ALVEOLOPLASTY
A
Fibrosing alveolitis is an
autoimmune dis-
order
(in which the immune system
attacks the body’s own tissues). In some
cases, it occurs with other autoimmune
disorders, such as
rheumatoid arthritis
or
systemic
lupus erythematosus
.
Radiation alveolitis is caused by irra-
diation of the lungs and may occur as a
rare complication of
radiotherapy
for
lung or breast cancer.
SYMPTOMS AND DIAGNOSIS
Alveolitis usually causes a dry cough
and breathing difficulty on exertion.
A
chest X-ray
of a person suffering
from alveolitis usually shows mottled
shadowing across the lungs.
Blood tests
may be performed to look for specific
antibodies (proteins manufactured by
the immune system: see
antibody)
to an
allergen. They may also be performed to
look for evidence of an autoimmune
disorder (in which the immune system
attacks the body’s own tissues).
Pul-
monary function tests
show reduced lung
capacity without obstruction to air flow
through the bronchi (air passages to the
lungs). A lung
biopsy
(removal of a
sample of tissue for microscopic analy-
sis) may be the only way to make a
conclusive diagnosis of alveolitis.
TREATMENT AND OUTLOOK
For most types of alveolitis, a short
course of
corticosteroid drugs
relieves
symptoms, but for fibrosing alveolitis
the drugs may need to be taken indefi-
nitely. If the cause of allergic alveolitis is
recognized and avoided before lung
damage
occurs,
the
effects
are
not
permanent. In fibrosing alveolitis, the
damage progresses despite treatment,
causing increasing breathing difficulty
and, sometimes,
respiratoryfailure
.
alveoloplasty
Dental surgery that is carried out to
remove protuberances and to smooth
out other uneven areas from tooth-
bearing bone in the jaw. Alveoplasty is
performed either under a general anaes-
thetic (see
anaesthesia, dental)
or, more
usually,
under local anaesthetic. The
procedure is usually carried out to facil-
itate the fitting of dentures on people
whose alveolar ridge, underlying the
gums, would not otherwise be smooth
and even enough for dentures to be fit-
ted easily or worn comfortably.
An incision is made in the gum,
which is then peeled back to expose the
uneven bone. The bone is then either
reshaped with large forceps or filed
down to the required shape. Finally, the
gum is drawn back over the bone and
stitched together. Some bruising and
swelling of the mouth may occur, but
the gum usually heals within two weeks.
alveolus, dental
The bony cavity or socket supporting
each tooth in the jaw.
alveolus, pulmonary
One of millions of tiny, balloonlike sacs
at the end of a bronchiole (one of the
many small air passages in the lungs)
where gases are exchanged during
res-
piration.
In
each
lung,
there
are
approximately 300 million alveoli that
are
arranged
in
groups
resembling
bunches of grapes.
Alzheimer’s disease
A progressive condition in which nerve
cells in the brain degenerate and the
brain shrinks. Alzheimer’s disease is the
most common cause of
dementia
(a
general decline in all areas of mental
ability). Its onset is uncommon before
the age of 60, but incidence increases
steadily with age thereafter.
CAUSES
Early onset Alzheimer's disease, in which
symptoms develop before the age of 60,
is often inherited as a dominant trait
(see
genetic disorders).
Late onset Alzheimer's disease is asso-
ciated with one of the genes that is
responsible for the production of the
blood protein
apolipoprotein
E. Genetic
factors
also
result in
the
abnormal
deposition of a protein in the brain
called beta amyloid. Other chemical
abnormalities include deficiency of the
neurotransmitter
acetylcholine.
SYMPTOMS AND SIGNS
The features of Alzheimer’s disease vary,
but there are three broad stages. At
first, the affected individual becomes
increasingly
forgetful;
and
problems
with memory may cause
anxiety
and
depression.
Some deterioration in mem-
ory is a feature of normal
aging,
and
this alone is not evidence of dementia.
In the second stage of the disease,
loss of memory, particularly for recent
events, gradually becomes more severe,
and there may be disorientation as to
time or place. The person’s concentra-
tion and numerical ability decline, and
there is noticeable
dysphasia
(inability
to find the right word). Anxiety increas-
es, mood changes are unpredictable,
and personality changes may occur. If
the patient is left unsupervised, he or
she may repeatedly wander off.
Finally, confusion becomes profound.
There may be symptoms of
psychosis
,
such
as
hallucinations
and
delusions.
Signs of nervous system disease, such as
abnormal
reflexes
(involuntary actions)
and faecal or urinary
incontinence,
begin
to develop.
DIAGNOSIS
Alzheimer’s disease is usually diagnosed
from the symptoms, but tests including
blood tests and
CTscanning
or
MRI
(tech-
niques that produce cross-sectional or
three-dimensional images) of the brain
may be needed to exclude other causes
of dementia.
MRI of the brain in Alzheimer’s disease
The volume of the brain substance has shrunk
markedly, resulting in deep folding of the tissue
and enlargement of the fluid-filled brain ventricles.
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