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Thoracic Cavity (thoracic + cavity)
Selected AbstractsThe use of combined ultrasound and magnetic resonance imaging in the detection of fetal anomaliesPRENATAL DIAGNOSIS, Issue 5 2010Xiomara M. Santos Abstract Objective To compare the referral diagnosis based on prenatal ultrasound to diagnoses made following combined ultrasound (US) and magnetic resonance imaging (MRI) evaluation at the Texas Children's Fetal Center (TCFC) and postnatal diagnosis. Methods We performed a retrospective review of patients referred to the TCFC between September 2001 and July 2007 with a fetal structural malformation. Data were abstracted to compare the referral diagnosis to TCFC imaging diagnoses and both were compared to postnatal diagnosis. Results Two hundred and twenty-four patients were referred who had a fetal US and MRI at TCFC. The most frequent indications were for abnormalities of the central nervous system (38%) and lung/thoracic cavity (34%), with congenital diaphragmatic hernia (CDH) the single most common referral diagnosis (n = 39; 17%). In 99 cases (42.7%) the referral diagnosis was concordant with the post-referral diagnosis, however, in 68 cases (29.3%) the post-referral diagnosis changed completely, and in 65 cases (28%) additional findings were discovered. Prenatal diagnoses following imaging at TCFC were concordant with postnatal diagnoses in 94.9% of cases. Conclusions Combined ultrasound and MRI provides additional diagnostic information or a corrected diagnosis in 57% of cases over the referral ultrasound diagnosis. Copyright © 2010 John Wiley & Sons, Ltd. [source] IL-4,/, mice with lethal Mesocestoides corti infections , reduced Th2 cytokines and alternatively activated macrophagesPARASITE IMMUNOLOGY, Issue 12 2009A. E. O'CONNELL Summary Protection against Mesocestoides corti, a cestode that invades vital organs, is dependent on the production of IL-4, as IL-4,/, mice were found to have higher parasite burdens when compared with wild-type mice. The goal of this study was to investigate the role of IL-4 in immunity to M. corti, focusing on the immunological profile and on potential mediators of pathology. IL-4,/, mice infected with M. corti showed 100% mortality by 32 days, whereas wild-type mice survived for approximately 1 year. Parasite burdens were significantly increased in the liver, peritoneal, and thoracic cavities of IL-4,/, mice, associated with impaired recruitment of inflammatory cells and a reduction in monocytes and macrophages. IL-5 production by splenocytes and expression in liver tissue was decreased in infected IL-4,/, mice compared with wild-type mice. In contrast, IL-4,/, mice produced increased amounts of IFN, and TNF,. Alternatively activated macrophages were a major feature of liver granulomas in wild-type mice evidenced by Arginase I expression, while livers from infected IL-4,/, mice showed impaired alternative macrophage activation without increased classical macrophage activation. Thus, lethality during M. corti infection of IL-4,/, mice is associated with decreased Th2 cytokines, increased Th1 cytokines and impairment of alternatively activated macrophages. [source] Morphology of Haemal Nodes in the Roe Deer (Capreolus capreolus)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 5 2010Y. Akaydin Bozkurt With 5 figures Summary The present study was aimed at the determination of the morphology of haemal nodes in the roe deer (Capreolus capreolus). The morphology of haemal nodes located in the abdominal and thoracic cavities of six roe deer (two adult male, two adult female and two foetuses) was studied by gross inspection and histological methods. Oval- and round-shaped haemal nodes with colours varying from pink to dark red were observed particularly between the abdominal aorta and caudal vena cava, and at the beginning of the main branches of the abdominal aorta. These nodes, having connection only with blood vessels, were covered with a thin or thick capsule of connective tissue in the foetus and the adult respectively. Trabeculae were not observed in foetal nodes. In adults, the capsule, trabeculae and, in particular, the sinuses were strongly supported by reticular fibres and cells. The morphology of these nodes displayed similarity to that of other ruminant species. [source] Initial Clinical Experience With the HeartMate II Ventricular Assist System in a Pediatric InstitutionARTIFICIAL ORGANS, Issue 7 2010William R. Owens Abstract In many adult cardiac programs, intracorporeal mechanical circulatory support has become a routine treatment for end-stage cardiac failure. For the pediatric population, options are often limited by a small body habitus. Even when an adolescent's weight may suggest adequate space for device implant, most intracorporeal adult devices remain too large for adolescents. The Thoratec HeartMate II (HM II) (approved by the FDA in April of 2008) is a small, noiseless device that is easily operated and monitored. By having an uncomplicated operating system and small percutaneous drive line, the HM II provides an opportunity for these patients to aggressively rehabilitate to become a better transplant candidate and also provides the potential to be discharged home. The two youngest patients ever to utilize the HM II are also the first two cases of using the HM II at a freestanding pediatric hospital. A 12-year-old, 53 kg, girl with dilated cardiomyopathy was supported for 85 days before receiving her heart transplant. The second patient, a 13-year-old, 149 kg, Hispanic male suffering from morbid obesity and dilated cardiomyopathy, was supported for 128 days. The HM II allowed for rehabilitation and nutritional education, resulting in this patient losing 50 kg before heart transplant. Despite both of these patients' size, their thoracic cavities were that of a preadolescent and thus techniques were developed to avoid morbidities like chest wall abrasion and bleeding. Because of differences between adult and pediatric patients and institutions, these cases provided unique challenges. However, as pediatric device therapy is now maturing, pediatric programs such as Texas Children's Hospital have begun to develop strategies for mechanical support that factor in patient's size and need for long-term or temporary support, utilizing the growing number of devices (i.e., Jostra Rotoflow, Tandem Heart PTVA, Thoratec CentriMag, Berlin Heart EXCOR, etc.) that are now available to children. [source] Effects of Delaying Fluid Resuscitation on an Injury to the Systemic Arterial VasculatureACADEMIC EMERGENCY MEDICINE, Issue 4 2002James F. Holmes MD Abstract. Objectives: To determine the effects of delaying fluid on the rate of hemorrhage and hemodynamic parameters in an injury involving the arterial system. Methods: Twenty-one adult, anesthetized sheep underwent left anterior thoracotomy and transection of the left internal mammary artery. A chest tube was inserted into the thoracic cavity to provide a continuous measurement of blood loss. The animals were randomly assigned to one of three resuscitation protocols: 1) no fluid resuscitation (NR), 2) standard fluid resuscitation (SR) begun 15 minutes after injury, or 3) delayed fluid resuscitation (DR) begun 30 minutes after injury. All of the animals in the two resuscitation groups received 60 mL/kg of lactated Ringer's solution over 30 minutes. Blood loss and hemodynamic parameters were measured throughout the experiment. Results: Total hemorrhage volume (mean ± SD) at the end of the experiment was significantly lower (p = 0.006) in the NR group (1,499 ± 311 mL) than in the SR group (3,435 ± 721 mL) or the DR group (2,839 ± 1549 mL). Rate of hemorrhage followed changes in mean arterial pressure in all groups. Hemorrhage spontaneously ceased significantly sooner (p = 0.007) in the NR group (21 ± 14 minutes) and the DR group (20 ± 15 minutes) than in the SR group (54 ± 4 minutes). In the DR group, after initial cessation of hemorrhage, hemorrhage recurred in five of six animals (83%) with initiation of fluid resuscitation. Maximum oxygen (O2) delivery in each group after injury was as follows: 101 ± 34 mL O2/kg/min at 45 minutes in the DR group, 51 ± 20 mL O2/kg/min at 30 minutes in the SR group, and 35 ± 8 mL O2/kg/min at 60 minutes in the NR group. Conclusions: Rates of hemorrhage from an arterial injury are related to changes in mean arterial pressure. In this animal model, early aggressive fluid resuscitation in penetrating thoracic trauma exacerbates total hemorrhage volume. Despite resumption of hemorrhage from the site of injury, delaying fluid resuscitation results in the best hemodynamic parameters. [source] A high status burial from Ripon Cathedral, North Yorkshire, England: differential diagnosis of a chest deformityINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 6 2003S. Groves Abstract Excavations beneath the crossing at Ripon Cathedral in North Yorkshire recently revealed a burial radiocarbon dated to the late 15th century AD. The burial was that of a young adult female; the location of the grave suggests a person of relatively high status. The very well preserved skeleton revealed abnormal changes to the bones of the thoracic cavity including anterior bowing of the sternum, flattening of the spinous processes of thoracic vertebrae three to nine against the processes below each one, and changes to the ribs that suggested anterior displacement of the rib cage. The skeletal changes are described and differential diagnoses presented. Treatment to an underlying chest deformity, ,pectus carinatum', is thought to be the underlying cause of the skeletal changes; this study may lend direct insight into the concepts of body image in the Medieval period. Copyright © 2003 John Wiley & Sons, Ltd. [source] Lymph drainage of the mammary glands in female catsJOURNAL OF MORPHOLOGY, Issue 3 2006F. Raharison Abstract The mammary gland is a common site of neoplasms in the female cat. All the malignant tumors metastasize to a lesser or a greater extent through the lymphatic system. However, the anatomical knowledge of this system is not sufficiently well known in cats to develop a reasoned model for the extirpation of these glands in case of malignant tumors. A study of the lymph drainage in 50 female cats was done by indirect injection in vivo of India ink inside the mammary parenchyma. After a waiting interval, mammary glands were extracted and the thoracic cavity opened. All the lymph nodes were examined after clearing. The success rate of the colorations of lymph nodes and lymph vessels was 91.8%. Out of the 100 observed mammary chains, the two intermediate mammary glands (T2, A1) may drain caudally to the superficial inguinal lymph center and/or cranially to the axillary lymph center. The T1 gland always drains exclusively cranially and A2 exclusively caudally. The two mammary glands (T1 and A1) often drain towards the sternal cranial lymph nodes, but 100% of the T2 drain towards it. This research assumes that the limit between the two directions of drainage can exist only between glands T2 and A1. The results obtained with the study of the 1st, 2nd, 3rd, and 4th mammary glands permit production of new and more complete data of functional significance that will eventually aid block dissection surgical technique in the removal of malignant tumors in cats. J. Morphol. © 2005 Wiley-Liss, Inc. [source] Myocardial perforation by a stick foreign body in a dogJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2008Augusta Pelosi DVM, DACVS Abstract Objective: To report a case of myocardial perforation by a stick foreign body in a dog. Case Summary: A 3-year-old castrated male Labrador Retriever was examined because of a puncture wound seen after an unsupervised run in the woods. The wound was suspected to penetrate into the thoracic cavity on the basis of physical exam and radiographs. Uniform ventricular premature complexes (VPCs) and junctional beats were noted on electrocardiogram (ECG). Thoracotomy was performed and a 6-cm wooden stick was seen protruding from the right ventricle through the pericardium toward the sternum. The stick was removed while purse string sutures were tied around the resultant myocardial defect. Follow-up echocardiography revealed intact intracardiac structures. VPCs were treated with lidocaine and resolved completely within 24 hours of presentation. New or Unique Information Provided: Thoracic trauma can result in myocardial injury; penetration into the myocardium represents a life-threatening situation for the emergency clinician. Cardiac injury should be included in the differential diagnoses of penetrating thoracic foreign bodies. [source] Rapid cine MRI of the human heart using reconstruction by estimation of lines and inhibition of fold-inMAGNETIC RESONANCE IN MEDICINE, Issue 5 2002Wolfgang G. Rehwald Abstract A fast imaging method is described that yields an approximately six-fold acquisition time reduction relative to conventional techniques. The method involves: 1) acquisition of every sixth k -space line; 2) shifting of acquired k -space lines between odd and even frames; and 3) a single-frame correction image. Reconstruction is achieved by temporal interpolation for k -space lines not acquired combined with subtraction of stationary fold-in artifacts. Seven patients with heart disease and one volunteer were evaluated. SNR was measured in myocardium and the ventricular cavity for both the conventional and new technique. The method is best suited for fast imaging of moving objects confined to a small region within a larger stationary object, such as the heart within the thoracic cavity. It can be implemented in cine and functional imaging sequences and, in principle, in perfusion sequences. Magn Reson Med 47:844,849, 2002. © 2002 Wiley-Liss, Inc. [source] A Review of Sympathetically Maintained Pain Syndromes in the Cancer Pain Population:PAIN PRACTICE, Issue 4 2001The spectrum of ambiguous entities of RSD, other pain states related to the sympathetic nervous system Abstract: Accepted wisdom contends that sympathetically maintained pain is rare in cancer pain syndromes. But this may be more of an artifact of how we diagnose this condition than a reflection of its true prevalence. One area in which one might suspect this to be true is in postsurgical states. While there are case reports of sympathetically maintained pain occurring after radical neck dissection, orbital and maxillary exenteration, it has not been reported in the more common areas of postsurgical pain. For instance, although one should suspect that the nerve damage that accompanies post-thoracotomy and postmastectomy pain syndromes would bring into being a certain incidence of sympathetically maintained pain, it is difficult to find collaborative reports. This may have more to do with the difficulty inherent in diagnosing sympathetically maintained pain than its actual contribution to these persistent cancer pain syndromes. The reason that it is more commonly reported in limb amputation is less comprehensible since blocking the sympathetic fibers that travel to an extremity is easier than those going to the thoracic cavity. In addition to surgically induced sympathetically maintained pain, medical patients with lymphoma and leukemia may have an element of sympathetically maintained pain when they develop postherpetic neuralgia. While the contribution of sympathetically maintained pain in these cases is not totally ignored, its involvement, as in the surgical patients mentioned above, is worthy of another analysis. This paper will discuss the topics introduced above and suggest diagnostic and therapeutic options available for this condition. [source] DIAGNOSTIC VALUE OF THORACOSCOPIC PLEURAL BIOPSY FOR PLEURISY UNDER LOCAL ANAESTHESIAANZ JOURNAL OF SURGERY, Issue 8 2006Motoki Sakuraba Background: We find pleural effusion in clinical practice frequently. However, it is difficult to make a diagnosis definitively by thoracocentesis or closed pleural biopsy. We directly examine the thoracic cavity by thoracoscopy under local anaesthesia, carry out pleural biopsy and make a definitive pathological diagnosis in pleurisy. Method: A retrospective study of 138 patients who had been diagnosed by thoracoscopy in our hospital was carried out between January 1995 and January 2005. Results: The patients were 114 men and 24 women, ranging in age from 21 to 85 years, with a mean of 59 years. The right side was involved in 83 patients and the left side in 55. The operations took 11,145 min, with a mean of 46 min. Thoracoscopy directly without thoracocenteses was carried out in 28 of 138 patients. Lung cancer with pleural dissemination was diagnosed in 27, malignant pleural mesothelioma in 10, tuberculous pleurisy in 32, non-specific pleurisy in 58, other tumour in 2 and pyothorax in 9 patients. The overall diagnostic efficacy was 97.1% (134/138). The diagnostic efficacy in the cases of carcinoma was 92.6% (25/27), in malignant pleural mesothelioma it was 100% (10/10) and in tuberculosis it was 93.8% (30/32). No major complications occurred during the examination. Conclusion: Pleural biopsy by thoracoscopy under local anaesthesia should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely carried out. [source] Human Clinical Fitting Study of the DexAide Right Ventricular Assist DeviceARTIFICIAL ORGANS, Issue 7 2009Yoshio Ootaki Abstract The DexAide right ventricular assist device (RVAD) has been developed as an implantable RVAD. The purpose of this study was to determine the final design and optimal anatomical placement of the DexAide RVAD when implanted simultaneously with either of two commercially available left ventricular assist devices (LVADs) in patients. A mock-up DexAide RVAD was used to assess configuration with each of two types of commercially available LVADs at the time of LVAD implantation in three human clinical cases. The pump body of the DexAide RVAD was placed either in the preperitoneal space or in the right thoracic cavity. The DexAide RVAD placed into the right thoracic cavity is suitable for use with the Novacor or HeartMate II LVADs. The results of this study will guide the finalization of the inflow cannula and optimal placement of the DexAide RVAD for human clinical trials. [source] Analysis of Baroreflex Sensitivity During Undulation Pump Ventricular Assist Device SupportARTIFICIAL ORGANS, Issue 7 2009Hongjian Liu Abstract The aim of this study was to examine the baroreflex sensitivity (BRS), which involves the autonomic nervous system, in a goat with a chronically implanted undulation pump ventricular assist device (UPVAD). The UPVAD involved transforming the rotation of a brushless DC motor into an undulating motion by a disc attached via a special linking mechanism, and a jellyfish valve in the outflow cannula to prevent diastolic backflow. The pump was implanted into the thoracic cavity of a goat by a left thoracotomy, and the inflow and outflow cannulae were sutured to the apex of the left ventricle and to the descending aorta, respectively. The driving cable was wired percutaneously to an external controller. Electrocardiogram and hemodynamic waveforms were recorded at a sampling frequency of 1 kHz. BRS was determined when awake by the slope of the linear regression of R-R interval against mean arterial pressure changes, which were induced by the administration of methoxamine hydrochloride, both with continuous driving of the UPVAD as well as without assistance. BRS values during the UPVAD support and without assistance were 1.60 ± 0.30 msec/mm Hg and 0.98 ± 0.22 msec/mm Hg (n = 5, P < 0.05), respectively. BRS was significantly improved during left ventricular assistance. Therefore, UPVAD support might decrease sympathetic nerve activity and increase parasympathetic nerve activity to improve both microcirculation and organ function. [source] Nutrient intakes in women and congenital diaphragmatic hernia in their offspring,BIRTH DEFECTS RESEARCH, Issue 3 2008Wei Yang Abstract BACKGROUND: Congenital diaphragmatic hernia (CDH) is a severe birth defect where there is an opening in the diaphragm through which a portion of the abdominal contents protrudes into the thoracic cavity. The etiologies of CDH remain unknown, although experimental animal data suggest dietary factors might play a role. This study examined whether maternal nutrient intakes were associated with delivering infants with CDH. METHODS: We analyzed infants with isolated CDH who were born from 1997 to 2003 and recruited into the National Birth Defects Prevention Study (NBDPS), a multisite, population-based case-control study. Exposure data were obtained from telephone interviews, which were completed within 24 months after delivery, and were available for 377 case mothers and 5,008 control mothers. A food frequency questionnaire was used to derive nutrient intakes during the year before pregnancy. RESULTS: A crude OR of 0.6 (95% CI: 0.3,1.0) was observed for higher intake of choline. Elevated ORs (1.4 to 1.7) were found for lower intakes of choline, cysteine, methionine, and protein. Among women who took vitamin supplements, higher intakes of B vitamins (i.e., folate, vitamin B1, B2, B6, and B12), minerals (i.e., calcium, iron, magnesium, and zinc), and vitamin E were inversely associated with CDH (ORs from 0.7,0.3). Moreover, among women who did not take vitamin supplements, lower intakes of calcium, retinol, selenium, vitamin B12, and vitamin E had positive associations with CDH (ORs from 1.4 to 2.1). CONCLUSIONS: Our observations contribute to a limited body of evidence suggesting a woman's periconceptional diet might be associated with CDH in her offspring. Birth Defects Research (Part A), 2008. © 2007 Wiley-Liss, Inc. [source] | |||||||||||||