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Dissertations / Theses on the topic 'Lung disorder'
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1
Bhogal, Ranjev. "The characterisation of binding sites for islet amyloid polypeptide and calcitonin gene-related peptide in mammalian lung." Thesis, Imperial College London, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.261471.
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Pouliot, Robert A. "DEVELOPMENT AND CHARACTERIZATION OF LUNG DERIVED EXTRACELLULAR MATRIX HYDROGELS." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4465.
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Chronic obstructive pulmonary disease (COPD) including emphysema is a devastating condition, increasing in prevalence in the US and worldwide. There remains no cure for COPD, rather only symptomatic treatments. Due to unique challenges of the lung, translation of therapies for acute lung injury to target chronic lung diseases like COPD has not been successful. We have been investigating lung derived extracellular matrix (ECM) hydrogels as a novel approach for delivery of cellular therapies to the pulmonary system.
During the course of this work we have developed and characterized a lug derived ECM hydrogel that exhibits “injectability,” allowing cells or dugs to be delivered in a liquid and encapsulated at body temperature. The hydrogel self assembles in <5 minutes and achieves mechanical stiffness similar to other soft tissue ECM hydrogels. The hydrogel can support 3D cell growth and encapsulated cell viability. Encapsulated hMSCs can also still be activated by simulated inflammatory environments. Naïve mouse macrophages exposed to the fully formed gel were not significantly induced to express markers for pro or anti-inflammatory polarized phenotypes, but increased expression for several secreted inflammatory mediators was observed.
We also investigated a novel approach for preparing and solubilizing the isolated ECM proteins, using digestion time as a variable for controlling hydrogel density (interconnectivity), mechanical stiffness, component protein size distribution, and cell behavior on fully formed gels. The potential future impact for the presented research includes optimization for future animal studies, expansion to additional applications, and the development of new derivative materials.
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Improgo, Ma Reina D. "Regulation and Function of Neuronal Nicotinic Acetylcholine Receptors in Lung Cancer: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/550.
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Lung cancer is the leading cause of cancer-related mortality worldwide. The main risk factor associated with lung cancer is cigarette smoking. Research through the years suggests that nicotine in cigarettes promotes lung cancer by activating signaling pathways that lead to cell proliferation, cell survival, angiogenesis, and metastasis. Nicotine’s cellular actions are mediated by its cognate receptors, nicotinic acetylcholine receptors (nAChRs). Here, I describe the expression levels of all known human nAChR subunit genes in both normal and lung cancer cells. Of note, the genes encoding the α5, α3, and β4 subunits (CHRNA5/A3/B4) are over-expressed in small cell lung carcinoma (SCLC), the most aggressive form of lung cancer. This over-expression is regulated by ASCL1, a transcription factor important in normal lung development and lung carcinogenesis. The CHRNA5/A3/B4 locus has recently been the focus of a series of genetic studies showing that polymorphisms in this region confer risk for both nicotine dependence and lung cancer. I show that CHRNA5/A3/B4 depletion results in decreased SCLC cell viability. Furthermore, while nicotine promotes SCLC cell viability and tumor growth, blockade of α3β4 nAChRs inhibits SCLC cell viability. These results suggest that increased expression and function of nAChRs, specifically the α3β4α5 subtype, potentiate the effects of nicotine in SCLC. This dual hit from the carcinogens in tobacco and the cancer-promoting effects of nicotine, may provide a possible mechanism for the increased aggressiveness of SCLC. In addition, nAChRs can be activated by the endogenous ligand, acetylcholine, which acts as an autocrine/paracrine growth factor in SCLC. Increased function of α3β4α5 nAChRs in SCLC could also potentiate acetylcholine’s mitogenic effects. This mechanism, combined with other known autocrine/paracrine growth loops in SCLC, may help explain the ineffectiveness of available therapies against SCLC. In an effort to add to the current arsenal against SCLC, I screened a 1280-compund library using a bioluminescence-based viability assay I developed for high-throughput applications. Primary screening, followed by secondary and tertiary verification, indicate that pharmacologically active compounds targeting neuroendocrine markers inhibit SCLC cell viability.
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Malaney, Prerna. "Significance of PTEN Phosphorylation and its Nuclear Function in Lung Cancer." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6539.
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Phosphorylation mediated inactivation of PTEN leads to multiple malignancies with increased severity. However, the consequence of such inactivation on downstream functions of PTEN are poorly understood. Therefore, the objective of my thesis is to ascertain the molecular mechanisms by which PTEN phosphorylation drives lung cancer. PTEN phosphorylation at the C-terminal serine/threonine cluster abrogates its tumor suppressor function. Despite the critical role of the PTEN C-tail in regulating its function, the crystal structure of the C-tail remains unknown. Using bioinformatics and structural analysis, I determined that the PTEN C-tail is an intrinsically disordered region and is a hot spot for post-translational modifications (particularly phosphorylation) and protein-protein interactions. Evolutionary analysis of PTEN and its interacting proteins revealed that the PTEN C-tail has only recently evolved to acquire the ability to engage in a myriad of protein-protein interactions, resulting in its versatile functions.
Replacement of the PTEN C-tail serine/threonine residues with alanines generated an artificial mutant, PTEN-4A, which remained “phospho-deficient” and therefore constitutively active. Interestingly, PTEN-4A suppressed cell proliferation and migration to a greater extent than PTEN-WT. PTEN-4A preferentially localized to the nucleus where it suppressed E2F-mediated transcription of cell cycle genes. PTEN physically interacted with the E2F1 protein and at E2F1-binding sites on chromatin, a likely mechanism for its transcriptional function. Further, deletion analysis on various PTEN domains revealed that the C2 domain of PTEN is indispensable for suppression of E2F-related genes. Systematic transcriptional promoter-reporter assays identified disease-associated C2 domain mutations that lose their ability to suppress E2F-mediated transcription, supporting the concept that these mutations are oncogenic in patients. Consistent with my findings, I observed increased level of PTEN phosphorylation and reduced nuclear PTEN levels in lung cancer patient samples.
Further, to determine whether the enhanced growth-suppressive properties of PTEN-4A may be due to differential protein-protein interactions, I performed a comparative proteomic profiling of PTEN-WT and PTEN-4A interactomes using the SILAC methodology. Galectin-1 was identified as a candidate protein that binds preferentially to PTEN-WT and inhibits its tumor suppressive function. Taken together, the various tumor suppressive mechanisms of PTEN-4A may be harnessed therapeutically as adjunctive cancer therapy. Use of small molecule inhibitors that hinder PTEN C-tail phosphorylation is a plausible approach to activate PTEN function to reduce tumor burden.
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Lee, Sherman. "The effect of acute cigarette smoke exposure on regional pulmonary blood flow, volume, red cell transit and polymorphonuclear leukocyte retention in the rabbit lung." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24840.
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Regional pulmonary blood flow and volume was measured in ten rabbits
anesthetized with pentobarbital (30 mg/kg). Tracheostomy was performed and
catheters were placed into the jugular vein and carotid artery. The cardiac
⁹⁹mtc output was measured using the indicator-dilution technique using Tc labelled RBC followed by an injection of radiolabelled macroaggregates (MAA) to mark regional blood flow. Measurements were made both before and after either exposure to cigarette smoke (3 cigarettes for ten minutes at 4 puffs/minute) or sham exposure to air. The animals were sacrificed and the lungs were removed with the vessels tied. The lungs were then inflated and rapidly frozen over liquid nitrogen. The lungs were sampled into slices by vertical height, each slice was further sampled and then gamma counted for the injected isotopes. Regional pulmonary blood flow was calculated by setting the total lung MAA counts for each MAA equal to the cardiac output so that the sample flow was calculated as the fraction of sample counts to total counts times the cardiac output. The blood volume was marked by the labelled RBC and RBC transit was calculated as blood volume (ml) divided by blood flow (ml/sec).
In a second series of experiments (N=10) , ⁵¹Cr PMN were injected as a bolus along with ⁹⁹mtc RBC in an indicator-dilution run. Following the injection of the cells, the blood flow was marked with MAAs and then the same sham or smoke treatments were given as in the previous experiments. At the end of ten minutes, the animals were sacrificed and the lungs were processed the same as before. Regional PMN retention was calculated as the [formula omitted]. The data show that smoke exposure increased pulmonary blood volume (p<.01), pulmonary transit time (p<C.05) and the ratio of lung blood volume to central blood volume (p <C-05) without changing central blood volume or cardiac output. Smoke exposure also caused a redistribution of blood flow from upper to lower lung regions (p <C-05). This lengthened the regional RBC transit times in all regions but particularly in the upper zones. These changes in RBC transit had no effect on PMN retention.
We conclude that acute smoke exposure lengthens the RBC transit through the pulmonary circulation by increasing blood volume and redistributing blood flow. This change in red cell behavior was not associated with a consistent change in PMN retention in the lungs.<br>Medicine, Faculty of<br>Pathology and Laboratory Medicine, Department of<br>Graduate
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Langhammer, Arnulf. "Respiratory symptoms, lung function, and bone mineral density in a comprehensive population study : The Nord-Trøndelag Health Study 1995-97, The Bronchial Obstruction in Nord-Trøndelag Study." Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2003. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-126.
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<p>The prevalence of respiratory symptoms and diseases like asthma and chronic obstructive pulmonary disease (COPD), seem to have increased the last decades. The reason for the increase in asthma related symptoms and allergy is uncertain. Some, but not all, of this increase might be ascribed to lowered threshold for use of the diagnosis by medical doctors, change in diagnostic criteria, and increased awareness of symptoms in the population. Studies have indicated that increased prevalence might be explained by a reduction during the last decades in exposure to environmental factors in infancy, These factors are supposed to stimulate the change from Th-2 to TH-1 helper cells (hygiene hypothesis), but even low level of allergen exposure seems to contribute to increase in risk for allergy. The increase in COPD in developed countries is closely related to the smoking pattern during the last two to four decades, and the increased therefore, is mainly seen in women. Further, studies have indicated that women are more vulnerable for the deleterious effects of tobacco smoking than men are; if this is true the current smoking pattern with increased female smoking, is worrying. </p><br>Paper 1 reprinted with kind permission of Journal of Epidemiology and Community Health. Papers 2 and 3 reprinted with kind permission of European Respiratory Society Journals Ltd. Paper 4 reprinted with kind permission of John Wiley and Sons Limited.
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Ekta, Rani. "Ayurvedic ways to treat lung disorders." Thesis, Буковинський державний медичний університет, 2012. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/1422.
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Heeley, Emma Louise. "Lung surfactant and secretory phospholipase Aâ†2 in inflammatory lung disorders." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323970.
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Kotecha, Sailesh. "The role of cytokines in chronic lung disease of prematurity." Thesis, Imperial College London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244032.
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Gonzalez, Brian David. "Prevalence, Predictors, and Correlates of Patient Concealment of a Lung Cancer Diagnosis." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4679.
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Most cases of lung cancer have a commonly-understood behavioral etiology. Thus, individuals with lung cancer are often blamed for their illness by others and may therefore seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of diagnosis concealment, examine potential predictors of concealment, and test parts of a cognitive-affective-behavioral model of the effects of concealing a concealable stigma among individuals receiving treatment for lung cancer. With regard to predictors of concealment, it was hypothesized that concealment would be positively associated with male gender, introversion, and trait social anxiety and would be negatively associated with social support and the use of seeking guidance and support as a coping strategy. Hypothesized correlates of concealment included poorer self-esteem as well as greater anxiety, cancer-specific distress, and social avoidance. A sample of 117 participants receiving chemotherapy or radiation for stage I-IV non-small cell lung cancer and limited to extensive stage small cell lung cancer was recruited during routine outpatient visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of coping strategies, introversion, trait social anxiety, social avoidance, social support, anxiety, depression, cancer-specific distress, self-esteem, perceived stigma, public self-consciousness, and private self-consciousness. Results indicated that 31% of participants concealed their diagnosis from others since their diagnosis and 26% concealed their diagnosis in the month preceding their participation in the study. Hypotheses regarding predictors and correlates of concealment were not supported. However, exploratory analyses identified use of alcohol, recency of a recurrence of lung cancer, use of positive reappraisal as a coping strategy, and social support as predictors of concealment as well as internalized shame as a correlate of concealment. These findings serve to extend existing literature on concealing a concealable stigma and support parts of an existing model on the effects of concealment. Future research should aim to test the impacts of concealment in the context of certain social situations to examine longitudinal relationships between predictors and consequences of concealment.
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Jones, Mark Philip. "A low frequency acoustic method for detecting abnormalities in the human thorax." Thesis, University of Southampton, 1996. https://eprints.soton.ac.uk/253034/.
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Schins, Peter Frans Roeland. "Biomarkers of mineral dust induced lung disorders molecular epidemiologic studies in coal workers /." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1996. http://arno.unimaas.nl/show.cgi?fid=6697.
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Clayton, Nicola. "The effect of COPD on laryngopharyngeal sensitivity and swallow function." Connect to full text, 2007. http://hdl.handle.net/2123/2236.
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Thesis (M. Sc. Med.)--University of Sydney, 2008.<br>Title from title screen (viewed 29 July 2008). Submitted in fulfilment of the requirements for the degree of Master of Science in Medicine to the Discipline of Medicine, Faculty of Medicine. Degree awarded 2008; thesis submitted 2007. Includes bibliographical references. Also available in print form.
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Gonzalez, Brian D. "Depression in Lung Cancer Patients: Role of Perceived Stigma." Scholar Commons, 2010. https://scholarcommons.usf.edu/etd/1645.
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Previous research suggests that lung cancer patients are at an increased risk for depressive symptomatology; however, little is known about the possible etiology or correlates of depression among these patients. This study examined the relationship between perceived stigma and depressive symptomatology among lung cancer patients, and sought to find potential mediators of this relationship. It was hypothesized that more perceived stigma would be related to greater depressive symptomatology and that perceived stigma would contribute unique variance to depressive symptomatology above and beyond that contributed by clinical, demographic, and psychosocial variables. A sample of 95 participants receiving chemotherapy for stage II-IV non-small cell lung cancer was recruited during routine outpatient chemotherapy visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of perceived stigma, depressive symptomatology, and other psychosocial variables. As hypothesized, there was a positive association of perceived stigma to depressive symptomatology. Perceived stigma contributed significant unique variance to depressive symptomatology. In addition dyadic adjustment and dysfunctional attitudes mediated this relationship. Future research should aim to replicate and extend these findings in longitudinal analyses and attempt to ameliorate lung cancer patients' depressive symptomatology by targeting perceived stigma.
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Zaetta, Cristina. "Disastro del Vajont: conseguenze a lungo termine sulla salute psichica e fisica dei sopravvissuti." Doctoral thesis, Università degli studi di Padova, 2008. http://hdl.handle.net/11577/3425042.
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BACKGROUND AND AIMS
The negative impact of traumatic events on psychological functioning has been well-established (Wagner, 2000). Recent research suggests that trauma may have deleterious effects on physical functioning (Schnurr, 1996).
Some research (Lauterbach, 2005) indicates that the relationship between traumatic experiences and health problems could be mediated by post-traumatic stress disorder (PTSD) or depression (MDD). Experts (Ford et al., 2004) suggest that only long term studies may allow to understand the trauma exposure consequences on physical health from a statistical-epidemiological point of view. Two studies on Vajont survivors were conducted by our research group.
The aim of the first study was to assess the psychiatric consequences of the Vajont disaster more than 36 years after the event, with a particular attention to the presence of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) and to the relationship between the degree of traumatic exposure and its consequences on psychological functioning.
The second study aimed to investigate the relationship between physical health and trauma severiy, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD) in a group of Vajont survivors and in a control group, 44 years after trauma.
METHODS
In the first study, 90 survivors were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnosis of PTSD and MDD.
In the second study, 60 survivors were assessed by means of a semistructured interview to investigate health status, and the extent of the traumatic experience, and a structured diagnostic interview for the diagnosis of PTSD and MDD. The health status was also assessed by the survivor's general practitioner. Some self-reported questionnaires were administred to measure quality of life, social support, temperament and the presence of type D personality. A control group of 48 subjects was assessed, too.
RESULTS
Our first study shows that large scale disasters such as the Vajont one affect the psychological health of survivors for decades. Moreover our research confirms the role of risk factors such as the degree of trauma exposure and female gender in the development of psychiatric consequences after a disaster.
The second study confirms the deleterious effects on physical health of extreme traumatic experiences. This effects do not seem to be related to direct effects of trauma or to the degree of exposure. The study shows the role of PTSD or symptoms of PTSD and social support as mediators between trauma exposure and health status. The trauma consequences, in particular on psychological health, have an influence on the Vajont survivors's quality of life.
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Böhm, Birgitta. "Risk and resilience in children born preterm : cognitive and executive functioning at 5 1/2 years of age /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-729-0/.
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Hedlund, Ulf. "Occupational air pollutants and non-malignant respiratory disorders especially in miners : the obstructive lung disease in Northern Sweden studies : thesis IX /." Doctoral thesis, Umeå universitet, Yrkes- och miljömedicin, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1591.
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Aim. To assess associations between occupational air pollution and respiratory health, especially in miners. Background. Indications of associations between occupational exposure or social economic status and respiratory health have been found in several population-based studies. However, there have been few longitudinal studies of the putative correlations, the effects of environmental and genetic factors have seldom been simultaneously studied, and studies of miners have generated conflicting results. Material and methods. Population-based Obstructive Lung Disease in Northern Sweden (OLIN) cohorts surveyed in 1986, 1992 and 1996, and two industry-based materials, were used in cross-sectional and longitudinal studies. Inflammatory markers were compared in sputa from miners after a vacation of at least four weeks, after repeated occupational exposures for at least three months, and controls. The mortality from silicosis was studied in 7729 miners with at least 1 year of exposure. Multivariate analyses were used to adjust for confounders. Results. Up to about 30-40% (etiologic fraction) of incident symptoms in persons both with and without a family history of asthma (FHA) could be explained by exposure to occupational air pollution. Low socio-economic status (SES) was associated with impaired respiratory health. Population attributable risks for most examined disorders were about 10%. Current and ex-miners had increased prevalence of recurrent wheeze, longstanding cough, physician-diagnosed chronic bronchitis, and a trend for increased sputum production. For physician-diagnosed chronic bronchitis a multiplicative interaction was found between exposure and smoking habits. Ex-miners that had been exposed for on average 13 years and whose exposure had ceased 16 years before the study had an increased prevalence of physician-diagnosed chronic bronchitis and chronic productive cough and a trend to increased use of asthma medicines. Miners exposed underground for 18 years, on average, to diesel exhaust (with 0.28 mg/m3 nitrogen dioxide and 27 μg/m3 elemental carbon on average, EC) and particles (3.2 mg/m3 inhalable dust on average) had signs of higher inflammatory activity in their airways, i.e. significantly higher frequencies of macrophages, neutrophils, and total cells compared with referents. The activity in miners was similar after a vacation of at least four weeks and after repeated exposures for three months. There were 58 deaths from silicosis (underlying and contributing cause of death) and a clear dose-response relationship. The data indicated an increased risk of severe silicosis after long-term exposure to 0.1 mg/m3 respirable quartz, the current maximum allowable concentration (MAC) in Sweden and many other countries. Conclusion. Occupational exposure to dust, gases, and fumes impaired respiratory health, accounting for up to 30-40% of some respiratory symptoms in the general population. Low socio-economic status was associated with impaired respiratory health. The complex profiles of dust and diesel exhaust substances found in mines may cause inflammatory reactions in their lungs and persistent respiratory symptoms in occupationally exposed miners. Long-term exposure to quartz at the present MAC level may cause severe silicosis.
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Sargurupremraj, Muralidharan [Verfasser], Bertram [Akademischer Betreuer] [Gutachter] Müller-Myhsok, and Johannes [Gutachter] Beckers. "Genetics of complex lung disorders - new approaches in asthma and COPD / Muralidharan Sargurupremraj ; Gutachter: Bertram Müller-Myhsok, Johannes Beckers ; Betreuer: Bertram Müller-Myhsok." München : Universitätsbibliothek der TU München, 2017. http://d-nb.info/1133261922/34.
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Doke, Mayur Arvind. "The Role of ID3 and PCB153 in the Hyperproliferation and Dysregulation of Lung Endothelial Cells." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3808.
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Uncontrolled growth of vascular stem cells as a result of endothelial-mesenchymal transition is considered to cause hyper-proliferative vascular remodeling in severe pulmonary arterial hypertension (PAH) patients. Hyperplastic intimal growth is one of the causes of closure of the lumen of pulmonary arterioles. This abnormal vessel remodeling leads to the progressive increase in pressure of the pulmonary arterioles causing severe PAH; and debilitating harm to patients resulting in mortality from right heart failure. Environmental factors, including polychlorinated biphenyls (PCBs), are considered to be involved in hyper-proliferative vascular remodeling because genetic makeup can only explain about 10% of severe PAH cases. PCB involvement in lung toxicity has received attention because (i) they have been reported to accumulate in the lung; (ii) PCBs produce pathological vascular remodeling in the experimental model; high levels of PCBs are found in human lung tissue; and (iii) epidemiological studies show the association between lung toxicity and PCBs; and prevalence of hypertension and elevated concentrations of particularly PCB153. Recent studies identify PCB153 as one of the largest contributors for total PCB body burden in humans. Our previous studies demonstrated PCB153 mediated vascular endothelial dysfunction and activated the inhibitor of differentiation protein 3 (ID3). ID3 is an important determinant of mitogen and reactive oxygen species-induced G1→S phase cell cycle progression. Although phosphorylation of ID3 increases cell growth by antagonizing the transcription of cell cycle inhibitors, still there is a critical gap in understanding the molecular mechanism(s) of pulmonary proliferative vascular remodeling associated with PCB exposure in humans and the role of the transcription regulator ID3. Our overall objective was to investigate ID3 mediated transcriptional reprogramming as a driver of PCB153-induced pathological proliferative vascular remodeling. Stable ectopic expression of ID3 in lung endothelial cells contributed to endothelial-mesenchymal transition (EndMT), cell proliferation, and cell migration. Using an endothelial spheroid assay, an established method to measure aberrant hyper-proliferation of endothelial cells in PAH patients, we show that stable ectopic expression of ID3 increased the number and size of vascular spheres. ID3 overexpressing cells exposed to environmentally relevant concentrations of PCB153 showed a two-fold increase in cell proliferation as determined by MTT, SRB, and BrdU assays. ID3 overexpressing cells showed the loss of VE-cadherin and gain of MMP9 and vimentin, which are markers of EndMT. PCB153 also increased phosphorylation of ID3 in lung endothelial cells. To determine the molecular mechanism by which ID3 contributes to hyper-proliferative endothelial cells, we investigated ID3 transcriptional reprogramming using ChIP-Seq and RNA-Seq technology. We show here for the first time that ID3 is part of a more general mechanism of transcriptional regulation. Our ChIP-Seq data show that ID3 binds to a subset of approximately 1200 target genes. Comprehensive motif analysis of ChIP-Seq data using the MEME Suite software toolkit revealed that ID3 bound to the GAGAGAGAGA motif sequence on genomic DNA. We also show a significant preference of ID3 binding to motifs associated with transcription factors IRF1, BC11A, IRF4, PRDM1, FOXJ3, SMAD4, ZBTB6, GATA1, and STAT2. Using an integrative approach of ChIP-Seq and RNA-Seq data, we identified 19 genes whose promoter region was bound by ID3 and RNA was differentially expressed in ID3 overexpressing cells. In summary, our data demonstrated that PCB153 and/or ID3 induces proliferation of lung endothelial cells via transcriptional reprogramming. Discoveries from these findings will lay the necessary groundbreaking work for testing the efficacy of ID3 antagonists for the prevention and treatment of pathological vascular remodeling as well as provide a new paradigm by which PCBs may contribute to lung vascular toxicity.
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McNaughton, Lance. "Nitric oxide and matrix metalloproteinases as mediators of chronic and acute inflammatory disorders in humans, focus on chronic liver damage and acute lung injury." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0010/NQ59635.pdf.
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Saraiva, Cristina Maria da Silva. "A qualidade de vida dos doentes com insuficiência respiratória crónica submetidos a ventilação não invasiva." Master's thesis, Instituto Superior de Psicologia Aplicada, 2003. http://hdl.handle.net/10400.12/907.
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Dissertação de Mestrado em Psicologia da Saúde<br>A Ventilação Não invasiva (VNl) associada à Oxigenoterapia de Longa Duração (OLD) tem sido largamente usada, na última década do século XX, em situações clínicas com compromisso respiratório crónico para correcção das síndromes hipoventilatórias.
O principal objectivo deste estudo foi averiguar em que medida a VNl influencia a Qualidade de Vida (QDV) dos doentes com Insuficiência Respiratória Crónica (IRC) estabilizada.
A amostra é constituída por 92 participantes distribuídos por três grupos sendo a média de idade de 66,51 anos, compreendidas entre os 47 e 85 anos de idade.
O Grupo A, constituído por 31 participantes, que fazem parte da população saudável; o Grupo B, também constituído por 31 participantes com o diagnóstico de IRC a fazerem OLD e o Grupo C constituído por 30 participantes com o diagnóstico de IRC a fazerem VNl por Pressão Positiva (VNPP).
A maioria dos participantes são maioritariamente do sexo masculino (85,87%), sendo respectivamente 26 homens e 5 mulheres do Grupo A; 27 homens e 4 mulheres do Grupo B e 26 homens e 4 mulheres do grupo C.
A amostra do Grupo A foi intencional e recolhida da população saudável e os restantes participantes do Grupo B e C, são utentes de diferentes serviços do Departamento de Pneumologia do Hospital de Pulido Valente, em Lisboa.
O desenho de investigação é observacional-descritivo, comparativo e transversal.
A QDV foi avaliada através da aplicação de dois questionários, o Questionário de Estado da Saúde (SF-36) e o St. George's Respiratory Questionnaire (SGRQ) específico para doentes com obstrução das vias aéreas.
Na avaliação da QDV entre os grupos com IRC estabilizada a fazerem OLD e VNI, verificou-se que não existem diferenças significativas, excepto na dimensão Saúde Mental.
Os resultados demonstraram que a VNl em doentes com IRC em estádio avançado da sua doença, tem efeitos benéficos unicamente numa das dimensões de Qualidade de Vida, nomeadamente na dimensão Saúde Mental.
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Uddenfeldt, Per. "Primary biliary cirrhosis : an epidemiological and clinical study based on patients from northern Sweden." Doctoral thesis, Umeå universitet, Medicin, 1990. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96911.
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Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease, which primarily affects middle-aged women. The liver histology is characterized by inflammation and destruction of the intrahepatic bile ducts as well as a high frequency of granuloma. Although the etiology is unknown, the occurrence of associated multiorganic abnormalities such as Sjogren's syndrome, scleroderma, rheumatic disorders and thyroid gland diseases have been cited as evidence favouring an autoimmune background. Addison and Gull in 1851 described the first patient with jaundice and xanthomatosis. PBC was first mentioned in 1876 as an entity by Hanot. PBC was considered to be a rare disease until in 1973 Sherlock and Scheuer described 100 patients. Since then a greater awareness of the disease combined with a wider use of laboratory screening methods has led to the discovery of an increasing number of patients with PBC. In an epidemiological investigation of PBC in the northern part of Sweden a point prevalence of 151 per 106 was found, which is the highest so far reported, and the mean annual incidence amounted to 13.3 per 106. Asymptomatic PBC was present in more than one third of the patients which is consistent with the finding in other epidemiological investigations and is supposed to explain the higher prevalence of PBC and the better prognosis. Nevertheless 25 patients died during the study period, 14 as a direct consequence of the liver disease. Chronic intrahepatic cholestasis has been reported in sarcoidosis and, moreover, a high frequency of liver granuloma is found. The implication of the present study is that a negative Kveim test in combination with positive mitochondrial antibodies is accurate in differentiating PBC from sarcoidosis. Multisystem involvement is frequently observed in PBC and the present study confirms this. In the prospective investigation of 26 PBC patients 50 % had arthropathy considered to be associated with PBC. Rheumatoid arthritis was found in 5 patients, who all had symptoms of liver disease in addition. Lung function impairment was present in 56% (1 asymptomatic PBC). Most commonly a reduced diffusion capacity was found (36%). Bronchial asthma was present in three patients, and severe lung emphysema in one. Features of Sjogren's syndrome was found in 73% (3 asymptomatic PBC). In 6 patients keratoconjunctivitis sicca (KCS) was evident with the rose bengal test demonstrating corneal staining and a Schirmer test of less than 5 mm. Radiological findings of sialectasia were demonstrated in 6 patients, of whom 5 had KCS as well. The ultimate treatment in PBC is liver transplantation and to calculate the need for that, good epidemiological surveys are needed, and also indicators of hepatocellular function. The present investigation indicates that determination of the von Willebrand factor could be used for this purpose.<br><p>Härtill 6 uppsatser</p><br>digitalisering@umu
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Karlsson, Emma, and Marcus Sonesson. "Jämförelse av energiomsättning och aktivitetsnivå vid fysisk aktivitet mellan barn med cystisk fibros och en frisk kontrollgrupp." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-125560.
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<p><strong>Aim:</strong> The aim of this study was to describe the total energy expenditure (TEE) and physical activity levels (PAL) within a group of children with cystic fibrosis (CF) and to compare the results with a control group with healthy children. The aim also was to compare the rated activity levels between the groups as well comparing the difference between boys and girls within the groups. <strong>Method:</strong> The study included 30 participating children, divided into two groups with 15 participants in each group. One of the groups was a CF-group and the other a group of controls, matched for gender and age. Activity diaries were studied and data were presented decrepitly and analyzed with Wilcoxon rank sum test. <strong>Result:</strong> The result showed no difference between the groups while comparing TEE and PAL. Half of the participants in both groups (53,34 % and 46,67 %) reached a moderate or high physical activity level during the registration. No significance was proved between the groups as they rated their activity level, numbered 6-9, in their activity diaries. Neither could any differences be proved significant in rated activity between the boys and girls within the groups. <strong>Conclusion:</strong> The conclusion was that no significant differences appeared regarding TEE or PAL between the CF-group and the control group participating in this study. Neither were there any differences in activity level between boys and girls within the groups.</p><br><p><strong>Syfte:</strong> Syftet med studien var att beskriva energiomsättning och fysisk aktivitetsnivå hos en grupp barn med cystisk fibros (CF) och jämföra resultatet med friska barn i en kontrollgrupp. Syftet var också att jämföra skattade aktivitetsnivåer mellan grupperna samt mellan flickor och pojkar inom de båda grupperna. <strong>Metod:</strong> I studien deltog 30 barn, indelade i två grupper om 15 deltagare. Grupperna var en CF-grupp och en kontrollgrupp matchad efter kön och ålder. Aktivitetsdagböcker granskades och data sammanställdes och data presenterades deskriptivt och analyserades med Wilcoxsons rangsummetest. <strong>Resultat:</strong> Resultatet visade att det inte fanns skillnad mellan de båda grupperna vid jämförelse av TEE och PAL. Ungefär hälften av alla deltagare (53,34 % resp. 46,67 %) nådde moderat eller hög aktivitetsnivå under de registrerade dagarna. Det förekom ingen signifikant skillnad mellan grupperna med avseende antal skattade 6-9:or i aktivitetsdagboken. Inte heller någon skillnad mellan könen inom de båda grupperna kunde påvisas. <strong>Slutsats:</strong> Slutsatsen var att det inte fanns någon signifikant skillnad beträffande energiomsättning eller fysisk aktivitet mellan barn med CF och friska barn som deltog i denna studie. Inte heller kunde någon skillnad i aktivitetsnivå mellan könen inom grupperna påvisas.</p>
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RAMOS, Beatriz Peixoto. "AVALIAÇÃO HISTOLOGICA DE PULMÃO DE BOVINOS DA RAÇA NELORE TERMINADOS A PASTO E EM CONFINAMENTO." Universidade Federal de Goiás, 2009. http://repositorio.bc.ufg.br/tede/handle/tde/914.
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Previous issue date: 2009-02-13<br>Most Brazilian states have common features, as the problems that affect the health
of animals. Infectious and contagious diseases, parasites, and metabolic
deficiencies, are of great importance, directly interfering in economic indicators.
Respiratory diseases have highlighted the various systems of breeding cattle,
because they have lung particular characteristics making them more vulnerable to
diseases of the respiratory system. There are no confirmed reports that in feedlot of
dirt would be a case of pneumonia higher compared to other systems to create due
to the high population density, stress and dust. Therefore, the objective of this
project is to assess the level of changes in lung tissue of cattle Nelore finished
under confinement conditions compared to the finished under grazing. We used 96
animals, 48 animals raised on pasture (AP) and 48 animals from confinement (AC).
These were identified in the corral of waiting, with the slaughter line and perform a
collection of fragments of the cranial lobe and the median on the ramp inspection.
The samples were fixed in buffered solution of formol 10%, preserved in alcohol at
70% and histological processed, making the color of slides with hematoxylin and
eosin (H&E) and the optical microscope analysis. Initially the data were submitted to
descriptive statistics and later to the chi-square, Wilcoxon and Mann-Whitney. None
of the evaluated parameters was influenced by the different lobes and different
systems of termination<br>A maioria dos estados brasileiros apresentam características comuns,
quanto aos problemas que afetam a saúde dos animais. Enfermidades
infecto-contagiosas, parasitárias, metabólicas e carências, são de grande
importância, interferindo diretamente nos indicadores econômicos. As doenças
respiratórias possuem destaque nos vários sistemas de criação de bovinos, devido
estes terem características pulmonares particulares tornando-os mais vulneráveis
às patologias do sistema respiratório. Existem relatos não comprovados de que em
confinamentos de terra batida haveria uma casuística maior de pneumonias
comparado a outros sistemas de criação devido à alta densidade populacional,
estresse e poeira. Portanto, o objetivo desse projeto é avaliar o nível de alterações
teciduais em pulmões de bovinos da raça Nelore terminados sob condições de
confinamento em comparação aos terminados a pasto. Foram utilizados 96 animais,
sendo 48 animais criados a pasto (AP) e 48 animais terminados em confinamento
(AC), abatidos na empresa frigorífica FRIBOI. A colheita de fragmentos do lobo
cranial e médio foi efetivada na plataforma de inspeção e logo após fixados em
solução tamponada de formol a 10%, conservados em álcool a 70% e processados
histotologicamente, fazendo a coloração das lâminas com hematoxilina e eosina
(H&E). Foram avaliadas as alterações do interstício alveolar e as alterações dos
condutos respiratórios. Inicialmente os dados foram submetidos à estatística
descritiva e posteriormente ao teste de Qui-quadrado, Fisher-Yates, Wilcoxon e
Mann-Whitney. A maioria dos parâmetros avaliados não sofreram influência em
relação aos diferentes lobos e diferentes sistemas de terminação.
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MORAIS, Caio César Araújo. "Aplicabilidade de técnicas de expansão pulmonar em pacientes com comprometimento no nível de consciência." Universidade Federal de Pernambuco, 2015. https://repositorio.ufpe.br/handle/123456789/18326.
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Previous issue date: 2015-03-06<br>FACEPE<br>A sobrevivência de pacientes com lesões no sistema nervoso central é
geralmente acompanhada de sequelas físicas e mentais, que favorecem a
restrição prolongada ao leito, e podem prejudicar a função pulmonar. As
técnicas de Breath stacking (BS) e Pressão Expiratória Positiva nas Vias
Aéreas (EPAP) têm sido usadas como rotina terapêutica para evitar o
surgimento de complicações respiratórias. No entanto, existe uma lacuna na
descrição fisiológica dessas técnicas e no efeito sobre a expansão pulmonar
(ganho de aeração) em pacientes não cooperativos com restrição prolongada
ao leito. Esta dissertação apresenta dois artigos originais. O primeiro foi um
estudo fisiológico que objetivou descrever o comportamento da distribuição do
fluxo de ar dentro dos pulmões, através da tomografia de impedância elétrica
(TIE), durante as técnicas de BS e EPAP em 10 pacientes não cooperativos e
em 10 indivíduos saudáveis. Foi observada a transferência do fluxo de ar entre
as regiões ventral e dorsal durante as técnicas apenas no grupo de pacientes
não cooperativos. Os períodos com a inversão da direção do fluxo aéreo
ocorreram na ausência de variações significativas do volume corrente,
sugerindo a existência do fenômeno “pendelluft”. O segundo estudo foi um
ensaio clínico randomizado do tipo crossover que comparou o efeito agudo do
BS e do EPAP na aeração pulmonar regional através da TIE, e a duração do
efeito terapêutico de expansão pulmonar. Observou-se que a aeração do
pulmão aumentou significativamente em comparação com os valores basais
durante a EPAP e BS (ANOVA two-way e teste post hoc de Sidak, p <0,001).
No entanto, os efeitos sobre a expansão de pulmão foram mantidos durante um
curto período de tempo, 4,6 ± 3,7 minutos e 2,3 ± 2,0 minutos para EPAP e BS,
respectivamente. Concluímos que durante as técnicas BS e EPAP houve a
presença do fenômeno “pendelluft” no grupo de pacientes não cooperativos.
Essas técnicas geraram mudanças significativas nos volumes pulmonares,
contudo, não duráveis. A existência de contração abdominal pode ter
minimizado o efeito de expansão pulmonar proposto por estas técnicas.<br>The survival of patients with lesions in the central nervous system is usually
accompanied by physical and mental sequelae. These impairments favor the
prolonged restriction to the bed, which may contribute with changes in
respiratory function. Breath Stacking (BS) and Expiratory Positive Airway
Pressure (EPAP) have been used as a prophylaxis routine to prevent
respiratory complications. However, there is a gap in the physiological
description and in the effect on lung aeration in non-cooperative patients with
prolonged bed rest. This master's thesis presents two articles. The first was a
physiological study that aimed to describe the physiological behavior of airflow
displacement into the lung, using electrical impedance tomography (EIT), during
BS and EPAP techniques in 10 non-cooperative patients and in 10 health
subjects. It was observed an airflow shift between ventral and dorsal regions
during BS and EPAP techniques in the non-cooperative group. The ventilatory
tracings showed that all periods with reversing of the airflow direction occurred
in the absence of significant variations in VT and flow, suggesting the existence
of pendelluft phenomenon. The second study was a randomized crossover
study trial that compared the acute effect of BS and EPAP on the regional lung
aeration by EIT, measured the duration of the therapeutic effect of lung
expansion and evaluated the influence of these techniques on cardiorespiratory
system. It was observed that lung aeration increased significantly in comparison
with baseline during EPAP and BS (2-way ANOVA and Sidak post hoc, all P <
0.001). However, the effects on lung expansion were kept for a short time, 4.6 ±
3.7 minutes and 2.3 ± 2.0 minutes for EPAP and BS, respectively. There were
no clinically significant differences on cardiorespiratory variables. We conclude
that there was a presence of the pendelluft phenomenon during BS and EPAP
in non-cooperative patients, and these techniques generated a significant
change on lung volumes, but not durable. The existence of expiratory muscle
contraction may have minimized the effect of lung expansion proposed by these
techniques.
26
Pinal, Fernández Iago. "Estudio de nuevas técnicas de imagen en la evaluación y seguimiento de la neumopatía intersticial en las enfermedades autoinmunes sistémicas." Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/285194.
Full textAbstract:
La tomografía computarizada de alta resolución (TCAR) es la prueba de
referencia para la valoración de las alteraciones estructurales del parénquima pulmonar
en la enfermedad pulmonar intersticial (EPI) de las enfermedades autoinmunes
sistémicas, también denominadas enfermedades del tejido conectivo (ETC). Junto con
las pruebas de función respiratoria (PFRs), esenciales para el estudio del funcionalismo
pulmonar de estos pacientes, la TCAR es la herramienta más útil para el diagnóstico y
seguimiento de la EPI en estos pacientes.
Muchos de los pacientes que presentan ETC son jóvenes, algunos incluso niños
o mujeres gestantes, y las radiaciones ionizantes de la TCAR son potencialmente
oncogénicas, lo que es motivo de preocupación y limita la generalización de su uso.
Son pues necesarias técnicas de imagen, como la ecografía o la resonancia
magnética pulmonar, que no utilicen radiaciones ionizantes y que puedan sustituir con
garantías a las ya existentes en la ayuda al diagnóstico y seguimiento de la neumopatía
intersticial en los pacientes con enfermedades autoinmunes sistémicas.
Esta tesis doctoral pretende arrojar algo más de luz sobre la posible utilidad en la
práctica clínica de exploraciones que no utilicen radiaciones ionizantes en la EPI que
acompaña a las ETCs.
Entre las enfermedades autoinmunes sistémicas, son aquellas del espectro de la
esclerodermia (SSc) y la miopatía inflamatoria, especialmente el síndrome por
anticuerpos antisintetasa (SAA), las que con mayor frecuencia presentan EPI. Así pues,
la población a estudio se circunscribirá a estos grupos de pacientes.
Los objetivos de esta tesis doctoral fueron analizar la utilidad de la ecografía
pulmonar en el estudio de la neumopatía intersticial en pacientes con miositis y
esclerodermia, identificar nuevos signos ecográficos que ayuden a definir mejor las
alteraciones del parénquima pulmonar secundarias al SAA y a la SSc y determinar la
validez de la resonancia magnética pulmonar en comparación con la TCAR como
prueba diagnóstica para el estudio de la extensión de la afectación pulmonar intersticial
en la SSc.
Para lograr estos objetivos se realizaron tres trabajos independientes que
estudiaron respectivamente la correlación de las líneas B ecográficas con la TCAR y las
PFRs en el SAA, la irregularidad pleural como nuevo signo ecográfico de EPI en la SSc
y el SAA y compararon una secuencia rápida de resonancia magnética torácica de 1.5T
con la TCAR para la valoración de la extensión de la EPI en pacientes con
esclerodermia.
Con estos estudios se concluyó que (1) la presencia de irregularidades pleurales,
pero no la de líneas B ecográficas, permite el diagnóstico de EPI en los pacientes con
neumopatía intersticial estudiados (SAA y SSc); (2) En pacientes con SAA las líneas B
ecográficas se correlacionan con la extensión de condensaciones en vidrio esmerilado y
la irregularidad pleural con la extensión de imágenes “panal de abeja”; (3) la
irregularidad pleural es más útil para el estudio de la EPI en pacientes con SSc que en
pacientes con SAA; (4) la TACAR y la ecografía pulmonar presentan una mala
correlación con las PFRs en pacientes con ETCs y que (5) tanto la presencia de
irregularidades pleurales como la cuantificación del área afecta por RM parecen ser
alternativas útiles al TACAR en la toma de decisiones terapéuticas en la EPI de los
pacientes con SSc.<br>High-resolution computed tomography (HRCT) is the gold standard to assess the
structural involvement of interstitial lung disease (ILD) secondary to autoimmune and
systemic disorders, also called connective tissue diseases (CTD). HRCT is the most
useful tool for the diagnosis and follow-up of ILD over time, along with respiratory
function tests (PFTs), essential for the study of lung function in these patients.
Patients with CTDs are frequently young, some even children or pregnant
women, and ionizing radiations due to HRCT are potentially oncogenic, which is a
matter of concern and limits its extensive use.
Imaging techniques lacking ionizing radiation, such as lung ultrasound or
magnetic resonance, could replace HRCT in the diagnosis and follow-up of interstitial
lung disease due to autoimmune and systemic diseases.
This doctoral thesis seeks to deepen in the usefulness of examinations without
ionizing radiations for the study of ILD accompanying CTDs.
Among autoimmune and systemic diseases, scleroderma (SSc) and
inflammatory myopathies, especially antisynthetase syndrome (ASS), are those with
higher frequencies of ILD. Thus, the study population will be limited to these patient
groups.
The objectives of this doctoral thesis were to analyze the usefulness of lung
ultrasound in the evaluation of ILD in patients with myositis and scleroderma, identify
new sonographic signs to study the involvement of lung parenchyma secondary to ASS
and SSc and compare MRI with HRCT for the study of the extent of interstitial lung
disease in SSc.
To achieve these objectives, we designed three separate projects studying
respectively the correlation of ultrasound B-lines with HRCT and PFTs in the ASS, the
pleural irregularity as a new sonographic sign of ILD in SSc and ASS and finally
compared lung MRI with HRCT to assess the extent of ILD secondary to systemic
sclerosis.
With these studies we concluded that (1) pleural irregularities, but not ultrasound
B lines, are able to diagnose ILD in patients with ASS and SSc; (2) B-lines correlate
with the extent of ground-glass opacities and pleural irregularities with the extent of
honeycombing in patients with ASS; (3) pleural irregularity is more useful in patients
with ILD secondary to SSc than in ASS; (4) HRCT and lung ultrasound have a poor
correlation with PFTs in patients with CTDs and (5) both the presence of pleural
irregularities and the extent of ILD assessed by MRI seem to be useful alternatives to
HRCT in the therapeutic decision-making process of ILD in patients with SSc.
27
Pavlikhina, Ekaterina. "Vliv zmeny postury na respiracni funkce u pacientu s postižením michy." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-396995.
Full textAbstract:
Author: Bc. Pavlikhina Ekaterina Title: Influence of the posture's change on respiratory function in spinal cord injury patients. Objectives: The purpose of this thesis is to analyze change in respiratory function on change of posture in patients with spinal cord injury (SCI). Another objective is to compare the respiratory functions in a health subjects and in a SCI patients. Last but not least is an effort to find out whether SCI patients have a pattern of restrictive pulmonary dysfunction. The findings can help understanding development of respiratory complications after spinal cord injury. It may help in choosing optimal position during respiratory examination and respiratory rehabilitation. Methods: In theoretical part, there were explored the available knowledges about respiratory complications and their effects on posture. In practical part, there were 26 subjects - 16 patients with SCI and 10 healthy subjects. Subjects with SCI were divided into two groups - one with paraplegia and other one with quadriplegia. Measurements were performed with spirometer on each subject during supine, sitting and standing postures. There were collected vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) data from all subjects. All data were processed in...
28
Jenkins, Heather Mary Leanne. "Involuntary breath stacking in children with neuromuscular disorders." 2011. http://hdl.handle.net/1993/4520.
Full textAbstract:
ABSTRACT
Rationale: Respiratory insufficiency is one of the most common causes of death in patients with neuromuscular disorders (NMD). Due to weakness and cognitive level, children with NMD often cannot perform required maneuvers to recruit lung volume. Data from cooperative adults suggest that breath stacking with a mask and one-way valve can obtain significantly higher lung volumes.
Methods: To study the effectiveness of a breath stacking mask in patients with NMD, we studied 23 children (17 male, 6 female) over 3 years, mean age 11 y (range 3-19 y) and body mass 43.8 kg (range 12-80 kg). Fifteen were cognitively aware and able to communicate verbally. For involuntary breath stacking a one-way valve and pneumotach were attached to a cushioned mask that was held to the face, covering around nose and mouth with a tight seal. Flow signals were acquired to computer (AcqKnowledge BIOPAC Inc.). Tidal volumes (Vt) and minute ventilation (VE) were calculated from the recording for 30 s before and 30 s after 15 s of valve closure during which expiration was prevented. Oxygen saturation (SaO2) was measured.
Results: The mean Vt before valve closure was 277 ml (range 29-598 ml). The mean increase in volume by stacking was 599 ± 558 ml (range -140 to 2,916 ml). When normalized to body mass, mean increase above normal end inspiratory level was 14.7 ± 14.7 ml/kg (range -2.7 to 52.2 ml/kg). The mean number of stacked breaths was 4.5 ± 3.6 (range 0-17). VE increased on average by 18% after stacking (p<0.05, paired t-test). There was no change in SaO2 after stacking. Four of the 23 children did not stack.
Conclusions: Our findings show that breath stacking with a mask and a one-way valve can achieve breath volumes approximately 3x Vt. The mask was tolerated well, and cooperation of the child was not required.
29
Landini, Nicholas. "Characterization of Connective Tissue Disorders related Interstitial Lung Disease (CTD-ILD) with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)." Doctoral thesis, 2022. http://hdl.handle.net/2158/1260834.
Full textAbstract:
Purpose/Objectives
Interstitial Lung Disease (ILD) is a major complication of Systemic Sclerosis (SSc), with high morbidity and mortality. Computed tomography is the gold standard for ILD imaging assessment. However, recent Ultra-Short Echo-Time (UTE) Magnetic Resonance Imaging (MRI) sequences are promising for lung parenchyma evaluation. Moreover, different Dynamic Contrast Enhancement (DCE) MRI patterns seems able to identify prevalent inflammatory and fibrotic ILD, with possible implications in the management of the therapy. We aimed to verify the reliability of respiratory triggered UTE Spiral VIBE-MRI sequence in SSc-ILD assessment, compared to Computed Tomography (CT). Moreover, we tested the feasibility of DCE-MRI ILD analysis.
Materials and methods
54 SSc patients performed chest CT and MRI in the same day. The MRI protocol included a UTE Spiral VIBE sequence before contrast administration and a VIBE sequence, scanned pre and post contrast administration (after 1, 3, 5 and 10 minutes). Two radiologists, independently and in consensus, analyzed CT and UTE verifying ILD presence/absence and performing a semiquantitative analysis (sQA) of ILD, Ground Glass Opacities (GGO), Reticulations and Honeycombing (HC) extents on CT and UTE. A CT software quantitative texture analysis (QA) of alterations extents was also performed. Then, in patients with ILD on CT, the two readers assessed the prevalent CE pattern as following: pattern 1) early enhancement and washout with discernible peak enhancement at 1 or 3 min; pattern 2) slight enhancement with no discernible peak enhancement at a specific time-point; and pattern 3) delayed persistent enhancement with discernible peak enhancement at 5 or 10 min. Pattern 1 was considered inflammatory, patterns 2
3
and 3 fibrotic. For ILD detections as well as for DCE MRI analysis, intra- and inter-reader agreements were computed with Cohen’s K coefficient. UTE sensitivity and specificity for ILD detection against CT were assessed. For extents analysis, intra-/inter-reader agreements and UTE performance against CT were computed by Lin’s concordance coefficient (CCC).
Results
51 subjects were included for visual assessment, as 3 UTE were discarded for low quality. ILD was diagnosed in 39/51 CT. 16 out of the 51 included patients accepted to underwent VIBE pre and post contrast administration scans: 14 patients had ILD on CT and DCE-MRI were analyzed (no one discarded for low quality). UTE intra and inter-reader K in ILD diagnosis was 0.56 and 0.26, respectively. UTE showed 92.8% sensitivity and 75.0% specificity in ILD detection. 42 out of 51 QA segmentations were accepted. ILD, GGO and Reticulations extents were 14.8%, 7.7% and 7.1% on CT sQA and 13.0%, 11.2% and 1.6% on CT QA. HC was <1% and not further considered. UTE intra- and inter-reader CCC was 0.92 and 0.89 for ILD extent and 0.84 and 0.79 for GGO extent, respectively. UTE RET extent intra and inter-reader CCC was 0.22 and 0.18, respectively. ILD and GGO extents CCC were 0.95 and 0.93 against CT sQA and 0.89 and 0.88 against QA. RET extent CCC were 0.35 against CT sQA and 0.22 and against CT QA. DCE-MRI analysis has intra- and inter- reader K of 1 and 0.63 (disagreement in one patient), respectively. Only one patients demonstrated a prevalent inflammatory pattern.
Conclusions
In SSc patients, UTE Spiral VIBE-MRI sequence may suffer of low inter-reader agreement in ILD detection, but it is a reliable tool in assessing ILD and GGO extents in ascertained ILD. DCE-MRI ILD evaluation seems feasible could add information on inflammatory ILD activity.
30
Green, Robin J. "Atopy and acquired immune deficiency - issues of control of two extremes of a spectrum of paediatric respiratory disorders with an immunological basis." Thesis, 2013. http://hdl.handle.net/2263/32940.
Full textAbstract:
Twenty publications are submitted. All deal with the issues of control of two
ends of the spectrum of immune-mediated respiratory disorders in children,
namely atopic (asthma and allergic rhinitis) and HIV-related lung disease.
This submission summarises the research by the author into this spectrum of
lung diseases of children in South Africa, highlighting the diversity of conditions
that are not only clinically important, but also common. Understanding of all
conditions is required to improve the health of children in this region.
Management of chronic conditions requires two major end points - adequate
and timely diagnosis and - management to control the condition. The author has
a passion for improving the quality of life of children and firmly believes that the
research findings will, and have, led to transformation in management of both
these common disorders. This document follows the progression of the authors research work and
highlights how interesting and important is the scope of two disorders which
could be thought to have a central origin, namely in the T-cell. T-cells form the
basis of cellular immunity and an excess of T-helper 2 cell activity promotes
atopy, whilst the human immunodeficiency (HI) virus infects T-helper cells and
promotes cellular immune deficiency and its attendant clinical disorders. The
author’s research work is not based on the immunological basis of these
conditions but does deal with the clinical implications and especially aspects
relating to control of these two extremes of a clinical spectrum of disorders. To
take the clarity of two diseases at the end of a spectrum to its natural conclusion
these extremes are defined in aetiology or pathophysiological differences
(excess versus suppression of the immune system), occurring in the affluent
and poor alike versus just the poor, control being required to improve quality of
life versus to save lives and finally that management requires anti-inflammatory
therapy versus antibiotic and anti-infective therapy. For the eight publications based on atopic respiratory disease in children the
themes are firstly that children with asthma and chronic rhinitis are diagnosed
late, that most individuals with these conditions are not well controlled and
finally that the reasons for lack of control are becoming obvious.
For the first time, the significant lack of asthma and allergic rhinitis control in
South Africa is documented. These studies suggest that, like surveys from the
rest of the world, asthma control is seriously under-estimated and neglected in
all asthmatics in South Africa, in both the privileged and the under-privileged.
The research also defines reasons for poor asthma and allergic rhinitis control
in this region. As in many studies published from around the world it is now
evident that poor asthma and allergic rhinitis control cannot be blamed on any
one source. A multitude of reasons underlie this phenomenon and each of the
subsequent papers in this section illustrates attempts at defining these
principles. The three most important reasons for poor control are probably that
most asthmatics are managed in the wrong hands (by doctors who don’t
understand adequate control and who aren’t empowered to use the correct
therapy), that control may actually be a pipe dream and practically difficult to do
or even impossible to achieve and lastly that the allergic basis of asthma is over
emphasised and may not in fact determine all asthma. The subsequent papers summarise research work in the field of HV infection in
children and exposes the opposite end of a spectrum of Paediatric respiratory
disease and highlight research into the conditions common in HIV-infected
children. Eleven papers are presented. For the diseases associated with the HI
virus the major complications of inadequate diagnosis and prevention in
children are acute pneumonia (especially severe pneumonia) and
bronchiectasis. Bronchiolitis is not common in HIV infected children, despite
epidemics of this condition in non-infected children. Passive smoking does not
aggrevate or worsen disease progression in children. The complications of HIV
related diseases in children require the same principles of adequate diagnosis
and control as would apply to the chronic atopic conditions. Once the author delved into the disorders at the other end of the clinical
spectrum, namely those associated with immune deficiency secondary to HIVinfection
he faced the question of a possible relationship between the
conditions. One submission explores that relationship.
This research has a unique perspective, conferred by the fact that these two
conditions do not occur to the same extent anywhere else in the world. Atopic
respiratory conditions and HIV-related lung diseases occur side by side in
abundance in this region. This perspective has created a clarity for research to
address the two most important aims in clinical medicine, namely to diagnose
correctly and then to manage the condition so that control is achieved. These
must be universal principles of the successful practice of medicine.<br>Thesis (DSc)--University of Pretoria, 2013.<br>gm2013<br>Paediatrics and Child Health<br>unrestricted
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Larsson, Lars-Gunnar. "Snoring and other symptoms related to obstructive sleep apnea : prevalence, risk factors, and relation to respiratory disorders : the obstructive lung disease in Northern Sweden study III." Doctoral thesis, 2001. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-110671.
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Chen, Jian-Jung, and 陳建仲. "Contemporary Study of Tongue Diagnosis of Chinese Medicine An Additional Study about The Relationship of Tongue States to Functional Disorders of the Lung in Chronic Obstructive Pulmonary Diseases." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/19541458698748940911.
Full textAbstract:
博士<br>中國醫藥學院<br>中國醫學研究所<br>87<br>The aim of this thesis is to establish the scientific bases of Chinese medical tongue diagnosis. The first step is to create the best environment for taking accurate photographs of the tongue. The second is to apply the color model to automatically visually separate the tongue fur and tongue body. The third step is to investigate the relationship of tongue states to functional disorders of the lung in chronic obstructive lung diseases in the clinical context.
The environment created was as follows: RB5000 light set with color-temperature of 5,300ok and a luminance of 3,100 Lux. A Nikon E2 digital camera with a Micro-Nikkor 105mm f/ 2.8D lens, an exposure speed of 1/125 seconds and aperture of f11 was used and gray card correction was performed regularly. A special fixture was designed with a chin-rest, and placed in a darkroom. Subjects were instructed to protrude their tongues to ensure a standard position of the tongue.
The processing procedure involved extracting features from the photographic images of the tongue on the basis of RGB color components. The differences of color in the tongue and its surrounding areas were enhanced and discriminated by a contour procedure. The contour of the tongue corresponded to that perceived by human vision. The color, thickness, amount, and distribution of the tongue fur were then derived.
As to the relationship between the state of the lung function and the condition of the tongue, the results show that the yellow tongue fur and the purple tongue are predominant in patients suffering from severe functional disorders of the lung. This study thus has established a valid program for differentiating white from yellow tongue fur, and red from purple tongue body.
It shows that digital image processing is appropriate for the scientific study of Chinese medical tongue diagnosis.