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PubMed2006

Coexistent lung carcinoma and active pulmonary tuberculosis in the same lobe.

We observed a rare case of lung carcinoma accompanied by active pulmonary tuberculosis in the same lobe. The chest x-ray of a 49-year-old man revealed an abnormal shadow in the right upper field and a giant bulla in the left upper field. Chest computed tomography (CT) revealed a nodule with consolidation, which was not continuous in the right S3. Bronchoscopically, epidermoid carcinoma existed in the proximal right upper bronchus. In the sputum specimens, the smear was negative, but the polymerase chain reaction of Mycobacterium tuberculosis and culture was positive. Anti-tuberculosis treatments were administered for approximately 4 weeks, but the chest x-ray remained unchanged. Right upper lobectomy with bronchoplasty (wedge resection of the right upper bronchus) was performed, and the anastomosis was covered with an intercostal muscle flap. Lymphadenectomy of the right hilum and mediastum was also performed. Microscopy revealed epidermoid carcinoma in the proximal tumor (pT3N0M0-stage IIB) and epithelioid granuloma with caseous necrosis, granulomatous pneumonia, exudative lesions, and fibrocaseous nodules in the distal lung. After surgery, anti-tuberculosis treatment was resumed.

Antitubercular Agents↗
PubMed2006

A case of needle tract implantation of hepatocellular carcinoma after percutaneous biopsy with an 18G Tru-cut needle.

Needle tract implantation of hepatocellular carcinoma (HCC) is a rare complication of percutaneous biopsy, and it is largely associated with end-cutting needles or aspiration biopsy. The CT findings that have been reported include oval or round soft tissue nodules with persistent contrast enhancement along the needle tract, mostly in the subcutaneous tissue or the intercostal muscle layers. In this report, we describe a case of needle tract implantation of HCC after US-guided percutaneous biopsy with an 18G tru-cut needle.

Adult↗
PubMed2006

[Solid variant of aneurysmal bone cyst; report of a case].

We report a rare case of a solid variant of aneurysmal bone cyst (ABC) of the right 4th rib. A 29-year-old woman was admitted to our hospital for an abnormal shadow on chest X-ray. Chest computed tomography (CT) demonstrated the lesion mass to be located in the area of the right 4th rib. Bone scintigram revealed a hot spot in the right 4th rib. The right 4th rib was resected en bloc with the parietal pleura, and adjacent intercostal muscles via right anterior thoracotomy. Postoperative pathological evaluation was consistent with a solid variant of ABC.

Adult↗
PubMed1991

[Clinical forms of respiration disorders in newborn infants].

Ventilatory disturbances are the most often cause of death in neonates. The study was carried out on 80 neonates, treated in the intensive care unit. In all during the first 48 hours the following symptoms occurred: tachypnoea (above 60 per minute), cyanosis, retraction of the intercostal muscles, expiratory disturbances. Diagnosis of clinical forms of ventilatory disturbances was made basing on Hjalmarson's criteria. The results of this study imply that the most often seen form of ventilatory disturbances in neonates in the hyaline membrane disease--found in 45% of the cases. The highest mortality (75%) was seen in the meconium aspiration syndrome.

Humans↗
PubMed1991

[An approach to correcting scoliosis. Mechanism and operative procedure].

In the treatment of scoliosis, we found that soft tissue contracture on the concave side is the main force maintaining deformity, resisting correction and rejecting implants. So the release of contracture would get rid of the bow-string effect of the contractured tissues from the main curve, such as the capsules and ligaments around costo-transverse joints, the inter-transverse and intercostal muscles, together with the posterior section of the corresponding ribs would also be taken off by those shrunken tissues close to the main curve, like the capsules and ligaments around the costo-vertebral joints. Since 1982, 23 patients aged 6 to 16 years were treated operatively. The operation was done in 2 stages: contracture release on the concave side and fusion with bone grafting on both side laminae through body cast. Follow up for 1 to 8.5 years showed satisfactory results. The mechanism and effect of soft tissue contracture of idiopathic and congenital scoliosis are discussed in detail.

Adolescent↗
PubMed1991

[A case of cystic hygroma of the chest wall].

Hygroma is generally regarded as a benign tumor occurring favoritely in the cervical region of a child. Recently we have experienced a case of hygroma which was initially detected as a right chest wall tumor in a 16-year-old man, then was surgically diagnosed as cystic hygroma; chest roentgenography on a check up examination in his senior high school pointed out some anomaly, leading to his hospitalization. On admission, he had no subjective symptom, but chest roentgenography and CT confirmed an abnormal shadow in the right pulmonary area and a tumor with calcification on the right chest wall, respectively, so he was operated on for excisional biopsy. The tumor was extirpated together with the 7th intercostal muscle adhered to the tumor, and postoperative pathohistological examination led to diagnosis as cystic hygroma. Cystic hygroma of the chest wall is so rare that we would like to report this case, together with some addition consideration of related literature.

Adolescent↗
PubMed1990

[Techniques involved in the protection of the lung and heart-lung for the purpose of transplantation].

Impaired healing of the bronchial anastomosis and its subsequent complications has been an important problem following lung transplantation. The decrease in the dosage of steroids, the use of cyclosporine immunosuppressive therapy and the use of an omental flap to revascularize rapidly the bronchial anastomosis, have reduced considerably the incidence of these post-operative bronchial complications. We have recently demonstrated that the application of a pedicled intercostal muscle graft or peritracheal membrane adipose tissue wrap on the bronchial anastomosis improved bronchial healing by restoring a vascular flow across the anastomosis within 7 days after left lung allotransplantation. Since the introduction of heart-lung transplantation at Stanford (USA) in 1981 and Pittsburgh in 1982 for the treatment of Eisenmenger's syndrome and terminal pulmonary vascular diseases, more than 250 combined heart-lung transplantations have been carried out throughout the world. However the present intermediate and long term results obtained with this operation have not yet reached the same level of success as cardiac transplantation alone. While several factors such as selection of candidates and donors have played a role in this difference, a prominent cause has been the lack of a reliable and simple method for pulmonary protection against prolonged ischemia. Most of the techniques proposed against ischemia can be classified as normothermic or static hypothermic cardiopulmonary preservation. The utilization of the normothermic method has not always been successful. For this reason, interest has now been directed towards the potential for hypothermic preservation of the heart-lung bloc and the use of free radical scavenger therapy in the reduction of reperfusion injury.

Animals↗
PubMed1990

[A case of giant cell tumor originating in the rib].

A rare case of giant cell tumor originating in the rib is reported. A 23-year-old female was admitted because of a mass in the right chest wall, right back pain and bloody pleural effusion. Exploration revealed tumor originating from the 2nd or 3rd rib and invading the intercostal muscles and the right lung. We completely resected the tumor with chest wall and performed right pneumonectomy. The defect of the chest wall was reconstructed using polyester mesh covered with a Gore-tex soft tissue patch. The pathological diagnosis was a malignant giant cell tumor of the rib. She is now doing well and has had no recurrence for 18 months since the operation.

Adult↗
PubMed1990

[Cervical spinal epidural abscess: case report].

Most cases of spinal epidural abscesses occur in a midthoracic or lower lumbar location. Cervical spinal epidural abscess is distinctly rare, and its prognosis is not favorable due to respiratory problems. We report a case of cervical spinal epidural abscess. A 77-year-old male was admitted because of tetraparesis and dyspnea. Two months before admission, he had been treated by femoro-femoral bypass for arteriosclerosis obliterans , and he had suffered from postoperative wound infection one month later. He had noticed neck pain two days before admission, followed by a numbness and motor weakness in both hands. Neurological examination showed flaccid tetraplegy with an absence of DTRs, paralysis of intercostal muscles, loss of sensation below the C4 dermatome, and bladder dysfunction. A spinal CT scan revealed a mass lesion in the anterior epidural space from C2 to C6, which displaced the spinal cord posteriorly. A myelogram showed complete blockage of contrast medium at the level of C7-T1. He was treated by emergency laminectomy of C3 to C6 with evacuation of the epidural abscess. Culture showed staphylococcus aureus, for which appropriate antibiotics were administered. In spite of such an intensive treatment, the patient showed poor neurological improvement and died 42 days after operation.

Abscess↗
PubMedDate not supplied

[Extra-arachnoid subdural injection, an accident of peridural anesthesia].

Two cases are presented, with accidents of peridural anesthesia, Anesthesia of the entire brain stem, paralysis of the intercostal muscles, and of the upper limbs, apnoea and miosis that developed later indicate an extension of the anesthetic effects far higher that it could have been expected considering the technical details of the procedure. On the other hand the absence of any durable coma, of extreme mydriasis, and of severe arterial hypotension, as well as the relatively rapid retrocession of the additional effects of the administration of an anesthetic exclude the possibility of total rachianesthesia, and it can be concluded that there was an accidental injection of anesthetic in the extra-arachnoid subdural space.

Adult↗
PubMed1989

[Therapy of parenchyma and bronchus fistula in chronic pleural empyema and the remaining empyema cavity].

The peripheral bronchial fistula, which is not visible by direct endoscopic examination, is closed by endoscopic application of fibrin glue. Sometimes only conservative therapy with irrigation of the pleural space is sufficient and effective. The postlobectomy fistula of the bronchus stump is treated by preoperative puncture and irrigation of the pleural space, followed by a corrective reamputation of the stump of the bronchus or a sleeve resection with end-to-end anastomosis. The post-pneumonectomy fistula has to be corrected by preoperative irrigation of the pleural space and a corrective second amputation by an extrapleural transmediastinal procedure. Sometimes it is necessary to use an opposite posterior access. An alternative is to cover the stump by an intercostal muscle flap without directly closing the fistula by suture. The remaining pleural space must be obliterated by using an additive pedunculated muscle flap of the thoracic wall.

Bronchial Fistula↗
PubMed1977

Autopsy of an Egyptian mummy (Nakht--ROM I).

Autopsy of a 3200-year-old Egyptian mummy by an international multidisciplinary team yielded much information about diseases of the ancient past. Major contributions were made by the disciplines of anatomy, dentistry, genetics, hematology, histology, microbiology, nuclear medicine, occupational medicine, orthopedic surgery, otolaryngology, pathology, pediatrics, plastic surgery, radiology and virology. Scientists from Toronto, Detroit, Philadelphia and Cardiff participated in the investigation. The following were the main findings of medical interest: skeleton, infection or malnutrition as suggested by Harris's lines in distal femoral metaphyses; muscle (intercostal), cyst of Trichinella spiralis; lungs, deposits of anthracotic pigment and granite particles; spleen, enlargement with evidence of possible rupture; liver, early cirrhosis and calcified ova of Schistosoma sp.; kidney, calcified ova of Schistosoma sp.; and large and small intestines, calcified ova of Schistosoma and Taenia spp. This autopsy demonstrated the value of well coordinated efforts by specialists in various medical disciplines. Such efforts are essential when such a rare scientific endeavour is to yield a maximum of useful and reliable information.

Adolescent↗
PubMed1986

A quantitative ultrastructural comparison of alpha and gamma motoneurons in the thoracic region of the spinal cord of the adult cat.

The cell bodies of motoneurons supplying both the levator costae and external intercostal muscles were identified after retrograde labelling with horseradish peroxidase. A quantitative ultrastructural comparison of cell bodies of large (greater than 40 microns) and small (less than 30 microns) diameter revealed that the intracellular appearance of large and small motoneurons was similar. However, small motoneurons had less than half the synaptic terminal frequency or cover of large motoneurons. Furthermore, only synapses of the S- and F-type were seen on small motoneurons, while S- T- F- and C-type terminals were consistently seen on large motoneurons. The variation between individual small motoneurons for various aspects of their synaptic features was more than twice that found for large motoneurons. No correlation between small motoneuronal ultrastructure and cell body diameter was found, although scatter diagrams of synaptic terminal cover against cell body size indicated the presence of two groups of small motoneurons: one with relatively high values for synaptic cover and the other with relatively low values. On the basis of the similarity of their cell body diameters to those of electrophysiologically identified alpha and gamma motoneurons, it is concluded that the large and small motoneurons examined in the present study are alpha and gamma motoneurons respectively. The synaptic difference found between alpha and gamma motoneurons is discussed in relation to both their different functional properties and the different natures of their respective peripheral targets.

Animals↗
PubMed1979

[Effect of inspiratory resistance loading on temporal parameters of respiration in anesthetized cats].

In anesthetized cats, an increase in inspiratory resistance in conditions of growing hypercapnia entailed elongation of inspiration and of the whole respiratory cycle, as well as decrease of the volume threshold for cessation of inspiration. The latter occurred after bilateral vagotomy too, whereas no significant changes of the temporal parameters followed the increase in the resistance. The temporal rearrangements of the respiratory cycle seem to be due to the vagal effects, while the extravagal influences, probably the reflexes from the stretch receptors of intercostal muscles, are responsible for changes of the volume component in the relations characterizing the mechanism of cessation of inspiration.

Airway Resistance↗
PubMed1979

The intercostal flap: an anatomical and hemodynamic approach.

The intercostal island flap is a new omnipotential flap that is extremely valuable for torso reconstruction, provided one understands the intricacies of intercostal anatomy. Human cadaver dissections were done to determine the precise course and branching pattern of the lower (T7-T11) intercostal neurovascular bundles. On the basis of these dissections, the intercostal structures can be divided into four anatomical segments: vertebral, costal groove, intermuscular, and rectus. The anatomical segments can be safely combined in many ways to create versatile skin flaps. Three different clinical applications with requisite modifications in surgical technique are described in detail to exemplify important anatomical observations. The potential value of the intercostal island flap in reconstructive surgery is discussed.

Adult↗
PubMed1984

Redistribution of acetylcholine receptors on developing rat myotubes.

The mechanism of formation of acetylcholine receptor (AChR) clusters at developing mammalian endplates was investigated in vitro, using intercostal muscles from embryonic rats. The muscles were explanted in organ culture with the spinal cord attached, as described previously (Ziskind-Conhaim, L., and M. J. Dennis (1981) Dev. Biol. 85: 243-251). AChRs on the myofibers were labeled with [125I]-alpha-bungarotoxin shortly before clusters appeared and subsequently were cultured in unlabeled toxin for 1 day. Autoradiography of the cultured fibers demonstrated the presence of labeled clusters of AChRs indicating that the AChRs in the newly formed clusters arise from AChRs that had previously been uniformly distributed on the muscle surface.

Animals↗
PubMed1983

[Hering and Breuer reflexes in kittens in the early stages of postnatal ontogeny].

In 16 one to twelve-day old decerebrate kittens with intact nn. vagi, the reflex responses to trachea occlusion and alteration of the lung volume were studied. The EMGs of diaphragm and intercostal muscles were recorded as well as the tidal volume and the intratracheal pressure. The character of responses to above stimuli is similar in kittens and in adult cats. The trachea occlusion induces a greater elongation of expiration in kittens. Both in newborn and adult cats there is no obvious difference in intensity of expiratory-facilitating reflex in response to lung inflation. The threshold of inspiratory-exciting reflex in response to augmentation of the lung volume is relatively high in kittens. This reflex as well as the reflex to the lung collapse can be less regularly induced than in adults. It can be assumed that the sensitivity of bulbar respiratory center to impulses from the lung mechanoreceptors is relatively high in newborn animals.

Animals↗