help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on October 11, 2004, doi:10.1164/rccm.200405-659OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Supplement
Right arrow All Versions of this Article:
200405-659OCv1
171/1/40    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kim, V.
Right arrow Articles by Solomides, C. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kim, V.
Right arrow Articles by Solomides, C. C.
American Journal of Respiratory and Critical Care Medicine Vol 171. pp. 40-47, (2005)
© 2005 American Thoracic Society
doi: 10.1164/rccm.200405-659OC

Original Article

Small Airway Morphometry and Improvement in Pulmonary Function after Lung Volume Reduction Surgery

Victor Kim, Gerard J. Criner, Heba Y. Abdallah, John P. Gaughan, Satoshi Furukawa and Charalambos C. Solomides

Division of Pulmonary and Critical Care Medicine, Department of Medicine, and the Departments of Biostatistics, Pathology, and Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania

Correspondence and requests for reprints should be addressed to Gerard J. Criner, M.D., Division of Pulmonary and Critical Care Medicine, Temple Lung Center, Temple University Hospital, 777 Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140. E-mail: crinerg{at}tuhs.temple.edu

We examined small airway morphometry from resected lung specimens in 25 patients with severe emphysema undergoing lung volume reduction surgery (LVRS) and correlated their pathologic findings to changes in FEV1 6 months after LVRS. Patients were classified into two groups: responders had a more than 12% and a more than 200-ml change in FEV1 at 6 months, and nonresponders had 12% or less and/or 200 ml or less change in FEV1. Epithelial height (EH) and perimeters and areas of peribronchial smooth muscle, epithelium, and subepithelial space were measured quantitatively. The degrees of interstitial fibrosis, vascular sclerosis, goblet cell hyperplasia, squamous metaplasia, chronic inflammation, peribronchial fibrosis, and bullous disease were assessed semiquantitatively. Despite similar baseline characteristics, nonresponders had a greater EH (0.045 vs. 0.035 mm, p = 0.025), greater EH adjusted for basement membrane perimeter (0.040 vs. 0.011, p = 0.016), greater epithelial area adjusted for basement membrane area (0.561 vs. 0.499, p = 0.040), and less bullous disease (1.7 vs. 2.6, p = 0.011) compared with responders. We found a linear relationship between percentage change in FEV1 and bullous disease and inverse relationships between percentage change in FEV1 and interstitial fibrosis, goblet cell hyperplasia, peribronchial fibrosis, and vascular sclerosis. We conclude that small airway morphometry and lung histopathology in patients with severe emphysema have an important influence on changes in FEV1 6 months after LVRS.

Key Words: emphysema • pathology, surgical • pulmonary disease, chronic obstructive/pa (pathology) • pulmonary surgical procedures • respiratory function tests




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
W. Weder, M. Tutic, D. Lardinois, W. Jungraithmayr, S. Hillinger, E. W. Russi, and K. E. Bloch
Persistent Benefit From Lung Volume Reduction Surgery in Patients With Homogeneous Emphysema
Ann. Thorac. Surg., January 1, 2009; 87(1): 229 - 237.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
V. Kim, T. J. Rogers, and G. J. Criner
New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, May 1, 2008; 5(4): 478 - 485.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
P. T. Diaz, A. S. Bruns, M. E. Ezzie, N. Marchetti, and B. M. Thomashow
Optimizing Bronchodilator Therapy in Emphysema
Proceedings of the ATS, May 1, 2008; 5(4): 501 - 505.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. Buduhan, L. Tan, K. Kasian, and S. N. Mink
Volume Reduction Surgery Impairs Immediate Postoperative Pulmonary Function in Canine Emphysema
Am. J. Respir. Crit. Care Med., December 15, 2006; 174(12): 1310 - 1318.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe
Update in chronic obstructive pulmonary disease 2005.
Am. J. Respir. Crit. Care Med., May 15, 2006; 173(10): 1056 - 1065.
[Full Text] [PDF]

Home page
 Am. J. Respir. Cell Mol. Bio.Home page
O. W. Williams, A. Sharafkhaneh, V. Kim, B. F. Dickey, and C. M. Evans
Airway Mucus: From Production to Secretion
Am. J. Respir. Cell Mol. Biol., May 1, 2006; 34(5): 527 - 536.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2005 American Thoracic Society 		  SOTA, FL