tag:blogger.com,1999:blog-42725724698679550562024-03-13T04:53:05.796-07:00DISEASES OF RESPIRATORY SYSTEMAnonymoushttp://www.blogger.com/profile/06267357132580929345noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4272572469867955056.post-28345040260924076452013-11-03T22:40:00.001-08:002013-11-03T22:40:18.390-08:00RESPIRATORY SYSTEM DISEASES<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="H1">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 20.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> DISEASES OF RESPIRATORY SYSTEM<o:p></o:p></span></div>
<div class="H2">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">ACUTE BACTERIAL INFECTIONS OF
THE LUNGS<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Occur when normal lung or systemic
protective mechanisms are impaired. Pulmonary protective mechanisms include
nasal, tracheobronchial, and alveolar mechanisms to filter, neutralize, and
clear inhaled organisms and particles.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Important factors interfering with
normal lung defenses are<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Decreased cough reflex leading to aspiration
(seen in coma, anesthesia, drug effects).<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Injury to mucociliary apparatus (as with
cigarette or other smoke / gaseous inhalations).<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. Decreased phagocytic /bactericidal function of
the alveolar macrophage (as a result of alcohol, tobacco, oxygen toxicity).<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4. Edema/congestion (CIHD).<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">5. Accumulation of secretions.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">There are a lot of diseases, of
pulmonary system as well as the etiologic factors, which cause these diseases.
Acute and chronic bronchitis, pneumonia, destructive processes (abscess and
gangrene), bronchial asthma, chronic non-specific pulmonary diseases and cancer
of lungs are the most common.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pathogenic organisms gain access to the lung through
the airways, through the bloodstream, by traumatic implantation, or by direct
spread across the diaphragm from the subphrenic source, probably through the
lymphatics. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The
most common route is the airways.<o:p></o:p></span></div>
<div class="H2">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pneumonias<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pneumonia is acute inflammation of the
respiratory tract with deposition of intraalveolar exudates.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Etiologic
classification of pneumonia:<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l5 level2 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bacterial pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l5 level2 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Viral and mycoplasmal pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l5 level2 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Other types of pneumonias:<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.5in; mso-list: l5 level3 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">a)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pneumocystis carini pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.5in; mso-list: l5 level3 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">b)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Legionella pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.5in; mso-list: l5 level3 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">c)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Aspiration pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.5in; mso-list: l5 level3 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">d)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Hypostatic pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.5in; mso-list: l5 level3 lfo1; mso-pagination: widow-orphan; tab-stops: list 1.5in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">e)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Lipid pneumonia.<o:p></o:p></span></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Clinical-morphological classification:<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l0 level1 lfo2; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Lobar pneumonia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l0 level1 lfo2; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchopneumonia (lobular pneumonia).<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin-left: 1.0in; mso-list: l0 level1 lfo2; mso-pagination: widow-orphan; tab-stops: list 1.0in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Interstitial pneumonia.<o:p></o:p></span></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Lobar pneumonia<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Synonyms: crupous, lobular, fibrinous,
pleurapneumonia.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span class="bolditalic"><span style="font-family: Calibri, sans-serif; font-size: 12pt;">Croupous pneumonia</span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;"> is infectious-allergic infection and involves a lobe of
lung.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Most lobar pneumonias are caused by pneumococci and
Klebsiella pneumonia which enter the lungs via the airways.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The pneumococcus continues to be responsible for 30%
to 80% or more of community-acquired pneumonias.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Groups at particular risk include the very young and
very old, alcoholics, diabetics, spleenectomized subjects, and patients with
multiple myeloma or circle cell disease.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Hypersensivity of immediate type plays an important
role in pathogenesis.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pleural involvement occurs commonly in lobar pneumonia
Pneumococcal pneumonia typically presents the picture of lobar pneumonia. One
or occasionally several lobes of the lung are involved. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Fibrinous
exudates in alveoli are presence.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Traditionally the progress of the
disease is divided into four stages:</span></span><span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level1 lfo3; mso-pagination: widow-orphan; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Congestion and Edema </span></span><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">predominates
in the first 24 hours. The initial response to the organism is edema, which
spreads throughout the lobe through pores of Kohn and bronchioles. At this
stage an involved lobe appears distended, moist, and deep red of purple. The
pleura are shiny, and fluid exudes from the cut surface.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level1 lfo3; mso-pagination: widow-orphan; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span></span><!--[endif]--><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Red hepatization</span></span><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> (2 days) describes
lung tissue with confluent acute exudate containing neutrophils and red cells,
giving a red, firm. </span></span><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Lobe is liver-like.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level1 lfo3; mso-pagination: widow-orphan; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Gray hepatization</span></span><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> (4-6 days)
follows, as the red cells disintegrate and the remaining fibrinous-suppurative
exudates persist, giving a gray-brown gross appearance.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l6 level1 lfo3; mso-pagination: widow-orphan; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span></span><!--[endif]--><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Resolution</span></span><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> (9-11 days) is the favorable final stage
in which consolidated exudates undergoes enzymatic and cellular degradation and
clearance. </span></span><span class="01perecen1"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Normal structure is restored.<o:p></o:p></span></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Complications:</span></span><span class="italik"><span lang="RU" style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-left: .75in; mso-list: l4 level1 lfo4; mso-pagination: widow-orphan; tab-stops: list .75in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="bolditalic"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Carnification</span></span><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> is
organization of fibrinoid exudate.<o:p></o:p></span></span></div>
<div class="MsoBodyText3" style="margin-left: .75in; mso-list: l4 level1 lfo4; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Abscess formation.
Lung abscess results from the breakdown of alveolar walls.<o:p></o:p></span></span></div>
<div class="MsoBodyText3" style="margin-left: .75in; mso-list: l4 level1 lfo4; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Empyema (spread of
infection to pleural cavity).<o:p></o:p></span></span></div>
<div class="MsoBodyText3" style="margin-left: .75in; mso-list: l4 level1 lfo4; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen0"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span></span><!--[endif]--><span class="01perecen0"><span lang="RU" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Gangrene.<o:p></o:p></span></span></div>
<div class="MsoBodyText3" style="margin-left: .75in; mso-list: l4 level1 lfo4; tab-stops: list .75in; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">5.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="01perecen0"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bacteremic spread
leads to purulent meningitis, bacterial endocarditis, arthritis, pericarditis
and other organs.<o:p></o:p></span></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Causes of death</span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;"> are acute cardiac-respiratory
insufficiency and purulent complications.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchopneumonia (focal
pneumonia)<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span class="bolditalic"><span style="font-family: Calibri, sans-serif; font-size: 12pt;">Bronchopneumonia </span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">is marked by patchy exudative consolidation of lung
parenchyma<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Polyetiologic. The most often agents are bacterias:
pneumococci, staphylococci, streptococci, hemophylus influenzae, pseudomonas
aeruginosa, and coliform bacteria.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Bronchopneumonia often arises due to autoinfection.
Depending pathogenesis autoinfectional bronchopneumonia may be aspirationous,
hypostatic, postoperative, immunodificiency.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Bronchopneumonia often is a complication of others
disease.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">According to extent may be acynous, lobular,
segmental, and miliary.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Initially bronchi are affected. Then, inflammation
spreads to parenchyma of lungs with accumulation of exudates in the alveoli.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Grossly, the lungs show dispersed, elevated, focal
areas of palpable consolidation and suppuration.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Histological features consist of acute (neutrophilic)
suppurative, serous, hemorrhagic or mixed exudates filling airspaces and
airways, usually about bronchi and bronchioles.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Outcomes and complications: resolution of the exudates
usually restores normal lung structure, but organization may occur and result
in fibrous scarring in some cases. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Aggressive disease may produce abscess,
pleurisy, and empyema.<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Streptococcal
pneumonia<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Beta-hemolytic streptococci are an uncommon cause of
pneumonia at the present time. In adults streptococcal pneumonia like other
pneumonias usually occurs in elderly, severely debilitated patients. Diabetes
is also a risk factor. Infections caused by this microbe in the newborn are
discussed elsewhere.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The lower lobe is usually the site of major
involvement.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The airways appear thickened and are filled with a
hemorrhagic or purulent exudate.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The pneumonia is lobular with consolidated patches
clearly centered on terminal bronchioles. The distinctive microscopic feature
of streptococcal pneumonia is greater interstitial involvement than in other
bacterial pneumonias. There is necrosis of the epithelium of distal airways
with infiltration of the bronchial walls by neutrophils and mononuclear cells.
The interstitial infiltrate also extends into the adjacent alveolar walls.<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Staphylococcal
pneumonia<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Staphylococcal pneumonia usually occurs either in the
presence of a source of bacteremia or after viral infection.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Hematogenous pneumonia is seen in those with
soft-tissue infections, in patients undergoing long-term dialysis. The lesions
may appear as septic infarcts that are yellow and purulent but preserve to some
degree the wedge-shaped configuration of infarcts and are associated with
thrombosed vessels, or they may be rounded patches of necrotizing pneumonia
that break down, giving rise to abscesses.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Staphylococcal pneumonia also results from spread of
organisms from the colonized nasopharynx. The lesions are those of
bronchopneumonia accompanied by a hemorrhagic and necrotizing bronchitis.
Purulent exudate fills the bronchioles and spreads into the adjacent acini.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Staphylococcal bronchopneumonia is not rare in
children less than 6 months of age. A notable feature of staphylococcal
pneumonia in small children is development of abscesss.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Local complications of staphylococcal pneumonia
include empyema and bronchopleural fistula.<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Aspiration pneumonia<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Aspiration pneumonia results from inhaling different agents into the
lungs. These substances include food, gastric contents, infected material from
oral cavity, amniotic fluid or meconium in infants, etc.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; mso-pagination: widow-orphan; text-align: justify; text-indent: 28.35pt;">
<br /></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Hypostatic pneumonia<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Hypostatic pneumonia is the term used for the
collection of edema fluid and secretions in the dependent parts of the lungs in
bed-patients.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Interstitial pneumonia<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Infections by viruses, mycoplasma pneumonia, pneumocystis carinii, etc.
result in varied clinical and pathologic patterns, ranging from relatively mild
upper respiratory tract involvements to severe lower respiratory tract disease.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Patchy or lobar areas of congestion without the
consolidation of bacterial pneumonias.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">A predominance of interstitial pneumonitis with
widened, edematous alveolar walls containing a mononuclear inflammatory cell
infiltrates.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The formation of hyaline membranes, reflecting diffuse
alveolar damage.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pneumocystic pneumonia is characterized by
desquamation of alveolar epithelium. Alveoli filled by foamy fluid and
pneumocysts, and also hyperemia and inflammatory infiltration of the alveolar
septs. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">It
may pattern in AIDS.<o:p></o:p></span></div>
<div class="H2">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">CHRONIC OBSTRUCTIVE PULMONARY
DISEASE<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The term Chronic Obstructive Pulmonary disease (COPD) refers to a group
of conditions that share a major symptom – dyspnea - and are accompanied by
chronic or recurrent obstruction to air flow within the lung.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Obstructive diseases are characterized by increased
resistance to airflow because of chronic or recurring expiratory obstruction.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">In their prototypical forms, these individual
disorders – chronic bronchitis, bronchiectasis, asthma, emphysema – have
distinct anatomic and clinical characteristic.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Hypertension of pulmonary circulation and “cor
pulmonale” develops in all Chronic Obstructive Pulmonary diseases.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Amyloidosis of kidneys and chronic renal insufficiency
may develop often.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Death of the most patients with COPD is due to<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1) Respiratory acidosis and coma,<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2) Right-sided failure,<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3) Massive collapse of the lung secondary to pneumothorax.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Chronic Bronchitis<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The widely accepted definition of <span class="bold"><span style="color: windowtext;">chronic bronchitis</span></span> is a clinical one –
chronic bronchitis (CB) is present in any patient who has persistent cough with
sputum production for at least 3 months in at least 2 consecutive years.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">This disorder, so common among habitual smokers and
inhabitants of smog-laden cities, is not nearly so trivial as was once thought.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The role of infection appears to be secondary. It is
not responsible for the initiation of CB but is probably significant in
maintaining it and may be criterial in producing acute exacerbations.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pathogenesis. Two sets of factors
are important in the genesis of chronic bronchitis:</span></span><span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Chronic irritation by inhaled substances.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Microbiologic infections.<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The hallmark and earliest failure of CB is
hypersecretion of mucus in the large airways, and is associated with
hypertrophy of the submucosal glands in the trachea and bronchi.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">As CB persists, there is also a marked increase in
goblet cells of small airways – small bronchi and bronchioles – leading to
excessive mucus production that contributes to airway obstruction.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Although mucus hypersecretion in large airways is the
cause of sputum overproduction, it is now thought that accompanying alterations
in the small airways of the lung can result in physiologically important and
early manifestations of the chronic airway obstruction.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Histological features of the small
airways:</span></span><span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Goblet cell metaplasia with mucus plugging of the lumen.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Clustering of pigmented alveolar macrophages.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. Inflammatory infiltration.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4. Fibrosis of bronchiolar wall.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Outcomes and
complications<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Lead to </span><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">“cor pulmonale”</span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;"> and heart failure.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Cause atypical metaplasia and dysplasia of the
respiratory epithelium, providing a possible soil for cancerous transformation.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Amyloidosis of kidneys.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Lead to bronchiectasis.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchiectasis (BE)<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">BE is chronic necrotizing infection of the bronchi and bronchioles
leading to or associated with abnormal dilation of these airways.<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">BE has many origins and usually develops in association with following
conditions:<o:p></o:p></span></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="color: #33cccc; mso-list: l3 level1 lfo5; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchial obstruction, due to tumor, foreign bodies, and
occasionally mucous impaction, in which the BE are localized to the
obstructed lung segment; or due to diffuse obstructive airway disease,
most commonly atopic asthma and chronic bronchitis, measles.<o:p></o:p></span></span></li>
</ol>
<div class="MsoBodyText3" style="margin-left: .5in; mso-list: l3 level1 lfo5; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span></span><!--[endif]--><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Congenital or
hereditary conditions, including congenital BE, cystic fibrosis, intralobar
sequestration of the lung states, and immune cilia and Kartagener’s syndromes.<o:p></o:p></span></span></div>
<ol start="3" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="color: #33cccc; mso-list: l3 level1 lfo5; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Necrotizing pneumonia, most often caused by tubercle bacillus or
staphylococci or mixed infections.<o:p></o:p></span></span></li>
</ol>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">BE usually affects the lower lobes bilaterally,
particularly those air passages that is most vertical, and is most severe in
the more distal bronchi and bronchioles.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">When tumors or aspiration of foreign bodies leads to
BE, the involvement may be sharply localized to a single segment of the lungs.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The pleura is usually fibrotic
and thickened with adhesions to the chest wall. Cut surface has honey-combed
appearance. The walls of bronchi are thickened and the lumen arc filled with
mucus.</span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;"><o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The airways are dilated; sometime up to four times
normal size. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">These
dilations may produce:<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Long, tube-like enlargements (cylindroid BE) in 1 to 4 type of
bronchus.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. May cause fusiform or even sharply saccular distention (saccular BE)
in 6-10 types of bronchus.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The histologic findings vary with the activity and
chronicity of the disease:<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. In the full-down active case, there in an intense acute and chronic
inflammatory exudation within the walls of bronchi and bronchioles, associated
with desquamation of the lining epithelium and extensive areas of necrotizing
ulceration. There may be squamous
metaplasia of the remaining epithelium.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. In some instances, the necrosis completely destroys the bronchial or
bronchiolar walls and forms a lung abscess.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. Fibrosis of the bronchial and bronchiolar walls and peribronchial
fibrosis develop in the more chronic cases.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Outcomes and
complications<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Obstructive ventilatory insufficiency can lead to marked dyspnea and
cyanosis.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Pulmonary hemorrhage.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. Pulmonary abscess.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4. Empyema of the pleura.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">5. Metastatic brain abscess.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">6. “Cor pulmonale” and chronic cardiac-pulmonary insufficiency.<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">7. Amyloidosis are less frequent complications of BE.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Emphysema<o:p></o:p></span></div>
<div class="BodyText">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Emphysema</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> is a
condition of the lung characterized by abnormal permanent enlargement of the
airspace distal to the terminal bronchiole, accompanied by destruction of their
walls, and without obvious fibrosis. In contrast, the enlargement of airspaces
unaccompanied by destruction is termed overinflation, for example, the
distention of airspaces in the opposite lung following unilateral
pneumonectomy. <o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pathogenesis<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">While details of the genesis of the two common forms of emphysema –
centiacinar and panacinar – remain unsettled, the most plausible hypothesis to
account for the destruction of alveolar walls is the protease-antiprotease
mechanism. Thus, emphysema is seen to result from the destructive effect of the
high protease activity in subjects with low antiprotease activity.<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The protease-antiprotease hypothesis also explains the deleterious
effect of cigarette smoking.<o:p></o:p></span></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormal" style="color: #33cccc; mso-list: l1 level1 lfo6; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Smokers have greater numbers of neutrophils and macrophages in
their alveoli. The increased recruitment of neutrophils into the lung is
likely to result, in part, from the release by activated alveolar
macrophages of neutrophil chemotactic factors, this release being
stimulated by smoking. In addition, nicotine is chemotactic for
neutrophils, and cigarette smoke activates the alternative compliment
pathway.<o:p></o:p></span></span></li>
<li class="MsoNormal" style="color: #33cccc; mso-list: l1 level1 lfo6; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Smoking stimulates release of elastase from neutrophils.<o:p></o:p></span></span></li>
<li class="MsoNormal" style="color: #33cccc; mso-list: l1 level1 lfo6; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Smoking enhances elastolytic proteases activity in macrophages;
macrophage elastase is not inhibited by alpha-1 –AT and, indeed, can
proteolytically digest this enzyme.<o:p></o:p></span></span></li>
<li class="MsoNormal" style="color: #33cccc; mso-list: l1 level1 lfo6; mso-pagination: widow-orphan; tab-stops: list .5in; text-align: justify;"><span class="01perecen1"><span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Oxidants in cigarette smoke and oxygen free radicals secreted by
neutrophils inhibit alpha-1-AT and thus decrease net antielastase activity
in smokers.<o:p></o:p></span></span></li>
</ol>
<div class="BodyText">
<span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;">It is
thus postulated that impaction of smoke particles in the small bronchi and
bronchioles, with the resultant influx of neutrophils and macrophages, and
increased elastase and decreased alpha-1-AT activity causes to the centriacinar
emphysema seen in smokers.<o:p></o:p></span></span></div>
<div class="H6">
<span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Classification</span></span><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;"><o:p></o:p></span></span></div>
<div class="BodyText">
<span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;">Although
the term “emphysema” is sometimes loosely applied to diverse conditions, there
are four types:<o:p></o:p></span></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. </span></i></b><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Centriacinar (cenrolobular)
emphysema.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> The distinctive feature of this type is the pattern of involvement of
the lobules; the central or proximal parts of the acini, formed by respiratory
bronchioles, are affected, whereas distal alveoli are spared. The walls of the
emphysematous spaces often contain large amount of black pigment. Inflammation
around bronchi and bronchioles and in the septa is common. Moderate-to-severe
degrees of emphysema occur predominantly in heavy smokers, often in association
with chronic bronchitis. In addition, some lesions of so-called coal workers’
pneumoconiosis bear a striking resemblance to centriacinar emphysema.<o:p></o:p></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. </span></i></b><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Panacinar (panlobular) emphysema.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> In
this type the acini are uniformly enlarged from the level at the respiratory
bronchiole to the terminal blind alveoli. This type of emphysema is associated
with alpha-1-antitrypsin deficiency.<o:p></o:p></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. </span></i></b><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Paraseptal (distal acinar) emphysema.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> In
this type the proximal portion of the acinus is normal, but the distal part is
dominantly involved. The emphysema is more striking adjacent to the pleura,
along the lobular connective tissue septa, and at the margins of the lobules.
This type of emphysema probably underlies many of the cases of spontaneous
pneumothorax in young adults.<o:p></o:p></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4. </span></i></b><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Irregular emphysema</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">, so
named because the acinus is the irregularly involved, is almost invariably
associated with scarring. Thus, it may be
the most common form of emphysema, as careful search of most lungs at autopsy
shows one or more scars from a healed inflammatory process. In most instances,
these foci of irregular emphysema are asymptomatic.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Types of emphysema
according to cause<o:p></o:p></span></div>
<div class="01perecen">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Compensatory E.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> This
term is sometimes used to designate dilation of alveoli but not destruction of
septal walls in response to loss of lung substance elsewhere. It is best
exemplified by the hyperexpansion of the residual lung parenchyma that follows
surgical removal of a diseased lung or lobe.<o:p></o:p></span></div>
<div class="01perecen">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Obstructive overinflation</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
refers to the condition in which the lung expands because air is trapped within
it.<o:p></o:p></span></div>
<div class="01perecen">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">3. Senile E.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
refers to the overdistended, sometimes voluminous lungs found in the aged.<o:p></o:p></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bullous E.</span></i></b><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> refers merely to at any form of E. that produces large subpleural blebs
or bullae (spaces more than 1 cm in diameter in the distended state).<o:p></o:p></span></div>
<div class="01perecen">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">4. Interstitial E.</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> The
entrance of air into the connective tissue stroma of the lung, mediastinum, or
subcutaneous tissue is designated interstitial emphysema.<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The diagnosis and classification of
the emphysemas are based on naked eye (or hand lens) examination of lungs fixed
in a state of inflation.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Panacinar emphysema, when well
developed, produces voluminous lungs, often overlapping the heart and hiding it
when the anterior chest wall is removed.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The macroscopic signs of centriacinar
emphysema are less impressive. The lungs may not appear particularly pale or
voluminous unless the disease is well advanced.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Generally, the upper two-thirds of the
lungs are more severely affected.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Large apical blebs or bulla are more
characteristic of irregular emphysema secondary to scarring.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Microscopical examination is accessory
to visualize the abnormal fenestrations in the walls of the alveoli, the
complete destruction of septal walls, and the distribution of damage within the
pulmonary lobule. With advance of the disease, adjacent alveoli fuse, producing
even larger abnormal airspaces and possibly blebs or bulla. Often the
respiratory bronchioles and vasculature of the<b> </b>lung are deformed and
compressed by the emphysematous distortion of the airspaces, and, as mentioned,
there may or may not be evidence of bronchitis or bronchiolitis.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchial Asthma (BA)<o:p></o:p></span></div>
<div class="BodyText">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Bronchial asthma</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> is a
disease characterized by hyper-reactive airways, leading to episodic,
reversible bronchoconstriction, owing to increased responsiveness of the
tracheobronchial tree to various stimuli. A
severe and unremitting type of the disease termed status asthmaticus may prove
fatal.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Pathogenesis<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Chronic airway inflammation involving many cell types
and inflammatory mediators accompanies the bronchial hyper-responsiveness of
asthma.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Nevertheless, the relationship of the inflammatory
cells and their mediators to airway hyper-reactivity is not fully understood.<o:p></o:p></span></div>
<div class="H6">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Classification<o:p></o:p></span></div>
<div class="01perecen">
<b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. </span></i></b><span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Extrinsic BA</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> is
initiated by a type 1 hypersensitivity reaction induced by exposure to an
extrinsic antigen. Subtypes include atopic (allergic), BA, occupational BA
(many forms), and allergic bronchopulmonary aspergillosis (bronchial
colonization with aspergillus organisms followed by development of IgE
antibodies).<o:p></o:p></span></div>
<div class="01perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. In contrast, <span class="bold"><span style="color: windowtext;">intrinsic
BA</span></span> is initiated by diverse, nonimmune mechanisms, including
aspirin, pulmonary infections; especially those caused by viruses, cold,
inhaled irrigants (pollutants such as sulfur dioxide), stress, and exercise.<o:p></o:p></span></div>
<div class="MsoNormal" style="mso-pagination: widow-orphan; text-align: justify;">
<br /></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The morphologic changes in asthma have been
described principally in patients dying of status asthmaticus, but it appears
that the pathology in nonfatal cases is similar.</span><b><i><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></i></b></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Grossly</span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">, the lungs are
overdistended because of overinflation, and there may be small areas of
atelectasis.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The most striking macroscopic finding is occlusion of
bronchi and bronchioles by thick, tenacious mucous plaques.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Histologically</span></span><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">, the mucous
plaques whorls of shed epithelium, which give, rise to the well-known
Curschmann’s spirals.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Numerous eosinophils and Charcot-Leyden crystals are
present.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The other characteristic histologic findings of BA
include:<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Thickening of the basement membrane of the bronchial epithelium.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Edema and inflammatory infiltrate in the bronchial walls, with a prominence
of eosinophils, which form 5 to50% of the cellular infiltrate.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- An increase in size of the submucosal glands.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Hypertrophy of the bronchial wall muscle, a reflection of prolonged
bronchoconstriction.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Emphysematous changes sometimes
occur, and if chronic bacterial infection has supervened, bronchitis may occur.<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The classic <span class="bolditalic">asthmatic attack</span> lasts up to
several hours and is followed by prolonged coughing; the raising of copious
mucous secretions provides considerable relief of the respiratory difficulty.
In some patients, these symptoms persist at a low level all the time. In its
most severe form, status asthmaticus, the severe acute paroxysm persists for
days and even weeks, and, under these circumstances, ventilatory function may
be so impaired as to cause severe cyanosis and even death.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Chronic Lung Abscess (LA)<o:p></o:p></span></div>
<div class="BodyText">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The term “LA” describes a local suppurative process within the lung
characterized by necrosis of lung tissue.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Oropharyngeal surgical procedures, bronchial
infections, dental sepsis, and bronchiectases play important roles in their
development.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span class="italik"><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span></span><!--[endif]--><span class="italik"><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The causative organisms are
introduced by the following mechanisms:</span></span><span class="italik"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: "MS Mincho"; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Aspiration of infective material.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Antecedent primary bacterial infection.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Septic embolism.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Obstructive tumors.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Direct traumatic punctures.<o:p></o:p></span></div>
<div class="02perecen">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">- Miscellaneous.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="RU" style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">When all these causes are excluded, there are still
cases in which no reasonable basis for the LA formation can be identified. </span><span lang="RU" style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">These are
referred to as “primary cryptogenic” LA.<o:p></o:p></span></div>
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<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Abscesses vary in diameter from lesions of a few
millimeters to large cavities of 5 to 6 cm. <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">They may affect any part of the lung and may be single
or multiple.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The cavity may or may not be filled with suppurative
debris, depending on the presence or absence of a communication with one of the
air passages.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">When such communications exist, the contained exudate
may be partially drained to create an air-containing cavity.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Superimposed saprophytic infections are prone to
flourishing within the already necrotic debris of the abscess cavity.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Continued infection leads to large, fetid,
green-black, multilocular cavities with poor demarcation of their margins,
designated gangrene of the lung.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">The cardinal histologic change in all abscesses is
suppurative destruction of the lung parenchyma within the central area of
cavitation.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">A reactive fibrous wall often surrounds chronic
abscesses.<o:p></o:p></span></div>
<div class="BodyText">
<span class="bold"><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Complications</span></span><span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
include extension of the infection into the pleural cavity, hemorrhage, the
development of brain abscesses or meningitis from septic emboli, and rarely
reactive secondary amyloidosis.<o:p></o:p></span></div>
<div class="H3">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Idiopathic Pulmonary Fibrosis<o:p></o:p></span></div>
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<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; layout-grid-mode: line; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Diffuse interstitial fibrosis occurs as a result
of different pulmonary diseases. It is so called “idiopathic pulmonary
fibrosis” or “cryptogenic fibrosing alveolitis” or “chronic interstitial pneumonitis”<o:p></o:p></span></div>
<div class="H5">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphology<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Pathological changes are bilateral and
widespread.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Macroscopically the lungs are dense,
reduced volume.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">Honey-combing (i.e. enlarged,
thick-walled air spaces) develops in parts of lung. Microscopically, changes
vary according to the stage of the disease with formation of hyaline membranes.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">There is edema and cellular infiltrate
in the alveolar septa in early stage.<o:p></o:p></span></div>
<div class="Mark" style="margin-left: 50.2pt; tab-stops: list 50.2pt; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: windowtext; font-family: Symbol; font-size: 14pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><!--[endif]--><span style="color: windowtext; font-family: Calibri, sans-serif; font-size: 12pt;">There is organization of the alveolar
exudate and replacement fibrosis in the alveoli and in the interstitial septal
wall with variable amount of inflammation in advanced stage.<o:p></o:p></span></div>
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