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Background: The incidence of thoracic empyema has been steadily rising in many parts of the world, including Canada. This study aimed to determine which population characteristics are contributing to the [...]

The current study characterizes the mechanical properties of the human thoracic duct and demonstrates a role for adrenoceptors, thromboxane, and endothelin receptors in human lymph vessel function. With ethical permission and informed consent, portions of the thoracic duct (2-5 cm) were resected and retrieved at T7-T9 during esophageal and cardia cancer surgery. Ring segments (2 mm long) were mounted in a myograph for isometric tension (N/m) measurement. The diameter-tension relationship was established using ducts from 10 individuals. Peak active tension of 6.24 [+ or -] 0.75 N/m was observed with a corresponding passive tension of 3.11 [+ or -] 0.67 N/m and average internal diameter of 2.21 mm. The equivalent active and passive transmural pressures by LaPlace's law were 47.3 [+ or -] 4.7 and 20.6 [+ or -] 3.2 mmHg, respectively. Subsequently, pharmacology was performed on tings from 15 ducts that were normalized by stretching them until an equivalent pressure of 21 mmHg was calculable from the wall tension. At low concentrations, norepinephrine, endothelin-1, and the thromboxane-A2 analog U-46619 evoked phasic contractions (analogous to lymphatic pumping), whereas at higher contractions they induced tonic activity (maximum tension values of 4.46 [+ or -] 0.63, 5.90 [+ or -] 1.4, and 6.78 [+ or -] 1.4 N/m, respectively). Spontaneous activity was observed in 44% of ducts while 51% of all the segments produced phasic contractions after agonist application. Acetylcholine and bradykinin relaxed norepinephrine preconstrictions by ~20% and ~40%, respectively. These results demonstrate that the human thoracic duct can develop wall tensions that permit contractility to be maintained across a wide range of transmural pressures and that isolated ducts contract in response to important vasoactive agents. lymphatic system; lymph pump; lymphangion; lymphatic smooth muscle doi: 10.1152/ajpheart.01089.2009.

In the current study, vasorelaxant effect produced by the aqueous extract of Melissa officinalis L. ssp. officinalis (MOO) (Lamiaceae) and its possible mechanism in isolated rat aortic rings precontracted with [...]

Objective: While malnutrition, especially fat-free mass index (FFMI), is a predictor for mortality in chronic obstructive pulmonary disease (COPD), less information on prevalence and mechanisms is available in patients with [...]

Objective: To compare surgical and endovascular stent graft (ESG) treatment of blunt thoracic aortic injury (BAI) in the emergency setting. Design and setting: Retrospective case control study in two surgical [...]

A case study of a 22-year-old woman, suffering from low back and leg pain who was diagnosed with sick cell anemia at six years of age, is presented. The woman had fallen backwards while ice-skating, six days before she was admitted in the hospital and was declared dead 23 hours later.

Byline: P. P. Golikov (1), N. Yu. Nikolaeva (1), B. V. Davydov (1), E. V. Klychnikova (1), A. N. Pogodina (1), E. B. Nikolaeva (1), M. M. Abakumov (1) Abstract: The correlations between nitric oxide products (NO.sub.x) and the angiotensin-converting enzyme (ACE) activity and malondialdehyde (MDA) were studied in the blood serum of patients with thoracic wounds (the test group) 1, 3, 7, and 14 days after the injury. The severity of a patient's state scored from 8 to 15 on the APACHE II scale. The control group comprised 20 blood donors. One day after wounding, NO.sub.x, MDA, and ACE activity significantly increased. Subsequently, NO.sub.x and ACE activity decreased, whereas MDA increased. A significant negative correlation was found between NO.sub.x and MDA, and a significant positive correlation, between NO.sub.x and ACE activity. The correlations observed in the control group were undetectable in the patients one day after wounding but were restored on the third day. Thus, thoracic injury was accompanied by an increase in NO.sub.x and MDA, which determine the severity of oxidative stress. The positive correlation between NO.sub.x and ACE activity in the control and test groups reflects their concerted action in regulating the physiological functions and metabolism. Author Affiliation: (1) Sklifosovskii Institute of Emergency Medical Care, Moscow, Russia Article History: Registration Date: 28/12/2004

Among the most frequent diagnostic tests performed in rural areas is the chest x-ray (CXR) (Fig. 1 above). In spite of its familiarity to rural physicians, the interpretation of a [...]

Byline: R. Spencer (), W.H. Robichaux (), D.W. Superneau (), V.W. Lucas () Abstract: Two unrelated cases of conjoined twins were found to have cardiac malformations that apparently have not been reported previously. In one case, thoracopagus twins had an extensive thoracoabdominal wall defect that resulted in ectopia cordis of a conjoined heart along with evisceration of the shared liver and intestine along with one spleen. These malformations, accompanied by defects in the sternum, diaphragm, and supraumbilical abdominal wall, constitute a conjoined pentalogy of Cantrell. In the second case, the heart of one of omphalopagus twins consisted of a solid ventricular mass with only a minute aortic cavity but no atrioventricular communication--an ineffective heart that could develop only in a conjoined or chorioangiopagus twin. In both cases, a common atrium lay in the primitive (embryologic) position caudal to the ventricles. Author Affiliation: () Associate Professor of Surgery (retired), Louisiana State University School of Medicine, and Clinical Associate Professor of Surgery (retired), Tulane University School of Medicine, New Orleans, LA 70115, USA, US () Department of Pathology and Laboratory Medicine, Tulane University Health Sciences Center, New Orleans, LA 70115, USA, US () Section of Medical Genetics, Ochsner Clinic, New Orleans, LA 70115 USA, US () Pediatric Cardiology, Ochsner Pediatric Heart Institute, New Orleans, LA 70115, USA, US

Byline: H. Gunen (1), C. Evereklioglu (2), F. Kosar (3), H. Er (2), O. Kizkin (1) Keywords: Key words: Behcet's--Thorax--Diagnostic criteria Abstract: In Behcet's disease (BD), controversy has existed over the incidence of thoracic involvement, which may be a direct threat to the patient's life. The aim of this study is to evaluate the incidence of thoracic involvement in BD and its correlation with the number of diagnostic BD criteria of The International Study Group (ISG), gender, disease duration, and the presence of symptoms. Forty-two BD patients, who had consecutively applied to different clinics in Turgut Ozal Medical Center Research Hospital, were included in the study. They were either newly diagnosed or already under treatment. All patients were examined by standard chest roentgenogram, spirometry, and thorax CT. Perfusion scintigraphies were obtained in patients with thoracic involvement. Thoracic pathologic conditions were found in five patients (11.9%). All thoracic pathologic conditions appeared in patients with at least four diagnostic criteria (26 patients) of the ISG for BD. In this subgroup, the rate of thoracic involvement was 19.2%. Also, 25% of the patients with pulmonary symptoms (12 patients) had thoracic lesions. Gender and the duration of the disease did not correlate with thoracic involvement. Our findings suggest that the rate of thoracic involvement in BD is greater than is generally believed. An increased number of diagnostic BD criteria of the ISG may indicate other organ system involvement and an increased risk of thoracic pathosis. All BD patients with at least four diagnostic criteria or any pulmonary symptoms should be evaluated for thoracic involvement, which is a major menace to life and necessitates early intervention. Author Affiliation: (1) Department of Pulmonary Medicine, Inonu University, Turgut Ozal Medical Hospital Research Center, Malatya, Turkey, TR (2) Department of Ophthalmology, Inonu University, Turgut Ozal Medical Hospital Research Center, Malatya, Turkey, TR (3) Department of Cardiology, Inonu University, Turgut Ozal Medical Hospital Research Center, Malatya, Turkey, TR Article note: Accepted for publication 13 March 2000

Brain natriuretic peptide (BNP) is an efficient renal vasodilator that enhances renal blood flow and glomerular filtration rate and increases sodium discharge by reducing distal fractional and proximal reabsorption. It also augments production of renal guanosine 3,5'-cyclic monophosphate (cGMP). BNP is an efficient natriuretic and vasoactive peptide promoting tubular and proximal actions in normal dogs.

A 68-year-old man presents to the emergency department of a remote British Columbia diagnostic and treatment centre with a 15-hour history of chest discomfort. He has no preceding cardiac history [...]

A 9-year-old boy was referred to the Oncology Department because of a thoracic soft-tissue mass thought to be a chest wall tumour. He had a history of grass inflorescence (Hordeum murinum) aspiration 2 weeks prior to this admission. On physical examination a tender soft-tissue mass under the right scapula and diminished breath sounds from the right lower lobe were detected. Thoracic CT confirmed soft-tissue swelling of the right posterior chest wall. There was a hypodense area within the soft-tissue mass suggesting a foreign body and also focal consolidation of the right lower lobe adjacent to the soft-tissue swelling.We report here unique CT findings of grass inflorescence aspiration before and after its migration through the airways. Keywords Lungs * Chest wall * Aspiration * Grass inflorescence * Child

Table 1: Prevalence of lung and heart CT abnormalities according to cumulative smoke exposure and according to time since interruption Never smoker Pack year group p?value (p per trend) Never [...], Introduction: The aim was to determine the prevalence of lung and heart abnormalities on thoracic CT scans in HIV?infected patients who were treated with antiretroviral therapy (ART). Material and Methods: Thoracic CT scans of 903 patients infected with HIV (mean age 48±7 yrs, 29% females) were reviewed by three radiologists by consensus. Patients were phenotyped according to smoking status, pack years and years since cessation for ex?smokers. Individuals known to have active lung or heart disease at the time of CT scanning were excluded. Multimorbidity lung and heart disease (MLHD) was defined by the presence of >2 lung or heart abnormalities on the CT scan. Results: Prevalence of lung abnormalities were: 326 patients (36.1%) with emphysema, 271 (30.0%) with bronchiolitis, 44 (4.9%) with non?calcified lung nodules, 568 (63%) with significant bronchial wall thickening, 150 (16.7%) with bronchiectasis, 9 (1%) with interstitial lung disease. Overall, 445 patients (49.3%) had >2 lung abnormalities. Imaging findings suggestive of prior myocardial infarction (MI) were found in 1.4% (13 patients); 26.6% (240 patients) had CAC scores of 1 to 100, and 9.8% (89 patients) had CAC>100. 13.6% (123 patients) of the patients had CAC>100 and/or previous MI. MLHD was present in 484 patients (53.6%) and among 78 patients (16%) who never smoked. Table 1 describes CT findings according to pack year and stop smoking groups vs never smokers. MLHD increased proportional to cumulative smoking history (p for trend Conclusions: MLHD is common in HIV?infected individuals even in non?smokers. Reduced CD4 count (hence severity of HIV infection) may be an important risk factor for chronic lung and heart disease. Thoracic CT scans may provide an excellent screening tool to detect MLHD in HIV?infected patients.