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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma colloid osmotic pressure was reduced by 76% (from 19.6 +/- 0.6 to 4.7 +/- 1.5 mm Hg) in five baboons while pulmonary capillary hydrostatic pressure was maintained at a normal level. This resulted in fluid retention, weight gain, peripheral edema and ascites, but no pulmonary edema. Thoracic duct lymph flow increased 6-fold and pulmonary lymph flow 7-fold. Thoracic duct lymph had a lower colloid osmotic pressure (2.0 +/- 0.7 mm Hg) than plasma (4.7 +/- 1.5 mm Hg), whereas the colloid osmotic pressure of pulmonary lymph (4.7 +/- 0.7 mm Hg) was the same as that of plasma. The lymph-plasma ratio for albumin fell in thoracic duct lymph but remained unchanged in pulmonary lymph. The difference between plasma colloid osmotic pressure and pulmonary artery wedge pressure decreased from 15.3 +/- 1.9 to -0.7 +/- 2.9 mm Hg. Despite this increase in filtration force, the lungs were protected from edema formation by a decrease of 11 mm Hg in pulmonary interstitial colloid osmotic pressure and a 7-fold increase in lymph flow.
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PMID:Lymph and pulmonary response to isobaric reduction in plasma oncotic pressure in baboons. 10 11

Thoracic compliance measurements by use of readily available equipment were determined to be practical and safe in dogs. Twenty healthy dogs (age 1 to 16 years, weight 2.3 to 49.5 kg) were anesthesized for routine procedures such as dentistry or neutering. The animals were first hyperventilated to reduce pulmonary atelectasis, to check for leakage at the endotracheal tube cuff, and to induce mild hypocarbia, thus minimizing voluntary respiratory efforts. Total thoracic compliance measurements were calculated as the difference between exhaled volumes at static inspiratory pressures of 15 and 20 cm of H2O, divided by the pressure difference, and expressed as a function of body weight. The procedure was easy, took 5 to 10 minutes, and caused no recognizable ill effects in any of the dogs studied. Mean total thoracic compliance was 42.25 +/- 32 ml/cm of H2O. There was a significant correlation with weight, but no significant relationship was seen between compliance and age, or gender. The mean weight-adjusted total thoracic compliance was 1.85 +/- 0.56 ml/cm of H2O/kg. In studies in a small group of dogs with documented respiratory tract disease, 4 of 7 had a mean compliance greater than 2 SD below the normal range. Thus, this test may become part of the routine workup of any animal being anesthetized for procedures such as bronchoscopy to evaluate respiratory tract disease. Routine monitoring of animals on ventilators could provide early warning of complications such as pneumonia, pleural effusion, or pulmonary edema.
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PMID:Static thoracic compliance as a measurement of pulmonary function in dogs. 176 78

Thoracic CT for patients in intensive care is cumbersome but provides important additional information in the presence of complicated lung changes. Total opacification of a lung field visualised on conventional portable films may be due to infiltration and/or fluid and/or collapse by using the clinical information in conjunction with densitometric measurements. CT may help in the differentiation of pulmonary oedema, particularly in the presence of ARDS and its complications. It is also possible to accurately localise abscesses and empyemas in the presence of extensive consolidation. This makes it possible to drain abscesses or empyemas, or pleural fluid in unusual situations, which has become loculated, or to aspirate a pneumothorax.
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PMID:[Computerized tomography of the thorax in intensive care patients]. 303 34

Measurement of hemodynamic parameters by noninvasive techniques is gaining more and more popularity in the face of severe complications associated with invasive methods. Thoracic electrical bioimpedance is a noninvasive means of estimating cardiac output (CO) and pulmonary edema formation. The validity of this method, however, has been controversial. In the present study a new bioimpedance monitoring system (NCCOM 3) was used in 10 intensive care patients undergoing mechanical hemofiltration (group I) and in 20 cardiac surgery patients undergoing either aortic valve replacement (AVR, group IIa, n = 10) or aorto-coronary bypass grafting (CABG, group IIb, n = 10). In cardiac surgery patients the measurements were performed before as well as after extracorporeal circulation (ECC). CO measured by the impedance monitor was compared to the standard thermodilution method; pulmonary fluids were estimated by a thermo-dye technique and by measurement of total electrical impedance (base impedance), expressed as the thoracic fluid index (TFI). The principal finding of the study was that CO as measured by the two techniques differed significantly in all groups with regard to absolute values. The relative changes in CO, however, were comparable in both intensive care patients and CABG patients. In patients with special thoracic blood flow conditions (regurgitation in aortic insufficiency patients), no corresponding course of CO could be found.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Non-invasive versus invasive cardiovascular monitoring. Determination of stroke volume and pulmonary hydration using a new bioimpedance monitor]. 326 52

Five cases of coagulopathy caused by consumption of indanedione (diphacinone)-based rodenticides are reported. In each case, acute onset of lethargy and respiratory distress were the predominant initial clinical signs. Thoracic radiography revealed pulmonary edema, pleural effusion, and/or pericardial effusion as consistent findings. Laboratory evaluations confirmed coagulopathies that responded to vitamin K1 therapy.
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PMID:Diphacinone-induced coagulopathy in the dog. 394 17

Hyperthyroidism was diagnosed in 131 cats during a 3 1/2-year period. The cats ranged in age from 6 to 20 years; there was no breed or sex predilection. The most frequent clinical signs included weight loss, polyphagia, increased activity, polydipsia, polyuria, and vomiting. Common serum biochemical abnormalities included high values for alkaline phosphatase activity (75%), lactate dehydrogenase activity (66%), aspartate transaminase activity (66%), and alanine transaminase activity (54%). Electrocardiographic changes included tachycardia (greater than or equal to 240 beats/min) and increased R-wave amplitude in lead II (greater than or equal to 0.9 mV) in 66% and 29% of the 131 cats, respectively. Thoracic radiography in 82 cats revealed cardiomegaly in 40 (49%) of these cats; 16 cats with congestive heart failure also had pulmonary edema or pleural effusion. In 5 cats with markedly increased fecal volume, mean 48-hour fecal fat content was significantly greater than normal, with daily fat excretion 2 to 15 times the upper limit of normal. Base-line serum thyroxine concentrations were increased above normal range in all cats, whereas triiodothyronine concentrations were increased in 127 (97%) of the 131 cats. In 11 cats tested, mean thyroxine concentration did not increase significantly after thyroid-stimulating hormone administration. Mean 24-hour percentage of thyroid radioiodine uptake in 32 hyperthyroid cats was significantly higher (39.1%) than normal (9.2%). Thyroid scans, performed on 126 cats, showed enlargement and increased radionuclide accumulation in 1 thyroid lobe in 36 (29%) and both lobes in 90 (71%) of the cats.
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PMID:Feline hyperthyroidism: pretreatment clinical and laboratory evaluation of 131 cases. 687 10

Severe anemia in a weanling kitten resulted in volume overload hypertrophy of the heart and signs of congestive heart failure. A 6-week-old moribund kitten was admitted to the hospital with a PCV of 3%. The anemia was determined to have resulted from severe flea infestation and iron deficiency. Supportive therapy consisted of flea removal, blood transfusions, and oral nutritional support. On day 3 of hospitalization, the kitten had signs of depression and became tachypneic. Auscultation revealed a systolic murmur, gallop rhythm, and crackles over the ventral lung fields. Thoracic radiography revealed pulmonary edema and massive cardiomegaly. Echocardiographic evaluation revealed dilatation of all cardiac chambers. The addition of furosemide to the kitten's treatment protocol resulted in resolution of the pulmonary edema. On follow-up examination 1 month later, the kitten had mild residual cardiomegaly and the anemia had resolved. Anemia is a well-known sequela to severe flea infestation in young animals. A less commonly reported, but potentially life-threatening, sequela to anemia may include the development of volume overload hypertrophy of the heart and congestive heart failure.
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PMID:Severe cardiomegaly secondary to anemia in a kitten. 846 24

In an attempt to identify the range of opinions influencing the diagnosis and therapy of patients with the adult respiratory distress syndrome (ARDS), a postal survey was mailed to 3,164 physician members of the American Thoracic Society Critical Care Assembly. The questionnaire asked opinions regarding the factors important in the diagnosis of ARDS and its treatment. Thirty-one percent of physicians surveyed responded within 4 weeks, the vast majority of which were board certified or eligible in Internal Medicine, Pulmonary Disease, and/or Critical Care Medicine. A known predisposing cause, measure of oxygenation efficiency, and a chest radiograph depicting pulmonary edema were reported to be the most important criteria for a clinical and research diagnosis of ARDS. Lung compliance and bronchoalveolar lavage neutrophil or protein content were reportedly less important. The initial treatment of patients with ARDS was reported to be most commonly accomplished using volume-cycled ventilation in the assist/control mode. Nearly half the responders reported using lower tidal volumes (5 to 9 mL/kg) than the traditionally recommended 10 to 15 mL/kg. Most respondents indicated they have intentionally allowed CO2 retention. On average, oxygen toxicity was thought to begin at an FIO2 between 0.5 and 0.6. It was reported that modest levels of positive end-expiratory pressure (PEEP) were used in incremental fashion as FiO2 requirements increased. Perceived indications for insertion of pulmonary artery catheters and compensation of the effects of PEEP on the pulmonary artery occlusion pressure varied widely among the responders. We conclude that reported practice patterns regarding the care of ARDS patients vary widely even within a relatively homogenous group of critical care practitioners.
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PMID:Diagnosis and therapy of acute respiratory distress syndrome in adults: an international survey. 890 79

Knowledge of common and uncommon thoracic pathologic conditions in children with acquired immunodeficiency syndrome (AIDS) can expedite disease management. Chest radiography, computed tomography (CT), and magnetic resonance (MR) imaging are useful in cases involving possible complications of thoracic AIDS. Lymphocytic interstitial pneumonitis (LIP) is generally seen on plain radiographs and CT scans as a diffuse, symmetric, reticulonodular or nodular pattern, occasionally associated with mediastinal or hilar adenopathy. Chronic consolidations and bronchiectasis may be observed in pediatric AIDS patients with no evidence of previous LIP. Bacterial pneumonia, a frequent initial manifestation of AIDS, appears as lobar or segmental consolidations on radiographs. Radiographic findings of Pneumocystis carinii pneumonia, the most common infection, include rapidly progressive increased air-space opacity with air bronchograms. Lymphoma often appears as a mediastinal or hilar mass, often without involvement of the lung parenchyma. Thoracic smooth muscle tumors have also been observed in children with AIDS. Multilocular thymic cysts have low attenuation on CT scans and increased signal intensity on T2-weighted MR images. Most pediatric AIDS patients with cardiac disease have cardiomegaly, often associated with pulmonary edema, at chest radiography. An esophagogram may show ulceration, plaque formation, mucosal edema, and dysmotility in patients with candidal esophagitis.
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PMID:Thoracic disease in children with AIDS. 894 40

Dr. Lyman Augustus Brewer III, a distinguished, colorful thoracic surgeon and among the first to practice that specialty in the West, died on June 25, 1988, in Los Angeles, California, after a courageous battle with lymphoma. Dr. Brewer was a great humanist, innovative clinical surgeon, charismatic teacher, and surgical leader. In World War II, Lieutenant Colonel Brewer served in the Second Auxiliary Surgical Group in the Mediterranean and European theaters and helped define criteria that became the standard for the management of thoracic war injuries. Out of this experience he authored the classic paper, "The Wet Lung in War Casualties." Dr. Brewer's scientific contributions embraced the broad spectrum of thoracic surgical topics, including treatment of tuberculosis, classification of lung cancer, bronchial stump buttressing using the pericardial fat pad (Brewer fat pad), and management of esophageal perforation. Dr Brewer wrote seven books and more than 100 papers, and served as First Vice President of The American College of Surgeons and as President of the American Association for Thoracic Surgery, The Society of Thoracic Surgeons, and The Pacific Coast Surgical Association.
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PMID:Lyman A. Brewer III (1907-1988): surgeon-scientist, inspirational teacher, and humanist. 993 May 19


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