Improved expandable prosthesis in postpneumonectomy syndrome with deformed thorax.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Although axial images are sufficient for diagnosis in most instances, knowledge of multiplanar imaging techniques is essential to apply them in appropriate circumstances. In particular, appropriately applied multiplanar imaging adds confidence to interpretations and assists surgeons and bronchoscopists in planning procedures. The need for multiplanar imaging must be assessed before performing any study so that the image acquisition parameters allow for suitable reformations.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Thoracic great vessel injury accounts for a significant amount of the acute mortality rate from trauma. Early recognition permits early repair, usually best accomplished by the simplest yet most effective technique. Use of prosthetic material is encouraged. Cardiopulmonary bypass, hypothermia, and shunts are rarely required.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The influence of fractionation of the radiation dose in up to 16 fractions on late occurring effects in rat lungs was studied. Measurement of the breathing frequency (BF) was used to monitor changes in lung function during the 76-wk follow-up period. At the end of this period the lungs were examined histologically and the hydroxyproline (HP) content of the lung tissue was determined as a biochemical indicator of the amount of fibrosis. Dose-response curves for BF could only be made at 76 wk post-irradiation. No dose-response curves could be constructed for HP/mg dry tissue; dose-related increases observed in HP/total left lung were entirely attributable to increases in lung dry weight. Histopathology data indicated a dose-related increase in two histological alterations, septal fibrosis and granulomatous pneumonia. The alpha/beta ratios were calculated for each of the endpoints using both the Fe-plot and Direct Analysis method. The calculated values for alpha/beta were in the range of 1.1 to 3.6 Gy, corresponding well to published data obtained in mouse lungs. The number of tissue rescuing units (TRU's) was also calculated. It was smaller for BF than for the histopathology endpoints, suggesting different target structures. However, the difference was not significant due to large confidence intervals.
Explore the source record for details and available documents.
This study evaluates the effectiveness of percutaneous transtracheal ventilation (PTV) in a canine shock model. Five mongrel dogs (25 to 35 kg), splenectomized two weeks prior to study, were anesthetized (pentobarbital, 22 mg/kg) and bled to and sustained at a mean arterial pressure (MAP) of 20 mm Hg for 60 minutes. Ringer's lactate was infused and the descending thoracic aorta was cross-clamped. Simultaneously, PTV was begun with 60% O2 through the cricothyroid membrane. Hemodynamic measurements and arterial blood gases were obtained at 0, 5, 15, and 30 minutes following the initiation of PTV. Orotracheal ventilation was then instituted in place of PTV and continued for 30 minutes, and measurements were repeated. Auto-transfusion was also begun at this time. During PTV, PO2 and PCO2 were adequate in all dogs at each interval. We conclude that PTV provides effective oxygenation and ventilation in dogs subjected to profound shock, thoractomy, and thoracic aortic cross-clamp.
Positron emission tomography imaging has proven valuable in the evaluation and management of thoracic abnormalities. It is more accurate than CT or MR imaging in characterizing indeterminate focal abnormal pulmonary opacities, staging lung cancer, and assessing the therapeutic response. PET imaging in lung cancer also appears to be cost-effective, particularly with whole-body studies. The metabolic and physiologic abnormalities used in FDG-PET imaging, rather than conventional anatomic or morphologic characteristics, provide an invaluable model for the future of tumor imaging.
Explore the source record for details and available documents.
Pancoast's syndrome is characterized by pain in the shoulders and upper extremities, Horner's syndrome, bone loss and hand muscle atrophy. Bronchogenic carcinoma is the most common cause, although other neoplasms or lung infection are occasionally responsible. An apical mass on the chest film can be seen in over 90% of cases, although apical pleural thickening is sometimes the only radiographic finding. We describe a patient whose clinical picture was highly suggestive of Pancoast's syndrome but whose chest film was normal. Magnetic resonance imaging disclosed a cervical mass adjacent to the brachial plexus that proved to be cervical metastasis from an unknown primary tumor. We emphasize the need to consider the possibility of a metastatic cervical tumor compromising the brachial plexus in patients with a normal chest X-ray but clinical signs highly suggestive of Pancoast's syndrome.
A prospective, randomised out-of-hospital study in a two-tiered system with active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) versus standard (STD) CPR in patients following non-traumatic cardiac arrest was planned to test the hypothesis that ACD-CPR by the first tier may increase the occurrence of ventricular fibrillation as compared with STD-CPR. Furthermore, in a later phase of the study, sternal and rib fractures induced by both CPR methods were determined by extensive autopsy. After enrolling 90 patients the study was terminated because of a high frequency of chest injuries found at autopsy. Forty-two patients received STD-CPR from the first tier and ACD-CPR from the second tier. Thirty-three patients received ACD-CPR only by the first and the second tier, while 15 patients received STD-CPR only from the first and second tiers. In order to obtain a sufficiently large control group for autopsy findings after STD-CPR, STD-CPR was performed in an additional 33 patients within a second period of 4 months. There was no improvement in the number of patients found in ventricular fibrillation after ACD-CPR as compared to STD-CPR performed by the first tier. In patients undergoing autopsy (n = 35) there were significantly more sternal fractures with ACD-CPR versus STD-CPR (14/15 vs. 6/20; P <0.005) and rib fractures (13/15 vs. 11/20; P < 0.05) In conclusion, ACD-CPR appears to cause more CPR-related injuries than does standard CPR, but as a result of a number of limitations on this study, this fact cannot be proven beyond doubt.
Six patients with Stage III non-small cell lung cancer completed therapy which consisted of 4 whole body hyperthermia (WBH) treatments during the first 2 weeks of a 6 week course of radiotherapy (60 Gy). A radiant heat system was used to deliver the 41.8 degree C WBH. To reduce the danger of transverse myelitis, the spinal cord (and therefore part of the mediastinum and contralateral hilar region) was not irradiated during the first 2 weeks of radiotherapy and concurrent WBH. Subsequent treatments (weeks 3-6) included conventional irradiation to the primary tumor, mediastinal lymph nodes and spinal cord. Areas of gross disease responded to therapy in 5/6 patients. No radiation pneumonitis was observed. In 2/6 patients, relapse (after 10 months and 6 months, respectively) occurred with malignant pericardial effusions. The mediastinum in these patients was not an area of bulky disease involvement initially. To eliminate such WBH-radiation sanctuary zones, the protocol was modified to include greater combined WBH-radiation treatment. This is accomplished by having one WBH treatment "sandwiched" between 2 radiation fractions. The preclinical basis for the revised protocol is presented.