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At least 1,081 records · Page 60Linked to original sources
PubMed2003

Intrathoracic extravasation of antineoplastic agents: case report and systematic review.

A case history is presented of a 34-year-old woman who was treated postoperatively for breast cancer with combination chemotherapy including epirubicin. The catheter of the port penetrated the wall of the superior vena cava, and extravasation in the mediastinum occurred. Severe pain, fever, and bilateral pleural effusion developed that necessitated two drainage procedures. She recovered well without sequelae. A comprehensive search of the medical literature was conducted using MEDLINE including bibliographies of all selected articles. Six additional cases of intrathoracic cytostatic agent extravasation were identified and the etiologic factors, clinical course, treatment strategy, and outcome were reviewed for each case.

Adult↗
PubMed1985

Gas embolism as a cause of death.

Systemic venous gas embolism other than that due to air is a great rarity. A case is reported and the criteria for the diagnosis are discussed. The clinical similarities between embolism of systemic venous air and that of systemic venous gas are emphasized. The two conditions can be differentiated by laboratory investigation only.

Adult↗
PubMed1989

Central venous catheter vascular erosions. Diagnosis and clinical course.

Central venous catheter (CVC) vascular erosions are difficult to diagnose, and they cause serious complications. From 1985 to 1987, ten patients receiving the surgical services at the University of Florida suffered CVC vascular erosions. By chest roentgenogram, nine CVC tips were in the superior vena cava (SVC), although three catheter tips abutted the lateral wall of the SVC. One catheter tip was in the right atrium. All patients had sudden onset of symptoms, the most common of which was shortness of breath. Initial diagnosis was respiratory insufficiency in five patients, cardiac failure in three patients, pulmonary embolism in one, and sepsis in one. Four patients required intensive care. Two patients suffered pericardial tamponade, and pleural effusions developed in eight patients. One patient died of cardiac arrest. The average time interval from CVC placement to onset of symptoms was 60.2 hours, and from the onset of symptoms to the time of diagnosis, the interval was 16.7 hours. The mean volume obtained at thoracentesis was 1324 ml and at pericardiocentesis was 250 ml.

Adult↗
PubMed2006

The use of carbon dioxide wedged hepatic venography to identify the portal vein: comparison with direct catheter portography with iodinated contrast medium and analysis of predictive factors influencing level of opacification.

PURPOSE: This study was conducted to assess the value of wedged hepatic venography (WHV) with CO(2) as a contrast agent for identification of the portal venous system in patients with cirrhosis. Additionally, the predictive value of several parameters that potentially influence the level of portal vein opacification by CO(2) WHV was analyzed. MATERIALS AND METHODS: In 163 patients, CO(2) WHV was performed before transjugular intrahepatic portosystemic shunt creation to opacify and map the portal vein for subsequent targeting by intrahepatic puncture technique. Concordance between CO(2) WHV and direct catheter portography with iodinated contrast medium was assessed by analysis of sensitivity parameters. Additionally, analysis of factors potentially influencing the opacification of the portal vein with use of CO(2) WHV was assessed. RESULTS: CO(2) WHV was successfully performed in all 163 patients. In three patients (1.8%), CO(2) extravasation was noted, but without any clinical consequence. Sensitivity rates of CO(2) WHV for opacification of the right and left portal veins and the portal main trunk were 93.83% and 68.52%, respectively. Positive predictive factors (P < .05, Wilcoxon two-sample test) were high portosystemic gradient, spontaneous splenorenal shunt, esophageal varices, and reversed portal flow. One negative predictive factor was a patent umbilical vein. CONCLUSIONS: CO(2) WHV is safe, highly efficient, and reliable in the identification of the right and left portal veins. CO(2) WHV is clearly less effective in opacifying the entire portal main trunk. With use of CO(2) WHV, the portal venous system is most distinctly opacified in patients presenting with a high portosystemic gradient, a spontaneous splenorenal shunt, esophageal varices, and reversed portal flow.

Adult↗
PubMed1991

Pleuropulmonary complications of fine bore naso-enteric feeding tubes.

Fine bore naso-enteric feeding tubes are commonly used for enteral alimentation. Although regarded as generally safe, complications associated with their use occur. Case reports presented here highlight the potential hazards of these tubes. Pleuropulmonary complications are reviewed and guidelines suggested for the safe insertion of such tubes.

Aged↗
PubMed1996

Effect on phloridzin on net rate of liquid absorption from the pleural space of rabbits.

Previous indirect findings have suggested the occurrence of solute-coupled liquid absorption from the pleural space, consistent with Na(+)-K(+)-ATPase on the interstitial side plus a Na(+)-H+ and CI(-)-HCO3- double exchange on the luminal side of the pleural mesothelium. To assess whether Na(+)-glucose cotransport also operates on the luminal side, the relationship between net rate of liquid absorption from the right pleural space (Jnet) and volume of liquid injected into this space (0.5, 1 or 2 ml) was determined in anaesthetized rabbits during hydrothoraces with phloridzin (10(-3)M) or with phloridzin plus 4-acetamido-4'-isothiocyanatostilbene-2, 2'-disulphonic acid (SITS; 1.5 x 10(-4)M). The relationship obtained during hydrothoraces with phloridzin was displaced downwards by 0.09 ml h-1 relative to that in control hydrothoraces (P < 0.01). The decrease in Jnet was similar in hydrothoraces of various sizes. The relationship obtained in hydrothoraces with phloridzin plus SITS was displaced downwards by 0.16 ml h-1 relative to that in control hydrothoraces (P < 0.01), i.e. the decrease in Jnet was similar to the sum (0.17 ml h-1) of the decreases in Jnet produced individually by phloridzin and by SITS (0.08 ml h-1). The decrease in Jnet was similar in hydrothoraces of differing size. The above findings are consistent with the occurrence of Na(+)-glucose cotransport on the luminal side of the pleural mesothelium, operating simultaneously with the double exchange also under physiological conditions.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed1997

Effect of adrenaline and alpha-agonists on net rate of liquid absorption from the pleural space of rabbits.

Indirect evidence supporting a solute-coupled liquid absorption from the pleural space of rabbits has recently been provided; moreover, the beta 2-adrenoceptor agonist terbutaline has been found to increase this absorption. In this study the effect of adrenaline and alpha-adrenoceptor agonists on net rate of liquid absorption (Jnet) from albumin Ringer hydrothoraces of various sizes has been determined in anaesthetized rabbits. In hydrothoraces with adrenaline (5 x 10(-6) M) the relationship between Jnet and volume of liquid injected was displaced upwards by 0.09 ml h-1 relative to that in control hydrothoraces (P < 0.01). This displacement did not occur with lower adrenaline concentrations or after pretreatment with the beta-blocker propranolol. Hence, this increase in Jnet is mediated by stimulation of beta-receptors. It seems to be caused by an increase in solute-coupled liquid absorption, since beta-agonists inhibit lymphatic activity while, at relatively high concentrations, they may increase active transport. Conversely, the strong stimulation of lymphatic alpha-receptors that should occur with adrenaline after beta-blockade may fail to increase lymphatic drainage, because it has been shown that the increase in contraction frequency of lymphatics may be balanced by the decrease in their stroke volume. Arterial blood pressure during the hydrothoraces with adrenaline was unchanged. In hydrothoraces with the alpha 2-agonist clonidine (5 x 10(-6) M; a less potent agent than adrenaline) the slope of the relationship between Jnet and volume injected increased by 26% (P < 0.01), while its origin did not change. This increase in slope did not occur with a lower clonidine concentration or after pretreatment with the alpha-blocker phentolamine. Hence, it is caused by stimulation of alpha 2-receptors, which probably lead to an increase in lymphatic drainage related to liquid load. In hydrothoraces with the alpha 1-agonist phenylephrine (5 x 10(-6) or 10(-7) M) Jnet was simlar to control values.

Absorption↗