A method for estimating contact time of red blood cells through lung capillary from O2 and CO2 concentrations in rebreathing air in man

The gas exchange ratio (R) obtained from O2 and CO2 concentrations measured in rebreathing air usually shows a linear relation to the PCO2. By referring to this relation and the R which equals the Haldane effect coefficient and zero, the true- and oxygenated-venous PCO2 are obtained in addition to the alveolar PCO2. When these PCO2 are evaluated, the R-PCO2 line can also be computed theoretically from a numerical solution on the overall O2 and CO2 diffusions in the red blood cell. By comparing both the experimental and theoretical R-PCO2 lines with each other, we derived a contact time equation. Since the linear approximation of the R-PCO2 relation gave rise to an error in the contact time (tc), first a factor to correct the linearity of the R-PCO2 line was derived. Next, using these parameter values, tc was quantitatively determined from experimental data obtained during rebreathing in 5 normal subjects and it was compared with that estimated from the pulmonary diffusing capacity for CO in the same rebreathing experiment. When the extracellular HCO3- dehydration rate was taken to be 0.1 s in time constant, the tc, being ca. 0.7 and 0.4 s at rest and during exercise, respectively, showed good agreement with those obtained from the diffusing capacity for CO.

Pulmonary function after lobectomy in children under ten years of age

A long-term follow-up study on pulmonary function in twelve lobectomized children under ten years of age at the time of surgery was performed to determine the patterns of compensation. In the patients over ten years old at the time of the test performed over two years postoperatively, there was neither compensatory regeneration nor compensatory overdistension of the remaining lung tissue. However, there appeared to be an increase in the vital capacity, probably due to the growth of surrounding tissue such as thorax, respiratory muscles, and diaphragm. In contrast, the children tested under the age of eight years showed evidence of mild overdistension during the early postoperative period, but not at two years. There was no sign of overdistension in the patients over ten years of age at the time of testing.

Protection against oxygen-induced reperfusion injury of the isolated canine heart by superoxide dismutase and catalase

While oxygen-derived free radicals have been implicated in the pathogenesis of myocardial injury, the exact nature of this injury is still unclear. To test the hypothesis that oxygen-induced injury may influence the recovery of cardiac function from ischemic damage, we used an oxygen free radical scavenger, superoxide dismutase (SOD), together with catalase, during the reperfusion of isolated canine heart which had been subjected to 15 min of normothermic ischemic arrest followed by 2 hr of hypothermic cardioplegic preservation using a modified Collins solution. Determinations of thiobarbituric acid reactive substances and coenzyme Q10 within the myocardium showed that the treatment with SOD and catalase was capable of inhibiting lipid peroxidation induced by reperfusion. This inhibition was apparently associated with the improvement of myocardial energy metabolism and cardiac performance. Coronary flow was significantly higher in the heart treated with SOD and catalase during the working stage with a corresponding increase in oxygen consumption. Myocardial adenosine triphosphate (ATP) was partially, but significantly restored during reperfusion in these hearts whereas no restoration was observed in the heart without the enzymes. The treatment with SOD and catalase also improved left ventricular stroke work index and left ventricular maximum dp/dt at an early stage of the working mode. These results suggest that the use of SOD and catalase during reperfusion can protect the ischemic heart against reperfusion injury by scavenging oxygen-derived free radicals.

Numerical solution of partial differential equations describing the simultaneous O2 and CO2 diffusions in the red blood cell

To describe the overall gas exchange rates in red blood cells (RBC), a computer program for solving the diffusion equations for O2, CO2, and HCO3-that accompany the chemical reactions of Bohr- and Haldane-effects was developed. Three diffusion equations were solved alternatively and repeatedly in an increment time of 2 ms. After solving the diffusion equations the Po2, O2 saturation (So2), Pco2, pH, and HCO3-content were corrected by using the Henderson-Hasselbalch equation, where the buffer value was newly derived from the CO2 dissociation curve. In computing the Haldane effect, the buffer value was taken to be 44mmol X l(RBC)-1 X pHc-1, so that the change in intracellular dissolved CO2 caused by the So2 change was fully compensated by the subsequent CO2 diffusion. The oxygenation and deoxygenation rate factors of hemoglobin were assumed to be 2.09 X (1-S)2.02 and 0.3s-1 X Torr-1, respectively. The Po2 change due to the Bohr-shift was computed from Hill's equation, in which the K value was given by a function of the intracellular pH. When the parameter values thus far measured were used, the computed Bohr- and Haldane-effects coincided well with the experimental data, supporting the validity of the equations. The overall gas exchange profiles calculated in the pulmonary capillary model showed that the CO2 equilibration time was significantly longer than the oxygenation time.

Evaluation of uneven distribution of VA/Q ratio from data on exchange of respiratory gases

A new approach has been developed for evaluating uneven distribution of ventilation/perfusion ratio, VA/Q, based on a two-compartment model with a reciprocal VA/Q relation. The VA/Q ratios were expressed by mu . (1-rho)/rho and mu . rho/(1-rho), where mu and rho were referred to as the "ideal" VA/Q ratio and unevenness factor, respectively. During steady state breathing, arterial blood was analyzed for PO2 and PCO2, and end-tidal PCO2 as well as the gas exchange ratio, R, was measured. After steady state breathing a rebreathing experiment was performed, and the arterial-venous O2 content difference, (a-v)CO2, was measured, and then, multiplying it by R, the venous-arterial CO2 content difference, (v-a)CCO2, was obtained. Referring to these values the mixed venous PO2 and PCO2 were estimated from arterial PO2 and PCO2, using the O2 and CO2 dissociation curves. The VA/Q line and iso-R line were drawn to find mu, and further, total arterial, and alveolar PO2 and PCO2 of the two-compartment model were computed by changing both rho and the mixing weight factor, phi. The phi value was determined so as to make the above PO2-PCO2-locus pass through the measured arterial PO2 and PCO2. The rho value was selected so that the computed alveolar PCO2 fitted to the end-tidal one. The experiments were performed on 8 normal subjects in normoxia and hyperoxia with PIO2 245 Torr. The mean phi values in normoxia and hyperoxia were 0.50 and 0.56, respectively. The mean rho values in normoxia and hyperoxia were 0.438 and 0.428, respectively. The VA/Q ratio was decreased in hyperoxia because of a decrease in VA value.

Analysis of endodontic therapy in patients irradiated for head and neck cancer

The outcome of endodontic therapy in 16 patients irradiated for head and neck cancer was studied. Thirty-five postradiation endodontically treated teeth (54 roots) were included in the study. The follow-up period ranged from 6 months to 54 months. At the time of last follow-up, 46 of 54 roots were being maintained. No osteoradionecroses were seen in association with teeth that had been endodontically treated. From this review, it is clear that endodontic therapy is a viable method of treating diseased teeth in patients irradiated for oral neoplasms.

Allocation and Turnover of Photosynthetically Assimilated CO(2) in Leaves of Glycine max L. Clark

The allocation and turnover of photosynthetically assimilated (14)CO(2) in lipid and protein fractions of soybean (Glycine max L. Clark) leaves and stem materials was measured. In whole plant labeling experiments, allocation of photosynthate from a pulse of (14)CO(2) into polymeric compounds was: 25% to proteins in 4 days, 20% to metabolically inert cell wall products in 1 to 2 days, 10% to lipids in 4 days, and 4% to starch in 1 day. The amount of (14)C labeled photosynthate that an actively growing leaf (leaf 4) used for its own lipid synthesis immediately following pulse labeling was about 25%. The (14)C of labeled proteins turned over with half-lives of 3.8, 3.3, and 4.1 days in leaves 1, 2, and 3, respectively; and turnover of (14)C in total shoot protein proceeded with a half-life of 5.2 days. Three kinetic (14)C turnover patterns were observed in lipids: a rapid turnover fraction (within a day), an intermediate fraction (half-life about 5 days), and a slow turnover fraction. These results are discussed in terms of previously published accounts of translocation, carbon budgets, carbon use, and turnover in starch, lipid, protein, and cell wall materials of various plants including soybeans.

[Three surgically treated cases of spontaneous rupture of the esophagus with reference to a new surgical approach--eversion stripping and esophagogastrostomy through the posterior mediastinum]

Three surgical cases of spontaneous rupture of the esophagus were reported. Case 1 was a 56-year-old man who was admitted 3 days after the onset was treated with open drainage. He had no complications whatsoever 8 years after the treatment. In case 2 (a 55-year-old man), eversion stripping of the esophagus and gastrostomy were performed 2 months after diagnosis, but esophageal reconstruction was not successful. He died of acute congestive heart failure 5 years after surgery. The Third case was a 60-year-old women whose rupture was confirmed 11 days after the onset. Cervical esophagostomy, gastrostomy and jejunostomy were performed 16 days after the rupture. Thereafter, esophageal eversion stripping and esophagogastrostomy through the posterior mediastinum were successfully carried out 2 months after the first surgery. She had no postoperative complications. Eversion stripping of the esophagus with esophagogastrostomy through the posterior mediastinum is an effective and safe method for some advanced cases of spontaneous esophageal rupture. We have not found any reports of surgical cases with spontaneous esophageal rupture treated by this approach in the literature.

Surgical treatment of pulmonary abscess in children under ten years of age

Ten children under ten years of age with pulmonary abscess were treated surgically between 1962 and 1982. In nine patients, lobectomies with or without pulmonary decortication were performed; and in one case, drainage via a chest tube directly from the abscess cavity was successful. There were no surgical or late postoperative deaths. All patients recovered without any complication. The postoperative course has been followed for two months to 20 years. The effect of treatment is correlated with the clinical type of abscess.