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At least 271 records · Page 15Linked to original sources
PubMed1981

Lung-thorax compliance in the artificially ventilated premature rabbit neonate in relation to variations in inspiration:expiration ratio.

Surfactant-deficient premature newborn rabbits obtained by hysterotomy on day 27 of gestation were tracheostomized at birth, kept in a multichambered pressure-constant body plethysmograph, and subjected to intermittent positive pressure ventilation using a standardized insufflation pressure (30 cm H2O). A sequence of various frequencies (20, 40, and 60/min) and inspiration:expiration (I:E) ratios (1:4, 1:2, 1:1, 2:1, and 4:1) were applied, and the effect of these various respirator settings on tidal volume (VT) and flow was evaluated by means of a Fleisch tube connected to the body plethysmograph. Irrespective of respirator frequency, increasing I:E ratio from the basic setting of 1:1 resulted in increased VT; decreasing I:E ratio had the opposite effect. There was a nearly linear relation between variations in I:E ratio and VT, but the slope of the regression line was steeper at frequencies 40 and 60/min than at 20/min. At a frequency of 20/min, values (X +/- S.D.) for lung-thorax compliance at I:E ratios of 1:4 and 4:1 were 0.50 +/- 0.26 and 0.99 +/- 0.42 ml/cm H2O.kg, respectively. Corresponding figures for frequency of 60/min were 0.21 +/- 0.10 and 0.73 +/- 0.36 ml/cm H2O.kg. At the two higher frequencies and low I:E ratios (less than or equal to 1:1), the duration of the inspiration phase was not sufficient to provide the maximal degree of lung expansion attainable with this insufflation pressure under static conditions. At frequency of 60/min and I:E ratio of 4:1, the expiration was short enough to prevent zero flow before onset of inspiration.

Animals↗
PubMed1980

Bone scanning of the spine and thorax in idiopathic thoracic scoliosis.

Bone scanning of the spine and the anterior thorax was performed in 5 girls with recently diagnosed, progressive, thoracic, idiopathic scoliosis. In all patients, the scan of the spine showed a homogenous isotope uptake which was considered to suggest that, at least during the early stages of the development of the spinal deformity, there are no obvious disturbances of the metabolic activity of the affected vertebrae in idiopathic, thoracic scoliosis. On the contrary, in all patients there were differences in isotope activity between ribs on the left and right side at the costochondral area. In 4 of the patients, the higher uptake was found in the ribs on the concave side, which might indicate that the longitudinal growth of the ribs on this side was increased as compared with that of the ribs on the opposite side. Because of the restricted number of patients allowed to be included in this study, this observation could not be verified statistically and has to be considered preliminary, in need of verification as well as of further investigation.

Adolescent↗
PubMed1994

Effect of neuromuscular blockade on the elastic properties of the lungs, thorax, and total respiratory system in anesthetized pigs.

OBJECTIVE: To evaluate the effect of neuromuscular blockade on the elastic properties of the lungs, thorax, and total respiratory system in pigs anesthetized to suppress spontaneous breathing. DESIGN: Prospective, randomized, experimental study. SETTING: A research laboratory at a university medical center. SUBJECTS: Eight healthy, anesthetized pigs, weighing 22 to 25 kg. INTERVENTIONS: Pigs, with and without muscular blockade, were mechanically ventilated during an infusion of sodium pentobarbital that was titrated to suppress spontaneous breathing activity. MEASUREMENTS AND MAIN RESULTS: No significant differences were observed between pressure/volume curves of the lungs, the chest wall, and the total respiratory system, as determined by inflating and deflating the lungs during anesthesia, with or without neuromuscular blockade, in random order. Functional residual capacity was 985 +/- 87 mL with neuromuscular blockade and 997 +/- 78 mL without neuromuscular blockade (NS). A comparison of the total respiratory system, lung, and chest wall compliances obtained with and without neuromuscular blockade showed high correlations (total respiratory system compliance [r2 = .86]; chest wall compliance [r2 = .83]). CONCLUSION: Neuromuscular blockade does not alter the elastic properties of the lungs, chest wall, or total respiratory system in mechanically ventilated pigs receiving sodium pentobarbital anesthesia to suppress spontaneous breathing efforts.

Analysis of Variance↗
PubMed1977

[Wide-spread haemangioma racemosum of the mediastinum associated with paresis of the diaphragm; a finding to be considered in the differential diagnosis of the arteriovenous aneurysm of the thorax (author's transl)].

The paper reports on a 5 year old boy showing a sprawling haemangioma racemosum of the right side of the mediastinum. The vascular tumor is fed by a tortuous A. thoracica interna dextra and numerous arterial vessels arising from the right subclavian artery and from the aorta including the right coronary artery and branches from the abdominal aorta. The child presents also paresis of the right diaphragm probably secondary to the pressure of the pulsatile tumore along the course of the phrenic nerve. After ligation of three major feeding arteries the continuous murmur disappeared and fatigability and anorexia became less. Apart from this report a review of the literature on vascular malformations of the arterio-venous fistula type within the thorax sums up the most important features of these vascular anomalies: haemodynamics, localisation, clinical signs, therapy, natural history, therapy and etiology.

Arteriovenous Malformations↗
PubMedDate not supplied

[Compliance of the lung-thorax system in pregnancy complicated by pre-eclampsia].

Compliance of the lungs and thorax was studied in 65 pregnant women during cesarean section. The measurements were carried out in a group of healthy controls and in patients with preeclampsia. The detected changes indicated increased rigidity of the lungs even in normal pregnancy. Comparison of the results indicates an appreciable increase of rigidity of the lungs in patients with preeclampsia, this permitting us to regard it as a status involving interstitial pulmonary hyperhydration.

Adolescent↗
PubMed1976

[Experimental model of coronary thrombosis in the closed thorax in swine].

Coronary thrombosis was induced in 14 miniature pigs by means of direct current. The induction electrode was introduced via the common carotid artery into the coronary artery. The intensity of current (1 mA) and the duration of current flow (60 min) were kept constant in all the experimental animals. 6 miniature pigs survived the period of observation (48 h). In all instances, an injury to the intima was the morphopathological location factor. With the exception of one animal, which died after an induction time of 60 min, coronary thrombosis was stated in all the miniature pigs. The experimental arrangement which produces closed-thorax coronary thrombosis is suited for cardiosurgical, physiopathological and pharmacological experiments, especially because the anatomy and the degree of development of the porcine heart are most similar to those of the human heart.

Angiography↗
PubMed2000

Cervical sentinel lymph node biopsy for melanomas of the head and neck and upper thorax.

OBJECTIVE: To describe a clinical experience with sentinel lymph node biopsy (SLNB) of head and neck nodal basins for clinical stage I melanomas draining to these areas. DESIGN: Consecutive clinical case series with a mean follow-up of 10.7 months. SETTING: University tertiary care referral medical center. PATIENTS: Seventy patients with clinical stage I cutaneous melanoma who underwent SLNB of cervical and/or parotid lymph node basins. INTERVENTIONS: Patients underwent same-day preoperative technetium Tc 99m lymphoscintigraphy followed by SLNB using gamma probe and blue dye (66 patients) and blue dye alone (4 patients). Patients with histological evidence of tumor (here in after "positive") according to SLNB results underwent modified cervical completion lymph node dissection, including parotidectomy, as appropriate. Patients without histological evidence of tumor (hereinafter "negative") according to SLNB results were followed up clinically without undergoing completion lymph node dissection. MAIN OUTCOME MEASURES: The rates of SLNB success, SLNB positivity, completion lymph node dissection positivity, complications, and SLNB false-negative results were determined by clinical follow-up. RESULTS: Locations of melanomas in the 70 patients were the face (n = 20), neck (n = 14), ear (n = 9), scalp (n = 9), and upper thorax (n = 18). Locations of basins that underwent biopsy (n = 104) were in the cervical (n = 68), parotid (n = 19), and axillary (n = 17) regions. The mean Breslow thickness was 2.1 mm (range, 0.4-12.0 mm). Sentinel lymph node biopsy was successful in 103 basins (99%). The mean number of sentinel lymph nodes per basin was 2.5 (range, 1.0-8.0). Positive sentinel lymph nodes were found in 12 patients (17%) and 15 basins (14%). Sentinel lymph node biopsy results correlated with the American Joint Committee on Cancer tumor stage (P = .05) and a Breslow thickness of 1.23 mm or greater (P = .03). Additional tumor-containing nodes were noted in 5 (42%) of the 12 patients who underwent completion lymph node dissection, and these results correlated with the presence of multiple positive sentinel lymph nodes (P = .01). There were complications in 3 patients (4%) (seromas in 2 patients and temporary spinal accessory nerve paresis in 1 patient). One nodal recurrence in a basin that was negative according to SLNB results (SLNB with blue dye only) was noted (false-negative rate, 2%). The results of SLNB were accurate in 69 patients (99%). CONCLUSIONS: Sentinel lymph node biopsy using lymphoscintigraphy and blue dye to manage cutaneous melanomas draining to the head and neck nodal areas is reliable and safe. Sentinel lymph node biopsy results correlated with a Breslow thickness of 1.23 mm or greater and the American Joint Committee on Cancer tumor stage. Completion lymph node dissection is recommended after determining positive SLNB results.

Adolescent↗
PubMed2000

FDG PET evaluation of head and neck cancer: value of imaging the thorax.

BACKGROUND: Patients with primary tumors of the head and neck have been reported to have a high rate of synchronous primary tumors of the upper aerodigestive tract. This study was performed to determine whether inclusion of the thorax in the scan volume would be diagnostically useful for positron emission tomography (PET) with [F-18] fluorodeoxy-D-glucose (FDG) in patients with primary tumors of the head and neck. METHODS: FDG PET scans from the midcranium to the diaphragm were obtained on 56 patients with a variety of head and neck tumors on initial examination before definitive therapy. PET findings in the chest were correlated with results of all other imaging studies, biopsy results, and clinical follow-up. RESULTS: In nine studies (16%), areas of increased FDG uptake in the chest were seen and were judged to be tumors. Six of these probably were false-positive results, although one of these six may have been unconfirmed true positives. Of the three confirmed true-positive studies, two were obvious from other routine studies. In only one case did the PET study reveal a significant lesion not found by means of routine evaluation, resulting in a case-finding yield of 2%. If the unconfirmed possible true-positive results are included, the case-finding yield increases to 4%. CONCLUSIONS: No compelling indication was seen for including the chest in PET studies of patients with head and neck cancer.

Adult↗
PubMed1989

Efficacy of computed tomography of the thorax and upper abdomen and whole-body gallium scintigraphy for staging of lung cancer.

To assess the efficacy of performing both computed tomography (CT) of the thorax and upper abdomen and whole-body gallium scintigraphy for staging lung cancer, the results of each test were compared with those obtained by chest radiography and clinical examination in 100 patients. Clinical efficacy was defined in terms of accuracy in staging the tumor based either on surgery, biopsy, or clinical and radiologic follow-up. The CT provided significantly superior accuracy in 27 patients and minor additional staging information in 17 patients compared with the gallium scan. Whole-body gallium scintigraphy provided important additional information in nine patients and minor additional information in a further eight. The diagnostic yield of CT and gallium scanning was considered equivalent in 39 cases. Of the nine cases in which gallium was significantly superior to CT, clinical findings which suggested the presence of metastases had been noted before the scan in four cases. The authors' results confirm the utility of CT for staging lung cancer and indicate that the additional yield from gallium scintigraphy is relatively low provided a thorough history and physical examination have been performed.

Adult↗
PubMed1984

Blunt thorax oesophageal stripping: an emergency procedure for caustic ingestion.

We report our experience with an original procedure which we have applied to the management of acute necrotic caustic burns of the upper gastro-intestinal tract. Blunt thorax oesophageal stripping is performed through a cervicotomy and a laparotomy, thus avoiding a wide pleural exposure and the frequent and often fatal respiratory complications of a thoracotomy. The stripping method permitted survival of 13 of 17 patients and is thus considered to be a safer and more successful technique than open thoracic oesophagectomy.

Adult↗
PubMed1994

Morphology, physiology, and homology of the N-cell and muscle receptor organs in the thorax of the crayfish Cherax destructor.

The serial homology of arthropods, together with our ability to identify individual neurons from segment to segment, and from animal to animal, provides opportunities for studying the changes wrought by natural selection on specific neural elements when functional requirements change in different parts of the trunk. Using this concept as a guide, we studied the morphology and physiology of the thoracic N-cells and muscle receptor organs (MROs) of the crayfish Cherax destructor for evidence of serial homology and functional plasticity. Methylene blue staining, together with anterograde and retrograde filling with cobalt through cut axons, revealed the morphology of the receptors, disposition of their endings, and the pathways of their axons from receptor to ganglion. The seventh thoracic segment has tonic and phasic MROs with receptor muscles in parallel with different heads of the deep thoraco-abdominal extensor muscle. The sixth segment has a tonic MRO with a receptor muscle in parallel with one head of the abdominal abductor. These three receptors are typical MROs complete with accessory nerves. Thoracic segments 1-5 each give rise to one mechanosensory N-cell with a small cell body and long processes ramifying in a target muscle. N-cell 5 is associated with the abdominal-thoracic abductor muscle, and the other four are associated with parts of the epimeral attractor. The responses of N-cells 1-4 range from tonic to phasico-tonic and show a range of thresholds to passive muscle stretch and active contraction. Cobalt introduced into bundles of nerve fibers known to include N-cell axons reveals projections with branching patterns and morphology similar to abdominal MROs. The present findings, together with information on thoracic MROs and N-cells from other species, were tabulated according to neurotome. The clear pattern revealed leads us to propose that N-cells are derivatives of segmentally repeating MROs modified to monitor postural and locomotory movements in the less mobile thorax.

Animals↗
PubMed1995

Ultrasound guided fine-needle aspiration cytology: diagnosis of hydatid disease of the abdomen and thorax.

Eight cases of hydatid disease of the abdomen and thorax were diagnosed by fine-needle aspiration (FNA) cytology under ultrasound guidance. The age of the patients ranged from 28 to 60 yr with a median of 34.5 yr; the male to female ratio was 2:6. None of the cases were diagnosed clinically as hydatid diseases but following ultrasonography suspicion of hydatid cyst was raised in two cases. The locations of cysts were the liver in six cases, the lung in one case, and the mediastinum in one case. FNA yielded clear fluid in five cases and turbid fluid in three cases. Laminated cyst wall, scolices, and hooklets were observed in one case, scolices and hooklets were present in two cases, and laminated cyst wall along with hooklets were seen in two cases. The remaining three cases showed only laminated cyst walls which yielded positive reaction with periodic acid-Schiff reaction. Inflammatory cell reaction in the form of neutrophils was observed in four cases, including the three cases where turbid fluid was aspirated. Epithelioid cell reaction was present in one case. None of our eight cases showed any untoward allergic reaction following FNA.

Adult↗
PubMed1994

Impalement injury of the thorax: report of a case.

We report herein the case of a 33-year-old man who survived an impalement injury of the thorax involving the heart, esophagus, and spinal cord. The patient was transported to our hospital with the impalement object left in situ and it was extracted under cardiopulmonary bypass in an operating room. The important principles of surgical management contributing to the successful outcome of such patients are discussed following the presentation of this case.

Adult↗
PubMed1999

Multichannel magnetocardiographic measurements with a physical thorax phantom.

Artificial dipolar sources were applied inside a physical thorax phantom to experimentally investigate the accuracy obtainable for non-invasive magnetocardiographic equivalent current dipole localisation. For the measurements, the phantom was filled with saline solution of electrical conductivity 0.21 S m-1. A multichannel cardiomagnetometer was employed to record the magnetic fields generated by seven dipolar sources at distances from 25 mm to 145 mm below the surface of the phantom. The inverse problem was solved using an equivalent current dipole in a homogeneous boundary element torso model. The dipole parameters were determined with a non-linear least squares fitting algorithm. The signal-to-noise ratio (SNR) and the goodness of fit of the calculated localisations were used in assessing the quality of the results. The dependence between the SNR and the goodness of fit was derived, and the results were found to correspond to the model. With SNR between 5 and 10, the average localisation error was found to be 9 +/- 8 mm, while for SNR between 30 and 40 and goodness of fit between 99.5% and 100%, the average error reduced to 3.2 +/- 0.3 mm. The SNR values obtained in this study were also compared with typical clinical values of SNR.

Cardiology↗
PubMed2004

[Radiological diagnostics of Hodgkin- and non-Hodgkin lymphomas of the thorax].

Malignant lymphomas belong to the most important malignant diseases in western countries with an increasing incidence of Non-Hodgkin lymphoma. The thorax is the location of primary manifestation especially in patients with Hodgkin's disease. Progression of disease and therapy associated complications are frequently located in the chest. Based on morphological imaging criteria the two types of lymphoma cannot be differentiated, helpful for differentiation is, however, the way of disease spread. Primary and secondary thoracic lymphoma represent a diagnostic challenge in radiology: the patterns are variable in radiography as well as in computed tomography and alter under therapy. Radiological studies, especially CT, are an integral part of the staging process. MRI is considered advantageous for chest wall disease. PET as functional imaging technique has its proven role for staging of high grade lymphomas, the combination of functional and morphological information provided by PET-CT will become the first diagnostic standard in the future.

Diagnosis, Differential↗
PubMed2001

Hearing dimorphism, trait variation and conflicts over space in the thorax of the bushcricket Requena verticalis (Listroscelidinae: Tettigoniidae: Orthoptera).

The hearing system of Requena verticalis is sexually dimorphic. Previous work has shown size of the auditory spiracle determines absolute threshold and as female spiracles are, on average, larger than males, females are more sensitive to the main energy of the male call. In all measured traits in morphology and physiology, females showed lower coefficient of variation than males. This difference was significant for bulla volume and hearing threshold. In addition, female ear size covaries with thorax dimensions but this is not so in males. Such a finding suggests stabilising selection on ear size in females, perhaps explained by the requirement of females to recognise and locate the male. As the auditory bulla is larger in females than males, so occupying thoracic space, we suggest a possible trade-off in this brachypterous species between hearing sensitivity and sound production. Finally, we examine relative growth of body structures not associated with hearing and those that influence hearing sensitivity. Scaling, where traits are under strong selection, may result in allometry. Female hearing traits show positive allometry with absolute size and while the relationship between bulla volume and spiracle area was positively allometric in females this was not the case for males.

Animal Communication↗