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PubMed1991

Metal concentrations in human lung tissue, with special reference to age, sex, cause of death, emphysema and contamination of lung tissue.

Nine element concentrations in the lung tissues of 2,274 autopsies were determined in Japan by atomic absorption spectrometry. The metals determined were iron, calcium, magnesium, zinc, copper, cobalt, nickel, lead, and chromium. The range, mean, standard deviation, mode and median are described for each metal. Moreover, these data were analyzed statistically, based on their sex, age, degree of lung contamination (color and the amount of particle deposition), severity of pulmonary emphysema and cause of death. Iron, calcium, magnesium, zinc, copper and cobalt concentrations in the lung tissue seemed to be affected mostly by physiological variation and the levels in the blood. On the other hand, nickel, lead and chromium concentrations might reflect environmental exposure. Chromium concentration especially increased with age and showed a significantly positive correlation with the degree of contamination and severity of emphysema.

Age Factors↗
PubMed1977

Congenital lobar emphysema.

Congenital lobar emphysema is reported occurring in a 10 day old, low birth weight infant. Following resection, gross examination of the affected lobe revealed collapsed but unobstructed bronchi, suggesting a cartilaginous defect. The specimen was insufflated with formalin and the bronchial tree dissected out. Histological study including comparison with a normal pulmonary lobe, confirms that abnormalities of cartilage may be important in the pathogenesis of congenital lobar emphysema.

Cartilage↗
PubMed1988

Pulmonary barotrauma including orbital emphysema following inhalation of toxic gas.

Severe pulmonary barotrauma occurred following smoke and toxic gas inhalation in a 20-year-old male. He developed pneumothorax, pneumomediastinum, and extensive facial subcutaneous emphysema which intensified during treatment with positive pressure ventilation. Following the appearance of diplopia and exotropia, orbital emphysema was demonstrated radiologically. The diplopia and exotropia were manifestations of mechanical interference in extra-ocular muscle function by the intra-orbital air, an unusual expression of pulmonary barotrauma.

Adult↗
PubMed1981

[Proteolytic lung emphysema and obstructive airway disease (author's transl)].

Inhalation of papain by dogs produced morphological changes corresponding to a centrolobular emphysema. The papain inhalation also induced a purulent catarrhal bronchitis. However, the functional changes seen in chronic obstructive bronchitis were not observed. During papain inhalation an increased sensitivity of the bronchial systems develops corresponding to a tremendous increase in bronchospasm in response to Acetylcholine aerosol. The parenchymal lung tissue in dogs is more vulnerable in developing emphysema after papain exposure than is teh bronchial system in developing a chronic obstructive airway disease.

Animals↗
PubMed1992

Bilateral pneumothorax and mediastinal emphysema in systemic lupus erythematosus.

The association of pneumothorax and mediastinal emphysema in systemic lupus erythematosus (SLE) has not been described extensively in the literature. We describe a 36 year-old man with SLE, complicated by bilateral pneumothorax, mediastinal emphysema and pneumoperitoneum. Despite the treatment received, he died of respiratory failure.

Adult↗
PubMedDate not supplied

Pneumopericardium and subcutaneous emphysema of the neck. An unusual manifestation of colonoscopic perforation.

Subcutaneous neck emphysema has been reported infrequently following colonoscopic perforation and only a single case of pneumopericardium has been previously reported. The successful management of these patients in the literature has largely been non-operative. We report a case of colonoscopic perforation which presented with subcutaneous neck emphysema, pneumopericardium, and pneumoperitoneum that required operative intervention.

Adult↗
PubMed1986

Pulmonary emphysema in a neonate with Marfan syndrome.

A premature infant with arachnodactyly and congenital cyanotic heart disease had severe pulmonary emphysema, a little-known manifestation of Marfan syndrome. The possible etiologies of emphysema in this syndrome are discussed.

Humans↗
PubMed1990

The protease-antiprotease balance within the human lung: implications for the pathogenesis of emphysema.

Critical elements of the mechanisms of emphysema remain to be clarified. However, taken together, the existing evidence supports the concept that alveolar matrix destruction ensues as the regulatory interplay between oxidant and protease expression is subverted. The final common pathway of matrix destruction links the inherited and acquired forms of emphysema through the ultimate expression of unimpeded neutrophil elastase.

Animals↗
PubMed2003

Prophylactic anti-inflammation inhibits cigarette smoke-induced emphysema in guinea pigs.

In this study, the effect of prophylactic anti-inflammation on the development of smoke-induced emphysema was investigated. Young male guinea-pigs aged 1.5-2 months (weighing 198.3+/-26.9 g) were randomly divided into 4 groups: group A (cigarette smoke exposure only), group B (cigarette smoke exposure plus pentoxifylline-rich (PTX, 10 mg/d) forage feeding), group C (cigarette smoke exposure plus intermittent cortical steroid injection (Triamcinolone acetonide, 3 mg, i.m., every three weeks) and control group (group D: animals with sham smoke exposure, raised under the same conditions). Animals in group A, B and C were exposed to smoke of cigarettes for 1 to 1.5 h twice a day, 5 days a week. All animals were killed at the 16th week and followed by morphometrical analysis of the midsagittal sectioned lung slices. Smoke exposure of 16 weeks resulted in visible emphysematous development in Group A but not in Group B and C. It was evidenced by the indicator of air-space size, mean linear intercept (Lm): 120.6+/-16.0 microm in Group A; 89.8+/-9.2 microm in Group B and 102.4+/-17.7 microm in Group C. The average Lm in either group B or group C was shorter than that in Group A (ANOVA and Newman-Keuls test, F=8.80, P=0.0002) but comparable to that (94.8+/-13.2 microm) in group D (P>0.05). It is concluded that long-term prophylactic anti-inflammation inhibits pulmonary emphysema induced by cigarette smoking in the guinea pigs.

Animals↗
PubMed2001

Lung volume reduction surgery and nutritional status in patients with severe emphysema.

OBJECTIVE: We studied the short-term effect of lung volume reduction surgery on nutritional status including body composition and the relationship between preoperative nutritional status and postoperative morbidity. METHODS: Subjects were 28 patients with emphysema who underwent bilateral thoracoscopic lung volume reduction surgery (23 simultaneously, 5 staged). Functional tests, body weight, and body composition were measured before and 6 months after surgery. Fat-free mass and fat mass were assessed by bioelectrical impedance analysis. RESULTS: FEV1.0 improved 35.2% following surgery and maximal oxygen uptake 23.8%. Body weight and fat-free mass increased significantly after surgery, while fat mass was unchanged. Of the 23 undergoing simultaneous bilateral lung volume reduction surgery, 8 had major complications-3 required additional surgery to close air leaks, 3 required mechanical ventilation (> 72 hrs), and 2 developed postoperative infection. The preoperative percentage of ideal body weight and fat-free mass was significantly higher among patients without major complications. CONCLUSIONS: Bilateral lung volume reduction surgery increases fat-free mass and provides functional improvement for underweight patients with severe emphysema. We found fat-free mass and body weight to be good predictors of unacceptable postoperative complications following bilateral lung volume reduction surgery.

Aged↗
PubMed2001

Thoracoscopic lung volume reduction surgery for pulmonary emphysema patients with severe hypercapnia.

OBJECTIVES: We assessed whether hypercapnia patients with an extremely high level of PaCO2 > or = 60 mmHg were suitable candidates for lung volume reduction in the treatment of severe pulmonary emphysema. METHODS: Of 65 patients undergoing lung volume reduction surgery between May 1993 and August 1997, 6 (9.23%) who had a preoperative rest room air blood gas level of PaCO2 > or = 60 mmHg were selected for study. All patients underwent video-assisted thoracoscopic surgery. Of the 6 with severe hypercapnia, 5 underwent the unilateral procedure and 1 the bilateral procedure. RESULTS: All severe hypercapnia patients showed significant clinical improvement. When assessed at 3 to 6 months after lung volume reduction surgery, significant improvements were seen in mean forced expiratory volume in 1 second (preop: 0.44 +/- 0.04 L; postop: 0.74 +/- 0.20 L; p < 0.01), for a magnitude improvement of 69.8%, and in trapped gas volume (preop: 3.28 +/- 1.11 L; postop: 1.61 +/- 1.02 L; p < 0.05). Arterial blood gas analysis showed significant improvement in PaO2 from 51.1 +/- 6.68 mmHg to 69.8 +/- 7.87 mmHg (p < 0.001) with a decrease in PaCO2 from 70.4 +/- 9.41 mmHg to 46.9 +/- 3.44 mmHg (p < 0.01). Postoperative follow-up averaged 55 months (43-69 months). All but 1 patient remain alive and well. CONCLUSION: Patients with severe pulmonary emphysema accompanied by hypercapnia can gain relief and a better quality of life through volume reduction surgery and should not be excluded from surgical treatment simply based on this condition. Selection should involve a comprehensive view of the patient's condition that includes criteria such as the results of radiographic diagnosis and detailed pulmonary function tests.

Aged↗
PubMed1997

Comparison of 99mTc-Technegas SPECT with 133Xe dynamic SPECT in pulmonary emphysema.

This study was undertaken to compare axial images of 99mTc-Technegas SPECT (Technegas) with those of 133Xe gas dynamic SPECT in patients with pulmonary emphysema. There were 20 patients, 19 males and 1 female. All patients except one ex-smoker were heavy smokers with a mean age of 68.1 years. For Technegas scintigraphy, the patients inhaled 505 MBq 99mTc-Technegas in several tidal volume breaths in the supine position without breath holding. For 133Xe gas scintigraphy, the patients inhaled 370 MBq 133Xe gas. 133Xe gas dynamic SPECT was performed in the equilibrium phase for the last minute of the 3 minute inhalation in a closed circuit, and in the washout phase for 6 minutes of inhalation in a semi-closed circuit, by means of a gamma camera with dual detectors (Picker model Prism 2000). Abnormal findings included heterogeneity, defects and hot spots on Technegas images and on retention images taken 3 minutes after 133Xe gas washout. In 2 of 20 patients, the degree of abnormal findings on Technegas images depended on the area of 133Xe gas retention in the washout phase. In 3 patients, the degree of abnormal findings on both Technegas SPECT and 133Xe gas dynamic SPECT images were equivalent. In the remaining 15 patients, more detailed findings and a greater area were shown by Technegas SPECT than 133Xe gas dynamic SPECT. We conclude that in patients with pulmonary emphysema Technegas SPECT can demonstrate ventilation impairment more easily than 133Xe gas dynamic SPECT.

Aged↗
PubMed1997

Assessment of technetium-99m Technegas scintigraphy for ventilatory impairment in pulmonary emphysema: comparison of planar and SPECT images.

Pulmonary emphysema can be diagnosed easily by X-ray CT (CT) as a low attenuation area. Recently Tc-99m-Technegas (Technegas) has been used for ventilation scintigraphy. The present study was undertaken to assess the usefulness of planar and SPECT images by using Technegas scintigraphy in patients with pulmonary emphysema. Technegas scintigraphy, CT and pulmonary function tests were performed in 20 patients (males, age 32-78 years). We classified the findings of Technegas images into 4 grades. Comparing planar and SPECT images of Technegas, more detailed findings were shown by SPECT than by planar images in mild cases (6 cases, 30%). In more severe cases, findings of SPECT and planar images were equivalent (14 cases, 70%). The degree of abnormal findings obtained by SPECT was equivalent to that obtained by CT in severe cases (6 cases, 30%). SPECT should be excluded in advanced stages as indicated by planar images.

Adult↗
PubMed1996

Congenital lobar emphysema in congenital cytomegalovirus infection.

We report a case of congenital lobar emphysema diagnosed antenatally in an infant of 32 weeks' gestation. Histology and serology confirmed infection with cytomegalovirus (CMV). CMV pneumonitis leading to inflammation and obstruction in the bronchial tree may have resulted in the development of congenital lobar emphysema.

Adult↗
PubMed1999

Successful surgical treatment of impending rupture of thoracoabdominal aortic aneurysm in an elderly patient with severe pulmonary emphysema.

In a case of successful surgery for impending thoracoabdominal aortic aneurysmic rupture, an 83-year-old man with severe pulmonary emphysema was transferred to our hospital diagnosed with impending aneurysmic rupture. The aneurysm had been pointed out 2.5 years ago but surgical repair was not undertaken due to the patient's severe pulmonary emphysema. After admission, computed tomography showed an enlarging saccular thoracoabdominal aortic aneurysm. Emergency surgery was conducted because of severe pain below the left costal margin. We resected the wall of the saccular aortic aneurysm and reconstructed the aorta with an on-lay patch under femoro-femoral bypass and selective visceral organ perfusion. Tracheostomy provided respiratory care on the day following surgery. The patient was weaned from respiratory support 6 days after surgery. Postoperative aortography showed that the reconstructed thoracoabdominal aorta functioned satisfactorily. The patient remains in good health 18 months after surgery.

Aged↗
PubMed1996

[Thoracoscopic methods in treatment of pulmonary emphysema].

Technical advances in the field of endoscopical surgery have widened the spectrum of thoracoscopic operations in the therapy of lung emphysema. Especially in patients who are severely disabled as a result of their reduced lung function, a less surgical trauma should result in better postoperative performance. Bullectomy, which was an integral part of the spectrum in thoracic surgery for a long time, should be performed in a minimally invasive way today. In the American literature, disappointing results have been published concerning laser resection of emphysematous lung tissue. As a result, this method should be abandoned. In contrast, lung volume reduction surgery in patients with diffuse emphysema has caused significant improvement in lung function. The initial approach to this method was a median sternotomy. However, recent experiences in several centers have demonstrated the feasibility and efficiency of a thoracoscopic procedure.

Endoscopes↗
PubMed2007

[Unilateral cervicofacial emphysema after dental treatment. Case report].

Subcutaneous emphysema is characterized by the presence of air or other gases in the subcutis after a spontaenous or traumatic interruption in a air-carrying structure. We describe a patient who developed unilateral facial swelling after dental treatment. Considering the history, differential diagnostic possibilities and the physical examination, we diagnosed cervicofacial emphysema.

Dental Implantation↗
PubMed2007

[Cervical skin emphysema: a rare complication following tonsillectomy].

Emphysema of the subcutis or interstitial compartments of the neck or around the naso- oro- or hypopharynx is caused by a perforation. In most cases, it occurs after surgery in this area; spontaneous emphysema is very rare. The characteristic symptom is crepitation; the extension is best seen on a CT scan. Endoscopic control of the surgical area for other lesions is necessary. An anaerobic, gas producing infection must be ruled out. Antibiotics should be given prophylactically.

Adult↗