A New Approach to Pulmonary Emphysema

Abbott, Osler A.; Hopkins, William A.; Fleit, William E. Van; Robinson, Joe Sam

doi:10.1136/thx.8.2.116

Cited by 70 publications

(25 citation statements)

References 6 publications

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“…Investigations of bronchitis morbidity in hospital patients, working groups, and representative samples of the general community support the hypothesis. Abbott et al (1953) presented their findings in 294 patients suffering from various types of emphysema. They noted an almost constant history of protracted cough or so-called "chronic bronchitis " in these cases and considered that tobacco irritability was an important aetiological factor in 214.…”

mentioning

confidence: 99%

Tobacco Smoking, Respiratory Symptoms, and Ventilatory Capacity

Higgins¹

1959

BMJ

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mentioning

confidence: 99%

Tobacco Smoking, Respiratory Symptoms, and Ventilatory Capacity

Higgins¹

1959

BMJ

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“…The earliest procedures were designed to correct, what are now recognized as consequences, rather than causes of the disease. As a result, operations such as costochondrectomy or mobilization of the diaphragm proved disastrous [I], Later, attempts to alter surgically the autonomic nervous [2] or peri pheral chemoreceptor control [3] met with initial enthusiasm but have now been abandoned [1]. Procedures have been described that try to cope with expiratory airways closure [4,5], Selection of such cases with predominantly tracheal and main bronchial collapse remains difficult [6] and operations designed to support these structures require further evaluation.…”

mentioning

confidence: 99%

Surgery for Bullous Emphysema

FitzGerald¹,

Keelan²,

Gaensler³

1973

Respiration

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A 60-year-old man was observed for 7 years with progressive bullous emphysema that eventually rendered his right lung functionless and resulted in severe dyspnea. Thoracotomy revealed typical periacinar (paraseptal) emphysema. Excision and plication of bullae resulted in prompt relief of symptoms and return of function which were sustained during the next 5 years. The progressive course and recovery were documented by serial clinical, radiographic, physiologic and regional lung function studies. The natural evolution of bullous lung disease is reviewed as are the concomitant physiologic abnormalities and indications for surgerys

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“…Head & Avery (112) have suggested treating these patients by inserting a catheter into the cavity followed by suction. Other surgical procedures have been suggested (113,114). These include resection of nonperfused lung tissue, resection of sympathetic and parasympathetic nerves, and creation of collateral blood supply to the lung.…”

Section: Treatmentmentioning

confidence: 99%

“…Angiocardiography has been suggested as a means of defining areas of non perfused lung tissue (114,115).…”

Section: Treatmentmentioning

confidence: 99%

Pulmonary Emphysema

Ebert¹

1956

Annu. Rev. Med.

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A review of the recent literature on pulmonary emphysema seems appro priate at the present time, at which there has been an increasing interest in this disease. In part this is a reflection of the general emphasis on diseases affecting the older age groups and in part it is a result of the recent surge of interest in pulmonary physiology on the part of clinicians. The pathology of pulmonary emphysema is uninspiring and the roentgenologic appearance of the lungs is not dramatic. The disease does produce many alterations in the physiology of the lungs and for this reason investigation of this aspect of the disease has been most fruitful.The description of pulmonary emphysema by Laennec (1), which still stands as a model of writing on clinical subjects, should be read by anyone interested in the disease. Excellent reviews have been written by Kountz & Alexander (2) and by Christie (3). PATHOLOGYThere have been relatively few recent contributions to the pathology of pulmonary emphysema. Hartcroft (4) has made a major contribution to the understanding of the microscopic anatomy of the disease. He points out the need for the fixation of the lungs in an inflated state and for the consideration of the alveoli as three-dimensional structures. The alveoli are arranged about the alveolar duct as open stalls are related to the central passage of a barn. In emphysema the alveoli are increased in diameter and decreased in depth. The alveolar duct is increased in size. The appearance of rupture of the alveolar walls is an artifact resulting from the plane of the section passing through the mouths of the alveoli.There have also been studies of the bronchioles and vascular tree in pulmonary emphysema. One of the characteristic features of emphysema is increased resistance to air flow in the bronchial tree. Spain & Kaufman (5) made a careful study of the bronchioles in pulmonary emphysema. They found the walls of the terminal bronchioles to be thickened. The walls showed fibrosis and often inflammatory cell infiltration. The authors believe that these changes in the bronchioles are primary and that the changes in the alveoli are secondary to bronchiolar obstruction. Cudkowicz & Armstrong (6) described narrowing and obliteration of the intrapulmonary bronchial arteries in pulmonary emphysema. This resulted from medial hyperplasia and intimal thickening. Anastomoses between the bronchial and pulmonary 1 The survey of the literature pertaining to this review was completed in March, 1955. 123 Annu. Rev. Med. 1956.7:123-140. Downloaded from www.annualreviews.org Access provided by Lancaster University -UK on 02/05/15. For personal use only. Quick links to online content Further ANNUAL REVIEWS

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A New Approach to Pulmonary Emphysema

Abstract: Seventh, (61-70) Eighth , (71-80) 2.1127 45 ... ..

Cited by 70 publications

References 6 publications

Tobacco Smoking, Respiratory Symptoms, and Ventilatory Capacity

Tobacco Smoking, Respiratory Symptoms, and Ventilatory Capacity

Surgery for Bullous Emphysema

Pulmonary Emphysema

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