RELEASE ON RECEIPT





Reporters, Editors: Dr. Daniel and Dr. Truwit will be available on
Wednesday, April 26, from 1:30 to 2:30 p.m. to explain the
procedure.  A patient from Lynchburg who has benefitted from the 
surgery also will be available.  Please contact Marguerite Beck
at 804-924-5679 if you will be attending the briefing.


                                        Contact: Marguerite Beck

        U.VA. SURGEONS OFFER NEW TREATMENT FOR EMPHYSEMA

     CHARLOTTESVILLE, VA., April 21 -- A new surgical treatment for
emphysema is being performed at the University of Virginia Medical
Center. Until recently, there has been no surgical treatment
available except lung transplants for the more than a million
people who suffer from this deadly form of lung disease.
     Lung shaving, or lung-volume reduction surgery, was first used
as a treatment for emphysema about a year-and-a-half ago by Dr. Joel D. Cooper
at Washington University School of Medicine in St. Louis. A
surgical team headed by Dr. Thomas Daniel and Dr. Jonathon Truwit
has been performing the surgery at U.Va. since May 1994. In
properly selected patients, the results have been dramatic, with
about 85 percent showing marked improvement in breathing capacity,
according to Daniel, professor of surgery at U.Va.
     Emphysema occurs when the alveoli -- microscopic air sacs in
the lungs by which oxygen is added to the blood and carbon dioxide
is removed from it -- lose their natural elasticity, become
overstretched and rupture. In time, this process causes the lungs 
to overinflate, creating the characteristic barrel chest associated
with emphysema patients.
     "We know there is more to breathing than just the lungs -- the
diaphragm motion is what moves the air in and out," Daniel said. 
"With emphysema, the diseased lungs are hyperexpanded much like an
over-inflated balloon. This hyperexpansion makes it difficult for
the person to properly use the diaphragm or intercostal muscles --
the muscles along the rib cage -- that facilitate breathing.
     "Removing a small portion of the lungs reduces the overall
size, which may help the patient obtain more diaphragm or bellows
motion so breathing is easier and more effective."
      The lung shaving procedure involves making an incision across
the sternum or breastbone -- much like in a heart operation -- to
gain access to both lungs at the same time. The surgeon then shaves
or cuts off about 20 percent of the outside of each lung,
decreasing the over-expansion of the lung and allowing the patient
to breathe in and out more effectively.
     Although the surgical technique is not that difficult, Daniel
said success depends on the ability to determine who will make the
best candidate for the procedure and how much and what part of the
lung to remove. At U.Va., a careful patient selection process,
developed by Daniel and Truwit, is followed and pre- and post-
operative therapy are mandatory.
     Once a patient has been selected for surgery, the real work
begins. Each patient must participate in an intensive chest 
physiotherapy program for six weeks, including  workouts on a
treadmill five times a week. "Patients prepare for surgery like 
they are preparing for the Super Bowl," Daniel said.
     "With emphysema, the person's whole body is absorbed in trying
to stay alive by breathing. People lose weight and their breathing
is often so labored that they can't even speak in full sentences.
So we spend a great deal of time and effort trying to reverse the
ravages of the disease before surgery to improve the outcome."
     After surgery, patients are involved in another six-week
intensive therapy program to teach them how to breathe properly
again and increase their muscle strength and endurance.
     Daniel said that U.Va. is developing rehabilitation facilities
and a hospital unit with specially trained nurses and physical
therapists to offer pre- and post-operative care for patients
treated with the lung shaving procedure. Currently, U.Va. is using
the Martha Jefferson Hospital outpatient rehabilitation center for
the pre- and post-operative physical therapy.
     The procedure currently is covered by Medicare and Blue
Cross/Blue Shield. The lung shaving procedure costs about $35,000
whereas a lung transplant costs approximately $150,000 plus the
lifetime cost of medication to prevent rejection.  
                               ###
                                                 April 21, 1995