Surgical technique.

OBJECTIVE: To evaluate the exercise capacity of subjects with mild to moderate Parkinson's disease and determine whether abnormalities in respiratory function and gait affect exercise capacity. DESIGN: Descriptive. Subjects were categorized according to exercise history, disease severity, and presence/absence of upper airway obstruction. SUBJECTS AND SETTING: Sixteen volunteers with mild to moderate idiopathic Parkinson's disease attended a university research laboratory. MAIN OUTCOME MEASURES: Subjects performed a maximum exercise test on a cycle ergometer, together with respiratory function tests and a walking test. Peak values for oxygen consumption and work rate were recorded for the maximum exercise test. Measures of respiratory function included spirometry, flow-volume loops, lung volumes, and mouth pressures. Velocity, stride length, and cadence were measured for preferred and fast speeds of walking. The values obtained on each of these tests were compared with published predicted age- and gender-matched normal values. RESULTS: Peak oxygen consumptions and peak work loads achieved by subjects with Parkinson's disease were not significantly different from normal values, despite evidence of respiratory and gait abnormalities typical of Parkinson's disease. Exercise category was significantly correlated with percent predicted VO2peak (r = .64, p < .01), with sedentary subjects producing lower scores than exercising subjects. There was no significant correlation between disease severity and percent predicted VO2peak. CONCLUSION: Despite their neurological deficit, individuals with mild to moderate Parkinson's disease have the potential to maintain normal exercise capacity with regular aerobic exercise.

Airway Obstruction↗

PubMed1997

Pulmonary artery band migration producing endobronchial obstruction.

Pulmonary artery banding is used in infants to temporarily control excessive pulmonary blood flow. There are reports of band migration including intact bands eroding through the pulmonary artery. The patient presented here had bronchiectasis and eventual destruction of his right middle and lower lobes 5 years after pulmonary artery banding and subsequent definitive cardiac corrective surgery. After undergoing a right middle and lower lobectomy, recurring postoperative respiratory distress prompted repeat bronchoscopy where the original pulmonary artery band was identified and removed. It is hypothesized that this band migrated through the pulmonary artery and into the tracheobronchial tree where it led to obstruction and subsequent destruction of the right middle and lower lobes. Awareness of this potential complication is important for pediatric surgeons who so often care for patients with a past history of cardiac surgery.

Airway Obstruction↗