Postmortem assessment of chronic airways obstruction by tantalum bronchography.

Abstract

Thorax, 30,[405][406][407][408][409][410][411][412][413][414]. Postmortem assessment of chronic airways obstruction by tantalum bronchography. Tantalum bronchography was performed on 22 left lungs obtained at necropsy. Seven were from patients dying in cor pulmonale as a result of chronic airways obstruction and 15 were from unselected necropsies. Of the latter group, nine had no evidence of respiratory disease and six had pathological changes of emphysema and bronchial mucous gland enlargement when the lungs were examined following formalin fixation.A range of changes in the bronchographic appearances from the normal to the grossly abnormal is illustrated. The main changes in severely diseased lungs were: irregularity of the bronchial walls, failure of the walls to taper towards the periphery, areas of narrowing and dilatation, and 'pooling' of tantalum at the ends of airways.A count was made of the numbers of small airway branches in the most distal 4 cm of the lung and also of the number of airways of less than 1 mm in diameter. Patients dying in cor pulmonale had a significantly reduced total number of patent small airways in the area measured and also fewer patent airways of less than 1 mm diameter compared to both the other groups.Histological study of four of the lungs in greater detail revealed that the reduction in small airways filling was the result of a combination of obliteration and obstruction of the lumen by pus. Tantalum bronchography provides a good indication of the state of the bronchial tree at the time of death, and the changes seen are the result of both acute and chronic disease processes.

Airway Count and Emphysema Assessed by Chest CT Imaging Predicts Clinical Outcome in Smokers

“…Those subjects with Ն 25% emphysema had signi fi cantly lower TAC and generational airway counts than those subjects with , 25% emphysema. This fi nding is in agreement with an early study by Scott and Steiner, 29 which reported a decrease in macroscopic airway count by bronchography with tantalum in subjects with a high emphysema per centage measured by histologic means compared with those with a low emphysema percentage. Later, Montaudon et al 8 reported that there were no differences in the total and generational airway counts visible on CT scans between smokers and nonsmokers with normal lung function.…”

Dry powdered aerosols of diatrizoic acid nanoparticle agglomerates as a lung contrast agent

“…In addition, roentogenographic examination of the airways using the conventional liquid contrast media has several disadvantages including poor aerosolization efficiency and potential short residence times (Díaz-López et al, 2010; Fischer and Blaug, 1969; Nadel et al, 1968). More promising results have been obtained by inhalation of powdered contrast media (mostly tantalum) (Nadel et al, 1968; Nadel et al, 1970; Scott and Steiner, 1975); however, these formulations were not pursued because of the difficulty in administration (Lafitte et al, 1982; Strecker et al, 1979), high cost, and lack of approval by the FDA (Flower and Armstrong, 1986; Gamsu and Nadel, 1972). …”

Analysis of the conducting airway system in the lung: A new method combining morphometry with mathematical modeling for airway classification

“…Therefore, studies of airways have taken a more direct approach, using techniques that demonstrate relationships between branches in the airway system. These techniques include the use of resin casts of the airways, and images of the airway system following injection of radio-opaque media or derived from serial section reconstruction (Hansen et al, 1975;Horsfield and Cumming, 1968;Horsfield et al, 1966;Kitagawa et al, 1971;Parker et al, 1971;Scott and Steiner, 1975). However, these methods can be time-consuming, lack required detail, or destroy the surrounding tissues (thus identification of the airway generation can not be combined with analysis of tissue components of the airway structure).…”