• Title/Summary/Keyword: Pulmonary alveoli

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Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report

  • Jung, Jae Wan;Lee, Hyunho;Oh, Jimi
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.374-380
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    • 2021
  • Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

Human Pluripotent Stem Cell-Derived Alveolar Organoids: Cellular Heterogeneity and Maturity

  • Ji-Hye Jung;Se-Ran Yang;Woo Jin Kim;Chin Kook Rhee;Seok-Ho Hong
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.52-64
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    • 2024
  • Chronic respiratory diseases such as idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and respiratory infections injure the alveoli; the damage evoked is mostly irreversible and occasionally leads to death. Achieving a detailed understanding of the pathogenesis of these fatal respiratory diseases has been hampered by limited access to human alveolar tissue and the differences between mice and humans. Thus, the development of human alveolar organoid (AO) models that mimic in vivo physiology and pathophysiology has gained tremendous attention over the last decade. In recent years, human pluripotent stem cells (hPSCs) have been successfully employed to generate several types of organoids representing different respiratory compartments, including alveolar regions. However, despite continued advances in three-dimensional culture techniques and single-cell genomics, there is still a profound need to improve the cellular heterogeneity and maturity of AOs to recapitulate the key histological and functional features of in vivo alveolar tissue. In particular, the incorporation of immune cells such as macrophages into hPSC-AO systems is crucial for disease modeling and subsequent drug screening. In this review, we summarize current methods for differentiating alveolar epithelial cells from hPSCs followed by AO generation and their applications in disease modeling, drug testing, and toxicity evaluation. In addition, we review how current hPSC-AOs closely resemble in vivo alveoli in terms of phenotype, cellular heterogeneity, and maturity.

PAF in Pulmonary Surfactant Contributes to Neutrophilic Oxidative Stress-Induced Acute Lung Injury of Rats Given LPS Intratracheally (흰쥐에서 내독소로 유도된 급성폐손상에서 surfactant내 PAF의 역할)

  • Lee, Young-Man
    • Journal of Life Science
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    • v.22 no.10
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    • pp.1352-1358
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    • 2012
  • In acute lung injury (ALI) by lipopolysaccharide (LPS), the underlying cause of infiltration and migration of neutrophils into the alveoli is considered to be from increased production of platelet-activating factor (PAF) in the pulmonary surfactant lining the alveolar lumen. In this study I partially confirmed this concept. LPS increased lung leak and the infiltration of neutrophils in the lung of rats given LPS intratracheally. The migration of neutrophils into the lung, which had caused oxidative stress, was also morphologically identified. I verified that the metabolism of the pulmonary surfactant was affected and that there was increased production of PAF in the pulmonary surfactant, both of which are considered to contribute to ALI by LPS in rats.

Whole Lung Lavage in Pulmonary Alveolar Proteinosis associated with Lung Cancer Using Extracorporeal Membrane Oxygenation (ECMO) (폐암을 동반한 폐포 단백증환자에시 경피적 체외막 산소화를 이용한 성공적인 전폐세척술 치험 1예)

  • Kim Jin Hyun;Kim Kyung-Hwan
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.860-862
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    • 2005
  • We describe a case of pulmonary alveolar proteinosis in a male adult with lung cancer To achieve the successful operation of lung cancer, we used percutaneous veno-venous extracorporeal membrane oxygenation (ECMO) during whole lung lavage (WLL) of the contralateral lung. We performed successful WLL under ECMO support.

A Case of Bilateral Diffuse Infiltration (양측 미만성 폐침윤 1예)

  • Lee, Young Jae;Heo, Woo Young;Lee, Sang Wook;Park, Myoung Jae;Yoo, Jee Hong;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.683-686
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    • 2004
  • Pulmonary alveolar proteinosis is a rare disorder in which lipoproteinaceous material accumulates within the alveoli. We report a case of pulmonary alveolar proteinosis in a 41 year old female patient. She complained of a dry cough in the preceding 6 months. She presented symptoms of mild hypoxemia and diffuse infiltration at both lower lung fields. A milky fluid was obtained by bronchoalveolar lavage. We confirmed by light microscopic examinations of the lung tissues obtained by transbronchial lung biopsy. Through several follow-ups, the patients symptoms were mild.

Studies on infection rate and histopathological findings of canine heartworms in Inchon city (인천 지역 사육견의 심장사상충 감염률 및 병리조직학적 연구)

  • 이성모;황현순;김종훈
    • Korean Journal of Veterinary Service
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    • v.22 no.1
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    • pp.25-35
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    • 1999
  • The prevalence of canine heartworm(Dirofilaria immitis) infection in 150 mixed-breed dogs(male : 54, female : 96) from February to December 1997 was investigated by using antigen test kit(ICT $GOLD^{TM}$ HW, Synbiotics, USA) based on immunochromatographic assay in Inchon city. Also, gross and histopathological findings of an antigen positive dog were carried out. The results were summarized as follows ; 1. Four dogs were positive from 150 tested dogs(2.7%). They were all more than 2 years old and infection rates in male and outdoor dogs was higher than those in female and indoor, respectively. Species of infected dogs were Pug(2) , German Sheperd(1) and Great-dane (1). 2. Regional infection rates were closely related with housing system in the city. 3. Pathological findings of antigen-positive dog was excessive enlargement, congestion and hemorrhage of lung and D immitis in heart and histologically hemosiderin, hypertrophy of pulmonary alveoli wall and irregular hypertrophy of pulmonary artery inner wall. Microfilaria was observed in pulmonary artery and arteriole, ventricle and splenic artery.

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Radiographic Findings of Multiple Pulmonary Bullae by trauma in a Dog (개에서 창상에 의해 발생한 다발성 폐낭포의 방사선학적 진단례)

  • Park, Ki-Tae;Wang, Ji-Hwan;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.72-75
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    • 2009
  • Pulmonary bullae are air-filled spaces within the lung parenchyma that result from the destruction, dilatation and confluence of adjacent alveoli. Pulmonary bullae are found most often in healthy, middle aged, large breed or deep-chested dogs that have no previous history of lung disease and bulla may occur as a result of emphysema, inflammation or trauma. Clinical signs include respiratory distress, anorexia, depression and tachypnea. In this study, a dog with respiratory distress by traffic accident was diagnosed as pulmonary bullae with pneumothorax using radiography at Veterinary Medical Teaching Hospital, GNU. In radiographs, various sized, smooth margin, well defined, oval shaped, gas or fluid filled multiple bullae are shown in the left cranial, left caudal and right accessory lobes. At the initial stage of observation, there were indications of four bullae, two of which were not found in the following radiograph. At the same time, there were serious indications of lung consolidation that caused respiratory distress of patient. Ultimately, the patient was expired after ten hours.

Mechanism of Lung Damage Induced by Cyclohexane in Rats (Cyclohexane에 의한 랫드의 폐손상 기전)

  • 전태원;윤종국
    • Toxicological Research
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    • v.18 no.2
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    • pp.159-165
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    • 2002
  • Recently, we reported (korean J. Biomed. Lab. Sci., 6(4): 245-251, 2000) that cyclohexane (l.56 g/kg of body wt., i.p.) administration led to lung injury in rats. However the detailed mechanism remain to be elucidated. This study was designed to clarify the mechanism of lung damage induced by cyclohexane in rats. First, lung damage was assessed by quantifying bronchoalveolar lavage fluid (BAL) protein content as well us by histopathological examination. Second, activities of serum xanthine oxidase (XO), pulmonary XO and oxygen free radical scavenging enzymes. XO tope conversion (O/D + O, %) ratio and content of reduced glutathione (GSH) were determined. In the histopathological findings, the vasodilation, local edema and hemorrhage were demonstrated in alveoli of lung. And vascular lumens filled with lipid droplets, increased macrophages in luminal margin and increased fibroblast-like interstitial cells in interstitial space were observed in electron micrographs. The introperitoneal treatment of cyclohexane dramatically increased BAL protein by 21-fold compared with control. Cyclohexane administration to rats led to a significant rise of serum and pulmonary XO activities and O/D + O ratio by 47%,30% and 24%, respectively, compared witれ control. Furthermore, activities of pulmonary oxygen free radical scavenging enzymes such as superoxide dismutase, glutathione peroxidase and glutathione S-transferase, and GSH content were not found to be statistically different between control and cyclohexane-treated rats. These results indicate that intraperitoneal injection of cyclohexane to rats may induce the lipid embolism in pulmonary blood vessel and lead to the hypoxia with the ensuing of oxygen free radical generation, and which may be responsible for the pulmonary injury.

Effects of Increased Pulmonary Blood Flow Produced Bb Experimental left Pulmonary Artery Ligation on the Pulmonary Vascular Bed in Neonateal Goats (신생 염소에서 실험적 좌폐동맥 결찰술로 유발시킨 폐혈류량 증가가 폐혈관상에 미치는 영향)

  • 서경필
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1057-1066
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    • 1990
  • The possible relationship between pulmonary vascular pathologic changes and an increased pulmonary blood flow and pulmonary blood pressure has been the subject of investigation for many years. In an attempts to study the effects of increased pulmonary blood flow. long-term observations have been made in neonatal goats in which the total pulmonary vascular bed was restricted by means of ligation of left pulmonary artery, thereby diverting the total right ventricular output through the right lung. The left pulmonary artery and patent ductus arteriosus were ligated in 6 neonatal goats of under 3 weeks of age, and the goats were put to death at interval between 1 and 7 months of age. Pulmonary arterial development in both right and left lungs was studied by applying quantitative morphometric techniques, and compared with control group of goats between 1 and 6 months of age. The axial pulmonary artery and its branches were larger in the right lung than in the control group in all animals, and they were abnormally small in the left lung. In the right lung, arteries smaller than 50\ulcornerm showed abnormal increase in `% wall thickness’ in postoperative 2,3,5 and 6th months[p<0.05]. The proportion of non-muscular arteries was over 50% at postoperative 1st month in both right and left lungs, but an increase in proportion of partially muscular and wholly muscular arteries occurred thereafter. The ratio of alveoli/arteries was lower than normal in the right lung of postoperative 1st month[p<0.05], but was elevated thereafter. The failure to perfuse one pulmonary artery in neonatal goats changed growth and development of both lungs.

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Endogenous lipid pneumonia in a ringed seal (Pusa hispida subsp. ochotensis)

  • Gye-Hyeong Woo
    • Journal of Veterinary Science
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    • v.25 no.1
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    • pp.14.1-14.5
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    • 2024
  • An adult female ringed seal died suddenly and was subsequently examined for diagnostic purposes. The animal's lungs demonstrated mild non-collapsibility and multifocal white to yellow patches. Histopathological examination revealed multifocal pulmonary histiocytosis. Alveoli were filled with numerous foamy macrophages cytoplasm and scattered multinucleated giant cells containing cholesterol clefts. The foamy cytoplasm of the macrophages stained with oil red O stain. Further, lipid droplets within the cytoplasm were detected by electron microscopy. To the author's knowledge, this is the first case report describing the histochemical staining and electron microscopic findings associated with endogenous lipid pneumonia in ringed seal.