Mechanism of short-term improvement in lung function after emphysema resection.

Abstract:

:We prospectively investigated the mechanism of airflow limitation before and after targeted emphysematous resection in 12 consecutively studied adult patients 68 +/- 4 yr of age (mean +/- SD) with very severe COPD undergoing bilateral thoracoscopic stapling techniques. Lung function, static lung elastic recoil, and airway conductance was measured 2 wk before and 5 to 6 mo after surgery. After surgery, there was a significant (p < 0.01) reduction in TLC (9.3 +/- 0.3 [mean +/- SEM] to 7.7 +/- 0.4 L), functional residual capacity, and residual volume. Airway conductance, FVC, and FEV1 (0.7 +/- 0.1 to 1.2 +/- 0.2 L) all improved significantly (p < 0.01). Lung elastic recoil increased markedly at TLC (from 10.3 +/- 0.5 to 14.6 +/- 1.0 cm H20; p < 0.001) as did maximal expiratory airflow in every patient. Analysis of maximal expiratory flow-static elastic recoil pressure curve indicated that conductance of the S segment (Gs) increased from 0.20 +/- 0.03 (mean +/- SEM) to 0.27 +/- 0.03 L/s/cm H20 (p < 0.01), and the critical transmural pressure (Ptm') decreased from 3.1 +/- 0.2 to 2.4 +/- 0.2 cm H20 (p < 0.02). Mean airway conductance increased from 0.14 to 0.22 L/s/cm H20 (p < 0.01). The improvement in maximal expiratory airflow can be primarily attributed to increased lung elastic recoil and its secondary effect on enlarging airway diameter causing increased airway conductance, increased Gs, and decreased Ptm'.

authors

Gelb AF,Zamel N,McKenna RJ Jr,Brenner M

doi

10.1164/ajrccm.154.4.8887590

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

945-51

issue

4 Pt 1

eissn

1073-449X

issn

1535-4970

journal_volume

154

pub_type

杂志文章
  • beta1-Integrins mediate enhancement of airway smooth muscle proliferation by collagen and fibronectin.

    abstract::Airway smooth muscle (ASM) accumulation and enrichment of the extracellular matrix (ECM) with type I collagen and fibronectin are major pathologic features of airway remodeling in asthma. These ECM components confer enhanced ASM proliferation in vitro, but a requirement for specific integrin ECM receptors has not been...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200408-1046OC

    authors: Nguyen TT,Ward JP,Hirst SJ

    更新日期:2005-02-01 00:00:00

  • Heterogeneous increase in CD34-positive alveolar capillaries in idiopathic pulmonary fibrosis.

    abstract::To elucidate the apparent contradictions in vascular remodeling in the lungs of patients with idiopathic pulmonary fibrosis, we evaluated alveolar vascularity in relation to the various degrees of fibrosis in surgically biopsied lungs of usual interstitial pneumonia. Alveolar capillary endothelial cells were intensely...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200308-1111OC

    authors: Ebina M,Shimizukawa M,Shibata N,Kimura Y,Suzuki T,Endo M,Sasano H,Kondo T,Nukiwa T

    更新日期:2004-06-01 00:00:00

  • Inhaled tryptase causes bronchoconstriction in sheep via histamine release.

    abstract::Allergen-induced bronchoconstriction involves mast cell activation. Tryptase is a mast cell serine protease that is released during this process, but little is known about the action of tryptase in the airway. The purpose of this study was to determine: (1) if aerosolized tryptase causes bronchoconstriction, and (2) t...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.154.3.8810600

    authors: Molinari JF,Scuri M,Moore WR,Clark J,Tanaka R,Abraham WM

    更新日期:1996-09-01 00:00:00

  • Effect of the beta-agonist clenbuterol on dexamethasone-induced diaphragm dysfunction in rabbits.

    abstract::The present study was designed to examine whether clenbuterol (CLEN) could reduce dexamethasone (DEX)-induced diaphragm dysfunction. We studied four groups of New Zealand white (NZW) rabbits, each receiving one of the following daily injections subcutaneously for 2 wk: saline (control), DEX 3 mg/kg, DEX 3 mg/kg + CLEN...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.154.6.8970370

    authors: Jiang TX,Cairns A,Road JD,Wilcox PG

    更新日期:1996-12-01 00:00:00

  • Epithelial Na(+) channel (ENaC) expression in the developing normal and abnormal human perinatal lung.

    abstract::Impaired lung epithelial Na(+) channel (ENaC) activity at the time of birth results in respiratory distress. To investigate potential mechanisms, the ontogeny and cellular distribution of the alphaENaC subunit mRNA expression was studied in normal, immature, and abnormal (hypoplastic) human fetal lungs using nonradioi...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.161.4.9905064

    authors: Smith DE,Otulakowski G,Yeger H,Post M,Cutz E,O'Brodovich HM

    更新日期:2000-04-01 00:00:00

  • Indoor air pollution and asthma. Results from a panel study.

    abstract::Although there is abundant clinical evidence of asthmatic responses to indoor aeroallergens, the symptomatic impacts of other common indoor air pollutants from gas stoves, fireplaces, and environmental tobacco smoke have been less well characterized. These combustion sources produce a complex mixture of pollutants, ma...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.149.6.8004290

    authors: Ostro BD,Lipsett MJ,Mann JK,Wiener MB,Selner J

    更新日期:1994-06-01 00:00:00

  • Analysis of plasma-protein leakage and local secretion in sputum from patients with asthma and chronic obstructive pulmonary disease.

    abstract::In order to assess the usefulness of sputum analysis in studying plasma-protein exudation and local secretion of proteins in the airways, we measured specific proteins in the sputum sol phase (SSP) and sputum gel phase (SGP) from patients with stable asthma or chronic obstructive pulmonary disease (COPD). Protein leve...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.150.6.7952610

    authors: Schoonbrood DF,Lutter R,Habets FJ,Roos CM,Jansen HM,Out TA

    更新日期:1994-12-01 00:00:00

  • Ventilation-induced neutrophil infiltration depends on c-Jun N-terminal kinase.

    abstract::Positive pressure ventilation with large VTs has been shown to cause release of cytokines, including macrophage inflammatory protein-2 (MIP-2), a functional equivalent of human interleukin-8. The mechanisms regulating ventilation-induced cytokine production are unclear. Based on our previous in vitro model of lung cel...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200305-660OC

    authors: Li LF,Yu L,Quinn DA

    更新日期:2004-02-15 00:00:00

  • Children's urinary phthalate metabolites and fractional exhaled nitric oxide in an urban cohort.

    abstract:RATIONALE:Phthalates are used widely in consumer products. Exposure to several phthalates has been associated with respiratory symptoms and decreased lung function. Associations between children's phthalate exposures and fractional exhaled nitric oxide (Fe(NO)), a biomarker of airway inflammation, have not been examine...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201203-0398OC

    authors: Just AC,Whyatt RM,Miller RL,Rundle AG,Chen Q,Calafat AM,Divjan A,Rosa MJ,Zhang H,Perera FP,Goldstein IF,Perzanowski MS

    更新日期:2012-11-01 00:00:00

  • Disrupted prenatal maternal cortisol, maternal obesity, and childhood wheeze. Insights into prenatal programming.

    abstract:RATIONALE:Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. OBJECTIVES:We examined associations among prenatal maternal cortisol profiles, maternal obesity, and repeated wheeze up to age 2 years (n = 261). METHODS:Salivary cortisol was collected five times per day over 3 days ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1164/rccm.201208-1530OC

    authors: Wright RJ,Fisher K,Chiu YH,Wright RO,Fein R,Cohen S,Coull BA

    更新日期:2013-06-01 00:00:00

  • Genome-wide association study identifies BICD1 as a susceptibility gene for emphysema.

    abstract:RATIONALE:chronic obstructive pulmonary disease (COPD), characterized by airflow limitation, is a disorder with high phenotypic and genetic heterogeneity. Pulmonary emphysema is a major but variable component of COPD; familial data suggest that different components of COPD, such as emphysema, may be influenced by speci...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1164/rccm.201004-0541OC

    authors: Kong X,Cho MH,Anderson W,Coxson HO,Muller N,Washko G,Hoffman EA,Bakke P,Gulsvik A,Lomas DA,Silverman EK,Pillai SG,ECLIPSE Study NETT Investigators.

    更新日期:2011-01-01 00:00:00

  • Nasal high-flow versus Venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome.

    abstract:RATIONALE:Oxygen is commonly administered after extubation. Although several devices are available, data about their clinical efficacy are scarce. OBJECTIVES:To compare the effects of the Venturi mask and the nasal high-flow (NHF) therapy on PaO2/FiO2SET ratio after extubation. Secondary endpoints were to assess effec...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1164/rccm.201402-0364OC

    authors: Maggiore SM,Idone FA,Vaschetto R,Festa R,Cataldo A,Antonicelli F,Montini L,De Gaetano A,Navalesi P,Antonelli M

    更新日期:2014-08-01 00:00:00

  • Airway inflammation in nonasthmatic subjects with chronic cough.

    abstract::The physiopathology of chronic cough remains obscure. We evaluated the possibility that chronic cough in nonasthmatic subjects is associated with airway inflammation, and if this is so, what the relationship between this inflammation and the possible etiology of cough might be, as well as its response to inhaled stero...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1164/ajrccm.149.2.8306050

    authors: Boulet LP,Milot J,Boutet M,St Georges F,Laviolette M

    更新日期:1994-02-01 00:00:00

  • Objective predictors of response for staple versus laser emphysematous lung reduction.

    abstract::Recently described surgical approaches to the treatment of emphysema, including buttressed stapled volume reduction and laser coagulation, are associated with variable clinical outcomes. We examined objective preoperative factors as predictors of response to treatment in patients enrolled in a randomized trial of stap...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1164/ajrccm.155.4.9105070

    authors: Brenner M,McKenna R Jr,Gelb A,Osann K,Schein MJ,Panzera J,Wong H,Berns MW,Wilson AF

    更新日期:1997-04-01 00:00:00

  • Ethnic differences in adolescent lung function: anthropometric, socioeconomic, and psychosocial factors.

    abstract:RATIONALE:The relative contribution of body proportion and social exposures to ethnic differences in lung function has not previously been reported in the United Kingdom. OBJECTIVES:To examine ethnic differences in lung function in relation to anthropometry and social and psychosocial factors in early adolescence. ME...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200706-867OC

    authors: Whitrow MJ,Harding S

    更新日期:2008-06-01 00:00:00

  • Airway inflammation in childhood asthma.

    abstract::Airway pathology has been extensively investigated in adulthood asthma, whereas only few studies examined bronchial biopsies in childhood asthma. To evaluate the airway pathology in children with asthma, we analyzed bronchial biopsies obtained from 23 children undergoing bronchoscopy for clinical indications other tha...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200305-650OC

    authors: Barbato A,Turato G,Baraldo S,Bazzan E,Calabrese F,Tura M,Zuin R,Beghe B,Maestrelli P,Fabbri LM,Saetta M

    更新日期:2003-10-01 00:00:00

  • Elevated serum levels of mucin-associated antigen in patients with acute respiratory distress syndrome.

    abstract::Increased serum levels of mucin-associated antigen have been previously demonstrated in patients with cystic fibrosis (CF) and interstitial pneumonia, and in lung-transplant recipients. The present study assessed the serum airway mucin levels in patients with acute respiratory distress syndrome (ARDS). An enzyme-linke...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.156.5.9701061

    authors: Shih JY,Yang SC,Yu CJ,Wu HD,Liaw YS,Wu R,Yang PC

    更新日期:1997-11-01 00:00:00

  • Mutations of the cystic fibrosis gene and intermediate sweat chloride levels in children.

    abstract::The incidence of mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene in children with intermediate sweat chloride levels is unknown. The results of 2,349 sweat tests performed at two Belgian university hospitals were reviewed. Intermediate chloride concentrations were observed in 98 subjec...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1164/ajrccm.165.6.2104073

    authors: Lebecque P,Leal T,De Boeck C,Jaspers M,Cuppens H,Cassiman JJ

    更新日期:2002-03-15 00:00:00

  • Mucus Plugs and Emphysema in the Pathophysiology of Airflow Obstruction and Hypoxemia in Smokers.

    abstract:BACKGROUND:The relative roles of mucus plugs and emphysema in mechanisms of airflow limitation and hypoxemia in smokers with chronic obstructive pulmonary disease (COPD) are uncertain. METHODS:We analyzed computed tomography (CT) lung images and lung function in participants in the Subpopulations and Intermediate Outc...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.202006-2248OC

    authors: Dunican EM,Elicker BM,Henry T,Gierada DS,Schiebler ML,Anderson W,Barjaktarevic I,Barr RG,Bleecker ER,Boucher RC,Bowler RP,Christenson SA,Comellas A,Cooper CB,Couper D,Criner GJ,Dransfield M,Doerschuk CM,Drummond MB,

    更新日期:2020-11-12 00:00:00

  • Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.

    abstract::Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep- disordered breathing and self-reported CVD in 6,424 free-l...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1164/ajrccm.163.1.2001008

    authors: Shahar E,Whitney CW,Redline S,Lee ET,Newman AB,Nieto FJ,O'Connor GT,Boland LL,Schwartz JE,Samet JM

    更新日期:2001-01-01 00:00:00

  • An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease.

    abstract:BACKGROUND:The clinical utility of bronchoalveolar lavage fluid (BAL) cell analysis for the diagnosis and management of patients with interstitial lung disease (ILD) has been a subject of debate and controversy. The American Thoracic Society (ATS) sponsored a committee of international experts to examine all relevant l...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,实务指引

    doi:10.1164/rccm.201202-0320ST

    authors: Meyer KC,Raghu G,Baughman RP,Brown KK,Costabel U,du Bois RM,Drent M,Haslam PL,Kim DS,Nagai S,Rottoli P,Saltini C,Selman M,Strange C,Wood B,American Thoracic Society Committee on BAL in Interstitial Lung Disease.

    更新日期:2012-05-01 00:00:00

  • Maximal oxygen uptake and severity of disease in lymphangioleiomyomatosis.

    abstract::Lymphangioleiomyomatosis (LAM), a disease that occurs primarily in women, is characterized by cystic lung lesions causing respiratory failure, which may require lung transplantation. Lung diffusion (DLCO) and/or FEV1 are decreased, but frequently not in parallel with each other. Because cardiopulmonary exercise testin...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200206-593OC

    authors: Taveira-DaSilva AM,Stylianou MP,Hedin CJ,Kristof AS,Avila NA,Rabel A,Travis WD,Moss J

    更新日期:2003-12-15 00:00:00

  • Central Sleep-disordered Breathing Predicts Incident Atrial Fibrillation in Older Men.

    abstract:RATIONALE:Although research supports a sleep-disordered breathing and atrial fibrillation association, prospective data examining sleep-disordered breathing predicting incident atrial fibrillation are lacking. OBJECTIVES:To investigate sleep-disordered breathing indices as predictors of incident atrial fibrillation. ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1164/rccm.201508-1523OC

    authors: May AM,Blackwell T,Stone PH,Stone KL,Cawthon PM,Sauer WH,Varosy PD,Redline S,Mehra R,MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study Group.

    更新日期:2016-04-01 00:00:00

  • Integrating mortality and morbidity outcomes: using quality-adjusted life years in critical care trials.

    abstract:RATIONALE:Outcome measures that integrate mortality and morbidity, like quality-adjusted life years (QALYs), have been proposed for critical care clinical trials. OBJECTIVES:We sought to describe the distribution of QALYs in critically ill patients and estimate sample size requirements for a hypothetical trial using Q...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201206-1057OC

    authors: Ferguson ND,Scales DC,Pinto R,Wilcox ME,Cook DJ,Guyatt GH,Schünemann HJ,Marshall JC,Herridge MS,Meade MO,Canadian Critical Care Trials Group.

    更新日期:2013-02-01 00:00:00

  • Gene expression profiles of acute exacerbations of idiopathic pulmonary fibrosis.

    abstract:RATIONALE:The molecular mechanisms underlying acute exacerbations of idiopathic pulmonary fibrosis (IPF) are poorly understood. We studied the global gene expression signature of acute exacerbations of IPF. OBJECTIVES:To understand the gene expression patterns of acute exacerbations of IPF. METHODS:RNA was extracted ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200810-1596OC

    authors: Konishi K,Gibson KF,Lindell KO,Richards TJ,Zhang Y,Dhir R,Bisceglia M,Gilbert S,Yousem SA,Song JW,Kim DS,Kaminski N

    更新日期:2009-07-15 00:00:00

  • Genetic Admixture and Survival in Diverse Populations with Pulmonary Arterial Hypertension.

    abstract::Rationale: Limited information is available on racial/ethnic differences in pulmonary arterial hypertension (PAH).Objectives: Determine effects of race/ethnicity and ancestry on mortality and disease outcomes in diverse patients with PAH.Methods: Patients with Group 1 PAH were included from two national registries wit...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201907-1447OC

    authors: Karnes JH,Wiener HW,Schwantes-An TH,Natarajan B,Sweatt AJ,Chaturvedi A,Arora A,Batai K,Nair V,Steiner HE,Giles JB,Yu J,Hosseini M,Pauciulo MW,Lutz KA,Coleman AW,Feldman J,Vanderpool R,Tang H,Garcia JGN,Yuan JX,K

    更新日期:2020-06-01 00:00:00

  • Dietary antioxidants and asthma in adults: population-based case-control study.

    abstract::A protective role for dietary antioxidants in asthma has been proposed. However, epidemiological evidence to implicate antioxidant vitamins is weak, and data on the role of flavonoid-rich foods and antioxidant trace elements are lacking. We carried out a population-based case-control study in South London, UK, to inve...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.164.10.2104061

    authors: Shaheen SO,Sterne JA,Thompson RL,Songhurst CE,Margetts BM,Burney PG

    更新日期:2001-11-15 00:00:00

  • WITHDRAWN: Proposal for Initiative of Evidence-based Treatment of COVID-19 Patients with Worsening Hypoxia.

    abstract::Ahead of Print article withdrawn by publisher. ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.202009-3684CP

    authors: Kanwar BA

    更新日期:2020-10-07 00:00:00

  • Nonatopic children with multitrigger wheezing have airway pathology comparable to atopic asthma.

    abstract:RATIONALE:Epidemiologic studies have shown that, in atopic children, wheezing is more likely to persist into adulthood, eventually becoming asthma, whereas it appears to resolve by adolescence in nonatopic children. OBJECTIVES:To investigate whether among children with multitrigger wheeze responsive to bronchodilators...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200712-1818OC

    authors: Turato G,Barbato A,Baraldo S,Zanin ME,Bazzan E,Lokar-Oliani K,Calabrese F,Panizzolo C,Snijders D,Maestrelli P,Zuin R,Fabbri LM,Saetta M

    更新日期:2008-09-01 00:00:00

  • Respiratory effects of low-level photochemical air pollution in amateur cyclists.

    abstract::A group of male amateur cyclists was studied in the summer of 1991 in the east of the Netherlands. Lung function was measured before and after training sessions or competitive races on a number of occasions. Continuous heart rate monitors were employed to document exercise levels. Heart rate averaged 161 beats/min dur...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.150.4.7921470

    authors: Brunekreef B,Hoek G,Breugelmans O,Leentvaar M

    更新日期:1994-10-01 00:00:00