Biomedical subjects
Publications and source records attributed to S C Lenkei.
A patient with a pheochromocytoma involving the posterior wall of the left ventricle and the coronary sinus is reported. Complete surgical removal of the tumor was possible, although it caused a perioperative myocardial infarction. The literature regarding cardiac pheochromocytoma is reviewed.
Electric stimulation of the diaphragm via the phrenic nerve to induce ventilation has recently been used for the long-term management of chronic ventilatory insufficiency. Since 1973 three patients with inadequate alveolar ventilation have been treated with diaphragm pacing at the Toronto Western Hospital. Two, who had quadriplegia due to lesions of the spinal cord in the upper cervical region and a severe restrictive ventilatory defect, were treated with continuous diaphragm pacing. The third patient required assisted nocturnal ventilation because of primary alveolar hypoventilation. All three patients tolerated the diaphragm pacing well, and pulmonary function tests showed satisfactory gas exchange with the patients breathing room air. This form of therapy seems to be a practical clinical method of managing chronic ventilatory failure in patients with lesions of the upper cervical cord or primary alveolar hypoventilation.
Aortocoronary bypass operations are expensive. Economic benefit might be derived if such operations influenced the ability of persons with symptomatic coronary artery disease to be employed. Follow-up data were obtained for 329 survivors of bypass operations 2 to 60 months (mean, 22.9 months) postoperatively; 178 had been working prior to the operation and 213 were working at the time of follow-up, for a net gain of 35 employed patients. Therefore, bypass surgery does lead to a small but significant increase in the proportion of angina patients who are employed.
Myocardial infarction is uncommon in persons with hyperthyroidism and also uncommon in the absence of demonstrable coronary artery disease. Cardiac catheterization and selective coronary angiography were performed in two men following apparent myocardial infarctions. Both patients were 33 years of age, thyrotoxic and angiographically free of coronary artery abnormalities.
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