부산대학교 도서관

The need for accurate clinical diagnostic tests in pulmonary emphysema has been reviewed and the importance of validating such tests by correlation with morphologically quantitated emphysema has been emphasized. Since physiologic tests may be numerically rated as to their absolute values and the extent to which they deviate from predicted norms, they may be used as reasonably objective tests. Data have been presented to illustrate the patterns of correlation of centrilobular and of combined centrilobular and panlobular emphysema with various pulmonary function tests, and it appears that the resting single breath carbon monoxide diffusing test, the RV/TLC ratio and possibly the terminal rise of the expired single breath nitrogen curve of Comroe and Fowler provide the best correlative information at the present status of this study. Although the extent of emphysema did not correlate to a high degree with the severity of airways obstruction as measured by expiratory airflow (FEV1.0 and FEF25-75), emphysema is clearly a disease in which airways obstruction is usually present.The perfusion lung scan using iodinated (I131) human serum albumin administered intravenously appears to augment the chest roentgenogram as a valuable method for detecting the presence and the location of destructive emphysematous changes. Preliminary scan data appear to correlate well with the single breath carbon monoxide diffusion test and, in a limited number of cases, with morphologic validation.