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At least 811 records · Page 45Linked to original sources
PubMed2001

Vertical rectus abdominis myocutaneous flap cover for lower abdomen, chest wall, groin and thigh defects following resection of malignant tumours.

Vertical rectus abdominis mycutaneous (VRAM) flap provides a reliable flap cover for large soft tissue defects of chest wall, torso, groin, perineum and thigh. It has been mainly used in trauma and benign conditions. Between January 1994 through January 1999, eight patients with locally advanced malignant tumors underwent radical resection and reconstruction using pedicled VRAM flap. Inferiorly based VRAM flap was used in five patients and superiorly based VRAM flap in three patients. Defect size ranged from 144 to 900 CM2. (mean 386 cm2). Average blood loss for combined resection and reconstruction was 600ml. (range 400-800 ml.) Primary closure of both donor and recipient sites achieved in all patients. There was no wound infection, flap necrosis or abdominal hernia. There patients received postoperative radiotherapy and chemotherapy and two patients received radiotherapy only. All the the patients are alive and free of local recurrence at mean follow up 32 months. Results of our study shows that VRAM flap is versatile and sturdy flap with a wide are of rotation and it can reach diverse anatomical sites like torso, chestwall, thigh and perineum to cover large defects following radical resection for tumors.

Adult↗
PubMed2003

Vestibular suppression during space flight.

Normal movements performed while voluntarily fixing the head to the torso can lead to motion sickness in susceptible individuals. The underlying mechanism may involve excessive suppression of vestibular responses. A similar motor strategy is often adopted in the early days of a space flight and might contribute to the development of space motion sickness. In a recent experiment, we monitored the eye, head and upper torso rotations of four Life and Microgravity Spacelab crew members. For the purposes of this study, all data were excluded except for periods during which the subject was performing pure yaw-axis head movements. All subjects showed a significant increase in gaze slip on the first day of their mission, suggesting that increased vestibular suppression was occurring. Furthermore, this amount of increased suppression would have been more than adequate to produce motion sickness in susceptible individuals on the ground. The results support the theory of two, independent mechanisms for space motion sickness.

Fixation, Ocular↗
PubMed1992

16-lead ECG changes with coronary angioplasty. Location of ST-T changes with balloon occlusion of five arterial perfusion beds.

Percutaneous transluminal coronary angioplasty (PTCA) occlusion in five individual coronary artery distributions produced significant ST elevation ("current of injury") in 48/50 PTCAs in 46 patients. Four patients had PTCA of two separate coronary arteries. Two patients had no significant ischemic ST changes in the 16 simultaneous lead ECG and no chest pain with PTCA. The six limb leads were recorded from Mason-Likar locations modified by moving them centrally on the anterior torso; the V leads were recorded in standard locations, except V1 was moved to V3R. Four extra leads were placed as follows: (1) left axilla, (2) left subcostal margin, (3) V8, and (4) midback at the level of V4-V8. The left axillary and back leads discriminated diagonal and left circumflex (LCX) PTCAs from the others and from each other. V6 showed ST elevation in all LCX PTCAs and in only 10% of left anterior descending occlusions. V3R showed ST elevation in 82% of right coronary PTCAs. In 48/50 (96%) of PTCA occlusions the ST elevation was localized to the torso locations defined in Forward Model Simulations as specific for the arterial perfusion bed involved. These data strongly support the hypothesis that additional resolution and sensitivity to ischemic change is to be expected with a broader array of ECG leads.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Multiple superficial basal cell carcinomata--topical imiquimod versus curette and cryotherapy.

BACKGROUND: Superficial basal cell carcinoma can be successfully managed by means other than surgical excision. Nonexcisional approaches include topical imiquimod, and curette and cryotherapy (C&C). OBJECTIVE: This article discusses the management of an insulin dependent diabetic man aged 52 years presenting with 17 torso basal cell carcinomas (BCCs); mostly superficial BCCs (SBCCs). DISCUSSION: Half were treated with topical imiquimod. The remaining lesions were treated with curette and cryotherapy. All lesions resolved with proven histologic clearance. The patient considered C&C caused him less discomfort and disruption. He developed a late secondary infection in some sites treated with imiquimod. At 12 months there was no evidence of recurrence though new nodular BCCs and SBCCs had developed elsewhere on his upper torso. He has elected to have future SBCCs managed with C&C. While excisional surgery remains the benchmark management for nonmelanoma skin cancer, topical imiquimod and C&C are important options for treating SBCCs.

Administration, Topical↗
PubMed2005

Functional training for dentistry: an exercise prescription for dental health care personnel.

Athlete's Performance, an organization of specialists in the development of athleticism and injury prevention, has analyzed the seated postural demands of dental health care workers for the purpose of developing an exercise protocol appropriate to the dental profession. As with their individualized exercise prescriptions for some of the world's most acclaimed athletes, the conditioning of the torso is the focus of a prescription for exercise when injury prevention is emphasized. An analysis of the seated postural demands common to dental health care workers is the basis for an exercise protocol intended to strengthen the torso and encourage "good" seated posture.

Dental Staff↗
PubMedDate not supplied

Comparison of the effects of arm position and support on blood pressure in hypertensive and normotensive subjects.

One hundred and twenty-three hypertensive patients were compared with 120 normotensive subjects, to study the effect of arm position and arm support on blood pressure (BP). The BP tended to increase from the sitting to the standing position in both groups, except when subjects were standing with the arm held out perpendicular to the body, in which case the BP decreased. The lowest standing recordings were observed when the elbow was slightly flexed and supported at this position. The highest BP was observed in the standing position with the arm hanging at the side. Differences in the systolic BP between those with the arm hanging and when it was perpendicular to the torso, or flexed and supported at the elbow were 7.45 mmHg in hypertensives (p = 0.002) and 16.35 mmHg in normotensives (p < 0.0001). Similar figures for diastolic BP were 7.84 mmHg for hypertensives (p < 0.0001) and 9.81 mmHg for normotensives (p < 0.0001). Failure to support the arm at the elbow, even when it was positioned perpendicularly to the torso, led to an increase of 4.87/4.81 mmHg in hypertensives and 7.61/2.83 mmHg in normotensives. Arm position and arm support affect the accuracy of BP measurements. The effect of arm position is more than that of arm support, although they are additive, and more in normotensives. Healthcare providers should adhere to recommended guidelines for BP measurement.

Aged↗
PubMedDate not supplied

Blunt diaphragmatic rupture in elderly patients.

BACKGROUND/AIMS: Severe blunt torso trauma can cause diaphragmatic rupture. Such trauma remains a diagnostic challenge to the trauma surgeon, particularly when the initial chest roentgenogram is unrevealing. Owing to age, preexisting diseases, and poor physiological reserves, elderly patients suffer higher mortality rates after trauma than young patients. The difference between elderly and young patients in terms of blunt diaphragmatic rupture is particularly interesting. METHODOLOGY: Records from 78 patients presenting with blunt diaphragmatic rupture at our hospital from July 1992 to January 2001 were retrospectively reviewed. Age, gender, co-morbid disease, trauma mechanism, associated organ injury, injury severity score, hemodynamic status on arrival at our Emergency Room, injury side and size of diaphragmatic rupture, delay before operation, and postoperative complications and mortality were determined for elderly (> or = 65 years) and young (<65 years) patients. RESULTS: 10 elderly and 68 young patients were collected and reviewed. Elderly patients had higher rate of preexisting disease (60% vs. 16.2%), associated injury of long bone fracture (60% vs. 23%), and initial normal chest roentgenogram (50% vs. 12%) and they had significant delays before operation. Only 20% of elderly patients were operated on within 24 hours of trauma, compared to 87% of young patients, and 50% elderly patients were actually operated on over a week after the trauma. Furthermore, no statistically significant differences existed between elderly and young patients in ISS (19.9 +/- 6.3 & 22.8 +/- 10.4), or the injury side of diaphragmatic rupture, although elderly patients did display shorter diaphragmatic ruptures (5.6 +/- 3.3 & 10.0 +/- 6.0cm, p<0.05), and longer periods on postoperative ventilatory support (17.7 +/- 21.2 & 3.2 +/- 5.0 days, p<0.05). Finally, elderly patients also had significantly higher rates of postoperative complications of pneumonia (30% & 5.9%), and mortality (50% & 2.9%) than young patients did. CONCLUSIONS: Compared to young patients, elderly patients with blunt diaphragmatic rupture had significantly higher rates of initial normal CXR, partly due to shorter length of diaphragmatic rupture, and partly due to ventilatory support, and consequent higher rate of delays before surgery. Furthermore, they also needed longer postoperative ventilator help, and prevailed higher rates of co-morbid disease, postoperative pneumonia, and mortality. Careful initial investigation and prudent radiological follow-up is recommended for elderly patients with severe blunt torso trauma.

Abdominal Injuries↗
PubMed1991

Mechanism of injury influences the pattern of injuries sustained by patients involved in vehicular trauma.

The authors examined the patterns of injury and death rates of patients involved in vehicle-related accidents who were admitted to the Regional Trauma Unit of Sunnybrook Health Science Centre in Toronto. Information was collected prospectively over a 36-month period. The subjects were placed in one of three mechanism-of-injury categories: four-wheel passenger vehicles, motorcycles and pedestrians. The patterns of injury were classified as primarily to the craniofacial and neck area, the torso, the extremities or to multiple regions. There were 815 patients who were involved in vehicle-related crashes and who suffered moderate to severe injuries (at least one region scoring more than 3 on the abbreviated injury scale). The death rate was 13% overall but was 21% in the group receiving multiple injuries. By mechanism of injury the death rates were: pedestrian group 20%, motorcycle group 18% and passenger-vehicle group 11% (p less than 0.01, chi 2 analysis). There was no difference in the mean injury severity score among the mechanism of injury groups. A higher proportion of the passenger-vehicle group sustained isolated craniofacial and torso injuries, and the pedestrian and motorcycle groups sustained more extremity injuries (p less than 0.001, chi 2 analysis). The results reveal a clear association between mechanism of injury and the patterns of injury observed.

Accidents, Traffic↗
PubMed1989

[Injury tolerance of the human skull in relation to simulation of impact acceleration].

A mathematical torso-neck-head model was used to simulate frontal and lateral head impact. The model consisted of nine rigid bodies representing the torso, the seven vertebrae, and the head. The external force acting during impact was described by a triangular force-time function. The impact conditions were varied, i.e., the mass of the head (1.5 and 5.5 kg), the mass (0.1 and 1.0 kg) and velocity (10, 30, and 50 m/s) of the impacting body, and the elasticity (0.5 and 1.0) of the impact. The computer simulations produced linear and angular head accelerations, which were compared with the tolerance level for injury and used to determine the tolerance curves which discriminate between "safe" and "unsafe" acceleration. For the linear head acceleration, the tolerance level was 1000 as defined by the Head Injury Criterion, and for the angular head acceleration the tolerance level was 1800 rad/s2. Our results showed that the risk of head injury was lower for linear head acceleration than for angular head acceleration, and it was lower for frontal impact than for lateral impact.

Acceleration↗
PubMed1988

The inverse problem in electrocardiography: solutions in terms of epicardial potentials.

The objective of the inverse problem in electrocardiography is to recover noninvasively regional information about intracardiac electrical events from electrical measurements on the body surface. The choice of epicardial potentials as the solution to the inverse problem is motivated by the availability of a unique epicardial potential solution for each body surface potential distribution, by the ability to verify experimentally the inverse-recovered epicardial potentials, by the proven relationship between epicardial potentials and the details of intracardiac regional events, and by the possibility of using the inverse solution as a supplement or possible replacement to clinical epicardial potential mapping prior to surgical intervention. Although, in principle, the epicardial potential distribution can be recovered from the body surface potential distribution, the inverse problem in terms of potentials is ill-posed, and naive attempts to reconstruct the epicardial potentials result in incorrect solutions which are highly oscillatory. Large deviations from the actual solution may result from inaccuracy of the data measurement, incomplete knowledge of the potential data over the entire torso, and inaccurate description of the inhomogeneous torso volume conductor. This review begins with a mathematical and qualitative description of the inverse problem in terms of epicardial potentials. The ill-posed nature of the problem is demonstrated using a theoretical boundary value problem. Effects of inaccuracies in the body surface potential data (stability estimates) are introduced, and a sensitivity analysis of geometrical and inhomogeneity parameters is presented using an analytical eccentric spheres model. Various computational methods for relating epicardial to body surface potentials, i.e., the computation of the forward transfer matrix, are described and compared. The need for regularization of the inverse recovery of epicardial potentials, resulting from the need to invert the ill-conditioned transfer matrix, is demonstrated. Several regularization techniques are compared in terms of their performance regarding noise in the data and inaccuracies in geometry and inhomogeneities. Finally, several existing, regularized inverse procedures that compute epicardial potentials from measured body surface potential data are introduced and compared. The review concludes with a section that points toward future directions for improving the quality of the inverse-reconstructed epicardial potentials. Future directions for the use of the inverse problem to obtain epicardial potential distributions noninvasively in both experimental animals and patients in a clinical se

Animals↗
PubMed1988

[Results of the radiotherapy of Hodgkin's disease (a JLRTG report). Japan Lymphoma Radiation Therapy Group].

A total of 234 patients of Hodgkin's disease treated at 7 institutions from 1972 through 1985 were analyzed. Male to female ratio was 157: 77, mean age was 39.8 years, and overall 5- and 10-year survival were 67% and 56%, respectively. Of 126 patients treated by radiotherapy with more than 36 Gy, alone or preceded to other treatments, 5- and 10-year survival rates were 84% and 80% for Stage I (43 patients), 79% and 69% for Stage II (71 pts.), and 52% and none for Stage III (12 pts.), respectively. Survival rate was better for LP, NS and MC histologies as compared to LD, better for patients without constitutional symptoms, as compared to patients with B, and better for patients with ages younger than 59 years as compared to those with ages over 60 years. Relapse was observed in 57 out of 126 patients. Relapse within the irradiation field was observed in only 4, and nodal areas outside the field, especially of abdomen (1/3), were the most common sites. Half of the relapses occurred within 20 months, and 80%, 40 months. Five-year survival of patients after relapse to lower torso lymph nodes (19 patients) was 37%, which was worse than patients after relapse to upper torso lymph nodes (15 patients: 63%) (z = 1.507, N.S.).

Adolescent↗
PubMed1986

Changes in QRS complex in dogs with normal and exaggerated tidal volumes.

The influence of normal and exaggerated ventilation on the QRS was studied in 10 dogs. Peak-to-peak amplitudes of QRS in 4 circumferential unipolar and 2 limb lead ECG were obtained during eupnea and during hyperinflation produced by intermittent positive pressure ventilation or negative extrathoracic pressure. Marked changes were not observed in any lead during eupnea. During hyperinflation to a transpulmonary pressure of 10 mm of Hg (whether by intermittent positive pressure ventilation or negative extrathoracic pressure), voltages decreased in leads I, V10, rV3, and aVF and were variable in leads V3 and V5. Radiography revealed that during the hyperinflation the heart was displaced to the nondependent side of the thorax further from the dependent electrodes and that the heart became generally smaller. Changes in voltage could be attributed to alterations in relationships between the heart and electrodes on the torso surface or to changes in volume conductor properties of the heart and torso.

Animals↗
PubMed1987

Fine grid computer simulation of QRS-T and criteria for the quantitation of regional ischemia.

A comprehensive fine grid simulation of excitation and recovery (QRS-T), realistic cardiac and torso anatomy, and electrophysiologic properties has been developed that produces a total body surface electrocardiogram (ECG) as output. The simulation leads to the specific hypothesis that additional leads on the upper and lower torso, and on the back, are required to optimize the quantitation and localization of regional ischemia and infarction. Criteria in the STT portion of the ECG for quantitating the severity of the ischemia were developed and presented. The combination of the leads in which the STT changes occur and the severity of the STT change provide a testable set of hypotheses for predicting the severity of ischemia, the probable coronary perfusion bed involved, the severity of the perfusion defect, and the severity of the proximal coronary obstruction.

Computer Simulation↗
PubMed1977

[Evaluation of the effects of cooling clothes on the adaptation to prolonged exertion in high temperatures by miners].

In order to improve the working conditions of coalminers exposed to high ambient temperature, the authors have studied the effects of wearing an under-vest and a cowl covering the head and shoulders made in sponge-cloth and soaked with cold water (cooling clothes). Eight coalminers volunteered for this study which included three sessions of prolonged intermittent exercise performed in a climatic room with the following ambient temperatures:--experiment A (comfortable environment): td = 28 degrees C; twb = 20 degrees C; bare head and bare torso;--experiment B (hot environment) :td = 38 degrees C; twb = 30 degrees C; bare head and bare torso;--experiment C (hot environment and cooling clothes) : td = 38 degrees C; twb = 30 degrees C; wet undervest and cowl soaked with cold water (16 degrees C) every 15 minutes. Each experiment included 5 periods of exercise each lasting 15 minutes separated by periods of rest lasting 15 minutes; the exercises were performed on a bicycle ergometer or on a treadmill and their intensity corresponded to 50% of the maximal oxygen intake. In the comfortable environment (experiment A), all subjects completed the experiment without undue fatigue; the final heart rate was 81/min and the final rectal temperature was 37.6 degrees C; the weight loss never exceeded 1 Kg. In the hot environment (experiment B), all subjects were exhausted at the end of the study which had to be shortened in 2 cases. The final heart rate was 125/min and the final rectal temperature 38.8 degrees C; the weight loss was above 2 Kg. The use of the "cooling clothes" in the hot environment (experiment C) resulted in significantly (p less than 0.001) lower heart rate (104/min), rectal temperature (38.3 degrees C) and weight loss (1.5 Kg); all subjects completed the experiment, none was exhausted and the "cooling clothes" were appreciated by all subjects. We conclude that the "cooling clothes" tested in the present study significantly reduce the physiological and subjective strain due to intermittent work in a hot environment; this cooling system is simple, of low cost and our results indicate that it is will be very useful in climatic conditions similar to those adopted in the present experimental protocol. Its usefulness in less severe climates has to be established but it might be limited by the subjective reactions of the subjects to the transient but sudden sensation of cold given by the "cooling clothes".

Adaptation, Physiological↗
PubMed1984

Patterns of skin temperature and surface heat flow in man during and after cold water immersion.

The region of the lateral thorax, previously identified as an area of high heat transfer during cold water immersion, was investigated using heat flow discs and thermography to determine values of local heat flow and surface temperature before, during and after immersion. The effect of different positions of the arms on local heat flow from the torso was also investigated. No large site-to-site variation in local heat flow was detected for immersion in water temperatures in the range 18.7-24 degrees C. When the arms were positioned close to the torso, there was a decrease in local heat flow and an increase in local surface temperatures. Thermographic examinations revealed local regions of elevated temperature after the arms were briefly held against the body in the post-immersion stage. In this circumstance, erroneous results can follow from the assumption that an elevated surface temperature always constitutes a signal of increased regional heat flow.

Adult↗
PubMed1984

Pityrosporum infection in an infant with lesions resembling erythema annulare centrifugum.

Erythematous, scaling patches over the face, torso, and extremities developed in a 2-month-old female infant. The facial lesions enlarged and became confluent, while the torso and leg lesions enlarged and assumed an annular configuration. Spores of Pityrosporum ovale and Pityrosporum orbiculare were found in large numbers in potassium hydroxide preparations from these lesions, a finding confirmed by culture. Clotrimazole ointment was applied, and the lesions resolved within one week, leaving depigmentation. The findings in this case and those of erythema gyratum atrophicans transiens neonatale resembled each other except for the demonstration of Pityrosporum spores. We assume that the disorder in our patient may represent superficial gyrate erythema (erythema annulare centrifugum) induced by Pityrosporum spores.

Administration, Topical↗
PubMedDate not supplied

Contact thermography of spinal root compression syndromes.

A thermographic technique is described that uses cholesteric liquid crystals that change color in response to variations in surface temperature. The crystals are embedded in elastic flexible sheets that conform to the contours of the torso and extremities. The technique is well suited to temperature measurement of individual skin dermatomes and myotomes. Typical heat patterns emanating from the torso and extremities have been observed and correlated with root compression syndromes at low cervical and low lumbosacral levels. The imaging results correlate well with clinical and surgical findings, particularly when the extremity dermatomes are included. The technique objectively documents the subjective complaint of pain and approaches myelography in accuracy. It was in agreement with myelography in 86% of cases and with surgery in 95% of cases. Liquid crystal thermography may, therefore, effectively screen patients of myelography and can complement it in identifying clinically significant abnormalities.

Diagnosis, Differential↗
PubMed1981

The fate of unruptured intrahepatic hematomas.

In 4 year's experience, we admitted 283 patients suffering from severe blunt torso trauma. Sixty-five had serious hepatic injury. Of these, 49 (75.4%) had explosive hemorrhagic hepatic injuries and underwent surgery immediately. The remaining 16 (24.6%) had intrahepatic hematomas (IHHs); three were receiving anticoagulants. Fourteen IHHs were diagnosed by liver-spleen scan within 1 to 3 days after injury, one was diagnosed at autopsy and one during surgery. Nine (56.3%) were successfully treated nonoperatively. Six (37.5%) were initially treated nonoperatively, but required emergency surgery later because of life-threatening complications. The onset of complications occurred from 1 to 28 days after injury. Indications for delayed operative intervention were hepatic abscess with sepsis (four patients) and expanding hematoma and blood loss (two patients). We conclude from this experience that: (1) Patients admitted with blunt torso trauma should undergo liver-spleen scan examinations; (2) IHHs should be treated initially nonoperatively; (3) the observation period for nonoperative management should be at least 28 days; (4) serious sequela of IHHS occur approximately 1 to 28 days after injury; (5) the combination of anticoagulation and IHH is highly lethal and must be treated aggressively; and (6) patient with progressive findings--worsening sepsis, increasing peritoneal findings, evidence of progressive blood loss, or expansion of IHHs--should be treated by urgent surgical intervention.

Adolescent↗