Emphysema pathology

In the past number of years a number of studies have shown that in a variety of diseases there is a significant oxidation of Met residues to Met(O) in specific proteins that results in a loss of biological activity. These diseases include cataracts, rheumatoid arthritis, adult respiratory distress syndrome and emphysema. The most convincing evidence that Met(O) in proteins may be involved in the etiology of a pathological condition comes from studies with a-l-PI. It is well accepted that a-l-PI is inactivated upon oxidation of its Met residues. A decreased activity of a-l-PI in lung tissue that would result in an increased elastase activity has been associated with pulmonary emphysema. In patients who have a... 

J. Bignon and G. L. Scarpa (Eds.), Biochemistry, Pathology and Genetics of Pulmonary Emphysema Proceedings of a Meeting held at Porto Conte, Sassari, April 27-30, 1981, Pergamon, New York, 1981. 

COPD includes chronic bronchitis and emphysema. Chronic bronchitis is defined clinically as a chronic productive cough for at least 3 months in each of two consecutive years in a patient in whom other causes have been excluded.1 Emphysema is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls without obvious fibrosis.1 The major risk factor for both conditions is cigarette smoking, and many patients share characteristics of each condition. Therefore, new consensus guidelines have moved away from using these subsets and instead focus on chronic airflow limitation. 

Emphysema The pathological accumulation of air in the organs or tissues, which usually gives rise to expansion and stretching and is followed by fibrosis and atropy. 

Emphysema is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis. 

Emmenagogue. A substance that promotes or assists the flow of menstrual fluid. Emollient. An agent that smoothes and protects the skin when applied locally. Emphysema. A pathological accumulation of air in tissues or organs applied especially to such a condition of the lungs. Endometrium. The inner mucous membrane of the uterus, the thickness and structure of which vary with the phase of the menstrual cycle. 

Antimony spots are temporary pustular skin eruptions that afflict workers exposed to antimony compounds. Prolonged or acute exposure results in the build up of antimony in the tissues, especially in liver, kidney, adrenals and thyroid. Antimony(III) is considered to be more toxic than antimony(V) because it is relatively slowly excreted. Long term exposures (up to 28 years) have resulted in pneumoconiosis and emphysema, but even after a few months exposure (5-10 mg m-3) to fumes from antimony smelting pathological symptoms were observed, e.g. rhinitis, pharyngitis and tracheitis.174... 

As indicated previously, bronchospasm is often present in COPD—that is, in chronic bronchitis and emphysema.121 Chronic bronchitis is a clinical diagnosis applied to a long-standing inflammation of the bronchial tree. Emphysema is a pathologic condition marked by the destruction of alveolar walls and enlargement of the terminal air spaces. 

The normal diffusing capacity value for an adult at rest is about 25 ml/min-ute/mm Hg for CO. This value is reduced, however, when diffusion is impaired as a result of certain pathologic states that lengthen the barrier for diffusion (e.g., interstitial edema, alveolar edema, and fibrous tissue deposition) or decrease the area for diffusion (e.g., emphysema and nonventilated alveoli). 

Fig. 19. Pathological destruction of the alveolar structure (a) normal acinus, (b) cen-trilobular, and (c) panlobular emphysema.

Chronic bronchitis (CB), chronic pulmonary emphysema (CPE) and chronic bronchial asthma (CBA) are common diseases. The concurrence in individual patients of CB and CPE is frequent and of CBA and CB is not unusual. In the United States, the incidence of CB with or without CPE is about 15-30% of all adults (1 ). The estimates for CBA are around 3% ( ). These diseases account for a significant proportion of the morbidity and mortality from all causes. Preventive measures and the use of therapeutic modalities aimed at reversing the pathologic change would be expected to have a significant impact in decreasing the incidence of disability and premature death. 

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