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1

Griva, N. A., P. V. Gavrilov, I. A. Nikitina, L. D. Kiryukhina, A. N. Narkevich, and E. G. Sokolovich. "Impact of Emphysema Subtypes and Volume on Lung Ventilation and Gas Exchange Functions as Evidenced by Computed Tomography." Journal of radiology and nuclear medicine 102, no. 6 (February 3, 2022): 349–58. http://dx.doi.org/10.20862/0042-4676-2021-102-6-349-358.

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Objective: to characterize the relationship between the subtype and volume of pulmonary emphysema on the indicators of lung ventilation and gas exchange functions. Material and methods. The data of radiation and functional studies were analyzed in 50 patients. The inclusion criteria were chronic obstructive pulmonary disease and emphysema, which had been diagnosed by computed tomography (CT) and confirmed by two radiologists; comprehensive pulmonary function studies, including spirometry and body plethysmography, were performed; diffusion capacity was measured using a single-breath method, involving inhalation of carbon monoxide, and a breath hold. Patients with primary pulmonary emphysema, any history of pulmonary surgery, and emphysema concurrent with other lung X-ray syndromes (consolidation, cavity) were excluded. CT was performed with a 1-mm thick slice and standard scanning parameters on Toshiba tomographs (Japan). Pulmonary function was tested using a MasterScreen Body Diffusion expert diagnostic unit (VIASYS Healthcare, Germany) in accordance with the criteria for correct pulmonary functional tests proposed by a joint group of experts from the American Thoracic Society and the European Respiratory Society. Volumetric analysis of emphysema was performed using the Lung Volume Analysis software package (Toshiba, Japan). In the study, there was a predominance of male patients (n = 42 (84%)), mainly in the 61-70 age group. Results. The isolated type of emphysema was rare: centrilobular and paraseptal emphysemas were seen in 3 (6%) and 2 (4%) patients, respectively. The mixed type of emphysema was detected in 90% of cases; 33 (66%) patients having a predominant centrilobular component constituted a large proportion. It was determined that as the volume of emphysema increased, the patency of the airways worsened, the static pulmonary volumes increased, the lungs were hyperinflated, pulmonary gas exchange worsened, the bronchial resistance slightly increased during calm breathing. No statistically significant results were found from the point of view of correlations between the volume of emphysema and other parameters of pulmonary function. Conclusion. An increase in the volume of emphysema deteriorates pulmonary function; the greatest contribution to the overall picture is made by the patients with a mixed type of emphysema with a predominance of the centrilobular component.
2

Petty, Thomas L. "Emphysema." Postgraduate Medicine 86, no. 6 (November 1989): 212–13. http://dx.doi.org/10.1080/00325481.1989.11704489.

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3

Slebos, Dirk-Jan, Karin Klooster, and Michiel Erasmus. "Emphysema!" American Journal of Respiratory and Critical Care Medicine 186, no. 2 (July 15, 2012): 197. http://dx.doi.org/10.1164/rccm.201201-0067im.

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4

Mahta, Ali, Alexander E. Merkler, Michael E. Reznik, Jaclyn E. Burch, Shadi Yaghi, Frank W. Sellke, Karen L. Furie, and Hooman Kamel. "Emphysema." Stroke 50, no. 4 (April 2019): 992–94. http://dx.doi.org/10.1161/strokeaha.118.024660.

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Background and Purpose— Protease/antiprotease imbalance is implicated in the pathogenesis of emphysema and may also lead to vessel wall weakening, aneurysm development, and rupture. However, it is unclear whether emphysema is associated with cerebral and aortic aneurysm rupture. Methods— We performed a retrospective cohort study using outpatient and inpatient claims data from 2008 to 2014 from a nationally representative sample of Medicare beneficiaries ≥66 years of age. Our predictor variable was emphysema, and our outcome was hospitalization for either aneurysmal subarachnoid hemorrhage or a ruptured aortic aneurysm. All predictors and outcomes were defined using previously reported International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithms. Survival statistics and Cox regression were used to compare risk between patients with and without emphysema. Results— We identified 1 670 915 patients, of whom 133 972 had a diagnosis of emphysema. During a mean follow-up period of 4.3 (±1.9) years, we identified 4835 cases of aneurysm rupture, 433 of which occurred in patients with emphysema. The annual incidence of aneurysm rupture was 6.5 (95% CI, 6.4–6.8) per 10 000 in patients without emphysema and 14.6 (95% CI, 13.3–16.0) per 10 000 in patients with emphysema. After adjustment for demographics and known risk factors for aneurysmal disease, emphysema was independently associated with aneurysm rupture (hazard ratio, 1.7; 95% CI, 1.5–1.9). Emphysema was associated with both aneurysmal subarachnoid hemorrhage (hazard ratio, 1.5; 95% CI, 1.3–1.7) and ruptured aortic aneurysm (hazard ratio, 2.3; 95% CI, 1.9–2.8). Conclusions— Patients with emphysema face an increased risk of developing subarachnoid hemorrhage and aortic aneurysm rupture, potentially consistent with shared pathways in pathogenesis.
5

Subramanyam, Rajeev, Andrew Costandi, and Mohamed Mahmoud. "Congenital lobar emphysema and tension emphysema." Journal of Clinical Anesthesia 29 (March 2016): 17–18. http://dx.doi.org/10.1016/j.jclinane.2015.10.008.

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6

Yane, Katsunari, Osamu Tanaka, and Takashi Matsunaga. "A Case of Spontaneous Mediastinal Emphysema with Subcutaneous Emphysema and Pharyngeal Emphysema." Practica oto-rhino-laryngologica. Suppl. 1990, Supplement37 (1990): 183–87. http://dx.doi.org/10.5631/jibirinsuppl1986.1990.supplement37_183.

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7

Ural, Alper. "An Overlooked Diagnosis: Orbital Emphysema." International Journal of Transplantation & Plastic Surgery 5, no. 2 (2021): 1–3. http://dx.doi.org/10.23880/ijtps-16000162.

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This case report aims to describe a usually overlooked diagnosis of orbital emphysema in a 29-year- old female patient with progressive palpebral edema, crepitus and restriction in the visual field. Orbital Emphysema is a condition that clinicians must be aware of since severe cases may even lead to blindness.
8

Putri, Ayu Vidya, Seto Adiantoro, and Harmas Yazid Yusuf. "Subcutaneuous emphysema as a complication of tooth extraction: Case Report." International Journal of Oral Health Dentistry 8, no. 1 (March 15, 2022): 67–71. http://dx.doi.org/10.18231/j.ijohd.2022.014.

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Subcutaneous emphysema is an uncommon complication of dental procedures. This complication arises when air forced beneath the tissue. In dentistry it may appear with the use of high-speed bur and could cause a serious complication including airway obstruction. This case report highlights a complication during dental procedure to give information for the clinician the factors, diagnosis, and management of subcutaneous emphysema.A 33 years old male patient with difficulty in breathing and swelling at right lower jaw, neck and chest region. The swelling occurred about 2 hours before admission during tooth extraction of second right lower molar using a high-speed bur about 30 minutes, then he started to feel difficulty in breathing with swelling at right lower jaw, neck and chest region occurred and pain. Then he was transferred to Hasan Sadikin Emergency Department for further treatment. The patient was diagnosed with subcutaneous emphysema at right lower jaw, neck and chest region due to suspect iatrogenic. The management of this patient was conservative treatment with oxygenation 3 lpm, close observation vital sign and wide emphysema, IVFD ringer lactate 1500 cc/ 24 hours, medication with Ceftriaxone 1 gr, Ketorolac 30 mg, Omeprazole 20 mg intravenous and being hospitalized for 4 days. After general condition stable he was performed tooth extraction.Iatrogenic subcutaneous emphysema could be a serious and potentially life-threatening, so dentist has to be more careful while using high-speed bur for tooth extraction.
9

Stephens, Julie A., Nolie K. Parnell, Kevin Clarke, William E. Blevins, and Dennis DeNicola. "Subcutaneous Emphysema, Pneumomediastinum, and Pulmonary Emphysema in a Young Schipperke." Journal of the American Animal Hospital Association 38, no. 2 (March 1, 2002): 121–24. http://dx.doi.org/10.5326/0380121.

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A 4-month-old, intact female schipperke was presented for evaluation and treatment of subcutaneous (SC) emphysema. Radiographs revealed pneumomediastinum and SC emphysema. Sequential radiographs confirmed a worsening of the SC emphysema. Extensive, nonsurgical evaluation failed to reveal the source of the air within the mediastinum. Exploratory thoracotomy revealed an emphysematous right middle lung lobe. Lobectomy of the right middle lung lobe resolved both the pneumomediastinum and SC emphysema. Histopathological evaluation confirmed pulmonary emphysema. A variation of congenital pulmonary emphysema was considered in this case.
10

Meier-Schroers, Michael, Alois Sprinkart, Manuel Becker, Rami Homsi, and Daniel Thomas. "Quantitative and Qualitative Assessment of Pulmonary Emphysema with T2-Weighted PROPELLER MRI in a High-Risk Population Compared to Low-Dose CT." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 190, no. 08 (March 7, 2018): 733–39. http://dx.doi.org/10.1055/a-0577-5619.

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Purpose To determine the suitability of T2-weighted PROPELLER MRI for the assessment of pulmonary emphysema. Materials and Methods 60 participants in a lung cancer screening program (30 subjects with pulmonary emphysema, and 30 control subjects without emphysema) were included for this retrospective study. All subjects were examined with low-dose CT (LDCT) and MRI within the screening program. The use of a T2-weighted PROPELLER sequence for the assessment of emphysema was analyzed and correlated with the results of LDCT. The presence and the extent of pulmonary emphysema were first assessed qualitatively using a three-point score, and then quantitatively with a semi-automated software program to obtain emphysema indices. Results All 30 cases with pulmonary emphysema were accurately detected by MRI. There were 3 cases with emphysema according to MRI without emphysematous changes on LDCT (false-positive results). The qualitative scores as well as the emphysema indices were significantly higher in the emphysema group compared to the control group for MRI and LDCT (p < 0.001). Both the scores and the indices correlated significantly between MRI and LDCT (qualitative score of severity: r = 0.912/p < 0.001 in the emphysema group and r = 0.668/p < 0.001 in the control group; emphysema index: r = 0.960/p < 0.001 in the emphysema group and r = 0.746/p < 0.001 in the control group). Conclusion The presence and the extent of pulmonary emphysema may be assessed qualitatively and quantitatively by T2-weighted PROPELLER MRI with very good correlation to LDCT. Key Points: Citation Format
11

Jacob, Joseph, Brian J. Bartholmai, Srinivasan Rajagopalan, Maria Kokosi, Toby M. Maher, Arjun Nair, Ronald Karwoski, et al. "Functional and prognostic effects when emphysema complicates idiopathic pulmonary fibrosis." European Respiratory Journal 50, no. 1 (July 2017): 1700379. http://dx.doi.org/10.1183/13993003.00379-2017.

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This study aimed to investigate whether the combination of fibrosis and emphysema has a greater effect than the sum of its parts on functional indices and outcome in idiopathic pulmonary fibrosis (IPF), using visual and computer-based (CALIPER) computed tomography (CT) analysis.Consecutive patients (n=272) with a multidisciplinary IPF diagnosis had the extent of interstitial lung disease (ILD) scored visually and by CALIPER. Visually scored emphysema was subcategorised as isolated or mixed with fibrotic lung. The CT scores were evaluated against functional indices forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide (DLCO), transfer coefficient of the lung for carbon monoxide (KCO), composite physiologic index (CPI)) and mortality.The presence and extent of emphysema had no impact on survival. Results were maintained following correction for age, gender, smoking status and baseline severity usingDLCO, and combined visual emphysema and ILD extent. Visual emphysema quantitation indicated that relative preservation of lung volumes (FVC) resulted from tractionally dilated airways within fibrotic lung, ventilating areas of admixed emphysema (p<0.0001), with no independent effect on FVC from isolated emphysema. Conversely, only isolated emphysema (p<0.0001) reduced gas transfer (DLCO).There is no prognostic impact of emphysema in IPF, beyond that explained by the additive extents of both fibrosis and emphysema. With respect to the location of pulmonary fibrosis, emphysema distribution determines the functional effects of emphysema.
12

Lin, Kyawzaw, Sandar Linn, Aung Naing Lin, Moshe Fuksbrumer, and Madhavi Reddy. "Gastric Emphysema." Gastroenterology, Hepatology & Digestive Disorders 1, no. 1 (March 30, 2018): 1–2. http://dx.doi.org/10.33425/2639-9334.1005.

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13

Liang, G., LC Zeng, MG Xie, MX Zhang, and ZH Hou. "Gastric emphysema." Hong Kong Medical Journal 27, no. 5 (October 25, 2021): 373.e1–373.e2. http://dx.doi.org/10.12809/hkmj208885.

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14

Hamdar, Hiba, Danielle Abou Khater, and Rawan Demachkie. "Pneumoscrotal Emphysema." Electronic Journal of Medical and Dental Studies 12, no. 1 (March 6, 2022): em0095. http://dx.doi.org/10.29333/ejmds/11873.

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15

Baskaran, AntonyArokiadass, Latha Balasubramaniam, Tanuja Britto, and PhilipA Thomas. "Subconjunctival emphysema." TNOA Journal of Ophthalmic Science and Research 57, no. 2 (2019): 184. http://dx.doi.org/10.4103/tjosr.tjosr_30_19.

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16

Spouge, David, John R. Mayo, Wellington Cardoso, and Nestor L. Müller. "Panacinar Emphysema." Journal of Computer Assisted Tomography 17, no. 5 (September 1993): 710–13. http://dx.doi.org/10.1097/00004728-199309000-00008.

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17

Fernandes, Breno dos Reis, Gabriel Mulinari-Santos, Roberta Okamoto, Oswaldo Belloti Neto, Sydney Mandarino, Jonathan Silva, and Rodrigo dos Santos Pereira. "Orbital Emphysema." Journal of Craniofacial Surgery 29, no. 6 (September 2018): e624-e625. http://dx.doi.org/10.1097/scs.0000000000004753.

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18

Roelofs, Kelsey A., Victoria Starks, and Michael K. Yoon. "Orbital Emphysema." Ophthalmic Plastic and Reconstructive Surgery 35, no. 1 (2019): 1–6. http://dx.doi.org/10.1097/iop.0000000000001216.

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19

Satoh, Shiro, Yoshio Kitazume, Shinichi Taura, Yuji Kimula, Toshizumi Shirai, and Shinichi Ohdama. "Pulmonary Emphysema." Journal of Computer Assisted Tomography 32, no. 4 (July 2008): 576–82. http://dx.doi.org/10.1097/rct.0b013e31814b276a.

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20

Teramoto, Shinj, and Yoshinosuke Fukuchi. "Bullous emphysema." Current Opinion in Pulmonary Medicine 2, no. 2 (March 1996): 90–96. http://dx.doi.org/10.1097/00063198-199603000-00003.

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21

Hunts, John H., James R. Patrinely, John B. Holds, and Richard L. Anderson. "Orbital Emphysema." Ophthalmology 101, no. 5 (May 1994): 960–66. http://dx.doi.org/10.1016/s0161-6420(94)31230-9.

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22

Chotirmall, S. H., and R. K. Morgan. "Subcutaneous emphysema." Case Reports 2014, mar18 1 (March 18, 2014): bcr2013201127. http://dx.doi.org/10.1136/bcr-2013-201127.

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23

Gupta, Rahul K., Abhaya Gupta, Beejal Sanghvi, Sandesh V. Parelkar, and Pankaj Mishra. "Subcutaneous Emphysema." Journal of Bronchology & Interventional Pulmonology 16, no. 2 (April 2009): 124–26. http://dx.doi.org/10.1097/lbr.0b013e3181a39b6f.

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24

Hutchison, D. C. S. "Pulmonary emphysema." BMJ 309, no. 6964 (November 12, 1994): 1244–45. http://dx.doi.org/10.1136/bmj.309.6964.1244.

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25

Tsai, Shih-Hung, and Shi-Jye Chu. "Orbital Emphysema." Journal of Trauma: Injury, Infection, and Critical Care 65, no. 5 (November 2008): 1200. http://dx.doi.org/10.1097/01.ta.0000236035.18788.9c.

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26

Hashimoto, Toru, Yuuki Okamatsu, Yohei Hyakuna, Yasuhiro Sedutsu, Kenji Miyata, Hideki Origuchi, Masahiro Mohri, and Hideo Yamamoto. "Perianeurysmal Emphysema." Circulation 129, no. 18 (May 6, 2014): 1900–1901. http://dx.doi.org/10.1161/circulationaha.114.009337.

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27

Demedts, Maurits, and Jef Aumann. "Early Emphysema." Chest 94, no. 2 (August 1988): 337–42. http://dx.doi.org/10.1378/chest.94.2.337.

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28

Garza, Ulises, and Christopher Gayer. "Gastric Emphysema." New England Journal of Medicine 370, no. 22 (May 29, 2014): e33. http://dx.doi.org/10.1056/nejmicm1310201.

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29

Lee, Scott L., David M. Mills, Dale R. Meyer, and Steven M. Silver. "Orbital Emphysema." Ophthalmology 113, no. 11 (November 2006): 2113.e1–2113.e2. http://dx.doi.org/10.1016/j.ophtha.2006.06.013.

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30

D'Cruz, Rachel, and Sherif Emil. "Gastroduodenal emphysema." Journal of Pediatric Surgery 43, no. 11 (November 2008): 2121–23. http://dx.doi.org/10.1016/j.jpedsurg.2008.07.019.

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31

Tetley, T. D. "Emphysema revisited." Respiratory Medicine 86, no. 3 (May 1992): 187–93. http://dx.doi.org/10.1016/s0954-6111(06)80053-3.

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32

Spodick, David H. "Pulmonary Emphysema." American Journal of Geriatric Cardiology 16, no. 6 (November 2007): 390. http://dx.doi.org/10.1111/j.1076-7460.2007.06217.x.

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33

Murnan, Sean D., Jill Miller, and Anne Kuhn. "Gastric Emphysema." Pediatric Emergency Care 35, no. 8 (August 2019): e152-e153. http://dx.doi.org/10.1097/pec.0000000000001202.

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34

Hunts, J. H., J. R. Patrinely, J. B. Holds, and R. L. Anderson. "Orbital Emphysema." Ophthalmic Plastic & Reconstructive Surgery 11, no. 2 (June 1995): 147. http://dx.doi.org/10.1097/00002341-199506000-00026.

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35

Woolley, P. D. "Subconjunctival emphysema." Postgraduate Medical Journal 61, no. 719 (September 1, 1985): 805. http://dx.doi.org/10.1136/pgmj.61.719.805.

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36

Weissberg, Dov. "Subcutaneous Emphysema." Chest 105, no. 1 (January 1994): 321. http://dx.doi.org/10.1378/chest.105.1.321a.

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37

Sheu, C. C., J. R. Tsai, I. W. Chong, and J. J. Hwang. "Nutritional emphysema." Internal Medicine Journal 37, no. 8 (July 19, 2007): 578–79. http://dx.doi.org/10.1111/j.1445-5994.2007.01411.x.

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38

Balaji, S. M. "Subcutaneous Emphysema." Journal of Maxillofacial and Oral Surgery 14, no. 2 (March 22, 2011): 515–17. http://dx.doi.org/10.1007/s12663-010-0158-9.

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39

Friedrich, M. J. "Preventing Emphysema." JAMA 301, no. 5 (February 4, 2009): 477. http://dx.doi.org/10.1001/jama.2009.40.

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40

Demura, Y., T. Ishizaki, M. Nakanishi, S. Ameshima, and H. Itoh. "Persistent diffuse pulmonary interstitial emphysema mimicking pulmonary emphysema." Thorax 62, no. 7 (February 27, 2007): 652. http://dx.doi.org/10.1136/thx.2006.074724.

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41

Demura, Y., T. Ishizaki, M. Nakanishi, S. Ameshima, and H. Itoh. "Persistent diffuse pulmonary interstitial emphysema mimicking pulmonary emphysema." Case Reports 2009, jan27 1 (February 2, 2009): bcr0920080882. http://dx.doi.org/10.1136/bcr.09.2008.0882.

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Demura, Y., T. Ishizaki, M. Nakanishi, S. Ameshima, and H. Itoh. "Persistent diffuse pulmonary interstitial emphysema mimicking pulmonary emphysema." Case Reports 2009, feb16 1 (February 18, 2009): bcr2006074724. http://dx.doi.org/10.1136/bcr.2006.074724.

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43

Jonathan, Steven, Triya Damayanti, and Budhi Antariksa. "Pathophysiology of Emphysema." Jurnal Respirologi Indonesia 39, no. 1 (January 2, 2019): 60–69. http://dx.doi.org/10.36497/jri.v39i1.43.

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Pulmonary emphysema is part of pathological condition in chronic obstructive pulmonary disease (COPD) which is characterized by lung parenchymal destruction. Morphology classification of emphysema had been made according to histologic structure in pathology. There were some causes known to be the culprit of emphysema; one that caught most attention is protease-antiprotease activity from cigarette smoke exposure. Destructive effect of emphysema gives disturbance of lung function in expiration (obstruction). The primary mechanism is elastic recoil reduction which causes air trapping, lung volume increase, lung compliance increase and airways that is susceptible to collapse. Hyperinflation in emphysema causes some disadvantages which complicate inspiration and give a dyspnea sensation. Equal pressure point drop in emphysema happens because of elastic recoil reduction. This drop may cause early airway closure. (J Respir Indo 2019; 39(1): 60-9)
44

Bhushita B., Lakhkar, Bhushan N. Lakhkar, and Bhavana Lakhkar. "Congenital Lobar Emphysema: A Diagnostic Dilemma." Indian Journal of Trauma and Emergency Pediatrics 8, no. 2 (2016): 145–46. http://dx.doi.org/10.21088/ijtep.2348.9987.8216.18.

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45

Ronit, Andreas, Thomas Kristensen, Vilde S. Hoseth, Dalia Abou-Kassem, Jørgen T. Kühl, Thomas Benfield, Jan Gerstoft, et al. "Computed tomography quantification of emphysema in people living with HIV and uninfected controls." European Respiratory Journal 52, no. 1 (June 7, 2018): 1800296. http://dx.doi.org/10.1183/13993003.00296-2018.

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People living with HIV (PLWH) may be more susceptible to the development of emphysema than uninfected individuals. We assessed prevalence and risk factors for emphysema in PLWH and uninfected controls. Spirometry and chest computed tomography scans were obtained in PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study and in uninfected controls from the Copenhagen General Population Study (CGPS) who were >40 years. Emphysema was quantified using a low attenuation area < −950 Hounsfield units (%LAA-950) and the 15th percentile density index (PD15) and assessed by semi-quantitative visual scales. Of 742 PLWH, 21.2% and 4.7% had emphysema according to the %LAA-950 threshold with cut-offs at 5% and 10%, respectively. Of 470 uninfected controls, these numbers were 24.3% (p=0.23) and 4.0% (p=0.68). HIV was not associated with emphysema (adjusted OR 1.25, 95% CI 0.68–2.36 for %LAA-950 >10%) by PD15 or by visually assessed emphysema. We found no interaction between HIV and cumulative smoking. Breathlessness and sputum production were more common in PLWH with emphysema, and emphysema seemed to be more prevalent in PLWH with airflow limitation. HIV was therefore not independently associated with emphysema, but the clinical impact of emphysema was greater in PLWH than in uninfected controls.
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Ochiai, Satoru, Yoshihito Nomoto, Yasufumi Yamashita, Tomoki Inoue, Shuuichi Murashima, Daisuke Hasegawa, Yoshie Kurita, et al. "The impact of emphysema on dosimetric parameters for stereotactic body radiotherapy of the lung." Journal of Radiation Research 57, no. 5 (September 1, 2016): 555–66. http://dx.doi.org/10.1093/jrr/rrw060.

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Abstract The purpose of this study was to evaluate the impact of emphysematous changes in lung on dosimetric parameters in stereotactic body radiation therapy (SBRT) for lung tumor. A total of 72 treatment plans were reviewed, and dosimetric factors [including homogeneity index (HI) and conformity index (CI)] were evaluated. Emphysematous changes in lung were observed in 43 patients (60%). Patients were divided into three groups according to the severity of emphysema: no emphysema ( n = 29), mild emphysema ( n = 22) and moderate to severe emphysema groups ( n = 21). The HI ( P &lt; 0.001) and the CI ( P = 0.029) were significantly different in accordance with the severity of emphysema in one-way analysis of variance (ANOVA). The HI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema (Tukey, P &lt; 0.001) and mild emphysema groups ( P = 0.002). The CI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema group ( P = 0.044). In multiple linear regression analysis, the severity of emphysema ( P &lt; 0.001) and the mean material density of the lung within the PTV ( P &lt; 0.001) were significant factors for HI, and the mean density of the lung within the PTV ( P = 0.005) was the only significant factor for CI. The mean density of the lung within the PTV was significantly different in accordance with the severity of emphysema (one-way ANOVA, P = 0.008) and the severity of emphysema ( P &lt; 0.001) was one of the significant factors for the density of the lung within the PTV in multiple linear regression analysis. Our results suggest that emphysematous changes in the lung significantly impact on several dosimetric parameters in SBRT, and they should be carefully evaluated before treatment planning.
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Yeung, Ho-Man, and Lauren Gaffaney. "Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency." Case Reports in Medicine 2022 (December 9, 2022): 1–4. http://dx.doi.org/10.1155/2022/9840085.

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Basilar predominant emphysema, or disproportionate emphysematous involvement of the lung bases compared to the apices, is an uncommon radiographic pattern of emphysema traditionally associated with alpha-1-antitrypsin deficiency (AATD). We present a case of a 59-year-old female with 41 pack-year tobacco use, Stage IV COPD with supplemental oxygen, and bibasilar predominant emphysema who successfully underwent bronchoscopic lung volume reduction. She presented with recurrent hospitalizations for frequent exacerbations. After lung reduction, the patient displayed improvement in functional status without hospitalizations at the 15-month follow-up. Careful history taking is essential for any patients diagnosed with lower lobe emphysema to elucidate the underlying etiology. This case challenges the notion that basilar emphysema is sensitive or specific for AATD and emphasizes that this pattern of emphysema has a broad differential diagnosis and alternative etiologies should be considered. Our patient was ultimately diagnosed with smoking-related emphysema, with atypical bibasilar involvement. Furthermore, basilar predominant emphysema should be considered a separate entity from its apical predominant counterpart.
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Antunes, Mariana A., and Patricia R. M. Rocco. "Elastase-induced pulmonary emphysema: insights from experimental models." Anais da Academia Brasileira de Ciências 83, no. 4 (October 7, 2011): 1385–96. http://dx.doi.org/10.1590/s0001-37652011005000039.

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Several distinct stimuli can be used to reproduce histological and functional features of human emphysema, a leading cause of disability and death. Since cigarette smoke is the main cause of emphysema in humans, experimental researches have attempted to reproduce this situation. However, this is an expensive and cumbersome method of emphysema induction, and simpler, more efficacious alternatives have been sought. Among these approaches, elastolytic enzymes have been widely used to reproduce some characteristics of human cigarette smoke-induced disease, such as: augmentation of airspaces, inflammatory cell influx into the lungs, and systemic inflammation. Nevertheless, the use of elastase-induced emphysema models is still controversial, since the disease pathways involved in elastase induction may differ from those occurring in smoke-induced emphysema. This indicates that the choice of an emphysema model may impact the results of new therapies or drugs being tested. The aim of this review is to compare the mechanisms of disease induction in smoke and elastase emphysema models, to describe the differences among various elastase models, and to establish the advantages and disadvantages of elastase-induced emphysema models. More studies are required to shed light on the mechanisms of elastase-induced emphysema.
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Sakai, Fumikazu, Junya Tominaga, Akiko Kaga, Yutaka Usui, Minoru Kanazawa, Takashi Ogura, Noriyo Yanagawa, and Tamiko Takemura. "Imaging Diagnosis of Interstitial Pneumonia with Emphysema (Combined Pulmonary Fibrosis and Emphysema)." Pulmonary Medicine 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/816541.

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Based on clinical and radiological findings, Cottin defined combined pulmonary fibrosis and emphysema (CPFE) as pulmonary emphysema in the upper lungs and interstitial pneumonia in the lower lungs with various radiological patterns. Pathologic findings of CPFE probably corresponded with diffuse interstitial pneumonia with pulmonary emphysema, emphysema with fibrosis, and the combination of both. We described reported radiological findings of CPFE.
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Bouwmeester, Noor H., Hans Kieft, Ghada MM Shahin, and Arno P. Nierich. "A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2091898. http://dx.doi.org/10.1177/2050313x20918989.

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A 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure therapy were used to resolve the emphysema. The subcutaneous emphysema decreased significantly, and after 1 week the vacuum-assisted closure therapy was ended successfully. This technique has previously been described in several case reports, where it is a promising treatment in severe subcutaneous emphysema, but it is not yet widely used. This case report supports the further use of vacuum-assisted closure therapy in subcutaneous emphysema. Successful treatment of severe mediastinal and subcutaneous emphysema in Pneumocystis jirovecii pneumonia can be achieved by vacuum-assisted closure therapy on infraclavicular skin incisions.

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