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Biomedical subjects

E Nemoto

Publications and source records attributed to E Nemoto.

49 records · Page 3Linked to original sources
PubMed1985

Does pleural bronchial wrapping improve wound healing in right sleeve lobectomy?

The effect of bronchial circulation on wound healing at the site of anastomosis after right upper sleeve lobectomy was studied in dogs. In two dogs (Group I), the bronchial arteries were carefully preserved during the sleeve lobectomy. In 16 dogs (Group II), only sleeve lobectomy was performed after all bronchial arteries in the hilum were ligated. In three dogs (Group III), the site of anastomosis was wrapped by a Penrose drain after sleeve lobectomy. In three other dogs (Group IV), the site of anastomosis was wrapped with a free pleural flap after sleeve lobectomy. In another group of 11 dogs (Group V), the anastomotic site was wrapped with a pedicled pleural flap. The dogs in Group I were put to death immediately and bronchial arterial circulation was recognized to consist primarily of systemic arterial blood. In Group II dogs, bronchial arteries distal to the anastomosis filled with pulmonary arterial blood immediately after the sleeve lobectomy. Although the majority of bronchial arteries became filled with systemic arterial blood with time, some vessels were filled with pulmonary arterial blood even 7 days after the sleeve lobectomy. In Group III dogs, wound healing at the site of anastomosis was severely delayed, and 7 days after the sleeve lobectomy the majority of bronchial arteries in the bronchial wall distal to the anastomosis were filled with pulmonary arterial blood. In Group IV dogs, the state of wound healing at the bronchial anastomotic site was similar to that of Group III dogs. In Group V, although the state of wound healing at the anastomosis was relatively good in most of the animals, the pedicled pleural wrap did not significantly improve bronchial circulation over that of Group II.

Animals↗
PubMed1983

Possible significance of the pharmacological differentiation of beta-blocking agents in hemodynamic effects in essential hypertension.

Thirteen beta-blocking agents with different pharmacological properties were administered orally to 161 outpatients with essential hypertension for 5 weeks to assess their hemodynamic effects. Cardioselective ones, such as atenolol, metoprolol and acebutolol, reduced mean blood pressure (MBP) and the cardiac index. (CI) without any changes of the total peripheral resistance index. (TPRI). In the total 44 patients treated with these drugs, a positive correlation (r = 0.529, p less than 0.005) was found between the decrease in MBP and that of TPRI, but the decrease in MBP did not correlate with that of CI. Effects of non-cardioselective ones were classified arbitrarily into the following 3 patterns: 1) reduction of CI of more than 0.50 L/min/m2 and a slight increase of TPRI by more than 150 dyne . sec . cm-5 . m2 (nadolol, propranolol, o.prenolol and penbutolol), 2) reduction of TPRI by more than 150 dyne . sec . cm-5 . m2 (pindolol, bunitrolol and labetalol) and 3) the intermediate hemodynamic responses between the two patterns described above (carteolol, bupranolol and bufetolol). In all these 3 groups, the decrease in MBP correlated with that of TPRI (the first group, n = 45, r = 0.557, p less than 0.005; the second, n = 37, r = 0.525, p less than 0.005; the third, n = 35, r = 0.612, p less than 0.005), but did not correlate with the decrease of CI. These results suggest that the antihypertensive effects of beta-blocking agents mainly depend on the reduction of peripheral resistance, although their pharmacological properties are not uniform and their cardiodepressant effects are variable. Reduction of cardiac performance with these beta-blocking agents seemed to be a consequence of overall pharmacological actions including beta-receptor blockade, central effects and membrane stabilizing effects, and it may be antagonized by intrinsic sympathomimetic activity and the reduction in afterload for the heart. Vascular beta-receptor blocking action may play a part in decreasing the degree of reduction of the total peripheral resistance index, while their intrinsic sympathomimetic action on the vascular site may induce vasodilating effects.

Acebutolol↗
PubMed1983

[Endobronchial metastasis of testicular embryonal cell carcinoma--a case report].

Four cases of endobronchial metastasis in testicular embryonal cell carcinoma have been reported in the literature. We now present a new case, a 39-year-old male who underwent right orchiectomy for testicular embryonal cell carcinoma. Ten months later, tumor like shadows were identified in the left upper lobe on a follow up chest X-ray. Bronchoscopy revealed an endobronchial tumor mimicking a bronchogenic carcinoma in the left superior posterior bronchus. A metastatic embryonal cell carcinoma of the testis was histologically diagnosed. Left upper lobectomy was performed, and the patient is still alive 11 months thereafter.

Adult↗
PubMed1980

Effect of postcirculatory-arrest life-support on neurological recovery in monkeys.

The existence of treatable postischemic (PI) changes which influence neurological outcome has been documented by this group before. A global brain ischemia model without cardiac arrest was developed in monkeys. It includes high-pressure neck tourniquet inflation plus hypotension for a reproducible ischemic insult; survival with reproducible neurological deficit (ND) under continuous PI life-support for 7 days with control of extracranial variables; and new ND and histopathological damage scoring systems. Hypoxemia, hypercarbia, hypotension, uremia, sepsis, and other extracranial complications PI in 50 unsatisfactory experiments led to immediate worsening in ND and brain death (ND = 100%) in most of these monkeys. In contrast, all monkeys with the same initial insult, with life-support according to protocol, survived with a 7 day ND of 60% or less. In 46 experiments of seven treatment groups, after 16 or 18 min ischemia, life support was according to protocol for 7 days. The control 1 protocol (spontaneous breathing when feasible) resulted in a mean 7-day ND score of 53% (including quadriplegia). Immobilization with pancuronium and controlled ventilation ameliorate deficit to an ND score of 19% (P less than 0.05) (including quadriparesis); this became control 2 protocol. Immobilization resulted in less neuronal damage in the neocortex. Severe repetitive hypertension worsened ND to 46%, versus 19% in controls (P less than 0.05). In separate series, neither heparinization over 72 hours PI, nor hemodilution to hematocrit 25% with dextran 40, changed final ND significantly from that of their control groups. Histopathological damage scores correlated with ND scores.

Animals↗
PubMed1971

Pulmonary artery pressure and alveolar gas exchange in man during acclimatization to 12,470 ft.

Pulmonary hemodynamics and gas exchange were studied in four physicians during 72 hr acclimatization to 12,470 ft. Pulmonary catheters were left in three subjects for 72 hr. Resting mean pulmonary arterial pressure (PAP) rose progressively during the first 24 hr from 10.3 +/-1.0 to 21.1 +/-4.0 torr and remained at this level. During this same 24 hr period cardiac output increased from 7.1 +/-1.4 to 8.4 +/-2.0 liters/min and total pulmonary resistance rose from 122 +/-16 to 209 +/-40 dynes.sec/cm(-5). Excercise at 60 w after 24 hr of hypoxia increased PAP to 28.8 +/-5.1 torr and decreased total pulmonary resistance to 155 +/-25. Shunt fractions were 11 +/-3.8% after 24 hr at altitude and fell to 7 +/-0% after 72 hr. Alveolar to arterial O(2) difference (P(A-a)(O2)) breathing oxygen fell from 116 +/-10.8 to 92 +/-33.3 torr during the same period of acclimatization, whereas dead space to tidal volume ratio (V(D)/V(T)) rose from 33 +/-4.0% to 40 +/-5.3% and P(A-a)(O2) breathing ambient air rose from 8 +/-2.6 to 11 +/-3.0 torr. Inspiratory static lung compliance decreased significantly from a control of 176 +/-8 to 141 +/-8 ml/cm H(2)O after 72 hr of hypoxia. After 4-7 days at altitude, further deterioration in gas exchange was observed after a 5 mile, 1800 ft climb to the summit (14,255 ft) and return. P(A-a)(O2) on air rose from 2.5 +/-2.1 just before starting, to 16.3 +/-2.8 at the summit (rested), and was still 9.0 +/-2.2 several hours after returning. The O(2)-breathing values paralleled these, whereas dead space appeared to fall. We speculate that the hypoxic pulmonary hypertension which develops over 24 hr in some way may be responsible for a reduction of compliance and deterioration in oxygen exchange efficiency, possibly representing a sub-clinical form of pulmonary edema of high altitude. The increased alveolar to arterial O(2) difference induced by hypoxic exercise persists for several hours of hypoxic rest.

Acclimatization↗
PubMedDate not supplied

E-PASS (The Estimation of Physiologic Ability and Surgical Stress) scoring system helps the prediction of postoperative morbidity and mortality in thoracic surgery.

OBJECTIVE: When a new scoring system, 'E-PASS', standing for the Estimation of Physiologic Ability and Surgical Stress that predicts the postoperative surgical risk by quantification of the patient's reserve and surgical stress applied to a population of general thoracic surgery patients, it should be investigated if this system could help us or not. METHODS: The comprehensive risk score (CRS) of the E-PASS and the clinical course were evaluated retrospectively in 282 consecutive patients with primary lung cancer (group A), and in 458 patients who underwent elective thoracic operations (group B). RESULTS: The morbidity and mortality rates in both group A and group B increased as the CRS increased. The CRS correlated significantly with the morbidity score, length of stay and cost of hospitalization. CONCLUSIONS: E-PASS scoring system may be useful in surgical decision-making and evaluating quality of care in patients who are tolerable for lung resection.

Adult↗