A) Studies on Unoperated Patients.
Thirty TB patients who have been admitted to the Masan Transportation Sanatorium
were selected for the study along with ten healthy men acting as the control group.
Patients were divided into three equal groups, the minimal(Min),
moderately-advanced(MA) and far-advanced(FA), dependent upon the severity of
disease. Ages of subjects ranged from 20 to 48 years old, with the average of 33.
The vital capacity and its subdivisions, the residual volume, the maximal breathing
capacity, the minute volume and the date obtained from each group was compared with
one another. Results may be briefly su㎜arized as follows:
1. The vital capacity as well as the inspiratory capacity and the expiratory reserve
volume showed a moderate reduction in the FA group, suggesting a reduction in the
ventilatory volume of the lung as a result of the extensive lesion in this group.
2. The residual volume increased progressively as the severity of TB increased.
3. The maximal breathing capacity was lowered while the timed vital capacity was
delayed in the FA group.
4. The calculated values of both the Lesli´s index and the index of air trapping were
significantly increased.
5. Neither the capacity ratio nor the calculated air velocity index showed any
significant difference among various groups, suggesting that the air-way resistance is
not altered in TB patients.
6. The minute volume as well as the resting oxygen consumption showed no
significant difference among various groups.
7. These results are considered to be largely due to both the emphysematous and
fibrotic changes of the lung, which are known to occur secondarily in the far-advanced
TB patients.
B) Studies on Operated Patients
Various surgical operation such as pneumonetomy(3 cases), thoracoplasty(4 cases), left
upper lobectomy(4 cases) and right upper lobectomy(5 cases) were performed on
pulmonary TB patients when they were considered to improve the disease. Ages of
patients ranged from 30 to 47 years old, with the average of 35.
Measurements of various lung volumes and of ventilatory capacities, as indicated in
the previous section were made before and after(3 to 12 months) the operation and
results are compared as summarized below:
1. The vital capacity as well as the inspiratory capacity and the expiratory reserve
volume were reduced most after the pneumonectomy, moderately after the left or right
upper lobectomy and least after the thoracoplasty.
2. The R.V./T.L.C. ratio was increased by 14.3% and 5.5% after left upper lobectomy
and pneumonectomy, respectively, but it showed little change after either right upper
lobectomy or thoracoplasty. The increase in this ratio seems to indicate that the
remaining lung tissue overexpands in order to fill the space provided by the resection.
3. The maximal breathing capacity was lowered most after both the
pneumonectomy(by 28.4%) and the thoracoplasty(by 19.3%), and decreased less after the
left or right upper lobectomy.
4. The timed vital capacity showed slight improvement(by 5%) in all groups after the
surgery.
5. Calculted values of the air velocity index the capacity ratio the Leslie´s index and
the index or air trapping showed no significant change in all groups after the surgery.
6. The resting minute volume was significantly increased after the pneumonectomy,
while the resting oxygen consumption was not altered, with the result that the
ventilation equivalent was raised in this group.
This is probably due to the reduction in the surface area available for the gas
exchange after the pneumonectomy, which would invariably lower the overall effciency
of the gas exchange. No significant changes were seen in other groups.
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