Alvan G. Foraker

Emphysema in Lung Macrosections Correlated with Smoking Habits

The relationship between smoking and pulmonary emphysema was explored in 71 autopsies, by correlating Gough-Wentworth lung macrosections with smoking histories. An increasing percentage of smokers was found with each increment of emphysema. Particularly close relationship was observed between centrilobular emphysema and smoking. No definite association was found between smoking and panlobular emphysema.

Centrilobular emphysema and panlobular emphysema: two different diseases

Anderson, A. E., and Foraker, A. G. (1973).Thorax, 28, 547-550. Centrilobular emphysema and panlobular emphysema: two different diseases. Twenty-one cases of centrilobular emphysema and 19 cases of panlobular emphysema, previously so designated according to recommended criteria, were reassessed for differences in zonal distribution within lungs through systematic sampling and statistical comparisons. Characteristic distribution profiles were defined for the two forms of disease. Centrilobular emphysema appeared to be mainly a disease of the upper lobe and the apices within the upper and lower lobes. In contrast, panlobular emphysema was a more or less diffuse process within lobes and lungs with mild preferential involvement of the lower lobe. These regional trends coupled with the typical appearance of individual lesions within lobules are considered to provide strong support for the contention that centrilobular emphysema and panlobular emphysema are morphologically distinct entities. Probable reasons for difficulties in differentiating some examples of centrilobular and panlobular emphysema are given. The need for further clarification of associated and background factors is stressed.

Further observations on luminal deformity and stenosis of nonrespiratory bronchioles in pulmonary emphysema.

In an endeavour to elucidate the anatomical basis for the increased resistance to airflow which characterises the most peripheral conducting air passages in pulmonary emphysema, lumina of nonrespiratory bronchioles of lungs with mainly centrilobular disease were assessed for two- and three-dimensional features by: (1) determination of percentage conformity of the lumina of individual bronchioles in histological sections to hypothetical planes through cylinders (ie, ellipses with the same areas and circumferences), and (2) comparison of luminal areas at regular intervals along bronchiolar longitudinal axes. The lumina of most nonrespiratory bronchioles from normal lungs conformed closely to their respective ellipses, thus corroborating previous observations that they are normally cylindroid. In contrast, there was a substantial excess of plane section deformities in the lumina of nonrespiratory bronchioles from the emphysematous specimens. The incidence of stenotic bronchioles (by both diameter and area determinations) was also greatly increased in emphysema. Since there was a strong positive association between such stenotic lesions and bronchiolar deformity, the latter was concluded to be a major factor in bronchiolar restriction. Furthermore, these characteristics seemed to have three-dimensional expression, for the lumina of stenotic bronchioles in emphysema were irregular in a longitudinal fashion.

Glycogen in invasive squamous carcinoma of the uterine cervix

Abstract Variable degrees of glycogen staining were demonstrated in 13 of 21 examples of invasive squamous-cell carcinoma of the uterine cervix. Caution in interpreting the absence or presence of glycogen staining as a highly valid criterion in the diagnosis of cervical carcinoma in smears or tissue sections is advised.

THE BRONCHIAL GLANDS IN AGING

The basic histologic change in chronic bronchitis often is assumed to be hyperplasia and hypertrophy of the bronchial glands ( 1 4 ) . “Bronchitis,” in this sense, has been the subject of extensive study in recent years. I t s relations to emphysema (5, 6) , smoking (3, 7, 8) and atmospheric pollution (9, 10) have been of special interest. I n addition, we have been impressed with a possible association between bronchial gland overgrowth and aging, irrespective of the presence of emphysema and known exposure to inhaled irritants. Documentation of these presumed effects seemed pertinent t o a broader perspective of other conditions associated with, but not necessarily a direct function of, aging. The effects of aging on the bronchial glands, however, have not been systematically investigated to our knowledge. The purpose of this presentation is to describe the outcome of such an analysis of the glands, as well as certain other bronchial components. The bronchi of a group of aged subjects were compared in several ways with the bronchi of a group of younger subjects. Although there was a goodly spread between their ages, the subjects were matched with respect to emphysema and smoke exposure. All were nonsmokers. Such an approach revealed substantial evidence of bronchial gland overgrowth in association with aging.

Topology of nonrespiratory bronchioles of normal and emphysematous lungs

Abstract A series of bronchiolar lumina were reconstructed from serial histologic sections of nine nonrespiratory bronchioles from lungs of six normal male subjects and compared with 18 similar preparations from eight male subjects with severe centrilobular emphysema. The lumina of the normal nonrespiratory bronchioles had smooth surfaces and were generally cylindrical in shape between branchings. Irregular dichotomy was the rule. In contrast, the lumina of the nonrespiratory bronchioles from patients with emphysema showed a marked tendency to have rough surfaces, multiple levels of stenosis, occasional dilatation, and tortuosity along a longitudinal axis. These defects in the peripheral conducting air passages of the lungs are thought to provide logical bases for much of the fixed increased flow resistance that has been shown to prevail at this level in emphysema.

Fate of the corpus albicans: a morphologic approach

Abstract Ten cases each of prepubertal, premenopausal, and postmenopausal ovaries were collected. Slides of these cases were stained with hematoxylin and eosin, Massons trichrome, Verhoeffs elastic, and Snooks reticulum stains. The slides were then studied with regard to any corpora albicantia present. The postulation that the corpus albicans is resorbed by the stroma of the premenopausal ovary has been presented.

Comparative incidence of bronchogenic carcinoma in subjects with centrilobular and panlobular emphysema

Twenty‐one cases of centrilobular emphysema and nineteen cases of panlobular emphysema, all previously reported for morphological characteristics, were analyzed for the comparative incidence of bronchogenic carcinoma. Seven of the patients with centrilobular disease also had lung cancer, whereas, none of the patients with panlobular emphysema was so affected. These differences were statistically significant, suggesting a much closer tie between bronchogenic carcinoma and centrilobular emphysema than with panlobular disease. It was proposed that the frequent co‐existence of the two conditions reflected separate effects of a common agent, i.e. tobacco smoke.

The fate of the corpus albicans: A quantitative approach

Abstract Hematoxylin and eosin-stained sections of ovaries from 14 premenopausal and 6 postmenopausal women were studied. Planimetric methods after image tracing on graph paper were employed to measure the corpora albicantia of these ovaries selected from our surgical files. No significant differences were found concerning the quantitative aspect of the corpora albicantia of pre- and postmenopausal women. The problem of the fate of the corpora albicantia formed during the reproductive life of a woman has been introduced.

Selective Venting of Cigarette Smoke in Dichotomous Ducts and Preserved Human Bronchi

Mechanically generated cigarette smoke and ambient air were injected into dichotomous ducts and geometrically preserved human bronchi in a fashion simulating typical smoking technique. When the air passages were at ambient temperature, the smoke settled into the lower branches. Smoke which was injected into passages warmed to body temperature rose to the upper branches. The latter selective distribution of the smoke resembled the distribution of centrilobular emphysema in the lungs.