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Biomedical subjects

A Aida

Publications and source records attributed to A Aida.

At least 19 recordsLinked to original sources
PubMed1999

Effects of inhaled bronchodilators on pulmonary hemodynamics at rest and during exercise in patients with COPD.

INTRODUCTION: Inhaled anticholinergic drugs are often recommended for use as a first-line therapy for patients with COPD because they provide similar or more effective bronchodilating actions, as well as fewer side effects. It is not known, however, which class of bronchodilators is more advantageous for pulmonary hemodynamics, particularly during exercise. OBJECTIVES: To compare the effects of oxitropium and fenoterol on pulmonary hemodynamics in patients with COPD at rest and during exercise. PATIENTS: The study participants consisted of 20 consecutive male patients with stable COPD, a mean (+/- SD) age of 68+/-8 years old, and an FEV1/FVC ratio of 47.5+/-10.0%. METHODS: Eleven patients inhaled two puffs of oxitropium, and nine patients inhaled two puffs of fenoterol. Seven members of each group performed incremental exercise using a cycle ergometer. The hemodynamic measurements with right heart catheterization were performed by taking the average of three consecutive respiratory cycles before and after the administration of inhaled bronchodilators at rest and during exercise. RESULTS: At rest, despite a similar improvement of spirometric data with the two drugs, fenoterol, not oxitropium, caused significant increases in heart rate and cardiac output, a decrease in pulmonary vascular resistance, and a deteriorated Pao2. During exercise, however, both drugs similarly attenuated elevations in the mean pulmonary arterial pressure (40+/-12 to 38+/-10 mm Hg by oxitropium, and 41+/-9 to 36+/-9 mm Hg by fenoterol), the mean pulmonary capillary wedge pressure, and the mean right atrial pressure. CONCLUSION: Our findings indicate that both classes of bronchodilators are equally beneficial in the attenuation of right heart afterload during exercise in patients with COPD.

Administration, Inhalation↗
PubMed1999

[An analysis of nutritional status and pulmonary hypertension in patients with sequela of pulmonary tuberculosis and chronic obstructive pulmonary disease].

The prognostic value of hypercapnia and/or pulmonary hypertension differs in patients with sequela of pulmonary tuberculosis (TBseq) and those with chronic obstructive pulmonary disease (COPD) who are receiving home oxygen therapy (HOT). In an attempt to identify the factors, if any, that might explain this difference, we first compared nutritional status, respiratory function test results, dyspnea indexes, and other data for hypercapnic patients (PaCO2 > or = 45 Torr) and normocapnic patients (PaCO2 < 45 Torr) receiving HOT. Second, we examined the relationship between the degree of pulmonary hypertension and several respiratory function parameters for patients in each disease category. In 44 patients with TBseq, nutritional status estimated by body mass index and serum albumin was significantly better in the hypercapnic patients than in the normocapnic patients. However, this difference was not observed in 37 patients with COPD. In 30 patients with TBseq, the degree of pulmonary hypertension correlated significantly only with PaO2; in 32 patients with COPD, however, significant correlations were observed not only with PaO2 but also with PaCO2, %VC, and FEV1. These differences distinguishing groups of patients with the 2 diseases may provide an explanatory basis for the difference in prognostic value of hypercapnia and/or pulmonary hypertension in patients receiving HOT.

Aged↗
PubMed1998

Prognostic value of hypercapnia in patients with chronic respiratory failure during long-term oxygen therapy.

Hypercapnia observed in patients with chronic respiratory failure may not be an ominous sign for prognosis when they are receiving long-term oxygen therapy (LTOT). In this study, we selected 4,552 patients with chronic obstructive pulmonary disease (COPD) and 3,028 with sequelae of pulmonary tuberculosis (TBsq) receiving LTOT from 1985 to 1993 throughout Japan and prospectively analyzed their prognoses. The hypercapnic patients (PaCO2 >= 45 mm Hg) had a better prognosis than the normocapnic patients (35 <= PaCO2 < 45 mm Hg) for TBsq, but no difference was found between the two groups with COPD. Furthermore, Cox's proportional hazards model revealed that in TBsq hypercapnia was an independent factor for favorable prognosis, and that the relative risk for mortality was 0.76 in patients with 45 <= PaCO2 < 55 mm Hg, 0.64 for those with 55 <= PaCO2 < 65 mm Hg, and 0. 49 for patients with PaCO2 >= 65 mm Hg against normocapnic patients. This favorable effect of hypercapnia in TBsq was particularly apparent in the patients without severe airway obstruction. Even a rise of 5 mm Hg or more in PaCO2 over the initial 6- to 18-mo follow-up period was not associated with poor prognosis in TBsq, although it was in COPD. From these findings, we conclude that hypercapnia should not be generally considered an ominous sign for prognosis in those patients who receive LTOT.

Aged↗
PubMed1998

[Three adults with mild varicella and bronchial mucosal lesions].

We encountered three adults with varicella and bronchial mucosal lesions. Respiratory symptoms were minimal in all three. Chest X-ray films showed bilateral, diffuse, small, nodular shadows. Small, elevated lesions with white plaque's were seen on the bronchial mucosa bronchoscopically. Transbronchial lung biopsy, bronchial mucosal biopsy, and bronchoalveolar lavage were also done. The lung-biopsy specimen showed infiltration of lymphocytes into the interstitial space: VZV antigen was found by immunohistochemical staining of the lesion in one case. Analysis of bronchoalveolar lavage fluid revealed abnormally low CD 4/8 ratios in three cases. These findings suggest a high incidence of respiratory complications, especially bronchial lesions, despite the lack of respiratory symptoms, in adults with varicella.

Adult↗
PubMed1997

[A case of cardiovascular Behçet's disease detected as multiple nodular shadows on chest X-ray].

A case of cardiovascular Behçet's disease is reported. A 30-year-old man was admitted to our hospital with a high fever. Multiple nodular shadows were revealed on chest X-ray. Echocardiography revealed a mural thrombus in the right ventricle. A diagnosis of multiple pulmonary septic embolisms was made, and antibiotics were administered. The mural thrombus soon resolved, but later recurred in the same location. On the 90th day after admission. The mural thrombus was surgically removed. Histologically, the thrombus consisted of numerous neutrophils and fibrin. Examination of the endocardium attached to the thrombus revealed nonspecific inflammation, with fibrotic change and necrosing granulation present. A diagnosis of cardiovascular Behçet's disease was made based on the following findings: oral ulcerations, acneiform nodules, thrombophlebitis, bilateral uveitis, and positive HLA-B51. After treatment with steroid hormones and cyclosporine, the thrombus resolved completely, and inflammatory signs diminished. Though various clinical and pathological characteristics of cardiovascular Behçet's disease have been reported, it is rare for a mural thrombus to produce multiple pulmonary septic embolisms.

Adult↗
PubMed1995

Effects of platelet depletion on PMA-induced acute lung injury in awake sheep.

Little is known about the role of circulating platelets in PMA-induced lung injury in vivo. We investigated the effects of platelet depletion (PD) on the injury using seven unanesthetized sheep with lung lymph fistulas and eight other sheep for morphological study. PD diminished a decrease in the lymph to plasma concentration ratio (L/P) after 1 microgram/kg PMA treatment (n = 4) and caused more increases in lung lymph flow, L/P and lung lymph clearance after 5 micrograms/kg PMA treatment (n = 3) than in control sheep. The high dose was lethal to platelet-depleted sheep. However, PD had no effects on pulmonary hemodynamics. Morphologically, alveolar hemorrhages and exudate, and bleb formation of type I epithelial cells were more prominent in the platelet-depleted sheep than in the control sheep. We conclude that circulating platelets have protective effects against PMA-induced lung injury but have little involvement in PMA-induced pulmonary hypertension.

Animals↗
PubMed1995

Gender effect on prognosis of patients receiving long-term home oxygen therapy. The Respiratory Failure Research Group in Japan.

Although long-term home oxygen therapy (LTOT) certainly prolongs survival, it is not known whether this advantageous effect is similar for both sexes. In this study, we analyzed sex-related differences in survival based on a very large population that had received LTOT from 1986 to 1993. A total of 9,759 patients with chronic obstructive pulmonary disease (COPD), sequelae of tuberculosis (TBsq), and chronic interstitial pneumonia (IP) were selected in 1,212 medical institutions for analysis of survival rates. The survival rates of both sexes were compared with each other using the Cutler-Ederer Method. Despite higher PaCO2 at the beginning, the survival rate of women was significantly better than that of men in these three disease categories. Cox's proportional hazards analysis further confirmed the gender effect on survival by eliminating the effects of age, PaO2, PaCO2, %VC, and FEV1/FVC. The mean survival periods of the women who died during follow-up periods were also significantly longer than those of men (0.41 yr in COPD, 1.84 yr in TBsq, and 0.78 yr in IP). From these findings, we conclude women have a better prognosis than men when they start receiving LTOT, regardless of the cause of respiratory failure.

Female↗
PubMed1995

[Effects of temperature and humidity on the stability of nitric oxide, and efficacy of soda lime as a selective absorber of nitrogen dioxide].

Although inhaled nitric oxide (NO) has attracted attention as a pulmonary vasodilator, little heed has been given to its potential toxicity. Nitric oxide is known to be rapidly oxidized to nitrogen dioxide (NO2), which may damage pulmonary tissue. We examined the effects of temperature and humidity on the production of NO2 from NO. We also evaluated the amount of NO2 absorbed by soda lime, which is usually placed in the inspiratory line. For this purpose, we measured changes over time in the concentrations of NO and NO2 in mixtures that included NO, oxygen, and nitrogen in various concentrations, and at different temperatures and humidities. We confirmed that the formation of NO2 from NO follows the equation: -d[NO]/dt = 2 k[NO]2 [O2], where k is the rate constant. We found that k was significantly smaller at 37 degrees C than at 25 degrees C but was not influenced by humidity (0%, 40% or 90%). Although soda lime was very effective in absorbing NO2 from the inspiratory line, NO was simultaneously absorbed at the same molar ratio when the two gases existed together in the line. We thus conclude that inhalation of NO at 37 degrees C is more desirable than inhalation at room temperature, to suppress the production of NO2. When soda lime is used in the inspiratory line, attention should be paid to the reduction in the concentration of NO in the line.

Absorption↗
PubMed1995

[Effects of inhaled oxitropium bromide, an anticholinergic drug, on pulmonary hemodynamics in patients with chronic obstructive pulmonary diseases].

We studied the effects of the inhaled anticholinergic agent oxitropium bromide (Ox) on pulmonary hemodynamics in eleven patients with chronic obstructive pulmonary disease. All the patients underwent right heart catheterization and seven of them underwent an incremental ergometer exercise test while in the supine position. Pulmonary hemodynamics and arterial blood gases were measured at rest and during maximal exercise, before and 30 minutes after inhalation of 2 puffs (200 micrograms) of Ox. Inhalation of Ox did not significantly change pulmonary hemodynamics at rest. The mean pulmonary arterial pressure and the mean pulmonary capillary wedge pressure during exercise decreased significantly (from 40.3 +/- 4.6 to 37.7 +/- 3.9 mmHg, and from 20.4 +/- 3.5 to 17.1 +/- 2.7 mmHg, respectively, mean +/- SE). However, neither cardiac output nor pulmonary vascular resistance changed with inhalation of the drug, at rest or during exercise. We therefore conclude that this commonly used dose of Ox does not directly affect the pulmonary vascular system. The small but significant decreases in pulmonary arterial pressure and pulmonary capillary wedge pressure with Ox may have been indirect effects, caused by bronchodilation.

Administration, Inhalation↗
PubMed1995

[Non-invasive evaluation of pulmonary hemodynamics by pulsed Doppler echocardiography in patients with chronic obstructive pulmonary disease].

Pulsed doppler echocardiography is reported to be a reliable method for evaluating pulmonary hemodynamics in patients with cardiovascular diseases, but not with chronic obstructive pulmonary disease (COPD) because of the difficulty in obtaining an appropriate echo-window in such patients. We examined 23 patients with COPD by doppler echocardiography (Hewlett-Packard, HP77020CV) with a 2.5 MHz transducer via the subcostal approach in a supine position. The right side of the heart catheterization was performed simultaneously in sixteen of these patients. The remaining 7 patients received the same procedure within one week of the doppler echocardiography. Adequate ejection flow pattern from the right ventricle was obtained in all the patients. Significant negative linear relationships were found between pulmonary arterial pressure and acceleration time (r = -0.67) and ejection time (r = -0.52). These findings show that doppler echocardiography can be useful when evaluating pulmonary hemodynamics even in patients with COPD.

Aged↗
PubMed1994

Role of pulmonary intravascular macrophages in anti-platelet serum-induced pulmonary hypertension in sheep.

It has been reported that an injection of anti-sheep platelet serum (AsPS) induces transient pulmonary hypertension in sheep, but the mechanism by which this occurs has not been well explained. To examine the hypothesis that pulmonary intravascular macrophages (PIMs) are involved in this phenomenon, we investigated the morphological features of PIMs from sheep that received three different kinds of AsPS injections. The pulmonary arterial pressure response was examined not only in sheep that have many PIMs in the lung and had received AsPS, but also in rats that reportedly have few PIMs and had received an injection of anti-rat platelet serum. The pulmonary arterial pressure responses of the two species were quite different in quality and quantity. In sheep whose pressure response was definitely positive in association with production of thromboxane in the pulmonary circulation, PIMs were found by fluorescent microscopy and electron microscopy to phagocytize aggregated platelets that bound AsPS. These results suggest that PIMs significantly contribute to AsPS-induced transient pulmonary hypertension in sheep.

Animals↗
PubMed1994

[Usefulness of twenty-four-hour home monitoring of oxygen saturation in patients with chronic obstructive pulmonary disease].

The clinical usefulness of 24 hr home monitoring of oxygen saturation (SaO2) with pulse oximeter was studied in 48 outpatients with COPD. In addition, doppler echocardiography for measurement of acceleration time (AcT), which inversely correlates with mean pulmonary arterial pressure, a 6-minute walk test, and an exercise study on a bicycle ergometer were performed in 26, 17, and 14 patients, respectively. Nadir SaO2 and the total time during which SaO2 was below 90% were calculated to estimate diurnal and nocturnal oxygen desaturation (diurnal nadir SaO2, diurnal TSaO2 < 90%, nocturnal nadir SaO2, and nocturnal TSaO2 < 90%). Relations between the indices of desaturation measured during home monitoring and dyspnea grade (Fletcher-Hugh-Jones), awake PaO2, AcT, Hb, Ht, and oxygen desaturation during the exercise tests were also studied. Diurnal nadir SaO2 was lowest and diurnal TSaO2 < 90% was longest in the group with dyspnea grade IV. In the other groups, various degrees of oxygen desaturation were observed, even within groups. Diurnal nadir SaO2 and nocturnal nadir SaO2 correlated with awake PaO2, but not with diurnal TSoO2 < 90%. Diurnal nadir SaO2 was similar to nadir SaO2 during the exercise tests. AcT, hemoglobin, and hematocrit correlated with diurnal oxygen desaturation but not with nocturnal oxygen desaturation. From the above findings, we conclude that pulmonary hypertension may be associated with diurnal oxygen desaturation, and that home monitoring of SaO2 is useful for the detection of oxygen desaturation not predicted from dyspnea grade and PaO2 while awake.

Aged↗
PubMed1994

[Dyspnea grade as a prognostic factor in patients with chronic obstructive pulmonary disease].

It is known that the prognosis of patients with chronic obstructive pulmonary disease (COPD) is related to some indices of pulmonary function tests representing airway obstruction and/or the level of arterial oxygenation. Although the grade of exertional dyspnea, which is a common complaint of such patients, has also been claimed by some to be an important prognostic factor, it is not certain whether dyspnea grade is independent of other objective indices. In this study, we examined the prognosis of 97 patients with COPD in a retrospective fashion by Kaplan-Meyer's method and compared the survival time according to the dyspnea grade. As a whole, the survival time in those patients (n = 22) whose dyspnea grade initially was 4 or 5 was shorter than in patients with dyspnea grade 1 or 2 (n = 40) and dyspnea grade 3 (n = 30) (dyspnea grade 4-5 vs. dyspnea grade 1-2 and 3, p < 0.001). Since patients with higher dyspnea grades are associated with lower pulmonary function, we selected the patients whose PaO2 and forced expiratory volume in 1 second were in the same range. Dyspnea grade varied even among these subjects, and again was significantly related to the survival time. We therefore conclude that dyspnea grade, even though a subjective complaint, is an independent prognostic factor in patients with COPD.

Aged↗
PubMed1993

Liver cirrhosis with severe hypoxemia and paradoxic pulmonary vascular response to graded inspiratory oxygen tension.

We present the findings in a patient with liver cirrhosis who showed oppositional pulmonary vascular responses to various alveolar oxygen tensions. In this case the pulmonary artery constricted on exposure to hyperoxia and then gradually dilated during progressive hypoxic inhalation. Such a paradoxic response must result in severe arterial hypoxemia because of severe V/Q mismatching.

Dyspnea↗
PubMed1993

[Efficacy of conventional CT in diagnosis of pulmonary emphysema: evaluation of low attenuation area by multiple observers].

The efficacy of conventional CT in the diagnosis of pulmonary emphysema (PE) was studied in 122 patients with miscellaneous diseases including 26 patients with PE. The density and the distribution of low attenuation area (LAA) were evaluated by six independent physicians. Analysis with kappa statistics showed a good inter-observer agreement in the detection of LAA. The grading of LAA correlated well with FEV1/FVC, DLCO/VA, and lung volumes, which indicated that PE could be detected by conventional CT by the evaluation of LAA. The agreement was poor, however, for the detection of low grade LAA and there were some false positives, and there was no specific pattern in the distribution of LAA in PE compared to other pulmonary diseases. We conclude that the evaluation of LAA by conventional CT is simple and effective in the screening of PE.

Aged↗
PubMed1993

[A case of chronic hepatitis C complicated by ischemia-like changes seen on the electrocardiogram during interferon treatment].

A 53-year-old woman was admitted to the hospital for chest pain with headache, nausea and vomiting, two and a half hours after an intramuscular injection of 6 x 10(6) units of IFN (interferon) alpha 2a, in the 11th week of IFN treatment for chronic hepatitis C. The electrocardiogram (ECG) showed ST depression and T inversion in leads II, III, aVF and V3-V6, as commonly seen in myocardial ischemia. However, emergency coronary angiography (CAG) did not show stenosis or spasms clearly, serum CPK was always within the normal limits, Tc-99m PYP scintigraphy and T1-201 scintigraphy did not show any abnormal uptake or defect, and the echocardiogram did not show any abnormality. She recovered from chest pain and the ischemia-like changes seen on the ECG, after IFN treatment was stopped, and she rested for 7 days from this treatment and other treatment using nitrites and a calcium-antagonist. After recovery, the ECG during exercise and hyperventilation showed changes similar to those seen on admission. From these findings, this case was considered to be precipitated by spasms of coronary microvessels, which were not noticeable in CAG. The cause was thought to be complicated by IFN treatment, because this episode appeared after IFN injection, and improved after stopping IFN treatment.

Electrocardiography↗