• Title/Summary/Keyword: Lung: pulmonary function

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Video-Assisted Thoracic Surgery Core Needle Biopsy for Pulmonary Nodules in Patients with Impaired Lung Function: Is It Feasible and Safe?

  • Yong-Seong Lee;Jong Duk Kim;Hyun-Oh Park;Chung-Eun Lee;In-Seok Jang;Jun-Young Choi
    • Journal of Chest Surgery
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    • v.56 no.1
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    • pp.1-5
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    • 2023
  • Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient's impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

Evaluation of Lung Preservation by Using of Canine Bilateral Sequential Lung Tranplantation (성견의 연속 양측 폐이식을 이용한 폐보존 평가 연구)

  • 박창권;김재범;유영선;권건영;전석길;김정식
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.377-384
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    • 2000
  • Background: Numerous studies of safe, long term preservation for lung transplantation have been performed using ex vivo models or in vivo single lung transplantation models. However, a safe preservation time which is applicable for clinical use is difficult to determine. We prepared LPDG solution for lung preservation study. In this study we examined the efficacy of LPDG(low potassium dextran glucose) solution in 24-hour lung preservation by using a sequential bilateral canine lung allotransplant model. Material and Method: Seven bilateral lung transplant procedures were performed using weight-matched pairs(24 to 25kg) of adult mongrel dogs. The donor lungs were flushed with LPDG solution and maintained hyperinflated with 100% oxygen at 1$0^{\circ}C$ for a planned ischemic time of 24 hours for the lung implanted first. After sequential bilateral lung transplantation, dogs were maintained on ventilators for 3 hours: arterial resistance were determined if the recipients hourly after bilateral reperfusion and compared with pretransplant-recipient values, which were used as controls. After 2hours of reperfusion, the chest X-ray, computed tomogram and lung perfusion scan were performed for assessmint of early graft lung function. Pathological examinations for ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery were performed. Result: Five of seven experiments successfully finished the whole assessments after bilateral reperfusion for three hours. Arterial oxygen tension in the recipients was markedly decrased in immediate reperfusion period but gradually recovered after reperfusion for three hours. The pulmonary artery and pulmonary vascular resistance showed singificant elevation(p<0.05 versus control values) but also recovered after reperfusion for three hours(p<0.05 versus immediate period value). The ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery showed reversible mild injury in 24 hours of lung perservation and reperfusion. Conclusion : This study suggests that LPDG solution provides excellent preservation in a canine model in which the dog is completely dependent on the function of the transplanted lung.

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Rt. Pneumonectomy in a Lung Cancer Patient with Poor Pulmonary function Test - A Case Report - (폐 기능검사가 불량한 2기 폐암환자에서 시행한 우전폐절제술 - l예 보고 -)

  • Jin, Ung;Lee, Sun-Hee;Chon, Jin-Young;Hong, Sung-Jin;Sim, Sung-Bo;Park, Jae-Kil;Kwack, Moon-Sub
    • Korean Journal of Bronchoesophagology
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    • v.6 no.2
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    • pp.192-195
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    • 2000
  • Pulmonary function test is used as a guideline for safe pulmonary resection without complications. Usually FEVl lower than 1 liter is considered as a contraindication of lobectomy. Therefore, the curative operation of resectable lung cancer can not be performed in the case of poor pulmonary functions. Nowadays, there are some arguing points about the value of preoperative PFTs before the pulmonary resection. We performed a right pneumonectomy for stage H lung cancer in a patient with poor lung function test; FVC 2.17L, FEVl 0.97L, FEVl/FVC 44%, FEF 25-75% 0.42L/sec, MVV 28L/min, TLC 5.18L, RV 2.99. During 4 months follow up, the patient had been tolerable. The follow up PFTs at postoperative 3 months 18 days showed up as follows; FVC 1.20L, FEVI 0.63L, FEVl/FVC 53%, FEF 25-75% 0.31L/sec, MVV 25L/min, TLC 3.80L, RV 2.33L.

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Long-Term Outcome of Chronic Obstructive Pulmonary Disease: A Review

  • Jo, Yong Suk
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.289-301
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    • 2022
  • Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation characterized by fixed airflow limitation and chronic respiratory symptoms, such as cough, sputum, and dyspnea. COPD is a progressive disease characterized by a decline in lung function. During the natural course of the disease, acute deterioration of symptoms leading to hospital visits can occur and influence further disease progression and subsequent exacerbation. Moreover, COPD is not only restricted to pulmonary manifestations but can present with other systemic diseases as comorbidities or systemic manifestations, including lung cancer, cardiovascular disease, pulmonary hypertension, sarcopenia, and metabolic abnormalities. These pulmonary and extrapulmonary conditions lead to the aggravation of dyspnea, physical inactivity, decreased exercise capacity, functional decline, reduced quality of life, and increased mortality. In addition, pneumonia, which is attributed to both COPD itself and an adverse effect of treatment (especially the use of inhaled and/or systemic steroids), can occur and lead to further deterioration in the prognosis of COPD. This review summarizes the long-term outcomes of patients with COPD. In addition, recent studies on the prediction of adverse outcomes are summarized in the last part of the review.

Analysis of Research about Pulmonary Rehabilitation of Patients with COPD (만성폐쇄성 폐질환 환자의 호흡재활 프로그램 관련 논문분석)

  • Park, Kyung-Min;Jang, Hee-Jung
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.312-322
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    • 2003
  • Purpose: This study is aimed to analyze the trend of research on pulmonary rehabilitation of patients with COPD (Chronic Obstructive Pulmonary Disease), and to suggest a direction for future research of pulmonary rehabilitation of COPD. Method: A total of 39 studies published from 1991 to 2002 were examined according to the year of publication, type of journal, characteristics of patients, rehabilitation program, research design, and instruments and research findings. Results: 1) The number of studies related to pulmonary rehabilitation of COPD patients has rapidly increased since 1996's (87.18%) 2) There were 10 studies published in the chest. There were 6 studies published in domestic journals and 33 studies published in international journals. 3) The samples in the studies were mostly outpatients whose lung function was moderate. 4) The total period of the pulmonary rehabilitation program shown in the literature was 5 to 12 weeks. The programs included exercise interventions, educational interventions and psychosocial interventions. 5) The outcomes of the pulmonary rehabilitation were measured with lung function, 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire. Research findings were found to be effective on 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire but not on lung function. Conclusion: Based on these findings, pulmonary rehabilitation should be further emphasized, and standardized protocols and community based pulmonary rehabilitation programs need to be provided. More qualitative research should also be conducted in the future to describe the experiences of the pulmonary rehabilitation of patients with COPD.

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Progressive Pulmonary Fibrosis: Where Are We Now?

  • Hyung Koo Kang;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.2
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    • pp.123-133
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    • 2024
  • Interstitial lung diseases (ILDs) are a diverse collection of lung disorders sharing similar features, such as inflammation and fibrosis. The diagnosis and management of ILD require a multidisciplinary approach using clinical, radiological, and pathological evaluation. Progressive pulmonary fibrosis (PPF) is a distinct form of progressive and fibrotic disease, occurring in ILD cases other than in idiopathic pulmonary fibrosis (IPF). It is defined based on clinical symptoms, lung function, and chest imaging, regardless of the underlying condition. The progression to PPF must be monitored through a combination of pulmonary function tests (forced vital capacity [FVC] and diffusing capacity of the lung for carbon monoxide), an assessment of symptoms, and computed tomography scans, with regular follow-up. Although the precise mechanisms of PPF remain unclear, there is evidence of shared pathogenetic mechanisms with IPF, contributing to similar disease behavior and worse prognosis compared to non-PPF ILD. Pharmacological treatment of PPF includes immunomodulatory agents to reduce inflammation and the use of antifibrotics to target progressive fibrosis. Nintedanib, a known antifibrotic agent, was found to be effective in slowing IPF progression and reducing the annual rate of decline in FVC among patients with PPF compared to placebos. Nonpharmacological treatment, including pulmonary rehabilitation, supplemental oxygen therapy, and vaccination, also play important roles in the management of PPF, leading to comprehensive care for patients with ILD. Although there is currently no cure for PPF, there are treatments that can help slow the progression of the disease and improve quality of life.

Cavitary Pulmonary Tuberculosis Treated by Ligation and Division of Bronchus -Report of One Case- (기관지 분단결찰을 병행한 중증 폐결핵 1 치험예)

  • 지일성;주택소
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.141-146
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    • 1969
  • The importance of bronchial occlusion which occurs in the natural course of tuberculosis as an inconstant but very fortunate event became obscured with the popularity of resection therapy for pulmonary tuberculosis and the resectional surgery and thoracoplasty are the standard method of surgical procedure in the treatment of pulmonary tuberculosis. However in some cases of far advanced pulmonary tuberculosis, the need for another surgical methods arise when standard method is not indicated under the consideration of poor pulmonary function or operative and postoperative complications such as bronchial fistula. The ligation and division of bronchus draining the involved part of the lung is one of the applicable method among the another surgical procedures. The authors experienced one case of far advanced pulmonary tuberculosis who had a huge cavity in the right upper lobe and a small cavity in the superior segment accomanying with several nodular densities in the basal segment and contralateral left lung field, and treated with right upper lobectomy, ligation and division of the superior segmental bronchus and concomitant rib-resectional thoracoplasty in order to prevent postoperative bronchial fistula and to preserve maximal lung function. The postoperative course was smooth without complication regarding to bronchial ligation and division technique and the general condition has been excellent without symptoms. The postoperative sputum examination for AFB on smear and culture has been negative during the 11 month period of follow up, and X-ray of the chest including tomography demonstrated no evidence of residual cavity indicating succesful collapse of cavity.

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Correlation between Physical Activity and Lung Function in Dusty Areas: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort

  • Han, Yuri;Heo, Yeonjeong;Hong, Yoonki;Kwon, Sung Ok;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.311-318
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    • 2019
  • Background: Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants. Methods: Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD. Results: Physical activity had a correlation with high forced expiratory volume in 1 second ($FEV_1$) among CODA cohort (p=0.03). While the active group exhibited significantly higher $FEV_1$ compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD. Conclusion: This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.

The Effect of Transcutaneous Electrical Nerve Stimulation on Pain and Pulmonary Function with Post-lobectomy Patient with Lung Cancer (경피적 전기신경자극이 폐암 환자의 폐엽절제술 후 통증과 폐기능에 미치는 효과)

  • Jeon, Hyun-Rye;Park, Jeong-Sook
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.519-528
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    • 2009
  • Purpose: This study was designed to evaluate the effect of TENS on pain and pulmonary function of post-lobectomy patients with lung cancer. Methods: The study data collection was done from February 4, 2008 to February 7, 2009. The subjects were assigned at random to the experimental group and control group with 20 subjects in each group. The experimental group was measured for pain and pulmonary function after surgery and then again after applying TENS 100 Hz frequency and 40 mA output for 20 minutes. The control group was measured the same as the experimental group except applying sham TENS. Results: The pain score of the experimental group which had TENS applied revealed that there were more significant reductions than the control group which had sham TENS applied. There was no significant difference with the number of times of receiving analgesics between the experimental and control group. The effect of TENS on pulmonary function was significantly different between the experimental group and the control group on VC 2 hours after surgery. There was no significant difference between FVC and FEV1. Conclusion: The findings of the study indicate that the TENS is effective in easing the pain of patients after a lobectomy.

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Pulmonary function improvement after decortication (흉막 박피술후 폐기능회복에 관한 연구)

  • Gwon, Eun-Su;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.27 no.7
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    • pp.587-597
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    • 1994
  • To study the recovery pattern of pulmonary function after decortication, the author performed serial pulmonary function tests using spirometry before and at lst., 3rd., 4th. week, lst., 3rd., 6th. month and 1st. year in 36 patients who underwent decortication from January 1989 to September 1991 at the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan, Korea. Patients were divided into 3 groups by the degree of compression of lung parenchyme. Group I was classified below 20%, Group II between 21 to 40%, Group III above 41%. Their serial changes of pulmonary function test were compared. The obtained results were as follows; 1. Maximal voluntary ventilation was recovered in 1st post perative week and even greater improvement was noted in group III in which ratio to 44 % of the preoperative value. 2. Vital capacity reached nearly to preoperative values in 3rd postoperative week and had increased much further to 26 % above the preoperative figure in group II. 3. Forced expiratory volume in 1 second returned rather slowly in 3rd-4th postoperative week and the mean VC was improved more higher in group II than the other groups following decorti cation. 4. There was an greatest improvement over all tests[MW, VC, FEV1] in 2nd decade which ratios to preoperative value were 34, 25 and 22 % respectively.

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