Biomedical subjects
Publications and source records attributed to S Nomoto.
We report a 82-year-old man who was found to have tibia bone metastasis 24 years after nephrectomy for renal cell carcinoma. We performed resection and bone graft. He died 1 year and 9 months after the operation with no evidence of recurrence.
The effect of preoperative left ventricular end-diastolic volume on hemodynamics after repair and the safety limit of left ventricular end-diastolic volume for total correction of tetralogy of Fallot were studied. Preoperative left ventricular volume was determined in 38 patients according to the area-length method from biplane cineangiocardiograms. The mean left ventricular end-diastolic volume of the 38 patients was 83% +/- 23% of normal. The left ventricular end-diastolic volume of 20 corrected patients (90% +/- 22% of normal) was significantly larger (p less than 0.05) than that of 18 with a systemic-pulmonary shunt (75% +/- 22% of normal). In the corrected patients, the total amount of dopamine required in the postoperative period showed an excellent inverse exponential correlation with the preoperative left ventricular end-diastolic volume (r = -0.826); it showed a poor inverse correlation with the ratio of pulmonary artery to aortic diameter (r = -0.587) and with myocardial ischemic time (r = -0.487); and it showed no correlation with postoperative right to left ventricular systolic pressure ratio (determined at the time of the chest closure) and residual right ventricular-pulmonary arterial pressure gradients. The patients with a left ventricular end-diastolic volume under 70% of normal had severe low-output syndrome after total correction. We recommend a left ventricular end-diastolic volume of 60% of normal as a safety limit for total correction in patients under 2 years of age. In patients over 2 years of age, the safety limit may be larger because there are more collaterals with increasing age.
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Six domestic pigeons with chronically implanted spinal thermodes were exercised on a treadmill at neutral ambient temperature. During the exercise the spinal cord was cooled to 34.7 +/- 0.4 degrees C (mean +/- S.E.M.). Oxygen consumption of the pigeons increased from 28.3 +/- 2.1 to 61.2 +/- 3.7 ml X min-1 X kg-1 due to exercise per se, and superimposed cooling of the spinal cord during exercise induced an additional increase in oxygen consumption to 84.9 +/- 4.5 ml X min-1 X kg-1. The result demonstrates that cooling of the spinal cord elicits shivering in exercising pigeons at thermoneutral conditions.
A new technique of adjustable pulmonary artery banding is presented. A tourniquet system has been used in eight consecutive infants with complex congenital cardiac anomalies during the past 2 years. They had severe congestive heart failure, and six of them required inotropic support preoperatively. All survived the banding procedure and there were no hospital deaths. Four of the eight infants required additional adjustment of the band to improve hypoxemia or persistent congestive heart failure 3 hours to 4 months postoperatively. Each adjustment was made easily via a small skin incision without thoracotomy. This technique allows fine adjustment by gentle and delicate tightening and loosening of the band during and after operation, so that the technique avoids most mortality and morbidity related to an inappropriate banding and brings satisfactory symptomatic palliation.
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Six adult white Pekin ducks were trained to run on a treadmill for 10 min at a speed of 1.43 km h-1. O2 consumption, CO2 production, breathing rate, blood gas tension and pH, sciatic and carotid blood flows and colonic and skin temperatures were measured in the experiments. A 2.6 times increase in oxygen consumption was observed when going from resting on the treadmill to exercise. The increased oxygen delivery was achieved by a 61% increase in cardiac output and a 51% increase in the arterio-venous oxygen content difference. Probably the reported resting oxygen consumption was higher than a true resting level causing the increment in oxygen consumption to be more correctly 3.6 times the resting level. Sciatic and carotid blood flow increased by 3.7 times and 2.3 times, respectively, during exercise. At cessation of exercise, the carotid blood flow decreased very rapidly, while the sciatic blood flow decreased more slowly. An increased web temperature above the exercise level was seen in the post-exercise period. The results suggest that the ducks prefer to use non-evaporative heat loss in the post-exercise period, respiratory evaporative cooling being of minor importance. this strategy may be correlated to the small internal heat load induced by the running (body temperature increased by only 0.3 degrees C.
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