{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:15:22Z","timestamp":1774620922477,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[1998,2,1]],"date-time":"1998-02-01T00:00:00Z","timestamp":886291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Since 1994 an endemic of chronic obstructive pulmonary disease (COPD) has developed in Taiwan after a prevalent use of a body-weight-reducing vegetable, Sauropus androgynus (SA). All conventional treatments for COPD, including steroids and bronchodilators, had been ineffective. Studies of limited lung biopsy specimens from these patients revealed bronchiolitis obliterans. A few patients died, but many developed protracted chronic respiratory failure. Because of the chronic debilitation and ineffective conventional treatments, single lung transplants were performed as the last resort in four patients. The excised lungs revealed focal fibromuscular sclerosis and obliteration of bronchial arteries in the wall of large bronchi 4 to 5 mm in diameter with segmental necrosis of bronchi 2 to 4 mm in diameter. Bronchi immediately proximal to the necrotic zone showed fibrosis and atrophy of cartilage, bronchial glands, and smooth muscle cells; bronchioles immediately distal showed obstruction or dilatation. Most bronchi larger than 5 mm, pulmonary vessels, small bronchioles, and alveoli were little altered. The pathologic changes were most consistent with segmental ischemic necrosis of bronchi at the water-shed zone of bronchial and pulmonary circulation. The specific etiologic agent and detail of pathogenesis of this SA-related COPD needs further investigation.<\/jats:p>","DOI":"10.1164\/ajrccm.157.2.9704040","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T13:31:15Z","timestamp":1365082275000},"page":"594-598","source":"Crossref","is-referenced-by-count":17,"title":["Segmental Necrosis of Small Bronchi after Prolonged Intakes of\n                    <i>Sauropus androgynus<\/i>\n                    in Taiwan"],"prefix":"10.1093","volume":"157","author":[{"given":"YIH-LEONG","family":"CHANG","sequence":"first","affiliation":[{"name":"Department of Pathology and Surgery, College of Medicine, National Taiwan University, Taipei; and National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YU-TUNG","family":"YAO","sequence":"additional","affiliation":[{"name":"Department of Pathology and Surgery, College of Medicine, National Taiwan University, Taipei; and National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NAI-SAN","family":"WANG","sequence":"additional","affiliation":[{"name":"Department of Pathology and Surgery, College of Medicine, National Taiwan University, Taipei; and National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YUNG-CHIE","family":"LEE","sequence":"additional","affiliation":[{"name":"Department of Pathology and Surgery, College of Medicine, National Taiwan University, Taipei; and National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1998,2,1]]},"reference":[{"key":"2026032709115830000_B1","first-page":"1","article-title":"Outbreak of obstructive ventilatory impairment associated with consumption of Sauropus androgynus vegetable.","volume":"34","author":"Lin","year":"1996","journal-title":"Clin. 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Pathol."},{"key":"2026032709115830000_B4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1148\/radiology.196.1.7784583","article-title":"Disease of bronchioles: CT and histopathological findings.","volume":"196","author":"Muller","year":"1995","journal-title":"Radiology"},{"key":"2026032709115830000_B5","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1055\/s-2007-1006264","article-title":"Clinical and histology spectrum of bronchiolitis obliterans, including bronchiolitis obliterans organizing pneumonia.","volume":"13","author":"Colby","year":"1992","journal-title":"Semin. Respir. Med."},{"key":"2026032709115830000_B6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1055\/s-2007-1006261","article-title":"Small airway injury in heart-lung transplant recipients.","volume":"13","author":"Yousem","year":"1992","journal-title":"Semin. Respir. Med."},{"key":"2026032709115830000_B7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/03062686.1975.11904165","article-title":"Nutritive value and toxicity of a Malaysian food, Sauropus albicans.","volume":"1","author":"Bender","year":"1975","journal-title":"Plant Foods Man."},{"key":"2026032709115830000_B8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/BF02193767","article-title":"Nutritive value of Sauropus androgynus leaves.","volume":"40","author":"Padmavathi","year":"1990","journal-title":"Plant Foods Hum. Nutr."},{"key":"2026032709115830000_B9","first-page":"S248","article-title":"Irreversible obstructive lung disease induced by taking vegetable Sauropus androgynus as weight-reducing diet.","volume":"57","author":"Hsiue","year":"1996","journal-title":"Chin. Med. J. 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