• Journal of Chest Surgery
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• v.24 no.4
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• pp.338-344
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• 1991

If the postoperative pulmonary function can be predicted in the patients undergoing pneumonectomy for lung cancer preoperatively, it will be helpful for identifying them as high or low risk candidates. Perfusion lung scan and spirometry were performed in 12 patients with lung cancer pre-operatively and the predicted postoperative Vital Capacity, FVC, FEV1.0, FEF25 - 75% and MVV were estimated by multiplying the preoperative values by the percentage of perfusion of the nonsurgical lung. Three months postoperation the patients were reinvestigated with spirometry and the obtained values were compared with the predicted values. The linear regression lines derived from the correlation between predicted values [X] and observed values [Y] were as follows; VC; R=0.532, Y=0.48X+1.28, P=0.075 FVC; R=0.566, Y=O 54X+1.15, P=0.055 FEV1.0; R=0.832, Y=0.68X+0.70, P=0.001 FEF25 ~ 75%; R=0.781, Y=0.68X+0.54, P=0.003 MVV; R=0.718, Y=0.67X+34.75, P=0.009 The prediction of postoperative FEV1.0, FEF25 ~ 75% and MVV in lung cancer patients undergoing pneumonectomy appear to be valid for evaluating preoperative pulmonary function.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.949-960
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• 1997

Background. Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this. study, we examined the efficacy of L DG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. Iwethods. Thirty-(our adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 1$0^{\circ}C$. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin El and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. Results. With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p < 0.05) and cardiac output higher(p <0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomoRravhic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. Conclusions, e concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.

• Nuclear Engineering and Technology
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• v.4 no.4
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• pp.327-330
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• 1972

$^{99m}$Tc Ferric Hydroxide Macroaggregates for Lung Perfusion Studies were prepared from home made Na $^{99m}$TcO$_4$ which was extracted by methyl ethyl ketone from low activity $^{99m}$Mo. Particle size was in between 20 and 60$\mu$. Rabbit and human body tests gave excellent results.sults.

• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.83-93
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• 2003

Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.533-540
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• 1991

We have performed 14 single lung transplantation in mongrel dogs transplanting the left lung exclusively from December 1989 to January 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantation[group I ] and a Euro Collins solution in the remaining 7 transplantations[group II ] as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5 - 0 prolene and the pulmonary artery was anastomosed using 6 - 0 prolene. The bronchus was anastomosed next with 4 - 0 Vicryl interruptly and covered with a greater omentum which had been prepared previously. In group I the three dogs died at eleven hours, 5 days, and 14 days, postoperatively and the remaining four doings were killed at 5 days, 5 days, 6 days, and 12 days, respectively. In group II the two dogs died during the operation, one dog died at 6 hours, two dogs died at 6 days postoperatively. Two dogs were killed at 5 days, and 7 days. No significant difference was noted between the two groups in survival time, lung infiltration of transplanted lungs, and perfusion defects in perfusion lung scans. Of the 8 dogs which died naturally, the causes of death were as follows: 2 cases of sepsis, 2 cases of ventricular fibrillations, 2 cases of malnutrition, and 2 cases of respiratory failures.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.188-196
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• 1986

Spirometry and regional function studies using 99m-Technetium were performed preoperatively to predict postoperative pulmonary function change in 34 patients who had various pulmonary resectional procedures at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Between two months and fourteen months postoperation all the patients were reinvestigated with spirometry and clinical examination to evaluate their functional respiratory status. The postoperative obtained values, especially forced vital capacity [FVC] and forced expiratory volume in one second [FEV1] among the other parameters were compared with the postoperative predicted values. Estimated values of FVC and FEV1 derived from preoperative spirometry and quantitative perfusion lung scan correlated well with the measured postoperative values. The linear regression line derived from correlation between postoperative estimated[X] and postoperative measured[Y] values of FVC and FEV1 in all patients are as follows; 1. Y=0.76x + 0.39 in correlation of FVC [r=0.91] 2. Y=0.88x + 0.17 in correlation of FEV1 [r=0.96],br> This method of estimation was one of the best methods of predicting postoperative pulmonary function change and valuable in determining the extent of safe resection and postoperative prognosis to a poor risk patient with chronic obstructive lung disease.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.608-610
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• 2002

Lung cancer with pleural seeding has poor prognosis and is generally treated by intravenous anticancer chemotherapy only. We performed intrapleural perfusion hyperthermic-chemotherapy in two lung cancer patients with pleural seeding. Herein, we report our outcome with literature review.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.58-60
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• 2019

Herein, we report a case of lung transplantation in a patient with profound preoperative hypercapnia, focusing on the cardiopulmonary bypass strategy used for brain perfusion during the operation. We applied the pH-stat method for acid-base regulation, and thereby achieved the desired outcome without any neurologic deficit.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.914-919
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• 1997

We analyzed the changes of pulmonary function after decortication i 33 patients with chronic empyema thoracis. In 11 patients of them, scintigraphic lung perfusion scan were performed. The results are as follows; 1, Forced expiratory volume in one second(FEVI) increased from 2.30 L/sec to 2.65 L/sec after decorticati on (p = 0.008) . 2. In patients under 20 years-old, PEV 1 increased significantly(p=0.001). 3. In patients who had tuberculosis empyema thoracis, FEVI increased significantly(p=0.008). The post-operative FEVI increased significantly 24 months later(p=0.013). 4. Te post-operative FEV1 increased significantly 24 months later(p=0013). 5. Perfusion and FEV1 of diseased lung changed from 21.5% to 26.9%(p=0.046) and 0.56 L/sec to 0.78 L/sec(p=0.071) after decortication respectively and perfusion of non-diseased lung changed 78.4% to 72.9% after decortication(p=0.042).

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.203-208
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• 2002

In patients with chronic liver disease, hepatopulmonary syndrome, the right to left shunt without previous pulmonary and cardiac disease, can develope and cause respiratory distress. Tools to prove shunt are contrast echocardiography, pulmonary angiography, and $^{99m}Tc-MAA$ perfusion lung scan. Among them, $^{99m}Tc-MAA$ scan is a simple and safe method detecting the right to left shunt. At the same time, quantitation of shunt amount is possible by this method. We report a case of hepatopulmonary syndrome confirmed by $^{99m}Tc-MAA$ scan and contrast echocardiography with review of literlatures.