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

Radiographic outcome and complications of Harrington-DTT (H) and Cotrel-Dubousset (CD) instrumentation of idiopathic adolescent thoracic scoliosis were compared retrospectively. The patient material consists of 55 consecutive patients in the H group and 52 consecutive patients in the CD group. The mean age at operation was 15 +/- 2 years (range, 11-19 years) in both groups. The follow-up interval was 43 +/- 18 months (range, 17-91 months) in the H group and 28 +/- 11 months (range, ten to 53 months) in the CD group (p = 0.0001). The preoperative radiographic measurements (Cobb angle of primary and secondary curve, apical rotation, thoracic kyphosis, lumbar lordosis) were fully comparable in both groups. The mean correction of the primary curve at the follow-up evaluation was 47% in both groups. Apical rotation of the primary curve remained almost unchanged in both groups. Rotation of the secondary curve increased significantly in the CD group. Thoracic kyphosis was unchanged in the CD group but decreased in the H group. Spinal balance worsened in 29% of the H cases and in 44% of the CD cases. There were no neurologic complications in either of the groups. Intraoperative lamina fractures (four cases) and postoperative hook dislodgement (five cases) occurred only in the CD group. One distraction rod breakage occurred in the H group. Three reoperations were performed in the H group, nine in the CD group.
Clin Orthop Relat Res 1993 Dec
PMID:Operative treatment of adolescent idiopathic thoracic scoliosis. Harrington-DTT versus Cotrel-Dubousset instrumentation. 824 24

Thoracic trauma is frequently complicated by the development of Adult Respiratory Distress Syndrome (ARDS). Over the past 20 years numerous articles and book chapter have explored the causes and clinical course of the syndrome. There still remains debate, however, concerning the pathophysiology and most effective treatment modalities. It is apparent that trauma activated numerous complex biochemical pathways, such as the complement and arachidonic acid cascades, which probably resulted in neutrophil and macrophage mediated tissue injury. This article examines some of the more recent thoughts about the underlying pathophysiology. It also outlines some of the latest treatment techniques for ARDS, as well as the accompanying nursing therapeutics.
Crit Care Nurs Clin North Am 1993 Dec
PMID:Adult respiratory distress syndrome following thoracic trauma. 829 60

Heart-lung transplantation is associated with high perioperative mortality rates. A modified operative technique was used by one surgeon operating on 17 patients at the University of Arizona, Tucson, and the Inland Northwest Thoracic Organ Transplant Program, Spokane, Washington. This technique gives greater exposure to the area of dissection behind the heart-lung block after implantation and makes maintaining hemostasis easier. No deaths from bleeding complications occurred and no reoperations for bleeding were required with this technique. The Kaplan-Meier survival was 82% at 1 year. This technique simplifies a difficult technical procedure and may reduce mortality rate.
J Thorac Cardiovasc Surg 1995 Dec
PMID:A technique to simplify and improve exposure in heart-lung transplantation. 852 67

To establish guidelines for the surgical treatment of patients with infective endocarditis who have cerebrovascular complications, we conducted a detailed retrospective study of 181 of 244 patients with cerebral complications among 2523 surgical cases of infective endocarditis of the Japanese Association of Thoracic Surgery. The results showed that 9.7% of all patients with infective endocarditis had associated cerebral complications: 108 (44.3%) had active native valve endocarditis, 96 (39.3%) had healed native valve endocarditis, and 40 (16.4%) had prosthetic valve endocarditis. The hospital mortality of the patients with cerebral complications was 11.0% in the group as a whole: 13.9% in active native valve endocarditis, 3.1% in healed native valve endocarditis, and 37.5% in prosthetic valve endocarditis. Diseased valves included the following aortic valve in 55.5%, mitral valve 49.8%, tricuspid valve in 1.3%, and pulmonary valve in 1.3%. In 181 patients with cerebral complications, organisms were detected as follows: gram-positive cocci in 133 (73.5% [Streptococcus in 85, Staphylococcus in 32]), gram-negative in 18 (9.9%), fungus in 11 (6.1%), and unknown in 64.6%, cerebral bleeding in 31.5%, cerebral abscess in 2.8%, and meningitis in 1.1%. Hospital mortality rate and an exacerbation rate of cerebral complications, including related death, according to the interval from onset of cerebral infarction to cardiac surgery, were as follows: 66.3% and 45.5% within 24 hours, 31.3% and 43.8% between 2 and 7 days, 16.7% and 16.7% between 8 and 14 days, 10.0% and 10.0% between 15 and 21 days, 26.3% and 10.5% between 22 and 28 days, and 7.0% and 2.3% over 4 weeks later, respectively. A significant correlation existed between the interval and the exacerbation of cerebral complications (tied p = 0.008). Preoperative risk factors affecting exacerbation of cerebral complications were as follows: (1) severity of cerebral complications (p = 0.006), (2) intervals (p = 0.012), and (3) uncontrolled congestive heart failure as indications for cardiac surgery (p = 0.014). One patient underwent a cardiac operation within 24 hours of the onset of cerebral hemorrhage and died of cerebral damage. No exacerbations occurred in 10 patients who underwent their operation between 2 and 28 days. Nevertheless, exacerbations occurred in 19.0% of patients whose operation was done more than 4 weeks later. These data suggest that cardiac operations can be done safely 4 weeks after cerebral infarction, and if the delay is more than 2 weeks, the exacerbation rate will be around 10%. The risk of progression of cerebral damage is still significant 15 days and even 4 weeks after cerebral hemorrhage.
J Thorac Cardiovasc Surg 1995 Dec
PMID:Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. 852 87

The aim was to investigate pulmonary mechanics in patients with cystic fibrosis during infancy and again in early childhood to see whether infant tests predicted status at school age. Plethysmographic measurements of thoracic gas volume and airways resistance were made in 29 patients at 6 months and again at 5 years 10 months. Maximum flow at functional residual capacity was measured during infancy for comparison with maximum expiratory flow rates during childhood. While many patients had normal measurements during infancy, pulmonary function had deteriorated by school age. Thoracic gas volume at school age was significantly related to the values in infancy, but other measurements made during childhood were independent of infant values. The relations between measurements in infancy and early childhood described here provide a background against which the role of external factors on pulmonary function in young children with cystic fibrosis can be investigated.
Arch Dis Child 1995 Dec
PMID:Lung function from infancy to school age in cystic fibrosis. 854 9

So-called carcinosarcoma of the esophagus is rare malignant tumors composed of carcinoma and sarcomataous components. We described a case of so-called carcinosarcoma and reviewed some literature. A 67-year-old man visited our hospital because of difficulty in swallowing, general fatigue, and sore throat. Barium swallow esophagogram showed a large polypoid lesion in the middle, lower thoracic esophagus. Endoscopy also demonstrated a pedunculated polypoid tumor. Histological examination of the biopsy specimen revealed malignant findings. Thoracic esophagectomy with cervical, thoracic, abdominal dissection was performed. A polypoid tumor, 10.5 x 5.2 x 3.5 cm in size, was removed. In the polypoid lesion, spindle-shaped cells made interlacing bundles similar to sarcoma and surrounded nests of squamous cell carcinoma. Near the pedicle, squamous cell carcinoma invaded muscularis mocosae. And lymph node metastasis was detected. Epitherial membrane antigen (EMA) was detected in some parts of the polypoid lesion. So according to Guide Lines for Clinical and Pathological Studies on Carcinoma of the Esophagus, this case was diagnosed as so called carcinosarcoma.
Nihon Kyobu Geka Gakkai Zasshi 1995 Dec
PMID:[A case of so-called carcinosarcoma of the esophagus]. 855 Oct 76

There are three milestones in the history of thoracic radiology. Thoracic radiology started in 1897 when Williams developed thoracic fluoroscopy and introduced the basic concepts of roentgenologic interpretation. At the same time, the first chest films were performed allowing decisive improvement in the diagnosis of many chest diseases. Continuous technical improvement is responsible for the fact that, even today, the conventional chest film remains a highly accurate and frequently used imaging modality. A third milestone was the development of digital radiography and its use in the chest. Computerised tomography changed thoracic imaging dramatically; in a first step mainly as a tool to visualise soft tissue abnormalities and, later on, also as a modality to study lung disease. The recent development of the digital chest radiograph has again added new perspectives to the approach and diagnosis of chest disease.
J Belge Radiol 1995 Dec
PMID:[Radioscopy and radiography of the thorax. Birth and maturation of an ever-current technique]. 857 26

There are three milestones in the history of thoracic radiology. Thoracic radiology started in 1897 when Williams developed thoracic fluoroscopy and introduced the basic concepts of roentgenologic interpretation. At the same time, the first chest films were performed allowing decisive improvement in the diagnosis of many chest diseases. Continuous technical improvement is responsible for the fact that, even today, the conventional chest film remains a highly accurate and frequently used imaging modality. A third milestone was the development of digital radiography and its use in the chest. Computerised tomography changed thoracic imaging dramatically; in a first step mainly as a tool to visualise soft tissue abnormalities and, later on, also as a modality to study lung disease. The recent development of the digital chest radiograph has again added new perspectives to the approach and diagnosis of chest disease.
J Belge Radiol 1995 Dec
PMID:Computed tomography, magnetic resonance imaging, and digital radiography. 857 27

To determine the value of the PCR assay of lymphomonocytic blood cells for the diagnosis of pulmonary tuberculosis, we compared, in a prospective study, PCR results with results of conventional diagnostic methods of Mycobacterium tuberculosis detection. Clinical investigators who were unaware of the PCR data classified 162 immunocompetent patients, who had been hospitalized because of suspected pulmonary tuberculosis, in accordance with the recommendations of the American Thoracic Society (ATS). By testing blood samples from these patients for mycobacterial DNA with three different PCR systems, we were able to demonstrate that nonquantitative PCR of peripheral blood leukocytes is of little value for the specific diagnosis of pulmonary tuberculosis. However, semiquantitative PCR assays might have some significance since we found an increasing level of mycobacterial DNA copies in blood from patients classified in ATS groups 2 to 5.
J Clin Microbiol 1995 Dec
PMID:Amplification of Mycobacterium tuberculosis from peripheral blood. 858 24

The transfusion of homologous blood carries risks associated with reactions to transfusion and the transmission of diseases. Minimizing surgery-related blood use is therefore of utmost importance. However, the application of blood-saving methods in surgery is restricted by a number of factors. Thoracic surgery poses particular problems in this regard due to the type of diseases treated, patients' general status and the use of neoadjuvant chemotherapy protocols. The aim of this study was to analyse the feasibility of a blood conservation program for thoracic surgery. A detailed analysis of blood-sparing techniques was carried out and the factors influencing blood consumption were evaluated in the preoperative, intraoperative and postoperative periods. Although pre-operative autologus blood donation is an extremely important factor, its effect is limited in thoracic surgery since only a few patients are suitable candidates for such a procedure. Our personal experience confirms the difficulty of applying a blood sparing program to thoracic surgery. Nevertheless the risks associated to transfusions, especially those related to the use of homologous blood, can be reduced by optimizing existing blood sparing techniques or developing new hemostatic agents.
Minerva Chir 1995 Dec
PMID:[Blood preservation in thoracic surgery: feasibility and limitations]. 872 62


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