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The pulmonary surfactant system includes specific proteins involved in the regulation of surfactant secretion and recycling, conversion of secreted lamellar bodies to tubular myelin, film adsorption, and stimulation of alveolar macrophages. Hydrophobic proteins are essential for the rapid physiological action of exogenous surfactants currently used in clinical practice.
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Ramanathan, Rangasamy. "Surfactants in the Management of Respiratory Distress Syndrome in Extremely Premature Infants." Journal of Pediatric Pharmacology and Therapeutics 11, no. 3 (July 1, 2006): 132–44. http://dx.doi.org/10.5863/1551-6776-11.3.132.
Respiratory distress syndrome (RDS) is primarily due to decreased production of pulmonary surfactant, and it is associated with significant neonatal morbidity and mortality. Exogenous pulmonary surfactant therapy is currently the treatment of choice for RDS, as it demonstrates the best clinical and economic outcomes. Studies confirm the benefits of surfactant therapy to include reductions in mortality, pneumothorax, and pulmonary interstitial emphysema, as well as improvements in oxygenation and an increased rate of survival without bronchopulmonary dysplasia. Phospholipids (PL) and surfactant-associated proteins (SP) play key roles in the physiological activity of surfactant. Different types of natural and synthetic surfactant preparations are currently available. To date, natural surfactants demonstrate superior outcomes compared to the synthetic surfactants, at least during the acute phase of RDS. This disparity is often attributed to biochemical differences including the presence of surfactant-associated proteins in natural products that are not found in the currently available synthetic surfactants. Comparative trials of the natural surfactants strive to establish the precise differences in clinical outcomes among the different preparations. As new surfactants become available, it is important to evaluate them relative to the known benefits of the previously existing surfactants. In order to elucidate the role of surfactant therapy in the management of RDS, it is important to review surfactant biochemistry, pharmacology, and outcomes from randomized clinical trials.
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Bernhard, Wolfgang, Andreas Gebert, Gertrud Vieten, Gunnar A. Rau, Jens M. Hohlfeld, Anthony D. Postle, and Joachim Freihorst. "Pulmonary surfactant in birds: coping with surface tension in a tubular lung." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 281, no. 1 (July 1, 2001): R327—R337. http://dx.doi.org/10.1152/ajpregu.2001.281.1.r327.
As birds have tubular lungs that do not contain alveoli, avian surfactant predominantly functions to maintain airflow in tubes rather than to prevent alveolar collapse. Consequently, we have evaluated structural, biochemical, and functional parameters of avian surfactant as a model for airway surfactant in the mammalian lung. Surfactant was isolated from duck, chicken, and pig lung lavage fluid by differential centrifugation. Electron microscopy revealed a uniform surfactant layer within the air capillaries of the bird lungs, and there was no tubular myelin in purified avian surfactants. Phosphatidylcholine molecular species of the various surfactants were measured by HPLC. Compared with pig surfactant, both bird surfactants were enriched in dipalmitoylphosphatidylcholine, the principle surface tension-lowering agent in surfactant, and depleted in palmitoylmyristoylphosphatidylcholine, the other disaturated phosphatidylcholine of mammalian surfactant. Surfactant protein (SP)-A was determined by immunoblot analysis, and SP-B and SP-C were determined by gel-filtration HPLC. Neither SP-A nor SP-C was detectable in either bird surfactant, but both preparations of surfactant contained SP-B. Surface tension function was determined using both the pulsating bubble surfactometer (PBS) and capillary surfactometer (CS). Under dynamic cycling conditions, where pig surfactant readily reached minimal surface tension values below 5 mN/m, neither avian surfactant reached values below 15 mN/m within 10 pulsations. However, maximal surface tension of avian surfactant was lower than that of porcine surfactant, and all surfactants were equally efficient in the CS. We conclude that a surfactant composed primarily of dipalmitoylphosphatidylcholine and SP-B is adequate to maintain patency of the air capillaries of the bird lung.
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PUTMAN, Esther, Lambert A. J. M. CREUWELS, Lambert M. G. van GOLDE, and Henk P. HAAGSMAN. "Surface properties, morphology and protein composition of pulmonary surfactant subtypes." Biochemical Journal 320, no. 2 (December 1, 1996): 599–605. http://dx.doi.org/10.1042/bj3200599.
Separation of surfactant subtypes is now commonly used as a parameter in assessing the amount of active compared with inactive material in various models of lung injury. The protein content, morphology and surface activity were determined of the heavy and light subtype isolated by differential centrifugation. Here we report the presence of surfactant proteins B and C in the heavy subtype but not in the light subtype. Adsorption studies revealed that separation of fast adsorbing bronchoalveolar lavage resulted in slowly adsorbing heavy and light subtypes. Surfactant, reconstituted from heavy and light fractions, did not show a high adsorption rate. It is concluded that the isolation procedures might result in a loss of fast adsorbing surfactant structures. Surface area cycling was used as a model in vitro for the extracellular surfactant metabolism. The heavy subtype is converted into the light subtype during conversion. Conversion performed with resuspended heavy subtype revealed the generation of a disparate subtype. Furthermore it was found that the conversion was dependent on preparation and handling of the samples before cycling. Finally, adsorption studies at low surfactant concentrations revealed a delayed adsorption of lipid-extracted surfactants compared with natural surfactants. These observations emphasize the importance of the (surfactant-associated protein A-dependent) structural organization of surfactant lipids in the adsorption process.
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Dobbs, L. G. "Pulmonary Surfactant." Annual Review of Medicine 40, no. 1 (February 1989): 431–46. http://dx.doi.org/10.1146/annurev.me.40.020189.002243.
Nguyen, Thuy N., Stephanie M. Cunsolo, Peter Gal, and J. Laurence Ransom. "Infasurf and Curosurf: Theoretical and Practical Considerations with New Surfactants." Journal of Pediatric Pharmacology and Therapeutics 8, no. 2 (April 1, 2003): 97–114. http://dx.doi.org/10.5863/1551-6776-8.2.97.
Type II pneumocytes, normally responsible for surfactant production and release, are insufficiently formed and differentiated in the premature infant born before 34 weeks' gestation. Without an adequate amount of pulmonary surfactant, alveolar surface tension increases, leading to collapse and decreased lung compliance. Pulmonary surfactants are naturally occurring substances made of lipids and proteins. They lower surface tension at the interface between the air in the lungs, specifically at the alveoli, and the blood in the capillaries. This review examines the relative benefits of the two most recently marketed surfactants, calfactan (Infasurf) and poractant alfa (Curosurf).
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Rosenberg, O. A. "Pulmonary Surfactant Preparations and Surfactant Therapy for ARDS in Surgical Intensive Care (a Literature Review)." Creative surgery and oncology 9, no. 1 (April 25, 2019): 50–65. http://dx.doi.org/10.24060/2076-3093-2019-9-1-50-65.
Introduction. Despite the fact that clinical studies of pulmonary surfactants conducted over many years have demonstrated their efficacy for the treatment of acute respiratory distress syndrome (ARDS) which led to their approval for use inRussia andBelarus, only a few similar positive results have been achieved in other countries. This calls for an extensive literature review for intensive care professionals.Materials and methods. Using the data from 87 papers this review covers the composition, properties, methods of administration and delivery strategies of surfactant in the treatment and prevention of ARDS in patients with sepsis, severe complex injuries, inhalation injuries and a range of complications associated with thoracic and cardiovascular surgical procedures, massive blood transfusions, severe obstetric pathologies and the A/H1N1 pneumonia.Results. The early administration of natural pulmonary surfactants within 24 hours following the onset of ARDS as a part of the ARDS combination treatment or prevention drives down the time on mechanical ventilation to six days or shorter, prevents ventilator-associated and hospital-acquired pneumonias, bringing the respiratory failure mortality rate down to 15–20%.Discussion. Offering the first attempt to discuss the causes of failure of Phase III multicenter clinical trials outsideRussia andBelarus, this review outlines recent developments in synthetic and powdered pulmonary surfactant preparations.Conclusion. Pulmonary surfactants are highly effective as a part of complex therapy in ARDS treatment and prevention, resulting in two to four fold drop in ARDS mortality rate. The timing of administration is seen as the key factor of the efficacy of surfactant therapy, explaining the differences in clinical trials results from different countries.
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Nishijima, Koji, Ken-ichi Shukunami, Hideo Yoshinari, Jin Takahashi, Hideyuki Maeda, Hitoshi Takagi, and Fumikazu Kotsuji. "Interactions among pulmonary surfactant, vernix caseosa, and intestinal enterocytes: intra-amniotic administration of fluorescently liposomes to pregnant rabbits." American Journal of Physiology-Lung Cellular and Molecular Physiology 303, no. 3 (August 1, 2012): L208—L214. http://dx.doi.org/10.1152/ajplung.00081.2011.
Although vernix caseosa is known to be a natural biofilm at birth, human pulmonary surfactant commences to remove the vernix from fetal skin into the amniotic fluid at gestational week 34, i.e., well before delivery. To explain this paradox, we first produced two types of fluorescently labeled liposomes displaying morphology similar to that of pulmonary surfactant and vernix caseosa complexes. We then continuously administered these liposomes into the amniotic fluid space of pregnant rabbits. In addition, we produced pulmonary surfactant and vernix caseosa complexes and administered them into the amniotic fluid space of pregnant rabbits. The intra-amniotic infused fluorescently labeled liposomes were absorbed into the fetal intestinal epithelium. However, the liposomes were not transported to the livers of fetal rabbits. We also revealed that continuous administration of micelles derived from pulmonary surfactants and vernix caseosa protected the small intestine of the rabbit fetus from damage due to surgical intervention. Our results indicate that pulmonary surfactant and vernix caseosa complexes in swallowed amniotic fluid might locally influence fetal intestinal enterocytes. Although the present studies are primarily observational and further studies are needed, our findings elucidate the physiological interactions among pulmonary, dermal-epidermal, and gastrointestinal developmental processes.
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Wright, Jo Rae, and Samuel Hawgood. "Pulmonary Surfactant Metabolism." Clinics in Chest Medicine 10, no. 1 (March 1989): 83–93. http://dx.doi.org/10.1016/s0272-5231(21)00606-7.
Hockey, Peter Morey. "Pulmonary surfactant and asthma." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274434.
Nilsson, Kristina. "Solute exchange across the alveolo-capillary barrier." Lund : Depts. of Clinical Physiology, Malmö University Hospital and Lund University Hospital, Lund University, 1997. http://books.google.com/books?id=A0hrAAAAMAAJ.
Mo, Young Keun. "Surfactant proteins in extra pulmonary sites /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19083.pdf.
Sullivan, Lucy Catherine. "The molecular evolution of vertebrate pulmonary surfactant /." Title page, summary and introduction only, 1996. http://web4.library.adelaide.edu.au/theses/09SB/09sbs949.pdf.
Worthman, Lynn-Ann D. "Surfactant protein A (SP-A) affects pulmonary surfactant morphology and biophysical properties." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape16/PQDD_0014/MQ34241.pdf.
Wood, Philip. "Control of pulmonary surfactant secretion : an evolutionary perspective /." Title page, table of contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phw878.pdf.
Mander, Ann. "Pulmonary surfactant and neutrophil function in cystic fibrosis." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310701.
Zaltash, Shahparak. "Pulmonary surfactant proteins B and C : molecular organisation and involvement in respiratory disease /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4571-3/.
International Symposium on Basic Research on Lung Surfactant (3rd 1988 Marburg, Germany). Basic research on lung surfactant. Edited by Wichert P. von and Müller B. 1952-. Basel: Karger, 1990.
Fernström Foundation Symposium "Surfactant and the Respiratory Tract" (1988 Lund, Sweden). Surfactant and the respiratory tract: Proceedings of the 15th Fernström Foundation Symposium 'Surfactant and the Respiratory Tract,' held in Lund (Sweden) 1-4 June, 1988. Edited by Ekelund Laila, Jonson Björn, and Malm Lars. Amsterdam: Elsevier, 1989.
Ross Conference on Pediatric Research (96th 1987 Carefree, Ariz.). Surfactant treatment of lung diseases: Report of the 96th Ross Conference on Pediatric Research. Columbus, Ohio: Ross Laboratories, 1988.
Book chapters on the topic "Pulmonary surfactant":
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Alemanno, Fernando. "Pulmonary Surfactant." In Biochemistry for Anesthesiologists and Intensivists, 119–21. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-26721-6_10.
Enhorning, G. "Evaluation of Pulmonary Surfactant." In Surfactant Replacement Therapy, 13–17. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-73305-5_2.
Harwood, John L., Llinos W. Morgan, and Tanya Greatrex. "Alveolar Surfactant." In Pulmonary Biology in Health and Disease, 44–63. New York, NY: Springer New York, 2002. http://dx.doi.org/10.1007/978-0-387-22435-0_3.
Robertson, B., and S. Schürch. "Assessment of surfactant function." In Methods in Pulmonary Research, 349–83. Basel: Birkhäuser Basel, 1998. http://dx.doi.org/10.1007/978-3-0348-8855-4_14.
Enhorning, G. "Pulmonary Surfactant: Evolution of Functional Concepts." In Surfactant Replacement Therapy, 1–9. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-73305-5_1.
Willson, Douglas F., Patricia R. Chess, Zhengdong Wang, and Robert H. Notter. "Pulmonary Surfactant: Biology and Therapy." In The Respiratory Tract in Pediatric Critical Illness and Injury, 1–14. London: Springer London, 2008. http://dx.doi.org/10.1007/978-1-84800-925-7_10.
Armbruster, S., J. Klein, E. M. Stouten, W. Erdmann, and B. Lachmann. "Surfactant in Pulmonary Oxygen Toxicity." In Oxygen Transport to Tissue IX, 345–49. Boston, MA: Springer US, 1987. http://dx.doi.org/10.1007/978-1-4684-7433-6_40.
Lachmann, B. "In Vivo Tests for Evaluation of Pulmonary Surfactant." In Surfactant Replacement Therapy, 28–36. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-73305-5_4.
Conference papers on the topic "Pulmonary surfactant":
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Gaver, Donald P., Melissa A. Krueger, and Samir N. Ghadiali. "The Influence of Surfactant Physicochemical Properties on Pulmonary Interfacial Flow Analogues." In ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0218.
Abstract Many of the lung’s mechanical properties are influenced by pulmonary surfactant physicochemical characteristics. Pulmonary surfactant is a complex lipid-protein mixture formed in the type II alveolar cells and secreted into the alveolar subphase [1]. These substances reduce the surface tension at the air-liquid interface of the lining fluid that coats the interior of the lung. At sufficiently high concentrations, pulmonary surfactant reduces the surface tension to near zero and. in the process, stabilizes the alveoli and small airways [2–4].
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Siebert, Trina A., and Sandra Rugonyi. "Surfactant Spreading on a Thin Film Is Sensitive to Film Thickness: Implications for In Vivo Pulmonary Systems Versus In Vitro Scenarios." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-174065.
The role of pulmonary surfactant is critical to the mechanics of the lung. Pulmonary surfactant forms a monolayer film at the air-liquid interface of a thin film of fluid lining the alveoli. Without surfactant, the air-liquid surface tension would be too high and the lungs would collapse during exhalation, as is the case with premature babies who develop respiratory distress syndrome (RDS) because they lack a sufficient amount of pulmonary surfactant [1]. Because an increase in surfactant surface concentration correlates with a decrease in surface tension, the surface tension gradients resulting when a monolayer of surfactant is deposited on a thin fluid film cause the surfactant to spread. This self-spreading phenomenon is of interest for applications such as surfactant replacement therapy in infants suffering from RDS and for drug delivery [1,2].
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Numata-Nakamura, M., H. Lee, H. W. Chu, M. A. Seibold, and D. R. Voelker. "Pulmonary Surfactant Lipids Antagonize Human Rhinovirus Infections." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5757.
Meissner, Sven, Stefan Adami, Lilla Knels, Xiangyu Hu, Nikolaus Adams, and Edmund Koch. "Experimental And Numerical Studies On Pulmonary Surfactant." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3021.
Briva, Arturo, Leonel Malacrida, Horacio Botti, Fabiana Rocchiccioli, Juan Pablo Soto, Martin Angulo, and Ana Denicola. "Halogenated Anesthetics Impairs Biophysical Properties Of Pulmonary Surfactant." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5241.
Arciniegas Flores, R. A., I. A. Vital, K. Medepalli, D. DeMarzo, M. K. Glassberg Csete, and R. A. Alvarez. "Pulmonary Fibrosis Due to a Novel Surfactant Protein Mutation." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5437.
Suman, A., N. Sinha, H. Kaura, H. Rawal, and A. G. Espinoza. "Drowning in Surfactant - A Case of Pulmonary Alveolar Proteinosis." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1478.
Hall, Stephen B., Ryan W. Loney, and Shankar B. Rananavare. "Mechanisms Of The Late Accelerated Adsorption Of Pulmonary Surfactant." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5243.
Furuhashi, K., S. Sakurai, H. Yasui, M. Karayama, Y. Suzuki, H. Hozumi, N. Enomoto, et al. "Surfactant Protein D in Patients with Chronic Pulmonary Aspergillosis." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3694.
Kumley, B., E. Area-Gomez, Y. Xu, M. A. Campos, R. F. Foronjy, and I. Garcia-Arcos. "Decreased Surfactant Phospholipids in COPD Patients Correlate with Pulmonary Function." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5355.
Cochrane, Charles G. Clinical Studies of Synthetic Peptide-Containing Pulmonary Surfactant in Patients with Adult Respiratory Distress Syndrome. Fort Belvoir, VA: Defense Technical Information Center, November 1995. http://dx.doi.org/10.21236/ada302217.
