Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THORACIC DUCT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed1978

Mediastinal thoracic duct cyst.

A case of mediastinal thoracic duct cyst is described; it is believed to be the first to be reported in Britain. Five surgically treated cases have been reported but in none was the diagnosis made before operation. Symptoms are caused by pressure of the cyst on the trachea and oesophagus and my be aggravted by eating a fatty meal. Differential diagnosis from other mediastinal tumours, especially bronchogenic cyst and neurofibroma, could perhaps be established before operation by lymphangiography.

Adult↗
PubMed1992

Lymphoscintigraphy in healthy dogs and dogs with experimentally created thoracic duct abnormalities.

Lymphoscintigraphic evaluation of the thoracic duct (TD) was performed in 10 healthy and 12 dogs with experimentally created TD abnormalities (6 dogs with TD lacerations and 6 dogs with cranial vena ligations). Complete imaging took 4 hours and caused no adverse effects or complications. Lymphoscintigraphy of healthy dogs failed to image the TD; however, background activity in the abdomen and thorax, and radioactivity in the kidneys, bladder, liver, and heart were noticed. Lacerations and transections of the TD were experimentally created in 6 dogs to ascertain whether TD rupture could be detected with lymphoscintigraphy. Lymphoscintigraphy was performed within 48 hours of creating the TD defect. There was no significant difference in the scintigraphic pattern of healthy dogs and those with experimentally created TD defects. Ligation of the cranial vena cava was performed in 6 dogs; 3 dogs developed chylothorax. In those 3 dogs, diffuse radioactivity was imaged in the thorax and was compatible with thoracic lymphangiectasia. In one of these dogs, linear activity consistent with the TD and localized regions of radioactivity cranial to the heart (compatible with the mediastinal lymph nodes) were noticed. Lymphoscintigraphic findings in these dogs correlated with lymphangiographic findings.

Animals↗
PubMed1975

Human thoracic duct cannulation: manipulation of tumor-specific blocking factors in a patient with malignant melanoma.

Thoracic duct lymph was drained for 28 days from a patient with disseminated malignant melanoma. Lymphocytes were separated from the lymph by centrifugation, and returned to the patient daily. Biochemical and hematologic parameters were monitored in blood and lymph, and were maintained at satisfactory levels throughout the period. Cell-mediated immunity and specific blocking activity directed against melanoma antigens were examined by the leukocyte adherence inhibition test. Blocking factors in drained lymph fell to undetectable levels after 6 days' thoracic duct drainage, whereas it took 9 days for serum blocking factors to fall to similar levels. Peripheral blood leukocytes demonstrated cell-mediated immunity against melanoma antigens before and throughout the period of drainage, except for the immediate postoperative period. Within 24 hours of closure of the thoracic duct fistula, serum blocking activity had returned, and 17 days later the patient died.

Adult↗
PubMed2002

[Surgical anatomy of superior and mid-thoracic areas of the thoracic duct].

To investigate the peculiarities of surgical anatomy of superior and mid-thoracic portions of the thoracic duct, 70 human corpses of adults of both sexes were studied using modern anatomical and experimental methods. Some regularities of the changes of syntopy of the mediastinal organs and vessels and the connection of these changes with the individual features of thoracic structure are described. The relation between these peculiarities with the quantitative parameters of surgical procedures performed in superior and mid-thoracic portions of the thoracic duct is demonstrated.

Adult↗
PubMed1978

Study of chemical constituents of thoracic duct lymph in schistosomal hepatic fibrosis.

Concentrations of serum and thoracic duct proteins, immunoglobulins, lipids, enzymes and electrolytes were estimated in 15 patients with schistosomal hepatic fibrosis and presinusoidal obstruction and in 12 controls. There was a significant decrease of thoracic duct total proteins, albumin and triglycerides, with marked and significant increase in IgG and IgM in SHF, compared to the controls. The levels of transaminases, alkaline phosphatases and inorganic phosphorus were significantly higher in the lymph of SHF patients compared with healthy controls. It is presumed that these changes represent the pattern of lymph constituents in presinusoidal obstruction.

Adult↗
PubMed1991

Effect of thoracic duct drainage on hydrostatic pulmonary edema and pleural effusion in sheep.

Positive end-expiratory pressure (PEEP) increases central venous pressure, which in turn impedes return of systemic and pulmonary lymph, thereby favoring formation of pulmonary edema with increased microvascular pressure. In these experiments we examined the effect of thoracic duct drainage on pulmonary edema and hydrothorax associated with PEEP and increased left atrial pressure in unanesthetized sheep. The sheep were connected via a tracheostomy to a ventilator that supplied 20 Torr PEEP. By inflation of a previously inserted intracardiac balloon, left atrial pressure was increased to 35 mmHg for 3 h. Pulmonary arterial, systemic arterial, and central venous pressure as well as thoracic duct lymph flow rate were continuously monitored, and the findings were compared with those in sheep without thoracic duct cannulation (controls). At the end of the experiment we determined the severity of pulmonary edema and the volume of pleural effusion. With PEEP and left atrial balloon insufflation, central venous and pulmonary arterial pressure were increased approximately threefold (P less than 0.05). In sheep with a thoracic duct fistula, pulmonary edema was less (extra-vascular fluid-to-blood-free dry weight ratio 4.8 +/- 1.0 vs. 6.1 +/- 1.0; P less than 0.05), and the volume of pleural effusion was reduced (2.0 +/- 2.9 vs. 11.3 +/- 9.6 ml; P less than 0.05). Our data signify that, in the presence of increased pulmonary microvascular pressure and PEEP, thoracic duct drainage reduces pulmonary edema and hydrothorax.

Animals↗
PubMed1975

[Changes in the thoracic duct and lymphodynamics in neoplastic diseases].

X-ray contrast study of the thoracic duct was conducted in 35 patients with various neoplasms of the chest and upper abdomen, as well as in tumor involvement of lymph nodes, located proximally to the main lymphatic collector. Pathological changes in the thoracic Duct and central lymphodynamics, observed in neoplastic lesions concerned, are described.

Abdominal Neoplasms↗
PubMed1976

Relationships between the concentrations of doxycycline in serum and in thoracic duct lymph after oral and intravenous administration in man.

The concentrations of doxycycline in serum and in thoracic duct lymph at various times after oral and intravenous administration of 200 mg of the drug were determined in 10 patients subjected to thoracic duct cannulation for diagnostic purposes. After oral administration, a mean peak serum concentration of 2.4 mug/ml (n=7) was obtained within 3 h; then the levels successively declined. The concentrations in thoracic lymph were lower, a mean peak concentration of 1.6 mug/ml being found 3 and 6 h after the intake. After intravenous administration (n=3), the concentrations of doxycycline in thoracic duct lymph were lower than but closely followed those in serum. The difference in concentrations between serum and lymph 1-6 h after the start of the infusion never exceeded 30%. The results suggest that doxycycline is rapidly distributed to the extracellular tissue fluids.

Administration, Oral↗
PubMed2000

Large thoracic duct cyst - a case report and review of the literature.

Large thoracic duct cysts are rare and standard lateral thoracotomy is usually used for resection. In the reported case the combination of an antero-lateral thoracotomy with a partial longitudinal median sternotomy (hemiclamshell approach) allowed an excellent visualization and dissection of a large thoracic duct cyst expanding in the anterior cervico-thoracic junction, and was associated with an uncomplicated recovery.

Biopsy, Needle↗
PubMed1991

Left thoracic duct lymph flow responses to angiotensin II or atrial natriuretic factor infusion in the ovine fetus.

In the ovine fetus it is known that left thoracic duct lymph flow rate relative to body weight is four to five times adult levels, but it is not known whether the circulating hormones modulate fetal lymph flow. To explore this, we intravenously infused either angiotensin II (10 to 400 ng/min, n = 8) or atrial natriuretic factor (500 to 1000 ng/min, n = 8) into chronically catheterized fetal sheep for 30 minutes. Significant increases occurred in fetal arterial (p less than 0.0001) and venous (p = 0.018) pressures during the angiotensin II infusion, and thoracic duct lymph flow rate underwent a dose-dependent increase (r = 0.888, p = 0.0033). With termination of the angiotensin II infusion, fetal vascular pressures rapidly returned to control levels, and lymph flow fell from 18.8% +/- 10.1% (mean +/- SE) above control to 13.7% +/- 7.7% below preinfusion levels (p less than 0.01). During the atrial natriuretic factor infusion, fetal arterial pressure and circulating blood volume decreased significantly (p less than 0.01), whereas thoracic duct lymph flow was unchanged. After termination of the atrial natriuretic factor infusion, fetal arterial pressure returned toward control, blood volume remained reduced, and lymph flow rate underwent a transient rise to 35.6% +/- 15.7% (p less than 0.05) above control levels. These data suggest that angiotensin II and atrial natriuretic factor have significant but opposite effects on fetal thoracic duct lymph flow rate, with angiotensin II stimulating and atrial natriuretic factor suppressing lymph flow.

Angiotensin II↗
PubMedDate not supplied

Nutritional management of thoracic duct fistulas. A comparative study of parenteral versus enteral nutrition.

Thoracic duct fistulas represent one of the serious technical complications of head and neck surgery, and reoperation for control of the leakage involves considerable morbidity and mortality. In an attempt to define the possibilities of both enteral and parenteral nutrition in the treatment of this problem, two comparable groups of patients were given, respectively, one or the other of these modalities. Significant advantages for parenteral nutrition could be demonstrated regarding duration of therapy (p less than 0.05), closure rate (p less than 0.05), and nutritional response (p less than 0.05). These results strongly recommended the utilization of parenteral nutrition in the primary therapy of thoracic duct fistulas.

Aged↗
PubMed1977

The effect of steroids on the circulating lymphocyte population. I. Changes in the thoracic duct lymphocyte population of the rat after neonatal thymectomy and prednisolone treatment.

The influence of prednisolone on the thoracic duct cells of rats was measured by the cell count in lymph at different times after a single injection and correlated with lymphocytolysis in lymphoid tissues. In both control and neonatally thymectomized animals there was a marked fall in the cell count and flow at 3 hours and the percentage reduction was greater in thymectomized animals. Restitution was rapid in both groups and pretreatment levels were regained in 17 hours. The blood mononuclear cells followed the same pattern. In animals with an intact thymus adrenalectomy causes a significant increase in thoracic duct cell counts but in neonatally thymectomized animals thoracic duct lymph is unchanged after adrenalectomy. It can be concluded that in the rat lymphocyte level in the circulating pool is thymus dependent but restoration of the circulating cell count after steroid induced involution is independent of intact thymic function. Our data support the hypothesis of lymphocyte trapping and redistribution as a major mechanism after a single cortisone dose.

Adrenalectomy↗
PubMed1992

[Preoperative diagnosis of a thoracic duct cyst arising in the supraclavicular fossa--surgical case report].

The incidence of cysts of the thoracic duct is very low, and they are reported to account for only 0.0005-0.5% of all mediastinal tumors. As far as we have been able to determine, there have been no more than 24 case reports of the surgical resection of such cysts, including our own. Moreover, lesions of the left supraclavicular fossa as in the present case were noted in only 2 reports from Western countries, and 2 cases can be found in the Japanese literature. We encountered a case of thoracic duct cyst where we were able to make a diagnosis preoperatively by means of needle aspiration, and report it here together with a discussion of the relevant literature. The patient was a 64-year-old woman who was admitted with the chief complaint of pain in the throat and a sense of pressure in the neck. A swelling was noted in the patient's left supraclavicular fossa, and when this was aspirated it yielded approximately 15 cc of yellowish-white, chylous fluid. No hoarseness or dysphagia were noted. CT scan of the thorax revealed a smooth-surfaced tumor extending from the left supraclavicular fossa to the anterior mediastinum. It showed the simple cystic lesion. On the basis of these findings, a diagnosis of thoracic duct cyst arising in the left supraclavicular space was made. Following excision, the patient's postoperative course was favorable.

Biopsy, Needle↗
PubMed2004

Thoracic duct injury during esophagectomy: 20 years experience at a tertiary care center in a developing country.

Thoracic duct injury is an uncommon complication of esophagectomy. Experience in managing these cases is limited to large centers performing esophagectomies in good numbers. We analyzed the prospectively maintained esophageal diseases database of patients presenting to a surgical unit between 1982 and 2002. Among 552 esophagectomies during this period we had encountered 14 cases of chylothorax (2.54%). We analyzed the type and site of lesion and the impact of neoadjuvant therapy on the incidence of thoracic duct injury. Among 459 patients of transhiatal esophagectomy, 11 developed postoperative chylothorax (2.40%). In 93 transthoracic resections, there were three cases of chylothorax (3.23%; (P = 0.9185)). The incidence following preoperative radiotherapy was 2.17%. None of the 31 patients, who had undergone esophagectomy for benign diseases had developed chylothorax. In the carcinoma group the incidence in middle third lesions was 5.85% and in lower third lesions was 0.80% (P = 0.0018). Seven patients were managed conservatively. Two of these patients, for whom surgery had been planned, died before they could be taken up for surgery. In the remaining seven patients transthoracic ligation of the thoracic duct was performed. Two patients in this group died. The average hospital stay was 20 days in the conservative group and 12 days in the surgery group. Among the factors studied, patients with middle third lesions were at increased risk of developing postoperative chylothorax, when compared to upper or lower third lesions.

Adenocarcinoma↗
PubMed2002

Effect of phosphodiesterase III inhibitor (Olprinone) on thoracic duct lymph flow in anesthetized sheep with experimentally induced heart failure by endothelin-1.

We investigated the short-term effects of a phosphodiesterase III inhibitor (Olprinone) on hemodynamics and thoracic duct lymph flow in anesthetized open-chest sheep with heart failure induced by endothelin-1 (cardiogenic shock). Ultrasound transit-time flow probes were attached to the thoracic duct, the ascending aorta and the renal artery. Arterial, pulmonary and central venous pressures were monitored. Endothelin-1 was infused intravenously at a dosage that reduced cardiac output to 50% or more of baseline (n=11). The effects of Olprinone were examined (n=5) by intravenous infusion after endothelin-1 administration. Other sheep (n=6) were used as controls. Olprinone significantly increased cardiac output that had been decreased by endothelin-1 and further increased thoracic duct flow that had been increased by endothelin-1. Increased arterial and pulmonary pressures induced by endothelin-1 administration were rapidly decreased by Olprinone. Renal arterial flow and central venous pressure were, however, unchanged by Olprinone. Overall, Olprinone acutely improved experimental cardiogenic shock (heart failure) induced by endothelin-1, and maintained thoracic duct lymph flow at a high level after endothelin-1 administration.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1997

Thoracic duct cyst in supraclavicular region.

A 28-year-old female attended an outpatient clinic in October, 1989, because of a tumor in the left supraclavicular fossa, detected in a health examination. Following exploratory puncture of the tumor which yielded milky-white fluid, suggesting a cyst in the thoracic duct, she was admitted to our department. The cyst was unilocular measuring about 6 cm in diameter, and the fluid content was chyle-rich in lipids. Lymphography demonstrated a lymphatic structure adjacent to the lesion and scattered lymph vessels on the cyst surface. On November 16 the cyst was resected. A restiform structure was observed between the cyst and the thoracic duct, but the presence or absence of communication was unclear. The histological diagnosis was thoracic duct cyst. Thoracic duct cyst occurring in the cervical region is very rare. Our case may provide useful information as to its pathogenesis and the mode of retention of cyst fluid.

Adult↗
PubMed1992

The effect of outflow pressure upon thoracic duct lymph flow rate in fetal sheep.

Edema develops when lymph does not return to the venous circulation at a rate equal to the rate of capillary filtration. Fetal sheep develop edema as well as an increased central venous pressure while undergoing atrial pacing at 320 beats per min. We hypothesized that the increased central venous pressure augmented the appearance of fetal edema by impairing the return of thoracic duct lymph to the venous circulation. To investigate this hypothesis, we studied the effect of outflow pressure upon thoracic duct lymph flow in 10 unanesthetized fetal sheep who had low resistance lymph catheters placed in the cervical thoracic duct near its junction with the left jugular vein. After the ewe and fetus recovered for 5 d, we altered the outflow pressure of the lymph catheter by adjusting its height with respect to amniotic fluid pressure and measured the resultant change in thoracic duct lymph flow rate. We found that lymph flow rate was constant over the range of outflow pressures (central venous pressures) normally encountered but decreased in a linear fashion at pressures greater than 0.68 kPa (5.1 torr). Lymph flow stopped at an outflow pressure of 2.40 kPa (18 torr). The data points are best fit by two lines obtained by a piecewise linear regression rather than a single line obtained from a linear regression. We conclude that fetal thoracic duct lymph flow is sensitive to elevations in outflow pressure. Lymph flow begins to diminish at outflow pressures corresponding to central venous pressures commonly encountered in pathologic conditions and may augment the appearance of fetal edema.

Animals↗