scholarly journals Pleural empyema from the point of view of a thoracic surgeon

2020 ◽  
pp. 267-268
Author(s):  
V.V. Sokolov
Keyword(s):  
Computed Tomography ◽  
Antibiotic Therapy ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Modern Method ◽  
Point Of View ◽  
Optimal Point ◽  
Pleural Thickening ◽  
Posterior Axillary Line ◽  
Adjacent Structures

Background. Pleural empyema (PE) is the presence of pus in the pleural cavity. The causes of PE include the diseases of adjacent organs (75 %), direct contamination of the pleural cavity during injuries or operations (20 %), and hematogenous dissemination of infection (5 %). Objective. To describe the modern views on the treatment of EP. Materials and methods. Analysis of literature sources on this topic. Results and discussion. Radiography, computed tomography, and ultrasound can be used to diagnose PE. To detect PE, radiography should always be performed in two projections, paying special attention to the posterior sinus and the space above the diaphragm. Computed tomography shows pleural layers’ separation and a “pregnant woman” symptom. Ultrasound can distinguish fluid, pleural thickening and pulmonary infiltration, as well as determine the optimal point for puncture. The ultimate goals of PE treatment include the obliteration of the pleural cavity or creating conditions for the formation of a sterile residual cavity. In case of acute PE, drainage, washing, and antibiotic therapy are applied; correction of concomitant diseases is carried out. Drainage of the pleural cavity should be preceded by a puncture of the pleural cavity to obtain pathological contents. The appearance and odor of the fluid obtained by puncture are the most important indicators of the pathology. Drainage can be performed at the point where the pus was obtained, or in the VII-VIII hypochondrium along the posterior axillary line. Drains from polyvinylchloride with a diameter of 6-8 mm are applied. The length depends on the task. Videothoracoscopy is a modern method of treating PE. This method is minimally invasive, removes fibrin and pus, destroys adhesions, connects cavities and provides drainage at the optimal point. To wash the pleural cavity, it is advisable to use decamethoxine or povidone-iodine. With regard to antibiotic therapy, levofloxacin or third-generation cephalosporins are used in combination with an antianaerobic drug, or carbapenems or glycopeptides. Conclusions. 1. PE is often a secondary infectious process caused by adjacent structures’ infection. 2. Pleural cavity sanitation during videothoracoscopy and drainage are the main methods of PE treatment. 3. Antibiotic therapy and pleural lavage are integral components of PE treatment.

Dilatation of Vascular Prostheses in Ascending Aortic Position: A Long-Term Follow-Up Computed Tomography Study with Comparison of Different Measurement Methods

2016 ◽  
Vol 66 (03) ◽  
pp. 206-214
Author(s):  
Matthias Endlich ◽  
Christian Krämer ◽  
Chris Probst ◽  
Armin Welz ◽  
Kai Wilhelm ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Measurement Methods ◽  
Point Of View ◽  
Cross Sectional ◽  
Vascular Prostheses ◽  
Aortic Replacement ◽  
Ascending Aortic Replacement ◽  
Long Term Follow Up ◽  
Methods Of Measurement

Background The aim of this study was to evaluate long-term dilatation of Hemashield Gold and Hemashield Platinum vascular prostheses in ascending aortic position using different measurement methods to obtain precise results. Methods Between 1999 and 2007, 73 patients with Stanford type A dissection received ascending aortic replacement with Hemashield Gold and Hemashield Platinum prostheses. Measurements were performed using multiplanar reconstruction mode of electrocardiogram (ECG)-gated, multislice spiral computed tomography (MSCT) in strictly orthogonal cross-sectional planes. Different methods of measurement were compared and maximum dilatation was estimated for different time spans. Results Diameters calculated from the measured circumference showed a significant (p = 0.037) but clinically not relevant difference (0.1 mm) to the mean between the largest and the shortest cross-sectional diameter of the prosthesis. Dilatation after 24.2 ± 10.2 months was 8.5 ± 4.5%. Long-term dilatation after 91.8 ± 34 months amounted to 11.8 ± 4.2%. Conclusion Based on ECG-gated MSCT images, the presented methods of measurement provided reliable results. Long-term analysis shows low dilatation rates for Hemashield prostheses, which therefore can be considered as safe from this point of view. Nevertheless, a maximal dilatation of 20% could be relevant in valve sparing root replacement. It remains unclear if a dilatation like this contributes to the formation of suture aneurysms.

FEATURES OF PLEURAL CAVITY DRAINAGE IN PATIENTS WITH ACUTE NONSPECIFIC PLEURAL EMPYEMA

2020 ◽  
pp. 39-42
Author(s):  
D. V. Minukhin ◽  
O. I. Tsyvenko ◽  
A. Yu. Korolevska ◽  
L. G. Tarasenko ◽  
D. Yu. Melnyk ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Pleural Drainage ◽  
Main Method ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Minor Surgery ◽  
Surgical Manipulation

Most authors considered pleural cavity drainage to be the main method of treatment of acute pleural empyema using minor surgery. Despite the simplicity of drainage of the pleural cavity, the number of complications after this surgical manipulation, according to the reports of some authors, varies from 3 to 8 %. The complications of pleural drainage in the patients with acute nonspecific pleural empyema have been studied and the technique of pleural drainage "blindly" has been introduced, which allows drainage to be located along the chest wall. At the first stage of the four−stage study, the complications of pleural drainage in 38 patients with acute nonspecific pleural empyema were analyzed, at the second stage a device for drainage of the pleural cavity "blindly" was developed to place drainage in parallel to the chest wall, at the third stage patients were tested; on IV −− drainage of the pleural cavity of 34 patients was performed according to the proposed method. The reason for the development of drainage complications in the pleural cavity of patients with acute pleural empyema was the inadequate location of drainage in the pleural cavity, drainage of the pleural cavity was carried out in general hospitals without the use of thoracoscopic equipment. Curved thoracoport with trocar for a blind drainage of the pleural cavity "blindly" was developed and introduced into clinical practice. This technique eliminates the involuntary location of the drainage in the pleural cavity, installing it along the chest wall, and is safe. Complications associated with drainage of the pleural cavity according to the developed method using a curved thoracoport with a trocar, inadequate location of drainage, were not observed in patients. Key words: acute pleural empyema, pleural cavity drainage, curved trocar.

scholarly journals Diagnostic value of magnetic resonance imaging and computed tomography for oral masses in dogs

2004 ◽  
Vol 75 (4) ◽  
Author(s):  
U.C.M. Kafka ◽  
A. Carstens ◽  
G. Steenkamp ◽  
H. Symington
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Bone Erosion ◽  
Diagnostic Value ◽  
Accurate Information ◽  
Gingival Hyperplasia ◽  
Resonance Imaging ◽  
Additional Information ◽  
Adjacent Structures

The purpose of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) and computed tomography (CT) in oral masses of dogs. Nineteen dogs underwent clinical, MR and CT examinations. Eleven malignant and ten non-malignant masses were evaluated. Osteosarcoma was the most commonly found malignant oral mass and gingival hyperplasia was the most commonly found benign mass. The results showed that MRI provided more accurate information regarding the size of the masses and invasion of adjacent structures although MRI and CT show similar accuracy in assessment of bone invasion. Calcification and cortical bone erosion was better seen on CT images. Whereas contrast-MRI provided useful additional information, contrast-CT had no added benefit. In general, oral masses located in the caudal mandible, oropharynx and maxilla are better evaluated using MRI, once the histological type has been verified.

scholarly journals Research Active Posterior Rhinomanometry Tomography Method for Nasal Breathing Determining Violations

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8508
Author(s):  
Oleg G. Avrunin ◽  
Yana V. Nosova ◽  
Ibrahim Younouss Abdelhamid ◽  
Sergii V. Pavlov ◽  
Natalia O. Shushliapina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pressure Drop ◽  
Flow Rate ◽  
Dynamic Change ◽  
Air Flow ◽  
Current Mode ◽  
Forced Response ◽  
Point Of View ◽  
Air Flow Rate ◽  
Nasal Breathing

This study analyzes the existing methods for studying nasal breathing. The aspects of verifying the results of rhinomanometric diagnostics according to the data of spiral computed tomography are considered, and the methodological features of dynamic posterior active rhinomanometry and the main indicators of respiration are also analyzed. The possibilities of testing respiratory olfactory disorders are considered, the analysis of errors in rhinomanometric measurements is carried out. In the conclusions, practical recommendations are given that have been developed for the design and operation of tools for functional diagnostics of nasal breathing disorders. It is advisable, according to the data of dynamic rhinomanometry, to assess the functioning of the nasal valve by the shape of the air flow rate signals during forced breathing and the structures of the soft palate by the residual nasopharyngeal pressure drop. It is imperative to take into account not only the maximum coefficient of aerodynamic nose drag, but also the values of the pressure drop and air flow rate in the area of transition to the turbulent quadratic flow regime. From the point of view of the physiology of the nasal response, it is necessary to look at the dynamic change to the current mode, given the hour of the forced response, so that it will ensure the maximum possible acidity in the legend. When planning functional rhinosurgical operations, it is necessary to apply the calculation method using computed tomography, which makes it possible to predict the functional result of surgery.

scholarly journals Computed Tomography Findings Associated with Treatment Failure after Antibiotic Therapy for Acute Appendicitis

2021 ◽  
Vol 22 (1) ◽  
pp. 63
Author(s):  
Wonju Hong ◽  
Min-Jeong Kim ◽  
Sang Min Lee ◽  
Hong Il Ha ◽  
Hyoung-Chul Park ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Treatment Failure

An Alternative Carcass Design to Prevent Flow-Induced Pulsations in Flexibles

2021 ◽  
Author(s):  
N. González Díez ◽  
S. P. C. Belfroid ◽  
T. Iversen Solfeldt ◽  
C. Kristiansen
Keyword(s):  
Pressure Drop ◽  
Theoretical Analysis ◽  
Numerical Simulations ◽  
Steel Strip ◽  
Point Of View ◽  
Theoretical Point ◽  
Adjacent Structures ◽  
Operational Constraints ◽  
Short Time ◽  
Fatigue Failures

Abstract Flow-induced pulsations (FLIP) are pressure oscillations generated inside of flexibles used in dry gas applications that can cause unacceptable vibration levels and eventually failure of equipment. Because of the design of inner layer of the flexibles, the carcass, the frequency of the pulsations is high, potentially leading to fatigue failures of adjacent structures in a relatively short time. The traditional carcass is made of a steel strip formed into an interlocked s-shape in a series of preforming and winding steps. To enable bending of the pipe, gaps are present between each winding with a shape that can cause FLIP. The gaps can be reduced, and the profiles optimized, but they will always be able to generate FLIP at a certain gas velocity. To remove the risk of FLIP in dry gas projects and ensure that operator does not get operational constraints, an alternative carcass design has been developed. This is essentially a conventional agraff carcass but with an additional cover strip to close the gap, making the resulting carcass nearly smooth bore in nature. With a smooth bore this carcass can be used for flexibles which have a risk of FLIP or to produce pipes with a lower internal roughness. This alternative design can be manufactured and can therefore build on the large manufacturing and design experience of the traditional strip carcass. This alternative carcass technology is to undergo a full qualification process, in which the risk of flow induced pulsations is an essential component. With the investigated alternative carcass design, the cavities present in the traditional agraff designs are covered. It is expected that the risk due to the appearance of FLIP is therefore eliminated. Theoretical analysis, numerical simulations and scaled experiments are used to explore the risk for the alternative technology to create FLIP. The theoretical analysis is based on existing knowledge and literature. The numerical simulations and scaled tests are done to generate direct evidence for the end statements resulting from the qualification process. Numerical simulations follow the power balance method presented by the same authors in earlier papers. The same applies to the techniques used for the scaled tests. The main outcome of the qualification presented here are the pressure drop performance and the anti-FLIP capabilities of the design. The new design performs significantly better than the nominal design carcass for the same purpose. The pressure drop coefficients found are close to those expected for a normal, non-corrugated pipe, and thus the recommendation given by the API 17J standard does not apply to this design. The pressure drop coefficient is dependent on the installation direction of the flexible with respect to the flow. No signs of FLIP are found for the nominal design of the investigated carcass technology. This is the case for either installation direction. This is explained from a theoretical point of view, but also numerical and experimental evidence are provided.

Shark teeth: a case of multiple supernumerary teeth

2021 ◽  
Vol 14 (3) ◽  
pp. 135-137
Author(s):  
Fionnuala Loy ◽  
Victoria Elton
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Unusual Case ◽  
Treatment Options ◽  
Cone Beam ◽  
Supernumerary Teeth ◽  
Shark Teeth ◽  
Adjacent Structures ◽  
The Family ◽  
Dental Hospital

A 44-year-old male was referred to the Department of Orthodontics at Manchester Dental Hospital. He presented with pain from his heavily restored, lower right second premolar, which had an apical supplemental tooth, visible radiographically. The dentist queried whether the second premolar tooth could be extracted and the supplemental tooth aligned in its place. Clinical examination revealed no relevant abnormalities. The family and medical history were non-contributory. Panoramic tomography revealed multiple supplemental supernumerary teeth in the canine and premolar regions. Cone beam computed tomography and multidisciplinary team input were required to plan the treatment for this unusual case. CPD/Clinical Relevance: These findings highlight the management and treatment options for a case of non-syndromic, multiple supernumerary teeth. Consideration must be given to the risk of damage to adjacent structures if surgically removing supernumerary teeth, and the risk that supernumerary teeth may be ankylosed and not amenable to alignment within the arch.

Trends in contrast media research the last 100 years

2021 ◽  
pp. 028418512110510
Author(s):  
Yousef W Nielsen ◽  
Henrik S Thomsen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Contrast Media ◽  
Alimentary Tract ◽  
Adverse Reactions ◽  
Point Of View ◽  
Imaging Procedures ◽  
Resonance Imaging ◽  
Media Research ◽  
Magnetic Resonance Imaging Mri

This review focuses on the trends in contrast media (CM) research published in Acta Radiologica during the last 100 years, since the first edition in 1921. The main topics covered are the developments of iodine- and gadolinium-based CM. Other topics include manganese-based CM for magnetic resonance imaging (MRI) and barium for the investigation of the alimentary tract. From a historic point of view, special CM for use in cholegraphy and myelography are addressed in the review. Today, these imaging procedures are obsolete due to the development of computed tomography, MRI, and ultrasound. The historical use of radioactive thorium-based CM for angiography is also addressed. Furthermore, publications on adverse reactions to CM are reviewed.

Pleural Effusion

Chest Imaging ◽  
2019 ◽  
pp. 165-170
Author(s):  
Christopher M. Walker
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Lateral Displacement ◽  
Pleural Space ◽  
Gravitational Effects ◽  
Pleural Thickening ◽  
Air Bubble ◽  
Fluid Analysis ◽  
Exudative Pleural Effusion

Pleural effusion discusses the radiographic and computed tomography (CT) manifestations of this entity. Pleural effusion is classified based on pleural fluid analysis using Light’s criteria: transudative and exudative. Free pleural fluid collects in the most dependent aspect of the pleural space due to gravitational effects. It exhibits a meniscus configuration on upright chest radiography. Pleural effusion in a supine or semiupright patient is more difficult to identify but may be suspected in cases with a homogeneous or gradient-like opacity over the lower hemithorax, elevation of the hemidiaphragm contour, or an apical cap. Subpulmonic pleural effusion manifests with lateral displacement of the apex of the ipsilateral hemidiaphragm contour and increased distance between the gastric air bubble and pseudodiaphragmatic contour. Exudative pleural effusion should be suspected in cases with CT findings of pleural thickening, enhancement, septations, and/or loculations.

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