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

Thoracic ratios (TRs) were measured segmentally (T1-12) in the chest radiographs of 412 children aged 0-17 years attending hospital with minimal disorder or diseases (boys 193, girls 219). A new method for measuring TRs was used which calculates the width of the left hemithorax, the right hemithorax and the total thorax relative to T1-T12 distance. The data were analysed in 3 age groups--infancy, childhood and puberty, after the classification of Karlberg (1989). The findings are as follows. 1. The chest broadens from T1 to about T10-11. 2. Between infancy and childhood, relative to its length the chest narrows from above downwards and particularly in the lower chest (T5-12 average diminution, boys 9.5%, girls 9.8%). In the upper chest, the narrowing is more marked in girls than boys (T1-4 average diminution, boys 5.1%, girls 8.2%). 3. Between childhood and puberty, the girl's but not the boy's chest narrows further in its lower half (below T6 average diminution 3.3%). At T6 and above there is no detectable change in the relative width of the chest in either boys or girls. 4. The relative narrowing of the chest during growth appears to result from several mechanisms: (1) elevation of upper rib-vertebra angles (above 90 degrees); (2) drooping of lower rib-vertebra angles (below 90 degrees); and (3) linear rib growth being impaired relative to thoracic spinal growth in the lower ribcage (T6-12) of girls between childhood and puberty (Grivas et al. 1991 d). 5. The hypothesis is suggested that the relative narrowing of the lower chest with increasing age reduces the rotational inertia of the thorax in gait. There is a greater need for such reduction in girls because of the greater rotational inertia generated by the mass of their larger pelves. This hypothesis provides a mechanical explanation for the proportionate change in the girl's lung in the later stages of growth (Simon et al. 1972). 6. Developmentally, the left hemithorax is ahead of the right hemithorax in childhood. 7. Thoracic asymmetry favouring the right chest is found, and more so in puberty than childhood which is connected with the larger size of the thorax and lung in the adult. 8. The evidence suggests that hemithoracic development is caudocranial; this is consistent with an adaptation of the human ribcage to control spinal rotation and counterrotation when bipedal gait was acquired in evolution. 9. In progressive infantile idiopathic scoliosis, the upper chest is funnel-shaped.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A segmental analysis of thoracic shape in chest radiographs of children. Changes related to spinal level, age, sex, side and significance for lung growth and scoliosis. 181 Sep 28

Thoracic spondylotic myelopathies are exceptional, only 29 observations could be found in the literature; we intend to describe three new cases here. The patients, two women and one man, 64, 69 and 72 years old, complained of weakness of the lower limbs, more marked on one side, which had been progressing slowly from several months to eight years. Examination revealed asymmetrical paraparesis with distal sensitivity deficits without thoracic sensory level. In the first case, the myelography remained virtually unchanged in front of T11, T12; in the second and third cases, there was slight extradural compression at T9 and T10 respectively. Magnetic Resonance Imaging (M.R.I.) performed in two patients was evocative of a thoracic disk herniation. A chest CT scan enabled us to establish correct diagnosis: in the three cases irregular hypertrophy of the posterior elements was evident at T11 and T12, T9 and T10, T10 and T11 respectively, with osteophytes originating in the articular process and deeply embedded in the spinal canal. Decompressive laminectomy associated with medial facetectomy resulted in the gradual improvement of walking in all three patients. Myelography and MRI are both useful in demonstrating the level compression, usually situated in the low thoracic spine, however only the CT allows differential diagnosis with other etiologies, especially anterior compression such as disk herniation.
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PMID:[Myelopathies caused by dorsal spinal canal spondylotic stenosis. 3 cases and a review of the literature]. 269 79

A 49-year-old man was admitted for the further examination of the abnormal shadow of the left posterior mediastinum, which was incidentally detected on routine chest X-ray. He has no complaints, and no abnormalities on neurological examination. Thoracic spine X-ray showed the destruction of the T12 vertebral body and the dilatation of the left intervertebral foramen between T12 and L1. Myelography showed no abnormalities, but contrast-enhanced CT scanned just after myelography revealed the extradural dumbbell-formed tumor. One stage removal of the tumor was safely performed through left posterolateral thoracotomy and transthoracic partial laminectomy. Postoperative course was uneventful. The tumor was histologically schwannoma, originated from the left thoracic sympathetic trunk. We think that this procedure is available for the operation of a kind of dumbbell tumor of the posterior mediastinum.
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PMID:[A case of dumbbell neurogenic tumors of the mediastinum]. 279 73

A 52-year-old male with pulmonary hypertension secondary to partial anomalous pulmonary venous return unassociated with atrial septal defect was given thoracic epidural anaesthesia for elective cholecystectomy. Partial anomalous pulmonary venous return is a rare congenital anomaly characterized by increased pulmonary blood flow which in severe cases results in pulmonary hypertension subjecting the right ventricle to strain. An epidural catheter was placed at the T11-T12 interspace and anaesthesia was established to the T4 dermatomal level with bupivacaine (180 mg) and lidocaine (100 mg). Central venous pressure, pulmonary artery pressure, radial artery pressure, and cardiac output were monitored. There was minimal change in pulmonary arterial pressure, although there was a significant drop in systemic arterial pressure. Thoracic epidural block is recommended for upper abdominal surgery in clinical situations with pulmonary hypertension.
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PMID:Low thoracic epidural anaesthesia for elective cholecystectomy in a patient with congenital heart disease and pulmonary hypertension. 682 89

We conducted a radiographic retrospective study in children to determine spinal lordosis and kyphosis. A total of 218 lateral standing full-length radiographs were studied: 104 normal and 114 scoliotic patients. Normal X-ray films were defined as those obtained for suspected disorder (e.g., scoliosis) with no abnormalities detected by the radiologist or orthopedist. Thoracic kyphosis is defined as the angle between perpendiculars drawn from the inferior endplate of T5 and the superior endplate of T12. Lordosis is the angle between perpendiculars from the inferior endplate of L1 and the superior endplate of L5. The angle between the inferior endplate of L5 and the top of the sacrum is the L5-S1 angle. Statistical analysis was undertaken to compare lordosis and kyphosis radiographic measurements with age, sex, height, and weight employing the SAS package program. No significant relationships were noted between degree of scoliosis, age, sex, height or weight, and kyphosis, lordosis, or L5-S1 angle. Neither could correlations among the three radiographic measurements be made. Lordosis measured 40 degrees (range 31-49.5 degrees) in normal and 48.5 degrees (range 40-55 degrees) in scoliotic patients. Kyphosis measured 27 degrees (range 21-33 degrees) in normal and 28 degrees (range 16.5-36 degrees) in scoliotic patients.
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PMID:Radiographic determination of lordosis and kyphosis in normal and scoliotic children. 687 32

Thoracic pedicle anatomy (interpedicular distance, transverse and sagittal pedicle widths, transverse and sagittal pedicle angles, and the distance from the axis of the pedicle to the axis of the transverse process) was assessed in 11 cadavers of elderly people. The cadaveric spines were extensively dissected to augment the accuracy of the measurements via caliper and goniometer. The results were compared with those of previous studies that assessed pedicle anatomy with computed tomography, direct measurement, and three-dimensional morphometry. Between the studies, significant differences were found in transverse pedicle width and transverse and sagittal pedicle angles. These morphometric differences may reflect either the diversity of the techniques used to measure the pedicle anatomy or sampling variation. This article presents a previously unreported morphometric finding, the rostral-caudal distance from the thoracic pedicle to the midpoint of the base of the transverse process. At T1, the transverse process is 5.45 +/- 1.2 mm rostral to the pedicle. This relationship gradually changes as the thoracic spine is descended, so that at T12, the transverse process is 6.6 +/- 2.4 mm caudal to the pedicle. Crossover consistently occurs at the T6-T7 region. Although the transverse process is a reliable external landmark for the location of the pedicle in the lumbar spine, this relationship in the thoracic spine is variable and only moderately predictable.
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PMID:Anatomy of the thoracic pedicle. 747 83

Thoracic epidural analgesia combined with chronic beta-adrenergic blocker medication may cause cardiac depression. We investigated the cardiovascular and myocardial metabolic effects of a T1-T12 epidural block in 18 patients (age < 65 yr, ejection fraction > 0.5), receiving chronic beta-adrenergic blocker medication and scheduled for aortocoronary bypass surgery. After randomization into a light or deeper general anesthetic group, the cardiovascular and myocardial metabolic effects of a subsequent general anesthesia induction were investigated. Thoracic epidural analgesia induced a moderate decrease in mean arterial pressure, coronary perfusion pressure, free fatty acids, and myocardial consumption of free fatty acids. General anesthesia with thiopental (2-4 mg/kg) and a low fentanyl dose (5 micrograms/kg) increased heart rate, coronary perfusion pressure, and coronary vascular resistance, whereas mean pulmonary arterial pressure and pulmonary capillary wedge pressure decreased. After thiopental (2-4 mg/kg) and a high fentanyl dose (30 micrograms/kg), mean arterial pressure and left ventricular stroke work index decreased. We conclude that a T1-T12 epidural block in well sedated, beta-adrenergic blocked patients does not induce clinically significant cardiovascular effects. Induction of general anesthesia was well tolerated, but the light general anesthetic could not prevent an increase in heart rate and coronary vascular resistance, whereas the deeper anesthetic induced slight myocardial depression. No effect on the atrioventricular conduction, as measured by the PQ-time, was noted.
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PMID:The influence of thoracic epidural analgesia alone and in combination with general anesthesia on cardiovascular function and myocardial metabolism in patients receiving beta-adrenergic blockers. 810 48

Four cases of thoracic spondylotic myelopathy are reported, one man and three women, respectively 61, 66, 67 and 76 years old. Clinical presentation was numbness and weakness in the lower limbs in two cases, weakness alone in one and numbness alone in the last one. Diagnosis was settled by both myelography and CT-myelogram in three cases, by both MRI and CT-scan in the other one. The involved thoracic levels were both T9-T10 and T10-T11 for two cases and T11-T12 for the other one. The stenosis was due to hypertrophic ossification of the ligamentum flavum in three cases and to osteophytic changes in one. A laminectomy was performed for each patient and three patients had a significant recovery and the fourth a mild one. Thoracic myelopathy is an uncommon disease which requires a meticulous study of myelogram and now MRI to be recognized and to be cured by laminectomy. As for cervical myelopathy, it results from mechanical and ischemic factors which can lead to a definitive myelomalacia.
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PMID:[Thoracic spondylotic myelopathies. Apropos of 4 new cases]. 908 41

Thoracic diabetic radiculopathy causing truncal pain and abdominal muscle bulging is a recognized though extremely rare complication of diabetes. We report here six cases, describing their clinical features and natural history in detail: the condition affects predominantly middle-aged men, usually on the right side of the abdominal wall, involving three to five adjacent nerve roots between T6 and T12. It may be accompanied by profound weight loss which is not normally due to poorly controlled diabetes. Complete resolution of this syndrome occurs after 3 to 12 months.
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PMID:Unilateral abdominal muscle herniation with pain: a distinctive variant of diabetic radiculopathy. 930 Feb 33

Monitoring the descending neural motor volleys (MEPs), in comparison to muscle action potentials, allows sensitive motor assessment under anesthesia irrespective of the use of muscular blockade and status of skeletal musculature. Ketamine hydrochloride (KH) had preserved muscle MEPs on a pre-established primate model. The present work examines the effect of incremental hypnotic KH dosages thoracic neural on somatosensory (SEP) and MEPs recorded epidurally in response to transcranial magnetic stimulation (TMS). Through a small thoracic T11-T12 laminotomy, an insulated double bipolar electrode was inserted epidurally and cephalad in seven cynomolgus monkeys. Thoracic spinal TMS-MEPs, and SEPs, were tested against graded increase of KH doses (0.01, 0.018, 0.032, 0.056, 0.1, and 0.18 mg kg(-1) min(-1) i.v. infusion). The direct (D-) and indirect (I-) epidural MEP peaks were well-defined under sole KH infusion. The waveforms were consistent at various dosages. At the highest cumulative dose (0.18 mg kg(-1) min(-1), total 6.5 mg kg(-1) over 150 min), I5 was host and I3 and I4 latencies were delayed. The scalp and spinal SEP showed no significant change. Recording of both neural D- and I- MEPs and SEPs is feasible under high sole i.v. KH. It is the first agent to maintain up to four later I1 peaks. The reproducibility of both modalities is unquestionable under KH-based deep anesthesia. This reflects the maintenance of state of neural excitability under KH.
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PMID:High-dose ketamine hydrochloride maintains somatosensory and magnetic motor evoked potentials in primates. 1176 Aug 82


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