• Title/Summary/Keyword: Small airways

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Small Airway Disease in Patients with Chronic Obstructive Pulmonary Disease

  • Singh, Dave
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.317-324
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    • 2017
  • Small airway disease (SAD) has been recognized for many years as a central feature of chronic obstructive pulmonary disease (COPD). Histopathology studies have shown that the narrowing and destruction of small airways in COPD combined with inflammatory cell infiltration in the submucosa increases the severity of the disease. SAD is present in the early stages of COPD and becomes more widespread over time as the disease progresses to more severe COPD. The development of inhalers containing extra-fine particles allows the small airways to be pharmacologically targeted. Recent clinical trials have shown the efficacy of extra-fine triple therapy that targets the small airways in patients with COPD. This article reviews the importance and treatment of SAD in COPD.

Wall Thickness Measurement of Respiratory Airway in CT Images: Signal Processing Aspects

  • Park, Sang-Joon;Kim, Jong-Hyo;Kim, Kwang-Gi;Lee, Sang-Ho
    • Proceedings of the IEEK Conference
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    • 2007.07a
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    • pp.279-280
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    • 2007
  • Airway wall thickness is an important bio-marker for evaluation of pulmonary diseases such as stenosis, bronchiectasis. Nevertheless, an image-based analysis of the airway tree can provide precise and valuable airway size information, quantitative measurement of airway wall thickness in CT images involves various sources of error and uncertainty. So we have developed an accurate airway wall measurement technique for small airways with three-dimensional (3-D) approach. To illustrate performance of these techniques, we used airway phantom that consisted of 4 acryl tubes with various inner and outer diameters. Results show that evaluation of interpolation and deconvolution methods of airways in 3-D CT images, and significant improvement over the full-width-half-maximum method for measurement of not only location of the luminal and outer edge of the airway wall but airway wall thickness.

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Bronchiolar Pathology (세기관지 질환의 병리)

  • Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1218-1224
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    • 1997
  • 세기관지를 침범하는 많은 질환들이 세기관지에 유사한 병리소견을 일으킴으로 이들의 원인, 병인, 진단을 위하여서는 임상 및 병리소견을 연관시킴이 거의 필수적이다. Small airways disease를 포함한 세기관지 질환의 병리소견 특히 호흡성 세기관지염, bronchiolitis obliterans organizing pneumonia, constrictive bronchiolitis obliterans 등에 대하여 중점적으로 기술하였다. BOOP은 어떤 급성 폐손상에 대한 비특이성 소견이며 조직병리적인 기술이다. 반면 Idiopathic BOOP은 COP와 동의어로써 특정한 질환이며 이의 주된 병리소견이 BOOP인 것으로 이해하는 것이 좋겠다. Constrictive bronchiolitis obliterans는 임상적으로나 병리학적으로 BOOP과는 다르다고 하겠다.

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Combination of isoproterenol and length oscillations in relaxing porcine airway smooth muscles

  • Al-Jumaily, Ahmed M.;Mathur, Meha;Cairns, Simeon
    • Biomaterials and Biomechanics in Bioengineering
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    • v.2 no.4
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    • pp.225-235
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    • 2015
  • Treatments for asthma are largely pharmaceutical, with some therapies also utilising alternative breathing techniques. The objective of both medical and alternative methods is to relax contracted airway smooth muscle (ASM). In normal subjects, tidal breathing- and deep inspiration-oscillations are believed to have a bronchodilatory effect. Similarly, application of length oscillations to isolated, contracted ASM also elicits muscle relaxation. As a means of investigating more-effective alternative treatment methods for contracted airways, we analyse the combined effects of bronchodilators and length oscillations on isolated, contracted ASM. The contractile state of the muscle tissue prior to treatment is of primary interest. Thereafter, the effect of applying a combination of small superimposed length oscillations with tidal breathing-like oscillations to ASM is studied alone and in combination with a common bronchodilator, isoproterenol (ISO). This work suggests that relaxation of isolated, contracted ASM following application of combined oscillations and ISO is larger than treatments of either combined oscillations or ISO alone. Further, the observed oscillation-associated relaxation is found to be amplitude- rather than frequency-dependent. This study gives additional insight into the role of oscillations and bronchodilators on contracted airways.

Virtual computed tomographic bronchoscopy: normal bronchial anatomy in six dogs

  • Oh, Dayoung;Choi, Mincheol;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.57 no.2
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    • pp.113-116
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    • 2017
  • The aim of this study was to examine normal bronchi in dogs by using virtual bronchoscopy (VB) and to evaluate the utility of VB in clinical practice. The bronchi of six dogs without tracheobronchial disease were visualized by VB. Airways from the tracheal bifurcation to the lobar bronchi were well visualized in all dogs. Segmental and subsegmental bronchi were also well identified, but the degree and number of those varied with dog size. The mean numbers of segmental and subsegmental bronchi identified in the six dogs were 41.83 and 50.17, respectively, whereas, the mean numbers in medium- and large-sized dogs were 55.00 and 82.67, respectively, and in small-sized dogs, the means were 28.67 and 17.67, respectively. Although there were size-dependent differences in VB visualization of the bronchi, it was possible to identify peripheral airways to the subsegmental bronchi level, which can rarely be accomplished via conventional bronchoscopy. VB is the noninvasive method that can be used to examine bronchial anatomy, and our results suggest that VB can be useful for evaluating bronchi, including segmental and subsegmental ones that cannot be examined routinely by conventional bronchoscopy. Thus, VB has potential as an alternative to conventional bronchoscopy in the examination of bronchi in dogs.

Genetic Variants of IL-13 and IL-4 in the Korean Population: Polymorphisms, Haplotypes and Linkage Disequilibrium

  • Ryu, Ha-Jung;Jung, Ho-Youl;Park, Jung-Sun;Kim, Jun-Woo;Kim, Hyung-Tae;Park, Choon-Sik;Han, Bok-Ghee;Koh, In-Song;Park, Chan;Kimm, Ku-Chan;Oh, Berm-Seok;Lee, Jong-Keuk
    • Genomics & Informatics
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    • v.3 no.4
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    • pp.149-153
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    • 2005
  • Asthma is an inflammatory airways disease characterized by bronchial hyperresponsiveness and airways obstruction, which results from a complex interaction of genetic and environmental factors. Interleukin (IL)-13 and IL-4 are important in IgE synthesis and allergic inflammation, therefore genes encoding IL-13 and IL-4 are candidates for predisposition to asthma. In the present study, we screened single-nucleotide polymorphisms (SNPs) in IL-13 and IL-4 and examined whether they are risk factors for asthma. We resequenced all exons and the promoter region in 12 asthma patients and 12 normal controls, and identified 18 SNPs including 2 novel SNPs. The linkage disequilibrium(LD) pattern was evaluated with 16 common SNPs, and haplotypes were also estimated within the block. Although IL-13 and IL-4 are localized within 27 kb on chromosome 5q31 and share many biological profiles, this region was partitioned into 2 blocks. One SNP and three SNPs were determined as haplotype-taggingSNPs (htSNPs) within IL-13 and IL-4 haplotype-block, respectively. No significant associations were observed between any of the SNPs or haplotypes and development of asthma in small number of Korean subjects. However, the genetic variants of IL-13 and IL-4 would provide valuable strategies for the genotyping studies in large population.

A Case of Bronchial Foreign Body Removal During Trans-Laryngeal Mask Airway Fiberoptic Bronchoscopy (소아에서 후두 마스크를 이용한 기관지이물 제거 경험 1예 보고)

  • Suhr, Ji-Won;Kim, Jong-Yul;Park, Kyu-Ho;Kang, Jun-Goo;Choi, Jin
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1433-1439
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    • 1997
  • Bronchial foreign body is not a rare disease in children and it is urgently necessary to remove this foreign body from the airway to relive life or to prevent further damages and complications. But the innate small size of airways in infants makes it difficult to access by interventional methods such as intubation or bronchoscopy and etc. Laryngeal mask airway is a new way of method of airway management which is relatively recently introduced into medical practice. It gives way to access to airways without reducing the size of airway or incresing airway pressure during procedure through it and have many other advantages compared to the previous traditional endotracheal intubation, especially in infants. We successfully removed a case of bronchial foreign body, peanut, via laryngeal mask airway during fiberoptic bronchoscopy and by this method we can avoid the unnecessary tracheostomy in this 1 year old infant.

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The Role of Innate and Adaptive Immune Cells in the Immunopathogenesis of Chronic Obstructive Pulmonary Disease

  • Nurwidya, Fariz;Damayanti, Triya;Yunus, Faisal
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.5-13
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    • 2016
  • Chronic obstructive pulmonary disease (COPD) is a chronic and progressive inflammatory disease of the airways and lungs that results in limitations of continuous airflow and is caused by exposure to noxious gasses and particles. A major cause of morbidity and mortality in adults, COPD is a complex disease pathologically mediated by many inflammatory pathways. Macrophages, neutrophils, dendritic cells, and CD8+ T-lymphocytes are the key inflammatory cells involved in COPD. Recently, the non-coding small RNA, micro-RNA, have also been intensively investigated and evidence suggest that it plays a role in the pathogenesis of COPD. Here, we discuss the accumulated evidence that has since revealed the role of each inflammatory cell and their involvement in the immunopathogenesis of COPD. Mechanisms of steroid resistance in COPD will also be briefly discussed.

Case Report of Acute Bronchitis Treated with Dojukgangki-tang (도적강기탕(導赤降氣湯)을 투여한 급성기관지염 치험 3례)

  • Kim, Kitae
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.1068-1074
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    • 2018
  • Objectives: Acute bronchitis is a common inflammatory disease with symptoms related to temporary inflammation of the airways. It is caused by a viral infections in over 95% of cases. A small minority of cases are caused by bacteria; however, there is little evidence that antibiotics are effective in the treatment of the condition. This report is a case of administering Dojukgangki-tang to three patients with acute bronchitis. Methods: Patients diagnosed with acute bronchitis were treated with Dojukgangki-tang, and the effects were studied using the bronchitis severity scale (BSS) and acute bronchitis severity scale (ABBS). Results: After treatment with Dojukgangki-tang for 2 weeks, average BSS score changed from $11.33{\pm}2.08$ to $1.67{\pm}1.15$. Average ABSS score decreased from $9.00{\pm}3.00$ to $2.00{\pm}1.00$. Conclusions: This study suggests that Dojukgangki-tang is effective in relieving coughs and sputum related to acute bronchitis.

The Importance of Early Chronic Obstructive Pulmonary Disease: A Lecture from 2022 Asian Pacific Society of Respirology

  • Don D. Sin
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.71-81
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    • 2023
  • Chronic obstructive pulmonary disease (COPD) affects close to 400 million people worldwide. COPD is characterized by significant airflow limitation on spirometry. Most patients with COPD are diagnosed in their fifth or sixth decades of life. However, the disease begins much earlier. By the time airflow limitation is detected on spirometry, patients with COPD have lost close to 50% of their small airways. Thus, identification of patients with early COPD, defined as persons with preserved spirometry, who demonstrate pathologic or functional hallmarks of COPD, is essential for disease modification and ultimately disease elimination. This paper provides an up-to-date overview of the current case definition of early COPD, its importance, the novel technologies required for its detection in young adults and future directions in therapeutics for treatment.