A) Studies on Unoperated Patients
Various pressure-volume relationships were studied in 5 healthy men(Control group)
as well as in 5 TB patients who were too receive various surgical treatments as
desired. Passive pressures exerted by the respiratory apparatus, such as the lung, the
thoracic cage (including the diaphragm) and the total respiratory system, were first
determined under various lung volumes and then the corresponding compliance values at
the resting lung volume were computed. The measurement of the lung pressure was
made by a means of the intraesophageal balloon method and the thoracic cage pressure
was calculated by substracting the lung pressure from the total respiratory pressure(or
the relaxation pressure). As the next step, both the maximum inspiratory and expiratory
pressures were determind under various lung volumes by a mercury manometer.
Results are compared between the two groups and may be briefly summarized as
follows:
1. Various pressure-volume curves of the respiratory apparatus such as the lung, the
thoracic cage and total respiratory system were not significantly different between two
groups, as long as the lung volumes were expressed as percent of the vital capacity.
2. Since values of the vital capacity were not identical in the two groups, compliance
values were computed for a comparison of the elasticity of the respiratory apparatus.
a. The lung compliance was 0.227 and 0.217ℓ/cmH2O in the control and
TB group, respectively.
b. The thoracic cage compliance was 0.186 and 0.118ℓ/cmH2O in the
control and TB group, respectively, indicating that the thoracic cage is much less elastic
in the patient as compared to the control.
c. The compliance of the total respiratory apparatus was 0.100 and 0.066ℓ
/cmH2O in the control and TB group, respectively. This lowered elasticity
of the thoracic cage.
3. Both the maximum inspiratory and expiratory pressures were lowed in the TB
group as compared to the control. On the average, the reduction in the maximum
expiratory pressure was greater than that of the maximun inspiratory pressure.
B) Studies on Operated Patients
Various surgical operations such as pneumonectomy(3 cases). thoracoplasty(4 cases),
left upper lobectomy(5 cases) and right upper lobectomy(5 cases) were performed on
pulmonary TB patients and the pressure-volume relationships of the respiratory
apparatus were studied on these patients at least 3 months after the operation. The
same methods as employed in the previous study (Part 2, Section A) were also adopted
for this series of investigation. Although subjects in this series were different form
those who were used in the previous series (Part 2, Section A) as the TB group, the
date obtained were comparison would be of some help in evaluating the effect of
various surgeries in the pulmonary functions of these patients. The results may be
briefly summarized as follows:
1. In the pneumonectomized group, the reduction in the vital capacity was greatest
and compliance values of the lung(0.091ℓ/cmH2O), the thoracic cage(0.103
ℓ/cmH2O) and the total respiratory apparatus(0.044ℓ
/cmH2O) were approximately one-half of the corresponding values obtained
in the non-operated FA group.
2. In the Case of thoracoplasty, compliance values of the thoracic cage(0.11ℓ
/cmH2O) and of the total respiratory apparatus(0.055ℓ
/cmH2O) were nearly as low as those in the pneumonectomized group
while the lung compliance(0.143ℓ/cmH2O) was higher than the latter.
3. In the case of left upper lobectomy, compliance values of the thoracic cage and of
the total respiratory apparatus were similar to those in the case of thoracoplasty, while
the lung compliance was as low as 0.104ℓ/cmH2O.
4. In the case of right upper lobectomy, various compliance values were similar to
those obtained from the group of thoracoplasty.
5. In general, the lung compliance was reduced in proportion to the extent of the
decrease in vital capacity. The compliance of the thoracic cage was reduced to the same
extent in all groups.
6. Both the maximum inspiratory and expiratory pressures were lowered in all groups.
The greatest reduction was seen in the pneumonectomized group whereas the least
reduction was seen in the group of right upper lobectomy. These results again suggest
that the reduction of these maximum respiratory pressures is proportional to the extent
of the decrease in vital capacity.
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