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Biomedical subjects

W Petro

Publications and source records attributed to W Petro.

At least 73 records · Page 4Linked to original sources
PubMed1983

Bullectomy.

The aims of this study were to investigate whether a relevant functional improvement before and after bullectomy was achieved in cases of a localized bulla and generalized bullous changes early and late postoperatively and to establish clear criteria for bullectomy. For this purpose, 21 patients with a localized bulla compressing the rest of the lung, and 19 with generalized bullae with emphysematous changes of the remaining lung were examined before and after (1 1/2 months and 1 1/2 years) surgery. Comparison of the preoperative and postoperative data and the follow-up included X-ray studies with planimetric assessment of the size of the bullae, lung function tests, perfusion scintigrams and clinical findings. The preoperative and postoperative statistical values of lung volume and respiratory mechanics showed the most significant differences. Bullectomy for a localized bulla with compression of the rest of the lung led to an improvement in gas exchange and respiratory mechanics. This operation, however, produced no functional improvement in cases of generalized bullous changes. Functional and clinical success is greater, the larger and more delimited the bulla is to be seen on X-ray, the more the healthy lung tissue is compressed, and, finally, the less associated diseases such as chronic bronchitis are present. Indication for bullectomy should be limited to these cases. The size of the bulla should amount to at least 2/3 of the hemithorax, preoperative function should be clearly reduced and the patient should be suffering from dyspnea.

Follow-Up Studies↗
PubMed1983

Functional diagnosis in surgery of the large airways.

The main indications for surgery of the airways are (1) non-tumorous airway stenosis and (2) tumors of the large airways with and without relevant stenoses. The aim of the following study was to find out which degree of stenosis is an absolute indication for resection and to what extent the functional disturbances are reversible following surgery. We investigated various groups of patients (stenosis of the trachea, lobectomy with sleeve resection, extended pneumectomy with resection of the distal trachea, pneumectomy with resection of the bifurcation, resection of the main bronchus and lobectomy, rupture of the main bronchus) from 1978 to 1982, before and up to 3 years after surgery. Body-plethysmography (one second forced expiratory volume = FEV1; one second forced inspiratory volume = FIV1; Residual volume = RV; total lung capacity = TLC; airway resistance = Raw; specific airway conductance = sGaw), flow volume relation measurements (maximal inspiratory flow = Vmax insp; maximal expiratory flow = Vmax exp; and flow at various lung volumes), blood gas analysis and an endoscopic estimation of the tracheal diameter were performed. Tracheal resection with end-to-end anastomosis in patients with non-tumerous tracheal stenosis improved the tracheal diameter from 6.0 to 11.7 mm, the sGaw from 0.04 to 0.08 (cmH2O s)-1 and the severity of dyspnea significantly. There was no measurable change in airway caliber following administration of beta 2-adrenergics. The most sensitive parameters for describing the tracheal stenosis are the resistance and flow volume values. A tracheal diameter smaller than 6.5 mm corresponding to a sGaw smaller than 0.03 (cmH2O s)-1 procedured severe dyspnea, which is incompatibly with normal life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1983

Clinical efficiency of neobiphyllineR-studies on lung function and serum levels after rectal application of a combination of methyl-xanthines.

In a group of 12 patients suffering from reversible airways obstruction, lung function data and serum levels were studied before and after rectal application of a combination of methyl-xanthines (400 mh theophylline, 600 mg diprophylline, 600 mg proxyphylline). The follow-up over a period of 10 hours showed an immediate bronchodilator effect of the mixture within 30 minutes to 1 hour; bronchodilation was still detectable after an interval of 10 hours. The improvement in lung function correlated with the serum levels. No side effects were noted after rectal administration of the drugs.

Adult↗
PubMed1982

[Long-term oxygen treatment (author's transl)].

Lung function was assessed repeatedly at variable intervals in 12 patients with severe manifest respiratory partial insufficiency. The purpose was to control the effect of long-term oxygen treatment (on average 7 months, oxygen insufflation for 16 h/d) commenced as in-patients and continued at home using oxygen concentrators. It was shown that the actual oxygen administration was shorter than prescribed. The readiness for cooperation of patients decreased with prolonged application of oxygen. Using long-term oxygen treatment and continuation of established forms of treatment a mean PaO2 increase of 6 mm Hg was achieved without concomitant relevant hypercapnia. Increases of PaO2 were the more pronounced the longer oxygen insufflation lasted during night and day. Alveolo-arterial O2 partial pressure difference decreased continuously. Lowering of alveolar hypoxia and arterial hypoxaemia led to diminished pulmonary arterial pressure at rest and during exercise as well as to a significant improvement of the haematocrit. Static and dynamic lung volumes only marginal improvements.

Aged↗
PubMed1982

Regional and global lung function in unilateral fibrothorax after conservative therapy and decortication.

Twenty-six patients suffering from unilateral fibrothorax were investigated before surgery or conservative therapy (decortication, n = 15; conservative treatment, n = 11) and followed up after 24.5 and 18.6 months respectively. Global lung function analysis was done by body plethysmography, ventilation and gas exchange analysis and blood-gas analysis under resting and exercise conditions. Regional lung function analysis included the semiquantitative description of fibrothorax by X-ray photos, and ventilation-perfusion scintigraphy. The functional result of unilateral fibrotic pleurisy is restriction which is also persistent after therapy, but to a lesser degree. This restriction is shown in an increased dead space ventilation as well as in ventilatory inhomogeneities, which causes a distortion of respiratory gas exchange. A decrease of compliance of the lung and chest wall is not measurable after therapy. Conservative treatment leads to a functional improvement to the same degree as decortication in cases of severe preoperative functional disturbances of the operated patients. After a course of 1.5 and 2 years respectively, the reference value has not been reached in either group. The regional pattern after therapy is characterized by a restriction and under-perfusion of the formerly affected site. The regional improvement of lung function is independent of the type of therapy, however, it shows a close correlation to the amount of pleurisy prior to therapy. Conservative treatment is the therapy of choice as long as no complications of insufficient recovery impede the course of the illness.

Adult↗
PubMed1982

Effects of surgery on airway mechanics in tracheal stenosis.

12 patients suffering from severe extrathoracic tracheal stenosis mainly caused by long-term artificial ventilation were investigated by comparing their airway mechanics before and after tracheal sleeve resection and during long-term follow up. The investigations included body plethysmography, flow-volume relation, effect of bronchodilator, bronchial challenge and endoscopic estimation of the tracheal diameter. Tracheal sleeve resection in stenosis doubles the tracheal diameter from 5.9 to 11.0 mm. Resistance parameters and forced expiratory flow values reflected the significant improvement best. Airway structure remains stable during long-term follow-up, and effort-dependent parameters improve further. Compared to normal volunteers with artificially induced stenosis patients show a higher tolerability for airway narrowing. A tracheal diameter of 5 mm produces severe complaints and distinct functional distortions which are shown in specific airway resistance of 7.5 cm H2O X s, specific airway conductance of 0.02 cm H2O-1 X s-1 and FEV1 of 1 l X s-1. These values are absolute indications for resection. Tracheal stenosis after long-term artificial respiration can be influenced slightly by bronchodilator therapy. Nonspecific bronchial hyperreactivity is present, suggesting increased reagibility of the bronchial smooth muscles.

Acetylcholine↗
PubMed1981

Determination of respiratory resistance by an oscillation method. Studies of long-term and short-term variability and dependence upon lung volume and compliance.

The respiratory resistance (Ros) as measured by an oscillation method, and the airway resistance (Raw) as measured by body plethysmography were determined in 10 healthy volunteers thrice daily every week over a period of 22 weeks. Ros in 9 of this group was measured at different breathing levels at constant respiratory rate and volume. Additionally, the phase angle between oscillatory pressure and flow (phi), the thoracic gas volume, the end-tidal volume, the functional residual capacity, Raw and the lung compliance were determined. Furthermore Ros of 116 patients was measured together with the lung and thorax compliance. Compared to Raw, the variability of Ros is smaller and the sensitivity is higher. There is a reciprocal relationship between Ros and lung volume, lung compliance, and compliance of the lung and thorax system. Therefore, measurements of Ros should be performed at a normal, stabilized mean breathing level.

Adult↗
PubMed1980

Site and type of impaired lung function in extrinsic allergic alveolitis.

We investigated 109 persons exposed and sensitized against organic antigens. 46 of them (group I) are affected with the typical clinical and roentgenological signs of allergic alveolitis. The other 59 subjects (group II) were sensitized only. Included in all examinations were immunological diagnosis by means of counterimmunoelectrophoresis, systematic interviewing for case histories, and registration of respiratory symptoms. Pulmonary function was recorded by means of the following techniques: analysis of ventilation (flow-volume indices), respiratory mechanics of the larger airways and lung (body plethysmography, esophageal balloon technique), respiratory mechanics of the small airways (closing volume, amplitude of cardiogenic oscillations), distributional analysis, diffusion analysis, blood gas analysis, and right heart catheterization. Extrinsic allergic alveolitis caused changes in lung mechanics, in airways as well as in lung tissue. The most impressive findings in allergic alveolitis are mechanical inequalities of ventilation. These inequalities may be caused by changed mechanics of overall airways indicated by obstruction parameters and by changed structure of lung tissue reflected in decreased compliance, transfer factors and increased pulmonary arterial pressure. Not only a restrictive but also an obstructive disturbance of ventilation is found. Impairments are less in sensitized persons. We find slight mechanical and ventilatory inhomogeneities. An overall airway obstruction is obvious but not to such a large extent as in allergic alveolitis. On the contrary, here the lung tissue is not affected. Compliance and diffusion are within the normal range. There is no typical functional pattern specific for the diagnosis of allergic alveolitis.

Adult↗