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PubMed2002

[Treatment of patients with destructive pulmonary tuberculosis with concomitant diabetes mellitus].

Diabetes mellitus accompanying tuberculosis complicates the course of the latter and remains a topical problem of phthisiology. Surgical treatment of patient with both conditions presents a high risk and is employed unreasonably rarely. The results of medical (173 patients) and surgical (107 patients) treatments were studied in patients with destructive tuberculosis concurrent with diabetes mellitus. Analyzing early and late results of treatment showed a more steady-state effect in the group of surgically treated patients. Thus, surgery should be desirably used in all patients with preserving destructive changes after the basic course of antibacterial therapy.

Adult↗
PubMed1992

[New reconstruction method for defect of chest wall using composite graft].

In the case of a 64-year-old man squamous cell carcinoma in the left lung with metastasis to the rib, we excised the affected portion of the chest wall and used a composite graft, a combination hydroxyapatite (HAP) filler, for reconstruction with good results. HAP filler is a ceramic that combines the calcium phosphate apatite hydroxide with 3-calcium phosphate. The Dacron fabric used was made of polyethylene terephthalate fiber. Two layers of Dacron fabric were laid together, stitched to the rib with nylon thread, and the resulting tubular cavity packed with HAP filler to create an artificial rib. The intercostal muscle was sandwiched between the layers of Dacron fabric and the ends of the natural rib laid across those of the artificial one. We used the periosteum and intercostal muscle to integrate the graft and complete reconstruction. Postoperative recovery was good, and there was no visible sign of deformation at the graft site. Even in palpation we were unable to tell that the rib was artificial.

Biocompatible Materials↗
PubMed2004

[Surgical approach to lung tuberculosis].

The article describes treatment results of 1228 patients operated on because of different forms of pulmonary tuberculosis. According to spreading of tuberculosis and developed complications in spite of the medicamental treatment the patients were divided in to two clinical groups. The first group included 417 patients with direct indications for surgery. The second group included 811 patients with complications of pulmonary tuberculosis (with spontaneous pneumothorax - 237, spontaneous pyopneumothorax - 170, tuberculous pleural empyema - 271, pulmonary hemorrhage - 105, with pulmonary reoperations - 28). The results of radical and paliative operations were as follows: 1176 (95.8%) patients recovered, and 52 patients (4.2%) died. CONCLUSION. When therapical treatment of pulmonary tuberculosis is ineffective, especially in drug resistant cases, the surgical treatment is indicated.

Adolescent↗
PubMedDate not supplied

Respiration during sleep in neuromuscular and thoracic cage disorders.

Many of the neuromuscular and thoracic cage disorders are associated with disorders of breathing during sleep. The abnormal mechanics of the chest wall impairs respiratory muscle function and this is compounded if there is underlying muscle weakness. Respiratory abnormalities appear during REM sleep before NREM or wakefulness. Central sleep apnoeas are characteristic, but obstructive apnoeas are also occur because of loss of tone in the upper airway dilator muscles. Arousals from sleep return the blood gases towards normal, but cause fragmentation of sleep, leading to daytime sleepiness. Ventilatory failure occurs particularly if the vital capacity is less than 1.0-1.5 litres or if the maximal inspiratory mouth pressure is less than 20-25cmH2O. Non invasive ventilation effectively prevents both central and obstructive apnoeas and improves the sleep architecture and daytime blood gases.

Humans↗
PubMed2006

[Experimental study of degradable chitin long fiber reinforced polycaprolactone for reconstruction of chest wall defects].

OBJECTIVE: To investigate the application of a novel degradable biomaterial as a chest wall prosthesis and provide valuable scientific basis for clinical application. METHODS: Preparation of chitin long fiber reinforced polycaprolactone (PCL) by means of melt blending and modeling. Full-thickness chest wall defects of 10 cm x 8 cm was created in 10 dogs and then repaired with long chitin fiber reinforced PCL artificial rib in 8 dogs (tested group) and Marlex mesh in 2 dogs (control group). It was dynamically observed that the situation of the implanted chest wall prosthesis and the progress of the regeneration of the chest wall tissue postoperatively. RESULTS: No operative and perioperative deaths were observed in all experimental dogs. In tested group, slight paradoxical respiration occurred in 2 dogs and could not be seen in 2 weeks. No chest wall subsidence and infection occurred. New bone tissue obviously regenerated around both resection ends of the ribs and integrated tightly with artificial ribs. In control group, there were evidently paradoxical respiration and chest wall subsidence. Marlex mesh folded and was enveloped by fibrous tissue. CONCLUSION: Degradable chitin long fiber reinforced PCL can provide effective support to chest walls and is a practicable material for chest wall reconstruction.

Animals↗