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At least 1,027 records · Page 57Linked to original sources
PubMed1999

[Cleaning cavity operation in treating relapse bacillary cavitary pulmonary tuberculosis].

OBJECTIVE: To study the effective surgical way for serious relapse multidrug resistant bacillary cavitary pulmonary tuberculosis. METHODS: 104 cases of serious relapse multidrug resistant bacillary cavitary pulmonary tuberculosis were cured by cleaning cavity operation from 1981 to 1998. The operation contained resecting the back rib covering the cavity, separating the intercostal tissue, cutting the external wall of the cavity, cleaning the cavity thoroughly, scraping the cavity till exposing the fresh tissue, killing the tuberculosis germs with organic acid, filling the cavity with the intercostal muscle, fixing and suturing the muscles. RESULTS: Among the 104 cases, 103 cases (99.0%) were cured, 101 cases (98.1%) were cured after the first operation, one case (1.0%) became better. Among the 98 cases followed up, the rate of returning to work were 96%, no one died or relapsed. CONCLUSIONS: The design of cleaning cavity operation is reasonable and it is the effective method to treat the relapse bacillary cavitary pulmonary tuberculosis, the rate of cure and sputum conversion are promising.

Adult↗
PubMed2001

Diagnosis and treatment of bronchial rupture from blunt thoracic trauma.

OBJECTIVE: To evaluate the diagnosis and management of bronchial rutpture from blunt thoracic trauma. METHODS: A group of 31 patients with bronchial rupture was involved. Chest roentgenography, tomography and bronchoscopy were performed on all patients. The surgical technique and complications were described. RESULTS: Diagnosis was confirmed by tomography and bronchoscopy in all the patients. End to end anastomosis was used in 26 patients. Four patients were operated with total pneumonectomy. One patient was repaired with an intercostal muscle and rib flap with blood supply. Of the 31 patients, one died of adult respiratory distress syndrome after operation. Most patients had excellent surgical outcomes. 81% (25/31) of the bronchial rupture were delayed in diagnosis and treatment. The classic symptoms and signs of bronchial rupture included subcutaneous emphysema, dyspnea and an intermediate coma interval. The roentgenogram showed mediastinal emphysema, pneumothorax, "drop lung" sign and marked radiodensity of hilum widened mediastinum. CONCLUSION: Bronchoscopy is a useful and accurate method to diagnose and treat the bronchial rupture, with which surgeons can easily locate the rupture site during surgery. Surgical treatment could restore pulmonary function in most patients.

Adolescent↗
PubMed2002

[Congenital tracheoesophageal fistula; report of an adult case].

We experienced an adult case of congenital tracheoesophageal fistula which was successfully treated by surgical intervention. A 69-year-old female was admitted with complaint of coughing and fever. The patient previously had had several episodes of pneumonia. Esophagography and thoracic CT demonstrated a tracheoesophageal fistula in the upper of the thoracic esophagus. Following the resection of the fistula, the trachea was closed with one layer suture and the esophagus was closed with two layer sutures. A pedicled fifth intercostal muscle was interposed between the tracheal and esophageal suture lines. There was mild inflammatory change in surrounding tissues of the fistula. Pathological examination revealed that the fistula was covered with the squamous epithelium, and had the muscularis mucosa. Her postoperative course was uneventful.

Aged↗
PubMed2002

[Castleman lymphoma originated from the posterior mediastinum resected thoracoscopically: report of a case].

We report thoracoscopic resection of Castleman lymphoma originated from the posterior mediastinum. The patient was a 19-year-old woman, who was pointed out to show an abnormal shadow in the left upper lung in the chest X-ray photograph. It was diagnosed as a blood-rich posterior mediastinal tumor by dynamic MRI, and thoracoscopic surgery was performed. The tumor was adjacent to the vertebral body of the fourth thoracic vertebra. Although operation involved 2 hours and 40 minutes and 670 ml of bleeding due to a strong adhesion between the tumor and the intercostal muscle and considerable bleeding from the tumor itself, it was successfully removed under thoracoscopy. The tumor was elastic and hard, and 50 x 45 x 25 mm in size. The histopathological diagnosis was a Castleman lymphoma, hyaline vascular type. The postoperative course was satisfactory, and the patient was discharged from the hospital on the 7th postoperative day. Castleman lymphoma originated from the posterior mediastinum tends to bleed considerably during its resection. If a blood-rich posterior mediastinal tumor was found preoperatively, thoracoscopic operation must be advanced carefully keeping this disease in mind.

Adult↗
PubMed1997

[Respiratory and hemodynamic responses to microinjections of opioids into the solitary tract nucleus].

Microinjections of morphin and leu-enkephaline into the solitary tract nucleus of anaesthetised rats induced a dose-dependent decrease in tidal volume and in external intercostal muscle activity. In addition, leu-enkephaline and -endorphine decreased the respiration frequency. The respiratory effects were accompanied by a decrease in the mean blood pressure and heart rate. Naloxone administration exerted an opposite effect. The data obtained suggests an involvement of opioid peptides in respiratory and circulatory control via the solitary tract nucleus.

Animals↗
PubMed2002

Surgical management of esophageal perforation: role of esophageal conservation in delayed perforation.

Definitive repair of esophageal perforation is considered the preferred treatment for patients presenting early (<24 hours). However, the optimal management of delayed presentation (>24 hours) has not been well defined. This study examined the management of esophageal perforation and compared the outcomes of early versus delayed presentation. Records of patients admitted with the diagnosis of esophageal perforation were reviewed. Contrast studies were used to confirm the diagnosis in all cases. Patient demographics and outcome were analyzed to determine differences between early and delayed presentation. A total of 22 cases of esophageal perforation were identified (eight early vs 14 delayed presentations). Operative interventions included primary repair (four), reinforced repair (14) either with intercostal muscle or pleural flap, and a complete esophageal resection (one). Debridement and drainage without repair were done in two patients and a proximal intramural tear was treated with antibiotics and observation. Two patients died during hospitalization. All surviving patients had near-normal restoration of esophageal function. Follow-up at 3 years has shown minimal gastrointestinal problems. One patient required repeat esophageal dilatations and two patients underwent antireflux therapy. Esophageal repair should be considered in all cases of nonmalignant esophageal perforation and should not be influenced by the time of presentation.

Debridement↗
PubMed2002

[Pyothorax in pneumonectomy cavity. Apropos of 24 cases].

AIM OF THE STUDY: Describe as series of post-pneumonectomy empyema episodes, with or without bronchial fistula treated at the department of Thoracic Surgery, University of Ibn Sina, Rabat, Morocco. PATIENTS, METHOD AND RESULTS: Twenty-four patients with post-pneumonectomy pyothorax cared for between 1991 and 2000 were reviewed retrospectively. There were 15 men and 9 women, mean age 34 years. Pneumonectomy was indicated for tuberculous pyothorax and destroyed lung (n = 8), 8 destroyed lung (n = 8), pulmonary aspergilloma (n = 2), pulmonary hydatidosis (n = 2), bronchial dilatation (n = 2), lung cancer (n = 1), and bullet wound (n = 1). The patients were divided into two groups according to presence or absence of bronchial fistula: group 1, 19 patients with without bronchial fistula, and group 2 5 with bronchial fistula. Fourteen patients in group 1 (73.7%) achieved definitive cure, 12 after drainage and washout (63%) at mean delay of 45 days and 2 after drainage and washout with thoracoplasty. Five patients did not respond to hospital drainage and washout and remained under definitive ambulatory drainage as they declined further surgical treatment. One death occurred in this group. Two patients in group 2 (40%) achieved definitive cure, one after daily aspiration, and the other after thoracoplasty. Two fistulae in one patient were treated with nitratage. For this patient, we also attempted revision of the bronchial stube via posterior throacotomy, the closure of the bronchial fistula using an intercostal muscle flap associated with thoracoplasty. All these methods failed. There were two deaths in this group. CONCLUSION: Sixteen patients were definitively cured (66.6%). Eight patients (33.3%) remain in a chronic condition. Patients with pyothorax on a pneumonectomy cavity should be managed in specialized centers before reaching the chronic stage. Thoracomyoplasty with preparation of the cavity by thoracostomy should be proposed.

Adolescent↗
PubMed1976

Foetal rhabdomyoma. Case report of a patient with two tumours.

A case report of a girl with two foetal rhabdomyomas is presented. One tumour was a small cutaneous lesion present at birth in the left thigh and the other was located in the chest wall deeply in the subcutaneous tissue and attached to the adjacent intercostal muscle. The patient also had the naevoid basal cell carcinoma syndrome which lends credence to the opinion that foetal rhabdomyoma is a malformation rather than a true neoplasm.

Basal Cell Carcinoma↗
PubMed2002

Comparison of selenium distribution in mice organs after the supplementation with inorganic and organic selenium compound selenosemicarbazide.

Studies on selenium organ content and its function in living organisms just like studies on other elements provide interesting results although their interpretation is not always clear. The aim of our study was to determine the concentration and distribution of selenium in several organs and tissues in mice after supplementation with our newly synthesized organic compound of selenium selenosemicarbazide (4-o-tolyl-selenosemicarbazide of o-chlorobenzoic acid) as compared to the effects of the supplementation with inorganic compounds. SWISS mice were fed with both types of compounds at the dose of 10(-3) g Se per kg for the period of 10 days. The concentrations of selenium in brains of mice treated with selenocarbazide and sodium selenite were higher than in controls (38.04 micrograms g-1 and 32.00 micrograms g-1 vs. 26.18 micrograms g-1). There was a statistically significant increase in the selenium contents in lungs after supplementation with selenosemicarbazide and sodium selenite (11.81 micrograms g-1 and 6.79 micrograms g-1 vs. 1.75 micrograms g-1 in controls). We found a statistically insignificant increase in selenium contents in intercostal muscles after supplementation with inorganic selenium compounds and a statistically significant increase after the supplementation with selenosemicarbazide (10.13 micrograms g-1; 14.21 micrograms g-1 and 28.84 micrograms g-1, respectively). Our investigations lead to a conclusion that 4-o-tolyl-seleno-semicarbazide of o-chlorobenzoic acid, an organic selenium compound may be more easily absorbed than inorganic sodium IV selenite.

Administration, Oral↗
PubMed2003

[So-called benign broncho-esophageal fistula].

Broncho-oesophageal fistulae are rare lesions and may be benign or malignant. The articles in medical literature generally concern one case of BEF, and rarely more cases. The term "benign" is debatable, considering the severity of this disease in view of the aetiology and the bronchopulmonary complications. The aetiology in the past was connected to tuberculosis or toxoplasmosis, now to bacterial, viral or fungal infections. The Authors report three acquired cases and one congenital. They confirm the importance of anamnesis, symptomatology and oesophagography for diagnosis and CT scan for detection of pulmonary lesions. The treatment is surgical with resection of fistula and suture of the oesophagus and bronchus, interposing pleura or pericardium or intercostal muscle.

Bronchial Fistula↗
PubMed2003

Congenital hypomyelinating neuropathy.

An eleven-month-old baby born out of non-consanguineous parentage presented with history of delayed motor milestones. The weakness was predominantly distal; there was intercostal muscle weakness, generalized hypotonia and areflexia. The nerve conduction velocities were unobtainable in all the four limbs. Sural nerve biopsy was consistent with the diagnosis of congenital hypomyelinating neuropathy, a rare form of hereditary motosensory neuropathy.

Biopsy, Needle↗
PubMedDate not supplied

[Respiratory form mof myasthenia gravis].

BACKGROUND: Extraocular, facial, bulbar and intercostal muscles are frequently affected in juvenile myasthenia gravis, especially during exacerbations. Acetylcholine receptor antibodies are often present in the blood in this type of myasthenic syndrome. CASE REPORT: A girl presented with an exertional dyspnea at the age of 13 years, that improved after rest. All investigations were negative, except for lung function tests that showed a restrictive pattern. The diagnosis of juvenile myasthenia gravis was finally made at the age of 15 years because of the recurrence of sudden exertional dyspnea and a history of subtle weakness on repetitive movement leading to poor suckling, together with vocal and occasional swallowing difficulties. Dyspnea immediately improved after intravenous injection of 1 mg neostigmine, but the response was transient. No acetylcholine receptor antibody was found and a search for thymoma proved negative. Ambenonium chloride (Mytelase) was effective on clinical exacerbations, but the only improved test after 9 months of treatment was the functional residual capacity. CONCLUSION: Anticholinesterase drugs must be tried in patients who present exertional dyspnea without bronchopulmonary or cardiac disease on the presumption of myasthenia gravis even when ocular or bulbar manifestations are absent.

Adolescent↗
PubMed2005

Cutaneous fascioliasis: a case report in Vietnam.

A 40 year-old woman living in Gialai, Kontum, Vietnam, developed a red solid mass in the epigastric region. From ultrasound investigation, liver abscess and myositis of the intercostal muscle was diagnosed. Two weeks after treatment with antibiotics, the mass disappeared, but a migratory track developed in the right upper quadrant of the abdomen. An aspiration of the vesicular end of the serpiginous track showed a light brown, living worm that was later identified as an immature Fasciola sp. This is the first case report of cutaneous fascioliasis in the form similar to creeping eruption.

Adult↗
PubMed2005

Postoperative bronchial stump fistula responding well to occlusion with metallic coils and fibrin glue via a tracheostomy: a case report.

An 80-year-old man underwent middle and lower lobectomy of the right lung to treat squamous cell carcinoma (SCC) (4 cm in diameter) originating from the right B4 bronchus. On the 4th postoperative day, a massive air leak from the thoracic drain was noted. At that time, a diagnosis of bronchial stump fistula was made on the basis of the bronchoscopic findings. Continuous thoracic drainage, aspiration of sputum via a tracheostomy and intravenous administration of antibiotics were performed immediately after the diagnosis. However, the patient's condition was complicated by aspiration pneumonia. On the 11th postoperative day, bronchoscopic procedure to close the bronchial fistula was performed via the tracheostomy. During this procedure, metallic coils were first inserted into the fistula to serve as the core for occlusion. Then, instead of directly infusing fibrin glue, several small beans-sized pieces of Surgicell cotton (Johnson & Johnson Co., Cincinnati, OH) soaked in fluid A (concentrated fibrinogen) and the same number of Surgicell cotton pieces soaked in fluid B (thrombin) were alternately inserted into the fistula, to allow closure of the bronchial fistula. After this procedure, the embolus created remained in place without being expectorated, and the aspiration pneumonia entered remission, allowing the patient to be discharged from the hospital on the 24th postoperative day. At preset, 14 months after surgery, the patient is in good condition. This technique allows simple and reliable closure of a fistula if a tracheostomy is available. It should be selected as a therapy of first choice when dealing with patients with a postoperative bronchial stump fistula in poor general condition. Patients undergoing right pneumonectomy or middle and lower lobectomy of the right lung should be considered as belonging to a high risk group for bronchial fistula and as requiring preventable measures (e.g., covering the stump with an intercostal muscle flap).

Aged↗
PubMed1992

[A case of postpneumonectomy empyema cured by open drainage thoracotomy and thoracoplasty with pectoral myoplasty].

The patient was a 57-year-old male with lung adenocarcinoma arising in right upper lobe. Because the tumor invaded to the trunchus intermedius and B6, right upper lobe, middle lobe and S6 was resected with bronchial plasty which was performed between the main bronchus and basal bronchus. Because the bronchial fistula appeared after 12 days of operation, completion pneumonectomy was performed, and the stump of the main bronchus was covered with intercostal muscle. Although fistula of the bronchial stump did not appear, open drainage thoracotomy was performed because of deterioration of empyema due to methicillin resistant staphylococcus aureus (MRSA). After 10 weeks of open drainage, although MRSA did not disappear, the thoracoplasty with interthoracic transposition of the major and minor pectoral muscles was performed. Empyema was cured, and the patient left the hospital 2 weeks after thoracoplasty. Thoracoplasty with pectoral myoplasty was useful for single-staged closure of post-pneumonectomy empyema.

Drainage↗
PubMed1992

A case of monensin poisoning in ostriches.

A clinical case of monensin poisoning in ostriches is presented. Analytical results and histopathologic changes in intercostal muscles and liver supported the ionophore toxicity diagnosis.

Animals↗
PubMed2005

[Prolonged hiccups causing worsened quality of life--successful medical therapy].

Hiccups are intermittent, involuntary spasmodic contractions of the diaphragm and the intercostal muscles leading to the cessation of inspiration due to an abrupt closure of the glottis. Hiccups are usually innocuous phenomena, which could easily be terminated by simple manoeuvres but sometimes they become permanent and intractable causing significant decline in the patient's quality of life. Besides a number of provoking exogenous factors hiccups are caused by organic or psychical disorders. This why in cases of permanent hiccups detailed investigations are important. Beyond physical manoeuvres, pharmacotherapy, surgical intervention and some other therapeutic measures may be effective forms of treatment. In the present report the authors give a review of two patients, whose permanent hiccups were successfully treated with combined medical therapy. They review the causes and therapy of permanent hiccups and call the attention to the therapeutic value of baclofen, a gamma-aminobutyric acid analog compound.

Adult↗
PubMed2000

Stress fracture of the eighth rib in a female collegiate rower: a case report.

OBJECTIVE: To present the case of a stress fracture of the eighth rib in a female collegiate rower. BACKGROUND: A female collegiate rower experienced severe pain in her chest, increasing with movement, deep breathing, and erect posture. No acute mechanism of injury was apparent. The team physician diagnosed a rib stress reaction based on clinical examination. The athlete rested for 2 days and then was able to resume rowing workouts. Five months later, she experienced the same sharp pain, with the diagnosis and treatment being the same. The athlete was able to compete in the championships 3 weeks later. At the end of the season, a bone scan revealed a stress fracture of the eighth rib. The athlete rested for 3 weeks and then returned to activity. DIFFERENTIAL DIAGNOSIS: Intercostal muscle strain, serratus anterior muscle strain. TREATMENT: Active rest, involving pain-free cardiovascular workouts and weight training, cessation of rowing until the athlete was asymptomatic, strengthening of dynamic support structures, and analgesic modalities. UNIQUENESS: Most stress fractures occur in the lower extremity. Those that do occur in the rib cage most often involve the first rib. A limited number of published works have addressed stress fractures to the remaining ribs; of these, posterior and posterolateral fracture sites are most often reported. This case is unique in that the fracture site was on the anterolateral aspect of the eighth rib. CONCLUSIONS: Stress fractures are thought to result from a variety of causes, including muscular fatigue, sudden changes in training intensity or duration, and microtrauma to bone at the muscular origin and insertion sites ("wear-and- tear" theory). In addition, hormonal factors in women can predispose an athlete with amenorrhea to a decrease in bone mineral content. Athletic trainers should be aware of these potential causes and focus on the prevention of stress fractures.

Journal Article↗