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Gastrointestinal sarcoidosis associated with pneumatosis cystoides intestinalis

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World Journal of Gastroenterology 2013年第7期19卷 1135-1139页

作者： Hussein Rahim Mubashir Khan Jay Hudgins Kevin Lee Lei Du Louis Amorosa Department of Medicine University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical SchoolNew BrunswickNJ 08820United States Department of Pathology University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical SchoolNew BrunswickNJ 08820United States

A 39-year-old male reported fevers,weight loss,watery loose stools,and decreased visual acuity in his right eye over the prior five *** was pancytopenic,had an elevated American council on exercise level,total bilirubin,and alkaline *** tomography revealed massive hepatosplenomegaly and emphysematous lung *** biopsy showed non caseating *** patient was diagnosed with extrapulmonary sarcoidosis and was treated with *** patient symptomatically improved but 5 mo later presented with abdominal pain caused by perforation of the *** underwent a cecectomy and pathology revealed pneumatosis cystoides *** represents the first reported association between pneumatosis cystoides intestinalis and *** etiology of pneumatosis cystoides intestinalis in this case was likely multifactorial and involved both effects of the corticosteroids as well as the advanced nature of the gastrointestinal *** this case has the unique features of emphysematous lung changes and pancytopenia which are uncommon with sarcoidosis.

关键词： Sarcoidosis Pneumatosis cystoides intestinalis Pancytopenia emphysema Corticosteroids

FINDINGS OF CHEST RADIOGRAPH AND SPIRAL COMPUTED TOMOGRAPHY IN SWYER-JAMES SYNDROME

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Chinese Medical Sciences Journal 2006年第1期21卷 53-56页

作者： He-shui Shi Fan Yang Ping Han Jin-long Zheng Gan-sheng Feng Yong-hua Liu Zhi-liang Tian Gang Liu Department of Radiology Union Hospital Tongji Medical College Huazhong University of Sciences and Technology Wuhan 430022

Objective To evaluate the value of X-ray and spiral computed tomography (SCT) in the diagnosis of Swyer-James syndrome (SJS).Methods A total of 28 patients, 12 males and 16 females, were studied *** ranged from 11 to 57 years, the mean age was 32 *** patients underwent inspiratory chest X-ray films, 5 with expiratory chest films and 1 with ***, inspiratory and expiratory SCT scans were *** SCT findings were analyzed and compared with X-ray *** SCT demonstrated 56 lobes with hyperlucency and diminished *** size of 51 lobes were smaller and 5 were normal.X-ray films showed that hyperlucency was only in 29 lobes, in which 19 lobes were small-sized and the other 10 lobes *** were 56 lobes with air-trapping on expiratory SCT scans, but only 5 lobes with air-trapping on expiratory X-ray *** in 1 case demonstrated bronchiectasis and bronchiolitis *** showed 24 patients with bronchiectasis, 9 patients with tuberculosis, 10 patients with bronchiolitis, and 2 with segmental *** SCT scan is superior to chest radiography in the diagnosis and differential diagnosis of SJS.

关键词： emphysema lung computed tomography Swyer-James syndrome

Anatomical changes correlated with chronic pain in forensic medicine

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Forensic Sciences Research 2017年第3期2卷 145-151页

作者： Henry J Carson Linn County Medical Examiner’s Office(retired) Cedar RapidsIAUSA

This study was performed to determine the relationships between chronic pain and anatomic changes that may occur in the *** were performed on fatalities that required death investigation in Linn County,IA,or adjacent and nearby *** with chronic pain were older than the control population at the time of ***,hypertension and depression were more common in persons with chronic *** causes of death may also have been related to chronic *** heart,lungs,liver,spleen and kidneys were significantly heavier in persons with chronic pain;emphysema and pleural and abdominal adhesions were more common in persons with chronic *** appear to have been diffuse changes in the body related to chronic *** changes may have been mediated by a number of systemic mechanisms that are involved with chronic pain,including cardiovascular activity,the immune system,the neuroendocrine system and others.

关键词： Forensic medicine pain,chronic depression emphysema adhesions tissue

Interventional pulmonology for chronic inflammatory airway diseases

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2024年第3期2卷 171-181页

作者： Han Yang Si Chen Jiayuan Sun Felix J.F.Herth Department of Respiratory and Critical Care Medicine Shanghai Chest HospitalShanghai Jiao Tong University School of MedicineShanghai 200030China Department of Respiratory Endoscopy Shanghai Chest HospitalShanghai Jiao Tong University School of MedicineShanghai 200030China Shanghai Engineering Research Center of Respiratory Endoscopy Shanghai 200030China Pneumology and Critical Care Medicine ThoraxklinikUniversity of HeidelbergHeidelberg 69126Germany Translational Lung Research Center Heidelberg German Center for Lung ResearchHeidelberg 69126Germany

Chronic inflammatory airway diseases,such as chronic bronchitis,chronic obstructive pulmonary disease,emphysema,and bronchial asthma,pose significant healthcare *** treatments offer promise as valuable complements to the optimal medical therapy recommended by the Global Initiative for Chronic Obstructive Lung Disease guideline and the Global Initiative for Asthma *** directly accessing the airways,these minimally invasive procedures enable precise *** encompass a wide range of techniques including bronchial thermoplasty and targeted lung denervation for both chronic obstructive pulmonary disease and severe asthma,bronchoscopic lung volume reduction(including the use of endobronchial valves,coils,and bronchoscopic thermal vapor ablation),airway bypass and peripheral stent placement for emphysema,bronchial rheoplasty and spray cryotherapy for chronic bronchitis,and other emerging *** interventional treatments aim to improve patients’symptoms by reducing lung volume,alleviating hyperinflation,eliminating vagal innervation,disrupting hyperplastic goblet cells and thus reducing excessive mucus secretion,and weakening submucosal smooth *** review highlights the potential advantages of interventional treatments for chronic inflammatory airway diseases and discusses relevant techniques tailored to specific disease *** overall aim is to assist interventional pulmonologists in selecting the most appropriate techniques for individual patients.

关键词： Chronic inflammatory airway disease Chronic obstructive pulmonary disease Asthma emphysema Bronchoscopic lung volume reduction Targeted lung denervation

In situ forming chitosan-based hydrogel as a lung sealant for biological lung volume reduction

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Science Bulletin 2015年第2期60卷 235-240,I0002页

作者： Titima Songkroh 谢红国于炜婷吕国军刘袖洞王林孙广炜徐小溪马小军 Dalian Institute of Chemical Physics Chinese Academy of Sciences University of Chinese Academy of Sciences College of Environment and Chemical Engineering Dalian University Affiliated Zhongshan Hospital of Dalian University

Biological lung volume reduction （BLVR） using lung sealant has received more attention recently as a new non-surgical approach to emphysema treatment. Many tissue sealants have been studied but only a few have been proposed for BLVR. In this work, we prepared in situ forming chitosan-based hydrogels （CSG） using covalent cross-linking of chitosan and genipin in the cooperation of ionic interaction between chitosan and sodium orthophosphate hydrate （Na3PO4.12H20） and characterized by Fourier transform infrared spectroscopy, scanning electron microscopy and rheological methods. CSG showed short gelation time （8 min）, high swelling ratio （〉100 %） and non-toxicity （3T3 mouse fibroblast cell viability 〉80 %） under physiological conditions. The application of lung sealant for BLVR was tested in a Chinese dog and evaluated by chest computed tomography. After 3 weeks of the installation of CSG in bronchopulmonary segment, the gel formation was detected at a localized region of bronchi and the local atelectasis occurred. Our findings indicate that this chitosan-based hydrogel is a promising new candidate for use as a lung sealant for BLVR.

关键词： Chitosan based hydrogels Biological lung volume reduction Lung sealants emphysema

Chronic Obstructive Pulmonary Disease:Evidence for an Autoimmune Component

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Cellular & Molecular Immunology 2009年第2期6卷 81-86页

作者： Anna M. Stefanska Patrick T. Walsh School of Biochemistry and Immunology Trinity College Dublin Immunology Research Centre School of Biochemistry and Immunology Biotechnology Building Trinity College Dublin

Chronic obstructive pulmonary disease （COPD） is characterized by an irreversible limitation on pulmonary airflow associated with chronic inflammation and mucous hypersecretion （chronic bronchitis） and/or the pathological destruction of alveolar airspaces leading to emphysema. COPD, predominantly as a result of tobacco smoke exposure, represents the fourth leading cause of mortality worldwide and its prevalence is increasing. Despite this, much of the basic mechanisms which contribute to disease progression remain to be elucidated and current therapeutic approaches are, for the most part, based upon alleviating patient symptoms （bronchodilators） as opposed to treating the underlying pathological mechanisms triggered in response to cigarette smoke exposure. The classic disease paradigm suggests that an imbalance of pulmonary matrix proteases versus anti-proteases underlies the tissue destruction and inflammation associated with COPD. However, there is a growing appreciation of the complex and multifaceted nature of the pathological mechanisms associated with disease progression. Recently, there has been mounting evidence indicating that COPD patients exhibit many of the characteristics of a classical autoimmune response. We will discuss current evidence in support of this paradigm and outline how future therapeutic approaches may be tailored to address this.

关键词： COPD autoimmunity emphysema Th 1 Th 17

Clinical study of simultaneous lung volume reduction surgery during resection of pulmonary or esophageal neoplasms

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Chinese Medical Journal 2009年第24期122卷 2973-2976页

作者： TANG Yi-jun WANG Chao-yang WANG Cheng-de DONG Yao-zhong Department of Chest Surgery Yuhuangding Hospital YantaiShandong 264000 China

Background If the emphysema lesions are not symmetrical, unilateral lung volume reduction surgery （LVRS） can be carried out on the more severe side. The aim of this research was to evaluate the feasibility and effects of LVRS performed simultaneously with resection of pulmonary and esophageal neoplasms. Methods Forty-five patients with pulmonary neoplasm and 37 patients with esophageal neoplasm were randomly assigned to group A or group B. In group A, LVRS was performed simultaneously on the same side as thoracotomy. In group B, only tumor resection was performed. The nonfunctional lung area was determined by preoperative chest computed tomography and lung ventilation/perfusion scan. The lung volume removed was about 20% to 30% of the lobes on one side. Preoperative and postoperative indexes including pulmonary function testing variables, arterial blood gas analysis variables, dyspnea scale, 6-minute walk distance, etc., were compared between the groups. Results There were no surgical deaths in this study. The postoperative forced vital capacity in 1 second, PaO2, PaCO2, dyspnea scale, and 6-minute walk distance were improved significantly in group A, whereas these indexes did not change or decreased slightly in group B. Conclusions For tumor patients who have associated emphysema, simultaneous LVRS not only increases the chance of receiving surgical therapy, but also improves the postoperative quality of life of the patient. LVRS has expanded the surgical indication for tumor patients.

关键词： emphysema lung volume reduction surgery pulmonary neoplasm esophageal neoplasm

New therapies for chronic obstructive pulmonary disease,lung regeneration

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World Journal of Respirology 2015年第1期5卷 34-39页

作者： Masaki Fujita Department of Respiratory Medicine Faculty of MedicineFukuoka University

Chronic obstructive pulmonary disease(COPD) is characterized by the presence of airflow limitations that are not fully reversible and is a major cause of chronic morbidity and mortality worldwide. Although there has been extensive research examining the molecular mechanisms underlying the development of COPD, there is no proven clinically effective treatment for promoting recovery from established COPD. At present, regeneration is the only hope for a cure in patients with COPD. In this article, we review current treatments for COPD, focusing particularly on recent advances in lung regeneration based on two major approaches: regeneration-promoting agents and cell therapy. Retinoic acids are the majorfocus among regeneration-promoting agents, while mesenchymal stem cells are the main topic in the field of cell-based therapy. This article aims to provide valuable information for developing new therapies for COPD.

关键词： emphysema Chronic inflammation Stem cell Retinoic acid TypeⅡcells

Factors Influencing Prognosis in the Endoscopic Extraction of Foreign Bodies in Kashmiri Population

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 32-48页

作者： M. S. Sheikh S. Gul Afshan Meelad Mohammad Sheikh S. Bunafsha Government Medical Collage R/o Gulshan Nagar Sector-C Srinagar India Women’s Medical Collage Hospital Dhaka Bangladesh Government Dhaka Medical College Dhaka Bangladesh Department of ENT Head and Neck Surgery Government Medical College Srinagar India

An updated approach in the management of 50 patients with foreign body inhalation is presented. Certain risk factors that lead to complications and mortality due to endoscopic extraction of foreign bodies and thus determine prognosis were identified. Remedial measures to reduce morbidity and mortality due to bronchoscopic removal of foreign bodies are suggested. Fifty patients of suspected foreign body inhalation presented to a Unit of the Department of ENT, Head and Neck Surgery of Government Medical College associated SMHS Hospital Srinagar, Kashmir from March 2007 to June 2017. Of these, 49 patients were subjected to rigid tube bronchoscopy for removal of the aspirated foreign bodies and one coughed out the foreign body spontaneously during admission for bronchoscopy. History of foreign body inhalation was positive in 90% of patients and remaining was mostly referred from Paediatric Units with un-resolving collapse-consolidation of the lung. Whereas plain radiography of the chest and the soft tissues of neck were the primary imaging modality used in this study to detect the inhaled foreign bodies or their effects there are reports of virtual bronchoscopy being done with a multidetector computed tomography scanner in 3D image generation from axial cuts of the internal walls of the tracheobronchial tree in the management of patients suspected with foreign body aspiration. Bronchoscopy is a difficult and potentially hazardous procedure in the infant and young child. Telescopes and telescopic forceps were used during bronchoscopy to facilitate extraction of a foreign body inhaled. The type of a foreign body, site of its enlodgement and the complications encountered during its extraction were noted. During bronchoscopy the patients were connected to an ECG monitor and a pulse oximeter. 80% of the patients with foreign body inhalation were children in the age group of 0 - 5 years. There was a definite history of choking over the foreign body in 88% of the patients lead

关键词： Inhaled Foreign Bodies Collapse-Consolidation Obstructive emphysema Virtual Bronchoscopy Rigid Tube Bronchoscopy Hypoxic Bradycardia Bronchospasm Subglottic Oedema Pneumothorax Tracheostomy Prognosis