Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumonectomy performed by the V.A.T.S. method-Video Assisted Thoracic Surgery-calls for great skill, concentration and experience of the surgeon and puts greater demands on him than classical surgery. Minithoracotomy (5-10 cm) combined with videothoracoscopy have the joint advantages of miniinvasive operation and safety and radicality of the operation. During surgery lymphadeaectomy can be performed, it is possible to suture injured arteries or veins. Postoperative recovery is markedly better after V.A.T.S. than after conventional surgery. In the group of the first 11 V.A.T.S. lobectomies and one V.A.T.S. pneumonectomy the authors recorded a very low morbidity and zero mortality. The patients usually do not suffer from postoperative pain and rehabilitate well. The easier, less painful postoperative course is associated with earlier discharge, rapid convalescence and early return to work. V.A.T.S. is, no doubt, a benefit for the patient with regard to the postoperative response and course of recovery.
 ...
PMID:[Video-assisted thoracic surgery--lobectomy, pneumonectomy]. 934 Aug 23

The aim of the study was first to evaluate whether mobility in the cervico-thoracic motion segment is an indicative factor of musculo-skeletal neck-shoulder pain and secondly to compare differences in individual factors between cases and controls for female and male subjects. One-hundred-and-forty-two male electricians and 139 female laundry workers participated in a cross-sectional study. An examination of the Cervico-Thoracic Ratio and a classification of mobility at level C7-T1 was done. All subjects answered a questionnaire about musculo-skeletal complaints. The analysis of relationship between relative flexion mobility in motion segments C7-T5 and neck-shoulder pain showed significant relationships between mobility in specific motion segments and neck-shoulder pain. The overall fit of the multiple regression analysis explained 10% of the variation in neck index (N1) for subjects classified as hypomobile at level C7-T1 and 18% for subjects classified as having an inverse C7-T1 function. Both female and male subjects classified as hypomobile at level C7-T1 showed elevated odds ratios of 2.7 and 2.2, respectively, to have had more than 7 days of neck pain during the previous 12 months, compared to subjects classified as having ordinary mobility at level C7-T1. The factor age showed that young subjects with hypoar hypermobility at level C7-T1 showed elevated odds ratios for neck pain compared to subjects with ordinary mobility in the same age group. In old subjects hypermobility at level C7-T1 was protective compared to subjects with ordinary mobility in the same age group. The factor number of working years showed significant difference between cases and controls among female subjects in the ordinary and hypermobile classes. The factor height showed no significant differences between female or male cases and controls; it did show significant correlation to C7-T1 mobility among female subjects, but not among male subjects. The factors exercise and smoking showed significant differences between cases and controls among female subjects in the ordinary mobility class. The conclusion was that relative flexion mobility is a factor related to the development of neck-shoulder pain rather than the cause of pain.
 ...
PMID:Mobility in the cervico-thoracic motion segment: an indicative factor of musculo-skeletal neck-shoulder pain. 912 45

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.
 ...
PMID:Unilateral abdominal muscle herniation with pain: a distinctive variant of diabetic radiculopathy. 930 Feb 33

From December 1991 to June 1995, video-assisted thoracic surgery (VATS) was performed on 207 patients at the Medical Center of Delaware with minimal complications and no mortality. A definitive diagnosis was made in all patients. Results with VATS procedures appear to be comparable to those with the standard open technique. Operating time was comparable to that with the open technique. Length of stay and pain and suffering were dramatically reduced compared with the open technique. We now consider VATS to be the preferred procedure in the following conditions: 1. Undiagnosed pulmonary infiltrate in the non-ventilator-dependent patient. 2. Indeterminate pulmonary nodule. 3. Undiagnosed disease of the pleural space. 4. Recurrent or persistent pneumothorax. 5. Mediastinal or pericardial cystic tumors. 6. Thoracic sympathectomy. 7. Selected patients requiring esophagocardiomyotomy. The utilization of VATS for resection of a pulmonary mass in patients with compromised pulmonary status (i.e., FEV < 1) is being studied.
 ...
PMID:The current role of video-assisted thoracic surgery (VATS) in the overall practice of thoracic surgery. A review of 207 cases. 937 64

Thoracic epidural anaesthesia (TEA) faces growing interest as an adjuvant anaesthetic and postoperative analgesic regimen. The procedure allows a specific blockade of nociceptive reflex arches and may exert beneficial effects on stress-induced alterations of organ function. Myocardial blood flow to areas at risk is improved, and paradoxical reactions of atherosclerotic coronary arteries after sympathetic stimulation are suppressed. After cardiac surgery, TEA improved postoperative recovery and resulted in better haemodynamic stability and allowed earlier extubation. During vascular surgery, the graft occlusion rate was significantly decreased. The improved pulmonary function after TEA is due to superior pain relief which allows the patients to breathe and cough sufficiently. After upper abdominal surgery, TEA leads to improved recovery of gastrointestinal function which reduces the risk of bacterial translocation. Although lumbar epidural anaesthesia is preferred by many anaesthesiologists as there is no risk of traumatizing the spinal cord, many positive effects are forgone. With insufficient rostral spread of a lumbar epidural block above the fifth thoracic level, cardiac complications can occur due to reflex activation of sympathetic outflow in unblocked thoracic regions. When the contraindications are carefully observed, TEA can be safely performed in most patients.
 ...
PMID:[Thoracic epidural anesthesia--more than an anesthesia technique]. 941 55

Following the development of video-assisted technologies and the principle of minimally-invasive surgery thoracoscopy has finally established itself as an integral part of the surgeon's armamentarium in the treatment of spontaneous pneumothorax. This procedure was performed on 18 patients at the Department of Cardio-Thoracic Surgery of the Medical University in Vienna from October 1995 to April 1996 and on 5 patients at the Department of Thoraco-Abdominal Surgery of the Medical University in Plovdiv from October 1996 to January 1997, all of which had been diagnosed as having complicated spontaneous pneumothorax. The main indications were: recurrent spontaneous pneumothorax or persistent pneumothorax following a five-day unsuccessful drainage of the pleural cavity. All our patients underwent partial parietal pleurectomy down to the level of the third intercostal space. Apical blebs were found in 14 patients and atypical wedge resection was performed. The authors used three trocars 5-12 mm in diameter. The thoracoscope was inserted in the fifth intercostal space in the midaxillary line. The other two operative trocars were inserted in the anterior and posterior axillary lines, respectively. The mean postoperative stay was 6 days. Our results support the view that video-assisted thoracic surgery is technically feasible and safe, associated with decreased perioperative pain and opiate requirements, shorter hospital stay, excellent cosmetic results, low recurrence rate, early return to routine activity and minimal morbidity and is therefore superior to conventional thoracotomy.
 ...
PMID:Video-assisted thoracic surgery in patients with spontaneous pneumothorax. 957 46

Thoracic surgical oncology involves surgical treatment of lesions of the thoracic wall, pulmonary parenchyma, or mediastinum (also including heart, esophagus, or trachea). The most common neoplasms of the thoracic wall are osteosarcoma and chondrosarcoma. Histopathologic type, the use of chemotherapy for osteosarcoma, and completeness of surgical margins are prognostic for survival. Relative to solitary pulmonary masses, carcinomas are most common, with histopathologic type, tumor size, tumor grade, and lymph node status prognostic for survival. Of the aforementioned variables, lymph node status is the most significant. Extensive preoperative workup, including bronchoscopy and transthoracic fine needle aspiration of solitary lung masses, is usually not recommended. Thymomas are the most common surgical mediastinal mass. Patients are frequently affected with paraneoplastic syndromes including myasthenia gravis, polymyositis, and nonthymic neoplasia. Patients without megaesophagus with surgically resectable masses have an excellent prognosis for survival. Provision of analgesia after surgery in thoracotomy patients is extremely important. Carefully selected analgesic agents in thoracotomy patients are far less damaging to cardiovascular status than is tachycardia from excessive pain. Given these and other guidelines, perioperative mortality in thoracotomy patients is minimal, and long-term survival in selected patients is excellent.
 ...
PMID:Thoracic surgical oncology. 963 48

Nine dogs with primary bone tumours were treated with Samarium-153-EDTMP (Sm-153-EDTMP). Conventional treatment protocols were precluded by the size of the dogs and the owners' refusal of limb amputation. All the tumours were of the appendicular skeleton; 4 were confirmed osteosarcomas. The other 5 tumours were radiologically suspect for osteosarcoma. Bone scans were performed on all dogs using Technetium-99m-methylene diphosphonate (Tc-99m-MDP) before administration of Sm-153-EDTMP. Regions of interest were identified over the contralateral limb at the same site as the tumour and counts per pixel were recorded for the tumour and contralateral limb and expressed as a ratio. The dogs were given 1 injection of 37 MBq/kg (1 mCi/kg) of Sm-153-EDTMP intravenously. Thoracic and primary tumour site radiographs were taken at monthly or 2-monthly intervals to monitor progression of the primary tumour and search for evidence of metastasis. Two dogs showed no response to treatment, with an increase in bone pain, and were euthanased within 1 month. In 1 dog, a tumour of the scapula underwent complete involution and the dog is considered free of disease at 20 months post Sm-153-EDTMP treatment. The overall tumourcidal effect of a single dose of Sm-153-EDTMP on primary bone tumours was difficult to evaluate in this group of dogs, as, with one exception, all the primary tumours progressed over time and the dogs were euthanased. Pain control, for which Sm-155-EDTMP is used in man, was not evident, except in the dog that responded completely to treatment.
 ...
PMID:Targeted radiotherapy with Sm-153-EDTMP in nine cases of canine primary bone tumours. 964 55

To assess thoracic analgesia by continuous infusion in surgery to repair pectus excavatum and carinatum in children. This prospective study enrolled 14 children aged 6 to 14 years old scheduled for surgery to correct pectus excavatum and carinatum. After induction of general anesthesia, the T8-T9 epidural space was accessed and a catheter was inserted to T3-T7 with radioscopic monitoring. A loading dose of 0.03-0.04 ml/kg per segment to be blocked (5 segments: T3-T8) of 0.125% bupivacaine and 3 micrograms/ml fentanyl was given to children under 7 years of age; a dose of 0.02-0.03 ml/kg per segment was administered to children over the age of 7 years. A continuous perfusion of 0.1-0.4 ml/kg/h was maintained, with the possibility of additional boluses of 1 ml at 20 min intervals during surgery and the first three days thereafter. An intraoperative bolus was given when the level of blockade was not reached or when mean blood pressure and heart rate increased 15% over baseline. Pain relief was assessed on a numerical scale of 0 to 5 or on a scale of facial icons, depending on the patient's age. During the postoperative period, the pediatric ICU nurse administered a bolus if pain was [symbol see text]3 or heart rate increased 75% over age-based reference values. Top-up analgesia was provided with Metamizole at a dose of 25 mg/kg. No complications attributable to the technique or to sympathetic blockade were observed. All tubes were removed in the operating room. The thoracic epidural catheter was left in place for 70.3 +/- 2.6 h. Mean initial doses of analgesia were 0.45 microgram/kg of fentanyl and 0.2 mg/kg of bupivacaine. The mean number of complementary boluses was 3 +/- 1 during surgery, 5 +/- 2 on the first postoperative day and 4 +/- 1 on the second day. No patient required top-up analgesia on the third day. Hemodynamic stability during surgery and the postoperative period was good. Analgesia was excellent (< 2) for 78.5% of the patients on the first day after surgery, for 85.7% on the second day and for all patients on the third day. We recorded one case of pruritus (7.1%), three of nausea (21.4%) that subsided when butorphanol was given epidurally (20 micrograms/kg), and two cases of light sedation. Thoracic epidural analgesia is effective for alleviating postoperative pain from corrective thoracic surgery in children. Side effects were minimal and no anesthetic complications were observed.
 ...
PMID:[Thoracic epidural analgesia in the postoperative period of pediatric surgery for the repair of pectus excavatum and pectus carinatum]. 964 55

Pain during pleurodesis is frequently severe and poorly suppressed with intravenous narcotics and/or local anesthetic installation. Epidural analgesia is very effective for all types of severe pain including surgical anesthesia, yet has not been reported in treating pleurodesis pain. Thoracic epidural can be safely and extremely effectively utilized when neural pathways are considered, as this case history demonstrates.
 ...
PMID:Complete analgesia during pleurodesis under thoracic epidural anesthesia. 969 6


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>