Panlobular Emphysema: Anatomy and Pathodynamics

Wyatt, John P.; Fischer, Vernon W.; Sweet, Herbert C.

doi:10.1378/chest.41.3.239

Cited by 40 publications

(16 citation statements)

References 26 publications

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“…This pattern of emphysema is typically more prominent in the upper lung zones (9,10). PLE uniformly affects the entire secondary lobule (11). This subtype differs from CLE, as it is associated with a 1 -antitrypsin deficiency and is more prominent in the lower lung zones (10).…”

Section: Pathology Of Copd and Pathophysiologic Consequences Emphysemamentioning

confidence: 99%

New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease

Kim¹,

Rogers²,

Criner³

2008

Proceedings of the American Thoracic Society

174

120

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Chronic obstructive pulmonary disease (COPD) is characterized by an abnormal persistent inflammatory response to cigarette smoke. This noxious insult leads to emphysema and airway remodeling, manifested by squamous and mucous metaplasia of the epithelium, smooth muscle hypertrophy, and airway wall fibrosis. These pathologic abnormalities interact synergistically to cause progressive airflow obstruction. Although it has been accepted that the spectrum of COPD is vast, the reasons for the development of different phenotypes from the same exposure to cigarette smoke have not been determined. Furthermore, it is becoming increasingly clear that airways disease and emphysema often coexist in many patients, even with a clear clinical phenotype of either emphysema or chronic bronchitis. Recent studies have focused on the nature of the inflammatory response to cigarette smoke, the inflammatory cell lines responsible for COPD pathogenesis, and new biomarkers for disease activity and progression. New cytokines are being discovered, and the complex interactions among them are being unraveled. The inflammatory biomarker that has received the most attention is Creactive protein, but new ones that have caught our attention are interleukin (IL)-6, tumor necrosis factor-a, IL-8, and IL-10. Further research should focus on how these new concepts in lung inflammation interact to cause the various aspects of COPD pathology.

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Section: Pathology Of Copd and Pathophysiologic Consequences Emphysemamentioning

confidence: 99%

New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease

Kim¹,

Rogers²,

Criner³

2008

Proceedings of the American Thoracic Society

174

120

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“…As observed from histologie sections, the 10ss of gas exchange area due to destruction of the a1veo1ar wa11s was comparable with the reduction of DL • In such destruction, both the a1veo1ar membranes co and pu1monary capi11ary beds were reduced (129). William and Zohman (125) reported in their studies of emphysematous patients that the lowering of diffusing capacity was not due to diminished blood flow.…”

Section: Discussion Lung Volumementioning

confidence: 72%

“…These changes result in a coarsening of the honeycomb structure of the lung. There -: is marked variation in the calibre of the fenestrated opening (129).…”

Section: Panlobular Emphysemamentioning

confidence: 99%

Experimental Pulmonary Emphysema in Dogs

1963

JAMA

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ABS'IBAC,!:EXPERn~TAL PULMONARY EMPHYSEMA IN DOGS by RUNGSUN PUSHPAKOM, M.D.Varying degrees of panlobular emphysem were produced in 10 dogs by intratracheal injection of papain. Pulmonary function was studied before and after the development of emphyserna. The production of emphysema led to an increase in ERC, RV and TIC of 23%, 24%, and 16% respectively.'fhe arterial oxygen saturation decreased by 8% and the Pao2 by 19 mrnHg.There was no significant effect on the Paco2' pH and bicarbonate. Steady state diffusing capa city was reduced by 55%, compliance increased by 63% Mr. L. Bartett's technical advice in designing and setting up the equipment for measuring the diffusing capacity was invaluable.Other technical help was provided by Mrs. L. Hoolwere, and Mrs. J.Pedneault who performed the blood gas analyses and Miss L. Lafontaine for preparing histological sections and Miss M. Charbonneau for preparing paper mounted whole lung sections. Miss G. E. Angus was responsible for the assessment of the internal surface area of the lung. The illustrations were done by Mr. M. Wanngeon.Very special thanks are extended to Mr. S. Vongpaisal and Mr.S. Nepszy for their assistance in so many ways to complete this thesis.Finally, thanks are due to Miss J. Lukjaniec for the many pains taken during the task of typing this thesis.(ii) ABSTRACT Varying degrees of pan1obu1ar emphysema was produced in 10 dogs by intratrachea1 injection of papain. Pu1monary function was studied before and after the deve10pment of emphysema. The production of emphysema 1ed to an increase FRC, RV and TLC of 23%, 24%, 16% respective1y. The arteria1 oxygen saturation decreased by 8% and the Pao 2 by 19 mmHg. There was no significant effect on the Paco 2 , pH and bicarbonate. Steady state diffusing capacity was reduced by 55, comp1iance increased by 63% and there was a shift in the static pressure volume curve of the 1ung upward and to the 1eft. The re1ationship between pu1monary resistance, ~, and 1ung volume was not significant1y changed. However, fo11owing excision of the 1ungs, ~ was partitioned by the retrograde catheter technique and the periphera1 resistance was abnorma11y high accounting from 33 to 84 of~. There was a decrease in the resistance of the central airways exp1aining the preservation of a norma1~. Trivial to moderate pan1obu1ar emphysema was found in the anima1s and was usua11y fair1y loca1ized in 2xtent. Mean 1inear intercept ranged from 0.124 to 0.258 (normal 0.009 -0.149). The a1veo1ar surface area at a standard 1ung volume was reduced to 33.0 -57.0 (normal 59 -71). With exception of the FRC there was no significant corre1a-tian between any of the function tests and the degree of emphysema. The data presented in this thesis represents an attempt ta crea te such a model in the dog.-2- Histological ReviewSince vesicu1ar and interstitial emphysema was first recognized and described by Laennec (66), in 1819, a number of studies on the disease have been reported. Many attempts to produce emphysema experimenta11y have been carried out on a...

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“…Diese gegenüber den E rgebnissen klinischer Messungen 3-bis 6fach höheren W iderstandsw erte können nicht als optim al angesehen w erden. W esentlich niedrigere W erte der n ich t elastischen W iderstände sind auch bei V ariation der A tem bedin gungen an der isolierten Lunge anscheinend nicht zu erreichen [36]. Hei sehr stark e r Steigerung der Ström ungsgeschw indigkeit u n ter den B edingungen forcierter E xspiration, bei der m it tu rb u le n te r S trö mung in den Luftw egen zu rechnen ist, liegen die W iderstände noch w esentlich höher [8,23].…”

Section: Strömungsgeschwindigkeit Und Strömungswiderstandunclassified

Messungen der dynamischen Volumendehnbarkeit isolierter normaler menschlicher Lungen

Hartung¹,

Büttinghaus²

1967

Respiration

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Panlobular Emphysema: Anatomy and Pathodynamics

Cited by 40 publications

References 26 publications

New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease

New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease

Experimental Pulmonary Emphysema in Dogs

Messungen der dynamischen Volumendehnbarkeit isolierter normaler menschlicher Lungen

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