scholarly journals A STUDY OF THE RELATION OF PULMONARY AND BRONCHIAL CIRCULATION

1913 ◽  
Vol 18 (5) ◽  
pp. 500-506 ◽  
Author(s):  
Albert A. Ghoreyeb ◽  
Howard T. Karsner
Keyword(s):  
Pulmonary Artery ◽  
Lung Tissue ◽  
Bronchial Artery ◽  
Venous Blood ◽  
Pulmonary Arteries ◽  
The Other ◽  
Main Trunk ◽  
Intimate Contact ◽  
Bronchial Arteries ◽  
Bronchial Circulation

The most striking point brought out in this study is that as long as a definite pressure is maintained in either the pulmonary or bronchial circulations, the admixture of bloods is extremely limited. It is easily conceivable that more mixture occurs normally than under the conditions of the experiment, but there is no reason for considering this to be a large difference. If, however, in either system the pressure sinks to zero the possibility of supply by the other system becomes evident. It takes much longer for the mass injected through the bronchial arteries to penetrate to all parts of the lung than when the mass is injected through the pulmonary artery; but when accomplished, the injection reaches to all capillaries including those of the pleura, the only vessels remaining uninjected being the larger trunks of the pulmonary artery. On the other hand, the injection of the bronchial vessels by way of the pulmonary arteries is not complete with normal pressure, but occurs rapidly when a high pulmonary pressure is employed. It is therefore probable that either circulation can suffice for the simple nutritive demands of the lung if the other system is interfered with. It has been shown that embolism of the pulmonary artery, without other circulatory disturbance, does not lead to necrosis of the affected area of the lung, but it is probable that the preservation of circulation is not due to collateral bronchial circulation so much as to the free anastomosis and early division into capillaries of the pulmonary artery. In support of this statement is the fact that the appearance is not altered when the bronchials are ligated at their origin. The same ligation shows no subsequent interference with the nutrition of the bronchi up to a period of five weeks, demonstrating that the pulmonary circulation is sufficient to provide for the nutrition of the bronchi. If, however, as Virchow has shown, the pulmonary artery supplying an entire lobe be occluded, the bronchial circulation can and does suffice for the nutrition of the lobe. In the case of the occlusion of a branch of the pulmonary artery the pressure in the area interfered with does not sink to zero because of the collateral circulation in this area; whereas, if the main trunk is occluded no collateral supply is available, the pressure sinks to zero, and the bronchial artery becomes available as a source of blood supply. It must be remembered that the lung tissue, as a whole, has ready access to oxygen and this gas is the nutritive element acquired by the blood in the lungs. From these studies it would appear that the part of the lung tissue not in intimate contact with oxygen in the air is supplied by oxygenated blood of the bronchial arteries, and that the tissues through which the pulmonary blood circulates take up whatever organized nutriment they need from the pulmonary blood and possibly provide for their oxygen and carbon dioxide interchange (which must be very slight) either directly with the alveolar air, or by finding sufficient oxygen in the venous blood of the pulmonary artery. The studies of the injected specimens confirm Küttner's findings of a very rapid breaking up of the pulmonary artery into capillaries. In all the specimens studied it was found that although the pleural vessels can be injected by way of the bronchial arteries when there is zero pressure in the pulmonary arteries, yet when the two sets of vessels are injected simultaneously in the dog, the pleural vessels invariably derive their supply of injection mass from the pulmonary artery.

scholarly journals P701 Usefulness of echocardiography in diagnosis and monitoring in patient with pulmonary embolism during pregnancy, a case report

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Starzyk ◽  
P Dybich ◽  
K Ciuraszkiewicz ◽  
W Rokita ◽  
B Wozakowska-Kaplon
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Pulmonary Arteries ◽  
Pulmonary Trunk ◽  
Clinical State ◽  
Main Trunk ◽  
Right Pulmonary Artery ◽  
Low Incidence ◽  
The Right

Abstract Pulmonary embolism is one of the leading causes of maternal mortality despite a low incidence of during pregnancy. We present 32-year-old woman, in the 35 week of first pregnancy, admitted to the Intensive Care Unit with dyspnea, tachycardia, cyanosis. Echocardiography confirmed the presence of embolic material in the main trunk of pulmonary artery, spreading to the right pulmonary artery. D-dimer and troponin T level were elevated, BNP remained within the normal range. The risk in PESI scale was assumed as intermediate high. LMWH therapy was initiated, the patient was constantly monitored. Venous thrombotic disease in lower extremities was excluded by ultrasonography. The treatment was carried out under obstetric supervision. The clinical state gradually improved, the patient was hemodynamically stable. Serial echocardiographic testing, revealed gradual regression of changes in the pulmonary trunk. Normalization of troponins and lowering of BNP levels were observed. The pregnancy was terminated in 39 week, by cesarean section (obstetric indications). The LMWH was continued few days after delivery, as the patient started lactation. She decided to terminate lactation in a first week after delivery so the therapy was switched into rivaroxaban for at least 3 months. Echocardiography after 3 month confirmed lack of changes in pulmonary trunk, the risk of pulmonary hypertension was low. Echocardiography can be a method of choice for confirming and monitoring pulmonary embolism during pregnancy, in a situation of high or intermediate clinical risk and good visualization of changes in pulmonary arteries Abstract P701 Figure. Embolism of pulmonary trunk and RPA

scholarly journals Observations on the poison of the common toad

1833 ◽  
Vol 2 ◽  
pp. 262-263
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
The Other ◽  
Venous Plexus ◽  
Common Toad ◽  
Popular Opinion ◽  
The Common

After adverting to the correctness of the popular opinion respect­ing the poisonous nature of the toad, which the professed naturalist has generally rejected, the author proceeds to describe the seat of the poison, which is chiefly in follicles in the cutis vera, and which, on pressure, exude from it in the form of a thick yellowish fluid, which, on evaporation, yields a transparent residue, very acrid, and acting on the tongue like extract of aconite. It is neither acid nor alkaline; and since a chicken inoculated with it received no injury, it does not appear to be noxious when absorbed and carried into the circulation. Indeed, although it chiefly abounds in the integuments of the toad, the author also detected it in the bile, the urine, and in small quan­tity in the blood. Dr. Davy thinks that the principal use of this poison is to defend the reptile against the attacks of carnivorous animals; he also re­marks, that as it contains an inflammable substance, it may be con­sidered as excrementitious; it may serve to carry off a portion of carbon from the blood, and thus be auxiliary to the function of the lungs. In support of this idea, the author observes that he finds each of the pulmonary arteries of the toad divided into two branches, one of which goes to the lung, and the other to the cutis, ramifying most abundantly where the largest venous follicles are situated, and where there is a large venous plexus, corresponding to the site of the tadpole’s gills, and seeming to indicate that the subcutaneous distri­bution of the second branch of the pulmonary artery may further aid the office of the lungs by bringing the blood to the surface to be acted on by the air.

Vascular remodeling in the circulations of the lung

2004 ◽  
Vol 97 (5) ◽  
pp. 1999-2004 ◽  
Author(s):  
Wayne Mitzner ◽  
Elizabeth M. Wagner
Keyword(s):  
Pulmonary Circulation ◽  
Vascular Remodeling ◽  
Pulmonary Arteries ◽  
Future Research ◽  
Striking Difference ◽  
The Novel ◽  
Molecular Signaling ◽  
Bronchial Arteries ◽  
Bronchial Circulation ◽  
Systemic Arteries

The lung is unique in its double sources of perfusion from the pulmonary and systemic circulations. One striking difference between the two circulations is the capacity for angiogenesis. The bronchial circulation has a capacity that seems quite similar to all systemic arteries, whereas the pulmonary circulation seems relatively inert in this regard. Extra-alveolar pulmonary arteries can grow somewhat in length, and septal capillaries seem to have the capability of reforming, but these processes do not seem to occur with nearly the same intensity associated with the bronchial arteries. In this review, we emphasize these differences between the two circulations of the lung, anticipating that future research will allow more focused probing into the molecular signaling that regulates the novel mechanistic and pathological pathways of each.

scholarly journals Cellular disposition of transported polyamines in hypoxic rat lung and pulmonary arteries

2000 ◽  
Vol 278 (3) ◽  
pp. L610-L617 ◽  
Author(s):  
Pavel Babal ◽  
S. Machelle Manuel ◽  
Jack W. Olson ◽  
Mark N. Gillespie
Keyword(s):  
Endothelial Cells ◽  
Smooth Muscle ◽  
Pulmonary Artery ◽  
Lung Tissue ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Rat Lung ◽  
Polyamine Transport ◽  
Pulmonary Arterial ◽  
Polyamine Uptake

The polyamines putrescine, spermidine (SPD), and spermine are a family of low-molecular-weight organic cations essential for cell growth and differentiation and other aspects of signal transduction. Hypoxic pulmonary vascular remodeling is accompanied by depressed lung polyamine synthesis and markedly augmented polyamine uptake. Cell types in which hypoxia induces polyamine transport in intact lung have not been delineated. Accordingly, rat lung and rat main pulmonary arterial explants were incubated with [14C]SPD in either normoxic (21% O2) or hypoxic (2% O2) environments for 24 h. Autoradiographic evaluation confirmed previous studies showing that, in normoxia, alveolar epithelial cells are dominant sites of polyamine uptake. In contrast, hypoxia was accompanied by prominent localization of [14C]SPD in conduit, muscularized, and partially muscularized pulmonary arteries, which was not evident in normoxic lung tissue. Hypoxic main pulmonary arterial explants also exhibited substantial increases in [14C]SPD uptake relative to control explants, and autoradiography revealed that enhanced uptake was most evident in the medial layer. Main pulmonary arterial explants denuded of endothelium failed to increase polyamine transport in hypoxia. Conversely, medium conditioned by endothelial cells cultured in hypoxic, but not in normoxic, environments enabled hypoxic transport induction in denuded arterial explants. These findings in arterial explants were recapitulated in rat cultured main pulmonary artery cells, including the enhancing effect of a soluble endothelium-derived factor(s) on hypoxic induction of [14C]SPD uptake in smooth muscle cells. Viewed collectively, these results show in intact lung tissue that hypoxia enhances polyamine transport in pulmonary artery smooth muscle by a mechanism requiring elaboration of an unknown factor(s) from endothelial cells.

Endogenous Hydrogen Sulfide Regulates Pulmonary Artery Collagen Remodeling in Rats with High Pulmonary Blood Flow

2009 ◽  
Vol 234 (5) ◽  
pp. 504-512 ◽  
Author(s):  
Xiaohui Li ◽  
Hongfang Jin ◽  
Geng Bin ◽  
Li Wang ◽  
Chaoshu Tang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Hydrogen Sulfide ◽  
Pulmonary Artery ◽  
Lung Tissue ◽  
Pulmonary Blood Flow ◽  
Pulmonary Arteries ◽  
Tissue Growth ◽  
Pulmonary Vasculature ◽  
Collagen Remodeling ◽  
Collagen Iii

The mechanisms responsible for the structural remodeling of pulmonary vasculature induced by increased pulmonary blood flow are not fully understood. This study explores the effect of endogenous hydrogen sulfide (H2S), a novel gasotransmitter, on collagen remodeling of the pulmonary artery in rats with high pulmonary blood flow. Thirty-two Sprague-Dawley rats were randomly divided into sham, shunt, sham+PPG (D,L-propargylglycine, an inhibitor of cystathionine-γ-lyase), and shunt+PPG groups. After 4 weeks of shunting, the relative medial thickness (RMT) of pulmonary arteries and H2S concentration in lung tissues were investigated. Collagen I and collagen III were evaluated by hydroxyproline assay, sirius-red staining, and immunohistochemistry. Pulmonary artery matrix metalloproteinase-13 (MMP-13), tissue inhibitor of metalloproteinase-1 (TIMP-1), and connective tissue growth factor (CTGF) were evaluated by immunohistochemistry. After 4 weeks of aortocaval shunting, resulting in an elevation of lung tissue H2S to 116.4%, rats exhibited collagen remodeling and increased CTGF expression in the pulmonary arteries. Compared with those of the shunt group, lung tissue H2S production was lowered by 23.4%, RMT of the pulmonary artery further increased by 39.5%, pulmonary artery collagen accumulation became obvious, and pulmonary artery CTGF expression elevated ( P < 0.01) in the shunted rats treated with PPG. However, pulmonary artery MMP-13 and TIMP-1 expressions decreased significantly in rats of shunt+PPG group ( P < 0.01). This study suggests that endogenous H2S exerts an important regulatory effect on pulmonary collagen remodeling induced by high pulmonary blood flow.

scholarly journals Hidden Pulmonary Arteries in Tetralogy of Fallot and Pulmonary Artery Pressure in Patients Operated with a Pulmonary Artery

2020 ◽  
Author(s):  
Mohammadreza Edraki ◽  
Bahram Ghasemzadeh ◽  
Kambiz Keshavarz ◽  
Ahmadali Amirghofran ◽  
Hamid Mohammadi ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Pulmonary Vein ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Pulmonary Artery Hypertension ◽  
The Other ◽  
Right Pulmonary Artery ◽  
Cardiac Disorders

Abstract Introduction: The absence of a pulmonary artery is a rare congenital anomaly that occurs on its own or with some congenital cardiac disorders, particularly tetralogy of Fallot (TOF), while the hidden pulmonary artery might originate from a closed ductus arteriosus (DA) that can be stented to reach the artery.Material and methods: This prospective study describes cardiac catheterization of our nine TOF patients who had the absence of the left pulmonary artery before the operation. The patients were stratified in three groups: group one, whose closed DA were found and stented successfully to the hidden pulmonary artery; group two, whose hidden pulmonary arteries were found via the pulmonary vein angiography; and group three, for whom we could not find the remnant of the DA, or our attempt to stent the DA to the hidden pulmonary artery was not successful.We also evaluated outcomes of the other surgically-corrected TOF patients who were operated with the absent left pulmonary artery.Results: The first group included patients aged 1, 24, and 30 months, whose CT angiography 6-9 months after stenting showed acceptable left pulmonary artery diameter for surgically correction, while the pulmonary vein angiography of the group two patients showed a hidden left pulmonary artery with a suitable diameter for surgical correction.However, we were unable to find or stent the DA of the group three patients, aged 12, 38, 60, and 63 months. Moreover, evaluation of the other six previously corrected patients who were operated with a right pulmonary artery revealed pulmonary artery hypertension of the entire patients.Conclusion: The concealed pulmonary artery might be found, and stenting of the closed DA to it might be performed to improve the diameter of the diminutive pulmonary artery. This procedure may allow TOF total surgical correction with two pulmonary arteries. Besides, pulmonary vein angiography can reveal the hidden pulmonary artery.

In situ central pulmonary artery thrombosis in primary pulmonary hypertension

2005 ◽  
Vol 46 (7) ◽  
pp. 696-700 ◽  
Author(s):  
P. P. Agarwal ◽  
A. L. Wolfsohn ◽  
F. R. Matzinger ◽  
J. M. Seely ◽  
R. A. Peterson ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Primary Pulmonary Hypertension ◽  
Pulmonary Arteries ◽  
Bronchial Arteries ◽  
Artery Thrombosis ◽  
Central Pulmonary Artery ◽  
Pulmonary Arterial ◽  
Segmental Arteries

A rare case of extensive in situ central pulmonary artery thrombosis in primary pulmonary hypertension (PPH) is presented. The differentiation from chronic thromboembolic pulmonary arterial hypertension (CTEPH) is of paramount importance because of different therapeutic strategies. In this case, the presence of mural thrombus in the central pulmonary arteries on computed tomography made the distinction difficult. However, the possibility of in situ thrombosis was suggested on the basis of absence of other findings of CTEPH (abrupt narrowing/truncation of segmental arteries, variation in size of segmental vessels, arterial webs, mosaic attenuation, pulmonary infarcts, and dilated bronchial arteries), and this was confirmed on final pathology.

scholarly journals Imaging Features of Thoracic Manifestations in Behçet’s Disease: Beyond Pulmonary Artery Involvement

2021 ◽  
Vol 17 ◽  
Author(s):  
Çisel Yazgan ◽  
Hakan Ertürk ◽  
Ayşenaz Taşkın
Keyword(s):  
Pulmonary Artery ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Pulmonary Arteries ◽  
Occurrence Rate ◽  
Imaging Features ◽  
Bronchial Arteries ◽  
Anatomic Structure ◽  
Behcet's Disease

Background: Behçet’s disease is a chronic multisystemic vasculitis affecting vessels of differing size in various organs. Thoracic manifestations of disease show wide spectrum involving a variety of anatomic structure within the chest. However, pulmonary artery involvement is a typical manifestation of disease that contributes significantly to mortality in patients. The study aimed to analyze CT features of thoracic manifestations, particularly pulmonary artery involvement, and to quantitatively assess bronchial arteries in Behçet’s disease. Methods: Patients with Behçet’s disease who underwent CT scans for suspected thoracic involvement between 2010 and 2018 were included. CT findings of 52 patients were retrospectively analyzed for thoracic manifestations of the disease. Bronchial arteries were assessed regarding diameter in patients with/without pulmonary artery involvement. The pulmonary symptoms were noted. Results: Of the 52 patients, 67% had thoracic manifestations including pulmonary artery involvement, parenchymal changes, superior vena cava thrombosis, and intracardiac thrombus. Pulmonary artery involvement was observed in 50% of the cohort. Peripheral pulmonary arteries (77%) were the most commonly affected branches, followed by lobar (42%) and central (35%) pulmonary arteries. Other thoracic findings were significantly correlated with pulmonary artery involvement (p<0.05). Compared to patients without pulmonary artery involvement, those with pulmonary artery involvement had a higher bronchial artery diameter (p<0.05) and occurrence rate of dilated bronchial arteries. Conclusion: Involvement of peripheral pulmonary arteries is frequently encountered in Behçet’s disease and it can resemble pulmonary nodules. Dilated bronchial arteries, which can be observed in cases of pulmonary artery involvement, should be considered in patients with hemoptysis.

Ligation of the bronchial artery in sheep attenuates early pulmonary changes following exposure to smoke

2000 ◽  
Vol 88 (3) ◽  
pp. 888-893 ◽  
Author(s):  
Olga Efimova ◽  
A. B. Volokhov ◽  
Sakineh Iliaifar ◽  
C. A. Hales
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Edema ◽  
Bronchial Artery ◽  
Lymph Flow ◽  
Smoke Inhalation ◽  
Acute Pulmonary Edema ◽  
Artery Ligation ◽  
Bronchial Arteries ◽  
Right Pulmonary Artery ◽  
The Right

Smoke inhalation can produce acute pulmonary edema. Previous studies have shown that the bronchial arteries are important in acute pulmonary edema occurring after inhalation of a synthetic smoke containing acrolein, a common smoke toxin. We hypothesized that inhalation of smoke from burning cotton, known to contain acrolein, would produce in sheep acute pulmonary edema that was mediated by the bronchial circulation. We reasoned that occluding the bronchial arteries would eliminate smoke-induced pulmonary edema, whereas occlusion of the pulmonary artery would not. Smoke inhalation increased lung lymph flow from baseline from 2.4 ± 0.7 to 5.6 ± 1.2 ml/0.5 h at 30 min ( P < 0.05) to 9.1 ± 1 ml/0.5 h at 4 h ( P < 0.05). Bronchial artery ligation diminished and delayed the rise in lymph flow with baseline at 2.8 ± 0.7 ml/0.5 h rising to 3.1 ± 0.8 ml/0.5 h at 30 min to 6.5 ± 1.5 ml/0.5 h at 240 min ( P < 0.05). Wet-to-dry ratio was 4.1 ± 0.2 in control, 5.1 ± 0.3 in smoke inhalation ( P< 0.05), and 4.4 ± 0.4 in bronchial artery ligation plus smoke-inhalation group. Smoke inhalation after occlusion of the right pulmonary artery resulted in a wet-to-dry ratio after 4 h in the right lung of 5.5 ± 0.8 ( P < 0.05 vs. control) and in the left nonoccluded lung of 5.01 ± 0.7 ( P < 0.05). Thus the bronchial arteries may be major contributors to acute pulmonary and airway edema following smoke inhalation because the edema occurs in the lung with the pulmonary artery occluded but not in the lungs with bronchial arteries ligated.

scholarly journals STUDIES IN INFARCTION

1913 ◽  
Vol 18 (5) ◽  
pp. 507-511 ◽  
Author(s):  
Howard T. Karsner ◽  
Albert A. Ghoreyeb
Keyword(s):  
Pulmonary Artery ◽  
High Pressures ◽  
Bronchial Artery ◽  
Normal Lung ◽  
Bronchial Arteries ◽  
Pulmonary Vessels ◽  
Pulmonary Pressure ◽  
Two Systems ◽  
Bronchial System ◽  
Bronchial Vessels

From series 1 it is concluded that increases in pulmonary pressure improve the circulation in the embolic areas and that decreases in pulmonary pressure limit the circulation in the same areas. In this series the bronchial vessels showed no tendency to take up the circulation in the area of pulmonary embolism until the pulmonary pressure was as low as zero, and then only to a limited degree. It has been shown, however, that in the circulation of an entire lobe the fall to zero pressure in the pulmonary circuit is followed by almost complete taking over of the circulation by the bronchial arterial supply and the most reasonable explanation of why this does not occur when embolism is present in a smaller branch of the pulmonary is the inference that the physiological anastomosis between the two systems takes place in part before the pulmonary artery breaks up into branches small enough to be occluded by seeds of about three millimeters in diameter. From series 2 it is concluded that although increases in pressure in the bronchial arteries cause somewhat greater inflow of bronchial injection mass into the embolic area, extremely high pressures are not sufficient to provide for complete circulation in the same district. This fact would tend to support further the belief that the anastomosis between the two vascular systems occurs before the smaller divisions of the pulmonary artery are reached. From series 3 it is concluded that with a zero pressure in the pulmonary artery there is improved injection of the embolic area through the bronchial artery which is to be expected when it is remembered that zero pressure in the pulmonary artery favors a taking over of the circulation by the bronchial system. What pressure is found in the smaller pulmonary vessels is supplied by the bronchials. It has been shown that the anastomosis between the two systems probably occurs before the branches are reached which would provide lodgment for the turnip radish seeds. The pressure supplied by the bronchials would naturally be less beyond this point and hence the injection would be less complete in the embolic area than in the normal lung. This is shown to be the case by the results of the experiment. From series 4 it is concluded that the absence of pressure in the bronchial circulation favors a better injection of the embolic area through the pulmonary vessels, which is to be expected when it is recalled that not until zero pressure is reached in the bronchial circuit does the pulmonary artery supply the bronchial vessels with blood. Throughout the study it was found that whenever the two vascular systems were injected simultaneously the pleural vessels over the embolic area, as well as those over the normal lung, received their supply from the pulmonary vessels. When only one system was used for injection the pleural vessels over the embolic area showed about the same degree of injection as those of the embolic area itself.

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