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

Because of unanswered questions about reference values for single-breath carbon monoxide diffusing capacity (DLCO) in Chinese, standardized DLCO measurements were carried out in a selected sample of 257 healthy nonsmoking Chinese aged 20-70 years. The methods of measurement essentially followed the American Thoracic Society (ATS) recommendations. The measured DLCO was corrected to a standard hemoglobin value. Observed mean values for DLCO were 25.87 +/- 5.64 mL/min/mmHg in men and 21.16 +/- 3.88 mL/min/mmHg in women. Correlations of DLCO indices with anthropometric variables revealed that DLCO was best correlated with age in both sexes (r = -0.71 for men and r = -0.61 for women, p < 0.001). For alveolar volume (VA), the most significant correlation was found with height. For specific diffusing capacity (DLCO/VA), there was a significant negative relationship with age. Reference equations using age and body surface area (BSA) as independent variables for DLCO, VA and DLCO/VA were derived separately for men and women. An analysis of the distribution of residuals was Gaussian with simple linear regressions. Predicted values for DLCO and VA, as estimated in the present study, were much lower than equations derived from Caucasian populations. On the contrary, DLCO/VA values, as predicted by the present set of equations, were comparable to those of Caucasian equations. Therefore, differences in DLCO values between Chinese and Caucasians may be explained by differences in lung volume rather than by ethnic variations in the inherent characteristics of the alveolar capillary membrane. Predicted values for Chinese should be obtained from equations established from this study rather than extrapolated from those of Caucasians. The results of this study will be of value to clinical laboratories dealing with pulmonary function testing for Chinese patients.
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PMID:Single-breath carbon monoxide diffusing capacity: effect of body size and age in healthy nonsmoking Chinese. 136 7

The measurement of single-breath diffusing capacity of the lung for carbon monoxide (DLCOsb) has traditionally used slow-responding analyzers that require large sample volumes for gas analysis. In addition, these measurement systems must use only assumed values of washout volume (Vwash) since gases are not measured continuously. More recently, a rapid analyzer was developed to continuously measure CO and methane (CH4, an inert tracer gas), which offers advantages, including accurate determination of Vwash and utilization of small sample volume (Vsamp) for gas analysis. We used this analyzer on 135 consecutive measurements of DLCOsb obtained from 70 patients and compared two analysis methods. (1) American Thoracic Society (ATS) guideline method: a standard Vwash (ATS-Vwash) of 0.75 L and a Vsamp of 0.75 L (for vital capacities [VC] less than 2.0 L, ATS-Vwash of 0.5 L and a Vsamp of 0.5 L); (2) VIS method: a Vwash visually just adequate to clear phases I and II of the CH4 washout curve (VIS-Vwash) and a Vsamp of 0.75 L (0.5 L for VC less than 2.0 L). We found that in four patients with VC less than 1.2 L, DLCOsb was attainable despite the small Vsamp (less than 500 ml). Of the other 66 patients whose tests were analyzed by both methods, 33 (50.0%) had Vis-Vwash less than or equal to ATS-Vwash such that phases I and II were actually cleared using ATS criteria. The other 33 patients (50.0%) had VIS-Vwash greater than ATS-Vwash such that phases I and II could not be cleared using ATS criteria.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Real-time gas analysis improves the measurement of single-breath diffusing capacity. 141 23

We have evaluated the effectiveness of a technique of blended anaesthesia (epidural-general) in 31 patients undergoing major surgery. Thoracic epidural blockade with lidocaina CO2, adrenalin 1/200000, ensures analgesia while induction and hypnosis maintenance were obtained with midazolam, alfentanil, atracurium and N2O/O2. This technique seems able to protect the patients from endotracheal intubation and surgical stress and also to enable a rapid, quiet awakening. The dose of midazolam necessary to maintain hypnosis was inversely proportional to the patient's age. The reversal of hypnosis was necessary in 4 patients only.
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PMID:[Alfentanyl and midazolam in combined anesthesia. Clinical evaluation]. 150 44

Because of unanswered questions about prediction equations for the single-breath carbon monoxide diffusing capacity (DLCO) and as part of a larger collaborative project, standardized DLCO measurements were carried out in a selected sample of 361 healthy nonsmoking volunteers (194 men and 167 women) living in the Barcelona metropolitan area (Spain). Except for the test FIO2 (0.18), the study essentially followed the American Thoracic Society (ATS) and European Community for Coal and Steel (ECCS) recommendations for standardizing the methodology of measuring DLCO. Prediction equations for ages 20 through 70 were calculated separately for both sexes. Simple linear equations using age, height, and body weight as independent variables predicted the DLCO indices (DLCO, VA, and DL/VA) as well as more complex equations. In addition, a complete analysis of the residuals (predicted measured values) showed that the assumptions of the multiple regression analysis (independence, homoscedasticity and Gaussian distribution of residuals) were fulfilled using simple linear equations. Correction for the instrumental and anatomic dead spaces decreased the DLCO an average of 4.7%. The standard error of estimates was lower than those reported from other series in the literature. The predicted values from this study were lower than those reported by some investigators and were in reasonable agreement with other studies. A portion but not all of the differences could be explained on the basis of recognized differences in testing methodology. The results of this study may be of value to clinical laboratories seeking predictive equations for DLCO most appropriate for their testing methodology and patient population, and may assist in the resolution of some controversies regarding differences among predictive equations for DLCO.
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PMID:Single-breath carbon monoxide diffusing capacity prediction equations from a Mediterranean population. 232 36

Influence of various hormones on the induction of cellular retinoic acid binding protein (CRABP) was investigated in the mouse mammary gland organ cultures. Thoracic pairs of mammary glands from the BALB/c mice were cultured for seven days in the presence of various hormones in CMRL medium at 37 degrees C under 50% O2, 5% CO2 and 45% N2 atmosphere. There was a modest increase of mammary CRABP by insulin (I) + prolactin (P), however, addition of progesterone (Pg) or estrogen (E) + Pg to the medium resulted in a dramatic increase in the CRABP. Aldosterone (A) + hydrocortisone (F), in addition to I + P, which promotes differentiation to an extent similar to that of I + P + E + Pg did not have any influence on the induction of CRABP. These results indicate that prolactin and/or Pg in the medium can increase the concentration of CRABP in the mammary gland in vitro. From the results presented in this report, as well as previous work by other investigators, it is concluded that the biological response to retinoids in the mammary tissues cannot be correlated with the absolute concentration of CRABP in the cells. However, the biological response may be dependent upon both the ability of the target organ cells to metabolize the retinoid and to have minimal concentration of CRABP for binding to the active metabolite. The functional significance of hormone-induced CRABP is presently unknown.
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PMID:Role of hormones on the induction of retinoic acid binding protein in mouse mammary gland organ culture. 299 Jul 55

The vasodilator effects of carbon monoxide (CO) were studied in an isolated perfused rat thoracic aorta preparation. Thoracic aortas from male Sprague-Dawley laboratory rats were dissected free of surrounding tissue, cannulated proximally, and tethered to in situ length. The vessels were perfused with oxygenated Krebs-Henseleit (KH) solution at 37 degrees C in a constant flow system with a circumferentially-applied, pulsatile (300/min), basal "systolic" pressure of 100 mm Hg. Aortas were precontracted with high-potassium (K+) or norepinephrine (NE). Changes in perfusion pressure were indicative of changes in vascular resistance induced by the test gas mixtures. Oxygen (O2) content of the perfusate was kept constant, while CO and nitrogen (N2) were altered. CO (2.5, 5 and 10%) dilated both K+-contracted and NE-contracted aortas in a dose-dependent manner. A significant vasodilation in response to 5% CO (24.5% of maximal), but not to 5% N2, was obtained in the K+-contracted aortas. After the endothelium was removed chemically, the aortas continued to dilate in response to CO. These results suggest that CO has a direct vasorelaxant effect on vascular smooth muscle which is nonspecific and is not endothelium-dependent.
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PMID:Vasodilating effects of carbon monoxide. 324 86

Single-breath transfer factor obtained using a multibreath estimate of alveolar volume (TI) was measured before and after salbutamol in twenty patients with reversible airflow limitation. The effective breathholding time was calculated by four methods due respectively to Ogilvie and colleagues as modified by the American Thoracic Society (ATS), ATS Epidemiological Standardization Project (ESP), Jones and Meade in which allowance was made for the time of sample collection and a simplified method in which the allowance for sampling was in terms of volume, not time. Two patients could perform the test procedure only after salbutamol. Amongst the remainder the transfer factor calculated using a single-breath estimate of alveolar volume (TI') was on average 12% less than TI. Carbon monoxide transfer coefficient (KCO), TI and TI' were highest by the ESP method and lowest by the Ogilvie method. Inhalation of salbutamol (200 gamma) did not affect TI' by any method or TI and KCO by the Jones and Meade method but results by the other methods were reduced; in the case of the modified Ogilvie method the reduction was 3.9%. This error was due to overestimation of effective breathholding time by neglecting the reduction of 39% which occurred in the time of sample collection. The time of inspiration was unchanged whilst the time of deadspace washout was reduced by 16%. After bronchodilatation the absence of a change in TI' was due to the overestimation of effective breathholding time being offset by an increase in the proportion of alveolar volume measured by the single-breath procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Measurement technique influences the response of transfer factor (TICO) to salbutamol in patients with airflow limitation. 336 32

Thoracic impedance apnea monitors may fail to detect obstructive apnea, may falsely alarm when the infant is breathing, and may confuse cardiac artifact with respiratory impedance. Therefore, we compared the performance of a respiratory inductive plethysmograph and a thoracic impedance monitor with a reliable measure of airflow, either nasal CO2 or pneumotachograph, during 29 studies in 28 patients referred for sleep laboratory evaluation. Sleep time averaged 72 +/- 37 (SD) minutes. The inductance plethysmography and the impedance monitor detected 99.6% +/- 0.6% and 98.3% +/- 3.0% of breaths, respectively. However, in two studies, the impedance monitor detected many extra breaths, once because of cardiac-induced impedance changes and once because of partial airway obstruction-induced impedance changes. In 11 studies, cardiac artifact was sometimes misinterpreted as a breath by the impedance monitor. The impedance monitor, but not the inductance plethysmograph, missed breaths following sighs in 16 of 29 studies. Both monitors detected all 60 episodes of central apnea. The inductance plethysmography detected 35 of 38 episodes of obstructive apnea, but the impedance monitor identified only two such events. Apnea was detected falsely four times by the inductance plethysmograph and 14 times by the impedance monitor. These results suggests that a respiratory inductive plethysmograph would have significant advantages over impedance monitoring, including the ability to detect obstructive apnea, and freedom from cardiac artifact.
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PMID:Comparison of respiratory inductive plethysmography and thoracic impedance for apnea monitoring. 362 4

Data on pulmonary gas exchange were collected in breathhold dives to 90 feet in a tank and in open-sea breathhold dives to depths of 217.5 and 225 feet. Thoracic blood volume displacements were measured at depths of 25, 50, 90, and 130 feet, by use of the impedance plethysmograph. The open-sea dives were carried out with an average speed of descent of 3.95 feet per second and an average rate of ascent of 3.50 feet per second. End-dive alveolar oxygen tensions did not fall below 36 millimeters of mercury, while alveolar carbon dioxide tension did not rise above 40 millimeters of mercury except in one case. These findings indicate that for diver Croft, who has unusual lung capacity, neither hypoxia nor hypercapnia determined the depth limits under those conditions. At depths of 90 and 130 feet blood was forced into the thorax, amounting to 1047 and 850 milliliters respectively.
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PMID:Pulmonary and circulatory adjustments determining the limits of depths in breathhold diving. 572 83

Thoracic endoscopic sympathectomy (TES) is a short surgical procedure used for the treatment of axillary and palmar hyperhydrosis. It involves creation of tension pneumothorax, lateral and head-up position and necessitates minimal lung excursions during breathing, so that a special anaesthetic technique is required. In six otherwise healthy patients an endobronchial double lumen tube was used for one-lung ventilation with intravenous anaesthesia and muscular relaxation, and circulatory response, FE CO2 and blood gases were monitored in order to compare this anaesthetic technique to conventional endotracheal intubation in previous patients. Some difficulties with inserting and securing the double lumen tube were encountered, but were far outweighed by the advantages of stable circulation, physiological blood gas values and easy access to a calm surgical field.
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PMID:[Endobronchial ventilation in transthoracic endoscopic sympathectomy]. 663 18


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