 cases of diffuse or peripheral lung lesions examined by transbronchial lung biopsy (TBLB), bronchial brushing (BB), and bronchial alveolar lavage (BAL) via fiberoptic bronchoscope, were reported. The positive diagnostic rate was 74.5% (76 cases). In lung cancer, the positive rate by means of BB was 77.1%, which was higher than that by TBLB (58.1%). In pulmonary tuberculosis, the positive rate by TBLB was 76.9%, higher than that by BAL fluid for identification of tubercle bacillus by culture (44.4%). If TBLB was combined with BB and BAL, the positive diagnostic rate would be further elevated. The data showed that if the size of the masses greater than or equal to 3cm in peripheral lung field on chest film, the possibility of lung cancer was greater than that of those less than 3cm. Most cases of localized infiltration in the lungs were caused by tuberculosis. But the diffuse lesions of the lungs were often caused by bronchiolo-alveolar carcinoma, adenocarcinoma, diffuse interstitial fibrosis of the lungs, silicosis, sarcoidosis, etc. By the careful study of the chest film and ascertainment of the exact locations of the pulmonary lesions there, we can carry out the TBLB and obtain a satisfactory specimen without any X-ray monitoring. In the present group of patients who underwent TBLB, one was complicated by haemorrhage (greater than 50ml) and two by pneumothorax, but all of them recovered promptly after proper management. By strick adherence to indication, adequate preoperative preparations and very careful performance of the procedure, the complications of TBLB could be reduced to minimum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Post-transplant obstructive lung disease ("bronchiolitis obliterans"): a clinical comparative study of bone marrow and lung transplant patients.

Patients at a single pulmonary centre who developed obstructive lung disease after bone marrow transplantation (BMT) and lung transplantation (LT) were studied, in order to compare the clinical expression of post-transplant obstructive lung disease (PTOLD) (bronchiolitis obliterans) in these two conditions, which have so far been studied separately. Nine out of 179 patients surviving more than 100 days after BMT (5%) and 9 out of 44 patients surviving more than 100 days after LT (20%) developed post-transplant obstructive lung disease. This was defined by an irreversible airflow obstruction, as characterized by a forced expiratory volume in one second divided by forced vital capacity (FEV1/FVC) of less than 70%, and a FEV1 of less than 70% of predicted value. The mean interval between transplantation and the diagnosis of post-transplant obstructive lung disease was 262 days and 217 days for BMT and LT patients, respectively. In all cases, pulmonary symptoms consisted of dyspnoea and progressively productive cough. Bronchial dilatation on high-resolution computed tomography scans was the main imaging feature present in both groups of patients at the onset of post-transplant obstructive lung disease. The mean FEV1/FVC ratio was 51 and 54% for BMT and LT patients, respectively. All BMT and LT patients had normal transfer coefficient. Clinical chronic graft-versus-host disease was present in all BMT patients before or concurrent with the onset of post-transplant obstructive lung disease, and all LT patients had presented at least one episode of acute lung rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗