scholarly journals Transmediastinal and Transcardiac Gunshot Wound with Hemodynamic Stability

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Leire Zarain Obrador ◽  
Yusef Mohamed Al-Lal ◽  
Jorge de Tomás Palacios ◽  
Iñaki Amunategui Prats ◽  
Fernando Turégano Fuentes
Keyword(s):  
Gunshot Wound ◽  
Median Sternotomy ◽  
Uneventful Recovery ◽  
Hemodynamic Stability ◽  
Group Iii ◽  
Entrance Wound ◽  
Group I ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Cardiac injuries caused by knives and firearms are slightly increasing in our environment. We report the case of a 43-year-old male patient with a transmediastinal gunshot wound (TGSW) and a through-and-through cardiac wound who was hemodynamically stable upon his admission. He had an entrance wound below the left clavicle, with no exit wound, and decreased breath sounds in the right hemithorax. Chest X-ray showed the bullet in the right hemithorax and large right hemothorax. The ultrasound revealed pericardial effusion, and a chest tube produced 1500 cc. of blood, but he remained hemodynamically stable. Considering these findings, a median sternotomy was carried out, the through-and-through cardiac wounds were suture-repaired, lung laceration was sutured, and a pacemaker was placed in the right ventricle. The patient had uneventful recovery and was discharged home on the twelfth postoperative day. The management and prognosis of these patients are determined by the hemodynamic situation upon arrival to the Emergency Department (ED), as well as a prompt surgical repair if needed. Patients with a TGSW have been divided into three groups according to the SBP: group I, with SBP>100 mmHg; group II, with SBP 60–100 mmHg; and group III, with SBP<60 mmHg. The diagnostic workup and management should be tailored accordingly, and several series have confirmed high chances of success with conservative management when these patients are hemodynamically stable.

scholarly journals Tracheobronchial Foreign Bodies in Children: A Strong History Associated with Plain Chest Radiography Findings Leads to Bronchoscopy

2021 ◽  
Author(s):  
Umut Alıcı ◽  
Çiğdem Öztunalı ◽  
Çiğdem Arslan Alıcı ◽  
Hüseyin İlhan ◽  
Baran Tokar
Keyword(s):  
Early Diagnosis ◽  
Group Structure ◽  
Delayed Diagnosis ◽  
Diagnostic Tools ◽  
X Ray ◽  
Group Iii ◽  
Diagnosis Group ◽  
Group I ◽  
Breath Sounds ◽  
Chest X Ray

Objective: History and chest x-ray are the main diagnostic tools in children with foreign body aspiration (FBA). The study aims to evaluate clinical, radiological, and bronchoscopic findings associated with early and delayed diagnosis of FBA. Methods: The records of 249 children having bronchoscopy for suspected FBA were analyzed in three groups as negative bronchoscopy for FBA (group I), early diagnosis (group II), and delayed diagnosis (group III). Results: Choking episodes, coughing, and decreased breath sounds were determined significantly in FBA. The percentage of radiopaque FBs was 6.2%. Emphysema in groups II and III; atelectasis and pneumonia in group III were significantly higher on chest x-ray. Pneumonia and significant inflammation found during bronchoscopy were prominent in group III. FBs were mostly vegetable origin and the majority were found in the bronchus, more on the right side. FBs were successfully removed by rigid bronchoscopy except one having thoracotomy. Conclusion: Review of the literature, our current (2010-2019) and previous (1994-2003) studies designed in the same group structure showed that choking episode associated with a radiopaque FB leads to bronchoscopy. Emphysema and atelectasis are also valuable for early diagnosis. Regardless of radiological findings, bronchoscopy should be considered in patients with a strong history.

Solitary fibrous tumour of mediastinum: an often asymptomatic neoplasm

2021 ◽  
Vol 14 (8) ◽  
pp. e241223
Author(s):  
Gerard Sexton ◽  
Joseph McLoughlin ◽  
Louise Burke ◽  
Kishore Doddakula
Keyword(s):  
Median Sternotomy ◽  
Mesenchymal Cell ◽  
Old Irish ◽  
Ct Guided ◽  
Solitary Fibrous Tumours ◽  
Effective Treatment Modality ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Thorax Ct

Solitary fibrous tumours (SFTs) are rare neoplasms derived from mesenchymal cell lines. They are often asymptomatic, follow an indolent growth pattern and are more often benign than malignant. Here, we present a case of a very large, asymptomatic mediastinal SFT in an otherwise healthy man. A 67-year-old Irish man was referred for workup of an asymptomatic murmur. Auscultation of the lung fields revealed diminished breath sounds on the right side. Chest X-ray identified a 20 cm mass localised within the thorax. CT of the thorax confirmed a pleural based, solid lesion with no local invasion. CT-guided core biopsies were reported as consistent with SFT. Primary excision of the lesion was undertaken via median sternotomy. Histological examination confirmed a diagnosis of SFT. The patient remains well at this time. Primary excisive surgery is a safe and effective treatment modality for SFTs.

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

Inhibition of cardiac vagal component of baroreflex by group III and IV afferents

1991 ◽  
Vol 260 (3) ◽  
pp. H730-H734 ◽  
Author(s):  
P. N. McWilliam ◽  
T. Yang
Keyword(s):  
Peroneal Nerve ◽  
Baroreceptor Reflex ◽  
Interval Prolongation ◽  
Group Iii ◽  
Control Value ◽  
Pressure Elevation ◽  
Group I ◽  
Afferent Fibers ◽  
The Difference ◽  
The Right

The action of electrically evoked activity in somatic afferent fibers on the sensitivity of the baroreceptor reflex was examined in decerebrate cats. The sensitivity of the reflex was expressed as the difference between the maximum prolongation of R-R interval in response to carotid sinus pressure elevation and the mean of 10 R-R intervals immediately before pressure elevation. The control value of R-R interval prolongation was 192 +/- 50 ms. Stimulation (10 Hz) of group I and II fibers of the right peroneal nerve (evoked volleys recorded from the sciatic nerve) had no effect on R-R interval prolongation (171 +/- 45 ms). Recruitment of group III fibers (10 Hz) conducting at 23.6 +/- 0.65 m/s reduced the prolongation of R-R interval to 52 +/- 14 ms. Recruitment of group IV fibers (10 Hz) conducting less than 2.5 m/s further reduced the prolongation of R-R interval to 1.0 +/- 8.0 ms. It is concluded that the inhibition of the cardiac vagal component of the baroreceptor reflex produced by electrical stimulation of the peroneal nerve is mediated by afferent fibers of groups III and IV.

Atrioventricular responses of canine heart following chronic unilateral vagotomy

1987 ◽  
Vol 253 (2) ◽  
pp. H394-H401 ◽  
Author(s):  
D. V. Priola ◽  
C. Anagnostelis ◽  
C. Sanchez-Wilson ◽  
T. M. Blomquist
Keyword(s):  
Frequency Response ◽  
Control Mechanisms ◽  
Canine Heart ◽  
Response Curves ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Right ◽  
Inotropic Responses ◽  
Intrinsic Cardiac Nerves

The intrinsic cardiac nerves (ICN) have been shown to develop supersensitivity to nicotine (NIC) following complete extrinsic cardiac denervation. The present experiments were performed to delineate the pattern of ICN distribution in the heart by examining the pattern of NIC supersensitivity after unilateral vagotomy (VGX). Thirty-eight dogs were placed on cardiopulmonary bypass and inotropy evaluated by means of isovolumic pressures from fluid-filled balloons placed in the atria and ventricles. The animals were divided into three groups: group I, sham-operated controls; group II, animals studied 1–2 wk after VGX; and group III, animals studied 8–12 wk after VGX. Chronotropic and inotropic responses were evaluated in terms of NIC and acetylcholine (ACh) dose-response curves as well as frequency-response curves to stimulation of the intact vagus nerve (0.5–30 Hz). No change in NIC sensitivity was observed in group II, and vagal frequency-response curves were identical to group I. In group III dogs, both the right atrium and right ventricle showed significant increases in NIC sensitivity after left vagotomy. All group III animals showed right-shifted frequency-response curves. We conclude that nicotinic supersensitivity of the ICN and inotropic unresponsiveness to vagal stimulation occur but are slow in developing (70–130 days); and preganglionic sprouting does not appear to play a functional role in the adjustment of cardiac control mechanisms to unilateral vagotomy.

scholarly journals BONE INDUCTION BY BMP-2 EXPRESSING ADENOVIRAL VECTOR IN RATS UNDER TREATMENT WITH FK506

2002 ◽  
Vol 06 (01) ◽  
pp. 23-29 ◽  
Author(s):  
Junya Sonobe ◽  
Kazuhisa Bessho ◽  
Shinji Kaihara ◽  
Yasunori Okubo ◽  
Tadahiko Iizuka
Keyword(s):  
Adenoviral Vector ◽  
Host Immunity ◽  
Bone Morphogenetic Protein 2 ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
Morphogenetic Protein ◽  
Human Bone Morphogenetic Protein ◽  
The Right

The purpose of this study was to investigate the effectiveness of human bone morphogenetic protein-2 (BMP-2) expressing adenoviral vector in vivo. The day before vector injection, immunosuppressant FK506 was given subcutaneously to each rat at doses of 12 mg/kg (Group I), 6 mg/kg (Group II) and 3 mg/kg (Group III). FK506 was not administered to the six rats of the control group. Twenty-five liters of AXCAOBMP-2 (3.93 × 109pfu/ml) were injected into the right calf muscle of all rats. On day 21 after vector injection, all groups were investigated radiologically, histologically, and biochemically. Osteoinduction was seen in the AxCAOBMP-2-injected groups with immunosuppression. However, no bone formation was observed in the control group. These findings suggest that AxCAOBMP-2 has the potential of osteoinduction under transient immunosuppression. AxCAOBMP-2 may be useful for future clinical application in bone reconstruction, if host immunity response can be regulated.

scholarly journals Comparison of clinical, biomechanical, and histopathological effects of various suture techniques on repair of tendon rupture by using autograft

2017 ◽  
Vol 61 (2) ◽  
pp. 231-237
Author(s):  
Celal Şahin Ermutlu ◽  
Vedat Baran
Keyword(s):  
Good Alternative ◽  
Suture Technique ◽  
Suture Techniques ◽  
Tissue Loss ◽  
Group Iii ◽  
Interrupted Suture ◽  
Group I ◽  
Tendon Ruptures ◽  
The Right ◽  
And Control

AbstractIntroduction: The purpose of this study was to compare the effectiveness of four different suture techniques in the treatment of experimentally modelled tendon injuries with tissue loss with autograft and grafting applications in rabbits.Material and Methods: The study was performed on 30 male mature (2-year-old) New Zealand rabbits with mean body weight of 3.1 kg, divided into three equal groups. A graft measuring 1 cm in length was collected from the m. tibialis cranialis of each rabbit under general anaesthesia. The graft collected from the right tendon was transplanted into the left tendon, and the graft from the left tendon was transplanted into the right tendon. In all groups, a simple interrupted suture was placed on the left tendon as control, a Bunnell-Mayer suture was placed on the right tendon in group I, a Locking-Loop suture in group II, and a Horizontal U suture in group III. Both hindlimbs were bandaged for four weeks. The tendons were assessed biomechanically and histopathologically.Results: According to the results of the tensile testing, the maximum durability of the techniques ranked as follows: Bunnell-Mayer, Horizontal U, Locking-Loop, and control groups.Conclusion: The use of autografts was a good alternative for the treatment of tendon ruptures with tissue loss. Furthermore, even though there were no clinical or histopathological differences, the suture technique can be chosen based on the results of the tensile test.

scholarly journals Effect of Piglet Birth Weight on Selected Characteristics of Pork

2014 ◽  
Vol 14 (4) ◽  
pp. 967-975 ◽  
Author(s):  
Anna Rekiel ◽  
Justyna Bartosik ◽  
Justyna Więcek ◽  
Martyna Batorska ◽  
Beata Kuczyńska ◽  
...  
Keyword(s):  
Birth Weight ◽  
Shear Force ◽  
Drip Loss ◽  
Large White ◽  
Group Iii ◽  
Group I ◽  
Longissimus Lumborum ◽  
Pig Meat ◽  
The Right ◽  
Age Determinations

Abstract The objective of the study was to determine how different birth weights of piglets influence some chemical and physical characteristics of pig meat. Piglets were grouped according to birth weight: ≤1.30 kg (group I), 1.31-1.70 kg (group II), ≥1.71 kg (group III). Animals were reared and fattened under standardized housing and feeding conditions. Tests were conducted with 60 samples of meat (20 per group) collected from the right side of the carcasses (M. longissimus lumborum) of threebreed crosses of (Polish Landrace × Polish Large White) × Duroc (barrows to gilts, 1:1), which were slaughtered at about 180 days of age. Determinations were made of basic chemical composition, colour of meat, drip loss, shear force value, and fatty acid profile. It was found that the birth weight of the piglets affects meat colour (redness), crude fat content and the proportion of some fatty acids (C16:1, C20:1 n-9, C20:2 n-6, C20:5 n-3).

scholarly journals Comparison of Lyophilized Glutaraldehyde-Preserved Bovine Pericardium with Different Vascular Prostheses for Use as Vocal Cords Implants: Experimental Study

2015 ◽  
Vol 2015 ◽  
pp. 1-9
Author(s):  
J. Raúl Olmos-Zuñiga ◽  
Rogelio Jasso-Victoria ◽  
Miguel Gaxiola-Gaxiola ◽  
Avelina Sotres-Vega ◽  
Claudia Hernández-Jiménez ◽  
...  
Keyword(s):  
Experimental Study ◽  
Inflammatory Reaction ◽  
Canine Model ◽  
Bovine Pericardium ◽  
Vocal Cords ◽  
Vascular Prostheses ◽  
Group Iii ◽  
Synthetic Materials ◽  
Group I ◽  
The Right

This study compared the use of lyophilized glutaraldehyde-preserved bovine pericardium (LGPBP), polytetrafluoroethylene (PTFE), polyethylene terephthalate (PET), and Teflon felt (TF) as implants for vocal cords (VC) medialization and aimed to assess the endoscopic, macroscopic, and microscopic VC changes after medialization in a canine model. In 18 mongrel dogs, the right VC were medialized with LGPBP and the left were implanted as follows: Group I (n=6): LGPBP and PTFE; Group II (n=6): LGPBP and PET; Group III (n=6): LGPBP and TF. Surgical handling of the implants was compared. Three months after surgery, macroscopic and microscopic changes of VC and implants were evaluated. LGPBP offered the best surgical handling (p=0.005, Kruskal-Wallis). TF implants showed extrusion (p=0.005, Kruskal-Wallis) and severe inflammation. All VC formed fibrous capsules around the implants; the ones developed by LGPBP implants were thinner (p=0.001, ANOVA, Tukey). VC implanted with synthetic materials showed eosinophilic infiltration (p=0.01, Kruskal-Wallis). We concluded that the LGPBP could be used as an implant for VC medialization because it is biocompatible, easy to handle and remove during surgical procedures, and nonabsorbable or extrudable and produces an inflammatory reaction similar to PTFE and PET.

scholarly journals Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

2020 ◽  
Vol 10 (1) ◽  
pp. 26743
Author(s):  
Khosrow Agin ◽  
Akram Sabkara ◽  
Farzaneh Sadat Mirsafai Rizi ‎ ◽  
Bita Dadpour ◽  
Maryam Vahabzadeh ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Diaphragmatic Paralysis ◽  
Recurrent Pneumonia ◽  
Emergency Center ◽  
Diabetes Mellitus Type Ii ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right

A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.

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