Idiopathic interstitial pneumonias are currently classified into four categories: usual interstitial pneumonia, nonspecific interstitial pneumonia with fibrosis, acute interstitial pneumonia and desquamative interstitial pneumonia. The fibrotic process in interstitial pneumonias appears to result from a complex interaction between fibroblasts, other lung parenchymal cells and macrophages. The complex relationship between the local release of growth-promoting cytokines by alveolar macrophages and resident fibroblasts represents a necessary step for fibrosis or remodeling after lung injury. Injury to the epithelium and basement membranes is likely necessary for the fibrotic process to occur. Usual interstitial pneumonia, most frequent among interstitial pneumonias and has a poor prognosis, appears on high-resolution CT as patchy subpleural areas of ground-glass attenuation, irregular linear opacity, and honeycombing. Nonspecific interstitial pneumonia with fibrosis, the second most frequent and has a better prognosis than usual interstitial pneumonia, appears as subpleural patchy areas of ground-glass attenuation with associated areas of irregular linear opacity on CT. Acute interstitial pneumonia with high mortality rate presents as extensive bilateral airspace consolidation and patchy or diffuse bilateral areas of ground-glass attenuation. Desquamative interstitial pneumonia with good prognosis presents as patchy subpleural areas of ground-glass attenuation in middle and lower lung zones.
Human ; Lung Diseases, Interstitial/radiography ; Lung Diseases, Interstitial/physiopathology ; Lung Diseases, Interstitial/pathology*

OBJECTIVETo study the characteristics and role of dynamic pressure-volume curve (P-V curve) in neonatal mechanical ventilation.

METHODSA dynamic P-V curve was automatically drawn by the Stephanie ventilator. The slope rate of dynamic P-V curve was measured in 25 neonates who received mechanical ventilation 1, 24, 48 and 72 hrs after ventilation and before weaning from ventilation. Minute-ventilation (MV), mean airway pressure (Pmean), and fraction of inspired oxygen (FiO2) were recorded. The patterns of dynamic P-V curve during abnormal ventilation (resistance to ventilator, part or complete airway obstruction, airway leaking and tracheal catheter exodus) were observed.

RESULTSWith the improvement of pulmonary disease, the slope rate of P-V curve and MV increased, Pmean and FiO2 decreased, and the P-V curve shifted to the volume axle. The slope rate of curve 48 and 72 hrs after ventilation and before weaning from ventilation (1.05+/-0.48, 1.10+/-0.42 and 1.13+/-0.37 mL/cmH2O respectively) increased significantly compared with that 1 hr after ventilation (0.76+/-0.53 mL/cmH2O) (p<0.05 or 0.01). Abnormal ventilation led to abnormal appearance of dynamic P-V curve.

CONCLUSIONSThe increasing slope rate of dynamic P-V curve and the curve shifting to volume axle in neonatal mechanical ventilation may be associated with the improvement of pulmonary disease. The appearance changes of the curve may be of value in the assessment of abnormal ventilation.

Female ; Humans ; Infant, Newborn ; Lung ; physiopathology ; Lung Diseases ; physiopathology ; Male ; Respiration, Artificial ; Respiratory Mechanics

OBJECTIVE: We wanted to demonstrate and compare the serial high-resolution CTs (HRCT) and the pulmonary function test (PFT) findings of the usual interstitial pneumonia (UIP) and the non-specific interstitial pneumonia (NSIP). MATERIALS AND METHODS: The serial HRCT scans and the PFT results were retrospectively analysed and compared for 35 patients having UIP without significant honeycombing (UIP-w/o hc, < 5% of honeycombing at CT), 35 patients having UIP with honeycombing (UIP-w/i hc, > or = 5% of honeycombing), and 25 patients with NSIP. The mortality rates were also compared. Follow-up CT scans were available in 75 patients (29 UIP-w/o hc patients, 22 UIP-w/i hc patients and 24 NSIP patients) and the follow-up periods ranged from 150 to 2, 370 days. The initial and follow-up PFT data were available for 71 patients. RESULTS: On the initial CT, significant differences were present between the UIP-w/i hc patients and both the UIP-w/o hc patients and the NSIP patients in the overall extent, ground-glass opacity (GGO) away from the reticulation, reticulation and honeycombing (all p < 0.05). Improvement was noticed in five (17%) of 29 UIP-w/o hc patients, none of 22 UIP-w/i hc patients, and 9 (37%) of 24 NSIP patients; deterioration was noted in six (21%) UIP-w/o hc patients, two (9%) UIP-w/i hc patients and three (13%) NSIP patients (p = 0.044 between UIP-w/o and UIP-w/i hc; p = 0.637 between UIP-w/o hc and NSIP; p = 0.007 between UIP-w/i hc and NSIP). The serial changes of the pulmonary function in the NSIP patients were different from those noted for the UIP-w/i hc and UIP-w/o hc patients (p = 0.440 between UIP-w/o and UIP-w/i hc; p = 0.022 between UIP-w/o hc and NSIP; p = 0.003 between UIP-w/i hc and NSIP). Five (14%) of the 35 patients with UIP-w/o hc, 16 (46%) of the 35 patients with UIP-w/i hc and three (12%) of the 25 patients with NSIP died (p = 0.002, comparison for the three groups). CONCLUSION: On CT, NSIP and UIP-w/o hc patients have similar patterns of parenchymal abnormalities and a similar likelihood of change in the extent of disease on follow-up. Patients with UIP-w/i hc have distinctive features and a worst prognosis.
*Tomography, X-Ray Computed ; Retrospective Studies ; Lung Diseases, Interstitial/mortality/*physiopathology/*radiography ; Lung/*physiopathology ; Humans ; Follow-Up Studies ; Female ; Aged

OBJECTIVETo study the effect of oxygen at lethal levels (95%) on pulmonary development and lung injury in neonatal rats and establish rat models of bronchopulmonary dysplasia.

METHODSThree-day-old and adult SD rats were assigned to experimental or control groups and subjected to 95% O(2) exposure and room air for 7 days. Body weight and length of the rats were recorded, and histological study of the lung tissue and radical alveoli count (RAC) were carried out.

RESULTSThe mortality rate of the neonatal and adult rats was 12.5% and 35.2% in hyperoxia group, respectively. The newborn rats in hyperoxic group had lower body weight (18.02-/+0.68 vs 13.24-/+0.59 g) and length (8.83-/+0.25 vs 6.76-/+0.51 cm) than those in the control group (P<0.05), with also lower RAC (9.50-/+1.05 vs 13.00-/+1.79, P<0.05); RAC of the adult rats with hyperoxic exposure (12.67-/+2.25) was higher that of exposed neonatal rats, but not significantly different from that of the adult or neonatal rats in the control group (P>0.05). Structure configuration of the rats on the first 10 days of life resembled that of adulthood. The lung of hyperoxic neonatal rats showed thinner walls of alveoli, simple alveolar structure, fewer and larger alveoli, expanded and shrunk alveoli, while the lung of the adult rats displayed thicker septa, smaller space of alveoli, and cells in the space of the alveoli.

CONCLUSIONExposure of neonatal rats to 95% O(2) may result in mild pulmonary inflammation in addition to growth impediment and impaired lung development, which shares morphologic similarities to human bronchopulmonary dysplasia.

Animals ; Animals, Newborn ; Disease Models, Animal ; Female ; Hyperoxia ; complications ; physiopathology ; Lung ; physiopathology ; Lung Diseases ; etiology ; physiopathology ; Lung Injury ; Pregnancy ; Pulmonary Alveoli ; pathology ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Adolescent ; Common Variable Immunodeficiency ; complications ; Female ; Humans ; Lung Diseases, Interstitial ; etiology ; pathology ; physiopathology ; Pneumonia ; etiology ; pathology ; physiopathology

OBJECTIVE: To explore the effect of dust exposure, type of work, age, length of service and duration of dust exposure on pulmonary function in coal miners by pulmonary function tests.
 METHODS: A total of 1 953 coal miners, who received occupational healthy examination and pulmonary function tests during June, 2013 and August, 2014 in Hunan Prevention and Treatment Institute, were enrolled for this study.
 RESULTS: A total of 1 302 miners (66.7%) displayed pulmonary dysfunction, including 1 139 with mild dysfunction (58.3%) and 163 with moderate or more serious dysfunction (8.3%). The risk factors for pulmonary dysfunction were age (OR=1.329, 95% CI: 1.196-1.620), dust exposure duration (OR=1.267, 95% CI: 1.136-1.413) and type of works (mining workers OR=1.156, 95% CI: 1.033-1.293; all P<0.05).
 CONCLUSION The incidence rate of pulmonary dysfunction in coal miners is relatively high in Hunan Province. Most of them are mild dysfunction. The incidence rate of pulmonary dysfunction in mining works is statistically higher than that in other work types. Older workers and long duration-exposed workers are more likely to have pulmonary dysfunction.
China ; Coal Mining ; Dust ; Humans ; Incidence ; Lung ; physiopathology ; Lung Diseases ; epidemiology ; Occupational Exposure ; Respiratory Function Tests ; Risk Factors

As the transportation of O2 and CO2 inside human body is an integrated aspect of Qi-blood transportation, a hemodynamic model is established based on the analysis of the respiratory and circulation system. The results of such model show that the abnormality of the circulatory and respiratory parameters always lead to a reduction of Po2 (O2 pressure) in tissue fluid, and then a Lung Qi-Deficiency Syndrome (QDS). This model can be used to quantitatively explain, to some extent, the physiological phenomena of Lung QDS, and could combine all the discoveries of in clinical researches, on Lung QDS. The measurement of Po2 in tissue fluid as an index to analyze Lung QDS is in accordance with TCM and TMM (the theory of modern medicine). This model may provide a new approach in clinical research of Lung QDS.
Hemodynamics ; Lung Diseases ; physiopathology ; Medicine, Chinese Traditional ; Models, Biological ; Qi ; Respiratory Mechanics

OBJECTIVETo evaluate the effect of health education on lung function and quality of life in stabilized patients with chronic pulmonary disease (COPD).

METHODS117 stabilized COPD patients were randomly devided into 4 groups with numbers as 31,26, 20 and 40 identified as Groups 1 to 4. Patients in Group 1 did not receive health education, but Groups 2,3 and 4 received one, two, three or more times health education in file. FEV1, FEV1%, FEV1/FVC and SGRQ score were compared pre and 6-month post the health education program.

RESULTSHealth education seemed successful in delaying the decline of FEV1, FEV%, FEV1/FVC and groups 2-4 were superior to group 1(P < 0.05) while groups 3 and 4 were superior to groups 1 or 2(P < 0.05). Health education was effective in raising the SGRQ score among the stabilized COPD patients with groups 2-4 superior to group 1 (P < 0.05) while groups 3 and 4 superior to groups 1 or 2 (P < 0.05).

CONCLUSIONHealth education could effectively delay the decline of both lung function and quality of life in stabilized patients with COPD.

Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Health Education ; Humans ; Lung ; physiology ; physiopathology ; Lung Diseases ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Recovery of Function

PURPOSE: Lung size mismatch is a major cause of poor lung function and worse survival after lung transplantation (LTx). We compared predicted total lung capacity (pTLC) and TLC measured by chest computed tomography (TLC(CT)) in LTx candidates. MATERIALS AND METHODS: We reviewed the medical records of patients on waiting lists for LTx. According to the results of pulmonary function tests, patients were divided into an obstructive disease group and restrictive disease group. The differences between pTLC calculated using the equation of the European Respiratory Society and TLC(CT) were analyzed in each group. RESULTS: Ninety two patients met the criteria. Thirty five patients were included in the obstructive disease group, and 57 patients were included in the restrictive disease group. pTLC in the obstructive disease group (5.50±1.07 L) and restrictive disease group (5.57±1.03 L) had no statistical significance (p=0.747), while TLC(CT) in the restrictive disease group (3.17±1.15 L) was smaller than that I the obstructive disease group (4.21±1.38 L) (p<0.0001). TLC(CT)/pTLC was 0.770 in the obstructive disease group and 0.571 in the restrictive disease group. CONCLUSION: Regardless of pulmonary disease pattern, TLC(CT) was smaller than pTLC, and it was more apparent in restrictive lung disease. Therefore, we should consider the difference between TLC(CT) and pTLC, as well as lung disease patterns of candidates, in lung size matching for LTx.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lung/*diagnostic imaging/pathology/*physiopathology ; Lung Diseases/diagnostic imaging/pathology/physiopathology/therapy ; *Lung Transplantation ; Male ; Middle Aged ; Organ Size ; *Patient Selection ; Retrospective Studies ; *Tomography, X-Ray Computed ; *Total Lung Capacity ; Young Adult

OBJECTIVETo analyze the clinical features and investigate the clinical diagnostic methods of hard metal lung disease (HMLD), then provide reference for the diagnostic criteria of occupational HMLD.

METHODSRetrieved the open published case reports associated with HMLD from January, 2000 to June, 2014. Regarding the ages, sex, types and years of work, clinical features and laboratory results for analyzing.

RESULTSCollected 21 clinical cases of HMLD belonged to 6 internal reports and 15 oversea reports. Among them 15 male and 6 female, ages were from 22 to 58, length of service between 1 year and 43 years. Clinical presentations included cough (20 cases), dyspnea on progressive (10 cases), and pulmonary function testing showed a restrictive abnormality. The imaging features presented as bilateral areas of ground-glass attenuation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The finding of giant cell interstitial pneumonia (GIP) was almost pathognomonic for hard metal pneumoconiosis. The main pathological findings contained a different levels of lymphocyte, acidophilic cell infiltration, hyperplasia of fibrous tissue and numerous large multinucleated histiocytes which ingested inflammatory cells were admixed with macrophages. 16 cases of the 21 reports showed GIP.

CONCLUSIONSClinical presentations include cough and dyspnea on progressive, and pulmonary function testing show a restrictive abnormality. The imaging features present as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The prime pathological findings contain interstitial pneumonia with intra-alveolar macrophages and a large amount of multinucleated histiocytes.

Adult ; Alloys ; Cobalt ; Female ; Humans ; Lung ; physiopathology ; Lung Diseases, Interstitial ; pathology ; Macrophages, Alveolar ; Male ; Middle Aged ; Occupational Diseases ; pathology ; Pneumoconiosis ; pathology ; Tungsten ; Young Adult