Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Degradation of elastin within alveolar walls is an important event in the development of pulmonary emphysema. Elastases release growth factors from extracellular matrices and interstitial cell surfaces, which can regulate the repair process. Brief treatment of matrix-laden rat pulmonary fibroblast cultures with porcine pancreatic elastase results in the release of soluble heparin-binding epidermal growth factor-like growth factor (HB-EGF) together with previously identified fibroblast growth factor-2 (FGF-2). In matrix-laden pulmonary fibroblasts, HB-EGF and two other EGF family ligands, i.e. EGF and transforming growth factor a, significantly down-regulate elastin mRNA via activation of the EGF receptor. HB-EGF treatment initiates a signaling pathway involving extracellular signal-regulated kinase 1 and 2 (ERK1/2) activation and subsequent nuclear accumulation of Fra-1, which leads to inhibition of elastin gene transcription. Co-addition of HB-EGF and FGF-2 results in an additive inhibitory effect on elastin mRNA levels. The increased effect of HB-EGF and FGF-2 on elastin mRNA is associated with their additive actions on ERK1/2 activation, c-fos mRNA induction and Fra-1 nuclear accumulation. Further, HB-EGF induces FGF-2 mRNA and protein, suggesting a potential role of endogenous FGF-2 in mediating HB-EGF-dependent responses. Cell migration represents an important component of injury/repair. A chemotactic activity for pulmonary fibroblasts was identified within the elastase-released products. Characterization of this activity indicates that elastase-released FGF-2 is a major chemotactic component of the elastase digest. Furthermore, our data strongly suggest that the elastase digest contains another component(s) that potentiates the chemotactic activity of FGF-2. Collectively, the present study supports a model in which elastase-released growth factors and other components act in concert to regulate elastin gene expression and cell migration in injury/repair situations. / 2031-01-01

Thesis (M.S.)--Boston University

This study concerned itself with planned teaching, based on principles of adult education, as a component of the rehabilitation of patients with chronic bronchitis and emphysema. The need for teaching in this area has been recognized, but as yet not researched. The purpose of this study was to determine whether the teaching intervention, conducted in groups and on a one-to-one basis, would affect the patient's ability to recognize and treat his disease symptoms. The null hypothesis was tested: there is no significant difference in the patient's ability to recognize and treat disease symptoms after he has participated in a teaching program as compared to his ability to recognize and treat disease symptoms before participating in such a program. Using two rehabilitation facilities in large metropolitan hospitals, all patients accepted for the rehabilitation programs over a four-month period were asked to participate in the study. Ultimately, twenty patients made up the study group. Patients were instructed in diary-keeping skills and given one diary per week for four weeks before they began the rehabilitation program. These diaries were reviewed on a weekly basis with the researcher. After the patients had participated in the teaching program they were again given diaries (one per week for eight weeks) which were reviewed weekly with the researcher. The patients were asked to describe each day as being a good (comfortable) day or a bad (uncomfortable) day, to record the presence of any symptoms that they experienced, and to record any activities or treatments that they used to make themselves more comfortable. Twelve symptoms and eleven treatments were under consideration. The symptoms and treatments were divided into before and after categories and analyzed using the t ratio for non-independent groups. The results of the analysis lead to the rejection of the null hypothesis with p=0.05, indicating that patients with chronic bronchitis and emphysema were better able to cope with their illnesses after the teaching intervention. The study recommends that health care facilities establish teaching programs for patients with these illnesses, and that nurses assume greater involvement and responsiblity for teaching patients. The study concludes with recommendations for further investigation. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis (Ph. D.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains vii, 141 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2008. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Analisamos as alterações cardíacas pós-indução de enfisema por instilação de papaína. Foram avaliados 75 ratos (grupos papaína e controle), sacrificados 30, 60, 90, 120 ou 180 dias pós-instilação. Foram realizados: gasometria do sangue arterial, avaliação morfométrica cardíaca e pulmonar. A papaína produziu destruição alveolar compatível com enfisema, sem repercussão nas trocas gasosas. Ventrículo direito e septo interventricular não apresentaram alterações significativas. Houve redução da área do ventrículo esquerdo, 90 dias pós-indução, e discreto espessamento de sua parede. / Cardiac alterations post-induction emphysema by instillation of papain were analyzed. Seventy-five rats (groups papain and control), sacrificed 30, 60, 90, 120 or 180 days post-instillation were evaluated. Arterial blood gases, cardiac and pulmonary morphometrical analysis were performed. Papain administration produced alveolar destruction compatible with emphysema, without arterial blood gases changes. Right ventricle and interventricular septum didn't show alterations. There were left ventricular area decrease (90 days post-induction) and light thickness increase of its wall.

Analisamos as alterações cardíacas pós-indução de enfisema por instilação de papaína. Foram avaliados 75 ratos (grupos papaína e controle), sacrificados 30, 60, 90, 120 ou 180 dias pós-instilação. Foram realizados: gasometria do sangue arterial, avaliação morfométrica cardíaca e pulmonar. A papaína produziu destruição alveolar compatível com enfisema, sem repercussão nas trocas gasosas. Ventrículo direito e septo interventricular não apresentaram alterações significativas. Houve redução da área do ventrículo esquerdo, 90 dias pós-indução, e discreto espessamento de sua parede. / Cardiac alterations post-induction emphysema by instillation of papain were analyzed. Seventy-five rats (groups papain and control), sacrificed 30, 60, 90, 120 or 180 days post-instillation were evaluated. Arterial blood gases, cardiac and pulmonary morphometrical analysis were performed. Papain administration produced alveolar destruction compatible with emphysema, without arterial blood gases changes. Right ventricle and interventricular septum didn't show alterations. There were left ventricular area decrease (90 days post-induction) and light thickness increase of its wall.

A Doença Pulmonar Obstrutiva Crônica (DPOC) destaca-se como um grave problema de saúde no mundo. O enfisema pulmonar, dentro do espectro das DPOC, caracteriza-se pelo alargamento dos espaços aéreos distais resultante da destruição do parênquima pulmonar. O tabagismo é considerado o principal fator relacionado ao surgimento da patologia. Considerando a escassez de aparelhos comercializados para exposição à fumaça de cigarro, bem como o elevado custo dos existentes, o presente projeto propôs um modelo experimental de enfisema por exposição à fumaça utilizando um novo aparato. Foram realizadas avaliações morfométricas e funcionais nos pulmões de ratos expostos à fumaça ou ao ar ambiente. Além disso, o peso dos animais foi aferido semanalmente. Os resultados indicaram alargamento dos espaços aéreos pulmonares, além de redução do ganho de peso nos animais expostos. Não houve diferenças funcionais entre os grupos controle e experimental. O trabalho objetivou o desenvolvimento de um aparato eficiente e menos custoso para estudos relacionados ao enfisema pulmonar. / The Chronic Obstructive Pulmonary Disease (COPD) stands out as a serious health problem in the world. The pulmonary emphysema, in the spectrum of COPD, has as main feature the enlargement of the airspaces distal resulting from destruction of lung parenchyma. Smoking is considered the main factor related to the development of pathology. Considering the lack of machines marketed for exposure to cigarette smoke, as well as the high cost of devices available, the currently project has proposed a experimental model of pulmonary emphysema induced by the use of a new apparatus. Were performed morphometric and functional measurements in the lung of rats exposed to cigarette smoke or clean air. Further, the animal weight was measured weekly. The results indicated enlargement of the pulmonary airspaces, as well as reduction of weight gain in animals exposed. There were no functional differences between control and experimental groups. The current study aimed to the development of an efficient and less costly apparatus for experimental studies related to the pulmonary emphysema.

O enfisema pulmonar é um dos maiores problemas de saúde pública atualmente. É caracterizado pela destruição permanente das paredes alveolares levando ao alargamento do espaço aéreo, à perda de retração elástica, à diminuição da superfície de troca gasosa, à hiperexpansão pulmonar e ao aumento do trabalho respiratório. Diferentes abordagens cirúrgicas são realizadas em pacientes enfisematosos, sendo a cirurgia redutora de volume pulmonar (CRVP) uma das mais utilizadas, devido à melhora imediata da qualidade de vida dos pacientes. Várias hipóteses são consideradas para explicar essa melhora, como o aumento do fluxo expiratório máximo, o aumento da elasticidade pulmonar, o aumento da capacidade vital e o crescimento pulmonar compensatório (CPC), sendo esta última uma das mais estudadas. Em modelos animais, a lobectomia (LBX) é utilizada para mimetizar a CRVP, pois o pulmão remanescente sofre rápido CPC, com restabelecimento de peso, volume, quantidade de DNA e níveis de proteínas do pulmão após 3 semanas. Este estudo teve o objetivo de investigar as mudanças estruturais e funcionais que ocorrem no pulmão após a LBX através de parâmetros morfométricos. Para tanto, utilizamos um modelo animal de enfisema pulmonar induzido pela instilação intratraqueal de elastase pancreática suína. Os efeitos do CPC foram avaliados 2 (T2), 4 (T4) e 16 (T16) semanas após a bilobectomia (ressecção dos lobos médio e cardíaco do pulmão direito). Os animais enfisematosos submetidos à LBX apresentaram: diminuição do intercepto linear médio (T2 e T16); aumento da proporção de fibras elásticas (T2 e T16); melhora da elastância pulmonar (T4 e T16); e CPC devido ao aumento de peso e volume pulmonar (T2 e T4) e aumento do volume total da região respiratória (T4 e T16) e do tecido respiratório (T2, T4 e T16). Concluímos que a bilobectomia promoveu o CPC nos animais enfisematosos com a reestruturação da arquitetura alveolar e melhora da função respiratória / Currently, the pulmonary emphysema is a major public health issues. It is characterized by permanent destruction of alveolar walls leading to airspace enlargement, elastic retraction loss, gas exchange surface reduction, lung overexpansion and increased breathing effort. Different surgical approaches are performed in patients with emphysema. Lung volume reduction surgery (LVRS) is one of the most widely used, due to immediate improvement in life quality of these patients. Several hypotheses are considered to explain this improvement, such as increasing the maximum expiratory flow, improved lung elasticity, increased vital capacity, and compensatory lung growth (CLG), which is one of the most studied. In animal models, lobectomy (LBX) is used to mimic LVRS because the remaining lung undergoes rapid CLG, with restoration of weight, volume, amount of DNA and protein levels of the lung after three weeks. This study investigated the structural and functional changes that occur in the lungs after LBX by morphometric parameters. We used an animal model of pulmonary emphysema induced by intratracheal instillation of porcine pancreatic elastase. The CLG effects were evaluated 2 (T2), 4 (T4) and 16 (T16) weeks after bilobectomy (resection of the middle and cardiac lobes of the right lung). After lobectomy, the emphysematous animals presented: mean linear intercept decrease (T2 and T16); increased proportion of elastic fibers (T2 and T16); lung elastance improvement (T4 and T16); and CLG due to the increase of both weight and volume of the lung (T2 and T4), beside the increase of total volume of respiratory region (T4 and T16) and respiratory tissue (T2, T4 and T16). We conclude that bilobectomy promoted the CLG in emphysematous animals by the restructuring of alveolar architecture and respiratory function improvement