Exercise Pulmonary Function Test in Preresection and Postresection of the Lung due to Malignancy - follow up after 4 weeks and 6 months / 대한내과학회지

OBJECTIVES: At present, the overall incidence of lung cancer is increasing, causing the age-adjusted lung cancer death rate to double every 15 years. Surgical resection of the tumor offers the best prospect of long-term survival in patients with lung cancer. Accurate prediction of postoperative ventilatory function should be helpful in determining in which patients the risk of surgery are acceptable. Exercise pulmonary function test has been widely applied to objective measure of work capacity, and can be extremely helpful for investigating exertional dyspnea. But no attempt is made to assess the contribution of the lung to be resected to performance, and it has been advocated as an additional predictor of postoperative complications. The present investigation was designed to evaluate the factors such as FEV1, FVC, VEmax, Vo2max, anaerobic threshold, heart rate reserve, breathing reserve and the corelation between FEV1 and VO2max at 4 weeks and 6months after resection in patients with lung cancer. METHODS: The eighteen of patients with lung cancer who considered surgically resectable underwent progre ssively incremental exercise test to symptom-limited stage before opera-tion, and also have done at surgical resection after 4 weeks, and 6 momths. Measurements were made of metabolic, cardiorespiratory, blood gases and symptoms during exercise test. RESULTS: 1) There were significant decreases in FEV1, FVC, VO2max, VE max in 4 weeks after operation and were more decreased in FEV1, FVC, VE max with significance, but fall in VO2max without significance in 6 month after operation. 2) There was a significant corre lation between the decrease of FEV1 and that of VO2max in 6 month after operation . Conclusions This result suggests that change of FEV1 is a relatively useful predictor of change in exercise performance after lung resection in 6 month after operation.

A Case of Ruptured Aneurysm of the Sinus of Valsalva

Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Valsalva sinus aneurysm consists of a separation or lack of fusion behveen the media of the aorta and the annus fibrosis of the aortic valve. Rupture usually occurs in the third or fourth decade of life, most often between the right coronary cusp and the right ventricle, but occasionally, when the noncoronary cusp is involved, the fistular drains into the right atrium. Abrupt rupture causes chest pain, bounding pulses, a continuous murmur, and volume overload of the heart. Associated cardiac lesions are common including VSD and AR. We experienced a typical case of ruptured aneurysm of the sinus of Valsalva into RA in a 31 year-old man presented sith sudden dyspnea, chest pain and palpitation. Diagnosis was made by 2D-echocardiography, cardiac catheterization and cine-angiogram. This case, the aneurysm was originated from the noncoronary sinus and ruptured into right atriurn. The ruptured aneurysm were repaired mth Dacron patch.