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Sample records for chest porcine ischemia

  1. Occurance of apoptosis during ischemia in porcine pancreas islet cells.

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    Stadlbauer, V; Schaffellner, S; Iberer, F; Lackner, C; Liegl, B; Zink, B; Kniepeiss, D; Tscheliessnigg, K H

    2003-03-01

    Pancreas islet transplantation is a potential treatment of diabetes mellitus and porcine organs provide an easily available source of cells. Unfortunately quality and quantity of isolated islets are still not satisfactory. Apoptosis occurs in freshly isolated islets and plays a significant role in early graft loss. We evaluated the influence of four storage solutions on porcine pancreas islets. After warm ischemia of 15-20 minutes 12 organs were stored in 4 cold preservation solutions: Histidine-Tryptophan-Ketoglutarate solution (HTK), Hank's buffered saline solution (HBSS), University of Wisconsin (UW) solution and Ringer-Lactate (R). After cold ischemia for 100 minutes, organs were fixed in 3% formalin. Apoptotic cells were counted on hematocylin-eosin stainings. Most apoptotic cells were found in organs stored in R. Low numbers were found in the other groups. The difference between organs stored in R and organs stored in UW, HTK, or HBSS was highly significant. No significant difference could be found between UW, HTK and HBSS. Cold and warm ischemia of the pancreas seems to induce apoptosis in islet cells. Preservation solutions cause less apoptosis than electrolyte solution. No significant differences could be found among the preservation solutions.

  2. The relationship between chest pain during thallium-201 scintigraphy with dipyridamole and myocardial ischemia

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    Takeishi, Yasuchika; Tono-oka, Ichiro; Meguro, Mitsuhiko; Hoshi, Hikaru; Masakane, Ikuto; Ikeda, Kozue; Tsuiki, Kai; Yasui, Shoji

    1991-01-01

    Dipyridamole thallium-201 scintigraphy (DP-Tl) and coronary angiography were studied on 74 patients with suspected coronary artery disease. We compared the clinical features, hemodynamic responses, angiographic results and scintigraphic findings of patients who had chest pain during DP-Tl testing ('chest pain' group) with those of patients who did not have chest pain ('no pain' group). Thirty eight (51%) of the 74 patients developed chest pain. Heart rate and rate pressure product during DP infusion of 'chest pain' group were greater than those of the 'no pain' group (p<0.05). Ischemic ST depression was more frequently observed among 'chest pain' patients (p<0.01). There were no differences in angiographic severity of coronary artery disease between 'chest pain' and 'no pain' group. Also, we could find no differences in extent and severity scores of perfusion defects and washout abnormalities between the two groups. However, when patients with myocardial infarction were excluded, the 'chest pain' group had significantly greater extent and severity scores of washout abnormalities than the 'no pain' group (extent score: 38±8 vs 18±5, p<0.05, severity score: 55±15 vs 18±7, p<0.01). Our study indicated that in patients without myocardial infarction, patients with 'chest pain' had more severe ischemia than 'no pain' patients. But in patients with myocardial infarction, myocardial ischemia not accompanied by chest pain might be as severe as that with chest pain. The presence or absence of myocardial infarction might have great influence on results regarding the relation of chest pain to myocardial ischemia. (author)

  3. Positive and Negative Affect Is Related to Experiencing Chest Pain During Exercise-Induced Myocardial Ischemia.

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    Stébenne, Philippe; Bacon, Simon L; Austin, Anthony; Paine, Nicola J; Arsenault, André; Laurin, Catherine; Meloche, Bernard; Gordon, Jennifer; Dupuis, Jocelyn; Lavoie, Kim L

    2017-05-01

    Silent myocardial ischemia is thought to be associated with worse cardiovascular outcomes due to a lack of perception of pain cues that initiate treatment seeking. Negative affect (NA) has been associated with increased pain reporting and positive affect (PA) with decreased pain reporting, but these psychological factors have not been examined within the context of myocardial ischemia. This study evaluated the associations between PA, NA, and chest pain reporting in patients with and without ischemia during exercise testing. A total of 246 patients referred for myocardial perfusion single-photon emission computed tomography exercise stress testing completed the positive and negative affect schedule-expanded version, a measure of PA and NA. Presence of chest pain and myocardial ischemia were evaluated using standardized protocols. Logistic regression analyses revealed that for every 1-point increase in NA, there was a 13% higher chance for ischemic patients (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02 to 1.26) and an 11% higher chance in nonischemic patients (OR = 1.11; 95% CI = 1.03 to 1.19) to report chest pain. A significant interaction of PA and NA on chest pain reporting (β = 0.02; 95% CI = 0.002 to 0.031) was also observed; nonischemic patients with high NA and PA reported more chest pain (57%) versus patients with low NA and low PA (13%), with high NA and low PA (17%), and with high PA and low NA (7%). Patients who experience higher NA are more likely to report experiencing chest pain. In patients without ischemia, high NA and PA was also associated with a higher likelihood of reporting chest pain. Results suggest that high levels of PA as well as NA may increase the experience and/or reporting of chest pain.

  4. Allogeneic amniotic membrane-derived mesenchymal stromal cell transplantation in a porcine model of chronic myocardial ischemia

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    Kimura M

    2012-01-01

    Full Text Available Introduction. Amniotic membrane contains a multipotential stem cell population and is expected to possess the machinery to regulate immunological reactions. We investigated the safety and efficacy of allogeneic amniotic membrane-derived mesenchymal stromal cell (AMSC transplantation in a porcine model of chronic myocardial ischemia as a preclinical trial. Methods. Porcine AMSCs were isolated from amniotic membranes obtained by cesarean section just before delivery and were cultured to increase their numbers before transplantation. Chronic myocardial ischemia was induced by implantation of an ameroid constrictor around the left circumflex coronary artery. Four weeks after ischemia induction, nine swine were assigned to undergo either allogeneic AMSC transplantation or normal saline injection. Functional analysis was performed by echocardiography, and histological examinations were carried out by immunohistochemistry 4 weeks after AMSC transplantation. Results. Echocardiography demonstrated that left ventricular ejection fraction was significantly improved and left ventricular dilatation was well attenuated 4 weeks after AMSC transplantation. Histological assessment showed a significant reduction in percentage of fibrosis in the AMSC transplantation group. Injected allogeneic green fluorescent protein (GFP-expressing AMSCs were identified in the immunocompetent host heart without the use of any immunosuppressants 4 weeks after transplantation. Immunohistochemistry revealed that GFP colocalized with cardiac troponin T and cardiac troponin I. Conclusions. We have demonstrated that allogeneic AMSC transplantation produced histological and functional improvement in the impaired myocardium in a porcine model of chronic myocardial ischemia. The transplanted allogeneic AMSCs survived without the use of any immunosuppressants and gained cardiac phenotype through either their transdifferentiation or cell fusion.

  5. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

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    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

  6. A porcine ex vivo lung perfusion model with maximal argon exposure to attenuate ischemia-reperfusion injury

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    An Martens

    2017-01-01

    Full Text Available Argon (Ar is a noble gas with known organoprotective effects in rodents and in vitro models. In a previous study we failed to find a postconditioning effect of Ar during ex vivo lung perfusion (EVLP on warm-ischemic injury in a porcine model. In this study, we further investigated a prolonged exposure to Ar to decrease cold ischemia-reperfusion injury after lung transplantation in a porcine model with EVLP assessment. Domestic pigs (n = 6/group were pre-conditioned for 6 hours with 21% O 2 and 79% N 2 (CONTR or 79% Ar (ARG. Subsequently, lungs were cold flushed and stored inflated on ice for 18 hours inflated with the same gas mixtures. Next, lungs were perfused for 4 hours on EVLP (acellular while ventilated with 12% O 2 and 88% N 2 (CONTR group or 88% Ar (ARG group. The perfusate was saturated with the same gas mixture but with the addition of CO 2 to an end-tidal CO 2 of 35-45 mmHg. The saturated perfusate was drained and lungs were perfused with whole blood for an additional 2 hours on EVLP. Evaluation at the end of EVLP did not show significant effects on physiologic parameters by prolonged exposure to Ar. Also wet-to-dry weight ratio did not improve in the ARG group. Although in other organ systems protective effects of Ar have been shown, we did not detect beneficial effects of a high concentration of Ar on cold pulmonary ischemia-reperfusion injury in a porcine lung model after prolonged exposure to Ar in this porcine model with EVLP assessment.

  7. Acute retinal ischemia caused by controlled low ocular perfusion pressure in a porcine model. Electrophysiological and histological characterisation

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    Kyhn, Maria Voss; Warfvinge, Karin; Scherfig, Erik

    2009-01-01

    The purpose of this study was to establish, and characterize a porcine model of acute, controlled retinal ischemia. The controlled retinal ischemia was produced by clamping the ocular perfusion pressure (OPP) in the left eye to 5 mm Hg for 2 h. The OPP was defined as mean arterial blood pressure...... of the amplitudes obtained in the experimental, left eye, and the control, right eye. Quantitative histology was performed to measure the survival of ganglion cells, amacrine cells and horizontal cells 2-6 weeks after the ischemic insult. An OPP of 5 mm Hg for 2h induced significant reductions in the amplitudes...... the ischemic insult. This model seems to be suitable for investigations of therapeutic initiatives in diseases involving acute retinal ischemia....

  8. Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model.

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    Rosow, David E; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I; Mueller, Peter R; Fernández-del Castillo, Carlos; Warshaw, Andrew L; Thayer, Sarah P

    2005-12-01

    Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly facilitates the use of CT angiography (CTA) in the clinical setting. We sought to determine whether M.D.CT-CTA could accurately demonstrate vascular anatomy and capture the earliest stages of mesenteric ischemia in a porcine model. Pigs underwent embolization of branches of the superior mesenteric artery, then imaging by M.D.CT-CTA with three-dimensional reconstruction protocols. After scanning, diseased bowel segments were surgically resected and pathologically examined. Multidetector row CT and CT angiography reliably defined normal and occluded mesenteric vessels in the pig. It detected early changes of ischemia including poor arterial enhancement and venous dilatation, which were seen in all ischemic animals. The radiographic findings--compared with pathologic diagnoses-- predicted ischemia, with a positive predictive value of 92%. These results indicate that M.D.CT-CTA holds great promise for the early detection necessary for successful treatment of acute mesenteric ischemia.

  9. Severity of exercise-induced ischemia with chest pain and recovery from ischemia after the disappearance of chest pain

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    Akutsu, Yasushi; Shinozuka, Akira; Kodama, Yusuke; Li, Hui-Ling; Yamanaka, Hideyuki; Katagiri, Takashi

    2004-01-01

    The severity of exercise-induced painful ischemia and its recovery after the disappearance of pain are unknown. The aim of this study was to investigate the difference in severity of ischemia at both exercise and postexercise between painful ischemia and painless ischemia. After injections of technetium-99m tetrofosmin at peak ergometer exercise and thallium-201 at 3 minutes postexercise, dual-isotope single photon emission tomography was performed in 78 patients with angiographically proven ischemic heart disease. The extent of ischemic areas (the number of areas), the depth of ischemia in the ischemic area (the severity score of ischemia) and the extension of ischemia toward long axis of the left ventricle (the number of left ventricular levels with ischemic areas in apical, middle, and basal levels) at both exercise and postexercise were compared on the basis of the presence of pain and a history of diabetes mellitus (DM). The symptoms improved within 3 minutes postexercise in all painful ischemia patients. Of 59 patients with reversible ischemia, except for 4 painful ischemia patients with DM, the extent and depth of ischemia at postexercise were more severe in 14 painful ischemia patients without DM and 13 painless ischemia patients with DM than 28 painless ischemia patients without DM (extent; 2.9±1.7 areas, 3.5±2.8 areas versus 1.4±1.8 areas, P=0.005, depth; 3.8±3.1 scores, 5.8±5.4 scores versus 1.9±3.0 scores, P=0.0084, respectively) despite a comparable severity of ischemia at peak exercise (extent; 5.4±2.6 areas, 6.0±2.4 areas versus 4.3±3.3 areas, depth; 9.3±5.7 scores, 10.7±7.3 scores and 7.5±8.1 scores, all NS). The extension of ischemia toward long-axis of the left ventricle at both peak exercise and postexercise was more severe in the former 2 groups than the latter group (peak exercise; 2.4±0.6 levels, 2.5±0.7 levels versus 1.9 ±0.8 levels, P=0.0263, postexercise: 1.8±0.7 levels, 1.5±0.9 levels versus 0.8±0.8 levels, P=0

  10. Effects of intracoronary melatonin on ischemia-reperfusion injury in ST-elevation myocardial infarction

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    Ekeløf, Sarah V; Halladin, Natalie L; Jensen, Svend E

    2016-01-01

    Acute coronary occlusion is effectively treated by primary percutaneous coronary intervention. However, myocardial ischemia-reperfusion injury is at the moment an unavoidable consequence of the procedure. Oxidative stress is central in the development of ischemia-reperfusion injury. Melatonin......, an endogenous hormone, acts through antioxidant mechanisms and could potentially minimize the myocardial injury. The aim of the experimental study was to examine the cardioprotective effects of melatonin in a porcine closed-chest reperfused infarction model. A total of 20 landrace pigs were randomized...... to a dosage of 200 mg (0.4 mg/mL) melatonin or placebo (saline). The intervention was administered intracoronary and intravenous. Infarct size, area at risk and microvascular obstruction were determined ex vivo by cardiovascular magnetic resonance imaging. Myocardial salvage index was calculated. The plasma...

  11. Myocardial bridging causing ischemia and recurrent chest pain: a case report

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    Abdou Mohamed

    2011-07-01

    Full Text Available Abstract Background Myocardial bridging is present when a segment of a major epicardial coronary artery runs intramurally through the myocardium. It usually has a benign prognosis, but in some cases myocardial ischemia, infarction and sudden cardiac death have been reported. We are here reporting a case of myocardial bridging which was complicated with recurrent chest pain and transient ST-segment elevation during exercise treadmill test. Case presentation A 40 year-old-man presented with recurrent retrosternal chest pain of 2 months duration. He had history of smoking and was obese, otherwise no physical abnormalities were detected by examination. Electrocardiogram and blood tests were normal apart from impaired glucose tolerance with elevated triglycerides and decreased level of high density lipoprotein cholesterol. While doing exercise treadmill test, the patient developed chest pain and significant ST-segment elevation in almost all precordial leads that persisted for about 15 minutes through recovery. We decided to admit the patient to the coronary care unit for further management and to perform coronary angiogram. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery. Medical treatment was decided. At one year follow up, our patient was healthy and had no cardiac complaints. In conclusion, myocardial bridging may predispose to coronary vasospasm that may leads to ischemic complications.

  12. Human Umbilical Cord-Derived Mesenchymal Stromal Cells Improve Left Ventricular Function, Perfusion, and Remodeling in a Porcine Model of Chronic Myocardial Ischemia

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    Liu, Chuan-Bin; Huang, He; Sun, Ping; Ma, Shi-Ze; Liu, An-Heng; Xue, Jian; Fu, Jin-Hui; Liang, Yu-Qian; Liu, Bing; Wu, Dong-Ying

    2016-01-01

    Stem cell therapy has emerged as a new strategy for treatment of ischemic heart disease. Although umbilical cord-derived mesenchymal stromal cells (UC-MSCs) have been used preferentially in the acute ischemia model, data for the chronic ischemia model are lacking. In this study, we investigated the effect of UC-MSCs originated from Wharton’s jelly in the treatment of chronic myocardial ischemia in a porcine model induced by ameroid constrictor. Four weeks after ameroid constrictor placement, the surviving animals were divided randomly into two groups to undergo saline injection (n = 6) or UC-MSC transplantation (n = 6) through the left main coronary artery. Two additional intravenous administrations of UC-MSCs were performed in the following 2 weeks to enhance therapeutic effect. Cardiac function and perfusion were examined just before and at 4 weeks after intracoronary transplantation. The results showed that pigs with UC-MSC transplantation exhibited significantly greater left ventricular ejection fraction compared with control animals (61.3% ± 1.3% vs. 50.3% ± 2.0%, p UC-MSC treatment improves left ventricular function, perfusion, and remodeling in a porcine model with chronic myocardial ischemia. Significance Ischemic heart disease is the leading cause of death worldwide. Many patients with chronic myocardial ischemia are not suitable for surgery and have no effective drug treatment; they are called “no-option” patients. This study finds that umbilical cord-derived mesenchymal stromal cells transplanted by intracoronary delivery combined with two intravenous administrations was safe and could significantly improve left ventricular function, perfusion, and remodeling in a large-animal model of chronic myocardial ischemia, which provides a new choice for the no-option patients. In addition, this study used clinical-grade mesenchymal stem cells with delivery and assessment methods commonly used clinically to facilitate further clinical transformation. PMID

  13. Electrocardiographically and symptomatically silent myocardial ischemia during exercise testing

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    Kurata, Chinori; Tawarahara, Kei; Sakata, Kazuyuki; Taguchi, Takahisa; Fukumoto, Yoshihiro; Kobayashi, Akira; Yamazaki, Noboru; Tanaka, Hiroshi

    1991-01-01

    Certain patients with coronary artery disease (CAD) may have neither ST depression nor chest pain during exercise despite the presence of myocardial ischemia. The frequency and characteristics of such electrocardiographically and symptomatically silent ischemia were studied in 171 patients with both angiographically documented CAD and scintigraphically documented ischemia. Fifty-six (33%) of 171 patients had neither ST depression nor chest pain (Group N), and 115 (67%) had ST depression and/or chest pain (Group P). The two groups were similar with respect to age, gender, the prevalence of prior infarction, and peak systolic blood pressure. Group N patients, however, had a higher mean peak heart rate and rate-pressure product, less severe scintigraphic ischemia, a lower lung thallium-201 uptake, and a smaller number of diseased vessels. Stepwise discriminant analysis showed a history of effort angina, lung thallium-201 uptake, and scintigraphic severity of ischemia to be significant discriminators between Groups N and P. In conclusion, electrocardiographically and symptomatically silent ischemia may be common during exercise in patients with CAD, and less severe ischemia may be one of important determinants. (author)

  14. Melatonin Does Not Affect Oxidative/Inflammatory Biomarkers in a Closed-Chest Porcine Model of Acute Myocardial Infarction

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    Halladin, Natalie L.; Ekelof, Sarah; Jensen, Svend Eggert

    2014-01-01

    Aim: To test whether melatonin reduces oxidative and inflammatory biomarkers in a closed-chest porcine model of acute myocardial infarction. Materials and Methods: Twenty pigs were randomized to receive a total dosage of 200 mg (0.4 mg/ml) of melatonin, or placebo immediately prior to reperfusion....... There was an increase in hs-TnT, but no significant difference between the melatonin-treated and placebo-treated groups. There were no significant differences in development of any of the circulating plasma markers between the two groups. Conclusion: Melatonin treatment did not result in reduction of inflammatory...

  15. Testing Danegaptide Effects on Kidney Function after Ischemia/Reperfusion Injury in a New Porcine Two Week Model.

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    Chris Amdisen

    Full Text Available Ischemia/reperfusion injury (I/R-I is a leading cause of acute kidney injury (AKI and is associated with increased mortality. Danegaptide is a selective modifier of the gap junction protein connexion 43. It has cytoprotective as well as anti-arrhythmic properties and has been shown to reduce the size of myocardial infarct in pigs. The aim of this study was to investigate the ischemia-protective effect of Danegaptide in a porcine renal I/R-I model with two weeks follow up.Unilateral renal I/R-I was induced in pigs by clamping the left renal artery over a two hour period. The model allowed examination of renal blood flow by magnetic resonance imaging (MRI and the measurement of single kidney GFR two weeks after injury. Eleven animals were randomized to Danegaptide-infusion while nine animals received placebo. Kidney histology and urinary neutrophil gelatinase-associated lipocalin (NGAL excretion were included as markers of AKI.Unilateral kidney I/R-I resulted in an immediate ~50% GFR reduction, associated with a four-fold increase in urinary NGAL-excretion. Fourteen days after I/R-I, the total GFR was ~75% of baseline with a significantly lower GFR in the injured left kidney compared to the right kidney. No differences in GFR were observed between the treated and non-treated animals immediately after I/R-I or at Day 14. Furthermore, no differences were observed in the urinary excretion of NGAL, renal blood flow or other markers of renal function.As expected this porcine renal I/R-I model was associated with reduced GFR two weeks after injury. Danegaptide did not improve renal function after I/R-I.

  16. ZP123 increases gap junctional conductance and prevents reentrant ventricular tachycardia during myocardial ischemia in open chest dogs

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    Xing, Dezhi; Kjølbye, Anne Louise; Nielsen, Morten S

    2003-01-01

    INTRODUCTION: The aim of this study was to determine if the stable antiarrhythmic peptide (AAP) analogue ZP123 increases gap junctional intercellular conductance and prevents reentrant ventricular tachycardia (VT) during coronary artery occlusion. METHODS AND RESULTS: Voltage clamp experiments...... demonstrated that 10 nM ZP123 improved gap junctional intercellular conductance by 69% +/- 20% in pairs of guinea pig ventricular myocytes. VT was induced by programmed stimulation in alpha-chloralose anaesthetized open chest dogs 1 to 4 hours after coronary artery occlusion. Three-dimensional activation...... AAP analogue ZP123 increased gap junctional intercellular conductance and specifically prevented the induction of reentrant VT during ischemia in a broad dose range without proarrhythmic or hemodynamic side effects. ZP123 is a promising candidate for use in preventing ischemia-induced VT....

  17. Exertional headache and coronary ischemia despite normal electrocardiographic stress testing.

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    Cutrer, F Michael; Huerter, Karina

    2006-01-01

    Exertional headaches may under certain conditions reflect coronary ischemia. We report the case of a patient seen in a neurology referral practice whose exertional headaches, even in the face of two normal electrocardiographic stress tests and in the absence of underlying chest pain were the sole symptoms of coronary ischemia as detected by Tc-99m Sestamibi testing SPECT stress testing. Stent placement resulted in complete resolution of headaches. Exertional headache in the absence of chest pain may reflect underlying symptomatic coronary artery disease (CAD) even when conventional electrocardiographic stress testing does not indicate ischemia.

  18. Protective effect of active perfusion in porcine models of acute myocardial ischemia

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    Feng, Zanxiang; Mao, Zhifu; Dong, Shengjun; Liu, Baohui

    2016-01-01

    Mortality rates associated with off-pump coronary artery bypass (CAB) are relatively high, as the majority of patients requiring CAB are at a high risk for cardiac events. The present study aimed to establish porcine models of acute myocardial ischemia, and evaluate the protective role of shunt and active perfusion. A total of 30 pigs were randomly assigned to five groups, as follows: i) Sham (control); ii) A1 (shunt; stenosis rate, 55%); iii) A2 (shunt; stenosis rate, 75%); iv) B1 (active perfusion; stenosis rate, 55%); and v) B2 (active perfusion; stenosis rate, 75%) groups. Aortic pressure (P0), left anterior descending coronary pressure (P1), and coronary effective perfusion pressure (P1/P0) were measured. The expression levels of tumor necrosis factor-α (TNF-α), cardiac troponin (cTnI), creatine kinase-myocardial band (CK-MB), interleukin (IL)-6, IL-10, B-cell lymphoma 2 (Bcl-2), and caspase-3 were detected using enzyme-linked immunosorbent assay or western blotting. The myocardial apoptosis rate was determined using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Ischemia models with stenosis rates of 55 and 75% were successfully constructed following suturing of the descending artery. Compared with the control, the 55 and 75% stenosis groups demonstrated significantly decreased P1/P0, increased expression levels of TNF-α, cTnI, CK-MB, IL-6, IL-10 and caspase-3, an increased rate of myocardial apoptosis, and a decreased expression level of anti-apoptotic protein, Bcl-2. At 30 min following successful establishment of the model (ST segment elevation to 1 mm), group B demonstrated significantly increased P1/P0, decreased expression levels of TNF-α, cTnI, CK-MB, IL-6, IL-10 and caspase-3, a decreased rate of myocardial apoptosis, and an increased expression level of anti-apoptotic protein, Bcl-2. Furthermore, the current study indicated that active perfusion was more efficacious in maintaining myocardial perfusion and alleviating

  19. Clinical evaluation of adenosine and exercise stress 99Tcm-MIBI myocardial imaging in detection of myocardial ischemia in patients with untypical chest pain

    International Nuclear Information System (INIS)

    Tian Yueqin; He Zuoxiang; Wang Qi; Hu Fenghuan; Yang Weixian; Qiao Shubing; Liu Xiujie

    2005-01-01

    Objective: To evaluate the value of adenosine and exercise stress 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial imaging for the diagnosis of myocardial ischemia in patients with untypical chest pain. Methods: Two groups included. Group 1: 67 cases of adenosine 99 Tc m -MIBI myocardial imaging. Group 2: 81 cases of exercise stress 99 Tc m -MIBI myocardial imaging. All of the patients had coronary angiography (CAG). The results of them were compared. Results: 23 out of 67 patients in group 1 had significant coronary stenosis after CAG, 16 showed reversible perfusion abnormalities in adenosine imaging. 41 of 44 patients with normal CAG showed normal adenosine imaging. The sensitivity, specificity and accuracy of adenosine imaging for coronary artery disease detection were 70%, 93% and 85%, respectively. Group 2: 22 out of 31 patients with significant coronany stenosis after CAG showed reversible perfusion abnormalities, 48 of 50 patients with normal CAG showed normal exercise imaging. The sensitivity, specificity and accuracy of exercise imaging for coronary artery disease detection were 71%, 96% and 86%, respectively. Conclusion: Reversible perfusion abnormalities found both in adenosine and exercise stress 99 Tc m -MIBI myocardial imaging were the key point for diagnosis of myocardial ischemia in patients with untypical chest pain. (authors)

  20. The relation between angina and myocardial ischemia during exercise stress in coronary artery disease

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    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1988-01-01

    To examine the mechanism of occurrence of anginal chest pain from the aspect of myocardial ischemia, myocardial Tl-201 SPECT scans were obtained immediately and 3 hr after exercise (Ex) in 35 patients with coronary artery disease (CAD). The extent of ischemia was defined as the percentage of ischemic segments to the entire left ventricle. The minimum washout (WO) rate correlated well with the ratio of Tl uptake in the ischemic area to that in the normal area during Ex in the other 9 patients having single vessel CAD without previous history of myocardial infarction. This suggested that the miminum WO rate reflects the severity of Ex-induced ischemia. According to the development of angina during Ex, patients were classified as having either symptomatic ischemia (n = 16) or silent ischemia (n = 19). In regard to age, sex, a history of myocardial infarction, severity of CAD, and the extent of Ex-induced ischemia, there was no difference between the two groups. The minimum WO rate and the incidence of Ex-induced ST depression were significantly lower and higher, respectively, in the group with symptomatic ischemia than that with silent ischemia. The severity of Ex-induced ischemia has important implications for the development of anginal chest pain. (Namekawa, K.)

  1. Detection of exercise-induced myocardial ischemia from symptomatology experienced during testing in men and women

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    D’Antono, Bianca; Dupuis, Gilles; Fortin, Christophe; Arsenault, André; Burelle, Denis

    2006-01-01

    BACKGROUND AND OBJECTIVES To examine the capacity of angina and related symptoms experienced during exercise-stress testing to detect the presence of ischemia, controlling for other clinical factors. METHOD The authors undertook a prospective study of 482 women and 425 men (mean age 58 years) undergoing exercise stress testing with myocardial perfusion imaging. One hundred forty-six women and 127 men reported chest pain, and of these, 25% of women and 66% of men had myocardial perfusion imaging evidence of ischemia during testing. The present article focuses on patients with chest pain during testing. MAIN OUTCOME MEASURES Outcome measures included chest pain localization, extension, intensity and quality, as well as the presence of various nonpain-related symptoms. Backward logistical regression analyses were performed separately on men and women who had experienced chest pain during testing. RESULTS Men who described their chest pain as ‘heavy’ were 4.6 times more likely to experience ischemia during testing (P=0.039) compared with other men, but this pain descriptor only slightly improved accuracy of prediction beyond that provided by control variables. In women, several symptoms added to the sensitivity of the prediction, such as a numb feeling in the face or neck region (OR 4.5; P=0.048), a numb feeling in the chest area (OR 14.6; P=0.003), muscle tension (OR 5.2; P=0.013), and chest pain that was described as hot or burning (OR 4.3; P=0.014). CONCLUSIONS A more refined evaluation of symptoms experienced during testing was particularly helpful in improving detection of ischemia in women, but not in men. Attention to these symptoms may favour timely diagnosis of myocardial perfusion defects in women. PMID:16639477

  2. Intracoronary infusion of Wharton’ jelly derived mesenchymal stem cells in the treatment of chronic ischemia cardiomyopathy in porcine model

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    Ning-kun ZHANG

    2015-11-01

    Full Text Available Objective To investigate the safety and efficacy of transplantation of allogeneic Wharton' jelly-derived mesenchymal stem cells (WJMSCs in a porcine model of chronic ischemia cardiomyopathy. Methods Cardiomyopathy models (CIMP were reproduced in 25 minipigs out of 29 by left anterior descending coronary artery balloon occlusion, and the 4 remains served as sham group. The left ventricular ejection fraction (LVEF was detected by echocardiography, and the value ≤45% was defined as successful modeling. Of that 25 minipigs, 5 died, 3 failed of modeling and 17 remains were successfully modelled. The dose safety experiment of WJMSCs transplantation was firstly performed in 3 successful models and 3 failed models. Three doses were teste d in turn at 6×106, 1×107 and 2×107 with 1 successful and 1 failed model for each dose, and TIMI 3 was considered safety dosage. The remainder 14 CIMP models were randomly assigned to transplantation group and control group (7 each, and given 2×107 WJMSCs intracoronary infusion or equal amounts of normal saline respectively. Echocardiography, histopathology and immunofluorescence tests were performed 8 weeks after WJMSCs transplantation. Results LVEF increased by 11.6% (P<0.01 and the left ventricular end systolic volume decreased by 4.1ml (P<0.05 in CIMP models 8 weeks after WJMSCs transplantation, while in control group the ventricular function further deteriorated (LVEF decreased from 42.8% to 35.9%, P<0.01 and the left ventricular further expanded [left ventricular end diastolic volume (LVEDV increased from 42.8±1.2ml to 46.7±1.3ml (P<0.05]. Histopathological assessment showed that the ventricular wall in the infarction area was significantly thickening and the vascular density in the border zone was obviously increased in transplantation group. Immunofluorescence test revealed that the injected Myc-WJMSCs survived in the immunocompetent host heart, and colocalized with cardiac troponin T, α-actin and

  3. Evaluation of adenosine preconditioning with 99mTc-His10-annexin V in a porcine model of myocardium ischemia and reperfusion injury: preliminary study

    International Nuclear Information System (INIS)

    Ye Fei; Fang Wei; Wang Feng; Hua Zichun; Wang Zizheng; Yang Xiang

    2011-01-01

    Purpose: The goal of this study was to evaluate the feasibility of 99m Tc-His 10 -annexin V for the detection of acute myocardial cell death and to assess the effect of adenosine preconditioning in a porcine model of myocardium ischemia and reperfusion injury (RI). Materials and Methods: 99m Tc-His 10 -annexin V was prepared by one-step direct labeling, and RCP and radiostability were tested. The binding of 99m Tc-His 10 -annexin V to apoptosis was validated in vitro using camptothecin-induced Jurkat cells. In vivo biodistribution was determined in mice by the dissection method. Ischemia of 20-30 min was induced by balloon occlusion of the epicardial coronary artery of the porcine model (n=14). Adenosine was infused intravenously in six pigs before coronary occlusion. 99m Tc-His 10 -annexin V (n=12) was injected intravenously at 1 h after reperfusion. SPECT/CT was acquired at 3 h postinjection. Myocardial perfusion imaging (MPI) with 99m Tc-MIBI was also performed 1 day after His 10 -annexin V imaging. Cardiac tissues were analyzed postmortem using hematoxylin-and-eosin and TUNEL staining. Caspase-3 activity was measured to confirm the presence of apoptosis. Results: 99m Tc-His 10 -annexin V had a RCP >98% and high stability 2 h after radiolabeling; it could bind to apoptotic cells with high affinity. Biodistribution of 99m Tc-His 10 -annexin V showed a predominant uptake in the kidney and relatively low uptake in the myocardium, liver and gastrointestinal tract; rapid clearance from blood and kidney was observed. In the untreated group, intense uptake of His 10 -annexin V was visualized in the defect which was shown in MPI, whereas in the adenosine group a mild uptake of 99m Tc-His 10 -annexin was found in the risk area which showed no defects in the 99m Tc-MIBI image. TUNEL staining and activated caspase-3 confirmed the ongoing apoptosis in RI. Adenosine preconditioning significantly diminished the level of apoptosis. Uptake of His 10 -annexin V in RI correlated

  4. Myocardial perfusion in silent myocardial ischemia

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1989-01-01

    To investigate myocardial perfusion in silent myocardial ischemia, we performed exercise stress myocardial tomography with thallium-201 (Tl) in 85 patients with coronary artery disease (CAD). Exercise stress myocardial tomography was obtained both immediately after exercise and three hours later. Patients were classified into two groups according to the presence (Symptomatic Group, n=36) or absence (Silent Group, n=49) of chest pain during exercise stress. Clinical features (age, gender and history of myocardial infarction) and arteriographically determined severity of CAD were the same in both groups. The extent of myocardial ischemia (% Ischemia) estimated by exercise stress myocardial tomography was the same in each group (30±10 % in Silent Group, 28±12 % in Symptomatic Group, NS). The severity of exercise-induced myocardial ischemia was expressed as a minimal value of myocardial Tl washout rate (minimal WOR) of each patient. Although exercise heart rate was identical in both groups, minimal WOR in Silent Group was significantly higher than that of Symptomatic Group (4±10% vs -16±14%, p<0.001). The study in patients who exhibited both silent and symptomatic ischemia showed the same results. These findings suggest that the severity of ischemia is a fundamental factor in determining the presence or absence of pain during exercise induced ischemia. (author)

  5. Multifocal electroretinogram for functional evaluation of retinal injury following ischemia-reperfusion in pigs

    DEFF Research Database (Denmark)

    Morén, Håkan; Gesslein, Bodil; Andreasson, Sten

    2010-01-01

    Multifocal electroretinogram (mfERG) has the power to discriminate between localized functional losses and overall retinal changes when evaluating retinal injury. So far, full-field ERG has been the gold standard for examining retinal ischemia and the effects of different neuroprotectants...... in experimental conditions. The aim of the present study was to establish mfERG, with simultaneous fundus monitoring, for analyzing the localized functional response in the retina after ischemia-reperfusion in the porcine eye....

  6. Exercise-induced silent myocardial ischemia: Evaluation by thallium-201 emission computed tomography

    International Nuclear Information System (INIS)

    Kurata, C.; Sakata, K.; Taguchi, T.; Kobayashi, A.; Yamazaki, N.

    1990-01-01

    Factors associated with silent myocardial ischemia (SMI) during exercise testing were studied by means of thallium-201 emission computed tomography (ECT) in 471 patients. Coronary angiography was done in 290, of whom 167 were found to have significant coronary artery disease (CAD). Exercise-induced ischemia and its severity were defined with ECT. During exercise 108 (62%) of 173 patients with ischemia and 57 (50%) of 115 with ischemia and angiographically documented CAD had no chest pain. One third of the patients showed an inconsistency between scintigraphic ischemia and ischemia ST depression. Age, sex, prior myocardial infarction, and diabetes mellitus were not related to SMI. Patients with SMI had less severe ischemia despite a higher peak double product compared to those with painful ischemia. Among 91 with prior myocardial infarction and exercise-induced ischemia, 51 with periinfarction ischemia had a higher frequency of SMI than did 14 with ischemia remote from the prior infarct zone despite similarities in the severity of ischemia. In conclusion, factors localized within ischemic myocardium such as less severe ischemia or adjacency to a prior infarct made SMI more prevalent

  7. Evaluation of adenosine preconditioning with {sup 99m}Tc-His{sub 10}-annexin V in a porcine model of myocardium ischemia and reperfusion injury: preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Ye Fei [Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, 68 Changle Road, Nanjing 210006 (China); Fang Wei [Cardiovascular Institute and Fuwai Hospital, No. 167 Bei-Li-Shi-Lu, Beijing 100037 (China); Wang Feng, E-mail: fengwang1972cn@gmail.co [Department of Nuclear Medicine, Nanjing First Hospital Affiliated to Nanjing Medical University, 68 Changle Road, Nanjing 210006 (China); State Key Laboratory of Pharmaceutical Biotechnology, Department of Biochemistry, College of Life Sciences, Nanjing University, 22 Hankou Road, Nanjing 210093 (China); Hua Zichun [State Key Laboratory of Pharmaceutical Biotechnology, Department of Biochemistry, College of Life Sciences, Nanjing University, 22 Hankou Road, Nanjing 210093 (China); Wang Zizheng [Department of Nuclear Medicine, Nanjing First Hospital Affiliated to Nanjing Medical University, 68 Changle Road, Nanjing 210006 (China); Yang Xiang [State Key Laboratory of Pharmaceutical Biotechnology, Department of Biochemistry, College of Life Sciences, Nanjing University, 22 Hankou Road, Nanjing 210093 (China)

    2011-05-15

    Purpose: The goal of this study was to evaluate the feasibility of {sup 99m}Tc-His{sub 10}-annexin V for the detection of acute myocardial cell death and to assess the effect of adenosine preconditioning in a porcine model of myocardium ischemia and reperfusion injury (RI). Materials and Methods: {sup 99m}Tc-His{sub 10}-annexin V was prepared by one-step direct labeling, and RCP and radiostability were tested. The binding of {sup 99m}Tc-His{sub 10}-annexin V to apoptosis was validated in vitro using camptothecin-induced Jurkat cells. In vivo biodistribution was determined in mice by the dissection method. Ischemia of 20-30 min was induced by balloon occlusion of the epicardial coronary artery of the porcine model (n=14). Adenosine was infused intravenously in six pigs before coronary occlusion. {sup 99m}Tc-His{sub 10}-annexin V (n=12) was injected intravenously at 1 h after reperfusion. SPECT/CT was acquired at 3 h postinjection. Myocardial perfusion imaging (MPI) with {sup 99m}Tc-MIBI was also performed 1 day after His{sub 10}-annexin V imaging. Cardiac tissues were analyzed postmortem using hematoxylin-and-eosin and TUNEL staining. Caspase-3 activity was measured to confirm the presence of apoptosis. Results: {sup 99m}Tc-His{sub 10}-annexin V had a RCP >98% and high stability 2 h after radiolabeling; it could bind to apoptotic cells with high affinity. Biodistribution of {sup 99m}Tc-His{sub 10}-annexin V showed a predominant uptake in the kidney and relatively low uptake in the myocardium, liver and gastrointestinal tract; rapid clearance from blood and kidney was observed. In the untreated group, intense uptake of His{sub 10}-annexin V was visualized in the defect which was shown in MPI, whereas in the adenosine group a mild uptake of {sup 99m}Tc-His{sub 10}-annexin was found in the risk area which showed no defects in the {sup 99m}Tc-MIBI image. TUNEL staining and activated caspase-3 confirmed the ongoing apoptosis in RI. Adenosine preconditioning significantly

  8. Reliability of the exercise ECG in detecting silent ischemia in patients with prior myocardial infarction

    International Nuclear Information System (INIS)

    Yamagishi, Takashi; Matsuda, Yasuo; Satoh, Akira

    1991-01-01

    To assess the reliability of the exercise ECG in detecting silent ischemia, ECG results were compared with those of stress-redistribution thallium-201 single-photon emission computed tomography (SPECT) in 116 patients with prior myocardial infarction and in 20 normal subjects used as a control. The left ventricle (LV) was divided into 20 segmental images, which were scored blindly on a 5-point scale. The redistribution score was defined as thallium defect score of exercise subtracted by that of redistribution image and was used as a measure of amount of ischemic but viable myocardium. The upper limit of normal redistribution score (=4.32) was defined as mean+2 standard deviations derived from 20 normal subjects. Of 116 patients, 47 had the redistribution score above the normal range. Twenty-five (53%) of the 47 patients showed positive ECG response. Fourteen (20%) of the 69 patients, who had the normal redistribution score, showed positive ECG response. Thus, the ECG response had a sensitivity of 53% and a specificity of 80% in detecting transient ischemia. Furthermore, the 116 patients were subdivided into 4 groups according to the presence or absence of chest pain and ECG change during exercise. Fourteen patients showed both chest pain and ECG change and all these patients had the redistribution score above the normal range. Twenty-five patients showed ECG change without chest pain and 11 (44%) of the 25 patients had the abnormal redistribution. Three (43%) of 7 patients who showed chest pain without ECG change had the abnormal redistribution score. Of 70 patients who had neither chest pain nor ECG change, 19 (27%) had the redistribution score above the normal range. Thus, limitations exist in detecting silent ischemia by ECG in patients with a prior myocardial infarction, because the ECG response to the exercise test may have a low degree of sensitivity and a high degree of false positive and false negative results in detecting silent ischemia. (author)

  9. [Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia].

    Science.gov (United States)

    Piovaccari, G; Melandri, G; Marzocchi, A; Scarfoglio, D; Sanguinetti, M; Magnani, B

    1989-04-01

    Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed.

  10. Sound transmission in porcine thorax through airway insonification.

    Science.gov (United States)

    Peng, Ying; Dai, Zoujun; Mansy, Hansen A; Henry, Brian M; Sandler, Richard H; Balk, Robert A; Royston, Thomas J

    2016-04-01

    Many pulmonary injuries and pathologies may lead to structural and functional changes in the lungs resulting in measurable sound transmission changes on the chest surface. Additionally, noninvasive imaging of externally driven mechanical wave motion in the chest (e.g., using magnetic resonance elastography) can provide information about lung structural property changes and, hence, may be of diagnostic value. In the present study, a comprehensive computational simulation (in silico) model was developed to simulate sound wave propagation in the airways, lung, and chest wall under normal and pneumothorax conditions. Experiments were carried out to validate the model. Here, sound waves with frequency content from 50 to 700 Hz were introduced into airways of five porcine subjects via an endotracheal tube, and transmitted waves were measured by scanning laser Doppler vibrometry at the chest wall surface. The computational model predictions of decreased sound transmission with pneumothorax were consistent with experimental measurements. The in silico model can also be used to visualize wave propagation inside and on the chest wall surface for other pulmonary pathologies, which may help in developing and interpreting diagnostic procedures that utilize sound and vibration.

  11. Sound transmission in porcine thorax through airway insonification

    Science.gov (United States)

    Dai, Zoujun; Mansy, Hansen A.; Henry, Brian M.; Sandler, Richard H.; Balk, Robert A.; Royston, Thomas J.

    2015-01-01

    Many pulmonary injuries and pathologies may lead to structural and functional changes in the lungs resulting in measurable sound transmission changes on the chest surface. Additionally, noninvasive imaging of externally driven mechanical wave motion in the chest (e.g., using magnetic resonance elastography) can provide information about lung structural property changes and, hence, may be of diagnostic value. In the present study, a comprehensive computational simulation (in silico) model was developed to simulate sound wave propagation in the airways, lung, and chest wall under normal and pneumothorax conditions. Experiments were carried out to validate the model. Here, sound waves with frequency content from 50 to 700 Hz were introduced into airways of five porcine subjects via an endotracheal tube, and transmitted waves were measured by scanning laser Doppler vibrometry at the chest wall surface. The computational model predictions of decreased sound transmission with pneumothorax were consistent with experimental measurements. The in silico model can also be used to visualize wave propagation inside and on the chest wall surface for other pulmonary pathologies, which may help in developing and interpreting diagnostic procedures that utilize sound and vibration. PMID:26280512

  12. Transthoracic impedance for the monitoring of quality of manual chest compression during cardiopulmonary resuscitation.

    Science.gov (United States)

    Zhang, Hehua; Yang, Zhengfei; Huang, Zitong; Chen, Bihua; Zhang, Lei; Li, Heng; Wu, Baoming; Yu, Tao; Li, Yongqin

    2012-10-01

    The quality of cardiopulmonary resuscitation (CPR), especially adequate compression depth, is associated with return of spontaneous circulation (ROSC) and is therefore recommended to be measured routinely. In the current study, we investigated the relationship between changes of transthoracic impedance (TTI) measured through the defibrillation electrodes, chest compression depth and coronary perfusion pressure (CPP) in a porcine model of cardiac arrest. In 14 male pigs weighing between 28 and 34 kg, ventricular fibrillation (VF) was electrically induced and untreated for 6 min. Animals were randomized to either optimal or suboptimal chest compression group. Optimal depth of manual compression in 7 pigs was defined as a decrease of 25% (50 mm) in anterior posterior diameter of the chest, while suboptimal compression was defined as 70% of the optimal depth (35 mm). After 2 min of chest compression, defibrillation was attempted with a 120-J rectilinear biphasic shock. There were no differences in baseline measurements between groups. All animals had ROSC after optimal compressions; this contrasted with suboptimal compressions, after which only 2 of the animals had ROSC (100% vs. 28.57%, p=0.021). The correlation coefficient was 0.89 between TTI amplitude and compression depth (pcompression depth and CPP in this porcine model of cardiac arrest. The TTI measured from defibrillator electrodes, therefore has the potential to serve as an indicator to monitor the quality of chest compression and estimate CPP during CPR. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Significantly improved survival time in pigs with complete liver ischemia treated with a novel bioartificial liver

    NARCIS (Netherlands)

    Flendrig, L. M.; Calise, F.; Di Florio, E.; Mancini, A.; Ceriello, A.; Santaniello, W.; Mezza, E.; Sicoli, F.; Belleza, G.; Bracco, A.; Cozzolino, S.; Scala, D.; Mazzone, M.; Fattore, M.; Gonzales, E.; Chamuleau, R. A.

    1999-01-01

    Aim of the study was to evaluate treatment efficacy and safety of a scaled-up version of our porcine hepatocytes based BAL system in pigs with complete liver ischemia (LIS). Thirty-one pigs underwent total devascularization of the liver (LIS) by termino-lateral porta-caval shunts and sutures around

  14. Chest pain in patients with arterial hypertension, angiographically normal coronary arteries and stiff aorta: the aortic pain syndrome.

    Science.gov (United States)

    Stakos, Dimitrios A; Tziakas, Dimitrios N; Chalikias, George; Mitrousi, Konstantina; Tsigalou, Christina; Boudoulas, Harisios

    2013-01-01

    Arterial hypertension is often associated with a stiff aorta as a result of collagen accumulation in the aortic wall and may produce chest pain. In the present study, possible interrelationships between aortic function, collagen turnover and exercise-induced chest pain in patients with arterial hypertension and angiographically normal coronary arteries were investigated. Ninety-seven patients with arterial hypertension, angiographically normal coronary arteries and no evidence of myocardial ischemia on nuclear cardiac imaging during exercise test were studied. Of these, 43 developed chest pain during exercise (chest pain group) while 54 did not (no chest pain group). Carotid femoral pulse-wave velocity (PWVc-f) was used to assess the elastic properties of the aorta. Amino-terminal pro-peptides of pro-collagen type I, (PINP, reflecting collagen synthesis), serum telopeptides of collagen type I (CITP, reflecting collagen degradation), pro-metalloproteinase 1 (ProMMP-1), and tissue inhibitor of metalloproteinase 1 (TIMP-1, related to collagen turnover) were measured in plasma by immunoassay. The chest pain group had higher PWVc-f, higher and /CITP ratio, and lower proMMP-1/ TIMP-1 ratio compared to the no chest pain group. PWVc-f (t=2.53, p=0.02) and PINP (t=2.42, p=0.02) were independently associated with the presence of chest pain in multiple regression analysis. Patients with arterial hypertension, exercise-induced chest pain and angiographically normal coronary arteries, without evidence of exercise-induced myocardial ischemia, had a stiffer aorta compared to those without chest pain. Alterations in collagen type I turnover that favor collagen accumulation in the aortic wall may contribute to aortic stiffening and chest pain in these patients.

  15. Transauricular embolization of the rabbit coronary artery for experimental myocardial infarction: comparison of a minimally invasive closed-chest model with open-chest surgery

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2012-02-01

    Full Text Available Abstract Introduction To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery. Methods New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG, cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining. Results In total, 38 subjects underwent EMI with a surgical (n = 17 or endovascular (n = 21 approach. ST-segment elevation (1.90 ± 0.71 mm occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68 within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05. Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68. Conclusion The proposed model of transauricular coronary coil embolization avoids

  16. Reproducible simulation of respiratory motion in porcine lung explants

    Energy Technology Data Exchange (ETDEWEB)

    Biederer, J. [Dept. of Diagnostic Radiology, Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany); Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany); Plathow, C. [Dept. of Diagnostic Radiology, Eberhard-Karls-Univ. Tuebingen (Germany); Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany); Schoebinger, M.; Meinzer, H.P. [Dept. of Medical and Biological Informatics, German Cancer Research Center, Heidelberg (Germany); Tetzlaff, R.; Puderbach, M.; Zaporozhan, J.; Kauczor, H.U. [Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany); Bolte, H.; Heller, M. [Dept. of Diagnostic Radiology, Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany)

    2006-11-15

    Purpose: To develop a model for exactly reproducible respiration motion simulations of animal lung explants inside an MR-compatible chest phantom. Materials and Methods: The materials included a piston pump and a flexible silicone reconstruction of a porcine diaphragm and were used in combination with an established MR-compatible chest phantom for porcine heart-lung preparations. The rhythmic inflation and deflation of the diaphragm at the bottom of the artificial thorax with water (1-1.5 L) induced lung tissue displacement resembling diaphragmatic breathing. This system was tested on five porcine heart-lung preparations using 1.5T MRI with transverse and coronal 3D-GRE (TR/TE=3.63/1.58, 256 x 256 matrix, 350 mm FOV, 4 mm slices) and half Fourier T2-FSE (TR/TE=545/29, 256 x 192, 350 mm, 6 mm) as well as multiple row detector CT (16 x 1 mm collimation, pitch 1.5, FOV 400 mm, 120 mAs) acquired at five fixed inspiration levels. Dynamic CT scans and coronal MRI with dynamic 2D-GRE and 2D-SS-GRE sequences (image frequencies of 10/sec and 3/sec, respectively) were acquired during continuous 'breathing' (7/minute). The position of the piston pump was visually correlated with the respiratory motion visible through the transparent wall of the phantom and with dynamic displays of CT and MR images. An elastic body splines analysis of the respiratory motion was performed using CT data. Results: Visual evaluation of MRI and CT showed three-dimensional movement of the lung tissue throughout the respiration cycle. Local tissue displacement inside the lung explants was documented with motion maps calculated from CT. The maximum displacement at the top of the diaphragm (mean 26.26 [SD 1.9] mm on CT and 27.16 [SD 1.5] mm on MRI, respectively [p=0.25; Wilcoxon test]) was in the range of tidal breathing in human patients. Conclusion: The chest phantom with a diaphragmatic pump is a promising platform for multi-modality imaging studies of the effects of respiratory lung

  17. Reproducible simulation of respiratory motion in porcine lung explants

    International Nuclear Information System (INIS)

    Biederer, J.; Plathow, C.; Schoebinger, M.; Meinzer, H.P.; Tetzlaff, R.; Puderbach, M.; Zaporozhan, J.; Kauczor, H.U.; Bolte, H.; Heller, M.

    2006-01-01

    Purpose: To develop a model for exactly reproducible respiration motion simulations of animal lung explants inside an MR-compatible chest phantom. Materials and Methods: The materials included a piston pump and a flexible silicone reconstruction of a porcine diaphragm and were used in combination with an established MR-compatible chest phantom for porcine heart-lung preparations. The rhythmic inflation and deflation of the diaphragm at the bottom of the artificial thorax with water (1-1.5 L) induced lung tissue displacement resembling diaphragmatic breathing. This system was tested on five porcine heart-lung preparations using 1.5T MRI with transverse and coronal 3D-GRE (TR/TE=3.63/1.58, 256 x 256 matrix, 350 mm FOV, 4 mm slices) and half Fourier T2-FSE (TR/TE=545/29, 256 x 192, 350 mm, 6 mm) as well as multiple row detector CT (16 x 1 mm collimation, pitch 1.5, FOV 400 mm, 120 mAs) acquired at five fixed inspiration levels. Dynamic CT scans and coronal MRI with dynamic 2D-GRE and 2D-SS-GRE sequences (image frequencies of 10/sec and 3/sec, respectively) were acquired during continuous 'breathing' (7/minute). The position of the piston pump was visually correlated with the respiratory motion visible through the transparent wall of the phantom and with dynamic displays of CT and MR images. An elastic body splines analysis of the respiratory motion was performed using CT data. Results: Visual evaluation of MRI and CT showed three-dimensional movement of the lung tissue throughout the respiration cycle. Local tissue displacement inside the lung explants was documented with motion maps calculated from CT. The maximum displacement at the top of the diaphragm (mean 26.26 [SD 1.9] mm on CT and 27.16 [SD 1.5] mm on MRI, respectively [p=0.25; Wilcoxon test]) was in the range of tidal breathing in human patients. Conclusion: The chest phantom with a diaphragmatic pump is a promising platform for multi-modality imaging studies of the effects of respiratory lung motion. (orig.)

  18. Experimental study of pulmonary thromboembolism ischemia-reperfusion injury in canine model

    International Nuclear Information System (INIS)

    Li Jianjun; Zhai Renyou; Zhang Dongpo; Huang Qiang; Yu Ping; Dai Dingke; Bao Na

    2009-01-01

    Objective: To establish a canine model of pulmonary thromboembolism ischemia- reperfusion injury (PTE IRI) that may be used for imaging study. Methods: Ten male and 10 female healthy mongrel canines with (18.6±0.8) kg/body weight, were used. A Swan-Ganz catheter was introduced into the right internal jugular vein via a preset percutaneous sheath using the Seldinger technique, and then was with further insertion the pulmonary artery. Balloon occlusion of the right inferior lobe pulmonary artery for 4 hours was followed by removing the catheter and ending with 4 hours of reperfusion. CT was performed before ischemia, 4 h after ischemia and 4 h after reperfusion. At last, dogs were killed and the bilateral inferior lung tissues were prepared for the examination by light and electronic microscopy. Results: All canine models were successfully developed pulmonary thromboembolism ischemia-reperfusion injury. The examination of CT, light and electron microscopy consistently indicated the presence of permeability pulmonary edema after reperfusion. Conclusions: A closed-chest canine model in vivo of pulmonary thromboembolism ischemia-reperfusion injury can be established with virtual pathophysiological process in human and be as well as for imaging experimental study. (authors)

  19. BNP was Associated with Ischemic Myocardial Scintigraphy and Death in Patients at Chest Pain Unit

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Jader Cunha de, E-mail: jadercazevedo@gmail.com [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Reis, Bruno Cezario Costa; Barreto, Nathalia Monerat P.B. [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); F, Diogenes S. Junior; Prezotti, Lais S. [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Procaci, Victor Rebelo; Octaviano, Vivian Werneck [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Volschan, Andre [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2015-01-15

    Recent studies have suggested that B-type Natriuretic Peptide (BNP) is an important predictor of ischemia and death in patients with suspected acute coronary syndrome. Increased levels of BNP are seen after episodes of myocardial ischemia and may be related to future adverse events. To determine the prognostic value of BNP for major cardiac events and to evaluate its association with ischemic myocardial perfusion scintigraphy (MPS). This study included retrospectively 125 patients admitted to the chest pain unit between 2002 and 2006, who had their BNP levels measured on admission and underwent CPM for risk stratification. BNP values were compared with the results of the MPS. The chi-square test was used for qualitative variables and the Student t test, for quantitative variables. Survival curves were adjusted using the Kaplan-Meier method and analyzed by using Cox regression. The significance level was 5%. The mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% of the sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher in patients with ischemia compared to patients with non-ischemic MPS (188.3 ± 208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mL was the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity = 70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-term mortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presence of ischemia. BNP levels are associated with ischemic MPS findings and adverse prognosis in patients presenting with acute chest pain to the emergency room, thus, providing important prognostic information for an unfavorable clinical outcome.

  20. Bronchoalveolar lavage with diluted porcine surfactant in mechanically ventilated term infants with meconium aspiration syndrome.

    Science.gov (United States)

    Lista, Gianluca; Bianchi, Silvia; Castoldi, Francesca; Fontana, Paola; Cavigioli, Francesco

    2006-01-01

    To evaluate the efficacy and safety of bronchoalveolar lavage (BAL) with diluted porcine surfactant in mechanically ventilated term infants with severe acute respiratory distress syndrome (ARDS) due to meconium aspiration syndrome (MAS). Eight consecutive mechanically ventilated term infants with severe ARDS due to MAS underwent BAL with 15 mL/kg of diluted (5.3mg phospholipid/mL) surfactant saline suspension (porcine surfactant [Curosurf]). Treatment was administered slowly in aliquots of 2.5 mL. The mean age of neonates at treatment was 3.5 (range 1-8) hours. Heart rate, systemic blood pressure and oxygen saturation were monitored continuously. Arterial blood gases were measured immediately before treatment, and again at 3 and 6 hours post-treatment. Chest x-rays were taken 6 and 24 hours after treatment. Radiological improvement was evident in all eight patients 6 hours post-treatment. Compared with pre-BAL values, significant improvements (p fluids that had been meconium-stained prior to BAL were clear of meconium after BAL. Only one patient required nitric oxide therapy for transient pulmonary hypertension. No adverse sequelae of treatment occurred during the study. BAL with dilute porcine surfactant administered slowly in 2.5 mL aliquots improved oxygenation and chest x-ray findings, without causing major adverse effects, in mechanically ventilated term infants with ARDS due to MAS.

  1. Multifactorial Biological Modulation of Warm Ischemia Reperfusion Injury in Liver Transplantation From Non-Heart-Beating Donors Eliminates Primary Nonfunction and Reduces Bile Salt Toxicity

    NARCIS (Netherlands)

    Monbaliu, Diethard; Vekemans, Katrien; Hoekstra, Harm; Vaahtera, Lauri; Libbrecht, Louis; Derveaux, Katelijne; Parkkinen, Jaakko; Liu, Qiang; Heedfeld, Veerle; Wylin, Tine; Deckx, Hugo; Zeegers, Marcel; Balligand, Erika; Buurman, Wim; van Pelt, Jos; Porte, Robert J.; Pirenne, Jacques

    Objective: To design a multifactorial biological modulation approach targeting ischemia reperfusion injury to augment viability of porcine liver grafts from non-heart-beating donors (NHBD). Background Data: Liver Transplantation (LTx) from NHBD is associated with an increased risk of primary

  2. Acute chest pain: a purely clinical problem or a question for radiology

    International Nuclear Information System (INIS)

    Loewe, C.

    2008-01-01

    Acute chest pain represents a very common clinical occurrence and at the same time poses a severe diagnostic dilemma. It can be due to an acute life-threatening event such as acute cardiac infarct, or a relatively harmless condition of pain and illness (e.g. vertebrogenic pain) under the main symptom category of acute chest pain. This often unclear symptomatic, behind which there can always be a life-threatening disease leads to an exaggerated grouping of patients into emergency cases and to an increased number of inpatients for observation. The diagnosis of acute coronary syndrome with no initial ECG changes typical for ischemia is especially problematic. The availability of modern multidetector computed tomography is becoming increasingly more important for radiologists in the diagnosis and clarification of acute chest pain. In this article the clinical difficulties and radiology options for the diagnosis of patients with acute chest pain will be presented and possible future algorithms for diagnosis will be discussed. (orig.) [de

  3. EFFECTS OF EARLY ANGIOTENSIN-CONVERTING ENZYME-INHIBITION IN A PIG MODEL OF MYOCARDIAL-ISCHEMIA AND REPERFUSION

    NARCIS (Netherlands)

    VANWIJNGAARDEN, J; TOBE, TJM; WEERSINK, EGL; BEL, KJ; DEGRAEFF, PA; DELANGEN, CDJ; VANGILST, WH; WESSELING, H

    In a blind, randomized study, the effects of perindopril, a nonsulfhydryl-containing angiotensin-converting enzyme (ACE) inhibitor, were compared with those of placebo in a closed-chest pig model of myocardial infraction. In anesthetized pigs, my ocardinal ischemia and reperfusion were induced by

  4. Protein kinase C in porcine retinal arteries and neuroretina following retinal ischemia-reperfusion

    DEFF Research Database (Denmark)

    Gesslein, Bodil; Gustafsson, Lotta; Wackenfors, Angelica

    2009-01-01

    Identification of the intracellular signal-transduction pathways activated in retinal ischemia may be important in revealing novel pharmacological targets. To date, most studies have focused on identifying neuroprotective agents. The retinal blood vessels are key organs in circulatory failure, an...

  5. Persistent chest pain following oral dipyridamole for thallium 201 myocardial imaging

    International Nuclear Information System (INIS)

    Kwai, A.H.; Jacobson, A.F.; McIntyre, K.M.; Williams, W.H.; Tow, D.E.

    1990-01-01

    A patient was admitted to the hospital with acute chest pain. After acute myocardial infarction was ruled out, he underwent a stress thallium 201 scintigraphy using oral dipyridamole and developed persistent angina with sedimentation time segement elevation. This complication has not been reported previously. It is recommended that appropriate intervention be available if severe ischemia develops following administration of dipyridamole for diagnostic imaging. (orig.)

  6. CT radiation dose and image quality optimization using a porcine model.

    Science.gov (United States)

    Zarb, Francis; McEntee, Mark F; Rainford, Louise

    2013-01-01

    To evaluate potential radiation dose savings and resultant image quality effects with regard to optimization of commonly performed computed tomography (CT) studies derived from imaging a porcine (pig) model. Imaging protocols for 4 clinical CT suites were developed based on the lowest milliamperage and kilovoltage, the highest pitch that could be set from current imaging protocol parameters, or both. This occurred before significant changes in noise, contrast, and spatial resolution were measured objectively on images produced from a quality assurance CT phantom. The current and derived phantom protocols were then applied to scan a porcine model for head, abdomen, and chest CT studies. Further optimized protocols were developed based on the same methodology as in the phantom study. The optimization achieved with respect to radiation dose and image quality was evaluated following data collection of radiation dose recordings and image quality review. Relative visual grading analysis of image quality criteria adapted from the European guidelines on radiology quality criteria for CT were used for studies completed with both the phantom-based or porcine-derived imaging protocols. In 5 out of 16 experimental combinations, the current clinical protocol was maintained. In 2 instances, the phantom protocol reduced radiation dose by 19% to 38%. In the remaining 9 instances, the optimization based on the porcine model further reduced radiation dose by 17% to 38%. The porcine model closely reflects anatomical structures in humans, allowing the grading of anatomical criteria as part of image quality review without radiation risks to human subjects. This study demonstrates that using a porcine model to evaluate CT optimization resulted in more radiation dose reduction than when imaging protocols were tested solely on quality assurance phantoms.

  7. Temperature profiles of different cooling methods in porcine pancreas procurement.

    Science.gov (United States)

    Weegman, Bradley P; Suszynski, Thomas M; Scott, William E; Ferrer Fábrega, Joana; Avgoustiniatos, Efstathios S; Anazawa, Takayuki; O'Brien, Timothy D; Rizzari, Michael D; Karatzas, Theodore; Jie, Tun; Sutherland, David E R; Hering, Bernhard J; Papas, Klearchos K

    2014-01-01

    Porcine islet xenotransplantation is a promising alternative to human islet allotransplantation. Porcine pancreas cooling needs to be optimized to reduce the warm ischemia time (WIT) following donation after cardiac death, which is associated with poorer islet isolation outcomes. This study examines the effect of four different cooling Methods on core porcine pancreas temperature (n = 24) and histopathology (n = 16). All Methods involved surface cooling with crushed ice and chilled irrigation. Method A, which is the standard for porcine pancreas procurement, used only surface cooling. Method B involved an intravascular flush with cold solution through the pancreas arterial system. Method C involved an intraductal infusion with cold solution through the major pancreatic duct, and Method D combined all three cooling Methods. Surface cooling alone (Method A) gradually decreased core pancreas temperature to <10 °C after 30 min. Using an intravascular flush (Method B) improved cooling during the entire duration of procurement, but incorporating an intraductal infusion (Method C) rapidly reduced core temperature 15-20 °C within the first 2 min of cooling. Combining all methods (Method D) was the most effective at rapidly reducing temperature and providing sustained cooling throughout the duration of procurement, although the recorded WIT was not different between Methods (P = 0.36). Histological scores were different between the cooling Methods (P = 0.02) and the worst with Method A. There were differences in histological scores between Methods A and C (P = 0.02) and Methods A and D (P = 0.02), but not between Methods C and D (P = 0.95), which may highlight the importance of early cooling using an intraductal infusion. In conclusion, surface cooling alone cannot rapidly cool large (porcine or human) pancreata. Additional cooling with an intravascular flush and intraductal infusion results in improved core porcine pancreas temperature profiles during procurement and

  8. A new function for ATP: activating cardiac sympathetic afferents during myocardial ischemia.

    Science.gov (United States)

    Fu, Liang-Wu; Longhurst, John C

    2010-12-01

    Myocardial ischemia activates cardiac sympathetic afferents leading to chest pain and reflex cardiovascular responses. Brief myocardial ischemia leads to ATP release in the interstitial space. Furthermore, exogenous ATP and α,β-methylene ATP (α,β-meATP), a P2X receptor agonist, stimulate cutaneous group III and IV sensory nerve fibers. The present study tested the hypothesis that endogenous ATP excites cardiac afferents during ischemia through activation of P2 receptors. Nerve activity of single unit cardiac sympathetic afferents was recorded from the left sympathetic chain or rami communicates (T(2)-T(5)) in anesthetized cats. Single fields of 45 afferents (conduction velocities = 0.25-4.92 m/s) were identified in the left ventricle with a stimulating electrode. Five minutes of myocardial ischemia stimulated 39 of 45 cardiac afferents (8 Aδ, 37 C fibers). Epicardial application of ATP (1-4 μmol) stimulated six ischemically sensitive cardiac afferents in a dose-dependent manner. Additionally, epicardial ATP (2 μmol), ADP (2 μmol), a P2Y agonist, and α,β-meATP (0.5 μmol) significantly activated eight other ischemically sensitive afferents. Third, pyridoxal phosphate-6-azophenyl-2',4'-disulfonic acid, a P2 receptor antagonist, abolished the responses of six afferents to epicardial ATP (2 μmol) and attenuated the ischemia-related increase in activity of seven other afferents by 37%. In the absence of P2 receptor blockade, cardiac afferents responded consistently to repeated application of ATP (n = 6) and to recurrent myocardial ischemia (n = 6). Finally, six ischemia-insensitive cardiac spinal afferents did not respond to epicardial ATP (2-4 μmol), although these afferents did respond to epicardial bradykinin. Taken together, these data indicate that, during ischemia, endogenously released ATP activates ischemia-sensitive, but not ischemia-insensitive, cardiac spinal afferents through stimulation of P2 receptors likely located on the cardiac sensory

  9. Retrograde Renal Cooling to Minimize Ischemia

    Directory of Open Access Journals (Sweden)

    Janet L. Colli

    2013-01-01

    Full Text Available Objective: During partial nephrectomy, renal hypothermia has been shown to decrease ischemia induced renal damage which occurs from renal hilar clamping. In this study we investigate the infusion rate required to safely cool the entire renal unit in a porcine model using retrograde irrigation of iced saline via dual-lumen ureteral catheter. Materials and Methods: Renal cortical, renal medullary, bowel and rectal temperatures during retrograde cooling in a laparoscopic porcine model were monitored in six renal units. Iced normal saline was infused at 300 cc/hour, 600 cc/hour, 1000 cc/hour and gravity (800 cc/hour for 600 seconds with and without hilar clamping. Results: Retrograde cooling with hilar clamping provided rapid medullary renal cooling and significant hypothermia of the medulla and cortex at infusion rates ≥ 600 cc/hour. With hilar clamping, cortical temperatures decreased at -0.9° C/min. reaching a threshold temperature of 26.9° C, and medullary temperatures decreased at -0.90 C/min. reaching a temperature of 26.1° C over 600 seconds on average for combined data at infusion rates ≥ 600 cc/hour. The lowest renal temperatures were achieved with gravity infusion. Without renal hilum clamping, retrograde cooling was minimal at all infusion rates. Conclusions: Significant renal cooling by gravity infusion of iced cold saline via a duel lumen catheter with a clamped renal hilum was achieved in a porcine model. Continuous retrograde irrigation with iced saline via a two way ureteral catheter may be an effective method to induce renal hypothermia in patients undergoing robotic assisted and/or laparoscopic partial nephrectomy.

  10. Myocardial capillary permeability after regional ischemia and reperfusion in the in vivo canine heart. Effect of superoxide dismutase

    DEFF Research Database (Denmark)

    Svendsen, J H; Bjerrum, P J; Haunsø, S

    1991-01-01

    This study assesses the effect of the superoxide anion scavenger superoxide dismutase on myocardial capillary permeability-surface area (PS) products for small hydrophilic molecules after ischemia and reperfusion. Open-chest dogs underwent a 20-minute occlusion of the left anterior descending...... the start of reperfusion. In 13 dogs, no scavenger treatment was given (nonprotected control group), whereas eight dogs were treated systemically with 15,000 units/kg superoxide dismutase during 1 hour, starting 20 minutes before ischemia. In the control group, three dogs developed reperfusion ventricular...

  11. Noninvasive Multimodal Imaging to Predict Recovery of Locomotion after Extended Limb Ischemia.

    Directory of Open Access Journals (Sweden)

    Jason S Radowsky

    Full Text Available Acute limb ischemia is a common cause of morbidity and mortality following trauma both in civilian centers and in combat related injuries. Rapid determination of tissue viability and surgical restoration of blood flow are desirable, but not always possible. We sought to characterize the response to increasing periods of hind limb ischemia in a porcine model such that we could define a period of critical ischemia (the point after which irreversible neuromuscular injury occurs, evaluate non-invasive methods for characterizing that ischemia, and establish a model by which we could predict whether or not the animal's locomotion would return to baselines levels post-operatively. Ischemia was induced by either application of a pneumatic tourniquet or vessel occlusion (performed by clamping the proximal iliac artery and vein at the level of the inguinal ligament. The limb was monitored for the duration of the procedure with both 3-charge coupled device (3CCD and infrared (IR imaging for tissue oxygenation and perfusion, respectively. The experimental arms of this model are effective at inducing histologically evident muscle injury with some evidence of expected secondary organ damage, particularly in animals with longer ischemia times. Noninvasive imaging data shows excellent correlation with post-operative functional outcomes, validating its use as a non-invasive means of viability assessment, and directly monitors post-occlusive reactive hyperemia. A classification model, based on partial-least squares discriminant analysis (PLSDA of imaging variables only, successfully classified animals as "returned to normal locomotion" or "did not return to normal locomotion" with 87.5% sensitivity and 66.7% specificity after cross-validation. PLSDA models generated from non-imaging data were not as accurate (AUC of 0.53 compared the PLSDA model generated from only imaging data (AUC of 0.76. With some modification, this limb ischemia model could also serve as a

  12. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very small dose ... Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the most commonly performed diagnostic ...

  13. Detection of viable myocardium in canine model with myocardial ischemia and ischemia-reperfusion by 125I-BMIPP: relation to regional blood flow

    International Nuclear Information System (INIS)

    Huang Gang; Zhao Huiyang; Shen Xuedong; Li Qing; Yuan Jimin; Zhu Cuiying

    1999-01-01

    Objective: The effects of BMIPP (β-methyl-iodophenyl pentadecanoic acid) on detecting viable myocardium and the relation between regional blood flow and the uptake of BMIPP were evaluated in canine model of myocardial ischemia and ischemia-reperfusion. Methods: 12 open-chest dogs under anesthesia were divided into two groups. Group I (ischemia group) had left circumflex coronary arterial occlusion for 2 h and group II (ischemia-reperfusion group) was occluded for 1 h and followed by 2 h reperfusion. Myocardial blood flow was measured with 99 Tc m -microspheres. 30 min after intravenous injection of 125 I-BMIPP and 99 Tc m -microspheres, the heart was excised rapidly and stained with Evans blue and NBT. Tissue samples (divided into approximately 1 g) of left ventricle were obtained, weighed and counted for 125 I and 99 Tc m . Regional blood flow and the uptake of BMIPP were expressed as percentages of average values in non-ischemic myocardium (two to three tissue samples) from the normal myocardium. Results: In ischemic myocardium (NBT positive samples), the uptake of BMIPP was relatively higher compared with regional blood flow [(67 +- 23)% vs (42 +- 19)%, P 0.05]. In ischemia-reperfusion group, regional blood flow was increased in ischemic and necrotic tissues, but the uptake of BMIPP was not enhanced with the increasing blood flow. Conclusions: BMIPP uptake seems to provide metabolic information independent of regional blood flow. The mismatching between regional blood flow and BMIPP uptake may indicate myocardial viability in the regions of hypoperfusion and the uptake of BMIPP in ischemic myocardium was related to existence of cellular metabolism

  14. Myocardial perfusion abnormality and chest pain in patients with hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa

    1991-01-01

    To investigate the role of myocardial ischemia in the development of chest pain in patients with hypertrophic cardiomyopathy (HCM), exercise stress (Ex) redistribution myocardial single photon emission CT's (SPECT's) with thallium-201 (Tl) were obtained in 27 patients with HCM. In all patients, coronary arteries were normal arteriographically. Patients were classified into NYHA Class I, II and III according to the frequency and severity of the chest pain during daily life. In these 3 groups, age, sex and intraventricular septal thickness measured by echocardiography were not different. Types of myocardial perfusion obtained by myocardial SPECT's were divided into 5: (1) normal perfusion, (2) no perfusion defect with abnormal myocardial Tl washout rate (WOR) during 3 hours (<30%) [Def(-)/WORabn], (3) reversible perfusion defect (RD), (4) fixed defect with abnormal WOR (FD/WORabn), and (5) fixed defect with normal WOR (FD/WORnl). In 14 patients of Class I, 9 patients (64%) showed normal perfusion but the rest showed perfusion abnormality (def(-)/WORabn in 3 and RD in 2). In Class II and III, all patients showed perfusion abnormalities of RD, FD/WORabn or FD/WORnl. As the functional class progressed from Class II to III, the ratio of fixed defect (both WORnl and WORabn) to RD increased, but it was not statistically significant. In 2 patients in whom Ex SPECT's were repeated because of the progression of the chest pain, the severity of the perfusion abnormality also progressed. Perfusion abnormalities were observed most frequently in anterior (35%), then inferior/posterior (20%) and septal wall (18%). The frequency of Ex induced ECG abnormalities (ST-depression or T wave changes) increased as the NYHA Class progressed (Class III vs I p<0.05). These findings suggested the following: chest pain in patients with HCM relates to the myocardial ischemia which may originate in the myocardial small arteries, and when the lesions progress myocardial necrosis may ensue. (author)

  15. Mild troponin I elevation does not predict ischemia on myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Le Dung Ha

    2017-08-01

    Full Text Available IntroductionData are limited on the degree of mild troponin I elevation and clinical risk factors in predicting myocardial ischemia.MethodsHospitalized adult patients who underwent myocardial perfusion imaging (MPI from 2015 to 2016 at Rochester General Hospital and had mild troponin I elevation (>0.1 and <1.5 ng/mL were included. Predictors of outcomes were determined using logistic regression model.ResultsOne hundred and sixty-six patients with mild troponin I elevation who underwent MPI were followed. Mean age was 69.6 ± 12.5 years and 53.0% of the patients were female. Fourteen patients (8.4% presented with typical chest pain (CP, 60 patients (36.1% had atypical CP and 92 patients (55.4% had no CP on presentation. MPI was positive for ischemia in 45 patients (27.1%. There was no difference in peak troponin I level with ischemia versus no ischemia on MPI (0.34 ng/dL [0.13-0.69] vs. 0.23 ng/dL [0.14-0.50], p value 0.254. Atypical CP did not predict the presence of ischemia on MPI (odds ratio [OR] 1.97, 95% confidence interval [CI] 0.91-4.26. Coronary artery disease (CAD history (age and sex adjusted p value 0.013, diabetes (adjusted p value 0.036, creatinine ≥2 mg/dL (adjusted p value 0.019 and dialysis (adjusted p value 0.006 were statistically significant predictors of ischemia on MPI.ConclusionsIn patients presenting with mild troponin I elevation, peak troponin I level did not predict ischemia on MPI. The presence of CAD history, diabetes, elevated creatinine and dialysis were predictors of ischemia on MPI.

  16. Sildenafil Protects against Myocardial Ischemia-Reperfusion Injury Following Cardiac Arrest in a Porcine Model: Possible Role of the Renin-Angiotensin System

    Science.gov (United States)

    Wang, Guoxing; Zhang, Qian; Yuan, Wei; Wu, Junyuan; Li, Chunsheng

    2015-01-01

    Sildenafil, a phosphodiesterase-5 inhibitor sold as Viagra, is a cardioprotector against myocardial ischemia/reperfusion (I/R) injury. Our study explored whether sildenafil protects against I/R-induced damage in a porcine cardiac arrest and resuscitation (CAR) model via modulating the renin-angiotensin system. Male pigs were randomly divided to three groups: Sham group, Saline group, and sildenafil (0.5 mg/kg) group. Thirty min after drug infusion, ventricular fibrillation (8 min) and cardiopulmonary resuscitation (up to 30 min) was conducted in these animals. We found that sildenafil ameliorated the reduced cardiac function and improved the 24-h survival rate in this model. Sildenafil partly attenuated the increases of plasma angiotensin II (Ang II) and Ang (1–7) levels after CAR. Sildenafil also decreased apoptosis and Ang II expression in myocardium. The increases of expression of angiotensin-converting-enzyme (ACE), ACE2, Ang II type 1 receptor (AT1R), and the Ang (1–7) receptor Mas in myocardial tissue were enhanced after CAR. Sildenafil suppressed AT1R up-regulation, but had no effect on ACE, ACE2, and Mas expression. Sildenafilfurther boosted the upregulation of endothelial nitric oxide synthase (eNOS), cyclic guanosine monophosphate (cGMP) and inducible nitric oxide synthase(iNOS). Collectively, our results suggest that cardioprotection of sildenafil in CAR model is accompanied by an inhibition of Ang II-AT1R axis activation. PMID:26569234

  17. Sildenafil Protects against Myocardial Ischemia-Reperfusion Injury Following Cardiac Arrest in a Porcine Model: Possible Role of the Renin-Angiotensin System

    Directory of Open Access Journals (Sweden)

    Guoxing Wang

    2015-11-01

    Full Text Available Sildenafil, a phosphodiesterase-5 inhibitor sold as Viagra, is a cardioprotector against myocardial ischemia/reperfusion (I/R injury. Our study explored whether sildenafil protects against I/R-induced damage in a porcine cardiac arrest and resuscitation (CAR model via modulating the renin-angiotensin system. Male pigs were randomly divided to three groups: Sham group, Saline group, and sildenafil (0.5 mg/kg group. Thirty min after drug infusion, ventricular fibrillation (8 min and cardiopulmonary resuscitation (up to 30 min was conducted in these animals. We found that sildenafil ameliorated the reduced cardiac function and improved the 24-h survival rate in this model. Sildenafil partly attenuated the increases of plasma angiotensin II (Ang II and Ang (1–7 levels after CAR. Sildenafil also decreased apoptosis and Ang II expression in myocardium. The increases of expression of angiotensin-converting-enzyme (ACE, ACE2, Ang II type 1 receptor (AT1R, and the Ang (1–7 receptor Mas in myocardial tissue were enhanced after CAR. Sildenafil suppressed AT1R up-regulation, but had no effect on ACE, ACE2, and Mas expression. Sildenafilfurther boosted the upregulation of endothelial nitric oxide synthase (eNOS, cyclic guanosine monophosphate (cGMP and inducible nitric oxide synthase(iNOS. Collectively, our results suggest that cardioprotection of sildenafil in CAR model is accompanied by an inhibition of Ang II-AT1R axis activation.

  18. Unilateral Partial Nephrectomy with Warm Ischemia Results in Acute Hypoxia Inducible Factor 1-Alpha (HIF-1α and Toll-Like Receptor 4 (TLR4 Overexpression in a Porcine Model.

    Directory of Open Access Journals (Sweden)

    Zhiyong Zhang

    Full Text Available Ischemia/reperfusion (I/R during partial nephrectomy (PN contributes to acute kidney injury (AKI, which is inaccurately assessed using existent clinical markers of renal function. We evaluated I/R-related changes in expression in hypoxia inducible factor 1α (HIF-1α and toll-like receptor 4 (TLR4, within kidney tissue and peripheral blood leukocytes (PBL in a porcine model of PN.Three adult pigs each underwent unilateral renal hilar cross clamping for 180 min followed by a 15 min reperfusion. The contralateral kidney served as control. Biopsies of clamped kidneys were obtained at baseline (time 0, every 60 min during the hypoxic phase, and post-reperfusion. Control kidneys were biopsied once at 180 min. Peripheral blood was sampled at time 0, every 30 min during the hypoxic phase, and post-reperfusion. HIF-1α and TLR4 expression in kidney tissue and PBL were analyzed by Western blotting. I/R-related histological changes were assessed.Expression of HIF-1α in clamped kidneys and PBL was below detection level at baseline, rising to detectable levels after 60 min of hypoxia, and continuing to rise throughout the hypoxic and reperfusion phases. Expression of TLR-4 in clamped kidneys followed a similar trend with initial detection after 30-60 min of hypoxia. Control kidneys exhibited no change in HIF-1α or TLR-4 expression. I/R-related histologic changes were minimal, primarily mild tubular dilatation.In a porcine model of PN, HIF-1α and TLR4 exhibited robust, I/R-related increases in expression in kidney tissue and PBL. Further studies investigating these molecules as potential markers of AKI are warranted.

  19. Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia.

    Directory of Open Access Journals (Sweden)

    Kenichiro Hanawa

    Full Text Available Although a significant progress has been made in the management of ischemic heart disease (IHD, the number of severe IHD patients is increasing. Thus, it is crucial to develop new, non-invasive therapeutic strategies. In the present study, we aimed to develop low-intensity pulsed ultrasound (LIPUS therapy for the treatment of IHD.We first confirmed that in cultured human endothelial cells, LIPUS significantly up-regulated mRNA expression of vascular endothelial growth factor (VEGF with a peak at 32-cycle (P<0.05. Then, we examined the in vivo effects of LIPUS in a porcine model of chronic myocardial ischemia with reduced left ventricular ejection fraction (LVEF (n = 28. The heart was treated with either sham (n = 14 or LIPUS (32-cycle with 193 mW/cm2 for 20 min, n = 14 at 3 different short axis levels. Four weeks after the treatment, LVEF was significantly improved in the LIPUS group (46±4 to 57±5%, P<0.05 without any adverse effects, whereas it remained unchanged in the sham group (46±5 to 47±6%, P = 0.33. Capillary density in the ischemic region was significantly increased in the LIPUS group compared with the control group (1084±175 vs. 858±151/mm2, P<0.05. Regional myocardial blood flow was also significantly improved in the LIPUS group (0.78±0.2 to 1.39±0.4 ml/min/g, P<0.05, but not in the control group (0.84±0.3 to 0.97±0.4 ml/min/g. Western blot analysis showed that VEGF, eNOS and bFGF were all significantly up-regulated only in the LIPUS group.These results suggest that the LIPUS therapy is promising as a new, non-invasive therapy for IHD.

  20. Dynamic myocardial perfusion in a porcine balloon-induced ischemia model using a prototype spectral detector CT

    Science.gov (United States)

    Fahmi, Rachid; Eck, Brendan L.; Fares, Anas; Levi, Jacob; Wu, Hao; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

    2015-03-01

    Myocardial CT perfusion (CTP) imaging is an application that should greatly benefit from spectral CT through the significant reduction of beam hardening (BH) artifacts using mono-energetic (monoE) image reconstructions. We used a prototype spectral detector CT (SDCT) scanner (Philips Healthcare) and developed advanced processing tools (registration, segmentation, and deconvolution-based flow estimation) for quantitative myocardial CTP in a porcine ischemia model with different degrees of coronary occlusion using a balloon catheter. The occlusion severity was adjusted with fractional flow reserve (FFR) measurements. The SDCT scanner is a single source, dual-layer detector system, which allows simultaneous acquisitions of low and high energy projections, hence enabling accurate projection-based material decomposition and effective reduction of BH-artifacts. In addition, the SDCT scanner eliminates partial scan artifacts with fast (0.27s), full gantry rotation acquisitions. We acquired CTP data under different hemodynamic conditions and reconstructed conventional 120kVp images and projection-based monoenergetic (monoE) images for energies ranging from 55keV-to-120keV. We computed and compared myocardial blood flow (MBF) between different reconstructions. With balloon completely deflated (FFR=1), we compared the mean attenuation in a myocardial region of interest before iodine arrival and at peak iodine enhancement in the left ventricle (LV), and we found that monoE images at 70keV effectively minimized the difference in attenuation, due to BH, to less than 1 HU compared to 14 HU with conventional 120kVp images. Flow maps under baseline condition (FFR=1) were more uniform throughout the myocardial wall at 70keV, whereas with 120kVp data about 12% reduction in blood flow was noticed on BH-hypoattenuated areas compared to other myocardial regions. We compared MBF maps at different keVs under an ischemic condition (FFR < 0.7), and we found that flow

  1. Protectant activity of defibrotide in cardioplegia followed by ischemia/reperfusion injury in the isolated rat heart.

    Science.gov (United States)

    Rossoni, G; Pompilio, G; Biglioli, P; Alamanni, F; Tartara, P; Rona, P; Porqueddu, M; Berti, F

    1999-01-01

    Previous studies have shown that defibrotide, a polydeoxyribonucleotide obtained by depolymerization of DNA from porcine tissues, has important protective effects on myocardial ischemia, which may be associated with a prostacyclin-related mechanism. The purpose of this study was to investigate the direct effects of defibrotide (given in cardioplegia or after ischemia) on a model of rat heart recovery after cardioplegia followed by ischemia/reperfusion injury. Isolated rat hearts, undergoing 5 minutes of warm cardioplegic arrest followed by 20 minutes of global ischemia and 30 minutes of reperfusion, were studied using the modified Langendorff model. The cardioplegia consisted of St. Thomas' Hospital solution augmented with defibrotide (50, 100, and 200 microg/mL) or without defibrotide (controls). Left ventricular mechanical function and the levels of creatine kinase, lactate dehydrogenase, and 6-keto-prostaglandin F1alpha (6-keto-PGF1alpha; the stable metabolite of prostacyclin) were measured during preischemic and reperfusion periods. After global ischemia, hearts receiving defibrotide in the cardioplegic solution (n = 8) manifested in a concentration-dependent fashion lower left ventricular end-diastolic pressure (p defibrotide in the cardioplegic solution also had, in a dose-dependent way, lower levels of creatine-kinase (p defibrotide was given alone to the hearts at the beginning of reperfusion (n = 7), the recovery of postischemic left ventricular function was inferior (p defibrotide was given in cardioplegia. Defibrotide confers to conventional crystalloid cardioplegia a potent concentration-dependent protective effect on the recovery of isolated rat heart undergoing ischemia/reperfusion injury. The low cost and the absence of contraindications (cardiac toxicity and hemodynamic effects) make defibrotide a promising augmentation to cardioplegia.

  2. Challenges in management of pediatric life-threatening neck and chest trauma

    Directory of Open Access Journals (Sweden)

    Shilpa Sharma

    2018-01-01

    Full Text Available Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2–10 years were managed. Mechanism of injury was road traffic accident, fall from height and other accidental injury in 2, 3 and 1 patient respectively. The presentation was respiratory distress and quadriplegia, exposed heart, penetrating injury in neck, dysphagia and dyspnea, and swelling over the chest wall in 1, 1, 1, 2 and 1 cases respectively. Injuries included lung laceration, open chest wall, vascular injury of the neck, tracheoesophageal fistula (2, and chest wall posttraumatic pyomyositis. One patient had a flare of miliary tuberculosis. Immediate management included chest wall repair; neck exploration and repair, esophagostomy, gastroesophageal stapling, and feeding jejunostomy (followed by gastric pull-up 8 months later. Chest tube insertion and total parenteral nutrition was required in one each. 2 and 4 patients required tracheostomy and mechanical ventilation. The patient with gastric pull-up developed a stricture of the esophagogastric anastomosis that was revised at 26-month follow-up. At follow-up of 40–61 months, five patients are well. One patient with penetrating neck injury suffered from blindness due to massive hemorrhage from the vascular injury in the neck and brain ischemia with only peripheral vision recovery. Conclusion: Successful management of neck and chest wall trauma requires timely appropriate decisions with a team effort.

  3. Prognostic significance of silent myocardial ischemia on a thallium stress test

    International Nuclear Information System (INIS)

    Heller, L.I.; Tresgallo, M.; Sciacca, R.R.; Blood, D.K.; Seldin, D.W.; Johnson, L.L.

    1990-01-01

    The clinical significance of silent ischemia is not fully known. The purpose of this study was to determine whether the presence or absence of angina during a thallium stress test positive for ischemia was independently predictive of an adverse outcome. Two hundred thirty-four consecutive patients with ischemia on a thallium stress test were identified. Ischemia was defined as the presence of defect(s) on the immediate postexercise scans not in the distribution of prior infarctions that redistributed on 4-hour scans. During the test 129 patients had angina, defined as characteristic neck, jaw, arm, back or chest discomfort, while the remaining 105 patients had no angina. Follow-up ranged from 2 to 8.2 years (mean 5.2 +/- 2.1) and was successfully obtained in 156 patients. Eighty-two of the 156 patients had angina (group A) and 74 had silent ischemia (group S). Group A patients were significantly older (62 +/- 8 vs 59 +/- 8 years, p less than 0.05). There was no significant difference between the 2 groups in terms of sex, history of prior infarction or presence of left main/3-vessel disease. A larger percentage of patients in group A were receiving beta blockers (60 vs 41%, p less than 0.05) and nitrates (52 vs 36%, 0.05 less than p less than 0.10). There was a large number of cardiac events (myocardial infarction, revascularization and death) in both groups (37 of 82 [45%] in group A; 28 of 72 [38%] in group S) but no statistically significant difference between the groups. Similarly, life-table analysis revealed no difference in mortality between the 2 groups

  4. Intracoronary Poloxamer 188 Prevents Reperfusion Injury in a Porcine Model of ST-Segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Jason A. Bartos, MD, PhD

    2016-06-01

    Full Text Available Poloxamer 188 (P188 is a nonionic triblock copolymer believed to prevent cellular injury after ischemia and reperfusion. This study compared intracoronary (IC infusion of P188 immediately after reperfusion with delayed infusion through a peripheral intravenous catheter in a porcine model of ST-segment elevation myocardial infarction (STEMI. STEMI was induced in 55 pigs using 45 min of endovascular coronary artery occlusion. Pigs were then randomized to 4 groups: control, immediate IC P188, delayed peripheral P188, and polyethylene glycol infusion. Heart tissue was collected after 4 h of reperfusion. Assessment of mitochondrial function or infarct size was performed. Mitochondrial yield improved significantly with IC P188 treatment compared with control animals (0.25% vs. 0.13%, suggesting improved mitochondrial morphology and survival. Mitochondrial respiration and calcium retention were also significantly improved with immediate IC P188 compared with control animals (complex I respiratory control index: 7.4 vs. 3.7; calcium retention: 1,152 nmol vs. 386 nmol. This benefit was only observed with activation of complex I of the mitochondrial respiratory chain, suggesting a specific effect from ischemia and reperfusion on this complex. Infarct size and serum troponin I were significantly reduced by immediate IC P188 infusion (infarct size: 13.9% vs. 41.1%; troponin I: 19.2 μg/l vs. 77.4 μg/l. Delayed P188 and polyethylene glycol infusion did not provide a significant benefit. These results demonstrate that intracoronary infusion of P188 immediately upon reperfusion significantly reduces cellular and mitochondrial injury after ischemia and reperfusion in this clinically relevant porcine model of STEMI. The timing and route of delivery were critical to achieve the benefit.

  5. Thallium-201 myocardial perfusion scintigraphy to evaluate patients with chest pain (preliminary study)

    International Nuclear Information System (INIS)

    Mahfouz, M.; Elhaddad, S.; Elghoneimy, I.; Elmesidy, S.; Haggag, F.; Sbdou, S.; Dayem, K.A.; Ezzeldiy, H.

    1985-01-01

    201 Tl perfusion scintigraphy for the diagnosis of coronary artery disease was carried out in 25 patients of mean age years, presenting with chest pain. Scintiscan were obtained at rest and after exercise and were compared with ECG studies at rest and after exercise. In all patients with previous myocardial infarctions, perfusion defects were present at rest, two of these patients showed abnormal stress scintigraphy consistent with a new ischemic response which was not detected by the stress ECG. In 3 out of the 8 patients with normal ECG, in 2 out of the 4 patients with response suggesting ischemia and in 4 out of the 7 patients with definite ECG proof of ischemia infarction was detected by 201 Tl. In all the previous, resting and exercise ECG failed to show evidence of infarction.1 fig.,2 tab

  6. Chest radiography after minor chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Rossen, B.; Laursen, N.O.; Just, S.

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

  7. Chest radiography after minor chest trauma

    International Nuclear Information System (INIS)

    Rossen, B.; Laursen, N.O.; Just, S.

    1987-01-01

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma. (orig.)

  8. Development of left ventricular hypertrophy in a novel porcine model of mitral regurgitation

    DEFF Research Database (Denmark)

    Ravn, Nathja; Zois, Nora Elisabeth; Moesgaard, Sophia Gry

    2014-01-01

    OBJECTIVES: We aimed to develop a porcine model for chronic nonischemic mitral regurgitation (MR) to investigate left ventricular (LV) enlargement and eccentric hypertrophy. DESIGN: Nonischemic MR was induced in 30 pigs by open-chest immobilization of the posterior mitral leaflet by transannular...... (LVIDd) from baseline to follow-up was significantly higher in the sMR group compared to that of the control group (P = 0.0017). Furthermore, LV weight was significantly increased in the mMR (P = 0.047) and the sMR (P = 0.0087) groups compared to that of the control group. CONCLUSIONS: A new model...

  9. Dynamic mechanisms of cardiac oxygenation during brief ischemia and reperfusion

    International Nuclear Information System (INIS)

    Parsons, W.J.; Rembert, J.C.; Bauman, R.P.; Greenfield, J.C. Jr.; Piantadosi, C.A.

    1990-01-01

    Myocardial oxygenation may be altered markedly by changes in tissue blood flow. During brief ischemia and reperfusion produced by transient occlusion of the left anterior descending artery in 10 open-chest dogs, changes in the oxygenation of tissue hemoglobin (Hb) plus myoglobin (Mb) and the oxidation-reduction (redox) state of mitochondrial cytochrome aa3 were monitored continuously using near-infrared spectroscopy. The nondestructive optical technique indicated that coronary occlusion produced an abrupt drop in tissue oxygen stores (tHb02 + Mb02), tissue blood volume (tBV), and the oxidation level of cytochrome aa3. Changes in the cytochrome oxidation state were related inversely to transmural collateral blood flow within the ischemic region (r = 0.77) measured with radiolabeled microspheres. Furthermore, there was a direct relationship (r = 0.91) between collateral blood flow and the tissue level of desaturated Hb and Mb (tHb + Mb). Reperfusion after 2 min of ischemia led to a synchronous overshoot of baseline in coronary flow and tBV followed by supranormal increases in tHb + Mb02 and the oxidation level of cytochrome aa3. The tHb + Mb level increased transiently during reperfusion. This response correlated inversely with collateral flow during ischemia (r = 0.91). Accordingly, the time required to reach peak tHb + Mb levels was shortest in dogs with high collateral flows (r = 0.75). Thus collateral blood flow partially sustains myocardial oxygenation during coronary artery occlusion and influences tissue reoxygenation early during reperfusion

  10. Imaging of Acute Mesenteric Ischemia Using Multidetector CT and CT Angiography in a Porcine Model

    OpenAIRE

    Rosow, David E.; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S.; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I.; Mueller, Peter R.; Castillo, Carlos Fernández-del; Warshaw, Andrew L.; Thayer, Sarah P.

    2005-01-01

    Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly f...

  11. Mesenteric Ischemia

    Directory of Open Access Journals (Sweden)

    Shannon Toohey

    2016-07-01

    Full Text Available Audience: This simulation session is appropriate for emergency medicine residents at any level or medical students. Introduction: Mesenteric ischemia is a rare, but serious cause of abdominal pain. Practitioners must recognize the diagnosis quickly. The clinical course rapidly advances from bowel ischemia to infarction, sepsis, and frequently death. Mesenteric ischemia accounts for approximately 1% of all ED cases of abdominal pain in the elderly, but the mortality is as high as 93%. Objectives: At the end of this simulation session, the learner will: 1 Recognize signs and symptoms of mesenteric ischemia; 2 order appropriately imaging and labs in the workup of an elderly patient with abdominal pain; 3 manage a patient with mesenteric ischemia, a rare, but serious cause of abdominal pain in the elderly; 4 discuss anchoring bias, specifically related to patients referred to the ED with an established diagnosis by outside specialists. Methods: This educational session is a high-fidelity simulation.

  12. Chick embryo partial ischemia model: a new approach to study ischemia ex vivo.

    Directory of Open Access Journals (Sweden)

    Syamantak Majumder

    Full Text Available BACKGROUND: Ischemia is a pathophysiological condition due to blockade in blood supply to a specific tissue thus damaging the physiological activity of the tissue. Different in vivo models are presently available to study ischemia in heart and other tissues. However, no ex vivo ischemia model has been available to date for routine ischemia research and for faster screening of anti-ischemia drugs. In the present study, we took the opportunity to develop an ex vivo model of partial ischemia using the vascular bed of 4(th day incubated chick embryo. METHODOLOGY/PRINCIPAL FINDINGS: Ischemia was created in chick embryo by ligating the right vitelline artery using sterile surgical suture. Hypoxia inducible factor- 1 alpha (HIF-1alpha, creatine phospho kinase-MB and reactive oxygen species in animal tissues and cells were measured to confirm ischemia in chick embryo. Additionally, ranolazine, N-acetyl cysteine and trimetazidine were administered as an anti-ischemic drug to validate the present model. Results from the present study depicted that blocking blood flow elevates HIF-1alpha, lipid peroxidation, peroxynitrite level in ischemic vessels while ranolazine administration partially attenuates ischemia driven HIF-1alpha expression. Endothelial cell incubated on ischemic blood vessels elucidated a higher level of HIF-1alpha expression with time while ranolazine treatment reduced HIF-1alpha in ischemic cells. Incubation of caprine heart strip on chick embryo ischemia model depicted an elevated creatine phospho kinase-MB activity under ischemic condition while histology of the treated heart sections evoked edema and disruption of myofibril structures. CONCLUSIONS/SIGNIFICANCE: The present study concluded that chick embryo partial ischemia model can be used as a novel ex vivo model of ischemia. Therefore, the present model can be used parallel with the known in vivo ischemia models in understanding the mechanistic insight of ischemia development and in

  13. Quantitative cardiac phosphoproteomics profiling during ischemia-reperfusion in an immature swine model

    Energy Technology Data Exchange (ETDEWEB)

    Ledee, Dolena R.; Kang, Min A.; Kajimoto, Masaki; Purvine, Samuel O.; Brewer, Heather M.; Pasa Tolic, Ljiljana; Portman, Michael A.

    2017-07-01

    Ischemia-reperfusion (I/R) results in altered metabolic and molecular responses, and phosphorylation is one of the most noted regulatory mechanisms mediating signaling mechanisms during physiological stresses. To expand our knowledge of the potential phosphoproteomic changes in the myocardium during I/R, we used Isobaric Tags for Relative and Absolute Quantitation-based analyses in left ventricular samples obtained from porcine hearts under control or I/R conditions. The data are available via ProteomeXchange with identifier PXD006066. We identified 1,896 phosphopeptides within left ventricular control and I/R porcine samples. Significant differential phosphorylation between control and I/R groups was discovered in 111 phosphopeptides from 86 proteins. Analysis of the phosphopeptides using Motif-x identified five motifs: (..R..S..), (..SP..), (..S.S..), (..S…S..), and (..S.T..). Semiquantitative immunoblots confirmed site location and directional changes in phosphorylation for phospholamban and pyruvate dehydrogenase E1, two proteins known to be altered by I/R and identified by this study. Novel phosphorylation sites associated with I/R were also identified. Functional characterization of the phosphopeptides identified by our methodology could expand our understanding of the signaling mechanisms involved during I/R damage in the heart as well as identify new areas to target therapeutic strategies.

  14. Acute chest pain: The role of MR imaging and MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hunold, Peter, E-mail: peter.hunold@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Bischoff, Peter, E-mail: peter.bischoff@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Barkhausen, Jörg, E-mail: joerg.barkhausen@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Vogt, Florian M., E-mail: florian.vogt@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany)

    2012-12-15

    MR imaging (MRI) and MR angiography (MRA) have gained a high level of diagnostic accuracy in cardiovascular disease. MRI in cardiac disease has been established as the non-invasive standard of reference in many pathologies. However, in acute chest pain the situation is somewhat special since many of the patients presenting in the emergency department suffer from potentially life-threatening disease including acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Those patients need a fast and definitive evaluation under continuous monitoring of vital parameters. Due to those requirements MRI seems to be less suitable compared to X-ray coronary angiography and multislice computed tomography angiography (CTA). However, MRI allows for a comprehensive assessment of all clinically stable patients providing unique information on the cardiovascular system including ischemia, inflammation and function. Furthermore, MRI and MRA are considered the method of choice in patients with contraindications to CTA and for regular follow-up in known aortic disease. This review addresses specific features of MRI and MRA for different cardiovascular conditions presenting with acute chest pain.

  15. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Anh, B. C.; Lee, J.; Lee, K. B

    2004-01-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP

  16. Detection of myocardial ischemia with myocardial perfusion SPECT in patients with diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Anh, B. C.; Lee, J.; Lee, K. B [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2004-07-01

    Diabetes mellitus(DM) is a critical disease associated with higher rates of cardiovascular morbidity and mortality. Atherosclerosis accounts for 65-80% of all deaths in diabetic patients and patients with DM are known to show high prevalence of coronary artery diseases(CAD). We evaluated the incidence of scintigraphic evidence of CAD in diabetic patients and results were compared with cardiovascular symptoms and clinical factors. 169 patients with DM(mean age 629years, 68 males) were referred for evaluation of CAD between Jan 2002 and Dec 2003. 101(60%) patients were with chest pain and 68(40%) were asymptomatic. Patients underwent exercise(n=6) or adenosine stress(n=163) SPECT myocardial perfusion imaging(MPI). Exclusion criteria included history of documented myocardial infarction, prior revascularization, clinically significant valvular heart disease, left-bundle branch block on rest ECG. We evaluated symptoms associated with cardiac problem and other clinical and laboratory data to reveal correlation with presence of CAD. MPI were assessed visually and semi-quantitatively with C-Equal program. Myocardial ischemia was detected in 52(31%) patients. Among them, 41 had 1-vessel and 9 had 2-vessel disease. In 52 patients with ischemia, 28(54%) were male and 24(46%) were female. 20/68(29%) asymptomatic and 32/101(32%) symptomatic patients had ischemia. Higher prevalence of neuropathy, hypertension, higher blood glucose level, HbA1c and CRP was noted in patients with myocardial ischemia. Serum levels of cholesterol and LDL was not significantly different between patients with ischemia and with normal MPI findings. Abnormal MPI findings were not related with gender and age. These results show a high prevalence of abnormal MPI results in diabetic patients regardless of symptoms. Screening stress MPI in diabetic patients should be indicated irrespective of symptoms, especially in patients with neuropathy, hypertension, higher level of blood glucose, or increased CRP.

  17. Early detection of cardiac ischemia using a conductometric pCO2 sensor: real-time drift correction and parameterization

    International Nuclear Information System (INIS)

    Tronstad, Christian; Martinsen, Ørjan G; Grimnes, Sverre; Pischke, Soeren E; Holhjem, Lars; Tønnessen, Tor Inge

    2010-01-01

    For detection of cardiac ischemia based on regional pCO 2 measurement, sensor drift becomes a problem when monitoring over several hours. A real-time drift correction algorithm was developed based on utilization of the time-derivative to distinguish between physiological responses and the drift, customized by measurements from a myocardial infarction porcine model (6 pigs, 23 sensors). IscAlert(TM) conductometric pCO 2 sensors were placed in the myocardial regions supplied by the left anterior descending coronary artery (LAD) and the left circumflex artery (LCX) while the LAD artery was fully occluded for 1, 3, 5 and 15 min leading to ischemia in the LAD-dependent region. The measured pCO 2 , the drift-corrected pCO 2 (ΔpCO 2 ) and its time-derivative (TDpCO 2 ) were compared with respect to detection ability. Baseline stability in the ΔpCO 2 led to earlier, more accurate detection. The TDpCO 2 featured the earliest sensitivity, but with a lower specificity. Combining ΔpCO 2 and TDpCO 2 enables increased accuracy. Suggestions are given for the utilization of the parameters for an automated early warning and alarming system. In conclusion, early detection of cardiac ischemia is feasible using the conductometric pCO 2 sensor together with parameterization methods

  18. Radiological diagnosis of chest wall tuberculosis: CT versus chest radiograph

    International Nuclear Information System (INIS)

    Liu Fugeng; Pan Jishu; Chen Qihang; Zhou Cheng; Yu Jingying; Tang Dairong

    2006-01-01

    Objective: To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis. Methods: The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all eases, while enhanced CT in 9 cases, and all images were reviewed by 2 radiologists. Results: Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(χ 2 =42.000, P 2 =4.421, P<0.05). Conclusion: CT, especially enhanced CT scan is the first choice in the diagnosis of chest wall tuberculosis. (authors)

  19. Breath pentane as a potential biomarker for survival in hepatic ischemia and reperfusion injury--a pilot study.

    Directory of Open Access Journals (Sweden)

    Changsong Wang

    Full Text Available BACKGROUND: Exhaled pentane, which is produced as a consequence of reactive oxygen species-mediated lipid peroxidation, is a marker of oxidative stress. Propofol is widely used as a hypnotic agent in intensive care units and the operating room. Moreover, this agent has been reported to inhibit lipid peroxidation by directly scavenging reactive oxygen species. In this study, using a porcine liver ischemia-reperfusion injury model, we have evaluated the hypothesis that high concentrations of breath pentane are related to adverse outcome and that propofol could reduce breath pentane and improve liver injury and outcome in swine in this situation. METHODOLOGY/PRINCIPAL FINDINGS: Twenty male swine were assigned to two groups: propofol (n = 10 and chloral hydrate groups (n = 10. Hepatic ischemia was induced by occluding the portal inflow vessels. Ischemia lasted for 30 min, followed by reperfusion for 360 min. Exhaled and blood pentane concentrations in the chloral hydrate group markedly increased 1 min after reperfusion and then decreased to baseline. Breath and blood pentane concentrations in the propofol group increased 1 min after reperfusion but were significantly lower than in the chloral hydrate group. A negative correlation was found between breath pentane levels and survival in the chloral hydrate group. The median overall survival was 251 min after reperfusion (range 150-360 min in the chloral hydrate group. All of the swine were alive in the propofol group. CONCLUSIONS: Monitoring of exhaled pentane may be useful for evaluating the severity of hepatic ischemia-reperfusion injury and aid in predicting the outcome; propofol may improve the outcome in this situation.

  20. Induced Hypothermia Does Not Harm Hemodynamics after Polytrauma: A Porcine Model

    Directory of Open Access Journals (Sweden)

    Matthias Weuster

    2015-01-01

    Full Text Available Background. The deterioration of hemodynamics instantly endangers the patients’ life after polytrauma. As accidental hypothermia frequently occurs in polytrauma, therapeutic hypothermia still displays an ambivalent role as the impact on the cardiopulmonary function is not yet fully understood. Methods. We have previously established a porcine polytrauma model including blunt chest trauma, penetrating abdominal trauma, and hemorrhagic shock. Therapeutic hypothermia (34°C was induced for 3 hours. We documented cardiovascular parameters and basic respiratory parameters. Pigs were euthanized after 15.5 hours. Results. Our polytrauma porcine model displayed sufficient trauma impact. Resuscitation showed adequate restoration of hemodynamics. Induced hypothermia had neither harmful nor major positive effects on the animals’ hemodynamics. Though heart rate significantly decreased and mixed venous oxygen saturation significantly increased during therapeutic hypothermia. Mean arterial blood pressure, central venous pressure, pulmonary arterial pressure, and wedge pressure showed no significant differences comparing normothermic trauma and hypothermic trauma pigs during hypothermia. Conclusions. Induced hypothermia after polytrauma is feasible. No major harmful effects on hemodynamics were observed. Therapeutic hypothermia revealed hints for tissue protective impact. But the chosen length for therapeutic hypothermia was too short. Nevertheless, therapeutic hypothermia might be a useful tool for intensive care after polytrauma. Future studies should extend therapeutic hypothermia.

  1. Induced Hypothermia Does Not Harm Hemodynamics after Polytrauma: A Porcine Model

    Science.gov (United States)

    Mommsen, Philipp; Pfeifer, Roman; Mohr, Juliane; Ruchholtz, Steffen; Flohé, Sascha; Fröhlich, Matthias; Keibl, Claudia; Seekamp, Andreas; Witte, Ingo

    2015-01-01

    Background. The deterioration of hemodynamics instantly endangers the patients' life after polytrauma. As accidental hypothermia frequently occurs in polytrauma, therapeutic hypothermia still displays an ambivalent role as the impact on the cardiopulmonary function is not yet fully understood. Methods. We have previously established a porcine polytrauma model including blunt chest trauma, penetrating abdominal trauma, and hemorrhagic shock. Therapeutic hypothermia (34°C) was induced for 3 hours. We documented cardiovascular parameters and basic respiratory parameters. Pigs were euthanized after 15.5 hours. Results. Our polytrauma porcine model displayed sufficient trauma impact. Resuscitation showed adequate restoration of hemodynamics. Induced hypothermia had neither harmful nor major positive effects on the animals' hemodynamics. Though heart rate significantly decreased and mixed venous oxygen saturation significantly increased during therapeutic hypothermia. Mean arterial blood pressure, central venous pressure, pulmonary arterial pressure, and wedge pressure showed no significant differences comparing normothermic trauma and hypothermic trauma pigs during hypothermia. Conclusions. Induced hypothermia after polytrauma is feasible. No major harmful effects on hemodynamics were observed. Therapeutic hypothermia revealed hints for tissue protective impact. But the chosen length for therapeutic hypothermia was too short. Nevertheless, therapeutic hypothermia might be a useful tool for intensive care after polytrauma. Future studies should extend therapeutic hypothermia. PMID:26170533

  2. Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

    Directory of Open Access Journals (Sweden)

    Vacek TP

    2014-09-01

    Full Text Available Thomas P Vacek, Shahnaz Rehman, Shipeng Yu, Ankush Moza, Ragheb Assaly Department of Internal Medicine, The University of Toledo Medical Center, Toledo OH, USAAbstract: Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient's blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause.Keywords: substernal, pleuritic, myocardial infarction, differential

  3. Chest X-Ray

    Medline Plus

    Full Text Available ... about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed x-ray exams and use a very small dose of ... of the inside of the chest. A chest x-ray is used to evaluate the lungs, heart and ...

  4. The clinical value of chest pain during thallium-201 scintigraphy with dipyridamole

    International Nuclear Information System (INIS)

    Takeishi, Yasuchika; Tono-oka, Ichiro; Meguro, Mitsuhiko; Hoshi, Hikaru; Yamaguchi, Yoshiko; Masakane, Ikuto; Tsuiki, Kai; Yasui, Shoji

    1990-01-01

    Sixty patients with suspected coronary artery disease underwent both dipyridamole-loaded thallium-201 scintigraphy and cardiac catheterization. Thirty four patients (57%) developed chest pain during dipyridamole stress testing (the pain group), and the other 26 did not (the no-pain group). Regarding sex, age, history of myocardial infarction, and the presence of coronary artery disease, there was no difference between the pain and no-pain groups. The pain group had significantly increased pulse rate and rate-pressure-product, as compared with the no-pain group. ST depression was more frequently observed in the pain group than the no-pain group. There was no significant difference in the angiographic involvement and the severity of coronary artery disease between the two groups. Nor was there significant difference in dipyridamole-loaded scintigraphic findings, such as defect size, and the extent and degree of decreased washout. However, for patients without a history of myocardial infarction, the pain group had a farther decreased washout than the no-pain group. Chest pain associated with iv injection of dipyridamole may have implications for the occurrence of serious ischemia. (N.K.)

  5. Intra-Abdominal Cooling System Limits Ischemia-Reperfusion Injury During Robot-Assisted Renal Transplantation.

    Science.gov (United States)

    Meier, R P H; Piller, V; Hagen, M E; Joliat, C; Buchs, J-B; Nastasi, A; Ruttimann, R; Buchs, N C; Moll, S; Vallée, J-P; Lazeyras, F; Morel, P; Bühler, L

    2018-01-01

    Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p-values system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries. © 2017 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

  6. Chest X-Ray

    Medline Plus

    Full Text Available ... talk with you about chest radiography also known as chest x-rays. Chest x-rays are the ... treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray ...

  7. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... d like to talk with you about chest radiography also known as chest x-rays. Chest x- ...

  8. FLAIL CHEST

    Directory of Open Access Journals (Sweden)

    Anton Crnjac

    2003-12-01

    Full Text Available Background. Major thoracic trauma is consistent with high mortality rate because of associated injuries of vital thoracic organs and dangerous complications. The flail chest occurs after disruption of the skeletal continuity of chest wall and demands because of its pathophysiological complexity rapid and accurate diagnosis and treatment.Conclusions. Basic pathophysiological mechanism of the flail chest is respiratory distress, which is provoked by pulmonary contusions and paradoxical chest wall motion. The treatment should be pointed to improvement and support of respiratory functions and include aggressive pain control, pulmonary physiotherapy and selective mechanical ventilation. Views about operative fixation of the flail chest are still controversial. Neither mortality rate neither long-term disability are improved after operative fixation.

  9. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... you about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed ...

  10. Porcine endogenous retroviral nucleic acid in peripheral tissues is associated with migration of porcine cells post islet transplant.

    Science.gov (United States)

    Binette, Tanya M; Seeberger, Karen L; Lyon, James G; Rajotte, Ray V; Korbutt, Gregory S

    2004-07-01

    Porcine islets represent an alternative source of insulin-producing tissue, however, porcine endogenous retrovirus (PERV) remains a concern. In this study, SCID mice were transplanted with nonencapsulated (non-EC), microencapsulated (EC) or macroencapsulated (in a TheraCyte trade mark device) neonatal porcine islets (NPIs), and peripheral tissues were screened for presence of viral DNA and mRNA. To understand the role of an intact immune system in PERV incidence, mice with established NPI grafts were reconstituted with splenocytes. Peripheral tissues were screened for PERV and porcine DNA using PCR. Tissues with positive DNA were analyzed for PERV mRNA using RT-PCR. No significant difference was observed between non-EC and EC transplants regarding presence of PERV or porcine-specific DNA or mRNA. In reconstituted animals, little PERV or porcine DNA, and no PERV mRNA was detected. No PERV or porcine-specific DNA was observed in animals implanted with a TheraCyte trade mark device. In conclusion, an intact immune system significantly lowered the presence of PERV. Microencapsulation of islets did not alter PERV presence, however, macroencapsulation in the TheraCyte device did. Lower PERV incidence coincided with lower porcine DNA in peripheral tissues, linking the presence of PERV to migration of porcine cells.

  11. Chest X-Ray

    Medline Plus

    Full Text Available ... I’d like to talk with you about chest radiography also known as chest x-rays. Chest x-rays are the most ... far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot org. Thank you for your time! ...

  12. 7 CFR 1230.611 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Porcine animal. 1230.611 Section 1230.611 Agriculture... CONSUMER INFORMATION Procedures for the Conduct of Referendum Definitions § 1230.611 Porcine animal. The term Porcine animal means a swine, that is raised: (a) As a feeder pig, that is, a young pig sold to...

  13. Chest tube placement in thorax trauma - comparison chest X-ray and computed tomography (CT)

    International Nuclear Information System (INIS)

    Heim, P.; Maas, R.; Buecheler, E.; Tesch, C.

    1998-01-01

    Estimation of chest tube placement in patients with thoracic trauma with regard to chest tube malposition in chest radiography in the supine position compared to additional computed tomography of the thorax. Material and methods: Apart from compulsory chest radiography after one or multiple chest tube insertions, 31 severely injured patients with thoracic trauma underwent a CT scan of the thorax. These 31 patients with 40 chest tubes constituted the basis for the present analysis. Results: In chest radiography in the supine position there were no chest tube malpositions (n=40); In the CT scans 25 correct positions, 7 pseudo-malpositions, 6 intrafissural and 2 intrapulmonary malpositions were identified. Moreover 16 sufficient, 18 insufficient and 6 indifferent functions of the chest tubes were seen. Conclusion: In case of lasting clinical problems and questionable function of the chest tube, chest radiography should be supplemented by a CT scan of the thorax in order to estimate the position of the chest tube. (orig.) [de

  14. Indications for chest CT. Retrospective study of cases with normal chest CT

    International Nuclear Information System (INIS)

    Obata, Shiro

    1995-01-01

    The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

  15. American College of Chest Physicians

    Science.gov (United States)

    ... Foundation Participate in the e-Community Get Social Career Connection Publications CHEST Journal CHEST SEEK Guidelines & Consensus Statements CHEST Physician CHEST NewsBrief Coding for Chest Medicine Tobacco Dependence Toolkit (3rd Ed.) Mobile Websites and Apps CHEST Journal ...

  16. Detection of myocardial ischemia before infarction, based on accumulation of labeled pyruvate

    International Nuclear Information System (INIS)

    Goldstein, R.A.; Klein, M.S.; Sobel, B.E.

    1980-01-01

    To determine whether ischemic, but not irreversibly injured myocardium, can be differentiated from normal tissue based on accumulation of labeled pyruvate, isolated hearts were perfused with buffer containing [ 14 C]pyruvate under conditions of normal or low flow. Fifteen minutes after the hearts were exposed to labeled material, myocardial radioactivity was fourfold greater in ischemic compared to control hearts, due to accumulation of label in sequestered lactate produced from the pyruvate. Open-chest rabbits subjected to coronary occlusion exhibited a 1.73:1 ratio of radioactivity in ischemic compared with normal myocardium 15 min after systemic injection of [ 14 C]pyruvate. The results obtained suggest that zones of myocardial ischemia should be detectable in vivo by positron tomography after systemic administration of [ 11 C]pyruvate as well

  17. Chest MRI

    Science.gov (United States)

    ... resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI Patient Instructions ... Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  18. Monoclonal antibodies specific to heat-treated porcine blood.

    Science.gov (United States)

    Raja Nhari, Raja Mohd Hafidz; Hamid, Muhajir; Rasli, Nurmunirah Mohamad; Omar, Abdul Rahman; El Sheikha, Aly Farag; Mustafa, Shuhaimi

    2016-05-01

    Porcine blood is potentially being utilized in food as a binder, gelling agent, emulsifier or colorant. However, for certain communities, the usage of animal blood in food is strictly prohibited owing to religious concerns and health reasons. This study reports the development of monoclonal antibodies (MAbs) against heat-treated soluble proteins (HSPs) of autoclaved porcine blood; characterization of MAbs against blood, non-blood and plasma from different animal species using qualitative indirect non-competitive enzyme-linked immunosorbent assay (ELISA); and immunoblotting of antigenic components in HSPs of porcine blood. Fifteen MAbs are specific to heat-treated and raw porcine blood and not cross-reacted with other animal blood and non-blood proteins (meat and non-meat). Twelve MAbs are specific to porcine plasma, while three MAbs specific to porcine plasma are cross-reacted with chicken plasma. Immunoblotting revealed antigenic protein bands (∼60, ∼85-100 and ∼250 kDa) in porcine blood and plasma recognized by the MAbs. Selection of MAbs that recognized 60 kDa HSPs of porcine blood and plasma as novel monoclonal antibodies would be useful for detection of porcine plasma in processed food using the immunoassay method. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

  19. Isoflurane administration before ischemia and during reperfusion attenuates ischemia/reperfusion-induced injury of isolated rabbit lungs.

    Science.gov (United States)

    Liu, R; Ishibe, Y; Ueda, M; Hang, Y

    1999-09-01

    To investigate the effects of isoflurane on ischemia/ reperfusion (IR)-induced lung injury, we administered isoflurane before ischemia or during reperfusion. Isolated rabbit lungs were divided into the following groups: control (n = 6), perfused and ventilated for 120 min without ischemia; ISO-control (n = 6), 1 minimum alveolar anesthetic concentration (MAC) isoflurane was administered for 30 min before 120 min continuous perfusion; IR (n = 6), ischemia for 60 min, followed by 60 min reperfusion; IR-ISO1 and IR-ISO2, ischemia followed by reperfusion and 1 MAC (n = 6) or 2 MAC (n = 6) isoflurane for 60 min; ISO-IR (n = 6), 1 MAC isoflurane was administered for 30 min before ischemia, followed by IR. During these maneuvers, we measured total pulmonary vascular resistance (Rt), coefficient of filtration (Kfc), and lung wet to dry ratio (W/D). The results indicated that administration of isoflurane during reperfusion inhibited an IR-induced increase in Kfc and W/D ratio. Furthermore, isoflurane at 2 MAC, but not 1 MAC, significantly inhibited an IR-induced increase in Rt. The administration of isoflurane before ischemia significantly attenuated the increase in IR-induced Kfc, W/D, and Rt. Our results suggest that the administration of isoflurane before ischemia and during reperfusion protects against ischemia-reperfusion-induced injury in isolated rabbit lungs.

  20. Chest Compressions during Sustained Inflations Improve Recovery When Compared to a 3:1 Compression:Ventilation Ratio during Cardiopulmonary Resuscitation in a Neonatal Porcine Model of Asphyxia.

    Science.gov (United States)

    Li, Elliott S; Görens, Immanuel; Cheung, Po-Yin; Lee, Tze-Fun; Lu, Min; O'Reilly, Megan; Schmölzer, Georg M

    2017-01-01

    Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia. Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-min normocapnic hypoxia followed by asphyxia. Cardiopulmonary resuscitation (CPR) was initiated when the heart rate decreased to 25% of baseline. Piglets were randomized into 3 groups: CC during SI at a rate of 90 CC/min (SI+CC 90, n = 8), a 3:1 C:V using 90 CC and 30 inflations (3:1, n = 8), or a sham group (n = 6). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. CC+SI significantly reduced the median (IQR) time of ROSC, i.e., 34 s (28-156 s) versus 210 s (72-300 s) in the 3:1 group (p = 0.048). CC+SI also significantly reduced the requirement for 100% oxygen, improved respiratory parameters, and resulted in a similar hemodynamic recovery. CC+SI during CPR significantly improved ROSC in a porcine model of neonatal resuscitation. This is of considerable clinical relevance because improved respiratory and hemodynamic parameters potentially minimize morbidity and mortality in newborn infants. © 2017 S. Karger AG, Basel.

  1. Chest Pain: First Aid

    Science.gov (United States)

    First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

  2. Porcine respiratory disease complex: Interaction of vaccination and porcine circovirus type 2, porcine reproductive and respiratory syndrome virus, and Mycoplasma hyopneumoniae.

    Science.gov (United States)

    Chae, Chanhee

    2016-06-01

    Porcine respiratory disease is a multifactorial and complex disease caused by a combination of infectious pathogens, environmental stressors, differences in production systems, and various management practices; hence the name porcine respiratory disease complex (PRDC) is used. Porcine circovirus type 2 (PCV2), porcine reproductive and respiratory syndrome virus (PRRSV), and Mycoplasma hyopneumoniae are considered to be the most important pathogens that cause PRDC. Although interactions among the three major respiratory pathogens are well documented, it is also necessary to understand the interaction between vaccines and the three major respiratory pathogens. PRRSV and M. hyopneumoniae are well known to potentiate PCV2-associated lesions; however, PRRSV and mycoplasmal vaccines can both enhance PCV2 viraemia regardless of the effects of the actual PRRSV or M. hyopneumoniae infection. On the other hand, M. hyopneumoniae potentiates the severity of pneumonia induced by PRRSV, and vaccination against M. hyopneumoniae alone is also able to decrease PRRSV viraemia and PRRSV-induced lung lesions in dually infected pigs. This review focuses on (1) interactions between PCV2, PRRSV, and M. hyopneumoniae; and (2) interactions between vaccines and the three major respiratory pathogens. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Manganese-Enhanced Magnetic Resonance Imaging Enables In Vivo Confirmation of Peri-Infarct Restoration Following Stem Cell Therapy in a Porcine Ischemia-Reperfusion Model.

    Science.gov (United States)

    Dash, Rajesh; Kim, Paul J; Matsuura, Yuka; Ikeno, Fumiaki; Metzler, Scott; Huang, Ngan F; Lyons, Jennifer K; Nguyen, Patricia K; Ge, Xiaohu; Foo, Cheryl Wong Po; McConnell, Michael V; Wu, Joseph C; Yeung, Alan C; Harnish, Phillip; Yang, Phillip C

    2015-07-27

    The exact mechanism of stem cell therapy in augmenting the function of ischemic cardiomyopathy is unclear. In this study, we hypothesized that increased viability of the peri-infarct region (PIR) produces restorative benefits after stem cell engraftment. A novel multimodality imaging approach simultaneously assessed myocardial viability (manganese-enhanced magnetic resonance imaging [MEMRI]), myocardial scar (delayed gadolinium enhancement MRI), and transplanted stem cell engraftment (positron emission tomography reporter gene) in the injured porcine hearts. Twelve adult swine underwent ischemia-reperfusion injury. Digital subtraction of MEMRI-negative myocardium (intrainfarct region) from delayed gadolinium enhancement MRI-positive myocardium (PIR and intrainfarct region) clearly delineated the PIR in which the MEMRI-positive signal reflected PIR viability. Human amniotic mesenchymal stem cells (hAMSCs) represent a unique population of immunomodulatory mesodermal stem cells that restored the murine PIR. Immediately following hAMSC delivery, MEMRI demonstrated an increased PIR viability signal compared with control. Direct PIR viability remained higher in hAMSC-treated hearts for >6 weeks. Increased PIR viability correlated with improved regional contractility, left ventricular ejection fraction, infarct size, and hAMSC engraftment, as confirmed by immunocytochemistry. Increased MEMRI and positron emission tomography reporter gene signal in the intrainfarct region and the PIR correlated with sustained functional augmentation (global and regional) within the hAMSC group (mean change, left ventricular ejection fraction: hAMSC 85±60%, control 8±10%; P<0.05) and reduced chamber dilatation (left ventricular end-diastole volume increase: hAMSC 24±8%, control 110±30%; P<0.05). The positron emission tomography reporter gene signal of hAMSC engraftment correlates with the improved MEMRI signal in the PIR. The increased MEMRI signal represents PIR viability and the

  4. Pediatric chest imaging. Chest imaging in infants and children. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Lucaya, Javier [Vall d' Hebron Hospitals, Barcelona (Spain). Dept. of Pediatric Radiology and Inst. of Diagnostic Imaging; Hospital Quiron, Barcelona (Spain). Dept. of Radiology; Strife, Janet L. (eds.) [Cincinnati Univ. Coll. of Medicine, Cincinnati, OH (United States). Dept. of Radiology Cincinnati Children' s Hospital Medical Center

    2008-07-01

    Imaging of the pediatric chest continues to evolve rapidly. All chapters in this 2nd edition of Pediatric Chest Imaging have been extensively updated, with additional disease-specific information and numerous new illustrations. The book thus presents the state of the art in the diagnosis of pediatric chest disorders, highlighting the role played by advanced technology. As the conventional features of most of these disorders are extremely well known, special attention is devoted to the technical aspects of the modern imaging modalities, their indications, and the diagnostic information that they supply. Individual chapters focus on chest ultrasound, nuclear medicine imaging, high-resolution chest CT, helical CT, and pediatric cardiac CT and pediatric cardiacMRI. Others are directed towards specific disorders, including congenital malformations of the chest, chest tumors, pulmonary infection, trauma, the lung in systemic diseases, the pediatric airway, foreign bodies, the thymus, and the chest wall. Without exception, the authors of this book are internationally known specialists with great expertise in the field. This book will serve as a handy, superbly illustrated reference for all who routinely image children, as well as for those who need access to information on how best to image them. (orig.)

  5. Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

    Science.gov (United States)

    Xu, Mingzhu; Yang, Xiangjun

    2015-01-01

    Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Interlaboratory testing of porcine sera for antibodies to porcine circovirus type 2

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.

    2004-01-01

    A panel of 20 porcine sera was distributed to 5 laboratories across Europe and Canada. Each center was requested to test the sera for the presence of porcine circovirus type 2 antibodies using the routine assays, indirect immunofluorescence assay (IFA) and indirect immunoperoxidase monolayer assa...... than did IFA, and paraformaldehyde gave higher titers than did acetone or ethyl alcohol. This report highlights the need for standardized procedures and biologicals for this virus....

  7. Chest computed tomography

    DEFF Research Database (Denmark)

    Loeve, Martine; Krestin, Gabriel P.; Rosenfeld, Margaret

    2013-01-01

    are not suitable to study CF lung disease in young children. Chest computed tomography (CT) holds great promise for use as a sensitive surrogate endpoint in CF. A large body of evidence has been produced to validate the use of chest CT as primary endpoint to study CF lung disease. However, before chest CT can...

  8. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    Science.gov (United States)

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38

  9. Myocardial perfusion assessed by contrast echocardiography and single photon emission computed tomography in the evaluation of patients with acute chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Soares, J. Jr.; Ferreira, S.M.A.; Matias, W. Jr.; Giorgi, M.C.P.; Izaki, M.; Luz, P.L.; Ramires, J.A.F.; Meneghetti, J.C.

    2002-01-01

    Aim : Evaluation of diagnostic accuracy of myocardial contrast echocardiography (MCE) in comparison with single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia in patients with acute chest pain. Material and Methods : Eighteen patients (pts) with chest pain lasting ≥30 minutes, occurring within 6 hours of emergency room presentation and a normal or no diagnostic electrocardiogram were studied. Pts underwent rest MCE and SPECT. For both exams myocardial perfusion was assessed in the same 7 segments (apical, anterior, inferior, anteroseptal, inferoseptal, lateral and posterior) of left ventricle. A total of 126 segments were analyzed. Images were classified as positive for ischemia if they had a perfusion defect. Coronary angiography was performed if MCE or SPECT images were classified as positive for ischemia or by clinical indication. Otherwise the patients underwent stress SPECT. Significant coronary artery disease (CAD) was defined as ≥70% stenosis in a major coronary artery or its branches. Final diagnosis of an acute coronary event (ACE) was established in the presence of positive findings in MCE or SPECT in addition to significant CAD in the corresponding territory. Kappa statistics were calculated to evaluate the concordance between MCE and SPECT. κ values of ≤0.4, >0.4 and >0.7 indicate fair, good and excellent agreement, respectively. Results: Thirteen out of 18 pts underwent coronary angiography (seven pts had positive findings on SPECT, 2 on MCE, 2 on both exams and 1 had clinical indication). Significant CAD was detected on six. Five pts underwent stress SPECT and no perfusion defect was detected. Therefore, six pts (33.3%) had an ACE and 12 (66.6%) had not. There were no statistical differences between groups according to age, gender, duration of pain, free pain interval, presence of risk factors and antecedents. Concordance between MCE and SPECT for evaluation of perfusion defects showed a ? coefficient of 0

  10. A Case of “en bloc” Excision of a Chest Wall Leiomyosarcoma and Closure of the Defect with Non-Cross-Linked Collagen Matrix (Egis®

    Directory of Open Access Journals (Sweden)

    Marco Rastrelli

    2016-10-01

    Full Text Available Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis® placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction.

  11. A Case of “en bloc” Excision of a Chest Wall Leiomyosarcoma and Closure of the Defect with Non-Cross-Linked Collagen Matrix (Egis®)

    Science.gov (United States)

    Rastrelli, Marco; Tropea, Saveria; Spina, Romina; Costa, Alessandra; Stramare, Roberto; Mocellin, Simone; Bonavina, Maria Giuseppina; Rossi, Carlo Riccardo

    2016-01-01

    Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis®) placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction. PMID:27920698

  12. Diagnosis of Coronary Artery Disease in Patients with Chest Pain by Means of Magnetocardiography

    International Nuclear Information System (INIS)

    Kwon, H.; Kim, K.; Kim, J. M.; Lee, Y. H.; Kim, T. E.; Lim, H. K.; Park, Y. K.; Ko, Y. G.; Chung, N.

    2006-01-01

    Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool for the detection of cardiac electrical abnormality associated with myocardial ischemia. In our previous study, we have proposed a new classification method of MCG parameters, based on the different populations of the parameters between coronary artery disease(CAD) patients, symptomatic patients and healthy volunteers. We used four parameters, representing the directional changes of the electrical activity in the period of an R-ST-T interval. In patients with chest pain and without ST-segment elevation, who were selected consecutively from all patients admitted to the hospital in 2004, the patients with CAD could be classified with a higher sensitivity than conventional methods, showing that the proposed method can be useful for the diagnosis of CAD with MCG. In this study, we examined the validity of the algorithm with the prior probability distribution in diagnosis of new patients admitted to the hospital in 2005. In the results, presence of CAD could be found with sensitivity and specificity of 81.3% and 71.4%, respectively, in patients with chest pain and non-diagnostic ECG findings

  13. Diagnostic value for coronary artery disease of ST depression and chest pain during dipyridamole loading

    International Nuclear Information System (INIS)

    Yonezawa, Yoshihiro; Doi, Yoshinori; Aono, Tadashi; Odawara, Hiroaki; Chikamori, Taishiro; Yamada, Mitsutoshi; Takata, Jun; Ozawa, Toshio; Hamashige, Naohisa.

    1991-01-01

    The diagnostic significance of both ST depression and chest pain during dipyridamole loading was assessed in 437 patients with coronary artery disease (CRD) who have received dipyridamole-loading thallium-201 myocardial scintigraphy and coronary arteriography. ST depression and chest pain were induced in 35% and 42%, respectively. ST depression occurred in 23% for one vessel disease, 55% for two-vessel disease, 67% for three-vessel disease, and 11% for non-significant disease. In the absence of myocardial infarction, it occurred in as many as 78% for two-vessel disease and 94% for three-vessel disease. ST depression had a sensitivity of 51% and a specificity of 89%. Chest pain had a lower specificity (77%), whereas the sensitivity remained the same (51%). In 42 (31%) of 134 patients with ST depression, coronary revascularization was necessary in the early stage. With a median follow up of 29 months, 3 patients (2%) died of cardiac events, and 12 (9%) had nonfatal cardiac complications. There was a significant correlation between reversible defects (RD) on myocardial scintigrams and ST depression; RD were seen in 81% of ST depression cases, and ST depression occurred in 51% of 210 RD cases. The more diseased vessels, the more frequently ST depression occurred in accordance with RD on myocardial scintigrams. Both ST depression and chest pain during dipyridamole loading tended to be associated with myocardial ischemia, suggesting the diagnostic value in CRD patients with limited exercise loading. RD on myocardial scintigrams was considered attributable to coronary steal phenomenon for multi-vessel disease and to the difference in the relative increase of the coronary flow for single vessel disease. (N.K.)

  14. Diagnostic value of chest ultrasound after cardiac surgery: a comparison with chest X-ray and auscultation.

    Science.gov (United States)

    Vezzani, Antonella; Manca, Tullio; Brusasco, Claudia; Santori, Gregorio; Valentino, Massimo; Nicolini, Francesco; Molardi, Alberto; Gherli, Tiziano; Corradi, Francesco

    2014-12-01

    Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. Cardiac surgery intensive care unit. One hundred fifty-one consecutive adult patients undergoing cardiac surgery. All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Chest Seal Placement for Penetrating Chest Wounds by Prehospital Ground Forces in Afghanistan.

    Science.gov (United States)

    Schauer, Steven G; April, Michael D; Naylor, Jason F; Simon, Erica M; Fisher, Andrew D; Cunningham, Cord W; Morissette, Daniel M; Fernandez, Jessie Renee D; Ryan, Kathy L

    Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting. To evaluate adherence to TCCC guidelines for chest seal placement among personnel deployed to Afghanistan. We obtained data from the Prehospital Trauma Registry (PHTR). Joint Trauma System personnel linked patients to the Department of Defense Trauma Registry, when available, for outcome data upon reaching a fixed facility. In the PHTR, we identified 62 patients with documented gunshot wound (GSW) or puncture wound trauma to the chest. The majority (74.2%; n = 46) of these were due to GSW, with the remainder either explosive-based puncture wounds (22.6%; n = 14) or a combination of GSW and explosive (3.2%; n = 2). Of the 62 casualties with documented GSW or puncture wounds, 46 (74.2%) underwent chest seal placement. Higher proportions of patients with medical officers in their chain of care underwent chest seal placement than those that did not (63.0% versus 37.0%). The majority of chest seals placed were not vented. Of patients with a GSW or puncture wound to the chest, 74.2% underwent chest seal placement. Most of the chest seals placed were not vented in accordance with guidelines, despite the guideline update midway through the study period. These data suggest the need to improve predeployment training on TCCC guidelines and matching of the Army logistical supply chain to the devices recommended by the CoTCCC. 2017.

  16. MRI of the Chest

    Medline Plus

    Full Text Available ... gives detailed pictures of structures within the chest cavity, including the mediastinum , chest wall, pleura, heart and ... helpful to assess the vessels of the chest cavity (arteries and veins). MRA can also demonstrate an ...

  17. MRI of the Chest

    Medline Plus

    Full Text Available ... to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI ... of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft ...

  18. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

  19. Diagnosis and Treatment of Chest Injury and Emergency Diseases of Chest Organs

    Directory of Open Access Journals (Sweden)

    A. M. Khadjibaev

    2016-01-01

    Full Text Available Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1% victims. There were 477 (22,6% patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3% patients and complicated forms of lung echinococcosis were evident in 72 patients.Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1% patients, whereas the traditional methods were effective only in 905 cases (42,9%.Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

  20. 3:1 compression to ventilation ratio versus continuous chest compression with asynchronous ventilation in a porcine model of neonatal resuscitation.

    Science.gov (United States)

    Schmölzer, Georg M; O'Reilly, Megan; Labossiere, Joseph; Lee, Tze-Fun; Cowan, Shaun; Nicoll, Jessica; Bigam, David L; Cheung, Po-Yin

    2014-02-01

    In contrast to the resuscitation guidelines of children and adults, guidelines on neonatal resuscitation recommend synchronized 90 chest compressions with 30 manual inflations (3:1) per minute in newborn infants. The study aimed to determine if chest compression with asynchronous ventilation improves the recovery of bradycardic asphyxiated newborn piglets compared to 3:1 Compression:Ventilation cardiopulmonary resuscitation (CPR). Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Piglets were randomized to receive resuscitation with either 3:1 compressions to ventilations (3:1C:V CPR group) or chest compressions with asynchronous ventilations (CCaV) or sham. Continuous respiratory parameters (Respironics NM3(®)), cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. Piglets in 3:1C:V CPR and CCaV CPR groups had similar time to return of spontaneous circulation, survival rates, hemodynamic and respiratory parameters during CPR. The systemic and regional hemodynamic recovery in the subsequent 4h was similar in both groups and significantly lower compared to sham-operated piglets. Newborn piglets resuscitated by CCaV had similar return of spontaneous circulation, survival, and hemodynamic recovery compared to those piglets resuscitated by 3:1 Compression:Ventilation ratio. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. CT Fluoroscopy-Guided Lung Biopsy with Novel Steerable Biopsy Canula: Ex-Vivo Evaluation in Ventilated Porcine Lung Explants

    International Nuclear Information System (INIS)

    Schaefer, Philipp J.; Fabel, Michael; Bolte, Hendrik; Schaefer, Fritz K. W.; Jahnke, Thomas; Heller, Martin; Lammer, Johannes; Biederer, Juergen

    2010-01-01

    The purpose was to evaluate ex-vivo a prototype of a novel biopsy canula under CT fluoroscopy-guidance in ventilated porcine lung explants in respiratory motion simulations. Using an established chest phantom for porcine lung explants, n = 24 artificial lesions consisting of a fat-wax-Lipiodol mixture (approx. 70HU) were placed adjacent to sensible structures such as aorta, pericardium, diaphragm, bronchus and pulmonary artery. A piston pump connected to a reservoir beneath a flexible silicone reconstruction of a diaphragm simulated respiratory motion by rhythmic inflation and deflation of 1.5 L water. As biopsy device an 18-gauge prototype biopsy canula with a lancet-like, helically bended cutting edge was used. The artificial lesions were punctured under CT fluoroscopy-guidance (SOMATOM Sensation 64, Siemens, Erlangen, Germany; 30mAs/120 kV/5 mm slice thickness) implementing a dedicated protocol for CT fluoroscopy-guided lung biopsy. The mean-diameter of the artificial lesions was 8.3 ± 2.6 mm, and the mean-distance of the phantom wall to the lesions was 54.1 ± 13.5 mm. The mean-displacement of the lesions by respiratory motion was 14.1 ± 4.0 mm. The mean-duration of CT fluoroscopy was 9.6 ± 5.1 s. On a 4-point scale (1 = central; 2 = peripheral; 3 = marginal; 4 = off target), the mean-targeted precision was 1.9 ± 0.9. No misplacement of the biopsy canula affecting adjacent structures could be detected. The novel steerable biopsy canula proved to be efficient in the ex-vivo set-up. The chest phantom enabling respiratory motion and the steerable biopsy canula offer a feasible ex-vivo system for evaluating and training CT fluoroscopy-guided lung biopsy adapted to respiratory motion.

  2. Subtraction electrocardiography: Detection of ischemia-induced ST displacement without the need to identify the J point.

    Science.gov (United States)

    Ter Haar, C Cato; Man, Sum-Che; Maan, Arie C; Schalij, Martin J; Swenne, Cees A

    2016-01-01

    When triaging a patient with acute chest pain at first medical contact, an electrocardiogram (ECG) is routinely made and inspected for signs of myocardial ischemia. The guidelines recommend comparison of the acute and an earlier-made ECG, when available. No concrete recommendations for this comparison exist, neither is known how to handle J-point identification difficulties. Here we present a J-point independent method for such a comparison. After conversion to vectorcardiograms, baseline and acute ischemic ECGs after 3minutes of balloon occlusion during elective PCI were compared in 81 patients of the STAFF III ECG database. Baseline vectorcardiograms were subtracted from ischemic vectorcardiograms using either the QRS onsets or the J points as synchronization instants, yielding vector magnitude difference signals, ΔH. Output variables for the J-point synchronized differences were ΔH at the actual J point and at 20, 40, 60 and 80ms thereafter. Output variables for the onset-QRS synchronized differences were the ΔH at 80, 100, 120, 140 and 160ms after onset QRS. Finally, linear regressions of all combinations of ΔHJ+… versus ΔHQRS+… were made, and the best combination was identified. The highest correlation, 0.93 (pJ point and 160ms after the onset of the QRS complex. With a ΔH ischemia threshold of 0.05mV, 66/81 (J-point synchronized differences) and 68/81 (onset-QRS synchronized differences) subjects were above the ischemia threshold, corresponding to sensitivities of 81% and 84%, respectively. Our current study opens an alternative way to detect cardiac ischemia without the need for human expertise for determination of the J point by measuring the difference vector magnitude at 160ms after the onset of the QRS complex. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Takotsubo cardiomyopathy: an overlooked cause of chest pain

    Directory of Open Access Journals (Sweden)

    Leonardo Hackbart Bermudes

    2014-06-01

    Full Text Available Takotsubo cardiomyopathy (TTC, also known as apical ballooning syndrome, broken heart syndrome, or stress-induced cardiomyopathy, is defined as a transient disturbance of the left ventricle, which is quite often associated with electrocardiographic abnormalities that may mimic acute myocardial infarction. The syndrome is also characterized by a mild alteration of cardiac biomarkers in absence of coronary blood flow obstruction on the coronariography. Clinical presentation is often manifested by angina, dyspnea, syncope, and arrhythmias. Peculiarly, the left ventricle takes the form of “tako-tsubo” (a Japanese word for “octopus trap” on the imaging workup. The authors report the case of a post-menopausal, hypertensive, dyslipidemic and type-II diabetic woman admitted at the emergency service with acute chest pain post physical exertion. Electrocardiogram showed signs of ischemia and myocardial necrosis markers were mildly increased. Echocardiography and ventriculography showed apical and mid-ventricular akinesia, with mild atherosclerotic coronary lesions. Thus diagnostic workup and the outcome followed the diagnostic criteria for TTC. The authors called attention to the potential of overlooking this diagnosis, since this syndrome is still not widely recognized.

  4. Myocardial ischemia in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio

    2000-01-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  5. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Chardoli Mojtaba

    2013-12-01

    Full Text Available 【Abstract】 Objective: Thoracic injuries are respon- sible for 25% of deaths of blunt traumas. Chest X-ray (CXR is the first diagnostic method in patients with blunt trauma. The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT in hemodynami- cally stable patients with blunt chest trauma. Methods: Study was conducted at the emergency department of Sina Hospital from March 2011 to March 2012. Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included. All patients underwent the same diagnostic protocol which consisted of physical examination, CXR and CT scan respectively. Results: Two hundreds patients (84% male and 16% female were included with a mean age of (37.9±13.7 years. Chin J Traumatol 2013;16(6:351-354 Rib fracture was the most common finding of CXR (12.5% and CT scan (25.5%. The sensitivity of CXR for hemothorax, thoracolumbar vertebra fractures and rib fractures were 20%, 49% and 49%, respectively. Pneumothorax, foreign body, emphysema, pulmonary contusion, liver hematoma and ster- num fracture were not diagnosed with CXR alone. Conclusion: Applying CT scan as the first-line diag- nostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome. Key words: Radiography; Thoracic injuries; Tomography, X-ray computed

  6. Chest tube insertion

    Science.gov (United States)

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

  7. Blunt chest trauma.

    Science.gov (United States)

    Stewart, Daphne J

    2014-01-01

    Blunt chest trauma is associated with a wide range of injuries, many of which are life threatening. This article is a case study demonstrating a variety of traumatic chest injuries, including pathophysiology, diagnosis, and treatment. Literature on the diagnosis and treatment was reviewed, including both theoretical and research literature, from a variety of disciplines. The role of the advance practice nurse in trauma is also discussed as it relates to assessment, diagnosis, and treatment of patients with traumatic chest injuries.

  8. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

    Directory of Open Access Journals (Sweden)

    Yan Wen

    2016-01-01

    Full Text Available Acupuncture at Fengchi (GB20 in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea and different needle twisting frequencies (60 or 120 times/minute at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]. The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the first treatment session and after the final session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness. No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

  9. Chest X-Ray

    Medline Plus

    Full Text Available ... some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a ... posted: How to Obtain and Share ...

  10. Thin chest wall is an independent risk factor for the development of pneumothorax after chest tube removal.

    Science.gov (United States)

    Anand, Rahul J; Whelan, James F; Ferrada, Paula; Duane, Therese M; Malhotra, Ajai K; Aboutanos, Michel B; Ivatury, Rao R

    2012-04-01

    The factors contributing to the development of pneumothorax after removal of chest tube thoracostomy are not fully understood. We hypothesized that development of post pull pneumothorax (PPP) after chest tube removal would be significantly lower in those patients with thicker chest walls, due to the "protective" layer of adipose tissue. All patients on our trauma service who underwent chest tube thoracostomy from July 2010 to February 2011 were retrospectively reviewed. Patient age, mechanism of trauma, and chest Abbreviated Injury Scale score were analyzed. Thoracic CTs were reviewed to ascertain chest wall thickness (CW). Thickness was measured at the level of the nipple at the midaxillary line, as perpendicular distance between skin and pleural cavity. Chest X-ray reports from immediately prior and after chest tube removal were reviewed for interval development of PPP. Data are presented as average ± standard deviation. Ninety-one chest tubes were inserted into 81 patients. Patients who died before chest tube removal (n = 11), or those without thoracic CT scans (n = 13) were excluded. PPP occurred in 29.9 per cent of chest tube removals (20/67). When PPP was encountered, repeat chest tube was necessary in 20 per cent of cases (4/20). After univariate analysis, younger age, penetrating mechanism, and thin chest wall were found to be significant risk factors for development of PPP. Chest Abbreviated Injury Scale score was similar in both groups. Logistic regression showed only chest wall thickness to be an independent risk factor for development of PPP.

  11. Chest X-Ray

    Medline Plus

    Full Text Available ... and chest wall and may be used to help evaluate shortness of breath, persistent cough, fever, chest ... or injury. It may also be useful to help diagnose and monitor treatment for a variety of ...

  12. 7 CFR 1230.18 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Porcine animal. 1230.18 Section 1230.18 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... animal. Porcine animal means a swine, that is raised as (a) a feeder pig, that is, a young pig sold to...

  13. Chest X-Ray

    Medline Plus

    Full Text Available ... breath, persistent cough, fever, chest pain or injury. It may also be useful to help diagnose and ... have some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to ...

  14. Heme Oxygenase-1 Gene Therapy Provides Cardioprotection Via Control of Post-Ischemic Inflammation: An Experimental Study in a Pre-Clinical Pig Model.

    Science.gov (United States)

    Hinkel, Rabea; Lange, Philipp; Petersen, Björn; Gottlieb, Elena; Ng, Judy King Man; Finger, Stefanie; Horstkotte, Jan; Lee, Seungmin; Thormann, Michael; Knorr, Maike; El-Aouni, Chiraz; Boekstegers, Peter; Reichart, Bruno; Wenzel, Philip; Niemann, Heiner; Kupatt, Christian

    2015-07-14

    Heme oxygenase-1 (HO-1) is an inducible stress-responsive enzyme converting heme to bilirubin, carbon monoxide, and free iron, which exerts anti-inflammatory and antiapoptotic effects. Although efficient cardioprotection after HO-1 overexpression has been reported in rodents, its role in attenuating post-ischemic inflammation is unclear. This study assessed the efficacy of recombinant adenoassociated virus (rAAV)-encoding human heme oxygenase-1 (hHO-1) in attenuating post-ischemic inflammation in a murine and a porcine ischemia/reperfusion model. Murine ischemia was induced by 45 min of left anterior descending occlusion, followed by 24 h of reperfusion and functional as well as fluorescent-activated cell sorting analysis. Porcine hearts were subjected to 60 min of ischemia and 24h of reperfusion before hemodynamic and histologic analyses were performed. Human microvascular endothelial cells transfected with hHO-1 displayed an attenuated interleukin-6 and intercellular adhesion molecule 1 expression, resulting in reduced monocytic THP-1 cell recruitment in vitro. In murine left anterior descending occlusion and reperfusion, the post-ischemic influx of CD45(+) leukocytes, Ly-6G(+) neutrophils, and Ly-6C(high) monocytes was further exacerbated in HO-1-deficient hearts and reversed by rAAV.hHO-1 treatment. Conversely, in our porcine model of ischemia, the post-ischemic influx of myeloperoxidase-positive neutrophils and CD14(+) monocytes was reduced by 49% and 87% after rAAV.hHO-1 transduction, similar to hHO-1 transgenic pigs. Functionally, rAAV.hHO-1 and hHO-1 transgenic left ventricles displayed a smaller loss of ejection fraction than control animals. Whereas HO-1 deficiency exacerbates post-ischemic cardiac inflammation in mice, hHO-1 gene therapy attenuates inflammation after ischemia and reperfusion in murine and porcine hearts. Regional hHO-1 gene therapy provides cardioprotection in a pre-clinical porcine ischemia/reperfusion model. Copyright © 2015 American

  15. Gastrin-releasing peptide in the porcine pancreas

    DEFF Research Database (Denmark)

    Holst, J J; Poulsen, Steen Seier

    1987-01-01

    to consist of one main form, namely the 27-amino acid peptide originally extracted from porcine stomach, and small amounts of a C-terminal fragment identical with the C-terminal 10-amino acid peptide. Gastrin-releasing peptide-like immunoreactivity released from the isolated perfused porcine pancreas during...... electrical vagal stimulation was shown by gel filtration to consist of the same two forms. By use of immunocytochemical techniques employing an antiserum directed against its N terminus, GRP was localized to varicose nerve fibers in close association with the exocrine tissue of the porcine pancreas...... in particular. Some fibers were found penetrating into pancreatic islets also. Immunoreactive nerve cell bodies as well as fibers were found within intrapancreatic ganglia. The potency of GRP in stimulating exocrine as well as endocrine secretion from the porcine pancreas, its presence in close contact...

  16. Chest tomosynthesis: technical and clinical perspectives.

    Science.gov (United States)

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. CT of chest trauma

    International Nuclear Information System (INIS)

    Goodman, P.C.

    1986-01-01

    There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

  18. The effect of collateral flow and myocardial viability on the distribution of technetium-99m sestamibi in a closed-chest model of coronary occlusion and reperfusion

    International Nuclear Information System (INIS)

    Chareonthaitawee, P.; O'Connor, M.K.; Gibbons, R.J.; Christian, T.F.; Ritman, E.L.

    2000-01-01

    The objective of this study was to determine the effect of myocardial viability and the degree of collateral blood flow on the uptake and retention of 99m Tc-sestamibi by examining three animal models of coronary occlusion and reperfusion, each reflecting a different state of viability and collateral blood flow. Three closed-chest animal models were studied: canine (high collateral flow, preserved viability), porcine (low collateral flow, absent viability) and porcine with slowly occlusive coronary stents producing infarction and enhanced collateral blood flow (high collateral flow, absent viability). There were seven dogs, seven pigs and six pigs, respectively, in each animal model. Animals from all three models were subjected to a 40-min total left anterior descending artery (LAD) occlusion followed by 2 h of reperfusion. 99m Tc-sestamibi and radiolabelled microspheres were injected during LAD occlusion 10 min prior to reperfusion. Animals were sacrificed after 2 h of reperfusion flow. Ex situ heart slice imaging to determine risk area was followed by viability staining to determine infarct size. Slices were subsequently sectioned into equally sized radial segments and placed in a gamma well counter. Risk area as determined by ex situ 99m Tc-sestamibi imaging was not significantly different by model. Pathological infarct size differed significantly by model [canine = 1%±1% of the left ventricle (LV); porcine = 13%±8% LV; porcine with stent = 14%±7% LV; P=0.002]. Collateral blood flow by microspheres during occlusion tended to differ among models (overall P=0.08), with the canine and porcine with stent models having relatively high flow rates compared with the acute porcine model. 99m Tc-sestamibi activity correlated with microsphere blood flow in all three models, with r values for individual animals (n=20) ranging from 0.86 to 0.96 (all P 99m Tc-sestamibi uptake with myocardial blood flow. 99m Tc-sestamibi uptake overestimated blood flow to a greater extent

  19. Aminopeptidase-N-independent entry of porcine epidemic diarrhea virus into Vero or porcine small intestine epithelial cells.

    Science.gov (United States)

    Ji, Chun-Miao; Wang, Bin; Zhou, Jiyong; Huang, Yao-Wei

    2018-04-01

    A monkey cell line Vero (ATCC CCL-81) is commonly used for porcine epidemic diarrhea virus (PEDV) propagation in vitro. However, it is still controversial whether the porcine aminopeptidase N (pAPN) counterpart on Vero cells (Vero-APN) confers PEDV entry. We found that endogenous expression of Vero-APN was undetectable in the mRNA and the protein levels in Vero cells. We cloned the partial Vero-APN gene (3340-bp) containing exons 1 to 9 from cellular DNA and subsequently generated two APN-knockout Vero cell lines by CRISPR/Cas9 approach. PEDV infection of two APN-knockout Vero cells had the same efficiency as the Vero cells with or without neuraminidase treatment. A Vero cells stably expressing pAPN did not increase PEDV production. SiRNA-knockdown of pAPN in porcine jejunum epithelial cells had no effects on PEDV infection. The results suggest that there exists an additional cellular receptor on Vero or porcine jejunal cells independent of APN for PEDV entry. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Quantification of Porcine Vocal Fold Geometry.

    Science.gov (United States)

    Stevens, Kimberly A; Thomson, Scott L; Jetté, Marie E; Thibeault, Susan L

    2016-07-01

    The aim of this study was to quantify porcine vocal fold medial surface geometry and three-dimensional geometric distortion induced by freezing the larynx, especially in the region of the vocal folds. The medial surface geometries of five excised porcine larynges were quantified and reported. Five porcine larynges were imaged in a micro-CT scanner, frozen, and rescanned. Segmentations and three-dimensional reconstructions were used to quantify and characterize geometric features. Comparisons were made with geometry data previously obtained using canine and human vocal folds as well as geometries of selected synthetic vocal fold models. Freezing induced an overall expansion of approximately 5% in the transverse plane and comparable levels of nonuniform distortion in sagittal and coronal planes. The medial surface of the porcine vocal folds was found to compare reasonably well with other geometries, although the compared geometries exhibited a notable discrepancy with one set of published human female vocal fold geometry. Porcine vocal folds are qualitatively geometrically similar to data available for canine and human vocal folds, as well as commonly used models. Freezing of tissue in the larynx causes distortion of around 5%. The data can provide direction in estimating uncertainty due to bulk distortion of tissue caused by freezing, as well as quantitative geometric data that can be directly used in developing vocal fold models. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Learning chest imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pedrozo Pupo, John C. (ed.) [Magdalena Univ., Santa Maria (Colombia). Respire - Inst. for Respiratory Care

    2013-03-01

    Useful learning tool for practitioners and students. Overview of the imaging techniques used in chest radiology. Aid to the correct interpretation of chest X-ray images. Radiology of the thorax forms an indispensable element of the basic diagnostic process for many conditions and is of key importance in a variety of medical disciplines. This user-friendly book provides an overview of the imaging techniques used in chest radiology and presents numerous instructive case-based images with accompanying explanatory text. A wide range of clinical conditions and circumstances are covered with the aim of enabling the reader to confidently interpret chest images by correctly identifying structures of interest and the causes of abnormalities. This book, which will be an invaluable learning tool, forms part of the Learning Imaging series for medical students, residents, less experienced radiologists, and other medical staff. Learning Imaging is a unique case-based series for those in professional education in general and for physicians in prarticular.

  2. Chest radiology

    International Nuclear Information System (INIS)

    Reed, J.C.

    1990-01-01

    This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case

  3. Diagnostic investigation of porcine periweaning failure-to-thrive syndrome: lack of compelling evidence linking to common porcine pathogens.

    Science.gov (United States)

    Huang, Yanyun; Gauvreau, Henry; Harding, John

    2012-01-01

    Porcine periweaning failure-to-thrive syndrome (PFTS), an increasingly recognized syndrome in the swine industry of North America, is characterized by the anorexia of nursery pigs noticeable within 1 week of weaning, and progressive loss of body condition and lethargy during the next 1-2 weeks. Morbidity caused by PFTS is moderate, but case fatality is high. The etiology of PFTS is presently unknown and may include infectious agent(s), noninfectious factors, or both. PFTS was identified in a high health status farm with good management in early 2007. A diagnostic investigation was undertaken to identify the pathological lesions of, and infectious agents associated with, pigs demonstrating typical clinical signs. Affected (PFTS-SICK) and unaffected (PFTS-HLTHY) pigs from an affected farm, and unaffected pigs from 2 unaffected farms, were examined. The most prevalent lesions in PFTS-SICK pigs were superficial lymphocytic fundic gastritis, atrophic enteritis, superficial colitis, lymphocytic and neutrophilic rhinitis, mild nonsuppurative meningoencephalitis, and thymic atrophy. Rotavirus A and Betacoronavirus 1 (Porcine hemagglutinating encephalomyelitis virus) were identified only in PFTS-SICK pigs, but the significance of the viruses is uncertain because PFTS is not consistent with the typical presentation following infection by these pathogens. Porcine reproductive and respiratory syndrome virus, Porcine circovirus-2, Influenza A virus, Alphacoronavirus 1 (Transmissible gastroenteritis virus), Torque teno virus 1, Brachyspira hyodysenteriae, and Brachyspira pilosicoli were not identified in PFTS-SICK pigs. Suid herpesvirus 2 (Porcine cytomegalovirus), Porcine enteric calicivirus, Torque teno virus 2, pathogenic Escherichia coli, and coccidia were detected in both PFTS-SICK and PFTS-HLTHY pigs. It was concluded that there is a lack of compelling evidence that PFTS is caused by any of these pathogens.

  4. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

    Directory of Open Access Journals (Sweden)

    Omar Hesham R

    2011-09-01

    Full Text Available Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  5. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

    Science.gov (United States)

    Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

    2011-09-27

    Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

  6. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Johnsen, Karen Kirstine; Thomsen, Henrik

    on collimation and dose reduction in digital chest radiography Methods and Materials A retrospective study of digital chest radiography is performed to evaluate the primary x-ray tube collimation of the PA and lateral radiographs. Data from one hundred fifty self-reliant female patients between 15 and 55 years...

  7. Myocardial capillary permeability for small hydrophilic indicators during normal physiological conditions and after ischemia and reperfusion

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup

    1991-01-01

    Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation of the inje......Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation...... including microvascular alterations. In open chest dogs transitory increases in capillary extraction fraction and PdS for small hydrophilic solutes were seen following 20 minutes of regional myocardial ischemia and reperfusion. This response could be inhibited by treatment directed against superoxide...

  8. Does the quality of chest compressions deteriorate when the chest compression rate is above 120/min?

    Science.gov (United States)

    Lee, Soo Hoon; Kim, Kyuseok; Lee, Jae Hyuk; Kim, Taeyun; Kang, Changwoo; Park, Chanjong; Kim, Joonghee; Jo, You Hwan; Rhee, Joong Eui; Kim, Dong Hoon

    2014-08-01

    The quality of chest compressions along with defibrillation is the cornerstone of cardiopulmonary resuscitation (CPR), which is known to improve the outcome of cardiac arrest. We aimed to investigate the relationship between the compression rate and other CPR quality parameters including compression depth and recoil. A conventional CPR training for lay rescuers was performed 2 weeks before the 'CPR contest'. CPR anytime training kits were distributed to respective participants for self-training on their own in their own time. The participants were tested for two-person CPR in pairs. The quantitative and qualitative data regarding the quality of CPR were collected from a standardised check list and SkillReporter, and compared by the compression rate. A total of 161 teams consisting of 322 students, which includes 116 men and 206 women, participated in the CPR contest. The mean depth and rate for chest compression were 49.0±8.2 mm and 110.2±10.2/min. Significantly deeper chest compression depths were noted at rates over 120/min than those at any other rates (47.0±7.4, 48.8±8.4, 52.3±6.7, p=0.008). Chest compression depth was proportional to chest compression rate (r=0.206, pcompression including chest compression depth and chest recoil by chest compression rate. Further evaluation regarding the upper limit of the chest compression rate is needed to ensure complete full chest wall recoil while maintaining an adequate chest compression depth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. ECG-Based Detection of Early Myocardial Ischemia in a Computational Model: Impact of Additional Electrodes, Optimal Placement, and a New Feature for ST Deviation.

    Science.gov (United States)

    Loewe, Axel; Schulze, Walther H W; Jiang, Yuan; Wilhelms, Mathias; Luik, Armin; Dössel, Olaf; Seemann, Gunnar

    2015-01-01

    In case of chest pain, immediate diagnosis of myocardial ischemia is required to respond with an appropriate treatment. The diagnostic capability of the electrocardiogram (ECG), however, is strongly limited for ischemic events that do not lead to ST elevation. This computational study investigates the potential of different electrode setups in detecting early ischemia at 10 minutes after onset: standard 3-channel and 12-lead ECG as well as body surface potential maps (BSPMs). Further, it was assessed if an additional ECG electrode with optimized position or the right-sided Wilson leads can improve sensitivity of the standard 12-lead ECG. To this end, a simulation study was performed for 765 different locations and sizes of ischemia in the left ventricle. Improvements by adding a single, subject specifically optimized electrode were similar to those of the BSPM: 2-11% increased detection rate depending on the desired specificity. Adding right-sided Wilson leads had negligible effect. Absence of ST deviation could not be related to specific locations of the ischemic region or its transmurality. As alternative to the ST time integral as a feature of ST deviation, the K point deviation was introduced: the baseline deviation at the minimum of the ST-segment envelope signal, which increased 12-lead detection rate by 7% for a reasonable threshold.

  10. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Prosch, H.; Negrin, L.

    2014-01-01

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [de

  11. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

    OpenAIRE

    Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

    2011-01-01

    Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a tru...

  12. Ultrasonic measurements of chest wall thickness and realistic chest phantom for calibration of Pu lung counting facilities

    International Nuclear Information System (INIS)

    Shirotani, Takashi

    1990-01-01

    There are four important problems for the measurements of chest wall thickness using ultrasonic device: (1) selection of optimum position of transducer and the number of measured points on the chest covered with detector, (2) estimation of adipose-to-muscle ratio in the chest wall, especially for dispersed adipose like 'marbled beef', (3) determination of regression equations for the prediction of chest wall thickness, derived from groups of different body shape, i.e. corpulent and lean, and (4) estimation of effective chest wall thickness involved self-absorption layer of lung tissue, which changes with distribution of activity in the lungs. This quantity can not be measured with ultrasonic device. Realistic chest phantom was developed. The phantom contains removable model organs (lungs, liver, kidneys and heart), model trachea and artificial rib cage, and also includes chest plates that can be placed over the chest to simulate wide range adipose-to-muscle ratio in the chest wall. Various soft tissue substitutes were made of polyurethane with different concentrations of additive, and the rib cage were made of epoxy resin with calcium carbonate. The experimental data have shown that the phantom can be used as a standard phantom for the calibration. (author)

  13. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Ciccone M

    2011-03-01

    Full Text Available Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini21Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO, 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, ItalyIntroduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis.Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries.Results: A statistically significant relationship (P = 0.023 was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively.Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in

  14. Exercise tolerance test in patients presenting with chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Sharieff, S.; Khan, Shah-e-Zaman

    2002-01-01

    Objective: To report the prevalence of abnormal exercise tolerance test (ETT) responses and to assess the risk factors for ischemic heart disease (IHD) in a population referred for the evaluation of chest pain with a normal baseline electrocardiogram (ECG). Design: A prospective study. The study was conducted at the National Institute of cardiovascular Diseases (NICVD), Karachi, Pakistan between 1st January 2000 and 31 December 2000. Subjects and Methods: One thousand one hundred and twenty-seven consecutive adult patients presenting in the outpatient department (OPD) with history of chest pain and having a normal baseline ECG were the subjects of the study after excluding patients with indeterminate or inconclusive test response. All these subjects underwent ETT and were screened for risk factor for IHD. Results: Of the patients studied 56.6% had abnormal ETT response. Male to female ratio of all patients was 4.85:1 Overall mean age was 50.3 +- 8.8 years. 65.9% of diabetic patients had ETT Suggestive of silent myocardial ischemia (p=0.012). Age > 50 year (p= <0.0001), male sex (p=0.015), diabetes mellitus (p=0.0033) and positive family history of IHD (p=0.0014) were the risk factor found in patient with abnormal ETT response. Conclusion: Age of more than 50 years, male gender, diabetes mellitus and positive family history of IHD are the significant risk factors for the development of ischemic heart disease in our population. Silent myocardial ischemic is common in diabetics. (author)

  15. Tachykinins in the porcine pancreas

    DEFF Research Database (Denmark)

    Schmidt, P T; Tornøe, K; Poulsen, Steen Seier

    2000-01-01

    The localization, release, and effects of substance P and neurokinin A were studied in the porcine pancreas and the localization of substance P immunoreactive nerve fibers was examined by immunohistochemistry. The effects of electrical vagus stimulation and capsaicin infusion on tachykinin release...... and the effects of substance P and neurokinin A infusion on insulin, glucagon, somatostatin, and exocrine secretion were studied using the isolated perfused porcine pancreas with intact vagal innervation. NK-1 and NK-2 receptor antagonists were used to investigate receptor involvement. Substance P immunoreactive...

  16. Non-Invasive Mechanic Ventilation Using in Flail Chest, Caused By Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Serdar Onat

    2008-01-01

    Full Text Available A 75-year-old woman admitted our faculty emergency room with shortness of breath, and chest pain after traffic accident’s second hour. She was diagnosed as bilateral multipl rib fractures, left clavicula fracture, and left flail chest by phsical and radiological examinations. She was transfered to Chest Surgery Depatment’s intensive care unit. The patient was undergone non-invasive mask mechanic ventilation support, because of the decreasing of blood oxygen saturation and increasing of arteriel blood partial carbondioxide pressure. The treatment of non-invasive mechanic ventilation was succesfull for ventilation support. With this report, we would like to attentioned that non-invasive mechanic ventilation for blunt chest trauma patients could be used succesfully and could be used instead of endotracheal invasive mechanic ventilation.

  17. Methods for the detection and serum depletion of porcine galectin-3.

    Science.gov (United States)

    Eliaz, Isaac; Patil, Aarti; Navarro-Alvarez, Nalu; Wang, Zhirui; Eliaz, Amity; Weil, Elaine; Wilk, Barry; Sachs, David H; Huang, Christene A

    2017-10-01

    Circulating galectin-3 (Gal-3) is elevated in systemic inflammatory disorders, fibrotic diseases, and in cancers. Gal-3 is a promising cancer target where it promotes tumorigenesis and metastasis, as well as in renal, pulmonary, hepatic, and cardiovascular diseases, because of its role as a driver of fibrotic remodeling. This reports goal was to establish methods for the detection and removal of porcine Gal-3 that will enable further studies of the therapeutic potential of Gal-3 depletion by apheresis in porcine disease models. The long-term aim is to develop a safe, effective method of removing Gal-3 via apheresis as a standalone therapeutic tool and as an adjuvant to other therapies. Purified recombinant porcine Gal-3 was prepared and used as the standard for development of a porcine Gal-3 enzyme-linked immunosorbent assay (ELISA). Different affinity column matrices that incorporated either a rat IgG2a anti-Gal-3 monoclonal antibody or carbohydrate ligand were assessed for depletion of Gal-3 from porcine serum. A porcine Gal-3 ELISA with a linear range from 0.3 to 20 ng/mL was able to detect native porcine Gal-3 in both fetal (∼150-200 ng/mL) and juvenile (∼5-15 ng/mL) porcine serum samples. Use of an anti-Gal-3 monoclonal antibody affinity column depleted Gal-3 from porcine serum to at least 313 pg/mL, the limit of ELISA detection. Methods have been developed for the detection and depletion of porcine Gal-3. These methods will be used to study the specific effects of Gal-3 depletion via apheresis in porcine models of disease. © 2017 Wiley Periodicals, Inc.

  18. Magnetic resonance spectroscopy and imaging in cerebral ischemia

    International Nuclear Information System (INIS)

    Rijen, P.C. van.

    1991-01-01

    In-vivo proton and phosphorus magnetic resonance spectroscopy was used to detect changes in cerebral metabolism during ischemia and other types of metabolic stress. Magnetic resonance imaging was performed in an animal model to observe morphological alterations during focal cerebral ischemia. Spectroscopy was performed in animal models with global ischemia, in volunteers during hyperventilation and pharmaco-logically altered cerebral perfusion, and in patients with acute and prolonged focal cerebral ischemia. (author). 396 refs.; 44 figs.; 14 tabs

  19. Lentiviral Vector Gene Transfer to Porcine Airways

    Directory of Open Access Journals (Sweden)

    Patrick L Sinn

    2012-01-01

    Full Text Available In this study, we investigated lentiviral vector development and transduction efficiencies in well-differentiated primary cultures of pig airway epithelia (PAE and wild-type pigs in vivo. We noted gene transfer efficiencies similar to that observed for human airway epithelia (HAE. Interestingly, feline immunodeficiency virus (FIV-based vectors transduced immortalized pig cells as well as pig primary cells more efficiently than HIV-1–based vectors. PAE express TRIM5α, a well-characterized species-specific lentiviral restriction factor. We contrasted the restrictive properties of porcine TRIM5α against FIV- and HIV-based vectors using gain and loss of function approaches. We observed no effect on HIV-1 or FIV conferred transgene expression in response to porcine TRIM5α overexpression or knockdown. To evaluate the ability of GP64-FIV to transduce porcine airways in vivo, we delivered vector expressing mCherry to the tracheal lobe of the lung and the ethmoid sinus of 4-week-old pigs. One week later, epithelial cells expressing mCherry were readily detected. Our findings indicate that pseudotyped FIV vectors confer similar tropisms in porcine epithelia as observed in human HAE and provide further support for the selection of GP64 as an appropriate envelope pseudotype for future preclinical gene therapy studies in the porcine model of cystic fibrosis (CF.

  20. A rapid and simple chemiluminescence method for screening levels of inosine and hypoxanthine in non-traumatic chest pain patients.

    Science.gov (United States)

    Farthing, Don E; Sica, Domenic; Hindle, Michael; Edinboro, Les; Xi, Lei; Gehr, Todd W B; Gehr, Lynne; Farthing, Christine A; Larus, Terri L; Fakhry, Itaf; Karnes, H Thomas

    2011-01-01

    A rapid and simple chemiluminescence method was developed for detection of inosine and hypoxanthine in human plasma. The method utilized a microplate luminometer with direct injectors to automatically dispense reagents during sample analysis. Enzymatic conversions of inosine to hypoxanthine, followed by hypoxanthine to xanthine to uric acid, generated superoxide anion radicals as a useful metabolic by-product. The free radicals react with Pholasin(®) , a sensitive photoprotein used for chemiluminescence detection, to produce measurable blue-green light. The use of Pholasin(®) and a chemiluminescence signal enhancer, Adjuvant-K™, eliminated the need for plasma clean-up steps prior to analysis. The method used 20 μL of heparinized plasma, with complete analysis of total hypoxanthine levels (inosine is metabolized to hypoxanthine using purine nucleoside phosphorylase) in approximately 3.7 min. The rapid chemiluminescence method demonstrated the capability of differentiating total hypoxanthine levels between healthy individuals, and patients presenting with non-traumatic chest pain and potential acute cardiac ischemia. The results support the potential use of chemiluminescence methodology as a diagnostic tool to rapidly screen for elevated levels of inosine and hypoxanthine in human plasma, potential biomarkers of acute cardiac ischemia. Copyright © 2009 John Wiley & Sons, Ltd.

  1. The study of the tolerance to skeletal muscle ischemia

    International Nuclear Information System (INIS)

    Tsubo, Masahiko; Takai, Hiroaki; Ikata, Takaaki; Sogabe, Takayuki; Miura, Iwao.

    1988-01-01

    A model of amputated and replanted legs were used for the study on the energy metabolism during long-period skeletal muscle ischemia. The energy metabolic changes and intracellular pH were measured continuously and non-invasively by 31 P-MRS technique. Immediately following ischemia, phosphocreatine declined and inorganic phosphate rose. However, ATP was maintained for 2 hours. During ischemia, phosphocreatine was not detected after about 3.5 hours and ATP was no longer detectable after about 5 hours. On the other hand, intracellular pH began declining linearly after 30 minutes. All cases of 4-hour ischemia and 57 % of 5-hour ischemia recovered. And all cases of 6-hour ischemia did not recover. (author)

  2. Progress, problems and prospects of porcine pluripotent stem cells

    Directory of Open Access Journals (Sweden)

    Hanning WANG,Yangli PEI,Ning LI,Jianyong HAN

    2014-02-01

    Full Text Available Pluripotent stem cells (PSCs, including embryonic stem cells (ESCs and induced PSCs (iPSCs, can differentiate into cells of the three germ layers, suggesting that PSCs have great potential for basic developmental biology research and wide applications for clinical medicine. Genuine ESCs and iPSCs have been derived from mice and rats, but not from livestock such as the pig─an ideal animal model for studying human disease and regenerative medicine due to similarities with human physiologic processes. Efforts to derive porcine ESCs and iPSCs have not yielded high-quality PSCs that can produce chimeras with germline transmission. Thus, exploration of the unique porcine gene regulation network of preimplantation embryonic development may permit optimization of in vitro culture systems for raising porcine PSCs. Here we summarize the recent progress in porcine PSC generation as well as the problems encountered during this progress and we depict prospects for generating porcine naive PSCs.

  3. Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): Diagnosis by combined atrial pacing and thallium 201 imaging--a case report

    International Nuclear Information System (INIS)

    Magarian, G.J.; Palac, R.; Reinhart, S.

    1990-01-01

    Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded

  4. Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report.

    Science.gov (United States)

    Idris, Baig M; Hefny, Ashraf F

    2016-01-01

    Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. A 63- year- old man presented to the Emergency Department complaining of left lateral chest pain due to a fall on his chest at home. On examination, he was hemodynamically stable. An urgent chest X-ray showed evidence of left sided pneumothorax. CT scan of the chest showed pneumothorax of more than 30% of the left hemithorax (around 600ml of air) with multiple left ribs fracture. Patient refused tube thoracostomy and was admitted to surgical department for close observation. The patient was managed conservatively without chest tube insertion. A repeat CT scan of the chest has shown complete resolution of the pneumothorax. The clinical spectrum of pneumothorax varies from asymptomatic to life threatening tension pneumothorax. In stable patients, conservative management can be safe and effective for small pneumothorax. To the best of our knowledge, this is the second reported case in the English literature with large pneumothorax which resolved spontaneously without chest drain. Blunt traumatic large pneumothorax in a clinically stable patient can be managed conservatively. Current recommendations for tube placement may need to be reevaluated. This may reduce morbidity associated with chest tube thoracostomy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Porcine circovirus diseases

    Directory of Open Access Journals (Sweden)

    Ristoski Trpe

    2009-05-01

    Full Text Available Porcine circovirus type 2 belongs on the family Circoviridae. This virus family includes small, non-enveloped viruses, with a circular, single-standed DNA genome.This virus causes mainly subclinical infections, but a number of diseases have been linked to it (porcine circovirus diseases, PCVD. The most economically important PCVD is postweaning multisystemic wasting syndrome (PMWS, which mainly affects pigs of 2 to 5 months of age, with progressive wasting, diarrhea and respiratory disorders. Main PMWS lesions are found in lymphoid tissues, which are characterized by lymphocyte depletion with granulomatous (histiocytic and multinucleate giant cell infiltration. PMWS is considered as multifactorial disease, with a number of infectious and non-infectious factors able to act as disease triggering in PCV2 infected pigs. PCVDs are worldwide distributed, and PMWS was diagnosed in Macedonia in 2007.

  6. MRI of the Chest

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging ( ... heart, valves, great vessels, etc.). top of page What are some common uses of the procedure? MR ...

  7. MRI of the Chest

    Medline Plus

    Full Text Available ... to assess the anatomy and function of the heart and its blood flow. Tell your doctor about ... chest cavity, including the mediastinum , chest wall, pleura, heart and vessels, from almost any angle. MRI also ...

  8. Deciphering the porcine intestinal microRNA transcriptome

    Directory of Open Access Journals (Sweden)

    Keller Andreas

    2010-04-01

    Full Text Available Abstract Background While more than 700 microRNAs (miRNAs are known in human, a comparably low number has been identified in swine. Because of the close phylogenetic distance to humans, pigs serve as a suitable model for studying e.g. intestinal development or disease. Recent studies indicate that miRNAs are key regulators of intestinal development and their aberrant expression leads to intestinal malignancy. Results Here, we present the identification of hundreds of apparently novel miRNAs in the porcine intestine. MiRNAs were first identified by means of deep sequencing followed by miRNA precursor prediction using the miRDeep algorithm as well as searching for conserved miRNAs. Second, the porcine miRNAome along the entire intestine (duodenum, proximal and distal jejunum, ileum, ascending and transverse colon was unraveled using customized miRNA microarrays based on the identified sequences as well as known porcine and human ones. In total, the expression of 332 intestinal miRNAs was discovered, of which 201 represented assumed novel porcine miRNAs. The identified hairpin forming precursors were in part organized in genomic clusters, and most of the precursors were located on chromosomes 3 and 1, respectively. Hierarchical clustering of the expression data revealed subsets of miRNAs that are specific to distinct parts of the intestine pointing to their impact on cellular signaling networks. Conclusions In this study, we have applied a straight forward approach to decipher the porcine intestinal miRNAome for the first time in mammals using a piglet model. The high number of identified novel miRNAs in the porcine intestine points out their crucial role in intestinal function as shown by pathway analysis. On the other hand, the reported miRNAs may share orthologs in other mammals such as human still to be discovered.

  9. The impact of chest compression rates on quality of chest compressions : a manikin study

    OpenAIRE

    Field, Richard A.; Soar, Jasmeet; Davies, Robin P.; Akhtar, Naheed; Perkins, Gavin D.

    2012-01-01

    Purpose\\ud Chest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables.\\ud Methods\\ud Twenty healthcare professionals performed two minutes of co...

  10. Extracellular Matrix Hydrogel Promotes Tissue Remodeling, Arteriogenesis, and Perfusion in a Rat Hindlimb Ischemia Model

    Directory of Open Access Journals (Sweden)

    Jessica L. Ungerleider, BS

    2016-01-01

    Full Text Available Although surgical and endovascular revascularization can be performed in peripheral arterial disease (PAD, 40% of patients with critical limb ischemia do not have a revascularization option. This study examines the efficacy and mechanisms of action of acellular extracellular matrix-based hydrogels as a potential novel therapy for treating PAD. We tested the efficacy of using a tissue-specific injectable hydrogel derived from decellularized porcine skeletal muscle (SKM and compared this to a new human umbilical cord-derived matrix (hUC hydrogel, which could have greater potential for tissue regeneration because of the younger age of the tissue source. In a rodent hindlimb ischemia model, both hydrogels were injected 1-week post-surgery and perfusion was regularly monitored with laser speckle contrast analysis to 35 days post-injection. There were significant improvements in hindlimb tissue perfusion and perfusion kinetics with both biomaterials. Histologic analysis indicated that the injected hydrogels were biocompatible, and resulted in arteriogenesis, rather than angiogenesis, as well as improved recruitment of skeletal muscle progenitors. Skeletal muscle fiber morphology analysis indicated that the muscle treated with the tissue-specific SKM hydrogel more closely matched healthy tissue morphology. Whole transcriptome analysis indicated that the SKM hydrogel caused a shift in the inflammatory response, decreased cell death, and increased blood vessel and muscle development. These results show the efficacy of an injectable ECM hydrogel alone as a potential therapy for treating patients with PAD. Our results indicate that the SKM hydrogel improved functional outcomes through stimulation of arteriogenesis and muscle progenitor cell recruitment.

  11. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

    Science.gov (United States)

    Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

    2016-12-01

    Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

  12. Endobronchial Tuberculosis and Chest Radiography

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Sasani

    2016-03-01

    Full Text Available Endobronchial tuberculosis and chest radiography I read, with interest, the article entitled “Clinical and Para-clinical Presentations of Endobronchial Tuberculosis” by Ahmadi Hoseini H. S. et al. (1 published in this journal. I would like to focus on some details about the chest X-ray of patients as elaborated by the authors in the results section. Accordingly, the findings of chest radiography in the available patients were as follows: pulmonary consolidation (75%, reduced pulmonary volume (20%, and hilar adenopathy (10%. This is an incomplete statement because the authors did not explain whether there was any normal chest radiography in the study population. In addition, it is not clear whether the X-ray examinations of the patients were normal, how many abnormal plain films yielded the presented data. On the other hand, the fact that the studied patients had no normal chest radiography is  controversial since in the literature, 10-20% of the patients with endobronchial tuberculosis are reported to have normal chest X-ray (2, 3. In fact, this is one of the problems in the diagnosis of the disease, as well as a potential cause of delayed diagnosis and treatment of the patients. Therefore, the absence of normal chest radiographs is in contrast to the available literature, and if not an error, it could be a subject of further investigation.

  13. Growth hormone-specific induction of the nuclear localization of porcine growth hormone receptor in porcine hepatocytes.

    Science.gov (United States)

    Lan, H N; Hong, P; Li, R N; Shan, A S; Zheng, X

    2017-10-01

    The phenomenon of nuclear translocation of growth hormone receptor (GHR) in human, rat, and fish has been reported. To date, this phenomenon has not been described in a domestic animal (such as pig). In addition, the molecular mechanisms of GHR nuclear translocation have not been thoroughly elucidated. To this end, porcine hepatocytes were isolated and used as a cell model. We observed that porcine growth hormone (pGH) can induce porcine GHR's nuclear localization in porcine hepatocytes. Subsequently, the dynamics of pGH-induced pGHR's nuclear localization were analyzed and demonstrated that pGHR's nuclear localization occurs in a time-dependent manner. Next, we explored the mechanism of pGHR nuclear localization using different pGHR ligands, and we demonstrated that pGHR's nuclear translocation is GH(s)-dependent. We also observed that pGHR translocates into cell nuclei in a pGH dimerization-dependent fashion, whereas further experiments indicated that IMPα/β is involved in the nuclear translocation of the pGH-pGHR dimer. The pGH-pGHR dimer may form a pGH-GHR-JAK2 multiple complex in cell nuclei, which would suggest that similar to its function in the cell membrane, the nuclear-localized pGH-pGHR dimer might still have the ability to signal. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Managing a chest tube and drainage system.

    Science.gov (United States)

    Durai, Rajaraman; Hoque, Happy; Davies, Tony W

    2010-02-01

    Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport. This article provides an overview of indications, insertion techniques, and management of chest tubes. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  15. Evaluation of chest tomosynthesis for the detection of pulmonary nodules: effect of clinical experience and comparison with chest radiography

    Science.gov (United States)

    Zachrisson, Sara; Vikgren, Jenny; Svalkvist, Angelica; Johnsson, Åse A.; Boijsen, Marianne; Flinck, Agneta; Månsson, Lars Gunnar; Kheddache, Susanne; Båth, Magnus

    2009-02-01

    Chest tomosynthesis refers to the technique of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest. In this study, a comparison of chest tomosynthesis and chest radiography in the detection of pulmonary nodules was performed and the effect of clinical experience of chest tomosynthesis was evaluated. Three senior thoracic radiologists, with more than ten years of experience of chest radiology and 6 months of clinical experience of chest tomosynthesis, acted as observers in a jackknife free-response receiver operating characteristics (JAFROC-1) study, performed on 42 patients with and 47 patients without pulmonary nodules examined with both chest tomosynthesis and chest radiography. MDCT was used as reference and the total number of nodules found using MDCT was 131. To investigate the effect of additional clinical experience of chest tomosynthesis, a second reading session of the tomosynthesis images was performed one year after the initial one. The JAFROC-1 figure of merit (FOM) was used as the principal measure of detectability. In comparison with chest radiography, chest tomosynthesis performed significantly better with regard to detectability. The observer-averaged JAFROC-1 FOM was 0.61 for tomosynthesis and 0.40 for radiography, giving a statistically significant difference between the techniques of 0.21 (p<0.0001). The observer-averaged JAFROC-1 FOM of the second reading of the tomosynthesis cases was not significantly higher than that of the first reading, indicating no improvement in detectability due to additional clinical experience of tomosynthesis.

  16. Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

    Science.gov (United States)

    Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

    2017-01-01

    Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Comparison of chest compression quality between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method during CPR.

    Science.gov (United States)

    Park, Sang-Sub

    2014-01-01

    The purpose of this study is to grasp difference in quality of chest compression accuracy between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method. Participants were progressed 64 people except 6 absentees among 70 people who agreed to participation with completing the CPR curriculum. In the classification of group in participants, the modified chest compression method was called as smartphone group (33 people). The standardized chest compression method was called as traditional group (31 people). The common equipments in both groups were used Manikin for practice and Manikin for evaluation. In the meantime, the smartphone group for application was utilized Android and iOS Operating System (OS) of 2 smartphone products (G, i). The measurement period was conducted from September 25th to 26th, 2012. Data analysis was used SPSS WIN 12.0 program. As a result of research, the proper compression depth (mm) was shown the proper compression depth (p< 0.01) in traditional group (53.77 mm) compared to smartphone group (48.35 mm). Even the proper chest compression (%) was formed suitably (p< 0.05) in traditional group (73.96%) more than smartphone group (60.51%). As for the awareness of chest compression accuracy, the traditional group (3.83 points) had the higher awareness of chest compression accuracy (p< 0.001) than the smartphone group (2.32 points). In the questionnaire that was additionally carried out 1 question only in smartphone group, the modified chest compression method with the use of smartphone had the high negative reason in rescuer for occurrence of hand back pain (48.5%) and unstable posture (21.2%).

  18. Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts.

    Science.gov (United States)

    Olson-Kennedy, Johanna; Warus, Jonathan; Okonta, Vivian; Belzer, Marvin; Clark, Leslie F

    2018-05-01

    Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery. Using a novel measure of chest dysphoria, this cohort study at a large, urban, hospital-affiliated ambulatory clinic specializing in transgender youth care collected survey data about testosterone use and chest distress among transmasculine youth and young adults. Additional information about regret and adverse effects was collected from those who had undergone surgery. Eligible youth were 13 to 25 years old, had been assigned female at birth, and had an identified gender as something other than female. Recruitment occurred during clinical visits and via telephone between June 2016 and December 2016. Surveys were collected from participants who had undergone chest surgery at the time of survey collection and an equal number of youth who had not undergone surgery. Outcomes were chest dysphoria composite score (range 0-51, with higher scores indicating greater distress) in all participants; desire for chest surgery in patients who had not had surgery; and regret about surgery and complications of surgery in patients who were postsurgical. Of 136 completed surveys, 68 (50.0%) were from postsurgical participants, and 68 (50.0%) were from nonsurgical participants. At the time of the survey, the mean (SD) age was 19 (2.5) years for postsurgical participants and 17 (2.5) years for nonsurgical participants. Chest dysphoria composite score mean (SD) was 29.6 (10.0) for participants who had not undergone chest reconstruction, which

  19. Ultrasonography of chest wall lesion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  20. Ultrasonography of chest wall lesion

    International Nuclear Information System (INIS)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H.

    1989-01-01

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  1. Clinical Features and Outcomes of Gastric Ischemia.

    Science.gov (United States)

    Sharma, Ayush; Mukewar, Saurabh; Chari, Suresh T; Wong Kee Song, Louis M

    2017-12-01

    Gastric ischemia is a rare condition associated with poor prognosis. Our study aim was to highlight the clinical features and outcomes of patients with gastric ischemia. A retrospective review of patients diagnosed with isolated gastric ischemia at our institution from January 1, 2000, to May 5, 2016, was performed. Demographic, clinical, endoscopic, radiologic, and outcome variables were abstracted for analysis. Seventeen patients (65% men) with mean age of 69.3 ± 11.3 years and body mass index of 28.8 ± 11.1 were identified. The etiologies for gastric ischemia included local vascular causes (n = 8), systemic hypoperfusion (n = 4), and mechanical obstruction (n = 5). The most common presenting symptoms were abdominal pain (65%), gastrointestinal bleeding (47%), and altered mental status (23%). The typical endoscopic appearance was mucosal congestion and erythema with or without ulceration. Gastric pneumatosis and portal venous air were more commonly seen on CT imaging. Radiologic and/or surgical intervention was needed in 9 patients, while the remaining 8 patients were managed conservatively with acid suppression, antibiotics, and nasogastric tube decompression. The median duration of hospital stay was 15 days (range 1-36 days). There were no cases of rebleeding and the mortality rate as a direct result of gastric ischemia was 24% within 6 months of diagnosis. Although uncommon, gastric ischemia is associated with significant mortality. Endoscopy and CT imaging play an important role in its diagnosis. The management of gastric ischemia is dictated by its severity and associated comorbidities.

  2. Sequence conservation between porcine and human LRRK2

    DEFF Research Database (Denmark)

    Larsen, Knud; Madsen, Lone Bruhn

    2009-01-01

     Leucine-rich repeat kinase 2 (LRRK2) is a member of the ROCO protein superfamily (Ras of complex proteins (Roc) with a C-terminal Roc domain). Mutations in the LRRK2 gene lead to autosomal dominant Parkinsonism. We have cloned the porcine LRRK2 cDNA in an attempt to characterize conserved...... and expression patterns are conserved across species. The porcine LRRK2 gene was mapped to chromosome 5q25. The results obtained suggest that the LRRK2 gene might be of particular interest in our attempt to generate a transgenic porcine model for Parkinson's disease...

  3. Clinical assessment compared with chest X-Ray after removal of chest tube to diagnose pneumothorax

    International Nuclear Information System (INIS)

    Majeed, F. A.; Noor, Q. U. H.; Mehmood, U.; Imtiaz, T.; Zafar, U.

    2017-01-01

    Objective: To evaluate clinical judgment in ruling out pneumothorax during the removal of the chest tube by auscultating the chest before removal and after the extubation of the chest tube in comparison to x ray radiological results. Study Design: Descriptive cross sectional study. Place and Duration of Study: Combined Military Hospital (CMH) Lahore Pakistan, from August 2015 to March 2016. Material and Methods: A sample size of 100 was calculated. Patients were selected via non probability purposive sampling. Children under 14 years were not included. The patients with mal-positioned chest tube, surgical site infection, air leak and the patients with more than one chest tube on one side were excluded. A proforma was made and filled by one person. Chest tubes were removed by two trained senior registrars according to a protocol devised. It was ensured that there was no air leak present before removal clinically and radiologically. Another chest x-ray was done within 24 hours of extubation to detect any pathology that might have occurred during the process. Any complication in the patient clinically was observed till the x-ray film became available. Two sets of readings were obtained. Set A included auscultation findings and set B included x ray results. Results: Out of 100 patients, 60 (60 percent) were males and 40 (40 percent) females. The ages of the patients ranged between 17-77 years. Mean age of the patient was 43.27 ± 17.05 years. In set A out of 100 (100 percent) no pneumothorax developed clinically. In set B out of 100 patients 99 (99 percent) showed no pneumothorax on chest x ray, only 1 (1 percent) showed pneumothorax which was not significant (less than 15 percent on X ray). However, the patient remained asymptomatic clinically and there was no need of reinsertion of the chest tube. Conclusion: Auscultatory findings in diagnosing a significant pneumothorax are justified. Hence, if the chest tube is removed according to the protocol, clinically by

  4. First identification of porcine parvovirus 6 in North America by viral metagenomic sequencing of serum from pigs infected with porcine reproductive and respiratory syndrome virus.

    Science.gov (United States)

    Schirtzinger, Erin E; Suddith, Andrew W; Hause, Benjamin M; Hesse, Richard A

    2015-10-16

    Currently, eight species in four genera of parvovirus have been described that infect swine. These include ungulate protoparvovirus 1 (classical porcine parvovirus, PPV), ungulate tetraparvovirus 2 (PPV3), ungulate tetraparvovirus 3 (which includes PPV2, porcine hokovirus, porcine partetravirus and porcine PARV4), ungulate copiparvovirus 2 (which includes PPV4 and PPV5), ungulate bocaparvovirus 2 (which includes porcine bocavirus 1, 2 and 6), ungulate bocaparvovirus 3 (porcine bocavirus 5), ungulate bocaparvovirus 4 (porcine bocavirus 7) and ungulate bocaparvovirus 5 (porcine bocavirus 3, 4-1 and 4-2). PPV6, the most recently described porcine parvovirus, was first identified in China in late 2014 in aborted pig fetuses. Prevalence of PPV6 in China was found to be similar in finishing age pigs from farms with and without evidence of swine reproductive failure. Porcine parvovirus 6 (PPV6) was detected by sequence-independent single primer amplification (SISPA) and confirmed by overlapping and real-time PCR in the serum of porcine reproductive and respiratory virus (PRRSv) positive samples. Seven nearly complete genomes of PPV6 were identified in PRRSv genotype 2 positive serum samples submitted to state veterinary diagnostic laboratories in 2014. Further testing using overlapping and real-time PCR determined PPV6 to be present in 13.2 % of the serums tested. Additionally, PPV6 was present in samples from all of the geographic locations sampled encompassing nine states in the United States and one state in Mexico. The presence of PPV6 in serum indicates that the PPV6 infection is disseminated and not localized to a specific tissue type. Alignments of the near full length genomes, NS1, and capsid genes identified one of the five PPV6 isolates from China (98.6-99.5 % identity with the North American strains) to be the North American strains nearest relative. These results are the first to report the presence of PPV6 in North America and demonstrate that the virus is

  5. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Vejle-Sørensen, Jens Kristian; Thomsen, Henrik

    ,3 mAs and SID SID of 180 centimetres using a phantom and lithium fluoride thermo luminescence dosimeter (TLD). Dose to risk organs mamma, thyroid and colon are measured at different collimations with one-centimetre steps. TLD results are used to estimate dose reduction for different collimations...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  6. Spinal cord ischemia following thoracotomy without epidural anesthesia.

    Science.gov (United States)

    Raz, Aeyal; Avramovich, Aharon; Saraf-Lavi, Efrat; Saute, Milton; Eidelman, Leonid A

    2006-06-01

    Paraplegia is an uncommon yet devastating complication following thoracotomy, usually caused by compression or ischemia of the spinal cord. Ischemia without compression may be a result of global ischemia, vascular injury and other causes. Epidural anesthesia has been implicated as a major cause. This report highlights the fact that perioperative cord ischemia and paraplegia may be unrelated to epidural intervention. A 71-yr-old woman was admitted for a left upper lobectomy for resection of a non-small cell carcinoma of the lung. The patient refused epidural catheter placement and underwent a left T5-6 thoracotomy under general anesthesia. During surgery, she was hemodynamically stable and good oxygen saturation was maintained. Several hours following surgery the patient complained of loss of sensation in her legs. Neurological examination disclosed a complete motor and sensory block at the T5-6 level. Magnetic resonance imaging (MRI) revealed spinal cord ischemia. The patient received iv steroid treatment, but remained paraplegic. Five months following the surgery there was only partial improvement in her motor symptoms. A follow-up MRI study was consistent with a diagnosis of spinal cord ischemia. In this case of paraplegia following thoracic surgery for lung resection, epidural anesthesia/analgesia was not used. The MRI demonstrated evidence of spinal cord ischemia, and no evidence of cord compression. This case highlights that etiologies other than epidural intervention, such as injury to the spinal segmental arteries during thoracotomy, should be considered as potential causes of cord ischemia and resultant paraplegia in this surgical population.

  7. Review on herbal medicine on brain ischemia and reperfusion简

    Institute of Scientific and Technical Information of China (English)

    Nahid; Jivad; Zahra; Rabiei

    2015-01-01

    Brain ischemia and reperfusion is the leading cause of serious and long-range disability in the world. Clinically significant changes in central nervous system function are observed following brain ischemia and reperfusion. Stroke patients exhibit behavioral, cognitive,emotional, affective and electrophysiological changes during recovery phase. Brain injury by transient complete global brain ischemia or by transient incomplete brain ischemia afflicts a very large number of patients in the world with death or permanent disability. In order to reduce this damage, we must sufficiently understand the mechanisms involved in brain ischemia and reperfusion and repair to design clinically effective therapy.Cerebral ischemia and reperfusion is known to induce the generation of reactive oxygen species that can lead to oxidative damage of proteins, membrane lipids and nucleic acids.A decrease in tissue antioxidant capacity, an increase in lipid peroxidation as well as an increase in lipid peroxidation inhibitors have been demonstrated in several models of brain ischemia. This paper reviews the number of commonly used types of herbal medicines effective for the treatment of stroke. The aim of this paper was to review evidences from controlled studies in order to discuss whether herbal medicine can be helpful in the treatment of brain ischemia and reperfusion.

  8. 46 CFR 169.743 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 169.743 Section 169.743... Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.743 Portable magazine chests. Portable magazine chests must be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST...

  9. Animal models of cerebral ischemia

    Science.gov (United States)

    Khodanovich, M. Yu.; Kisel, A. A.

    2015-11-01

    Cerebral ischemia remains one of the most frequent causes of death and disability worldwide. Animal models are necessary to understand complex molecular mechanisms of brain damage as well as for the development of new therapies for stroke. This review considers a certain range of animal models of cerebral ischemia, including several types of focal and global ischemia. Since animal models vary in specificity for the human disease which they reproduce, the complexity of surgery, infarct size, reliability of reproduction for statistical analysis, and adequate models need to be chosen according to the aim of a study. The reproduction of a particular animal model needs to be evaluated using appropriate tools, including the behavioral assessment of injury and non-invasive and post-mortem control of brain damage. These problems also have been summarized in the review.

  10. MRI of the Chest

    Medline Plus

    Full Text Available ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed ... in diagnosing a broad range of conditions, including cancer, heart and ... tissues, except for lung abnormalities where Chest CT is a preferred imaging ...

  11. Nodule detection in digital chest radiography: Summary of the radius chest trial

    International Nuclear Information System (INIS)

    Haakansson, M.; Baath, M.; Boerjesson, S.; Kheddache, S.; Grahn, A.; Ruschin, M.; Tingberg, A.; Mattson, S.; Maansson, L. G.

    2005-01-01

    As a part of the Europe-wide research project 'Unification of physical and clinical requirements for medical X-ray imaging' - governed by the Radiological Imaging Unification Strategies (RADIUS) Group - a major image quality trial was conducted by members of the group. The RADIUS chest trial aimed at thoroughly examining various aspects of nodule detection in digital chest radiography, such as the effects of nodule location, system noise, anatomical noise, and anatomical background. The main findings of the RADIUS chest trial concerning the detection of a lung nodule with a size in the order of 10 mm can be summarised as: (1) the detectability of the nodule is largely dependent on its location in the chest, (2) the system noise has a minor impact on the detectability at the dose levels used today, (3) the disturbance of the anatomical noise is larger than that of the system noise but smaller than that of the anatomical background and (4) the anatomical background acts as noise to a large extent and is the major image component affecting the detectability of the nodule. (authors)

  12. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... in the penumbra is recruited in the infarction process leading to a progressive growth of the infarct. The penumbra hence constitutes an important target for pharmacological treatment because of the existence of a therapeutic time window during which treatment with neuroprotective compounds may prevent...

  13. Spatial clustering of porcine cysticercosis in Mbulu district, northern Tanzania.

    Directory of Open Access Journals (Sweden)

    Helena A Ngowi

    Full Text Available BACKGROUND: Porcine cysticercosis is caused by a zoonotic tapeworm, Taenia solium, which causes serious disease syndromes in human. Effective control of the parasite requires knowledge on the burden and pattern of the infections in order to properly direct limited resources. The objective of this study was to establish the spatial distribution of porcine cysticercosis in Mbulu district, northern Tanzania, to guide control strategies. METHODOLOGY/PRINCIPAL FINDINGS: This study is a secondary analysis of data collected during the baseline and follow-up periods of a randomized community trial aiming at reducing the incidence rate of porcine cysticercosis through an educational program. At baseline, 784 randomly selected pig-keeping households located in 42 villages in 14 wards were included. Lingual examination of indigenous pigs aged 2-12 (median 8 months, one randomly selected from each household, were conducted. Data from the control group of the randomized trial that included 21 of the 42 villages were used for the incidence study. A total of 295 pig-keeping households were provided with sentinel pigs (one each and reassessed for cysticercosis incidence once or twice for 2-9 (median 4 months using lingual examination and antigen ELISA. Prevalence of porcine cysticercosis was computed in Epi Info 3.5. The prevalence and incidence of porcine cysticercosis were mapped at household level using ArcView 3.2. K functions were computed in R software to assess general clustering of porcine cysticercosis. Spatial scan statistics were computed in SatScan to identify local clusters of the infection. The overall prevalence of porcine cysticercosis was 7.3% (95% CI: 5.6, 9.4; n = 784. The K functions revealed a significant overall clustering of porcine cysticercosis incidence for all distances between 600 m and 5 km from a randomly chosen case household based on Ag-ELISA. Lingual examination revealed clustering from 650 m to 6 km and between 7.5 and 10 km

  14. Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

    International Nuclear Information System (INIS)

    Kim, Tae Jung; Lee, Kyoung Ho; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon; Hahn, Seokyung; Lee, Kyung Won

    2009-01-01

    Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

  15. Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Jung [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)], E-mail: kholee@snubhrad.snu.ac.kr; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Hahn, Seokyung [Medical Research Collaborating Center, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Seoul National University College of Medicine (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

    2009-03-15

    Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

  16. Postcircumcisional Ischemia of the Glans Penis Treated with Pentoxifylline

    Directory of Open Access Journals (Sweden)

    Ersagun Karaguzel

    2013-01-01

    Full Text Available Ischemia of the glans penis is a rare postcircumcision complication. We describe a four-year-old boy developing ischemia of the glans penis 48 h after circumcision. The ischemia completely resolved following treatment with iv pentoxifylline (PTX for six days, and the patient was discharged without any problems. PTX treatment should be kept in mind as an alternative treatment modality in ischemia of the glans penis which is a serious potential post-circumcision complication.

  17. Porcine SLITRK1

    DEFF Research Database (Denmark)

    Larsen, Knud Erik; Momeni, Jamal; Farajzadeh, Leila

    2014-01-01

    The membrane protein SLITRK1 functions as a developmentally regulated stimulator of neurite outgrowth and variants in this gene have been implicated in Tourette syndrome. In the current study we have cloned and characterized the porcine SLITRK1 gene. The genomic organization of SLITRK1 lacks...

  18. Functional verification of a porcine myostatin propeptide mutant.

    Science.gov (United States)

    Ma, Dezun; Jiang, Shengwang; Gao, Pengfei; Qian, Lili; Wang, Qingqing; Cai, Chunbo; Xiao, Gaojun; Yang, Jinzeng; Cui, Wentao

    2015-10-01

    Myostatin is a member of TGF-β superfamily that acts as a key negative regulator in development and growth of embryonic and postnatal muscles. In this study, the inhibitory activities of recombinant porcine myostatin propeptide and its mutated form (at the cleavage site of metalloproteinases of BMP-1/TLD family) against murine myostatin was evaluated in vivo by intraperitoneal injection into mice. Results showed that both wild type and mutated form of porcine propeptide significantly inhibited myostatin activity in vivo. The average body weight of mice receiving wild type propeptide or its mutated form increased by 12.5 % and 24.14%, respectively, compared to mice injected with PBS, implying that the in vivo efficacy of porcine propeptide mutant is greater than its wild type propeptide. Transgenic mice expressing porcine myostatin propeptide mutant were generated to further verify the results obtained from mice injected with recombinant porcine propeptide mutant. Compared with wild type (non-transgenic) mice, relative weight of gastrocnemius, rectusfemoris, and tibialis anterior increased by 22.14 %, 34.13 %, 25.37%, respectively, in transgenic male mice, and by 19.90 %, 42.47 %, 45.61%, respectively, in transgenic female mice. Our data also demonstrated that the mechanism by which muscle growth enhancement is achieved by these propeptides is due to an increase in fiber sizes, not by an increase in number of fiber cells.

  19. Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

    Science.gov (United States)

    Masuda, Norikazu; Yasojima, Hiroyuki; Mizutani, Makiko; Nakamori, Shoji; Kanazawa, Toru; Kuriyama, Keiko; Mano, Masayuki; Sekimoto, Mitsugu

    2014-01-01

    Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient's chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery. PMID:24660001

  20. Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yusuke Yamaoka

    2014-01-01

    Full Text Available Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient’s chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery.

  1. Improved drainage with active chest tube clearance.

    Science.gov (United States)

    Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Arakawa, Yoko; Horai, Tetsuya; Boyle, Edward M; Gillinov, A Marc; Fukamachi, Kiyotaka

    2010-05-01

    This study was performed to evaluate the efficacy of a novel chest drainage system. This system employs guide wire-based active chest tube clearance to improve drainage and maintain patency. A 32 Fr chest tube was inserted into pleural cavities of five pigs. On the left, a tube was connected to the chest canister, and on the right, the new system was inserted between the chest tube and chest canister. Acute bleeding was mimicked by periodic infusion of blood. The amount of blood drained from each chest cavity was recorded every 15 min for 2 h. After completion of the procedure, all residual blood and clots in each chest cavity were assessed. The new system remained widely patent, and the amount of drainage achieved with this system (670+/-105 ml) was significantly (P=0.01) higher than that with the standard tube (239+/-131 ml). The amount of retained pleural blood and clots with this system (150+/-107 ml) was significantly (P=0.04) lower than that with the standard tube (571+/-248 ml). In conclusion, a novel chest drainage system with active tube clearance significantly improved drainage without tube manipulations. 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Treatment with the C5a receptor antagonist ADC-1004 reduces myocardial infarction in a porcine ischemia-reperfusion model

    Directory of Open Access Journals (Sweden)

    Arheden Håkan

    2010-09-01

    Full Text Available Abstract Background Polymorphonuclear neutrophils, stimulated by the activated complement factor C5a, have been implicated in cardiac ischemia/reperfusion injury. ADC-1004 is a competitive C5a receptor antagonist that has been shown to inhibit complement related neutrophil activation. ADC-1004 shields the neutrophils from C5a activation before they enter the reperfused area, which could be a mechanistic advantage compared to previous C5a directed reperfusion therapies. We investigated if treatment with ADC-1004, according to a clinically applicable protocol, would reduce infarct size and microvascular obstruction in a large animal myocardial infarct model. Methods In anesthetized pigs (42-53 kg, a percutaneous coronary intervention balloon was inflated in the left anterior descending artery for 40 minutes, followed by 4 hours of reperfusion. Twenty minutes after balloon inflation the pigs were randomized to an intravenous bolus administration of ADC-1004 (175 mg, n = 8 or saline (9 mg/ml, n = 8. Area at risk (AAR was evaluated by ex vivo SPECT. Infarct size and microvascular obstruction were evaluated by ex vivo MRI. The observers were blinded to the treatment at randomization and analysis. Results ADC-1004 treatment reduced infarct size by 21% (ADC-1004: 58.3 ± 3.4 vs control: 74.1 ± 2.9%AAR, p = 0.007. Microvascular obstruction was similar between the groups (ADC-1004: 2.2 ± 1.2 vs control: 5.3 ± 2.5%AAR, p = 0.23. The mean plasma concentration of ADC-1004 was 83 ± 8 nM at sacrifice. There were no significant differences between the groups with respect to heart rate, mean arterial pressure, cardiac output and blood-gas data. Conclusions ADC-1004 treatment reduces myocardial ischemia-reperfusion injury and represents a novel treatment strategy of myocardial infarct with potential clinical applicability.

  3. Surgical treatment of chest instability

    International Nuclear Information System (INIS)

    Kitka, M.; Masek, M.

    2015-01-01

    Fractures of the ribs is the most common thoracic injury after blunt trauma. Chest wall instability (flail chest) is a common occurrence in the presence of multiple ribs fracture. Unilateral or bilateral fractures more ribs anteriorly or posteriorly will produce enough instability that paradoxical respiratory motion results in hypoventilation of an unacceptable degree. Open approach and surgical stabilisation of the chest preserved pulmonary function, improved pain control, minimized posttraumatic deformities and shorter back to work time. (author)

  4. Targeted Porcine Genome Engineering with TALENs

    DEFF Research Database (Denmark)

    Luo, Yonglun; Lin, Lin; Golas, Mariola Monika

    2015-01-01

    confers precisely editing (e.g., mutations or indels) or insertion of a functional transgenic cassette to user-designed loci. Techniques for targeted genome engineering are growing dramatically and include, e.g., zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs......, including construction of sequence-specific TALENs, delivery of TALENs into primary porcine fibroblasts, and detection of TALEN-mediated cleavage, is described. This chapter is useful for scientists who are inexperienced with TALEN engineering of porcine cells as well as of other large animals....

  5. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

    OpenAIRE

    Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

    2016-01-01

    Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective coho...

  6. Chest pain

    International Nuclear Information System (INIS)

    Martinez A, Juan Carlos; Saenz M, Oscar; Martinez M, Camilo; Gonzales A Francisco; Nicolas R, Jose; Vergara V, Erika P; Pereira G, Alberto M

    2010-01-01

    In emergency departments, chest pain is one of the leading motives of consultation. We thus consider it important to review aspects such as its classification, causes, and clinical profiles. Initial assessment should include a full clinical history comprising thorough anamnesis and physical examination. Adequate interpretation of auxiliary tests, ordered in accordance with suspected clinical conditions, should lead to accurate diagnosis. We highlight certain symptoms and clinical signs, ECG and X-ray findings, cardiac bio markers, arterial blood gases, and CT-scanning. Scores of severity and prognosis such as TIMI are assessed. Optimal treatment of the clinical conditions leading to chest pain depends on adequate initial approach and assessment.

  7. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A.

    2000-01-01

    In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

  8. Correlations between quality indexes of chest compression.

    Science.gov (United States)

    Zhang, Feng-Ling; Yan, Li; Huang, Su-Fang; Bai, Xiang-Jun

    2013-01-01

    Cardiopulmonary resuscitation (CPR) is a kind of emergency treatment for cardiopulmonary arrest, and chest compression is the most important and necessary part of CPR. The American Heart Association published the new Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2010 and demanded for better performance of chest compression practice, especially in compression depth and rate. The current study was to explore the relationship of quality indexes of chest compression and to identify the key points in chest compression training and practice. Totally 219 healthcare workers accepted chest compression training by using Laerdal ACLS advanced life support resuscitation model. The quality indexes of chest compression, including compression hands placement, compression rate, compression depth, and chest wall recoil as well as self-reported fatigue time were monitored by the Laerdal Computer Skills and Reporting System. The quality of chest compression was related to the gender of the compressor. The indexes in males, including self-reported fatigue time, the accuracy of compression depth and the compression rate, the accuracy of compression rate, were higher than those in females. However, the accuracy of chest recoil was higher in females than in males. The quality indexes of chest compression were correlated with each other. The self-reported fatigue time was related to all the indexes except the compression rate. It is necessary to offer CPR training courses regularly. In clinical practice, it might be better to change the practitioner before fatigue, especially for females or weak practitioners. In training projects, more attention should be paid to the control of compression rate, in order to delay the fatigue, guarantee enough compression depth and improve the quality of chest compression.

  9. Porcine aminopeptidase N mediated polarized infection by porcine epidemic diarrhea virus in target cells

    Energy Technology Data Exchange (ETDEWEB)

    Cong, Yingying; Li, Xiaoxue; Bai, Yunyun [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); Lv, Xiaonan [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); CAS Key Lab for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience & Technology of China, Beijing 100090 (China); Herrler, Georg [Institute for Virology, University of Veterinary Medicine, Hannover D-30559 (Germany); Enjuanes, Luis [Department of Molecular and Cell Biology, Centro Nacional de Biotecnología (CNB-CSIC), Campus Universidad Autónoma de Madrid, Cantoblanco, Madrid (Spain); Zhou, Xingdong [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China); Qu, Bo [Faculty of Life Sciences, Northeast Agricultural University, Harbin 150030 (China); Meng, Fandan [Institute for Virology, University of Veterinary Medicine, Hannover D-30559 (Germany); Cong, Chengcheng [College Animal Husbandry and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110161 (China); Ren, Xiaofeng; Li, Guangxing [College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030 (China)

    2015-04-15

    Infection of polarized intestinal epithelial cells by porcine epidemic diarrhea virus (PEDV) was characterized. Indirect immunofluorescence assay, real-time PCR, and transmission electron microscopy confirmed PEDV can be successfully propagated in immortalized swine small intestine epithelial cells (IECs). Infection involved porcine aminpeptidase N (pAPN), a reported cellular receptor for PEDV, transient expression of pAPN and siRNA targeted pAPN increased and decreased the infectivity of PEDV in IECs, respectively. Subsequently, polarized entry into and release from both Vero E6 and IECs was analyzed. PEDV entry into polarized cells and pAPN grown on membrane inserts occurs via apical membrane. The progeny virus released into the medium was also quantified which demonstrated that PEDV is preferentially released from the apical membrane. Collectively, our data demonstrate that pAPN, the cellular receptor for PEDV, mediates polarized PEDV infection. These results imply the possibility that PEDV infection may proceed by lateral spread of virus in intestinal epithelial cells. - Highlights: • PEDV infection of polarized intestinal epithelial cells (IECs) was characterized. • Porcine aminpeptidase N (pAPN) facilitated PEDV infection in IECs. • PEDV entry into and release from polarized cell via its apical membrane. • PEDV infection may proceed by lateral spread of virus in IECs.

  10. Porcine aminopeptidase N mediated polarized infection by porcine epidemic diarrhea virus in target cells

    International Nuclear Information System (INIS)

    Cong, Yingying; Li, Xiaoxue; Bai, Yunyun; Lv, Xiaonan; Herrler, Georg; Enjuanes, Luis; Zhou, Xingdong; Qu, Bo; Meng, Fandan; Cong, Chengcheng; Ren, Xiaofeng; Li, Guangxing

    2015-01-01

    Infection of polarized intestinal epithelial cells by porcine epidemic diarrhea virus (PEDV) was characterized. Indirect immunofluorescence assay, real-time PCR, and transmission electron microscopy confirmed PEDV can be successfully propagated in immortalized swine small intestine epithelial cells (IECs). Infection involved porcine aminpeptidase N (pAPN), a reported cellular receptor for PEDV, transient expression of pAPN and siRNA targeted pAPN increased and decreased the infectivity of PEDV in IECs, respectively. Subsequently, polarized entry into and release from both Vero E6 and IECs was analyzed. PEDV entry into polarized cells and pAPN grown on membrane inserts occurs via apical membrane. The progeny virus released into the medium was also quantified which demonstrated that PEDV is preferentially released from the apical membrane. Collectively, our data demonstrate that pAPN, the cellular receptor for PEDV, mediates polarized PEDV infection. These results imply the possibility that PEDV infection may proceed by lateral spread of virus in intestinal epithelial cells. - Highlights: • PEDV infection of polarized intestinal epithelial cells (IECs) was characterized. • Porcine aminpeptidase N (pAPN) facilitated PEDV infection in IECs. • PEDV entry into and release from polarized cell via its apical membrane. • PEDV infection may proceed by lateral spread of virus in IECs

  11. Comparison of commercial and experimental porcine circovirus type 2 (PCV2) vaccines using a triple challenge with PCV2, porcine reproductive and respiratory syndrome virus (PRRSV), and porcine parvovirus (PPV).

    Science.gov (United States)

    Shen, H G; Beach, N M; Huang, Y W; Halbur, P G; Meng, X J; Opriessnig, T

    2010-08-23

    The efficacies of commercial porcine circovirus type 2 (PCV2) vaccines and a live PCV1-2a chimeric vaccine were compared in conventional, PCV2-positive piglets using a PCV2-porcine reproductive and respiratory syndrome virus (PRRSV)-porcine parvovirus (PPV) coinfection challenge model. Seventy-three, 2-week-old pigs were randomized into seven groups including five vaccinated and two control groups. Pigs in the vaccinated groups were vaccinated at 3 weeks (one dose) or at 3 and 6 weeks (two dose) of age. All vaccine regimens tested were effective in reducing naturally occurring PCV2 viremia at 16 weeks of age and after PCV2 challenge, demonstrating the capability of the products to induce a lasting protective immunity despite the presence of PCV2 viremia at the time of vaccination. Copyright 2010 Elsevier Ltd. All rights reserved.

  12. The forgotten view: Chest X-ray - Lateral view

    Directory of Open Access Journals (Sweden)

    Abraham M. Ittyachen

    2017-01-01

    Full Text Available With CT (computed tomography chest gaining more importance as a diagnostic tool, chest X-ray especially the lateral view is taken less commonly nowadays. Besides CT chest is also proven to be superior to chest X-ray in patients with major blunt trauma. We are presenting a 68-year old male who was partially treated from outside for a left sided pneumonia. He came to our hospital because of persisting chest pain. Chest X-ray, frontal view (postero-anterior was almost normal except for a mild opacity in the left lower zone. CT scan of the chest revealed a fluid collection posteriorly enclosed within enhancing pleura. Chest X-ray, left lateral view showed a corresponding posterior pleural based opacity. We are presenting this case to highlight the importance of the lateral view of the chest X-ray. In selected cases there is still a role for the lateral view. With the three dimensional visualization provided by the CT, the lateral view of the chest may be easier to understand. Consequent to the initial diagnosis by CT further follow up can be done with the chest X-ray. In a limited way this mitigates unnecessary expenditure and more importantly prevents the patient from exposure to harmful radiation in the form of repeated CT.

  13. Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report

    OpenAIRE

    Idris, Baig M.; Hefny, Ashraf F.

    2016-01-01

    Introduction: Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. Presentation of case: A 63- year- old man presented...

  14. Circovirose suína Porcine circovirosis: a review

    Directory of Open Access Journals (Sweden)

    Ticiana do Nascimento França

    2005-06-01

    Full Text Available Por meio de revisão da literatura pertinente foram coligidos e são apresentados os principais dados relativos aos aspectos epidemiológicos, clínicos, anátomo e histopatológicos observados na infecção por Circovírus Porcino tipo 2 (PCV-2 em suínos. São abordados a Síndrome Definhante Multissistêmica dos Suínos Desmamados (SDMDS, o Tremor Congênito Suíno (TCS, a Síndrome da Nefropatia e Dermatite Porcina (SNDP, bem como outras enfermidades associadas ou correlatas, a Síndrome Respiratória e Reprodutiva Porcina (SRRP, a Pneumonia Necrotizante Proliferativa (PNP e as falhas reprodutivas. Uma vez que a SDMSD já foi registrada na Região Sul do Brasil e no Estado do Rio de Janeiro esse estudo objetiva chamar a atenção para o especial significado dessa virose para a suinocultura brasileira, em função dos prejuízos econômicos por ela determinados.The literature of Porcine Circovirosis, including the main data on epidemiology and clinical, macroscopic and microscopic alterations of the infection of swine by Porcine Circovirus type 2 (PCV-2, is reviewed. There are various forms of infection: the [Porcine] Postweaning Multisystemic Wasting Syndrome (PMWS, Porcine Congenital Tremor, Porcine Dermatitis and Nephropathy Syndrome, and other associated or correlated diseases as the Porcine Reproductive and Respiratory Syndrome, Proliferative Necrotizing Pneumonia, and reproductive disorders. As PMWS already has been reported from southern Brazil and from the state of Rio de Janeiro, the objective of this review is to draw attention to the implications of this virosis for swine production in Brazil and its economical importance.

  15. Dynamic CT myocardial perfusion imaging: detection of ischemia in a porcine model with FFR verification

    Science.gov (United States)

    Fahmi, Rachid; Eck, Brendan L.; Vembar, Mani; Bezerra, Hiram G.; Wilson, David L.

    2014-03-01

    Dynamic cardiac CT perfusion (CTP) is a high resolution, non-invasive technique for assessing myocardial blood ow (MBF), which in concert with coronary CT angiography enable CT to provide a unique, comprehensive, fast analysis of both coronary anatomy and functional ow. We assessed perfusion in a porcine model with and without coronary occlusion. To induce occlusion, each animal underwent left anterior descending (LAD) stent implantation and angioplasty balloon insertion. Normal ow condition was obtained with balloon completely de ated. Partial occlusion was induced by balloon in ation against the stent with FFR used to assess the extent of occlusion. Prospective ECG-triggered partial scan images were acquired at end systole (45% R-R) using a multi-detector CT (MDCT) scanner. Images were reconstructed using FBP and a hybrid iterative reconstruction (iDose4, Philips Healthcare). Processing included: beam hardening (BH) correction, registration of image volumes using 3D cubic B-spline normalized mutual-information, and spatio-temporal bilateral ltering to reduce partial scan artifacts and noise variation. Absolute blood ow was calculated with a deconvolutionbased approach using singular value decomposition (SVD). Arterial input function was estimated from the left ventricle (LV) cavity. Regions of interest (ROIs) were identi ed in healthy and ischemic myocardium and compared in normal and occluded conditions. Under-perfusion was detected in the correct LAD territory and ow reduction agreed well with FFR measurements. Flow was reduced, on average, in LAD territories by 54%.

  16. Noncardiac chest pain: diagnosis and management.

    Science.gov (United States)

    Yamasaki, Takahisa; Fass, Ronnie

    2017-07-01

    Noncardiac chest pain (NCCP) has been defined as recurrent chest pain that is indistinguishable from ischemic heart pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional chest pain. The purpose of this review is to discuss the current diagnosis and treatment of NCCP. Utilization of new diagnostic techniques such as pH-impedance and high-resolution esophageal manometry, and the introduction of a new definition for functional chest pain have helped to better diagnose the underlying mechanisms of NCCP. A better therapeutic approach toward GERD-related NCCP, the introduction of new interventions for symptoms due to esophageal spastic motor disorders and the expansion of the neuromodulator armamentarium for functional chest pain have changed the treatment landscape of NCCP. GERD is the most common esophageal cause of NCCP, followed by functional chest pain and esophageal dysmotility. The proton pump inhibitor test, upper endoscopy, wireless pH capsule and pH-impedance are used to identify GERD-induced NCCP. High-resolution esophageal manometry is the main tool to identify esophageal motor disorder in non-GERD-related NCCP. Negative diagnostic assessment suggests functional chest pain. Potent antireflux treatment is offered to patients with GERD-related NCCP; medical, endoscopic or surgical interventions are considered in esophageal dysmotility; and neuromodulators are prescribed for functional chest pain. Assessment and treatment of psychological comorbidity should be considered in all NCCP patients.

  17. Coronary artery dissection following chest trauma

    Directory of Open Access Journals (Sweden)

    Manoj K Agarwala

    2016-01-01

    Full Text Available Chest trauma has a high rate of mortality. Coronary dissection causing myocardial infarction (MI following blunt chest trauma is rare. We describe the case of an anterior MI following blunt chest trauma. A 39-year-old male was received in our hospital following a motorcycle accident. The patient was asymptomatic before the accident. The patient underwent craniotomy for evacuation of hematoma. He developed severe chest pain and an electrocardiogram (ECG revealed anterior ST segment elevation following surgery. Acute coronary event was medically managed; subsequently, coronary angiogram was performed that showed dissection in the left anterior coronary artery, which was stented.

  18. Acute testicular ischemia caused by incarcerated inguinal hernia.

    Science.gov (United States)

    Orth, Robert C; Towbin, Alexander J

    2012-02-01

    Acute testicular ischemia caused by an incarcerated inguinal hernia usually affects infants. There are few reports of diagnosis using US, and the effect of long-standing reducible hernias on testicular growth in infants and children is unknown. The objectives of this study were to determine the incidence of testicular ischemia secondary to an incarcerated inguinal hernia at scrotal sonography and to determine the effect on testicular size at diagnosis. A hospital database was used to locate scrotal sonography examinations documenting an inguinal hernia, and images were reviewed for signs of testicular ischemia. Testicular volumes were compared using the Wilcoxon signed rank test. A total of 147 patients were identified with an inguinal hernia (age 1 day to 23 years, average 6 years). Ten patients (6.8%) had associated testicular ischemia (age 3 weeks to 6 months, average 9 weeks) and showed a statistically significant increase in ipsilateral testicular size compared to the contralateral testicle (P = 0.012). Patients without testicular ischemia did not show a significant difference in testicular size, regardless of patient age. An incarcerated inguinal hernia should be considered as a cause of acute testicular ischemia in infants younger than 6 months of age.

  19. Early appearance of SARS on chest CT scan

    International Nuclear Information System (INIS)

    Cheng Xiaoguang; Feng Suchen; Xia Guoguang; Zhao Tao; Gu Xiang; Qu Hui

    2003-01-01

    Objective: To evaluate the early appearance of SARS on chest CT scan and its role in the early diagnosis. Methods: Forty cases of SARS in keeping with the criteria of the Ministry of Health had chest CT scans within 7 days of onset of symptoms, and CR chest X-ray films were available as well. These chest X-rays and CT images were retrospectively reviewed to determine if there were any abnormalities on the images. The lesions on the chest CT images were then further analyzed in terms of the number, location, size, and density. Results: Positive abnormalities on chest CT scans were revealed in all 40 SARS cases. Positive findings on CR chest films were showed in only 25 cases, equivocal in 6, and normal in 9 cases. The main abnormalities seen on CT and X-rays were pulmonary infiltrations varied markedly in severity. 70 % cases had 1 or 2 lesions on chest CT scan, 30 % cases had 3 or more lesions. The lesions seen on chest CT scan tended to be ground-glass opacification, sometimes with consolidation which was very faint and inhomogeneous, easily missed on chest X-rays. Typically the lesions were located in the periphery of the lung, or both central and peripheral lung, but very rare in a pure central location. They were commonly in the shape of patch or ball. Conclusions: Chest CT scan is much more sensitive in detecting the lesions of the lung in SARS. The early appearance of SARS on chest CT scan is characteristic but non-specific, indicating that chest CT scan plays a very important role in the early diagnosis and differential diagnosis of SARS

  20. The kinetics of interaction of porcine - alpha-, and porcine - beta -trypsin with intact and modified soybean trypsin inhibitor (kunitz)

    International Nuclear Information System (INIS)

    Hamid, M.A.

    1994-01-01

    The association of porcine trypsin with soybean trypsin inhibitor (Kunitz) resulted in characteristic changes in absorption spectrum, indicating an alteration of the micro environments of the enzyme chromophores as a consequence of the interaction. The rates of formation of the stable trypsin - inhibitor complexes from porcine - alpha - trypsin and soybean trypsin inhibitor and from porcine - beta - trypsin and either intact or modified soybean trypsin inhibitor were measured by mixing the equimolar concentration of the reactants in a Stopped - Flow apparatus at pH (4.5 to 10.0). The reaction of trypsin with soybean trypsin inhibitor was of first order with respect to the concentration of the reactants used. The rates of dissociation of the stable complexes, alpha - trypsin - soybean trypsin inhibitor, beta -trypsin - soybean trypsin inhibitor and beta -trypsin modified soybean trypsin inhibitor were also measured at pH (1.92 to 3.58). The values of first order rate constant, k/sub D/ obtained for the dissociation of all the three complexes were identical with one another. The kinetics results obtained for the porcine trypsin were compared with those of bovine trypsin system and it was suggested that the reaction mechanisms in both these systems were identical. (author)

  1. Improving screen-film chest radiography

    International Nuclear Information System (INIS)

    Shaikh, N.; Baker, R.A.

    1996-01-01

    Traditionally symmetric screens and double emulsion symmetric films with medium to wide latitutde are used for radiography of the chest. Beacuse of mismatch of transmitted exposure through the chest with limited latitude of the film, most of the dense areas of the chest are underexposed. Kodak's recent innovation of a unique asymmetry screen-film system (InSight) alleviates this problem. Our phantom measurement indicates that the InSight system offers wider recording range, and the flexible grid permits more positional latitude than conventional grids. Our five-year extensive clinical experience indicates that dense anatomic structures, such as mediastinum, retrocardiac and subdiaphragmatic, are more visible in the InSight system than in the conventional symmetric system. Similarly, a substantial improvement in image quality in portable chest imaging is realized by use of flexible grids because of scatter rejection and invisible grid lines. (author)

  2. Interpretation of neonatal chest radiography

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung

    2016-01-01

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice

  3. Interpretation of neonatal chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-05-15

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

  4. Regionally adaptive histogram equalization of the chest

    International Nuclear Information System (INIS)

    Sherrier, R.H.; Johnson, G.A.

    1986-01-01

    Advances in digital chest radiography have resulted in the acquisition of high-quality digital images of the human chest. With these advances, there arises a genuine need for image processing algorithms, specific to chest images. The author has implemented the technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with a regionally adaptive histogram equalization method. Histograms are calculated locally and then modified according to both the mean pixel value of a given region and certain characteristics of the cumulative distribution function. The method allows certain regions of the chest radiograph to be enhanced differentially

  5. Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial.

    Science.gov (United States)

    Haubruck, Patrick; Nickel, Felix; Ober, Julian; Walker, Tilman; Bergdolt, Christian; Friedrich, Mirco; Müller-Stich, Beat Peter; Forchheim, Franziska; Fischer, Christian; Schmidmaier, Gerhard; Tanner, Michael C

    2018-05-21

    The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce. The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS). In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module "Thoracocentesis" discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants' performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here, trainees gave information about their

  6. Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

    Science.gov (United States)

    Ober, Julian; Walker, Tilman; Bergdolt, Christian; Friedrich, Mirco; Müller-Stich, Beat Peter; Forchheim, Franziska; Fischer, Christian; Schmidmaier, Gerhard; Tanner, Michael C

    2018-01-01

    Background The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce. Objective The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS). Methods In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module “Thoracocentesis” discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants’ performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here

  7. Radiology in chest trauma

    International Nuclear Information System (INIS)

    Wenz, W.; Kloehn, I.; Wolfart, W.; Freiburg Univ.

    1979-01-01

    In chest trauma, a routine chest film, preferably in the lateral as well as the frontal projection, is the basic part of the work-up. Occasionally valuable additional methods are fluoroscopy, tomography, bronchography, contrast studies of the GI Tract and angiography and angiocardiography. In 679 chest trauma patients, traffic accidents and falls were the main reason for the trauma. There were 248 fractures; then - in order of frequency - hemopneumothorax (76), lung contusion (58), subcutaneous emphysema (33) cardiac (16) and vascular trauma (12) and damage to other organs. While 20-30% mistakes are made in diagnosing rib fractures in acute trauma, there is high accuracy in the diagnosis of the other injuries. Many cases are shown to demonstrate the value of diagnostic radiology. (orig.) [de

  8. The impact of chest compression rates on quality of chest compressions - a manikin study.

    Science.gov (United States)

    Field, Richard A; Soar, Jasmeet; Davies, Robin P; Akhtar, Naheed; Perkins, Gavin D

    2012-03-01

    Chest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables. Twenty healthcare professionals performed 2 min of continuous compressions on an instrumented manikin at rates of 80, 100, 120, 140 and 160 min(-1) in a random order. An electronic metronome was used to guide compression rate. Compression data were analysed by repeated measures ANOVA and are presented as mean (SD). Non-parametric data was analysed by Friedman test. At faster compression rates there were significant improvements in the number of compressions delivered (160(2) at 80 min(-1) vs. 312(13) compressions at 160 min(-1), P<0.001); and compression duty-cycle (43(6)% at 80 min(-1) vs. 50(7)% at 160 min(-1), P<0.001). This was at the cost of a significant reduction in compression depth (39.5(10)mm at 80 min(-1) vs. 34.5(11)mm at 160 min(-1), P<0.001); and earlier decay in compression quality (median decay point 120 s at 80 min(-1) vs. 40s at 160 min(-1), P<0.001). Additionally not all participants achieved the target rate (100% at 80 min(-1) vs. 70% at 160 min(-1)). Rates above 120 min(-1) had the greatest impact on reducing chest compression quality. For Guidelines 2005 trained rescuers, a chest compression rate of 100-120 min(-1) for 2 min is feasible whilst maintaining adequate chest compression quality in terms of depth, duty-cycle, leaning, and decay in compression performance. Further studies are needed to assess the impact of the Guidelines 2010 recommendation for deeper and faster chest compressions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Bacteriospermia in extended porcine semen.

    Science.gov (United States)

    Althouse, Gary C; Lu, Kristina G

    2005-01-15

    Bacteriospermia is a frequent finding in freshly extended porcine semen and can result in detrimental effects on semen quality and longevity if left uncontrolled. The primary source of bacterial contamination is the boar. Other sources that have been identified include environment, personnel, and the water used for extender preparation. A 1-year retrospective study was performed on submissions of extended porcine semen for routine quality control bacteriological screening at the University of Pennsylvania. Out of 250 sample submissions, 78 (31.2%) tested positive for bacterial contamination. The most popular contaminants included Enterococcus spp. (20.5%), Stenotrophomonas maltophilia (15.4%), Alcaligenes xylosoxidans (10.3%), Serratia marcescens (10.3%), Acinetobacter lwoffi (7.7%), Escherichia coli (6.4%), Pseudomonas spp. (6.4%), and others (23.0%). Prudent individual hygiene, good overall sanitation, and regular monitoring can contribute greatly in controlling bacterial load. Strategies that incorporate temperature-dependent bacterial growth and hyperthermic augmentation of antimicrobial activity are valuable for effective control of susceptible bacterial loads. Aminoglycosides remain the most popular antimicrobial class used in porcine semen extenders, with beta-lactam and lincosamide use increasing. With the advent of more novel antimicrobial selection and semen extender compositions in swine, prudent application and understanding of in vitro pharmacodynamics are becoming paramount to industry success in the use of this breeding modality.

  10. Use of chest sonography in acute-care radiology☆

    Science.gov (United States)

    De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

    2008-01-01

    Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

  11. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung [Samsung Medical Center, Seoul (Korea, Republic of); Chung, Seung Eun [Sangkye Paek Hospital, Seoul (Korea, Republic of)

    1996-12-15

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  12. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    International Nuclear Information System (INIS)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung; Chung, Seung Eun

    1996-01-01

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  13. Normobaric Oxygen Therapy for Scleral Ischemia or Melt

    Directory of Open Access Journals (Sweden)

    Farideh Sharifipour

    2012-01-01

    Full Text Available Purpose: To investigate the efficacy of normobaric oxygen (NBO therapy for treatment of scleral ischemia or melt. Methods: This prospective interventional case series includes 9 eyes of 8 patients with scleral ischemia or melt of diverse etiologies. Following the failure of conventional medical and/or surgical therapy to improve ischemia or upon clinical deterioration, NBO was initiated. All patients received 100% NBO at flow rate of 10 liters/minute by face mask for 1 hour, twice daily until complete vascularization of ischemic areas. Main outcome measures were improvement of scleral ischemia and healing of conjunctival epithelial defects. Results: NBO therapy led to epithelialization and vascularization of the ischemic sclera in all eyes; the repair process began 3-4 days after NBO had been initiated and was completed in 18.1±4.7 (range, 10-25 days. All patients remained stable over a 9-month follow-up period. Conclusion: NBO therapy seems effective for treatment of scleral ischemia or melt, and hence can be considered as a non-invasive alternative to surgical intervention in these conditions.

  14. Acute mesenteric ischemia: a vascular emergency.

    Science.gov (United States)

    Klar, Ernst; Rahmanian, Parwis B; Bücker, Arno; Hauenstein, Karlheinz; Jauch, Karl-Walter; Luther, Bernd

    2012-04-01

    Acute mesenteric ischemia is still fatal in 50% to 70% of cases. This consensus paper was written with the participation of physicians from all of the involved specialties for the purpose of improving outcomes. Mesenteric ischemia must be recognized as a vascular emergency requiring rapid and efficient clinical evaluation and treatment. We reviewed pertinent literature that was retrieved by a PubMed search on the terms "mesenteric ischemia" AND "arterial" OR "venous" OR "clinical presentation" OR "diagnosis" OR "therapy" OR "surgery" OR " interventional radiology." Our review also took account of the existing guidelines of the American College of Cardiology/American Heart Association. Intensive discussions among the participating physicians, representing all of the specialties involved in the management of mesenteric ischemia, led to the creation of this interdisciplinary paper. Biphasic contrast-enhanced computerized tomography is the diagnostic tool of choice for the detection of arterial or venous occlusion. If non-occlusive mesenteric ischemia is suspected, angiography should be performed, with the option of intraarterial pharmacotherapy to induce local vasodilation. Endovascular techniques have become increasingly important in the treatment of arterial occlusion. Embolic central mesenteric artery occlusion requires surgical treatment; surgery is also needed in case of peritonitis. Portal-vein thrombosis can be treated by local thrombolysis through a transhepatically placed catheter. This should be done within 3 to 4 weeks of the event to prevent later complications of portal hypertension. Rapid diagnosis (within 4 to 6 hours of symptom onset) and interdisciplinary cooperation in the provision of treatment are required if the poor outcome of this condition is to be improved.

  15. Ischemia modified albumin as laboratory marker of acute

    Directory of Open Access Journals (Sweden)

    Goran Miličević

    2009-02-01

    Full Text Available Daily clinical practice still lacks a marker of acute myocardial ischemia as compared with markers ofmyocardial necrosis. Ischemia modifed albumin (IMA has recently been proposed as a useful biochemicaltool for detection of ischemia – it is a test which determines the inability of N-terminal end ofalbumin to bind cobalt during ischemia. A strong relation between IMA and early myocardial ischemiahas been shown by several studies, in most of which percutaneous coronary intervention was used asa model of myocardial ischemia, where this test showed high sensitivity. IMA values raise during nextfew minutes after the ischemia has occured, and return back to normal levels within next six hours, butthe precise dynamics of its rise and fall are still unknown. Beside defining etiology of acute or sub-acutechest pain in patients with inconclusive electrocardiogram (ECG, in patients with “silent” myocardialischemia with ischemic changes in ECG or in patients with non-ischemic ECG changes during cardiacstress test, this promising marker could also be used as the earliest biochemical indicator of early developmentof myocardial infarction. Relatively low organ-specificity is a limitation of this test, becauseIMA levels are also raised during different ischemic conditions and diseases of other organs. If thisproblem is taken into consideration, IMA test shows good results in diagnosing myocardial ischemiadue to its high sensitivity.

  16. Porcine UCHL1: genomic organization, chromosome localization and expression analysis

    DEFF Research Database (Denmark)

    Larsen, Knud; Madsen, Lone Bruhn; Bendixen, Christian

    2012-01-01

    to and protection from Parkinson’s disease. Here we report cloning, characterization, expression analysis and mapping of porcine UCHL1. The UCHL1 cDNA was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) using oligonucleotide primers derived from in silico sequences. The porcine cDNA codes...... in developing porcine embryos. UCHL1 transcript was detected as early as 40 days of gestation. A significant decrease in UCHL1 transcript was detected in basal ganglia from day 60 to day 115 of gestation...

  17. Acute bowel ischemia: CT findings

    International Nuclear Information System (INIS)

    Angelelli, Giuseppe; Scardapane, Arnaldo; Memeo, Maurizio; Stabile Ianora, Amato Antonio; Rotondo, Antonio

    2004-01-01

    Acute bowel ischemia represents one of the most dramatic abdominal emergencies and, despite the fact it is more and more frequently observed in clinical practice, its mortality rate remains very high. In recent years Computed Tomography (CT) has proved to be a valid diagnostic tool in the evaluation of patients with acute abdominal syndrome and in the visualization of early signs of bowel ischemia. This paper reviews the aetiological and pathophysiological aspects as well as a broad spectrum of CT findings of this clinical condition

  18. Chest tube insertion - series (image)

    Science.gov (United States)

    Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed in the pleural space. The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest ...

  19. Investigation of the dosimetry of chest tomosynthesis

    Science.gov (United States)

    Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

    2009-02-01

    Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

  20. Current technology in assessing painless and painful ischemia

    International Nuclear Information System (INIS)

    Selwyn, A.P.

    1990-01-01

    Recent technologic advances have yielded diverse techniques for studying myocardial ischemia, a useful functional expression of coronary artery disease. These techniques have revealed new characteristics and expanded our understanding of myocardial ischemia. In turn this has led to the establishment of more realistic and discriminating criteria on which to base diagnostic and management decisions. Many of the techniques are noninvasive and can be performed in the cardiologist's office. These include treadmill exercise testing; radioisotope techniques, including ejection fraction studies, stress thallium scintigraphy, and tomographic imaging; and ambulatory monitoring. Other, newer techniques include provocative tests that induce ischemia in patients who cannot exercise. These new noninvasive tests should be used to detect transient ischemia, estimate its severity, and thus record a measure of the patient's risk for adverse coronary events

  1. Computed tomography of chest wall abscess

    International Nuclear Information System (INIS)

    Ikezoe, Junpei; Morimoto, Shizuo; Akira, Masanori

    1986-01-01

    Inflammatory lesions of the chest wall become less common because of the improvement of antibiotics and chemotherapeutic agents. Over a 5-year period, 7 patients with chest wall inflammatory diseases underwent chest computed tomography. These were 2 tuberculous pericostal abscesses, 2 empyema necessitatis, 1 spinal caries, and 2 bacterial chest wall abscesses (unknown organisms). Computed tomography (CT) helped in demonstrating the density, border, site, and extent of the lesions. CT images also demonstrated the accompaning abnormalities which included bone changes, pleural calcification, or old tuberculous changes of the lung. CT was very effective to demonstrate the communicating portions from the inside of the bony thorax to the outside of the bony thorax in 2 empyema necessitatis. (author)

  2. New stepwise cooling system for short-term porcine islet preservation.

    Science.gov (United States)

    Ikemoto, Tetsuya; Noguchi, Hirofumi; Fujita, Yasutaka; Takita, Morihito; Shimoda, Masayuki; Sugimoto, Koji; Jackson, Andrew; Naziruddin, Bashoo; Shimada, Mitsuo; Levy, Marlon F; Matsumoto, Shinichi

    2010-10-01

    Porcine islets are the most suitable for xeno-islet transplantation. However, it is necessary to establish an effective preservation method against its fragility. Recently, we developed a new cooling and preservation (Keep and Fresh [KFC]; FUJIYA Co, Tokushima, Japan) system, which can maintain viability of hepatocyte. In this study, we examined the KFC for porcine islet preservation. Isolated porcine islets were preserved in CMRL 1066 culture media with bovine serum at 37°C, 22°C, and 4°C and KFC for 24, 48, and 72 hours. Islet recovery rate, purity, and viability were evaluated. After 24-hour preservation, the recovery rate was the highest in the KFC, but no significant difference was found. After 48-hour preservation, the recovery rate by the KFC was 73.9% ± 17.3%, which was significantly higher than the other groups (48.7% ± 28.6% at 37°C, P KFC group, purities and viabilities were the highest among the groups after 24-, 48-, and 72-hour preservation. The KFC system significantly improved porcine islet preservation; therefore, the KFC might be useful for porcine islet preservation.

  3. 46 CFR 196.37-47 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE — KEEP...

  4. EFFICACY OF METOPROLOL AND DILTIAZEM IN TREATING SILENT-MYOCARDIAL-ISCHEMIA

    NARCIS (Netherlands)

    PORTEGIES, MCM; SIJBRING, P; GOBEL, JAM; VIERSMA, JW; LIE, KI

    1994-01-01

    Recent studies strongly support the prognostic importance of transient silent ischemia. Because patients with silent ischemia are at higher risk of a cardiac event, they are likely to benefit not only from control of symptoms, but also from treatment directed at prevention of ischemia. The efficacy

  5. Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Renzo Guarnieri

    2017-03-01

    Full Text Available Objectives: The aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing. Material and Methods: Thirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement. Results: The vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm were found significantly lower (P < 0.001, when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm. In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material. Conclusions: At the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.

  6. The single chest tube versus double chest tube application after pulmonary lobectomy: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Xuefei Zhang

    2016-01-01

    Conclusion: Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.

  7. Gastric injury induced by hemorrhage, local ischemia, and oxygen radical generation

    International Nuclear Information System (INIS)

    Wadhwa, S.S.; Perry, M.A.

    1987-01-01

    Gastric mucosal injury caused by local intra-arterial generation of oxygen-derived free radicals was compared with gastric injury caused by 30 min of hemorrhage-induced ischemia or local ischemia. The index of injury was the loss of 51 Cr-labeled red cells across the gastric mucosa. Generation of oxygen radicals in the celiac artery caused a rapid increase in mucosal blood loss during the period of radical generation, and this loss was maintained after radical production ceased. Local ischemia produced similar mucosal injury; however, this occurred after reperfusion of the stomach and not during the ischemic episode. Hemorrhage-induced ischemia produced a threefold greater mucosal blood loss than local ischemia. The results of this study indicate that (1) oxygen radicals generated enzymatically in the blood supply to the stomach cause mucosal bleeding of similar magnitude to that observed after local ischemia and (2) that gastric ischemia induced by systemic hypotension produces more severe gastric injury than the same level of local hypotension

  8. Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

    Science.gov (United States)

    Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

    2014-11-01

    To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

  9. The Neuroprotective Effect of Kefir on Spinal Cord Ischemia/Reperfusion Injury in Rats

    Science.gov (United States)

    Akman, Tarik; Yener, Ali Umit; Sehitoglu, Muserref Hilal; Yuksel, Yasemin; Cosar, Murat

    2015-01-01

    Objective The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. Methods Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. Results The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (pkefir group were significantly higher than ischemia group (pkefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (pkefir group compared with ischemia group (pkefir group were significantly higher than ischemia group at 24 h (pkefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future. PMID:26113960

  10. The Neuroprotective Effect of Kefir on Spinal Cord Ischemia/Reperfusion Injury in Rats.

    Science.gov (United States)

    Guven, Mustafa; Akman, Tarik; Yener, Ali Umit; Sehitoglu, Muserref Hilal; Yuksel, Yasemin; Cosar, Murat

    2015-05-01

    The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (pkefir group were significantly higher than ischemia group (pkefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (pkefir group compared with ischemia group (pkefir group were significantly higher than ischemia group at 24 h (pkefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future.

  11. Porcine embryonic stem cells

    DEFF Research Database (Denmark)

    Hall, Vanessa Jane

    2008-01-01

    The development of porcine embryonic stem cell lines (pESC) has received renewed interest given the advances being made in the production of immunocompatible transgenic pigs. However, difficulties are evident in the production of pESCs in-vitro. This may largely be attributable to differences...

  12. 46 CFR 108.651 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 108.651 Section 108.651... AND EQUIPMENT Equipment Markings and Instructions § 108.651 Portable magazine chests. Each portable magazine chest must be marked: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND FIRE AWAY” in letters at...

  13. Potential of ultrasound in the pediatric chest

    Energy Technology Data Exchange (ETDEWEB)

    Trinavarat, Panruethai, E-mail: pantrinavarat@hotmail.com [Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330 (Thailand); Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at [Department of Radiology, Division of Pediatric Radiology, University Hospital Graz (Austria)

    2014-09-15

    Ultrasound (US) of chest, even with inherent limitations of the US beam and air, has been useful in many pediatric chest conditions. It has extended its role and is now widely used by many subspecialists in medicine. This review article will cover techniques, indications, and applications of chest US in neonates, infants and children, including also different common as well as some rare and modern aspects and applications, such as pleural effusion, pneumothorax, pulmonary lesions, mediastinum, diaphragm, and chest wall. Other related imaging modalities are also briefly discussed.

  14. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence......The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several...... arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice....

  15. CT of blunt chest trauma in children

    International Nuclear Information System (INIS)

    Manson, D.; Babyn, P.S.; Palder, S.; Bergmann, K.

    1993-01-01

    While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

  16. Ligustrazine monomer against cerebral ischemia-reperfusion injury

    Directory of Open Access Journals (Sweden)

    Hai-jun Gao

    2015-01-01

    Full Text Available Ligustrazine (2,3,5,6-tetramethylpyrazine is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mechanism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administration, and the most effective mode of administration for clinical treatment of cerebral ischemia/reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine administration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[(1,1-dimethylethyloxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC195 after cerebral ischemia were better than ligustrazine.

  17. Management of chest drainage tubes after lung surgery.

    Science.gov (United States)

    Satoh, Yukitoshi

    2016-06-01

    Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.

  18. Migraine and ischemia

    NARCIS (Netherlands)

    van der Wammes-van der Heijden, E.A.

    2009-01-01

    An association between migraine and ischemic events, especially ischemic stroke, has been debated for many years. Whether migraine is a risk factor for ischemic events or ischemia triggers migraine, or both, is still unclear. This thesis explores different relationships between migraine and

  19. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  20. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    Newman, Beverley; Gawande, Rakhee; Krane, Elliot J.; Holmes, Tyson H.; Robinson, Terry E.

    2014-01-01

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  1. Dynamic Contrast-Enhanced MR Imaging of Renal Ischemia-Reperfusion Injury

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Jun Hyun; Ahn, Myeong Im; Park, Young Ha; Chung, Soo Kyo [Catholic University, Seoul (Korea, Republic of)

    2010-02-15

    To evaluate the usefulness of magnetic resonance imaging (MRI) in a renal ischemia-reperfusion injury. Twenty-four rabbits were randomly divided into four groups, including a sham operated group (n=3). Renal ischemia was induced for 30 minutes (group 1), 60 minutes (group 2) and 120 minutes (group 3). MR imaging was performed before ischemia as well as one hour, 24 hours, and 72 hours after reperfusion. A 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy was performed before ischemia, as well as 24 hours and 72 hours after reperfusion. The signal-to-noise ratio (SNR) on the T2WI, time-relative signal intensity (%RSI) curve on dynamic enhanced images, and relative left renal uptake (%) on DMSA scan were obtained and compared to the histologic findings. The SNR of the cortex on the T2WI changed significantly over the course of the reperfusion time (p<0.001), but was not significantly different among the ischemia groups. The area under the time-%RSI curve gradually decreased from cortex to inner medulla before ischemia, which was reversed and gradually increased after reperfusion. The areas under the time-%RSI curve of outer and inner medulla were significantly different among the ischemia groups (p=0.04, p=0.008). The relative renal uptake (%) of left kidney decreased significantly over the reperfusion time (p=0.03), and was also significantly different among the ischemia groups (p=0.005). Tubular cell necrosis was observed in 16 rabbits (76.2%). The histologic grades of group 3 were higher than those of group 1 and group 2 (p=0.002). Even in rabbits without tubular cell necrosis, the areas under the time-%RSI curves of the cortex, outer, and inner medulla after a 72 hour reperfusion time were significantly lower than those before ischemia (p=0.007, p=0.005, p=0.004). The results of this study suggest that dynamic enhanced MR imaging could be a useful tool for the evaluation of renal ischemia and reperfusion injury.

  2. Acute chest pain: a purely clinical problem or a question for radiology; Der akute Thoraxschmerz, ein rein klinisches Problem oder radiologische Fragestellung

    Energy Technology Data Exchange (ETDEWEB)

    Loewe, C. [Medizinische Universitaet Wien, Klinische Abteilung fuer Kardiovaskulaere und Interventionelle Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2008-05-15

    Acute chest pain represents a very common clinical occurrence and at the same time poses a severe diagnostic dilemma. It can be due to an acute life-threatening event such as acute cardiac infarct, or a relatively harmless condition of pain and illness (e.g. vertebrogenic pain) under the main symptom category of acute chest pain. This often unclear symptomatic, behind which there can always be a life-threatening disease leads to an exaggerated grouping of patients into emergency cases and to an increased number of inpatients for observation. The diagnosis of acute coronary syndrome with no initial ECG changes typical for ischemia is especially problematic. The availability of modern multidetector computed tomography is becoming increasingly more important for radiologists in the diagnosis and clarification of acute chest pain. In this article the clinical difficulties and radiology options for the diagnosis of patients with acute chest pain will be presented and possible future algorithms for diagnosis will be discussed. (orig.) [German] Der akute Thoraxschmerz repraesentiert ein sehr haeufiges klinisches Beschwerdebild und gleichzeitig ein grosses diagnostisches Dilemma, koennen sich doch sowohl lebensbedrohliche akute Ereignisse (wie der akute Herzinfarkt) als auch mehr oder weniger harmlose Schmerzzustaende und Erkrankungen (wie vertebrogene Schmerzen) unter dem Leitsymptom 'akuter Thoraxschmerz' praesentieren. Diese oft nicht eindeutige Symptomatik, hinter der immer auch ein lebensbedrohliches Krankheitsbild stecken kann, fuehrt zu einer Uebertriagierung der Patienten in Notaufnahmen und zu einer grossen Anzahl an stationaeren 'Absicherungsaufnahmen'. Besonders die Diagnose eines akuten Koronarsyndroms (AKS) bei initial fehlenden ischaemietypischen EKG-Veraenderungen stellt eine spezielle Problematik dar. Durch die Verfuegbarkeit moderner ultraschneller Multidetektorcomputertomographen (MDCT) spielt der Radiologe in der Diagnostik und

  3. How to remove a chest drain.

    Science.gov (United States)

    Allibone, Elizabeth

    2015-10-07

    RATIONALE AND KEY POINTS: This article aims to help nurses to undertake the removal of a chest drain in a safe, effective and patient-centred manner. This procedure requires two practitioners. The chest drain will have been inserted aseptically to remove air, blood, fluid or pus from the pleural cavity. ▶ Chest drains may be small or wide bore depending on the underlying condition and clinical setting. They may be secured with a mattress suture and/or an anchor suture. ▶ Chest drains are usually removed under medical instructions when the patient's lung has inflated, the underlying condition has resolved, there is no evidence of respiratory compromise or failure, and their anticoagulation status has been assessed as satisfactory. ▶ Chest drains secured with a mattress suture should be removed by two practitioners. One practitioner is required to remove the tube and the other to tie the mattress suture (if present) and secure the site. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. How this article could be used to educate patients with chest drains. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

  4. Dual-source CT in chest pain diagnosis

    International Nuclear Information System (INIS)

    Johnson, Thorsten R.C.; Nikolaou, K.; Fink, C.; Rist, C.; Reiser, M.F.; Becker, C.R.; Becker, A.; Knez, A.

    2007-01-01

    With the depiction of pulmonary arteries, coronary arteries, and the aorta, CT angiography of the chest offers a comprehensive diagnostic work-up of unclear chest pain. The aim of this study was to assess the diagnostic accuracy of dual-source CT in this patient group. A total of 47 patients suffering from unclear chest pain were examined with a Siemens Somatom Definition. Volume and flow of contrast media (Ultravist, Schering) were adapted to the body weight. The examinations were evaluated with regard to image quality and contrast opacification and to the diagnostic accuracy with reference to the final clinical diagnosis. Adequate contrast opacification was achieved in all examinations. The depiction of the coronary arteries was diagnostic in all cases. The cause of chest pain could be identified in 41 cases. Among the diagnoses were coronary and myocardial pathologies, valvular disease, aortic aneurysms and dissections, pulmonary embolism, and pneumonic consolidation. DSCT angiography of the chest offers a very good image quality even at high heart rates so that a high diagnostic accuracy is achieved in patients with acute chest pain. (orig.) [de

  5. Zinc translocation accelerates infarction after mild transient focal ischemia.

    Science.gov (United States)

    Lee, J-M; Zipfel, G J; Park, K H; He, Y Y; Hsu, C Y; Choi, D W

    2002-01-01

    Excess release of chelatable zinc (Zn(2+)) from central synaptic vesicles may contribute to the pathogenesis of selective neuronal cell death following transient forebrain ischemia, but a role in neurodegeneration after focal ischemia has not been defined. Adult male Long-Evans rats subjected to middle cerebral artery occlusion (MCAO) for 30 min followed by reperfusion developed delayed cerebral infarction reaching completion 3 days after the insult. One day after the insult, many degenerating cerebral neurons exhibited increased intracellular Zn(2+), and some labeled with the antibody against activated caspase-3. I.c.v. administration of the Zn(2+) chelator, EDTA saturated with equimolar Ca(2+) (CaEDTA), 15 min prior to ischemia attenuated subsequent Zn(2+) translocation into cortical neurons, and reduced infarct volume measured 3 days after ischemia. Although the protective effect of CaEDTA at this endpoint was substantial (about 70% infarct reduction), it was lost when insult severity was increased (from 30 to 60 min MCAO), or when infarct volume was measured at a much later time point (14 days instead of 3 days after ischemia). These data suggest that toxic Zn(2+) translocation, from presynaptic terminals to post-synaptic cell bodies, may accelerate the development of cerebral infarction following mild transient focal ischemia.

  6. A Novel Device for Accurate Chest Tube Insertion

    DEFF Research Database (Denmark)

    Katballe, Niels; Moeller, Lars B; Olesen, Winnie H

    2016-01-01

    BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity...... can be a challenge. METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax...

  7. Advances in chest drain management in thoracic disease

    Science.gov (United States)

    George, Robert S.

    2016-01-01

    An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

  8. Isolation and purification of porcine LH for radioimmunoassay and radioreceptor assay

    International Nuclear Information System (INIS)

    Ziecik, A.; Goralska, M.; Krzymowski, T.; Pogorzelski, K.

    1979-01-01

    The procedure of isolation and purification of LH from porcine pituitary glands is described. From 1 kg of pituitary glands 150 mg of LH GPZ-1 preparation of high purity were obtained. Immunization of rabbits with the prepared hormone gave homogeneous antibodies against porcine LH with high affinity and low cross-reactions with FSH. Radioreceptor assay with the use of the prepared porcine LH demonstrated the high capacity of cell membrane receptors of the boar tests for binding this hormone. (author)

  9. Immunological half-life of porcine proinsulin C-peptide

    Energy Technology Data Exchange (ETDEWEB)

    Oyama, H; Horino, M; Matsumura, S [Kawasaki Medical Coll., Kurashiki (Japan). Div. of Endocrinology; Kobayshi, K; Suetsugu, N [Yamaguchi Univ., Ube (Japan). School of Medicine

    1975-11-01

    Immunological half-lifes of injected porcine C-peptide and insulin with RIA were studied and calculated as 9.8 and 8.0 minutes. Higher circulating levels of C-peptide as compared to insulin in normal young swines lead to speculation about a longer half-life of C-peptide. This hypothesis was verified in this study. Immunological half-lifes of porcine proinsulin and insulin in the pig were 20 and 6 minutes, respectively.

  10. Myocardial ischemia in Kawasaki disease

    International Nuclear Information System (INIS)

    Fukuda, Tsuyoshi

    1993-01-01

    The detection of myocardial ischemia is essential for evaluation of patients with Kawasaki disease, especially who have had coronary artery lesions. To evaluate the clinical efficacy of Tl-201 single photon emission computed tomography (SPECT) after dipyridamole infusion (maximum dose 0.70 mg/kg) for detecting myocardial ischemia, 44 patients with Kawasaki disease aged 7.7±4.8 years at the study and 10 age matched controls were observed. In the Kawasaki disease group, significant coronary artery stenosis was observed in 14, coronary aneurysm without stenosis in 18, the regression of the coronary aneurysms in 2 and without coronary lesions in 10 patients. In 24 of 44 patients, treadmill exercise stress test was also performed at the same period. Myocardial ischemic changes were observed in 11 patients, all combined with significant coronary artery stenosis. The sensitivity of SPECT for detection of overall coronary stenosis was 79%, coronary that of treadmill exercise test was only 33% (p<0.001). Furthermore, among the patients having significant coronary stenosis, the severity score was significantly elevated in patients who had electrocardiographic abnormal Q wave compared to those without abnormal Q wave (51.0±38.8 versus 20.0±12.1, p<0.05). These data suggest that the pharmacological stress scintigraphy using dipyridamole injection provides not only the accurate detection but quantitative evaluation of myocardial ischemia in these patients. This noninvasive technique may become one of the most useful index for detection and follow-up of myocardial ischemia in Kawasaki disease. (author)

  11. Intermittent peripheral tissue ischemia during coronary ischemia reduces myocardial infarction through a KATP-dependent mechanism: first demonstration of remote ischemic perconditioning

    DEFF Research Database (Denmark)

    Schmidt, Michael Rahbek; Smerup, M; Konstantinov, I E

    2006-01-01

    . Intermittent limb ischemia during myocardial ischemia reduces MI, preserves global systolic and diastolic function, and protects against arrhythmia during the reperfusion phase through a K(ATP) channel-dependent mechanism. Understanding this process may have important therapeutic implications for a range...

  12. Outcomes of lower extremity bypass performed for acute limb ischemia.

    Science.gov (United States)

    Baril, Donald T; Patel, Virendra I; Judelson, Dejah R; Goodney, Philip P; McPhee, James T; Hevelone, Nathanael D; Cronenwett, Jack L; Schanzer, Andres

    2013-10-01

    Acute limb ischemia remains one of the most challenging emergencies in vascular surgery. Historically, outcomes following interventions for acute limb ischemia have been associated with high rates of morbidity and mortality. The purpose of this study was to determine contemporary outcomes following lower extremity bypass performed for acute limb ischemia. All patients undergoing infrainguinal lower extremity bypass between 2003 and 2011 within hospitals comprising the Vascular Study Group of New England were identified. Patients were stratified according to whether or not the indication for lower extremity bypass was acute limb ischemia. Primary end points included bypass graft occlusion, major amputation, and mortality at 1 year postoperatively as determined by Kaplan-Meier life table analysis. Multivariable Cox proportional hazards models were constructed to evaluate independent predictors of mortality and major amputation at 1 year. Of 5712 lower extremity bypass procedures, 323 (5.7%) were performed for acute limb ischemia. Patients undergoing lower extremity bypass for acute limb ischemia were similar in age (66 vs 67; P = .084) and sex (68% male vs 69% male; P = .617) compared with chronic ischemia patients, but were less likely to be on aspirin (63% vs 75%; P < .0001) or a statin (55% vs 68%; P < .0001). Patients with acute limb ischemia were more likely to be current smokers (49% vs 39%; P < .0001), to have had a prior ipsilateral bypass (33% vs 24%; P = .004) or a prior ipsilateral percutaneous intervention (41% vs 29%; P = .001). Bypasses performed for acute limb ischemia were longer in duration (270 vs 244 minutes; P = .007), had greater blood loss (363 vs 272 mL; P < .0001), and more commonly utilized prosthetic conduits (41% vs 33%; P = .003). Acute limb ischemia patients experienced increased in-hospital major adverse events (20% vs 12%; P < .0001) including myocardial infarction, congestive heart failure exacerbation, deterioration in renal function

  13. Emerging technologies to create inducible and genetically defined porcine cancer models

    Directory of Open Access Journals (Sweden)

    Lawrence B Schook

    2016-02-01

    Full Text Available There is an emerging need for new animal models that address unmet translational cancer research requirements. Transgenic porcine models provide an exceptional opportunity due to their genetic, anatomic and physiological similarities with humans. Due to recent advances in the sequencing of domestic animal genomes and the development of new organism cloning technologies, it is now very feasible to utilize pigs as a malleable species, with similar anatomic and physiological features with humans, in which to develop cancer models. In this review, we discuss genetic modification technologies successfully used to produce porcine biomedical models, in particular the Cre-loxP System as well as major advances and perspectives the CRISPR/Cas9 System. Recent advancements in porcine tumor modeling and genome editing will bring porcine models to the forefront of translational cancer research.

  14. Emerging Technologies to Create Inducible and Genetically Defined Porcine Cancer Models.

    Science.gov (United States)

    Schook, Lawrence B; Rund, Laurie; Begnini, Karine R; Remião, Mariana H; Seixas, Fabiana K; Collares, Tiago

    2016-01-01

    There is an emerging need for new animal models that address unmet translational cancer research requirements. Transgenic porcine models provide an exceptional opportunity due to their genetic, anatomic, and physiological similarities with humans. Due to recent advances in the sequencing of domestic animal genomes and the development of new organism cloning technologies, it is now very feasible to utilize pigs as a malleable species, with similar anatomic and physiological features with humans, in which to develop cancer models. In this review, we discuss genetic modification technologies successfully used to produce porcine biomedical models, in particular the Cre-loxP System as well as major advances and perspectives the CRISPR/Cas9 System. Recent advancements in porcine tumor modeling and genome editing will bring porcine models to the forefront of translational cancer research.

  15. Prevalence and Clinical Import of Thoracic Injury Identified by Chest Computed Tomography but Not Chest Radiography in Blunt Trauma: Multicenter Prospective Cohort Study.

    Science.gov (United States)

    Langdorf, Mark I; Medak, Anthony J; Hendey, Gregory W; Nishijima, Daniel K; Mower, William R; Raja, Ali S; Baumann, Brigitte M; Anglin, Deirdre R; Anderson, Craig L; Lotfipour, Shahram; Reed, Karin E; Zuabi, Nadia; Khan, Nooreen A; Bithell, Chelsey A; Rowther, Armaan A; Villar, Julian; Rodriguez, Robert M

    2015-12-01

    Chest computed tomography (CT) diagnoses more injuries than chest radiography, so-called occult injuries. Wide availability of chest CT has driven substantial increase in emergency department use, although the incidence and clinical significance of chest CT findings have not been fully described. We determine the frequency, severity, and clinical import of occult injury, as determined by changes in management. These data will better inform clinical decisions, need for chest CT, and odds of intervention. Our sample included prospective data (2009 to 2013) on 5,912 patients at 10 Level I trauma center EDs with both chest radiography and chest CT at physician discretion. These patients were 40.6% of 14,553 enrolled in the parent study who had either chest radiography or chest CT. Occult injuries were pneumothorax, hemothorax, sternal or greater than 2 rib fractures, pulmonary contusion, thoracic spine or scapula fracture, and diaphragm or great vessel injury found on chest CT but not on preceding chest radiography. A priori, we categorized thoracic injuries as major (having invasive procedures), minor (observation or inpatient pain control >24 hours), or of no clinical significance. Primary outcome was prevalence and proportion of occult injury with major interventions of chest tube, mechanical ventilation, or surgery. Secondary outcome was minor interventions of admission rate or observation hours because of occult injury. Two thousand forty-eight patients (34.6%) had chest injury on chest radiography or chest CT, whereas 1,454 of these patients (71.0%, 24.6% of all patients) had occult injury. Of these, in 954 patients (46.6% of injured, 16.1% of total), chest CT found injuries not observed on immediately preceding chest radiography. In 500 more patients (24.4% of injured patients, 8.5% of all patients), chest radiography found some injury, but chest CT found occult injury. Chest radiography found all injuries in only 29.0% of injured patients. Two hundred and two

  16. Chest Wall tumor: combined management

    International Nuclear Information System (INIS)

    Rao Bhaskar, N.

    1997-01-01

    Cancer is relatively rare disease among children and adolescents. The incidence of solid tumors other than CNS is less than 2/100,000. Tumors of the chest wall can arise either from the somatic tissue or ribs. These are rare, so either institutional reviews or multi institutional studies should determine optimal therapeutic management. Of the bony chest wall, Ewing's sarcoma or the family of tumor (peripheral neuro epithelioma, Askin tumor), are the most common. These lesions are lytic and have associated large extra pleural component. This large extra pleural component often necessitates major chest wall resection (3 or more ribs), and when lower ribs are involved, this entails resection of portion of diaphragm. Despite this resection, survival in the early 1970 was 10-20%. Since 1970 multi agent chemotherapy has increased survival rates. of importance, however, is these regimens have caused significant reduction of these extra pleural components so that major chest wall resections have become a rarity. With improved survival and decreased morbidity preoperative chemotherapy followed by surgery is now the accepted modality of treatment. Another major advantage of this regimen is that potential radiation therapy may be obviated. The most common chest wall lesion is rhabdomyosarcoma. In the IRS study of 1620 RMS patients, in 141 (9%) the primary lesion was in the chest wall. these are primarily alveolar histology. when lesions were superficial, wide local excision with supplemental radiation therapy was associated with low morbidity and good overall survival. however, a majority have significant intra- thoracic components. in these circumstances the resectability rate is less than 30% and the survival poor. Other lesions include non rhabdomyosarcomas, eosinophilic granuloma, chondrosarcoma, and osteomyelitis. The management of these lesions varies according to extent, histology, and patient characteristics

  17. Continuous Quadrupole Magnetic Separation of Islets during Digestion Improves Purified Porcine Islet Viability.

    Science.gov (United States)

    Weegman, Bradley P; Kumar Sajja, Venkata Sunil; Suszynski, Thomas M; Rizzari, Michael D; Scott Iii, William E; Kitzmann, Jennifer P; Mueller, Kate R; Hanley, Thomas R; Kennedy, David J; Todd, Paul W; Balamurugan, Appakalai N; Hering, Bernhard J; Papas, Klearchos K

    2016-01-01

    Islet transplantation (ITx) is an emerging and promising therapy for patients with uncontrolled type 1 diabetes. The islet isolation and purification processes require exposure to extended cold ischemia, warm-enzymatic digestion, mechanical agitation, and use of damaging chemicals for density gradient separation (DG), all of which reduce viable islet yield. In this paper, we describe initial proof-of-concept studies exploring quadrupole magnetic separation (QMS) of islets as an alternative to DG to reduce exposure to these harsh conditions. Three porcine pancreata were split into two parts, the splenic lobe (SPL) and the combined connecting/duodenal lobes (CDL), for paired digestions and purifications. Islets in the SPL were preferentially labeled using magnetic microparticles (MMPs) that lodge within the islet microvasculature when infused into the pancreas and were continuously separated from the exocrine tissue by QMS during the collection phase of the digestion process. Unlabeled islets from the CDL were purified by conventional DG. Islets purified by QMS exhibited significantly improved viability (measured by oxygen consumption rate per DNA, p < 0.03) and better morphology relative to control islets. Islet purification by QMS can reduce the detrimental effects of prolonged exposure to toxic enzymes and density gradient solutions and substantially improve islet viability after isolation.

  18. Continuous Quadrupole Magnetic Separation of Islets during Digestion Improves Purified Porcine Islet Viability

    Directory of Open Access Journals (Sweden)

    Bradley P. Weegman

    2016-01-01

    Full Text Available Islet transplantation (ITx is an emerging and promising therapy for patients with uncontrolled type 1 diabetes. The islet isolation and purification processes require exposure to extended cold ischemia, warm-enzymatic digestion, mechanical agitation, and use of damaging chemicals for density gradient separation (DG, all of which reduce viable islet yield. In this paper, we describe initial proof-of-concept studies exploring quadrupole magnetic separation (QMS of islets as an alternative to DG to reduce exposure to these harsh conditions. Three porcine pancreata were split into two parts, the splenic lobe (SPL and the combined connecting/duodenal lobes (CDL, for paired digestions and purifications. Islets in the SPL were preferentially labeled using magnetic microparticles (MMPs that lodge within the islet microvasculature when infused into the pancreas and were continuously separated from the exocrine tissue by QMS during the collection phase of the digestion process. Unlabeled islets from the CDL were purified by conventional DG. Islets purified by QMS exhibited significantly improved viability (measured by oxygen consumption rate per DNA, p<0.03 and better morphology relative to control islets. Islet purification by QMS can reduce the detrimental effects of prolonged exposure to toxic enzymes and density gradient solutions and substantially improve islet viability after isolation.

  19. [How to do - the chest tube drainage].

    Science.gov (United States)

    Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

    2015-03-01

    A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

  20. Association between aortic valve calcification and myocardial ischemia, especially in asymptomatic patients.

    Science.gov (United States)

    Yamazato, Ryo; Yamamoto, Hideya; Tadehara, Futoshi; Teragawa, Hiroki; Kurisu, Satoshi; Dohi, Yoshihiro; Ishibashi, Ken; Kunita, Eiji; Utsunomiya, Hiroto; Oka, Toshiharu; Kihara, Yasuki

    2012-08-01

    Aortic valve calcification (AVC) is recognized as a manifestation of systemic arteriosclerosis. However, it is unclear whether AVC is associated with myocardial ischemia. Stress myocardial perfusion SPECT (MPS) is widely used for the diagnosis of myocardial ischemia. However, routine MPS is not recommended, particularly in asymptomatic patients. Accordingly, we investigated the hypothesis that the presence of AVC is strongly associated with inducible myocardial ischemia, even among asymptomatic patients. We investigated 669 consecutive patients who underwent both adenosine stress (201)Tl MPS and echocardiography. We evaluated the extent and severity of myocardial ischemia by the summed difference score (SDS). We defined the presence of myocardial ischemia as SDS ≥ 3 and moderate to severe ischemia as SDS ≥ 8. We classified the severity of AVC according to the number of affected aortic leaflets. We also compared the mean SDS and the prevalence of SDS ≥ 3 and SDS ≥ 8 among patients stratified by the severity of AVC. The presence of AVC was significantly associated with myocardial ischemia (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.10-2.23; P = 0.013) and moderate to severe ischemia (OR, 2.16; 95% CI, 1.26-3.80; P = 0.0061). In 311 asymptomatic patients, AVC was strongly associated with moderate to severe ischemia (OR, 4.31; 95% CI, 1.67-12.8; P = 0.0043). However, the SDS value and the prevalence of SDS ≥ 3 and SDS ≥ 8 did not increase with increasing number of affected aortic leaflets. The presence of AVC may be associated with the presence of myocardial ischemia, particularly in asymptomatic patients. However, we found no association between the extent of AVC and inducible myocardial ischemia. The presence of AVC may be a useful anatomic marker to help identify patients at high risk of myocardial ischemia, particularly asymptomatic patients.

  1. Imaging of chest wall infections

    International Nuclear Information System (INIS)

    Chelli Bouaziz, Mouna; Jelassi, Helmi; Chaabane, Skander; Ladeb, Mohamed Fethi; Ben Miled-Mrad, Khaoula

    2009-01-01

    A wide variety of infections can affect the chest wall including pyogenic, tuberculous, fungal, and some other unusual infections. These potentially life-threatening disorders are frequent especially among immunocompromised patients but often misdiagnosed by physical examination and radiographs. The purpose of this article is to describe the clinical and imaging features of these different chest wall infections according to the different imaging modalities with emphasis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The outcome of chest wall infection depends on early diagnosis, severity of the immunosuppression, offending organism, and extent of infection. Because clinical findings and laboratory tests may be not contributive in immunocompromised patients, imaging plays an important role in the early detection and precise assessment of the disease. US, CT, and MRI are all useful: bone destruction is more accurately detected with CT whereas soft tissue involvement are better visualized with US and MRI. CT and US are also used to guide percutaneous biopsy and drainage procedures. MR images are helpful in pre-operative planning of extensive chest wall infections. (orig.)

  2. Exercise preconditioning exhibits neuroprotective effects on hippocampal CA1 neuronal damage after cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Nabi Shamsaei; Mehdi Khaksari; Sohaila Erfani; Hamid Rajabi; Nahid Aboutaleb

    2015-01-01

    Recent evidence has suggested the neuroprotective effects of physical exercise on cerebral isch-emic injury. However, the role of physical exercise in cerebral ischemia-induced hippocampal damage remains controversial. The aim of the present study was to evaluate the effects of pre-ischemia treadmill training on hippocampal CA1 neuronal damage after cerebral ischemia. Male adult rats were randomly divided into control, ischemia and exercise + ischemia groups. In the exercise + ischemia group, rats were subjected to running on a treadmill in a designated time schedule (5 days per week for 4 weeks). Then rats underwent cerebral ischemia induction th rough occlusion of common carotids followed by reperfusion. At 4 days after cerebral ischemia, rat learning and memory abilities were evaluated using passive avoidance memory test and rat hippocampal neuronal damage was detected using Nissl and TUNEL staining. Pre-ischemic ex-ercise signiifcantly reduced the number of TUNEL-positive cells and necrotic cell death in the hippocampal CA1 region as compared to the ischemia group. Moreover, pre-ischemic exercise significantly prevented ischemia-induced memory dysfunction. Pre-ischemic exercise mighct prevent memory deficits after cerebral ischemia through rescuing hippocampal CA1 neurons from ischemia-induced degeneration.

  3. Sodium nitroprusside enhanced cardiopulmonary resuscitation improves short term survival in a porcine model of ischemic refractory ventricular fibrillation.

    Science.gov (United States)

    Yannopoulos, Demetris; Bartos, Jason A; George, Stephen A; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P

    2017-01-01

    Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. SNPeCPR will increase short term (4-h) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5min. Basic life support was performed for 10min. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3min. CPR continued for a total of 45min, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60min, if unsuccessful. SNPeCPR animals received 2mg of SNP at minute 10 followed by 1mg every 5min until ROSC. Standard ACLS animals received 0.5mg epinephrine every 5min until ROSC. Primary endpoints were ROSC and 4-h survival. All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-h survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. SNPeCPR significantly improved ROSC and 4-h survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Characterization of serotonergic receptors in rabbit, porcine and human conjunctivae.

    Science.gov (United States)

    Turner, Helen C; Alvarez, Lawrence J; Candia, Oscar A; Bernstein, Audrey M

    2003-10-01

    To characterize the serotonin (5-HT) receptors linked to the modulation of adenylyl cyclase activity in rabbit, porcine and human conjunctivae. Serotonin receptor-subtype expression was examined using reverse transcription-polymerase chain reaction (RT-PCR) and receptor subtype-specific polyclonal antibodies for the immunofluorescent labeling of conjunctival cryosections. In addition, measurements of the effects of serotonergics on the short-circuit current (I(sc)) across rabbit and porcine conjunctivae were contrasted. RT-PCR assays indicated the expression of 5-HT(1B ) and 5-HT(1D) receptors, subtypes negatively coupled to adenylyl cyclase, in the rabbit conjunctiva. This approach also suggested the co-expression of 5-HT(1B), 5-HT(1D), 5-HT(1F), 5-HT(4) and 5-HT(7) mRNA's in the porcine conjunctiva, and 5-HT( 1D), 5-HT(1F) and 5-HT(7) in the human conjunctiva. Since the 5-HT(4) and 5-HT(7) receptors are positively linked to adenylyl cyclase, these results implied that the porcine and human tissues exhibited subtypes both positively and negatively linked to the enzyme. However, immunohistochemical observations, using currently available antibodies solely localized the 5-HT(7) moiety in the porcine and human epithelia, suggested that the 1B/1D forms may be minor elements. Consistent with this prospect, 5-HT was a stimulant of the transepithelial I(sc) across the porcine conjunctiva, an opposite response from earlier findings that demonstrated inhibitory effects by 5-HT on the rabbit I(sc), which are now explained by the localization of the 1B/1D receptors in the rabbit stratified epithelium. The 5-HT receptors expressed by mammalian conjunctivae are not identical. In terms of 5-HT receptor expression, the porcine tissue may be a more appropriate model for human, than is the rabbit, in that 5-HT may serve as a secretagogue in the human epithelium.

  5. Does the intrathecal propofol have a neuroprotective effect on spinal cord ischemia?

    Science.gov (United States)

    Sahin, Murat; Gullu, Huriye; Peker, Kemal; Sayar, Ilyas; Binici, Orhan; Yildiz, Huseyin

    2015-11-01

    The neuroprotective effects of propofol have been confirmed. However, it remains unclear whether intrathecal administration of propofol exhibits neuroprotective effects on spinal cord ischemia. At 1 hour prior to spinal cord ischemia, propofol (100 and 300 µg) was intrathecally administered in rats with spinal cord ischemia. Propofol pre-treatment greatly improved rat pathological changes and neurological function deficits at 24 hours after spinal cord ischemia. These results suggest that intrathecal administration of propofol exhibits neuroprotective effects on spinal cord structural and functional damage caused by ischemia.

  6. Should the lateral chest radiograph be routinely performed?

    International Nuclear Information System (INIS)

    Osman, Fatuma; Williams, Imelda

    2014-01-01

    Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

  7. Role of computed tomography in blunt chest trauma

    International Nuclear Information System (INIS)

    Cho, Jae Hyun; Kim, Sang Jin; Lee, Chan Wha; Kim, Hae Kyoon

    1994-01-01

    In patient with blunt trauma of chest, supine AP x-ray cannot differentiate the lung contusion, laceration, atelectasis, and hemothorax definitely. Therefore, computed tomographic evaluation is needed for accurate evaluation of the injuries. In our knowledge, there are few reports about CT findings of blunt chest trauma, in our country, therefore we tried to fluid the characteristic CT findings in patients with blunt trauma. We analyzed the plain x-ray and CT image of 4 patients with blunt chest trauma. Location and morphology of lung parenchymal contusion and laceration, hemopneumothorax, chest wall injuries and location of chest tube. Lung parenchymal contusion was noted in 53 segments., of 16 patients infiltration(n=27 segment), and multiple nodular pattern was noted in 15 segment, pattern of consolidation along the lung periphery was seen in 11 segment. Laceration was noted in 18 lesion and most commonly located in paravertebral area(b=8). CT scan of chest in patient with blunt chest trauma, provides accurate information of the pattern of injuries, and localization, therefore, should be performed as possible

  8. Calculation of the Cardiothoracic Ratio from Portable Anteroposterior Chest Radiography

    Science.gov (United States)

    Chon, Sung Bin; Oh, Won Sup; Cho, Jun Hwi; Kim, Sam Soo

    2011-01-01

    Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CDChest PA/CDChest AP ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CDChest PA was inferred from multiplying CDChest AP by this ratio. Incorporating this CD and substituting the most recent TDChest PA, we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CDChest PA/CDChest AP ratio was {0.00099 × (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP. PMID:22065900

  9. Mass chest radiography in Greece

    International Nuclear Information System (INIS)

    Papavasiliou, C.

    1987-01-01

    In Greece mass chest radiography has been performed regularly on various population groups as a measure to control tuberculosis. Routine chest radiography is performed in most Greek hospitals on admission. In this report available data-admittedly inadequate-directly or indirectly addressing the problem of benefit versus the risk or cost associated with this examination is presented

  10. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)

    2015-09-15

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  11. Does the intrathecal propofol have a neuroprotective effect on spinal cord ischemia?

    Directory of Open Access Journals (Sweden)

    Murat Sahin

    2015-01-01

    Full Text Available The neuroprotective effects of propofol have been confirmed. However, it remains unclear whether intrathecal administration of propofol exhibits neuroprotective effects on spinal cord ischemia. At 1 hour prior to spinal cord ischemia, propofol (100 and 300 µg was intrathecally administered in rats with spinal cord ischemia. Propofol pre-treatment greatly improved rat pathological changes and neurological function deficits at 24 hours after spinal cord ischemia. These results suggest that intrathecal administration of propofol exhibits neuroprotective effects on spinal cord structural and functional damage caused by ischemia.

  12. [Characteristics of porcine thoracic arteries fixed with polyepoxy compound].

    Science.gov (United States)

    Yu, Xi-Xun; Chen, Huai-Qing

    2005-09-01

    To investigate the characteristics of porcine thoracic arteries fixed with ethylene glycol diglycidyl ether (EX-810) and to provide the proper scaffold materials for tissue-engineered blood vessel. The porcine thoracic arteries were respectively treated with 40 ml/L EX-810 and 6.25 g/L glutaraldehyde, and then they were examined with naked-eye, light microscope and scanning electron microscope. The fixation index determination, the amino acid analysis and the biomechanics test were also performed. The antigenicity of vascular tissues can be diminished by EX-810 through getting rid of cell in the vascular tissues or reducing the level of free amino groups in the vascular tissues. The structural integrity of vascular tissues can be preserved after treatment with EX-810. It was also found that the EX-810-fixed porcine vascular tissues appeared more similar to the natural vascular tissues in color and mechanical properties, and were more pliable than the glutaraldehyde-fixed tissues. The EX-810-fixed porcine thoracic arteries with low cytotoxicity and low antigenicity showed favorable characteristic similar to those of natural vessel, and it should be a promising material for fabricating scaffold of tissue-engineered blood vessel.

  13. Porcine circovirus type 2 ORF4 protein binds heavy chain ferritin

    Indian Academy of Sciences (India)

    Porcine circovirus type 2 ORF4 protein binds heavy chain ferritin. Qizhuang Lv Kangkang Guo Tao Wang ... Keywords. Cellular protein; FHC; ORF4 protein; porcine circovirus type 2 (PCV2); yeast two-hybrid ... Journal of Biosciences | News ...

  14. Pulmonary nodule size evaluation with chest tomosynthesis.

    Science.gov (United States)

    Johnsson, Åse A; Fagman, Erika; Vikgren, Jenny; Fisichella, Valeria A; Boijsen, Marianne; Flinck, Agneta; Kheddache, Susanne; Svalkvist, Angelica; Båth, Magnus

    2012-10-01

    To evaluate intra- and interobserver variability, as well as agreement for nodule size measurements on chest tomosynthesis and computed tomographic (CT) images. The Regional Ethical Review Board approved this study, and all participants gave written informed consent. Thirty-six segmented nodules in 20 patients were included in the study. Eight observers measured the left-to-right, inferior-to-superior, and longest nodule diameters on chest tomosynthesis and CT images. Intra- and interobserver repeatability, as well as agreement between measurements on chest tomosynthesis and CT images, were assessed as recommended by Bland and Altman. The difference between the mean manual and the segmented diameter was -2.2 and -2.3 mm for left-to-right and -2.6 and -2.2 mm for the inferior-to-superior diameter for measurements on chest tomosynthesis and CT images, respectively. Intraobserver 95% limits of agreement (LOA) for the longest diameter ranged from a lower limit of -1.1 mm and an upper limit of 1.0 mm to -1.8 and 1.8 mm for chest tomosynthesis and from -0.6 and 0.9 mm to -3.1 and 2.2 mm for axial CT. Interobserver 95% LOA ranged from -1.3 and 1.5 mm to -2.0 and 2.1 mm for chest tomosynthesis and from -1.8 and 1.1 mm to -2.2 and 3.1 mm for axial CT. The 95% LOA concerning the mean of the observers' measurements of the longest diameter at chest tomosynthesis and axial CT were ±2.1 mm (mean measurement error, 0 mm). For the different observers, the 95% LOA between the modalities ranged from -2.2 and 1.6 mm to -3.2 and 2.8 mm. Measurements on chest tomosynthesis and CT images are comparable, because there is no evident bias between the modalities and the repeatability is similar. The LOA between measurements for the two modalities raise concern if measurements from chest tomosynthesis and CT were to be used interchangeably. © RSNA, 2012.

  15. Influence of chest radiotherapy in frequency and patterns of chest relapse in disseminated small cell lung carcinoma

    International Nuclear Information System (INIS)

    Mira, J.G.; Livingston, R.B.; Moore, T.N.

    1982-01-01

    The value of radiotherapy to the chest (RC) in disseminated small cell lung carcinoma (SCLC) has been questioned. Two protocols for disseminated SCLC from the Southwest Oncology Group (SWOG) have been compared. The first one included radiotherapy (RT), 3000 rad in two weeks, to the primary tumor, mediastinum and supraclavicular areas, while the second one deleted any RC. Multidrug chemotherapy (CT) and brain RT were used in both protocols. Nonresponders to CT were removed from the study. Our main findings are as follows: (1) Initial chest relapses (patients with no initial extrathoracic relapse) have increased from 24-55% when RC is not given (P = 0.0001). Overall chest relapse (adding those patients that relapsed simultaneously in the chest plus other sites) in the second protocol was 73%. (2) Amount of response to CT does not influence the chances for relapse. Even complete responders to CT have a high chance for chest relapse. (3) Sites of relapse without RC are mainly in the primary tumor, ipsilateral hilus and mediastinum. (4) With RC, relapses shift to the chest periphery, mostly to the lung outside the radiotherapy field and to the pleura. (5) The two very different CT regimens have produced similar percentages and duration of response. (6) CT schema with periodic reinductions prolongs duration of response and survival over schema with continuous maintenance. Hence, interruption of CT to allow RC does not seem to adversely influence CT efficacy

  16. Nonspecific motility disorders, irritable esophagus, and chest pain.

    Science.gov (United States)

    Krarup, Anne Lund; Liao, Donghua; Gregersen, Hans; Drewes, Asbjørn Mohr; Hejazi, Reza A; McCallum, Richard W; Vega, Kenneth J; Frazzoni, Marzio; Frazzoni, Leonardo; Clarke, John O; Achem, Sami R

    2013-10-01

    This paper presents commentaries on whether Starling's law applies to the esophagus; whether erythromycin affects esophageal motility; the relationship between hypertensive lower esophageal sphincter and vigorous achalasia; whether ethnic- and gender-based norms affect diagnosis and treatment of esophageal motor disorders; health care and epidemiology of chest pain; whether normal pH excludes esophageal pain; the role of high-resolution manometry in noncardiac chest pain; whether pH-impedance should be included in the evaluation of noncardiac chest pain; whether there are there alternative therapeutic options to PPI for treating noncardiac chest pain; and the usefulness of psychological treatment and alternative medicine in noncardiac chest pain. © 2013 New York Academy of Sciences.

  17. Anatomy and bronchoscopy of the porcine lung. A model for translational respiratory medicine.

    LENUS (Irish Health Repository)

    Judge, Eoin P

    2014-09-01

    The porcine model has contributed significantly to biomedical research over many decades. The similar size and anatomy of pig and human organs make this model particularly beneficial for translational research in areas such as medical device development, therapeutics and xenotransplantation. In recent years, a major limitation with the porcine model was overcome with the successful generation of gene-targeted pigs and the publication of the pig genome. As a result, the role of this model is likely to become even more important. For the respiratory medicine field, the similarities between pig and human lungs give the porcine model particular potential for advancing translational medicine. An increasing number of lung conditions are being studied and modeled in the pig. Genetically modified porcine models of cystic fibrosis have been generated that, unlike mouse models, develop lung disease similar to human cystic fibrosis. However, the scientific literature relating specifically to porcine lung anatomy and airway histology is limited and is largely restricted to veterinary literature and textbooks. Furthermore, methods for in vivo lung procedures in the pig are rarely described. The aims of this review are to collate the disparate literature on porcine lung anatomy, histology, and microbiology; to provide a comparison with the human lung; and to describe appropriate bronchoscopy procedures for the pig lungs to aid clinical researchers working in the area of translational respiratory medicine using the porcine model.

  18. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    International Nuclear Information System (INIS)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok; Ham, Soo-Youn; Lee, Ki Yeol; Choo, Ji Yung

    2014-01-01

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  19. Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Ham, Soo-Youn [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Ki Yeol; Choo, Ji Yung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of)

    2014-12-15

    The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

  20. Chest Trauma in Athletic Medicine.

    Science.gov (United States)

    Phillips, Nicholas R; Kunz, Derek E

    2018-03-01

    While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax. Basic field-side management should be rapid and focused, using the standardized approach of Advanced Traumatic Life Support protocol. Early and appropriate diagnosis and management can help allow safe and enjoyable sports participation.

  1. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  2. Preservation of enucleated porcine eyes for use in a wet laboratory

    NARCIS (Netherlands)

    Nibourg, Lisanne M.; Koopmans, Steven A.

    PURPOSE: To design a method to preserve enucleated porcine eyes for use in a wet laboratory. SETTING: Laboratory of Experimental Ophthalmology, University Medical Center Groningen, the Netherlands. DESIGN: Experimental study. METHODS: Porcine eyes were preserved using 15 methods including salt

  3. Noninvasive evaluation of myocardial ischemia in patients with heart problems

    Directory of Open Access Journals (Sweden)

    Mehdi Nikseresht

    2018-03-01

    Conclusion: It seems that the higher risk of myocardial ischemia in men aged 60-77 years, as compared to men aged 45-59 years, might be related to aging process and imbalance in the risk factors. Promoting physical activity can favorably affect the risk of myocardial ischemia in the middle-aged or elderly men. It is concluded that physical activity effectively decreased the risk of myocardial ischemia.

  4. Satisfaction of Search in Chest Radiography 2015.

    Science.gov (United States)

    Berbaum, Kevin S; Krupinski, Elizabeth A; Schartz, Kevin M; Caldwell, Robert T; Madsen, Mark T; Hur, Seung; Laroia, Archana T; Thompson, Brad H; Mullan, Brian F; Franken, Edmund A

    2015-11-01

    Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest. Sixty-four chest computed radiographs half demonstrating various "test" abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Results of previous studies were reanalyzed using similar modern techniques. In the present study, adding nodules did not influence detection accuracy for the other abnormalities (P = .93), but did induce a reluctance to report them (P chest radiography (P chest radiography has changed, but it is not clear why. SOS may be changing as a function of changes in radiology education and practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  5. Enzyme immunoassay for the detection of porcine gelatine in edible bird's nests.

    Science.gov (United States)

    Tukiran, Nur Azira; Ismail, Amin; Mustafa, Shuhaimi; Hamid, Muhajir

    2015-01-01

    Porcine gelatine is a common adulterant found in edible bird's nests (EBNs) used to increase the net weight prior to sale. This study aimed to develop indirect enzyme-linked immunosorbent assays (ELISAs) for porcine gelatine adulteration using anti-peptide polyclonal antibodies. Three indirect ELISAs were developed (PAB1, 2 and 3), which had limits of detection (LODs) of 0.12, 0.10 and 0.11 µg g(-1), respectively. When applied to standard solutions of porcine gelatine, the inter- and intra-assays showed coefficients of variation (CVs) less than 20% and were able to detect at least 0.5 ng µg(-1) (0.05%) porcine gelatine in spiked samples. The proposed ELISA offers attractions for quality control in the EBN industry.

  6. Possibilities of microscopic detection of isolated porcine proteins in model meat products

    Directory of Open Access Journals (Sweden)

    Michaela Petrášová

    2016-05-01

    Full Text Available In recent years, various protein additives intended for manufacture of meat products have increasing importance in the food industry. These ingredients include both, plant-origin as well as animal-origin proteins. Among animal proteins, blood plasma, milk protein or collagen are used most commonly. Collagen is obtained from pork, beef, and poultry or fish skin. Collagen does not contain all the essential amino acids, thus it is not a full protein in terms of essential amino acids supply for one's organism. However, it is rather rich in amino acids of glycine, hydroxyproline and proline which are almost absent in other proteins and their synthesis is very energy intensive. Collagen, which is added to the soft and small meat products in the form of isolated porcine protein, significantly affects the organoleptic properties of these products. This work focused on detection of isolated porcine protein in model meat products where detection of isolated porcine protein was verified by histological staining and light microscopy. Seven model meat products from poultry meat and 7 model meat products from beef and pork in the ratio of 1:1, which contained 2.5% concentration of various commercially produced isolated porcine proteins, were examined. These model meat products were histologically processed by means of cryosections and stained with hematoxylin-eosin staining, toluidine blue staining and Calleja. For the validation phase, Calleja was utilized. To determine the sensitivity and specificity, five model meat products containing the addition of isolated porcine protein and five model meat products free of it were used. The sensitivity was determined for isolated porcine protein at 1.00 and specificity was determined at 1.00. The detection limit of the method was at the level of 0.001% addition. Repeatability of the method was carried out using products with addition as well as without addition of isolated porcine protein and detection was repeated

  7. Surgical induction of choroidal neovascularization in a porcine model

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik

    2007-01-01

    PURPOSE: To develop a reproducible surgical technique for the induction of choroidal neovascularization (CNV) in the subretinal space of porcine eyes and to analyse the resulting CNV clinically and histologically. METHODS: Two different modifications of a surgical technique previously described...... were compared with the original method. In ten porcine eyes retinal pigment epithelial (RPE) cells were removed using a silicone tipped cannula, in ten porcine eyes Bruch's membrane was perforated once with a retinal perforator without prior RPE removal and in ten eyes RPE removal was followed...... by a single perforation of Bruch's membrane. Fifteen of the eyes, five from each group, were enucleated 30 minutes after surgery, while the remaining eyes were enucleated after 14 days. Prior to enucleation, at day 14, fundus photographs and fluorescein angiograms were obtained. Eyes were examined by light...

  8. Influence of prolonged cold ischemia in renal transplantation.

    NARCIS (Netherlands)

    Vliet, J.A. van der; Warle, M.C.; Cheung, C.L.; Teerenstra, S.; Hoitsma, A.J.

    2011-01-01

    van der Vliet JA, Warle MC, Cheung CLS, Teerenstra S, Hoitsma AJ. Influence of prolonged cold ischemia in renal transplantation. Clin Transplant 2011: 25: E612-E616. (c) 2011 John Wiley & Sons A/S. Abstract: Aim: To determine to what extent current cold ischemia times (CITs) affect the results of

  9. Deoxynivalenol exposure induces autophagy/apoptosis and epigenetic modification changes during porcine oocyte maturation

    International Nuclear Information System (INIS)

    Han, Jun; Wang, Qiao-Chu; Zhu, Cheng-Cheng; Liu, Jun; Zhang, Yu; Cui, Xiang-Shun; Kim, Nam-Hyung; Sun, Shao-Chen

    2016-01-01

    Deoxynivalenol (DON) is a widespread trichothecene mycotoxin which contaminates agricultural staples and elicits a complex spectrum of toxic effects on humans and animals. It has been shown that DON impairs oocyte maturation, reproductive function and causes abnormal fetal development in mammals; however, the mechanisms remain unclear. In the present study, we investigate the possible reasons of the toxic effects of DON on porcine oocytes. Our results showed that DON significantly inhibited porcine oocyte maturation and disrupted meiotic spindle by reducing p-MAPK protein level, which caused retardation of cell cycle progression. In addition, up-regulated LC3 protein expression and aberrant Lamp2, LC3 and mTOR mRNA levels were observed with DON exposure, together with Annexin V-FITC staining assay analysis, these results indicated that DON treatment induced autophagy/apoptosis in porcine oocytes. We also showed that DON exposure increased DNA methylation level in porcine oocytes through altering DNMT3A mRNA levels. Histone methylation levels were also changed showing with increased H3K27me3 and H3K4me2 protein levels, and mRNA levels of their relative methyltransferase genes, indicating that epigenetic modifications were affected. Taken together, our results suggested that DON exposure reduced porcine oocytes maturation capability through affecting cytoskeletal dynamics, cell cycle, autophagy/apoptosis and epigenetic modifications. - Highlights: • DON exposure disrupted meiotic spindle by reducing p-MAPK expression. • DON exposure caused retardation of cell cycle progression in porcine oocytes. • DON triggered autophagy and early-apoptosis in porcine oocytes. • DON exposure led to aberrant epigenetic modifications in porcine oocytes.

  10. Deoxynivalenol exposure induces autophagy/apoptosis and epigenetic modification changes during porcine oocyte maturation

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jun; Wang, Qiao-Chu; Zhu, Cheng-Cheng; Liu, Jun; Zhang, Yu [College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095 (China); Cui, Xiang-Shun; Kim, Nam-Hyung [Department of Animal Science, Chungbuk National University, Cheongju 361-763 (Korea, Republic of); Sun, Shao-Chen, E-mail: sunsc@njau.edu.cn [College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095 (China)

    2016-06-01

    Deoxynivalenol (DON) is a widespread trichothecene mycotoxin which contaminates agricultural staples and elicits a complex spectrum of toxic effects on humans and animals. It has been shown that DON impairs oocyte maturation, reproductive function and causes abnormal fetal development in mammals; however, the mechanisms remain unclear. In the present study, we investigate the possible reasons of the toxic effects of DON on porcine oocytes. Our results showed that DON significantly inhibited porcine oocyte maturation and disrupted meiotic spindle by reducing p-MAPK protein level, which caused retardation of cell cycle progression. In addition, up-regulated LC3 protein expression and aberrant Lamp2, LC3 and mTOR mRNA levels were observed with DON exposure, together with Annexin V-FITC staining assay analysis, these results indicated that DON treatment induced autophagy/apoptosis in porcine oocytes. We also showed that DON exposure increased DNA methylation level in porcine oocytes through altering DNMT3A mRNA levels. Histone methylation levels were also changed showing with increased H3K27me3 and H3K4me2 protein levels, and mRNA levels of their relative methyltransferase genes, indicating that epigenetic modifications were affected. Taken together, our results suggested that DON exposure reduced porcine oocytes maturation capability through affecting cytoskeletal dynamics, cell cycle, autophagy/apoptosis and epigenetic modifications. - Highlights: • DON exposure disrupted meiotic spindle by reducing p-MAPK expression. • DON exposure caused retardation of cell cycle progression in porcine oocytes. • DON triggered autophagy and early-apoptosis in porcine oocytes. • DON exposure led to aberrant epigenetic modifications in porcine oocytes.

  11. A porcine astrocyte/endothelial cell co-culture model of the blood-brain barrier.

    Science.gov (United States)

    Jeliazkova-Mecheva, Valentina V; Bobilya, Dennis J

    2003-10-01

    A method for the isolation of porcine atrocytes as a simple extension of a previously described procedure for isolation of brain capillary endothelial cells from adolescent pigs [Methods Cell Sci. 17 (1995) 2] is described. The obtained astroglial culture purified through two passages and by the method of the selective detachment was validated by a phase contrast microscopy and through an immunofluorescent assay for the glial fibrillary acidic protein (GFAP). Porcine astrocytes were co-cultivated with porcine brain capillary endothelial cells (PBCEC) for the development of an in vitro blood-brain barrier (BBB) model. The model was visualized by an electron microscopy and showed elevated transendothellial electrical resistance and reduced inulin permeability. To our knowledge, this is the first report for the establishment of a porcine astrocyte/endothelial cell co-culture BBB model, which avoids interspecies and age differences between the two cell types, usually encountered in the other reported co-culture BBB models. Considering the availability of the porcine brain tissue and the close physiological and anatomical relation between the human and pig brain, the porcine astrocyte/endothelial cell co-culture system can serve as a reliable and easily reproducible model for different in vitro BBB studies.

  12. Novel porcine repetitive elements

    Directory of Open Access Journals (Sweden)

    Nonneman Dan J

    2006-12-01

    Full Text Available Abstract Background Repetitive elements comprise ~45% of mammalian genomes and are increasingly known to impact genomic function by contributing to the genomic architecture, by direct regulation of gene expression and by affecting genomic size, diversity and evolution. The ubiquity and increasingly understood importance of repetitive elements contribute to the need to identify and annotate them. We set out to identify previously uncharacterized repetitive DNA in the porcine genome. Once found, we characterized the prevalence of these repeats in other mammals. Results We discovered 27 repetitive elements in 220 BACs covering 1% of the porcine genome (Comparative Vertebrate Sequencing Initiative; CVSI. These repeats varied in length from 55 to 1059 nucleotides. To estimate copy numbers, we went to an independent source of data, the BAC-end sequences (Wellcome Trust Sanger Institute, covering approximately 15% of the porcine genome. Copy numbers in BAC-ends were less than one hundred for 6 repeat elements, between 100 and 1000 for 16 and between 1,000 and 10,000 for 5. Several of the repeat elements were found in the bovine genome and we have identified two with orthologous sites, indicating that these elements were present in their common ancestor. None of the repeat elements were found in primate, rodent or dog genomes. We were unable to identify any of the replication machinery common to active transposable elements in these newly identified repeats. Conclusion The presence of both orthologous and non-orthologous sites indicates that some sites existed prior to speciation and some were generated later. The identification of low to moderate copy number repetitive DNA that is specific to artiodactyls will be critical in the assembly of livestock genomes and studies of comparative genomics.

  13. Radiation sensitivity of bacteria and virus in porcine xenoskin for dressing agent

    International Nuclear Information System (INIS)

    Jo, Eu-Ri; Jung, Pil-Mun; Choi, Jong-il; Lee, Ju-Woon

    2012-01-01

    In this study, gamma irradiation sensitivities of bacteria and viruses in porcine skin were evaluated to establish the optimum sterilization condition for the dressing material and a xenoskin graft. Escherichia coli and Bacillus subtilis were used as model pathogens and inoculated at 10 6 –10 7 log CFU/g. As model viruses, porcine parvovirus (PPV), bovine viral diarrhea virus (BVDV), and poliovirus were used and inoculated at 10 5 –10 6 TCID 50 /g into porcine skin. The D 10 value of E. coli was found to be 0.25±0.1 kGy. B. subtilis endospores produced under stressful environmental conditions showed lower radiation sensitivity as D 10 was 3.88±0.3 kGy in porcine skin. The D 10 values of PPV, BVDV, and poliovirus were found to be 1.73±0.2, 3.81±0.2, and 6.88±0.3 kGy, respectively. These results can offer the basic information required for inactivating pathogens by gamma irradiation and achieving dressing material and porcine skin grafts.

  14. Radiological diagnostic in acute chest pain

    International Nuclear Information System (INIS)

    Kawel, Nadine; Bremerich, Jens

    2010-01-01

    Acute chest pain is one of the main symptoms leading to a consultation of the emergency department. Main task of the initial diagnostic is the confirmation or exclusion of a potentially life threatening cause. Conventional chest X-ray and computed tomography are the most significant techniques. Due to limited availability and long examination times magnetic resonance tomography rather plays a limited role in routine clinical workup. In the following paper we will systematically review the radiological diagnostic of the acute life threatening causes of chest pain. Imaging modalities, technical aspects and image interpretation will be discussed. (orig.)

  15. Revascularization and Muscle Adaptation to Limb Demand Ischemia in Diet Induced Obese Mice

    Science.gov (United States)

    Albadawi, Hassan; Tzika, Aria; Rask-Madsen, Christian; Crowley, Lindsey M.; Koulopoulos, Michael W.; Yoo, Hyung-Jin; Watkins, Michael T.

    2016-01-01

    Background Obesity and type 2 diabetes are major risk factors for peripheral arterial disease (PAD) in humans which can result in lower limb demand ischemia and exercise intolerance. Exercise triggers skeletal muscle adaptation including increased vasculogenesis. The goal of this study was to determine whether demand ischemia modulates revascularization, fiber size, and signaling pathways in the ischemic hind limb muscles of mice with diet-induced obesity (DIO). Materials and Methods DIO mice (n=7) underwent unilateral femoral artery ligation (FAL) and recovered for 2-weeks followed by 4-weeks with daily treadmill exercise to induce demand ischemia. A parallel sedentary ischemia group (n=7) had FAL without exercise. The contralateral limb muscles of sedentary ischemia served as control. Muscles were examined for capillary density, myofiber cross-sectional area (CSA), cytokine levels, and phosphorylation of STAT3 and ERK1/2. Results Exercise significantly enhanced capillary density (pdemand ischemia compared to sedentary ischemia. These findings coincided with a significant increase in G-CSF (pDemand ischemia increased the PGC1α mRNA (pdemands ischemia in the setting of DIO causes myofiber atrophy despite an increase in muscle capillary density. The combination of persistent increase in TNFα, lower VEGF and failure to increase PGC1α protein may reflect a deficient adaption to demand ischemia in DIO. PMID:27620999

  16. Kidney ischemia and reperfunsion syndrome: effect of lidocaine and local postconditioning

    Directory of Open Access Journals (Sweden)

    IGOR NAGAI YAMAKI

    Full Text Available ABSTRACT Objective: to evaluate the effects of blocking the regulation of vascular tone on the ischemia and reperfusion syndrome in rats through the use of lidocaine in the postconditioning technique. Methods: we randomized 35 rats into seven groups of five animals: Group 1- Control; Group 2- Ischemia and Reperfusion; Group 3- Ischemia, Reperfusion and Saline; Group 4- Ischemic Postconditioning; Group 5- Ischemic Postconditioning and Saline; Group 6- Lidocaine; Group 7- Ischemic Postconditioning and Lidocaine. Except for the control group, all the others were submitted to renal ischemia for 30 minutes. In postconditioning groups, we performed ischemia and reperfusion cycles of five minutes each, applied right after the main ischemia. In saline and lidocaine groups, we instilled the substances at a rate of two drops per minute. To compare the groups, we measured serum levels of urea and creatinine and also held renal histopathology. Results: The postconditioning and postconditioning + lidocaine groups showed a decrease in urea and creatinine values. The lidocaine group showed only a reduction in creatinine values. In histopathology, only the groups submitted to ischemic postconditioning had decreased degree of tubular necrosis. Conclusion: Lidocaine did not block the effects of postconditioning on renal ischemia reperfusion syndrome, and conferred better glomerular protection when applied in conjunction with ischemic postconditioning.

  17. Sequence and expression analyses of porcine ISG15 and ISG43 genes.

    Science.gov (United States)

    Huang, Jiangnan; Zhao, Shuhong; Zhu, Mengjin; Wu, Zhenfang; Yu, Mei

    2009-08-01

    The coding sequences of porcine interferon-stimulated gene 15 (ISG15) and the interferon-stimulated gene (ISG43) were cloned from swine spleen mRNA. The amino acid sequences deduced from porcine ISG15 and ISG43 genes coding sequence shared 24-75% and 29-83% similarity with ISG15s and ISG43s from other vertebrates, respectively. Structural analyses revealed that porcine ISG15 comprises two ubiquitin homologues motifs (UBQ) domain and a conserved C-terminal LRLRGG conjugating motif. Porcine ISG43 contains an ubiquitin-processing proteases-like domain. Phylogenetic analyses showed that porcine ISG15 and ISG43 were mostly related to rat ISG15 and cattle ISG43, respectively. Using quantitative real-time PCR assay, significant increased expression levels of porcine ISG15 and ISG43 genes were detected in porcine kidney endothelial cells (PK15) cells treated with poly I:C. We also observed the enhanced mRNA expression of three members of dsRNA pattern-recognition receptors (PRR), TLR3, DDX58 and IFIH1, which have been reported to act as critical receptors in inducing the mRNA expression of ISG15 and ISG43 genes. However, we did not detect any induced mRNA expression of IFNalpha and IFNbeta, suggesting that transcriptional activations of ISG15 and ISG43 were mediated through IFN-independent signaling pathway in the poly I:C treated PK15 cells. Association analyses in a Landrace pig population revealed that ISG15 c.347T>C (BstUI) polymorphism and the ISG43 c.953T>G (BccI) polymorphism were significantly associated with hematological parameters and immune-related traits.

  18. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils

    Directory of Open Access Journals (Sweden)

    Hakuba Nobuhiro

    2010-09-01

    Full Text Available Abstract Background Because of the lack of reproducible brainstem ischemia models in rodents, the temporal profile of ischemic lesions in the brainstem after transient brainstem ischemia has not been evaluated intensively. Previously, we produced a reproducible brainstem ischemia model of Mongolian gerbils. Here, we showed the temporal profile of ischemic lesions after transient brainstem ischemia. Results Brainstem ischemia was produced by occlusion of the bilateral vertebral arteries just before their entry into the transverse foramina of the cervical vertebrae of Mongolian gerbils. Animals were subjected to brainstem ischemia for 15 min, and then reperfused for 0 d (just after ischemia, 1 d, 3 d and 7 d (n = 4 in each group. Sham-operated animals (n = 4 were used as control. After deep anesthesia, the gerbils were perfused with fixative for immunohistochemical investigation. Ischemic lesions were detected by immunostaining for microtubule-associated protein 2 (MAP2. Just after 15-min brainstem ischemia, ischemic lesions were detected in the lateral vestibular nucleus and the ventral part of the spinal trigeminal nucleus, and these ischemic lesions disappeared one day after reperfusion in all animals examined. However, 3 days and 7 days after reperfusion, ischemic lesions appeared again and clusters of ionized calcium-binding adapter molecule-1(IBA-1-positive cells were detected in the same areas in all animals. Conclusion These results suggest that delayed neuronal cell death took place in the brainstem after transient brainstem ischemia in gerbils.

  19. Reduced cerebral ischemia-reperfusion injury in Toll-like receptor 4 deficient mice

    International Nuclear Information System (INIS)

    Cao Canxiang; Yang Qingwu; Lv Fenglin; Cui Jie; Fu Huabin; Wang Jingzhou

    2007-01-01

    Inflammatory reaction plays an important role in cerebral ischemia-reperfusion injury, however, its mechanism is still unclear. Our study aims to explore the function of Toll-like receptor 4 (TLR4) in the process of cerebral ischemia-reperfusion. We made middle cerebral artery ischemia-reperfusion model in mice with line embolism method. Compared with C3H/OuJ mice, scores of cerebral water content, cerebral infarct size and neurologic impairment in C3H/Hej mice were obviously lower after 6 h ischemia and 24 h reperfusion. Light microscopic and electron microscopic results showed that cerebral ischemia-reperfusion injury in C3H/Hej mice was less serious than that in C3H/OuJ mice. TNF-α and IL-6 contents in C3H/HeJ mice were obviously lower than that in C3H/OuJ mice with ELISA. The results showed that TLR4 participates in the process of cerebral ischemia-reperfusion injury probably through decrease of inflammatory cytokines. TLR4 may become a new target for prevention of cerebral ischemia-reperfusion injury. Our study suggests that TLR4 is one of the mechanisms of cerebral ischemia-reperfusion injury besides its important role in innate immunity

  20. cGMP-Phosphodiesterase Inhibition Prevents Hypoxia-Induced Cell Death Activation in Porcine Retinal Explants.

    Directory of Open Access Journals (Sweden)

    Lorena Olivares-González

    Full Text Available Retinal hypoxia and oxidative stress are involved in several retinal degenerations including diabetic retinopathy, glaucoma, central retinal artery occlusion, or retinopathy of prematurity. The second messenger cyclic guanosine monophosphate (cGMP has been reported to be protective for neuronal cells under several pathological conditions including ischemia/hypoxia. The purpose of this study was to evaluate whether the accumulation of cGMP through the pharmacological inhibition of phosphodiesterase (PDE with Zaprinast prevented retinal degeneration induced by mild hypoxia in cultures of porcine retina. Exposure to mild hypoxia (5% O2 for 24h reduced cGMP content and induced retinal degeneration by caspase dependent and independent (PARP activation mechanisms. Hypoxia also produced a redox imbalance reducing antioxidant response (superoxide dismutase and catalase activities and increasing superoxide free radical release. Zaprinast reduced mild hypoxia-induced cell death through inhibition of caspase-3 or PARP activation depending on the cell layer. PDE inhibition also ameliorated the effects of mild hypoxia on antioxidant response and the release of superoxide radical in the photoreceptor layer. The use of a PKG inhibitor, KT5823, suggested that cGMP-PKG pathway is involved in cell survival and antioxidant response. The inhibition of PDE, therefore, could be useful for reducing retinal degeneration under hypoxic/ischemic conditions.

  1. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  2. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.

    Science.gov (United States)

    Reamy, Brian V; Williams, Pamela M; Odom, Michael Ryan

    2017-09-01

    Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. Validated clinical decision rules are available to help exclude coronary artery disease. Viruses are common causative agents of pleuritic chest pain. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Treatment is guided by the underlying diagnosis. Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.

  3. Digital tomosynthesis of the chest: A literature review

    International Nuclear Information System (INIS)

    Molk, N.; Seeram, E.

    2015-01-01

    Digital tomosynthesis is a relatively novel imaging modality using limited angle tomography to provide 3D imaging. The purpose of this review is to compare the sensitivity of digital tomosynthesis of the chest and plain film chest imaging in accurately identifying pulmonary nodules and to compare the effective dose between standard chest examinations using digital tomosynthesis and CT. A review of current literature has shown that small scale studies found digital tomosynthesis to be three times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses compared with routine chest CT examinations. This indicates that tomosynthesis could potentially be a beneficial imaging modality and could be used in a number of ways to detect and monitor pulmonary nodules for cancer. However with limited research, large-scale studies would need to be performed to confirm its benefits and identify where it is best used in the clinical setting. - Highlights: • The detection of pulmonary nodules is compared between tomosynthesis and plain film. • The effective dose of digital chest tomosynthesis and chest CT are compared. • The place of digital tomosynthesis of the chest in the clinical setting is explored. • Three times more pulmonary nodules are seen with tomosynthesis. • The effective dose of tomosynthesis is significantly lower than CT

  4. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification...-rays as described in Appendix A. (b) A chest X-ray to establish the existence of pneumoconiosis shall...

  5. Occult pneumomediastinum in blunt chest trauma: clinical significance.

    Science.gov (United States)

    Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

    2010-01-01

    Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (pchest thoracostomy tube was more common (ppneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of patients with occult pneumomediastinum showed complete resolution in all cases, in average 3 h after the initial exam. Occult pneumomediastinum occurred in approximately 6% of

  6. Left ventricular function abnormalities as a manifestation of silent myocardial ischemia.

    Science.gov (United States)

    Lambert, C R; Conti, C R; Pepine, C J

    1986-11-01

    A large body of evidence exists indicating that left ventricular dysfunction is a common occurrence in patients with severe coronary artery disease and represents silent or asymptomatic myocardial ischemia. Such dysfunction probably occurs early in the time course of every ischemic episode in patients with coronary artery disease whether symptoms are eventually manifested or not. The pathophysiology of silent versus symptomatic left ventricular dysfunction due to ischemia appears to be identical. Silent ischemia-related left ventricular dysfunction can be documented during spontaneous or stress-induced perturbations in the myocardial oxygen supply/demand ratio. It also may be detected by nitroglycerin-induced improvement in ventricular function or by salutary changes in wall motion following revascularization. Silent left ventricular dysfunction is a very early occurrence during ischemia and precedes electrocardiographic abnormalities. In this light, its existence should always be kept in mind when dealing with patients with ischemic heart disease. It can be hypothesized that because silent ischemia appears to be identical to ischemia with symptoms in a pathophysiologic sense, prognosis and treatment in both cases should be the same.

  7. Electronic versus traditional chest tube drainage following lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Licht, Peter B; Neckelmann, Kirsten

    2015-01-01

    thoracic surgery, we conducted a randomized controlled trial (RCT) investigating chest tube duration and length of hospitalization. METHODS: Patients undergoing lobectomy were included in a prospective open label RCT. A strict algorithm was designed for early chest tube removal, and this decision...... was delegated to staff nurses. Data were analysed by Cox proportional hazard regression model adjusting for lung function, gender, age, BMI, video-assisted thoracic surgery (VATS) or open surgery and presence of incomplete fissure or pleural adhesions. Time was distinguished as possible (optimal) and actual.......014). CONCLUSIONS: Electronic drainage systems did not reduce chest tube duration or length of hospitalization significantly compared with traditional water seal drainage when a strict algorithm for chest tube removal was used. This algorithm allowed delegation of chest tube removal to staff nurses, and in some...

  8. A porcine model of haematogenous brain infectionwith staphylococcus aureus

    DEFF Research Database (Denmark)

    Astrup, Lærke Boye; Agerholm, Jørgen Steen; Nielsen, Ole Lerberg

    2012-01-01

    A PORCINE MODEL OF HAEMATOGENOUS BRAIN INFECTION WITH STAPHYLOCOCCUS AUREUS Astrup Lærke1, Agerholm Jørgen1, Nielsen Ole1, Jensen Henrik1, Leifsson Páll1, Iburg Tine2. 1: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark boye@life.ku.dk 2: National Veterinary Institute......, Uppsala, Sweden Introduction Staphylococcus aureus (S.aureus) is a common cause of sepsis and brain abscesses in man and a frequent cause of porcine pyaemia. Here we present a porcine model of haematogenous S. aureus-induced brain infection. Materials and Methods Four pigs had two intravenous catheters...... thromboemboli (two pigs). The venous catheter was used for blood sampling before, during and after inoculation. The pigs were euthanized either 24 or 48 hours after inoculation. The brains were collected and examined histologically. Results We describe unifocal suppurative encephalitis 48 hours after...

  9. Usefulness of percutaneous transluminal coronary angioplasty in silent myocardial ischemia

    International Nuclear Information System (INIS)

    Hou, Mami

    1996-01-01

    The usefulness of percutaneous transluminal coronary angioplasty (PTCA) was assessed in patients with exercise-induced asymptomatic myocardial ischemia (silent ischemia) and compared with exercise-induced symptomatic myocardial ischemia (symptomatic ischemia). Patients with single vessel coronary artery disease (51 with angina pectoris, 40 with old myocardial infarction) and evidence of stress-induced ischemia on thallium-201 single photon emission computed tomography (SPECT) underwent successful PTCA. Thirty-seven percent of angina patients and 60% of infarction patients showed asymptomatic exercise-induced ischemia. There was no significant difference in population characteristics between silent and symptomatic patients. Patients with silent angina had significantly higher percentage thallium uptake and washout rate than symptomatic patients. After PTCA, both percentage diameter stenosis and percentage thallium uptake were improved in all patients with angina irrespective of the presence or absence of symptoms. There were no significant differences in percentage thallium uptake and washout rate between patients with silent and symptomatic infarction. After PTCA, percentage diameter stenosis, percentage thallium uptake, and washout rate improved in all infarction patients irrespective of the symptoms. Zero percent of silent angina patients, 12% of symptomatic angina patients, 12% of silent infarction patients, 19% of symptomatic infarction patients had cardiac events during about 4.5 years after PTCA. The incidence of cardiac events did not significantly differ in any patient group. PTCA improved myocardial perfusion in all patients, and the incidence of cardiac events did not differ between the silent and symptomatic groups. Revascularization with PTCA is suitable for patients with silent as well as symptomatic ischemia. (author)

  10. Molecular characterization of the porcine surfactant, pulmonary-associated protein C gene

    DEFF Research Database (Denmark)

    Cirera, S.; Nygård, A.B.; Jensen, H.E.

    2006-01-01

    The surfactant, pulmonary-associated protein C (SFTPC) is a peptide secreted by the alveolar type II pneumocytes of the lung. We have characterized the porcine SFTPC gene at genomic, transcriptional, and protein levels. The porcine SFTPC is a single-copy gene on pig chromosome 14. Two transcripts...

  11. Secretion of pancreastatins from the porcine digestive tract

    International Nuclear Information System (INIS)

    Boerglum Jensen, T.D.; Holst, J.J.; Fahrenkrug, J.

    1994-01-01

    Pancreastatin, a 49-amino acid peptide with a COOH-terminal glycine amide, was originally isolated from porcine pancreas, but pancreastatin immunoreactivity has been found in several neuroendocrine tissues. There are strong indications that pancreastatin is derived from chromogranin A, since the amino acid sequence 240-288 in porcine chromogranin A corresponds to pancreastatin flanked by typical signals for proteolytic processing. The authors studied the effect of electric stimulation of the nervous supply to perfused porcine pancreas, antrum, nonantral stomach, and small intestine on the release of immunoreactive pancreastatin, and they have characterized the molecular nature of the secreted immunoreactivity by using a radioimmunoassay specific for the COOH-terminal glycine amide of porcine pancreastatin in combination with chromatography. In all tissues nerve stimulation significantly increased the release of immunoreactive pancreastatin. The secreted immunoreactive pancreastatin was heterogeneous, consisting of pancreastatin itself, a COOH-terminal pancreastatin fragment, and NH 2 -terminally extended pancreastatin forms. Pancreastatin predominated in the perfusate from pancreas and antrum, whereas mainly NH 2 -terminally extended molecular forms were secreted from the antrectomized stomach and small intestine. The different molecular forms of pancreastatin were secreted from the perfused organs in the same molar ratio as they occur in extracts of the corresponding tissues. Thus, pancreastatin and other chromogranin A-derived peptides in organ-specific proportions regularly accompany the secretion of the peptide hormones from the gastrointestinal tissues on appropriate stimulation. 40 refs., 5 figs

  12. 46 CFR 78.47-70 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Portable magazine chests. 78.47-70 Section 78.47-70... Fire and Emergency Equipment, Etc. § 78.47-70 Portable magazine chests. (a) Portable magazine chest shall be marked in letters of at least 3 inches high “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND...

  13. 46 CFR 97.37-47 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 97.37-47 Section 97.37-47... OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP...

  14. Effectiveness of chest physiotherapy in the management of bronchiectasis

    International Nuclear Information System (INIS)

    Arif, M.; Bashir, M.S.

    2014-01-01

    Bronchiectasis is a chronic disease in which clearance of sputum is disturbed because bronchi dilated permanently. So for the clearance of sputum we have to use physiotherapy techniques such as postural drainage percussion and vibration (PDPY), active cycle of breathing technique (ACBT), autogenic drainage, positive expiratory pressure, high frequency chest wall oscillation. Objective: To determine the role of Chest Physical therapy intervention in the management of Bronchi ectasis. To compare the prognosis of bronchiectasis with and without chest physiotherapy. Methodology: Data was collected from Gulab Devi Chest Hospital, Lahore. A Randomized Control Trial (RCT) study method was used and 60 patients are studied. In this study, they were divided into 03 groups 1- Antibiotics Therapy 2-Chest Physical therapy 3-Antibiotics and Chest Physical therapy. Each group consistant. (author)

  15. Chest radiographic manifestations of scrub typhus.

    Science.gov (United States)

    Abhilash, Kpp; Mannam, P R; Rajendran, K; John, R A; Ramasami, P

    2016-01-01

    Respiratory system involvement in scrub typhus is seen in 20-72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. The study cohort contained 398 patients. Common presenting complaints included fever (100%), generalized myalgia (83%), headache (65%), dyspnea (54%), cough (24.3%), and altered sensorium (14%). Almost half of the patients (49.4%) had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%), acute respiratory distress syndrome (14%), airspace opacity (10.5%), reticulonodular opacities (10.3%), peribronchial thickening (5.8%), and pulmonary edema (2%). Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of 2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89-33.16), invasive ventilation (OR: 18.07; 95% CI: 6.42-50.88), inotropes (OR: 8.76; 95% CI: 4.35-17.62), higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; Pscrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.

  16. Impacted thoracic foreign bodies after penetrating chest trauma.

    Science.gov (United States)

    Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam

    2016-10-01

    Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.

  17. Posterior diaphragmatic defect detected on chest CT: the incidence according to age and the lateral chest radiographic appearances

    International Nuclear Information System (INIS)

    Lee, Son Youl; Choi, Yo Won; Jeon, Seok Chol; Heo, Jeong Nam; Park, Choong Ki

    2007-01-01

    We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age groups and its lateral chest radiographic appearances. The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n = 49, 50.4%) and middle one third (n = 36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n = 8). Lateral chest radiography showed a normal diaphragmatic contour (n = 51, 49.5%), blunting of the posterior costophrenic sulcus (n = 41, 39.8%), focal humping of the posterior diaphragm (n = 7, 6.8%), or upward convexity (n = 4, 3.9%) of the posterior costophrenic sulcus on the affected side. The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect

  18. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  19. First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--Chapter 3: Porcine islet product manufacturing and release testing criteria.

    Science.gov (United States)

    Rayat, Gina R; Gazda, Lawrence S; Hawthorne, Wayne J; Hering, Bernhard J; Hosking, Peter; Matsumoto, Shinichi; Rajotte, Ray V

    2016-01-01

    In the 2009 IXA consensus, the requirements for the quality and control of manufacturing of porcine islet products were based on the U.S. regulatory framework where the porcine islet products fall within the definition of somatic cell therapy under the statutory authority of the U.S. Food and Drug Administration (FDA). In addition, porcine islet products require pre-market approval as a biologic product under the Public Health Services Act and they meet the definition of a drug under the Federal Food, Drug, and Cosmetic Act (FD&C Act). Thus, they are subject to applicable provisions of the law and as such, control of manufacturing as well as reproducibility and consistency of porcine islet products, safety of porcine islet products, and characterization of porcine islet products must be met before proceeding to clinical trials. In terms of control of manufacturing as well as reproducibility and consistency of porcine islet products, the manufacturing facility must be in compliance with current Good Manufacturing Practices (cGMP) guidelines appropriate for the initiation of Phase 1/2 clinical trials. Sponsors intending to conduct a Phase 1/2 trial of islet xenotransplantation products must be able to demonstrate the safety of the product through the establishment of particular quality assurance and quality control procedures. All materials (including animal source and pancreas) used in the manufacturing process of the porcine islet products must be free of adventitious agents. The final porcine islet product must undergo tests for the presence of these adventitious agents including sterility, mycoplasma (if they are cultured), and endotoxin. Assessments of the final product must include the safety specifications mentioned above even if the results are not available until after release as these data would be useful for patient diagnosis and treatment if necessary. In addition, a plan of action must be in place for patient notification and treatment in case the

  20. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Energy Technology Data Exchange (ETDEWEB)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia

    2000-08-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  1. A high-resolution comparative RH map of porcine chromosome (SSC) 2.

    NARCIS (Netherlands)

    Rattink, A.P.; Faivre, M.; Jungerius, B.J.; Groenen, M.A.M.; Harlizius, B.

    2001-01-01

    A high-resolution comparative map was constructed for porcine Chromosome (SSC) 2, where a QTL for back fat thickness (BFT) is located. A radiation hybrid (RH) map containing 33 genes and 25 microsatellite markers was constructed for this chromosome with a 3000-rad porcine RH panel. In total, 16

  2. Post-Traumatic Late Onset Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Gencer Genc

    2014-03-01

    Full Text Available Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma. A 29 year-old male had been admitted to another hospital with loss of consciousness lasting for about 45 minutes after a hard parachute landing without head trauma three days ago. As his neurological examination and brain CT were normal, he had been discharged after 24 hours of observation. Two days after his discharge, he was admitted to our department with epileptic seizure. His neurological examination revealed left hemianopia. After observing occipital subacute ischemia at right side in brain magnetic resonance imaging (MRI, we performed cerebral angiography and no dissection was observed. Excluding the rheumatologic, cardiologic and vascular events, our final diagnosis was late onset cerebral ischemia. Anti-edema and antiepileptic treatment was initiated. He was discharged with left hemianopia and mild cognitive deficit. We suggest that it will be wise to hospitalize patients for at least 72 hours who has a history of unconsciousness following trauma.

  3. Treatment of funnel chest in children

    Directory of Open Access Journals (Sweden)

    Viktor N. Stalmakhovich

    2017-10-01

    Full Text Available Background. Funnel chest has a relatively high prevalence in the Russian population. Given the high percentage of the unsatisfactory results of thoracoplasty, further research for the development of new treatment methods is needed. Aim. To improve the treatment results for funnel chest in children. Materials and methods. We analyzed the treatment results of 230 children with funnel chest after thoracoplasty. We used 2 surgical techniques: classic thoracoplasty by Nuss (114 children and its modified version by the authors (116 children. The modified technique included two-sided thoracoscopy, partial resection of the deformed rib cartilages, and endoscopic longitudinal transection of the sternal cortical plate, resulting in subcutaneous emphysema along the sternum. Results. The comparison of the 2 surgical techniques showed no significant difference in terms of duration and invasiveness of the procedure. Recurrent episodes of funnel chest were observed in children who had undergone thoracoplasty before 7 years of age, regardless of the technique used. Conclusion. This study revealed that the author’s modified thoracoplasty method was more effective in children > 14 years of age with rigid funnel chest because it allowed the surgeon to decrease the thoracic pressure on the plate and the plate itself on the ribs, facilitating the repositioning of the sternum and preventing the deformation and development of pressure sores on the ribs.

  4. Classification and management of chest trauma

    International Nuclear Information System (INIS)

    Farooq, U.; Raza, W.; Zia, N.; Hanif, M.; Khan, M.M.

    2006-01-01

    Objective: To classify the predominant pattern of injuries following blunt and penetrating chest trauma and to assess the adequacy of treatment strategies, complications and mortality associated with such injuries. Design: Descriptive study. Place and Duration of Study: Surgical Unit I, Holy Family Hospital, Rawalpindi, from December 2000 to December 2003. Patients and Methods: One hundred consecutive patients with thoracic trauma either blunt or penetrating, admitted in the ward were evaluated. Their injuries were classified, treatment strategies outlined and complications and mortality were documented on a specially-designed proforma. Results: Out of the 100 patients presenting in emergency, 44% presented with blunt and 56% with penetrating trauma. Pneumothorax was detected in 39% of the patients, hemopneumothorax in 29%, hemothorax in 12%, flail chest in 9%. Two had involvement of the heart and major vessels, 4% had injury to the diaphragm and 5% had multiple trauma. During treatment, 3% of all the patients were managed conservatively, 83% of patients required chest intubations, 6% needed ventilatory support and 8 % required thoracotomy. Complications were experienced in 28% of the patients of which 9% had pneumonias, 14% empyema and 5% suffered from wound infections. The overall mortality was 7%. Conclusion: This series showed the pattern of injuries following blunt and penetrating chest trauma. Furthermore, it was found that chest incubation and simple resuscitation was adequate for majority of the cases. (author)

  5. Chest X-Ray

    Medline Plus

    Full Text Available ... also be useful to help diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  6. Construction of EMSC-islet co-localizing composites for xenogeneic porcine islet transplantation.

    Science.gov (United States)

    Kim, Jung-Sik; Chung, Hyunwoo; Byun, Nari; Kang, Seong-Jun; Lee, Sunho; Shin, Jun-Seop; Park, Chung-Gyu

    2018-03-04

    Pancreatic islet transplantation is an ultimate solution for treating patients with type 1 diabetes (T1D). The pig is an ideal donor of islets for replacing scarce human islets. Besides immunological hurdles, non-immunological hurdles including fragmentation and delayed engraftment of porcine islets need solutions to succeed in porcine islet xenotransplantation. In this study, we suggest a simple but effective modality, a cell/islet co-localizing composite, to overcome these challenges. Endothelial-like mesenchymal stem cells (EMSCs), differentiated from bone-marrow derived mouse mesenchymal stem cells (MSCs), and MSCs evenly coated the surface of porcine islets (>85%) through optimized culture conditions. Both MSCs and EMSCs significantly reduced the fragmentation of porcine islets and increased the islet masses, designated as islet equivalents (IEQs). In fibrin in vitro and in vivo angiogenesis analysis, constructed EMSC-islet composites showed higher angiogenic potentials than naked islets, MSC-islet composites, or human endothelial cell-islet composites. This novel delivery method of porcine islets may have beneficial effects on the engraftment of transplanted islets by prevention of fragmentation and enhancement of revascularization. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. CT findings of chest trauma

    International Nuclear Information System (INIS)

    Kim, Young Tong; Kim Young Il

    1998-01-01

    Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 persons under 40 years of age. Most pleural, pulmonary, mediastinal, and diaphragmatic injuries are not seen on conventional chest radiographs, or are underestimated. In patients with chest trauma, CT scanning is an effective and sensitive method of detecting thoracic injuries and provides accurate information regarding their pattern and extent. (author). 5 refs., 17 figs

  8. Chest sonography. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Mathis, Gebhard (ed.)

    2008-07-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  9. Chest sonography. 2. ed.

    International Nuclear Information System (INIS)

    Mathis, Gebhard

    2008-01-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  10. Liver ischemia and ischemia-reperfusion induces and trafficks the multi-specific metal transporter Atp7b to bile duct canaliculi: possible preferential transport of iron into bile.

    Science.gov (United States)

    Goss, John A; Barshes, Neal R; Karpen, Saul J; Gao, Feng-Qin; Wyllie, Samuel

    2008-04-01

    Both Atp7b (Wilson disease gene) and Atp7a (Menkes disease gene) have been reported to be trafficked by copper. Atp7b is trafficked to the bile duct canaliculi and Atp7a to the plasma membrane. Whether or not liver ischemia or ischemia-reperfusion modulates Atp7b expression and trafficking has not been reported. In this study, we report for the first time that the multi-specific metal transporter Atp7b is significantly induced and trafficked by both liver ischemia alone and liver ischemia-reperfusion, as judged by immunohistochemistry and Western blot analyses. Although hepatocytes also stained for Atp7b, localized intense staining of Atp7b was found on bile duct canaliculi. Inductive coupled plasma-mass spectrometry analysis of bile copper, iron, zinc, and manganese found a corresponding significant increase in biliary iron. In our attempt to determine if the increased biliary iron transport observed may be a result of altered bile flow, lysosomal trafficking, or glutathione biliary transport, we measured bile flow, bile acid phosphatase activity, and glutathione content. No significant difference was found in bile flow, bile acid phosphatase activity, and glutathione, between control livers and livers subjected to ischemia-reperfusion. Thus, we conclude that liver ischemia and ischemia-reperfusion induction and trafficking Atp7b to the bile duct canaliculi may contribute to preferential iron transport into bile.

  11. Pathology and biofilm formation in a porcine model of staphylococcal osteomyelitis

    DEFF Research Database (Denmark)

    Johansen, L K; Koch, J; Frees, D

    2012-01-01

    A porcine model was used to examine the potential of human and porcine Staphylococcus aureus isolates to induce haematogenously spread osteomyelitis. Pigs were inoculated in the right femoral artery with one of the following S. aureus strains: S54F9 (from a porcine lung abscess; n = 3 animals), N...... dependent on the strain of bacteria inoculated and on the formation of a biofilm....... with colonies of S. aureus as demonstrated immunohistochemically. By peptide nucleic acid fluorescence in situ hybridization bacterial aggregates were demonstrated to be embedded in an opaque matrix, indicating that the bacteria had formed a biofilm. Development of experimental osteomyelitis was therefore...

  12. An Investigation of the Pathology and Pathogens Associated with Porcine Respiratory Disease Complex in Denmark

    DEFF Research Database (Denmark)

    Hansen, Mette Sif; Pors, S. E.; Jensen, H. E.

    2010-01-01

    ), porcine reproductive and respiratory syndrome virus (both European and US type), porcine circovirus type 2 (PCV2), porcine respiratory coronavirus, porcine cytomegalovirus, Mycoplasma hyopneumoniae and Mycoplasma hyorhinis. All cases had cranioventral lobular bronchopneumonia consistent with PRDC....... There was a broad range of microscopical lesions and the cases were characterized as acute (n=10), subacute (n=24) or chronic (n=114) bronchopneumonia. Five bacterial species, five viruses and two Mycoplasma spp. were detected in different combinations. PCV2, M. hyopneumoniae, M. hyorhinis and Pasteurella multocida...

  13. Pediatric chest CT after trauma: impact on surgical and clinical management

    International Nuclear Information System (INIS)

    Patel, Rina P.; Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H.; Yu, Chang; Ray, Jackie

    2010-01-01

    Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

  14. Pediatric chest CT after trauma: impact on surgical and clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rina P. [Vanderbilt University School of Medicine, Nashville, TN (United States); Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H. [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Yu, Chang [Vanderbilt University, Department of Biostatistics, Nashville, TN (United States); Ray, Jackie [Vanderbilt University, Department of Pediatric Surgery, Vanderbilt Children' s Hospital, Nashville, TN (United States)

    2010-07-15

    Chest CT after pediatric trauma is frequently performed but its clinical impact, particularly with respect to surgical intervention, has not been adequately evaluated. To assess the impact of chest CT compared with chest radiography on pediatric trauma management. Two hundred thirty-five consecutive pediatric trauma patients who had both chest CT and radiography were identified. Images were reviewed and findings were categorized and correlated with subsequent chest interventions, blinded to final outcome and management. Of the 235 children, 38.3% (90/235) had an abnormal chest radiograph and 63.8% (150/235) had an abnormal chest CT (P < 0.0001). Chest interventions followed in 4.7% (11/235); of these, the findings could be made 1 cm above the dome of the liver in 91% (10/11). Findings requiring chest intervention included pneumothorax (PTX) and vertebral fractures. PTX was found on 2.1% (5/235) of chest radiographs and 20.0% (47/235) of chest CTs (P < 0.0001); 1.7% (4/235) of the children received a chest tube for PTX, 0.85% (2/235) seen on chest CT only. Vertebral fractures were present in 3.8% of the children (9/235) and 66.7% (6/9) of those cases were treated with spinal fusion or brace. There were no instances of mediastinal vascular injury. Most intrathoracic findings requiring surgical management in our population were identified in the lower chest and would be included in routine abdominopelvic CT exams; this information needs to be taken into consideration in the diagnostic algorithm of pediatric trauma patients. (orig.)

  15. Antimicrobial compounds of porcine mucosa

    Science.gov (United States)

    Kotenkova, E. A.; Lukinova, E. A.; Fedulova, L. V.

    2017-09-01

    The aim of the study was to investigate porcine oral cavity mucosa (OCM), nasal cavity mucosa (NCM), rectal mucosa (RM) and tongue mucosa (TM) as sources of antimicrobial compounds. Ultrafiltrates with MW >30 kDa, MW 5-30 kDa and MW 30 kDa, the zone of microbial growth inhibition was 7.5 mm, for the MW<5 kDa fraction, it was 7 mm, and for MW 5-30 kDa fraction, it was 4.5 mm. No significant differences were found in high molecular weight proteomic profile, while qualitative and quantitative differences were observed in the medium and low molecular weight areas, especially in OCM and NCM. HPLC showed 221 tissue-specific peptides in OCM, 156 in NCM, 225 in RM, but only 5 in TM. The results observed confirmed porcine mucous tissues as a good source of antimicrobial compounds, which could be an actual alternative for reduction of microbial spoilage of foods.

  16. Comparative analysis of the diagnostic and prognostic value of exercise ECG and thallium-201 scintigraphic markers of myocardial ischemia in asymptomatic and symptomatic patients

    International Nuclear Information System (INIS)

    Gibson, R.S.

    1989-01-01

    A considerable amount of data now exists that indicates that exercise ECG--due to its suboptimal sensitivity and specificity--has limited diagnostic and prognostic value in asymptomatic subjects, patients with chest pain of unclear etiology or those with chronic stable angina pectoris, and in patients recovering from acute myocardial infarction. Because of this and the well-recognized advantages of thallium-201 scintigraphy, there appears to be a strong rationale for recommending exercise perfusion imaging, rather than exercise ECG alone, as the preferred method for detecting CAD and staging its severity. This recommendation seems justified given the fact that (1) thallium-201 scintigraphy is far more sensitive and specific in detecting myocardial ischemia than exercise testing; (2) unlike stress ECG, thallium-201 scintigraphy can localize ischemia to a specific area of areas subtended by a specific coronary artery; and (3) thallium-201 scintigraphy has been shown to be more reliable to risk stratification of individual patients than exercise testing alone. The more optimal prognostic efficiency of thallium-201 scintigraphy is due, in part, to the fact that the error rate in falsely classifying patients as low-risk is substantially and significantly smaller with thallium-201 scintigraphy than with stress ECG. 52 references

  17. Porcine pluripotency cell signaling develops from the inner cell mass to the epiblast during early development

    DEFF Research Database (Denmark)

    Hall, Vanessa Jane; Christensen, Josef; Gao, Yu

    2009-01-01

      The signaling mechanisms regulating pluripotency in porcine embryonic stem cells and embryos are unknown. In this study, we characterize cell signaling in the in-vivo porcine inner cell mass and later-stage epiblast. We evaluate expression of OCT4, NANOG, SOX2, genes within the JAK/STAT pathway...... pluripotency in human embryonic stem cells is detectable in the porcine epiblast, but not in the inner cell mass. Copyright (c) 2009 Wiley-Liss, Inc.......  The signaling mechanisms regulating pluripotency in porcine embryonic stem cells and embryos are unknown. In this study, we characterize cell signaling in the in-vivo porcine inner cell mass and later-stage epiblast. We evaluate expression of OCT4, NANOG, SOX2, genes within the JAK/STAT pathway...... (LIF, LIFR, GP130), FGF pathway (bFGF, FGFR1, FGFR2), BMP pathway (BMP4), and downstream-activated genes (STAT3, c-Myc, c-Fos, and SMAD4). We discovered two different expression profiles exist in the developing porcine embryo. The D6 porcine blastocyst (inner cell mass stage) is devoid...

  18. Molecular characterization, sequence analysis and tissue expression of a porcine gene – MOSPD2

    Directory of Open Access Journals (Sweden)

    Yang Jie

    2017-01-01

    Full Text Available The full-length cDNA sequence of a porcine gene, MOSPD2, was amplified using the rapid amplification of cDNA ends method based on a pig expressed sequence tag sequence which was highly homologous to the coding sequence of the human MOSPD2 gene. Sequence prediction analysis revealed that the open reading frame of this gene encodes a protein of 491 amino acids that has high homology with the motile sperm domain-containing protein 2 (MOSPD2 of five species: horse (89%, human (90%, chimpanzee (89%, rhesus monkey (89% and mouse (85%; thus, it could be defined as a porcine MOSPD2 gene. This novel porcine gene was assigned GeneID: 100153601. This gene is structured in 15 exons and 14 introns as revealed by computer-assisted analysis. The phylogenetic analysis revealed that the porcine MOSPD2 gene has a closer genetic relationship with the MOSPD2 gene of horse. Tissue expression analysis indicated that the porcine MOSPD2 gene is generally and differentially expressed in the spleen, muscle, skin, kidney, lung, liver, fat and heart. Our experiment is the first to establish the primary foundation for further research on the porcine MOSPD2 gene.

  19. MR imaging in tumor invasion of the chest wall

    International Nuclear Information System (INIS)

    Bittner, R.C.; Lang, P.; Schorner, W.; Sander, B.; Weiss, T.; Loddenkemper, R.; Kaiser, D.; Felix, R.

    1989-01-01

    The authors have used MR imaging to study 22 patients who had intrathoracic, pleura-related malignancies and whose CT findings had suggested chest wall invasion. ECG-gated T1- and T2-weighted spin-echo sequences were used in all patients. Additionally, in 10 patients an ungated, multisection, gradient-echo sequence was used, which was repeated after intravenous administration of Gd-DTPA in five patients. Surgery confirmed chest wall invasion in 19 patients. CT showed tumor invasion only in 14 of these 19 patients. MR imaging showed high-signal-intensity lesion within chest wall and pleura in T2-weighted and Gd-DTPA-enhanced T1-weighted images as the typical pattern of chest wall invasion in all 19 patients. Two of the three patients with pleural inflammation and without chest wall invasion had high-signal-intensity pleural lesions, but none of these lesions were within the chest wall

  20. Concise classification of the genomic porcine endogenous retroviral gamma1 load to defined lineages.

    Science.gov (United States)

    Klymiuk, Nikolai; Wolf, Eckhard; Aigner, Bernhard

    2008-02-05

    We investigated the infection history of porcine endogenous retroviruses (PERV) gamma1 by analyzing published env and LTR sequences. PERV sequences from various breeds, porcine cell lines and infected human primary cells were included in the study. We identified a considerable number of retroviral lineages indicating multiple independent colonization events of the porcine genome. A recent boost of the proviral load in an isolated pig herd and exclusive occurrence of distinct lineages in single studies indicated the ongoing colonization of the porcine genome with endogenous retroviruses. Retroviral recombination between co-packaged genomes was a general factor for PERV gamma1 diversity which indicated the simultaneous expression of different proviral loci over a period of time. In total, our detailed description of endogenous retroviral lineages is the prerequisite for breeding approaches to minimize the infectious potential of porcine tissues for the subsequent use in xenotransplantation.

  1. Cardiogenic shock following blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Rodríguez-González Fayna

    2010-01-01

    Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

  2. Chest-lead ST-J amplitudes using arm electrodes as reference instead of the Wilson central terminal in smartphone ECG applications: Influence on ST-elevation myocardial infarction criteria fulfillment.

    Science.gov (United States)

    Lindow, Thomas; Engblom, Henrik; Khoshnood, Ardavan; Ekelund, Ulf; Carlsson, Marcus; Pahlm, Olle

    2018-05-07

    "Smartphone 12-lead ECG" for the assessment of acute myocardial ischemia has recently been introduced. In the smartphone 12-lead ECG either the right or the left arm can be used as reference for the chest electrodes instead of the Wilson central terminal. These leads are labeled "CR leads" or "CL leads." We aimed to compare chest-lead ST-J amplitudes, using either CR or CL leads, to those present in the conventional 12-lead ECG, and to determine sensitivity and specificity for the diagnosis of STEMI for CR and CL leads. Five hundred patients (74 patients with ST elevation myocardial infarction (STEMI), 66 patients with nonischemic ST deviation and 360 controls) were included. Smartphone 12-lead ECG chest-lead ST-J amplitudes were calculated for both CR and CL leads. ST-J amplitudes were 9.1 ± 29 μV larger for CR leads and 7.7 ± 42 μV larger for CL leads than for conventional chest leads (V leads). Sensitivity and specificity were 94% and 95% for CR leads and 81% and 97% for CL leads when fulfillment of STEMI criteria in V leads was used as reference. In ischemic patients who met STEMI criteria in V leads, but not in limb leads, STEMI criteria were met with CR or CL leads in 91%. By the use of CR or CL leads, smartphone 12-lead ECG results in slightly lower sensitivity in STEMI detection. Therefore, the adjustment of STEMI criteria may be needed before application in clinical practice. © 2018 The Authors. Annals of Noninvasive Electrocardiology Published by Wiley Periodicals, Inc.

  3. Biometric estimation of chest wall thickness of females

    International Nuclear Information System (INIS)

    Berger, C.D.; Lane, B.H.

    1985-01-01

    Optimal use of whole-body counting data to estimate pulmonary deposition of many of the actinides is dependent upon accurate measurement of the thickness of the chest wall because of severe attenuation of low-energy x rays and photons associated with the decay of these radionuclides. An algorithm for estimation of female chest wall thicknesses, verified by real-time ultrasonic measurements, has been derived based on the correlation of measured chest wall thickness and other common biometric quantities. Use of this algorithm will reduce the error generally associated with estimation of internal actinide deposition previously resulting from assuming an average chest wall thickness for all female subjects

  4. Thoracic Trauma: Which Chest Tube When and Where?

    Science.gov (United States)

    Molnar, Tamas F

    2017-02-01

    Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Mechanical versus manual chest compressions for cardiac arrest.

    Science.gov (United States)

    Brooks, Steven C; Hassan, Nizar; Bigham, Blair L; Morrison, Laurie J

    2014-02-27

    This is the first update of the Cochrane review on mechanical chest compression devices published in 2011 (Brooks 2011). Mechanical chest compression devices have been proposed to improve the effectiveness of cardiopulmonary resuscitation (CPR). To assess the effectiveness of mechanical chest compressions versus standard manual chest compressions with respect to neurologically intact survival in patients who suffer cardiac arrest. We searched the Cochrane Central Register of Controlled Studies (CENTRAL; 2013, Issue 12), MEDLINE Ovid (1946 to 2013 January Week 1), EMBASE (1980 to 2013 January Week 2), Science Citation abstracts (1960 to 18 November 2009), Science Citation Index-Expanded (SCI-EXPANDED) (1970 to 11 January 2013) on Thomson Reuters Web of Science, biotechnology and bioengineering abstracts (1982 to 18 November 2009), conference proceedings Citation Index-Science (CPCI-S) (1990 to 11 January 2013) and clinicaltrials.gov (2 August 2013). We applied no language restrictions. Experts in the field of mechanical chest compression devices and manufacturers were contacted. We included randomised controlled trials (RCTs), cluster RCTs and quasi-randomised studies comparing mechanical chest compressions versus manual chest compressions during CPR for patients with atraumatic cardiac arrest. Two review authors abstracted data independently; disagreement between review authors was resolved by consensus and by a third review author if consensus could not be reached. The methodologies of selected studies were evaluated by a single author for risk of bias. The primary outcome was survival to hospital discharge with good neurological outcome. We planned to use RevMan 5 (Version 5.2. The Nordic Cochrane Centre) and the DerSimonian & Laird method (random-effects model) to provide a pooled estimate for risk ratio (RR) with 95% confidence intervals (95% CIs), if data allowed. Two new studies were included in this update. Six trials in total, including data from 1166

  6. Penetrating chest injury: A miraculous life salvage

    Directory of Open Access Journals (Sweden)

    Santosh B Dalavi

    2013-01-01

    Full Text Available An unusual penetrating chest injury was caused by high velocity road traffic accident. An 18-year-old had a four wheeler accident and was brought in emergency department with a ′bamboo′ stick on the left side chest exiting through back. After the stabilization of vital parameters, an inter-costal tube drainage was done on the left side. Except the minor brochopleural fistula which healed by 10 th day, his recovery was uneventful. The outcome was consistent with current aggressive management of penetrating chest injuries. Management of penetrating chest injury involving pulmonary trauma is based on three principles. One is stabilization of hemodynamics of patient with proper clinical evaluation. Second, a mere intercostal tube drainage sufficient for majority of the cases. Third, post-operative active as well as passive physiotherapy is necessary for speedy recovery.

  7. A method to detect occult pneumothorax with chest radiography.

    Science.gov (United States)

    Matsumoto, Shokei; Kishikawa, Masanobu; Hayakawa, Koichi; Narumi, Atsushi; Matsunami, Katsutoshi; Kitano, Mitsuhide

    2011-04-01

    Small pneumothoraces are often not visible on supine screening chest radiographs because they develop anteriorly to the lung. These pneumothoraces are termed occult. Occult pneumothoraces account for an astonishingly high 52% to 63% of all traumatic pneumothoraces. A 19-year-old obese woman was involved in a head-on car accident. The admission anteroposterior chest radiographs were unremarkable. Because of the presence of right chest tenderness and an abrasion, we suspected the presence of a pneumothorax. Thus, we decided to take a supine oblique chest radiograph of the right side of the thorax, which clearly revealed a visceral pleural line, consistent with a diagnosis of traumatic pneumothorax. A pneumothorax may be present when a supine chest radiograph reveals either an apparent deepening of the costophrenic angle (the "deep sulcus sign") or the presence of 2 diaphragm-lung interfaces (the "double diaphragm sign"). However, in practice, supine chest radiographs have poor sensitivity for occult pneumothoraces. Oblique chest radiograph is a useful and fast screening tool that should be considered for cases of blunt chest trauma, especially when transport of critically ill patients to the computed tomographic suite is dangerous or when imminent transfer to another hospital is being arranged and early diagnosis of an occult pneumothorax is essential. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  8. A sensitive duplex nanoparticle-assisted PCR assay for identifying porcine epidemic diarrhea virus and porcine transmissible gastroenteritis virus from clinical specimens.

    Science.gov (United States)

    Zhu, Yu; Liang, Lin; Luo, Yakun; Wang, Guihua; Wang, Chunren; Cui, Yudong; Ai, Xia; Cui, Shangjin

    2017-02-01

    In this study, a novel duplex nanoparticle-assisted polymerase chain reaction (nanoPCR) assay was developed to detect porcine epidemic diarrhea virus (PEDV) and porcine transmissible gastroenteritis virus (TGEV). Two pairs of primers were designed based on the conserved region within the N gene of PEDV and TGEV. In a screening of 114 clinical samples from four provinces in China for PEDV and TGEV, 48.2 and 3.5 % of the samples, respectively, tested positive. Under optimized conditions, the duplex nanoPCR assay had a detection limit of 7.6 × 10 1 and 8.5 × 10 1 copies μL -1 for PEDV and TGEV, respectively. The sensitivity of the duplex nanoPCR assay was ten times higher than that of a conventional PCR assay. Moreover, no fragments were amplified when the duplex nanoPCR assay was used to test samples containing other porcine viruses. Our results indicate that the duplex nanoPCR assay described here is useful for the rapid detection of PEDV and TGEV and can be applied in clinical diagnosis.

  9. Use of the omentum in chest-wall reconstruction

    International Nuclear Information System (INIS)

    Fix, R.J.; Vasconez, L.O.

    1989-01-01

    Increased use of the omentum in chest-wall reconstruction has paralleled the refinement of anatomic knowledge and the development of safe mobilization techniques. Important anatomic points are the omental attachments to surrounding structures, the major blood supply from the left and right gastroepiploic vessels, and the collateral circulation via the gastroepiploic arch and Barkow's marginal artery. Mobilization of the omentum to the thorax involves division of its attachments to the transverse colon and separation from the greater curvature to fabricate a bipedicled flap. Most anterior chest wounds and virtually all mediastinal wounds can be covered with the omentum based on both sets of gastroepiploic vessels. The arc of transposition is increased when the omentum is based on a single pedicle, allowing coverage of virtually all chest-wall defects. The final method of increasing flap length involves division of the gastroepiploic arch and reliance on Barkow's marginal artery as collateral circulation to maintain flap viability. With regard to chest-wall reconstruction, we have included the omentum in the armamentarium of flaps used to cover mediastinal wounds. The omentum is our flap of choice for the reconstruction of most radiation injuries of the chest wall. The omentum may also be used to provide protection to visceral anastomoses, vascular conduits, and damaged structures in the chest, as well as to cover defects secondary to tumor excision or trauma. In brief, the omentum has proved to be a most dependable and versatile flap, particularly applicable to chest-wall reconstruction

  10. Chest x-ray

    Science.gov (United States)

    ... pain from a chest injury (with a possible rib fracture or lung complication) or from heart problems Coughing ... arteries Evidence of heart failure In the bones: Fractures or other problems of the ribs and spine Osteoporosis

  11. Tissue Sampling Guides for Porcine Biomedical Models.

    Science.gov (United States)

    Albl, Barbara; Haesner, Serena; Braun-Reichhart, Christina; Streckel, Elisabeth; Renner, Simone; Seeliger, Frank; Wolf, Eckhard; Wanke, Rüdiger; Blutke, Andreas

    2016-04-01

    This article provides guidelines for organ and tissue sampling adapted to porcine animal models in translational medical research. Detailed protocols for the determination of sampling locations and numbers as well as recommendations on the orientation, size, and trimming direction of samples from ∼50 different porcine organs and tissues are provided in the Supplementary Material. The proposed sampling protocols include the generation of samples suitable for subsequent qualitative and quantitative analyses, including cryohistology, paraffin, and plastic histology; immunohistochemistry;in situhybridization; electron microscopy; and quantitative stereology as well as molecular analyses of DNA, RNA, proteins, metabolites, and electrolytes. With regard to the planned extent of sampling efforts, time, and personnel expenses, and dependent upon the scheduled analyses, different protocols are provided. These protocols are adjusted for (I) routine screenings, as used in general toxicity studies or in analyses of gene expression patterns or histopathological organ alterations, (II) advanced analyses of single organs/tissues, and (III) large-scale sampling procedures to be applied in biobank projects. Providing a robust reference for studies of porcine models, the described protocols will ensure the efficiency of sampling, the systematic recovery of high-quality samples representing the entire organ or tissue as well as the intra-/interstudy comparability and reproducibility of results. © The Author(s) 2016.

  12. Review on herbal medicine on brain ischemia and reperfusion

    Directory of Open Access Journals (Sweden)

    Nahid Jivad

    2015-10-01

    Cerebral ischemia and reperfusion is known to induce the generation of reactive oxygen species that can lead to oxidative damage of proteins, membrane lipids and nucleic acids. A decrease in tissue antioxidant capacity, an increase in lipid peroxidation as well as an increase in lipid peroxidation inhibitors have been demonstrated in several models of brain ischemia. This paper reviews the number of commonly used types of herbal medicines effective for the treatment of stroke. The aim of this paper was to review evidences from controlled studies in order to discuss whether herbal medicine can be helpful in the treatment of brain ischemia and reperfusion.

  13. Effects of angiotensin-converting enzyme inhibition on transient ischemia: the Quinapril Anti-Ischemia and Symptoms of Angina Reduction (QUASAR) trial.

    Science.gov (United States)

    Pepine, Carl J; Rouleau, Jean-Lucien; Annis, Karen; Ducharme, Anique; Ma, Patrick; Lenis, Jacques; Davies, Richard; Thadani, Udho; Chaitman, Bernard; Haber, Harry E; Freedman, S Ben; Pressler, Milton L; Pitt, Bertram

    2003-12-17

    We sought to determine whether angiotensin-converting enzyme inhibition (ACE-I) (i.e., quinapril) prevents transient ischemia (exertional and spontaneous) in patients with coronary artery disease (CAD). It is known that ACE-I reduces the risk of death, myocardial infarction (MI), and other CAD-related outcomes in high-risk patients. Numerous studies have confirmed that ACE-I improves coronary flow and endothelial function. Whether ACE-I also decreases transient ischemia is unclear, because no studies have been adequately designed or sufficiently powered to evaluate this issue. Using a randomized, double-blinded, placebo-controlled, multicenter design, we enrolled 336 CAD patients with stable angina. None had uncontrolled hypertension, left ventricular (LV) dysfunction, or recent MI, and all developed electrocardiographic (ECG) evidence of ischemia during exercise. They were randomly assigned to one of two groups: 40 mg/day quinapril (n = 177) or placebo (n = 159) for 8 weeks. Patients then entered an additional eight-week treatment phase to examine the full dose range. Those assigned to 40 mg quinapril continued that dose and those assigned to placebo were titrated to 80 mg/day. Treadmill testing, the Seattle Angina Questionnaire, and ambulatory ECG monitoring were used to assess responses at baseline and at 8 and 16 weeks. The groups did not differ significantly at entry or in terms of indexes assessing myocardial ischemia at 8 or 16 weeks of treatment. In this low-risk population, ACE-I was not associated with serious adverse events. Our findings suggest short-term ACE-I in CAD patients without hypertension, LV dysfunction, or acute MI is not associated with significant effects on transient ischemia.

  14. The effect of aloe vera on ischemia--Reperfusion injury of sciatic nerve in rats.

    Science.gov (United States)

    Guven, Mustafa; Gölge, Umut Hatay; Aslan, Esra; Sehitoglu, Muserref Hilal; Aras, Adem Bozkurt; Akman, Tarik; Cosar, Murat

    2016-04-01

    Aloe vera is compound which has strong antioxidant and anti-inflammatory effects. We investigated the neuroprotective role of aloe vera treatment in rats with experimental sciatic nerve ischemia/reperfusion injury. Twenty-eight male Wistar Albino rats were divided equally into 4 groups. Groups; Control group (no surgical procedure or medication), sciatic nerve ischemia/reperfusion group, sciatic nerve ischemia/reperfusion+aloe vera group and sciatic nerve ischemia/reperfusion+methylprednisolone group. Ischemia was performed by clamping the infrarenal abdominal aorta. 24 hours after ischemia, all animals were sacrificed. Sciatic nerve tissues were also examined histopathologically and biochemically. Ischemic fiber degeneration significantly decreased in the pre-treated with aloe vera and treated with methylprednisolone groups, especially in the pre-treated with aloe vera group, compared to the sciatic nerve ischemia/reperfusion group (paloe vera group was not statistically different compared to the MP group (p>0.05). Aloe vera is effective neuroprotective against sciatic nerve ischemia/reperfusion injury via antioxidant and anti-inflammatory properties. Also aloe vera was found to be as effective as MP. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. The role of CT in assessing chest pain

    International Nuclear Information System (INIS)

    Capsa, R.

    2012-01-01

    Full text: Objective: Thoracic pain represents the common feature of a wide range of diseases of different causes. Usually, chest pain requires a fast workup, in order to eliminate potentially hazardous underlying conditions. The objective of the paper consists of presenting the role of computerized tomography (CT) in assessing the different causes and conditions related to chest pain. Materials and methods: The educational presentation relies on current literature data and mostly on images obtained from patients admitted in the various clinics and departments of our hospital, suffering from chest pain as admittance condition or as a symptom appeared during the hospital stay. Results: There are various radiological and imaging options for assessing a patient with chest pain, with reference to the underlying condition, type of pain onset (acute or chronic), specific indications and contraindications. From all these, CT is considered one of the most useful imaging options, in terms of diagnosis accuracy, fast workup, cost and availability. This paper focuses on the role of CT, presenting the most important diseases and conditions related to potential occurrence of chest pain and the most specific CT signs and findings usually reported in this setting. Furthermore, the presentation separates acute and chronic conditions, presenting the actual imaging protocols employed in this circumstances. Finally, there are considerations regarding CT rule-out protocols used in patients with acute chest pain in emergency conditions. Conclusions: Fast and accurate diagnosis is crucial for patient outcome, often life-saving, but currently there is no single algorithm in the imaging assessment of chest pain, while choosing the best imaging option relies mainly on history, clinical and laboratory data. CT is one of the most important imaging options available in patients with both acute and chronic chest pain. CT rule-out techniques have still to establish their clear role in a

  16. Chest X-Ray

    Medline Plus

    Full Text Available ... X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey Rubin, a radiologist ... about chest x-rays, visit Radiology Info dot org. Thank you for your time! Spotlight Recently posted: ...

  17. Chest X-Ray

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    Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  18. Chest X-Ray

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    Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray ... posted: How to Obtain and Share Your Medical Images Movement Disorders Video: The Basketball Game: An MRI ...

  19. Chest X-Ray

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    Full Text Available ... accurate diagnosis far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot ... Inc. (RSNA). To help ensure current and accurate information, we do not permit copying but encourage linking ...

  20. Chest X-Ray

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    Full Text Available ... Site Index A-Z Spotlight Recently posted: Pancreatic Cancer The Limitations of Online Dose Calculators Video: The ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  1. Chest X-Ray

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    Full Text Available ... evaluate shortness of breath, persistent cough, fever, chest pain or injury. It may also be useful to ... of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. For more information about ...

  2. Chest X-Ray

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    Full Text Available ... June is Men's Health Month Recently posted: Pancreatic Cancer The Limitations of Online Dose Calculators Video: The ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  3. Purification, characterization and immunolocalization of porcine surfactant protein D

    DEFF Research Database (Denmark)

    Sørensen, C.M.; Nielsen, Ove Lilholm; Willis, A.

    2005-01-01

    in a dose and Ca2+-dependent manner with a saccharide specificity similar to rat and human SP-D. The purified protein was used for the production of a monoclonal anti-pSP-D antibody. The antibody reacted specifically with pSP-D in the reduced and unreduced state when analysed by Western blotting......Surfactant protein D (SP-D) is a collectin believed to play an important role in innate immunity. SP-D is characterized by having a collagen-like domain and a carbohydrate recognition domain (CRD), which has a specific Ca2+-dependent specificity for saccharides and thus the ability to bind complex...... glycoconjugates on micro-organisms. This paper describes the tissue immunolocalization of porcine SP-D (pSP-D) in normal slaughter pigs using a monoclonal antibody raised against purified pSP-D. Porcine SP-D was purified from porcine bronchoalveolar lavage (BAL) by maltose-agarose and immunoglobulin M affinity...

  4. Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Sophia F. Shakur

    2013-01-01

    Full Text Available Cerebral vasospasm is a well-known consequence of aneurysmal subarachnoid hemorrhage (SAH triggered by blood breakdown products. Here, we present the first case of cerebral vasospasm with ischemia following a spontaneous spinal SAH. A 67-year-old woman, who was on Coumadin for atrial fibrillation, presented with chest pain radiating to the back accompanied by headache and leg paresthesias. The international normalized ratio (INR was 4.5. Ten hours after presentation, she developed loss of movement in both legs and lack of sensation below the umbilicus. Spine MRI showed intradural hemorrhage. Her coagulopathy was reversed, and she underwent T2 to T12 laminectomies. A large subarachnoid hematoma was evacuated. Given her complaint of headache preoperatively and the intraoperative finding of spinal SAH, a head CT was done postoperatively that displayed SAH in peripheral sulci. On postoperative day 5, she became obtunded. Brain MRI demonstrated focal restricted diffusion in the left frontoparietal area. Formal angiography revealed vasospasm in anterior cerebral arteries bilaterally and right middle cerebral artery. Vasospasm was treated, and she returned to baseline within 48 hours. Spontaneous spinal SAH can result in the same sequelae typically associated with aneurysmal SAH, and the clinician must have a degree of suspicion in such patients. The pathophysiological mechanisms underlying cerebral vasospasm may explain this unique case.

  5. Chest X-Ray

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    Full Text Available ... However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. ...

  6. Influence of MR imaging in radiation therapy of chest lymphoma

    International Nuclear Information System (INIS)

    Carlsen, S.E.; Hoppe, R.; Bergin, C.J.

    1991-01-01

    This paper evaluates the influence of MR detection of additional sites of chest lymphoma on radiation therapy. Chest MR images and CT scans of 56 patients with new or recurrent mediastinal lymphoma obtained within 1 month of each other were retrospectively reviewed. MR images included T1- and T2-weighted SE and STIR sequences. Images were assessed for pleural and extrapleural disease. Radiation portals of patients with pleural or chest wall disease were reevaluated and compared with portals originally designed with CT. MR imaging demonstrated chest wall disease in 15 patients (21 sites). Ten patients also had pleural disease (13 sites). CT identified chest wall disease in four of these patients (five sites) and pleural disease in three patients (five sites). Seven of the 15 patients with chest wall disease were treated with radiation therapy alone. Two of the seven patients had significant modification of radiation portals based on MR findings. Retrospectively, therapy would have been altered in an additional two patients in whom pleural disease was identified at MR. The increased sensitivity of MR in detecting chest wall or pleural disease has important implications for treatment planning in chest wall lymphoma

  7. Identification of the porcine homologous of human disease causing trinucleotide repeat sequences

    DEFF Research Database (Denmark)

    Madsen, Lone Bruhn; Thomsen, Bo; Sølvsten, Christina Ane Elisabeth

    2007-01-01

    in this paper the identification of porcine noncoding and polyglutamine-encoding TNR regions and the comparison to the homologous TNRs from human, chimpanzee, dog, opossum, rat, and mouse. Several of the porcine TNR regions are highly polymorphic both within and between different breeds. The TNR regions...

  8. The Effect of PM 10 on Ischemia- Reperfusion Induced Arrhythmias in Rats

    Directory of Open Access Journals (Sweden)

    Esmat Radmanesh

    Full Text Available ABSTRACT Epidemiological studies show that particulate matter (PM is the principal instigator of some adverse clinical symptoms involving cardiovascular diseases. PM exposure can increase experimental infarct size and potentiate myocardial ischemia and arrhythmias in experimental MI models such as ischemia-reperfusion (I/R injury.The present study was aimed to evaluate the effects of particulate matter (PM10 on ischemia- reperfusion induced arrhythmias with emphasis on the protective role of VA as an antioxidant on them. Male Wistar rats were divided into 8 groups (n=10: Control, VAc, Sham, VA, PM1 (0.5 mg/kg, PM2 (2.5 mg/kg, PM3 group (5 mg/kg, PM3 + VA group. Within 48 hours, PM10 was instilled into trachea in two stages. Then the hearts were isolated, transferred to a Langendorff apparatus, and subjected to global ischemia (30 minutes followed by reperfusion (60 minutes. The ischemia- reperfusion induced ventricular arrhythmias were assessed according to the Lambeth conventions.In the present study,the number, incidence and duration of arrhythmiasduring30 minutes ischemia were demonstrated to be more than those in the reperfusion stage. PM exposure increased significantly the number, incidence and duration of arrhythmias in the ischemia and reperfusion duration. Vanillic acid reduced significantly the number, incidence and duration of arrhythmias during the ischemia and reperfusion period.In summary, the results of this study demonstrated that the protective and dysrhythmic effects of VA in the PM exposure rats in I/R model are probably related to its antioxidant properties.

  9. MICROCIRCULATORY ISCHEMIA AND STATINS: LESSONS OF INTERVENTION CARDIOLOGY

    Directory of Open Access Journals (Sweden)

    An. A. Alexandrov

    2015-12-01

    Full Text Available Review is devoted to the pathogenesis of microcirculatory ischemia. Microcirculatory dysfunction has been identified in different groups of patients including syndrome X, diabetes mellitus 2 type, coronary heart disease. In coronary patients after transluminal angioplasty microcirculatory dysfunction is the reason of phenomenon of “non-reflow”. In result the procedure of revascularization is less effective. Therapy by statins can be beneficial for patients with microcirculatory ischemia.

  10. Chest X-Ray

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    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... x-ray is used to evaluate the lungs, heart and chest wall and may be used to ...

  11. Chest X-Ray

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    Full Text Available ... exams and use a very small dose of ionizing radiation to produce pictures of the inside of the ... chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs ...

  12. Chest X-Ray

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    Full Text Available ... change into a gown. You may have some concerns about chest x-rays. However, it’s important to ... You Sponsored by About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 ...

  13. An anatomical study of porcine peripheral nerve and its potential use in nerve tissue engineering

    Science.gov (United States)

    Zilic, Leyla; Garner, Philippa E; Yu, Tong; Roman, Sabiniano; Haycock, John W; Wilshaw, Stacy-Paul

    2015-01-01

    Current nerve tissue engineering applications are adopting xenogeneic nerve tissue as potential nerve grafts to help aid nerve regeneration. However, there is little literature that describes the exact location, anatomy and physiology of these nerves to highlight their potential as a donor graft. The aim of this study was to identify and characterise the structural and extracellular matrix (ECM) components of porcine peripheral nerves in the hind leg. Methods included the dissection of porcine nerves, localisation, characterisation and quantification of the ECM components and identification of nerve cells. Results showed a noticeable variance between porcine and rat nerve (a commonly studied species) in terms of fascicle number. The study also revealed that when porcine peripheral nerves branch, a decrease in fascicle number and size was evident. Porcine ECM and nerve fascicles were found to be predominately comprised of collagen together with glycosaminoglycans, laminin and fibronectin. Immunolabelling for nerve growth factor receptor p75 also revealed the localisation of Schwann cells around and inside the fascicles. In conclusion, it is shown that porcine peripheral nerves possess a microstructure similar to that found in rat, and is not dissimilar to human. This finding could extend to the suggestion that due to the similarities in anatomy to human nerve, porcine nerves may have utility as a nerve graft providing guidance and support to regenerating axons. PMID:26200940

  14. Dose and perceived image quality in chest radiography

    International Nuclear Information System (INIS)

    Veldkamp, Wouter J.H.; Kroft, Lucia J.M.; Geleijns, Jacob

    2009-01-01

    Chest radiography is the most commonly performed diagnostic X-ray examination. The radiation dose to the patient for this examination is relatively low but because of its frequent use, the contribution to the collective dose is considerable. Consequently, optimization of dose and image quality offers a challenging area of research. In this article studies on dose reduction, different detector technologies, optimization of image acquisition and new technical developments in image acquisition and post processing will be reviewed. Studies indicate that dose reduction in PA chest images to at least 50% of commonly applied dose levels does not affect diagnosis in the lung fields; however, dose reduction in the mediastinum, upper abdomen and retrocardiac areas appears to directly deteriorate diagnosis. In addition to patient dose, also the design of the various digital detectors seems to have an effect on image quality. With respect to image acquisition, studies showed that using a lower tube voltage improves visibility of anatomical structures and lesions in digital chest radiographs but also increases the disturbing appearance of ribs. New techniques that are currently being evaluated are dual energy, tomosynthesis, temporal subtraction and rib suppression. These technologies may improve diagnostic chest X-ray further. They may for example reduce the negative influence of over projection of ribs, referred to as anatomic noise. In chest X-ray this type of noise may be the dominating factor in the detection of nodules. In conclusion, optimization and new developments will enlarge the value of chest X-ray as a mainstay in the diagnosis of chest diseases.

  15. Diagnostic Evaluation of Nontraumatic Chest Pain in Athletes.

    Science.gov (United States)

    Moran, Byron; Bryan, Sean; Farrar, Ted; Salud, Chris; Visser, Gary; Decuba, Raymond; Renelus, Deborah; Buckley, Tyler; Dressing, Michael; Peterkin, Nicholas; Coris, Eric

    This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes. Cross-referencing published articles from the databases searched discovered additional articles. No dissertations, theses, or meeting proceedings were reviewed. The authors discuss the scope of this complex problem and the diagnostic dilemma chest pain in athletes can provide. Next, the authors delve into the vast differential and attempt to simplify this process for the sports medicine physician by dividing potential etiologies into cardiac and noncardiac conditions. Life-threatening causes of chest pain in athletes may be cardiac or noncardiac in origin, which highlights the need for the sports medicine physician to consider pathology in multiple organ systems simultaneously. This article emphasizes the importance of ruling out immediately life threatening diagnoses, while acknowledging the most common causes of noncardiac chest pain in young athletes are benign. The authors propose a practical algorithm the sports medicine physician can use as a guide for the assessment and diagnostic work-up of the athlete with chest pain designed to help the physician arrive at the correct diagnosis in a clinically efficient and cost-effective manner.

  16. Conceptus radiation dose and risk from chest screen-film radiography

    International Nuclear Information System (INIS)

    Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia; Prassopoulos, Panos; Gourtsoyiannis, Nicholas; Varveris, Haralambos

    2003-01-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d a ) was estimated for 51 women of childbearing age from chest CT examinations. The value of d a was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10 -3 mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d a estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

  17. Conceptus radiation dose and risk from chest screen-film radiography.

    Science.gov (United States)

    Damilakis, John; Perisinakis, Kostas; Prassopoulos, Panos; Dimovasili, Evangelia; Varveris, Haralambos; Gourtsoyiannis, Nicholas

    2003-02-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d(a)) was estimated for 51 women of childbearing age from chest CT examinations. The value of d(a) was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10(-3) mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d(a) estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

  18. Conceptus radiation dose and risk from chest screen-film radiography

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia [Department of Medical Physics, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Prassopoulos, Panos; Gourtsoyiannis, Nicholas [Department of Radiology, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Varveris, Haralambos [Department of Radiotherapy, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece)

    2003-02-01

    The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d{sub a}) was estimated for 51 women of childbearing age from chest CT examinations. The value of d{sub a} was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10{sup -3} mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d{sub a} estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is

  19. Chest trauma in children: A local experience

    International Nuclear Information System (INIS)

    Al-Saigh, A.; Fazili, Fiaz M.; Allam, Abdulla R.

    1999-01-01

    Chest trauma in childhood is relatively uncommon in clinical practice andhas been the subject of few reports in literature. This study was undertakento examine our experience in dealing with chest trauma in children. This wasa retrospective study of 74 children who sustained chest trauma and werereferred to King Fahd Hospital in Medina over a two-year period. The age,cause of injury, severity of injury, associated extrathoracic injuries,treatment and outcome were analyzed. The median age of patients was nineyears. Fifty-nine of them (80%) sustained blunt trauma in 62% of thechildren, gun shot wounds were seen in five and stab wounds in 10 children.Head injury was the most common injury associated with thoracic trauma andwas seen in 14 patients (19%) and associated intra-abdominal injuries wereseen in nine patients. Chest x-ray of the blunt trauma patients revealedfractured ribs in 24 children, pneumothorax in six, hemothorax in four,hemoneumothorax in three, and pulmonary contusions in 22 patients. Fifty onepercent of children were managed conservatively, 37% required tubethoracostomy, 8% were mechanically ventilated and 4% underwent thoractomy.The prevalence of chest trauma in children due to road traffic accidents ishigh in Saudi Arabia. Head injury is thought to be the most common associatedextrathoracic injuries, however, most of these patients can be managedconservatively. (author)

  20. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    International Nuclear Information System (INIS)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong

    1994-01-01

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax

  1. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong [Chung-Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-10-15

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.

  2. Utility of Chest Computed Tomography after a "Normal" Chest Radiograph in Patients with Thoracic Stab Wounds.

    Science.gov (United States)

    Nguyen, Brian M; Plurad, David; Abrishami, Sadaf; Neville, Angela; Putnam, Brant; Kim, Dennis Y

    2015-10-01

    Chest computed tomography (CCT) is used to screen for injuries in hemodynamically stable patients with penetrating injury. We aim to determine the incidence of missed injuries detected on CCT after a negative chest radiograph (CXR) in patients with thoracic stab wounds. A 10-year retrospective review of a Level I trauma center registry was performed on patients with thoracic stab wounds. Patients who were hemodynamically unstable or did not undergo both CXR and CCT were excluded. Patients with a negative CXR were evaluated to determine if additional findings were diagnosed on CCT. Of 386 patients with stab wounds to the chest, 154 (40%) underwent both CXR and CCT. One hundred and fifteen (75%) had a negative screening CXR. CCT identified injuries in 42 patients (37%) that were not seen on CXR. Pneumothorax and/or hemothorax occurred in 40 patients (35%), of which 14 patients underwent tube thoracostomy. Two patients had hemopericardium on CCT and both required operative intervention. Greater than one-third of patients with a normal screening CXR were found to have abnormalities on CCT. Future studies comparing repeat CXR to CCT are required to further define the optimal diagnostic strategy in patients with stab wounds to chest after normal screening CXR.

  3. Lung Morphological Changes in Closed Chest Injury (an experimental study

    Directory of Open Access Journals (Sweden)

    A. M. Golubev

    2012-01-01

    Full Text Available Objective: to study lung morphological changes in a closed chest injury model in laboratory animals. Material and methods. Experiments were carried out in 30 male albino nonbred rats weighing 350—380 g. Closed chest injury was simulated, by exposing the chest of anesthetized rats to a 300-g metal cylinder falling from a height of 30 cm. The observation periods were 1, 3, 6, and 24 hours. Results. The signs of evident perivenular edema that was uncharas-teristic to acute respiratory distress syndrome induced by other causes are an important peculiarity of lung morphological changes in this experimental model of closed chest injury. Conclusion. The experimental studies clarified the pattern of lung morphological changes in the early period after closed chest injury. Key words: closed chest injury, pulmonary edema.

  4. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T. [Pediatric Intensive Care Unit, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Horev, G. [Dept. of Diagnostic Radiology, Schneider Children' s Medical Center of Israel, Petah Tiqva (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2001-06-01

    A 3{sup 1}/{sub 2}-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  5. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    International Nuclear Information System (INIS)

    Nahum, E.; Ben-Ari, J.; Schonfeld, T.; Horev, G.

    2001-01-01

    A 3 1 / 2 -year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

  6. Diagnostic accuracy for X-ray chest in interstitial lung disease as confirmed by high resolution computed tomography (HRCT) chest

    International Nuclear Information System (INIS)

    Afzal, F.; Raza, S.; Shafique, M.

    2017-01-01

    Objective: To determine the diagnostic accuracy of x-ray chest in interstitial lung disease as confirmed by high resolution computed tomography (HRCT) chest. Study Design: A cross-sectional validational study. Place and Duration of Study: Department of Diagnostic Radiology, Combined Military Hospital Rawalpindi, from Oct 2013 to Apr 2014. Material and Method: A total of 137 patients with clinical suspicion of interstitial lung disease (ILD) aged 20-50 years of both genders were included in the study. Patients with h/o previous histopathological diagnosis, already taking treatment and pregnant females were excluded. All the patients had chest x-ray and then HRCT. The x-ray and HRCT findings were recorded as presence or absence of the ILD. Results: Mean age was 40.21 ± 4.29 years. Out of 137 patients, 79 (57.66 percent) were males and 58 (42.34 percent) were females with male to female ratio of 1.36:1. Chest x-ray detected ILD in 80 (58.39 percent) patients, out of which, 72 (true positive) had ILD and 8 (false positive) had no ILD on HRCT. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of chest x-ray in diagnosing ILD was 80.0 percent, 82.98 percent, 90.0 percent, 68.42 percent and 81.02 percent respectively. Conclusion: This study concluded that chest x-ray is simple, non-invasive, economical and readily available alternative to HRCT with an acceptable diagnostic accuracy of 81 percent in the diagnosis of ILD. (author)

  7. Limiting chest computed tomography in the evaluation of pediatric thoracic trauma.

    Science.gov (United States)

    Golden, Jamie; Isani, Mubina; Bowling, Jordan; Zagory, Jessica; Goodhue, Catherine J; Burke, Rita V; Upperman, Jeffrey S; Gayer, Christopher P

    2016-08-01

    Computed tomography (CT) of the chest (chest CT) is overused in blunt pediatric thoracic trauma. Chest CT adds to the diagnosis of thoracic injury but rarely changes patient management. We sought to identify a subset of blunt pediatric trauma patients who would benefit from a screening chest CT based on their admission chest x-ray (CXR) findings. We hypothesize that limiting chest CT to patients with an abnormal mediastinal silhouette identifies intrathoracic vascular injuries not otherwise seen on CXR. All blunt trauma activations that underwent an admission CXR at our Level 1 pediatric trauma center from 2005 to 2013 were retrospectively reviewed. Patients who had a chest CT were evaluated for added diagnoses and change in management after CT. An admission CXR was performed in 1,035 patients. One hundred thirty-nine patients had a CT, and the diagnosis of intra-thoracic injury was added in 42% of patients. Chest CT significantly increased the diagnosis of contusion or atelectasis (30.3% vs 60.4%; p pneumothorax (7.2% vs 18.7%; p chest CT. Chest CT changed the management of only 4 patients (2.9%). Two patients underwent further radiologic evaluation that was negative for injury, one had a chest tube placed for an occult pneumothorax before exploratory laparotomy, and one patient had a thoracotomy for repair of aortic injury. Chest CT for select patients with an abnormal mediastinal silhouette on CXR would have decreased CT scans by 80% yet still identified patients with an intrathoracic vascular injury. The use of chest CT should be limited to the identification of intrathoracic vascular injuries in the setting of an abnormal mediastinal silhouette on CXR. Therapeutic study, level IV; diagnostic study, level III.

  8. Melatonin attenuates lung injury in a hind limb ischemia–reperfusion rat model

    Directory of Open Access Journals (Sweden)

    Hamed Takhtfooladi

    2015-01-01

    Full Text Available Objective: This study evaluated the protective antioxidant effect of melatonin on lung injury as a remote organ after skeletal muscle ischemia–reperfusion in rats. Methods: Thirty male Wistar rats were allocated randomly into three experimental groups: operated with no ischemia (Sham group, ischemia–reperfusion group and ischemia–reperfusion + melatonin group. Hind limb ischemia was induced by clamping the femoral artery. After 2 h ischemia, the clamp was removed and the animal underwent 24 h reperfusion. Rats in the ischemia–reperfusion + melatonin group received melatonin (10 mg/kg i.v., immediately before the clamp was removed. At the end of the trial, animals were euthanized and the lungs were removed for water content determination, histopathological and biochemical studies. Results: In the ischemia–reperfusion + melatonin group, tissues showed less intense histological abnormalities such as neutrophilic infiltration, intra-alveolar hemorrhage and edema compared with the ischemia–reperfusion group. Histopathologically, there was a significant difference (P < 0.05 between the two groups. The lung water content in the ischemia–reperfusion + melatonin group was significantly lower than the ischemia–reperfusion group (P < 0.05. Lung tissue myeloperoxidase (MPO activity and nitric oxide (NO level were significantly (P < 0.05 increased by ischemia–reperfusion. The increase in these parameters was reduced by melatonin.Comparing the ischemia–reperfusion + melatonin group with the sham group, no significant increase in all analyzed aspects of the research was observed. Conclusions: These findings suggest that melatonin has preventive effects in lung tissue injury after transient femoral artery occlusion. Keywords: Melatonin, Ischemia–reperfusion, Lung remote injury, Histopathology, Myeloperoxidase, Nitric oxide

  9. CSF transthyretin neuroprotection in a mouse model of brain ischemia

    DEFF Research Database (Denmark)

    Santos, Sofia Duque; Lambertsen, Kate Lykke; Clausen, Bettina Hjelm

    2010-01-01

    Brain injury caused by ischemia is a major cause of human mortality and physical/cognitive disability worldwide. Experimentally, brain ischemia can be induced surgically by permanent middle cerebral artery occlusion. Using this model, we studied the influence of transthyretin in ischemic stroke. ...

  10. Porcine cluster of differentiation (CD) markers 2018 update.

    Science.gov (United States)

    Dawson, Harry D; Lunney, Joan K

    2018-06-01

    Pigs are a major source of food worldwide; preventing and treating their infectious diseases is essential, requiring a thorough understanding of porcine immunity. The use of pigs as models for human physiology is a growing area; progress in this area has been limited because the immune toolkit is not robust. The international community has established cluster of differentiation (CD) markers for assessing cells involved in immunity as well as characterizing numerous other cells like stem cells. Overall, for humans 419 proteins have been designated as CD markers, each reacting with a defined set of antibodies (Abs). This paper summarizes current knowledge of swine CD markers and identifies 359 corresponding CD proteins in pigs. A broad-based literature and vendor search was conducted to identify defined sets of monoclonal (mAbs) and polyclonal Abs (pAbs) reacting with porcine CD markers along with other reagents (fusion proteins, ELISAs, PCR assays, and gene edited cell and pig models). This process identified over 800 reagents that are reportedly reactive with 266 pig CD markers. Despite this number, there is a great need to develop and characterize additional CD marker reagents, particularly mAbs, for pig research. There are numerous high priority targets: reagents for the characterization of porcine innate lymphoid cells, polarized macrophages and T regulatory cells and for the detection of porcine CD45 isoforms. Overall, improved technologies and genomics have contributed to dramatic increases in our knowledge of the pig, its immune system, disease and vaccine responses, and utility as a biomedical model. The development of more CD reagents will clearly advance these initiatives. Published by Elsevier Ltd.

  11. Chest Radiographic Findings in Newly Diagnosed Pulmonary ...

    African Journals Online (AJOL)

    Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...

  12. Discovery of a novel putative atypical porcine pestivirus in pigs in the USA.

    Science.gov (United States)

    Hause, Ben M; Collin, Emily A; Peddireddi, Lalitha; Yuan, Fangfeng; Chen, Zhenhai; Hesse, Richard A; Gauger, Phillip C; Clement, Travis; Fang, Ying; Anderson, Gary

    2015-10-01

    Pestiviruses are some of the most significant pathogens affecting ruminants and swine. Here, we assembled a 11 276 bp contig encoding a predicted 3635 aa polyprotein from porcine serum with 68 % pairwise identity to that of a recently partially characterized Rhinolophus affinis pestivirus (RaPV) and approximately 25-28 % pairwise identity to those of other pestiviruses. The virus was provisionally named atypical porcine pestivirus (APPV). Metagenomic sequencing of 182 serum samples identified four additional APPV-positive samples. Positive samples originated from five states and ELISAs using recombinant APPV Erns found cross-reactive antibodies in 94 % of a collection of porcine serum samples, suggesting widespread distribution of APPV in the US swine herd. The molecular and serological results suggest that APPV is a novel, highly divergent porcine pestivirus widely distributed in US pigs.

  13. Porcine, murine and human sialoadhesin (Sn/Siglec-1/CD169): portals for porcine reproductive and respiratory syndrome virus entry into target cells.

    Science.gov (United States)

    Van Breedam, Wander; Verbeeck, Mieke; Christiaens, Isaura; Van Gorp, Hanne; Nauwynck, Hans J

    2013-09-01

    Porcine sialoadhesin (pSn; a sialic acid-binding lectin) and porcine CD163 (pCD163) are molecules that facilitate infectious entry of porcine reproductive and respiratory syndrome virus (PRRSV) into alveolar macrophages. In this study, it was shown that murine Sn (mSn) and human Sn (hSn), like pSn, can promote PRRSV infection of pCD163-expressing cells. Intact sialic acid-binding domains are crucial, since non-sialic acid-binding mutants of pSn, mSn and hSn did not promote infection. Endodomain-deletion mutants of pSn, mSn and hSn promoted PRRSV infection less efficiently, but also showed markedly reduced expression levels, making further research into the potential role of the Sn endodomain in PRRSV receptor activity necessary. These data further complement our knowledge on Sn as an important PRRSV receptor, and suggest - in combination with other published data - that species differences in the main PRRSV entry mediators Sn and CD163 do not account for the strict host species specificity displayed by the virus.

  14. Methimazole protects lungs during hepatic ischemia-reperfusion injury in rats: an effect not induced by hypothyroidism.

    Science.gov (United States)

    Tütüncü, Tanju; Demirci, Cagatay; Gözalan, Ugur; Yüksek, Yunus Nadi; Bilgihan, Ayse; Kama, Nuri Aydin

    2007-05-01

    Hepatic ischemia-reperfusion injury may lead to remote organ failure with mortal respiratory dysfunction. The aim of the present study was to analyze the possible protective effects of methimazole on lungs after hepatic ischemia-reperfusion injury. Forty male Wistar albino rats were randomized into five groups: a control group, in which bilateral pulmonary lobectomy was done; a hepatic ischemia-reperfusion group, in which bilateral pulmonary lobectomy was done after hepatic ischemia-reperfusion; a thyroidectomy-ischemia-reperfusion group (total thyroidectomy followed by, 7 days later, bilateral pulmonary lobectomy after hepatic ischemia-reperfusion); a methimazole-ischemia-reperfusion group (following methimazole administration for 7 days, bilateral pulmonary lobectomy was done after hepatic ischemia-reperfusion); and a methimazole +L-thyroxine-ischemia-reperfusion group (following methimazole and L-thyroxine administration for 7 days, bilateral pulmonary lobectomy was performed after hepatic ischemia-reperfusion). Pulmonary tissue specimens were evaluated histopathologically and for myeloperoxidase and malondialdehyde levels. All of the ischemia-reperfusion intervention groups had higher pulmonary injury scoring indices than the control group (P < 0.001). Pulmonary injury index of the ischemia-reperfusion group was higher than that of both the methimazole-supplemented hypothyroid and euthyroid groups (P = 0028; P = 0,038, respectively) and was similar to that of the thyroidectomized group. Pulmonary tissue myeloperoxidase and malondialdehyde levels in the ischemia-reperfusion group were similar with that in the thyroidectomized rats but were significantly higher than that in the control, and both the methimazole-supplemented hypothyroid and euthyroid groups. Methimazole exerts a protective role on lungs during hepatic ischemia-reperfusion injury, which can be attributed to its anti-inflammatory and anti-oxidant effects rather than hypothyroidism alone.

  15. Clinical utility of coronary CT angiography with low-dose chest CT in the evaluation of patients with atypical chest pain: a preliminary report

    International Nuclear Information System (INIS)

    Lim, Soo Jin; Choo, Ki Seok; Kim, Chang Won

    2008-01-01

    To determine the clinical utility of coronary CT angiography (CCTA) with low-dose chest CT in the evaluation of patients with atypical chest pain. Ninety-six patients (mean age 60.2 years; age range, 41-68 years; 70 males) were referred for CCTA with low-dose chest CT (16-slice MDCT, Siemens) for an evaluation of atypical chest pain. When significant stenoses (lumen diameter reduction > 50%) were detected on CCTA, invasive coronary angiography (CA) was performed as the standard of reference. In all patients, medical chart review or telephone contact with patients was used to evaluate the contribution of CCTA with low-dose chest CT to the final clinical diagnosis, at least 6 months after performing CCTA. Among 96 patients, seven patients (7%) had significant stenoses as detected on CCTA, whereas two patients (2%) had significant stenoses and five patients had insignificant stenoses or no stenosis, as detected on conventional catheter angiography. In 18 (19%) of the 89 patients without significant stenosis detected on CCTA, this protocol provided additional information that suggested or confirmed an alternate clinical diagnosis. In patients with atypical chest pain, CCTA with low-dose chest CT could help to exclude ischemic heart disease and could provide important ancillary information for the final diagnosis

  16. Evaluation of a Noise Reduction Procedure for Chest Radiography

    Science.gov (United States)

    Fukui, Ryohei; Ishii, Rie; Kodani, Kazuhiko; Kanasaki, Yoshiko; Suyama, Hisashi; Watanabe, Masanari; Nakamoto, Masaki; Fukuoka, Yasushi

    2013-01-01

    Background The aim of this study was to evaluate the usefulness of noise reduction procedure (NRP), a function in the new image processing for chest radiography. Methods A CXDI-50G Portable Digital Radiography System (Canon) was used for X-ray detection. Image noise was analyzed with a noise power spectrum (NPS) and a burger phantom was used for evaluation of density resolution. The usefulness of NRP was evaluated by chest phantom images and clinical chest radiography. We employed the Bureau of Radiological Health Method for scoring chest images while carrying out our observations. Results NPS through the use of NRP was improved compared with conventional image processing (CIP). The results in image quality showed high-density resolution through the use of NRP, so that chest radiography examination can be performed with a low dose of radiation. Scores were significantly higher than for CIP. Conclusion In this study, use of NRP led to a high evaluation in these so we are able to confirm the usefulness of NRP for clinical chest radiography. PMID:24574577

  17. A new specifically designed forceps for chest drain insertion.

    LENUS (Irish Health Repository)

    Andrews, Emmet

    2012-02-03

    Insertion of a chest drain can be associated with serious complications. It is recommended that the drain is inserted with blunt dissection through the chest wall but there is no specific instrument to aid this task. We describe a new reusable forceps that has been designed specifically to facilitate the insertion of chest drains.A feasibility study of its use in patients who required a chest drain as part of elective cardiothoracic operations was undertaken. The primary end-point was successful and accurate placement of the drain. The operators also completed a questionnaire rating defined aspects of the procedure. The new instrument was used to insert the chest drain in 30 patients (19 male, 11 female; median age 61.5 years (range 16-81 years)). The drain was inserted successfully without the trocar in all cases and there were no complications. Use of the instrument rated as significantly easier relative to experience of previous techniques in all specified aspects. The new device can be used to insert intercostal chest drains safely and efficiently without using the trocar or any other instrument.

  18. Chest radiographic manifestations of scrub typhus

    Directory of Open Access Journals (Sweden)

    KPP Abhilash

    2016-01-01

    Full Text Available Background and Rationale: Respiratory system involvement in scrub typhus is seen in 20–72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Materials and Methods: Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. Results: The study cohort contained 398 patients. Common presenting complaints included fever (100%, generalized myalgia (83%, headache (65%, dyspnea (54%, cough (24.3%, and altered sensorium (14%. Almost half of the patients (49.4% had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%, acute respiratory distress syndrome (14%, airspace opacity (10.5%, reticulonodular opacities (10.3%, peribronchial thickening (5.8%, and pulmonary edema (2%. Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of 2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89–33.16, invasive ventilation (OR: 18.07; 95% CI: 6.42–50.88, inotropes (OR: 8.76; 95% CI: 4.35–17.62, higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; P< 0.001, and higher mortality (OR: 4.63; 95% CI: 1.54–13.85. Conclusion: Almost half of the patients with scrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.

  19. Ventricular septal necrosis after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Alireza Ahmadi

    2012-07-01

    Full Text Available Ventricular Septal Defect (VSD after blunt chest trauma is a very rare traumatic affection.We report here a case of blunt chest injury-related VSD and pseudoaneurysm.A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edemaand echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely theintracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue somehidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinicalsequelae.

  20. Clinical effectiveness of percutaneous angioplasty for acute and chronic mesenteric ischemia: a six case series.

    Science.gov (United States)

    Jung, Yu Min; Jo, Yun Ju; Ahn, Sang Bong; Son, Byoung Kwan; Kim, Seong Hwan; Park, Young Sook; Bae, June Ho; Cho, Young Kwon

    2011-04-01

    Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.

  1. Enteric porcine viruses in farmed shellfish in Denmark.

    Science.gov (United States)

    Krog, J S; Larsen, L E; Schultz, A C

    2014-09-01

    Bivalve shellfish are at constant risk of being exposed to pathogens as a consequence of contamination of the shellfish beds with human or animal waste originating from sewage treatment plants or slurry fertilized fields. Consumption of contaminated oysters and mussels are frequently reported as causes of disease outbreaks caused by norovirus or hepatitis A virus. Other zoonotic pathogens such as hepatitis E virus (HEV), rotavirus (RV) and Salmonella from livestock may also be transmitted to shellfish via this route. In this study, 29 pooled samples from commercial Danish blue mussels were tested for porcine pathogens and indicator bacteria Escherichia coli (E. coli). All samples tested negative for HEV, RV and Salmonella, whereas E. coli and the highly stable porcine circovirus type 2 (PCV2) were detected in eight and 12 samples, respectively. This is the first study to report the detection of PCV2 in commercial mussels. Based on the detection of PCV2 in clean areas with low prevalence of the normally applied fecal indicator E. coli, testing for PCV2 may be a more sensitive and robust specific porcine waste indicator in shellfish harvesting areas. Copyright © 2014. Published by Elsevier B.V.

  2. Trauma of the chest

    International Nuclear Information System (INIS)

    Reuter, M.

    1996-01-01

    This paper describes the typical radiologic findings in chest trauma, and the value of conventional radiography, CT, MRI, and aortography is discussed. Conventional radiography rather than cross-sectional imaging is the mainstay in diagnosing thoracic trauma. During the critical phase with often concomitant shock, pelvic and spinal injuries tailored raiographic views or even upright chest radiographs are impractical. The severely traumatized patient is usually radiographed in the supine position and suboptimal roentgenograms may have to be accepted for several reasons. It is well documented that many abnormalities detected on CT were not apparent on conventional radiographs, but CT is reserved for hemodynamical stable patients. Nevertheless certain situations like aortic rupture require further evaluation by CT and aortography. (orig./MG)

  3. Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT).

    Science.gov (United States)

    Rodriguez, Robert M; Langdorf, Mark I; Nishijima, Daniel; Baumann, Brigitte M; Hendey, Gregory W; Medak, Anthony J; Raja, Ali S; Allen, Isabel E; Mower, William R

    2015-10-01

    Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients-6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of 20.8% (95% CI 19.2%-22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%-100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%-96.9%), a specificity of 25.5% (95% CI 23.5%-27.5%), and a NPV of 93.9% (95% CI 91.5%-95.8%) for either major or minor injury. Chest CT-Major had a sensitivity of 99.2% (95% CI 95.4%-100%), a specificity of

  4. Chest pain in daily practice: occurrence, causes and management.

    Science.gov (United States)

    Verdon, François; Herzig, Lilli; Burnand, Bernard; Bischoff, Thomas; Pécoud, Alain; Junod, Michel; Mühlemann, Nicole; Favrat, Bernard

    2008-06-14

    We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between primary and emergency care settings, where most previous studies have been performed. 59 GPs in western Switzerland recorded all consecutive cases presenting with chest pain. Clinical characteristics, laboratory tests and other investigations as well as the diagnoses remaining after 12 months of follow-up were systematically registered. Among 24,620 patients examined during a total duration of 300 weeks of observation, 672 (2.7%) presented with chest pain (52% female, mean age 55 +/- 19(SD)). Most cases, 442 (1.8%), presented new symptoms and in 356 (1.4%) it was the reason for consulting. Over 40 ailments were diagnosed: musculoskeletal chest pain (including chest wall syndrome) (49%), cardiovascular (16%), psychogenic (11%), respiratory (10%), digestive (8%), miscellaneous (2%) and without diagnosis (3%). The three most prevalent diseases were: chest wall syndrome (43%), coronary artery disease (12%) and anxiety (7%). Unstable angina (6), myocardial infarction (4) and pulmonary embolism (2) were uncommon (1.8%). Potentially serious conditions including cardiac, respiratory and neoplasic diseases accounted for 20% of cases. A large number of laboratory tests (42%), referral to a specialist (16%) or hospitalisation (5%) were performed. Twentyfive patients died during follow-up, of which twelve were for a reason directly associated with thoracic pain [cancer (7) and cardiac causes (5)]. Thoracic pain was present in 2.7% of primary care consultations. Chest wall syndrome pain was the main aetiology. Cardio - vascular emergencies were uncommon. However chest pain deserves full consideration because of the occurrence of potentially serious conditions.

  5. Ischemia-reperfusion injury in rat fatty liver: role of nutritional status.

    Science.gov (United States)

    Caraceni, P; Nardo, B; Domenicali, M; Turi, P; Vici, M; Simoncini, M; De Maria, N; Trevisani, F; Van Thiel, D H; Derenzini, M; Cavallari, A; Bernardi, M

    1999-04-01

    Fatty livers are more sensitive to the deleterious effects of ischemia-reperfusion than normal livers. Nutritional status greatly modulates this injury in normal livers, but its role in the specific setting of fatty liver is unknown. This study aimed to determine the effect of nutritional status on warm ischemia-reperfusion injury in rat fatty livers. Fed and fasted rats with normal or fatty liver induced by a choline deficient diet underwent 1 hour of lobar ischemia and reperfusion. Rat survival was determined for 7 days. Serum transaminases, liver histology and cell ultrastructure were assessed before and after ischemia, and at 30 minutes, 2 hours, 8 hours, and 24 hours after reperfusion. Survival was also determined in fatty fasted rats supplemented with glucose before surgery. The preischemic hepatic glycogen was measured in all groups. Whereas survival was similar in fasted and fed rats with normal liver (90% vs. 100%), fasting dramatically reduced survival in rats with fatty liver (14% vs. 64%, P nutritional repletion procedure may be part of a treatment strategy aimed to prevent ischemia-reperfusion injury in fatty livers.

  6. Chest tube care in critically ill patient: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Hanan Mohammed Mohammed

    2015-10-01

    Full Text Available Breathing is automatic. We don’t usually think too much about it unless we develop a problem. Lack of adequate ventilation and impairment of our respiratory system can quickly become life-threatening. There are many clinical conditions that may necessitate the use of chest tubes. When there is an accumulation of positive pressure in the chest cavity (where it should normally be negative pressure between pleurae, a patient will require chest drainage. Chest tubes may be inserted to drain body fluids or to facilitate the re-expansion of a lung. It is important for the clinician to determine the most appropriate tube size to use prior to intubation. The position of the chest tube is related to the function that the chest tube performs. When managing the care of patients who have chest tubes it is important to fully understand what to do in case problems arise. It is also important to be able to assess when the chest tube is ready to be discontinued. Nurses and other healthcare professionals who are responsible for the safe delivery of care should be knowledgeable about respiratory pathophysiology, signs of respiratory compromise, and the care and management of interventions that may be utilized to ensure adequate respiration.

  7. Metabolomic profiling to characterize acute intestinal ischemia/reperfusion injury.

    Directory of Open Access Journals (Sweden)

    Rachel G Khadaroo

    Full Text Available Sepsis and septic shock are the leading causes of death in critically ill patients. Acute intestinal ischemia/reperfusion (AII/R is an adaptive response to shock. The high mortality rate from AII/R is due to the severity of the disease and, more importantly, the failure of timely diagnosis. The objective of this investigation is to use nuclear magnetic resonance (NMR analysis to characterize urine metabolomic profile of AII/R injury in a mouse model. Animals were exposed to sham, early (30 min or late (60 min acute intestinal ischemia by complete occlusion of the superior mesenteric artery, followed by 2 hrs of reperfusion. Urine was collected and analyzed by NMR spectroscopy. Urinary metabolite concentrations demonstrated that different profiles could be delineated based on the duration of the intestinal ischemia. Metabolites such as allantoin, creatinine, proline, and methylamine could be predictive of AII/R injury. Lactate, currently used for clinical diagnosis, was found not to significantly contribute to the classification model for either early or late ischemia. This study demonstrates that patterns of changes in urinary metabolites are effective at distinguishing AII/R progression in an animal model. This is a proof-of-concept study to further support examination of metabolites in the clinical diagnosis of intestinal ischemia reperfusion injury in patients. The discovery of a fingerprint metabolite profile of AII/R will be a major advancement in the diagnosis, treatment, and prevention of systemic injury in critically ill patients.

  8. The administration of renoprotective agents extends warm ischemia in a rat model.

    Science.gov (United States)

    Cohen, Jacob; Dorai, Thambi; Ding, Cheng; Batinic-Haberle, Ines; Grasso, Michael

    2013-03-01

    Extended warm ischemia time during partial nephrectomy leads to considerable renal injury. Using a rat model of renal ischemia, we examined the ability of a unique renoprotective cocktail to ameliorate warm ischemia-reperfusion injury and extend warm ischemia time. A warm renal ischemia model was developed using Sprague-Dawley rats, clamping the left renal artery for 40, 50, 60, and 70 minutes, followed by 48 hours of reperfusion. An improved renoprotective cocktail referred to as I-GPM (a mixture of specific renoprotective growth factors, porphyrins, and mitochondria-protecting amino acids) was administered -24 hours, 0 hours, and +24 hours after surgery. At 48 hours, both kidneys were harvested and examined with hematoxylin and eosin and periodic acid-Schiff stains for the analysis of renal tubular necrosis. Creatinine, protein, and gene expression levels were also analyzed to evaluate several ischemia-specific and antioxidant response markers. I-GPM treated kidneys showed significant reversal of morphologic changes and a significant reduction in specific ischemic markers lipocalin-2, galectin-3, GRP-78, and HMGB1 compared with ischemic controls. These experiments also showed an upregulation of the stress response protein, heat shock protein (HSP)-70, as well as the phosphorylated active form of the transcription factor, heat shock factor (HSF)-1. In addition, quantitative RT-PCR analyses revealed a robust upregulation of several antioxidant pathway response genes in I-GPM treated animals. By histopathologic and several molecular measures, our unique renoprotective cocktail mitigated ischemia-reperfusion injury. Our cocktail minimized oxidative stress in an ischemic kidney rat model while at the same time protecting the global parenchymal function during extended periods of ischemia.

  9. Glucose metabolism and neurogenesis in the gerbil hippocampus after transient forebrain ischemia

    Directory of Open Access Journals (Sweden)

    Dae Young Yoo

    2016-01-01

    Full Text Available Recent evidence exists that glucose transporter 3 (GLUT3 plays an important role in the energy metabolism in the brain. Most previous studies have been conducted using focal or hypoxic ischemia models and have focused on changes in GLUT3 expression based on protein and mRNA levels rather than tissue levels. In the present study, we observed change in GLUT3 immunoreactivity in the adult gerbil hippocampus at various time points after 5 minutes of transient forebrain ischemia. In the sham-operated group, GLUT3 immunoreactivity in the hippocampal CA1 region was weak, in the pyramidal cells of the CA1 region increased in a time-dependent fashion 24 hours after ischemia, and in the hippocampal CA1 region decreased significantly between 2 and 5 days after ischemia, with high level of GLUT3 immunoreactivity observed in the CA1 region 10 days after ischemia. In a double immunofluorescence study using GLUT3 and glial-fibrillary acidic protein (GFAP, we observed strong GLUT3 immunoreactivity in the astrocytes. GLUT3 immunoreactivity increased after ischemia and peaked 7 days in the dentate gyrus after ischemia/reperfusion. In a double immunofluorescence study using GLUT3 and doublecortin (DCX, we observed low level of GLUT3 immunoreactivity in the differentiated neuroblasts of the subgranular zone of the dentate gyrus after ischemia. GLUT3 immunoreactivity in the sham-operated group was mainly detected in the subgranular zone of the dentate gyrus. These results suggest that the increase in GLUT3 immunoreactivity may be a compensatory mechanism to modulate glucose level in the hippocampal CA1 region and to promote adult neurogenesis in the dentate gyrus.

  10. Chest trauma in children: current imaging guidelines and techniques.

    LENUS (Irish Health Repository)

    Moore, Michael A

    2011-09-01

    Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child\\'s clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

  11. Assessment and diagnosis of acute bowel ischemia with multidetector computed tomography (MDCT)

    International Nuclear Information System (INIS)

    Sojka, B.; Gieszczyk-Paraniak, B.; Gibinska, J.; Konopka, M.

    2008-01-01

    Acute bowel ischemia (ABT) is a life-threatening condition which most often effects elderly patients. It requires an intensive treatment and quick diagnosis. Unfortunately ABI manifested not only by specific but also various nonspecific clinical or laboratory finding. The radiological symptoms of the bowel ischemia are also differentiated and often nonspecific while the specific findings are rather uncommon.That is why the knowledge of the bowel ischemia pathogenesis and possible CT findings is so important for the correct diagnosis. The our paper, we present the radiological findings of the acute bowel ischemia based on the analysis of the patients' abdominal -CT examination. The purpose of our study is to MDCT in patients with acute bowel ischemia. The material of this study consists of four computer tomography examinations - three of those an angio-CT and one abdominal - in patients with acute abdomen symptoms. The result revealed the mesenteric thrombosis in two cases, and mesenteric artery stenosis in one case. In one case, the thrombus was present in the abdominal aorta. In conclusion, we claim that the MDCT should be the modality of choice for the diagnosis of the acute bowel ischemia. (author)

  12. Gene expression in cerebral ischemia: a new approach for neuroprotection.

    Science.gov (United States)

    Millán, Mónica; Arenillas, Juan

    2006-01-01

    Cerebral ischemia is one of the strongest stimuli for gene induction in the brain. Hundreds of genes have been found to be induced by brain ischemia. Many genes are involved in neurodestructive functions such as excitotoxicity, inflammatory response and neuronal apoptosis. However, cerebral ischemia is also a powerful reformatting and reprogramming stimulus for the brain through neuroprotective gene expression. Several genes may participate in both cellular responses. Thus, isolation of candidate genes for neuroprotection strategies and interpretation of expression changes have been proven difficult. Nevertheless, many studies are being carried out to improve the knowledge of the gene activation and protein expression following ischemic stroke, as well as in the development of new therapies that modify biochemical, molecular and genetic changes underlying cerebral ischemia. Owing to the complexity of the process involving numerous critical genes expressed differentially in time, space and concentration, ongoing therapeutic efforts should be based on multiple interventions at different levels. By modification of the acute gene expression induced by ischemia or the apoptotic gene program, gene therapy is a promising treatment but is still in a very experimental phase. Some hurdles will have to be overcome before these therapies can be introduced into human clinical stroke trials. Copyright 2006 S. Karger AG, Basel.

  13. Dictionary-driven Ischemia Detection from Cardiac Phase-Resolved Myocardial BOLD MRI at Rest

    Science.gov (United States)

    Bevilacqua, Marco; Dharmakumar, Rohan; Tsaftaris, Sotirios A.

    2016-01-01

    Cardiac Phase-resolved Blood-Oxygen-Level Dependent (CP–BOLD) MRI provides a unique opportunity to image an ongoing ischemia at rest. However, it requires post-processing to evaluate the extent of ischemia. To address this, here we propose an unsupervised ischemia detection (UID) method which relies on the inherent spatio-temporal correlation between oxygenation and wall motion to formalize a joint learning and detection problem based on dictionary decomposition. Considering input data of a single subject, it treats ischemia as an anomaly and iteratively learns dictionaries to represent only normal observations (corresponding to myocardial territories remote to ischemia). Anomaly detection is based on a modified version of One-class Support Vector Machines (OCSVM) to regulate directly the margins by incorporating the dictionary-based representation errors. A measure of ischemic extent (IE) is estimated, reflecting the relative portion of the myocardium affected by ischemia. For visualization purposes an ischemia likelihood map is created by estimating posterior probabilities from the OCSVM outputs, thus obtaining how likely the classification is correct. UID is evaluated on synthetic data and in a 2D CP–BOLD data set from a canine experimental model emulating acute coronary syndromes. Comparing early ischemic territories identified with UID against infarct territories (after several hours of ischemia), we find that IE, as measured by UID, is highly correlated (Pearson’s r = 0.84) w.r.t. infarct size. When advances in automated registration and segmentation of CP–BOLD images and full coverage 3D acquisitions become available, we hope that this method can enable pixel-level assessment of ischemia with this truly non-invasive imaging technique. PMID:26292338

  14. Lipid Supplement in the Cultural Condition Facilitates the Porcine iPSC Derivation through cAMP/PKA/CREB Signal Pathway

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    2018-02-01

    Full Text Available Large numbers of lipids exist in the porcine oocytes and early embryos and have the positive effects on their development, suggesting that the lipids may play an important role in pluripotency establishment and maintenance in pigs. However, the effects of lipids and their metabolites, such as fatty acids on reprogramming and the pluripotency gene expression of porcine-induced pluripotent stem cells (iPSCs, are unclear. Here, we generated the porcine iPSCs that resemble the mouse embryonic stem cells (ESCs under lipid and fatty-acid-enriched cultural conditions (supplement of AlbuMAX. These porcine iPSCs show positive for the ESCs pluripotency markers and have the differentiation abilities to all three germ layers, and importantly, have the capability of aggregation into the inner cell mass (ICM of porcine blastocysts. We further confirmed that lipid and fatty acid enriched condition can promote the cell proliferation and improve reprogramming efficiency by elevating cAMP levels. Interestingly, this lipids supplement promotes mesenchymal–epithelial transition (MET through the cAMP/PKA/CREB signal pathway and upregulates the E-cadherin expression during porcine somatic cell reprogramming. The lipids supplement also makes a contribution to lipid droplets accumulation in the porcine iPSCs that resemble porcine preimplantation embryos. These findings may facilitate understanding of the lipid metabolism in porcine iPSCs and lay the foundation of bona fide porcine embryonic stem cell derivation.

  15. Effect of limb demand ischemia on autophagy and morphology in mice.

    Science.gov (United States)

    Albadawi, Hassan; Oklu, Rahmi; Milner, John D; Uong, Thuy P; Yoo, Hyung-Jin; Austen, William G; Watkins, Michael T

    2015-10-01

    Obesity is a major risk factor for diabetes and peripheral arterial disease, which frequently leads to lower limb demand ischemia. Skeletal muscle autophagy and mitochondrial biogenesis are important processes for proper oxidative capacity and energy metabolism, which are compromised in diabetes. This study compares autophagy, mitochondrial biogenesis, energy metabolism, and morphology in the hind limbs of obese diabetic mice subjected to demand or sedentary ischemia. Unilateral hind limb demand ischemia was created in a group of diet-induced obese mice after femoral artery ligation and 4 wk of daily exercise. A parallel group of mice underwent femoral artery ligation but remained sedentary for 4 wk. Hind limb muscles were analyzed for markers of autophagy, mitochondrial biogenesis, adenosine triphosphate, and muscle tissue morphology. At the end of the 4-wk exercise period, demand ischemia increased the autophagy mediator Beclin-1, but it did not alter the autophagy indicator, LC3B-II/I ratio, or markers of mitochondrial biogenesis, optic atrophy/dynamin-related protein. In contrast, exercise significantly increased the level of mitochondrial protein-succinate dehydrogenase subunit-A and reduced adipocyte accumulation and the percentage of centrally nucleated myofibers in the demand ischemia limb. In addition, demand ischemia resulted in decreased uncoupling protein-3 levels without altering muscle adenosine triphosphate or pS473-Akt levels. Limb demand ischemia markedly decreased adipocyte accumulation and enhanced muscle regeneration in obese mice, but it did not appear to enhance autophagy, mitochondrial biogenesis, energy metabolism, or insulin sensitivity. Future studies aimed at evaluating novel therapies that enhance autophagy and mitochondrial biogenesis in diabetes with peripheral arterial disease are warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    International Nuclear Information System (INIS)

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-01-01

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted

  17. Is chlormethiazole neuroprotective in experimental global cerebral ischemia? A microdialysis and behavioral study.

    Science.gov (United States)

    Thaminy, S; Reymann, J M; Heresbach, N; Allain, H; Lechat, P; Bentué-Ferrer, D

    1997-04-01

    Chlormethiazole, an anticonvulsive agent, has been shown to have a possible neuroprotective effect against cerebral ischemia. In addition, chlormethiazole inhibits methamphetamine-induced release of dopamine, protecting against this neurotransmitter's neurotoxicity. The aim of this work was to ascertain whether, in experimental cerebral ischemia, chlormethiazole administration attenuated the ischemia-induced rise of the extracellular concentration of aminergic neurotransmitters and whether it reduces ischemia-induced deficits in memory and learning. Histology for assessment of ischemic damage was a so included. The four-vessel occlusion rat model was used to induce global cerebral ischemia. Aminergic neurotransmitters and their metabolites in the striatal extracellular fluid obtained by microdialysis were assayed by high-performance liquid chromatography-electrochemical detection. The drug was administered either IP (50 mg/kg-1) or directly through the dialysis probe (30 microM) 80 min before ischemia. For the behavioral test and histology, the drug was given IP (100 mg/kg-1) 1 h postischemia. The results obtained did not demonstrate any statistically significant evidence that chlormethiazole has an effect on the ischemia-induced rise in extracellular dopamine and serotonin levels. There was also no variation in metabolite levels. Behavioral measures (learning, recall) were not changed appreciably by the treatment. We observed no significant cell protection in the hippocampus (CA1, CA1), striatum, and entorhinal cortex in animals treated with chlormethiazole. We conclude that, under our experimental conditions, chlormethiazole has little or no effect on the neurochemical, neurobehavioral, and histological consequences of global cerebral ischemia.

  18. Routine chest X-ray in the allergy clinic

    International Nuclear Information System (INIS)

    Garcia-Barredo, M.R.; Usamentiaga, E.; Fidalgo, I.

    1997-01-01

    To determine whether routine chest X-ray is indicated in allergy patients when there is no evidence of cardiopulmonary involvement. A retrospective study to analyze the indications and radiologic findings in 515 consecutive patients who underwent chest X-ray: Positive findings were considered to be any radiological sing that led to the performance of additional diagnostic measures or a change in the therapeutic management of the patient. Positive radiologic findings were observed in 39 cases (7.59%). Only two patients (0.38%) were diagnosed as having diseases that were susceptible to proper treatment. In one of them (0.19%), the failure to perform chest X-ray would have impeded the introduction of proper treatment. We do not recommend carrying out routine chest X-ray in this patient population. (Author) 7 refs

  19. Protective Effect of Platelet Rich Plasma on Experimental Ischemia/Reperfusion Injury in Rat Ovary.

    Science.gov (United States)

    Bakacak, Murat; Bostanci, Mehmet Suhha; İnanc, Fatma; Yaylali, Asli; Serin, Salih; Attar, Rukset; Yildirim, Gazi; Yildirim, Ozge Kizilkale

    2016-01-01

    Ovarian torsion is a common cause of local ischemic damage, reduced follicular activity and infertility. Platelet-rich plasma (PRP) contains growth factors with demonstrated cytoprotective properties; so we evaluated PRP efficacy in a rat ischemia/reperfusion (I/R) model. Sixty adult female Sprague-Dawley albino rats were randomly assigned to 6 groups of 8 animals each: Sham, Ischemia, I/R, Sham + PRP, I + PRP and I/R + PRP; and the remaining 12 used to prepare PRP. Ischemia groups were subjected to bilateral adnexal torsion for 3 h, while I/R and I/R + PRP groups received subsequent detorsion for 3 h. Intraperitoneal PRP was administered 30 min prior to ischemia (Ischemia + PRP) or reperfusion (I/R + PRP). Total oxidant status (TOS), oxidative stress index (OSI) and total ovarian histopathological scores were higher in Ischemia and I/R groups than in the Sham group (p OSI and histopathological scores in I + PRP and I/R + PRP groups compared to the corresponding Ischemia and I/R groups (p OSI (r = 0.877, p < 0.001). Peritoneal vascular endothelial growth factor was significantly higher in PRP-treated groups than corresponding untreated groups (p < 0.05). PRP is effective for the prevention of ischemia and reperfusion damage in rat ovary. © 2015 S. Karger AG, Basel.

  20. Bacteriological research for the contamination of equipment in chest radiography

    International Nuclear Information System (INIS)

    Choi, Seung Gu; Song, Woon Heung; Kweon, Dae Cheol

    2015-01-01

    The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections

  1. Bacteriological research for the contamination of equipment in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Gu; Song, Woon Heung; Kweon, Dae Cheol [Shinhan University, Uijeongbu (Korea, Republic of)

    2015-12-15

    The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections.

  2. EFFECT OF NATURAL PLANT EXTRACTS ON PORCINE OVARIAN FUNCTIONS

    Directory of Open Access Journals (Sweden)

    Attila Kádasi

    2015-02-01

    Full Text Available This report provides information about the impact of chosen natural plant extracts on basic ovarian functions. This article summarizes our results concerning the effect of selected plant extracts on proliferation, apoptosis and hormone secretion – release of progesterone (P4, testosterone (T and leptin (L on porcine granulosa cells (GC, We analyzed effects of ginkgo (GB, rooibos (RB, flaxseed (FL, green tea polyphenols (GTPP, green tea - epigallocatechin-3-gallate (EGCG, resveratrol (RSV and curcumin (CURC (0; 1; 10 and 100 μg.ml-1 on markers of proliferation, apoptosis and secretory activity of porcine ovarian granulosa cells by using immunocytochemistry and EIA. It was demonstrated, that all these natural plants and plant molecules inhibited the accumulation of proliferation-related peptide (PCNA and apoptosis-associated peptide (Bax in cultured. Furthermore, it was observed that natural plant extracts altered progesterone, testosterone and leptin release in porcine ovarian cells. It is concluded, that GB, RB, FL, RSV, CURC, GTPP and EGCG can directly affect ovarian cells and therefore they could potentially influence ovarian functions.

  3. Purine Metabolism in Acute Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Ye. V. Oreshnikov

    2008-01-01

    Full Text Available Objective: to study the specific features of purine metabolism in clinically significant acute cerebral ischemia. Subjects and materials. Three hundred and fifty patients with the acutest cerebral ischemic stroke were examined. The parameters of gas and electrolyte composition, acid-base balance, the levels of malonic dialdehyde, adenine, guanine, hypox-anthine, xanthine, and uric acid, and the activity of xanthine oxidase were determined in arterial and venous bloods and spinal fluid. Results. In ischemic stroke, hyperuricemia reflects the severity of cerebral metabolic disturbances, hemodynamic instability, hypercoagulation susceptiility, and the extent of neurological deficit. In ischemic stroke, hyperuri-corachia is accompanied by the higher spinal fluid levels of adenine, guanine, hypoxanthine, and xanthine and it is an indirect indicator of respiratory disorders of central genesis, systemic acidosis, hypercoagulation susceptibility, free radical oxidation activation, the intensity of a stressor response to cerebral ischemia, cerebral metabolic disturbances, the depth of reduced consciousness, and the severity of neurological deficit. Conclusion. The high venous blood activity of xanthine oxidase in ischemic stroke is associated with the better neurological parameters in all follow-up periods, the better early functional outcome, and lower mortality rates. Key words: hyperuricemia, stroke, xanthine oxidase, uric acid, cerebral ischemia.

  4. Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Merve Tarhan

    2016-12-01

    Full Text Available Objective: The physician is responsible for inserting one or more chest tubes into the pleural space or the mediastinal space and connecting them to an appropriate drainage system. When the general principles about care of patients with chest drains were implemented correctly and effectively by nurses, nurse will contribute to accelerate the healing process of patients. In this context, the aim of this study was to determine the nurses’ level of knowledge regarding the care of patients with chest drains. Methods: The study was conducted with 153 nurses who worked in a chest diseases and thoracic surgery hospital in July 2014. Questionnaire form of 35 questions prepared by investigators was used to collect data. For the analysis of results, frequency tests, independent sample t-test and oneway ANOVA test were used. Results: 69.3% of nurses stated that they had obtained information from colleguages. 35.3% considered their knowledge about chest drain management to be inadequate. 55.6% scored 13 points and above from knowledge questionnaire about chest drain management. There were statistically significant difference between knowledge level and educational background, clinic work type, working unit, years of professional experience and institutional experience, frequency of contact patients with chest drain and perception of knowledge level (p<0.05. Conclusion: Results of this study indicate that lack of evidence-based nursing care and insufficient training has resulted in uncertainty and knowledge deficit in important aspects of chest drain care. It can be concluded that nurses receive training needs and training protocols are about chest drain management.

  5. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain.

    Science.gov (United States)

    Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

    2016-03-01

    A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram. Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R(2)=0.092, p=0.004; β= -0.525, R(2)=0.290, p=0.010). No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.

  6. Chest radiographic findings in Human Immunodeficiency Virus ...

    African Journals Online (AJOL)

    This study was carried out to determine findings on chest radiographs in HIV positive/AIDS patients at the University of Benin Teaching Hospital (UBTH) Benin City. All consecutive HIV positive/AIDS patients, managed at the UBTH between 1991 and 2001 were included in the study. Patients had postero-anterior (PA) chest ...

  7. Induction profile of MANF/ARMET by cerebral ischemia and its implication for neuron protection

    OpenAIRE

    Yu, Yong-Qiang; Liu, Lian-Cheng; Wang, Fa-Cai; Liang, Yan; Cha, Da-Qin; Zhang, Jing-Jing; Shen, Yu-Jun; Wang, Hai-Ping; Fang, Shengyun; Shen, Yu-Xian

    2009-01-01

    Cerebral ischemia-induced accumulation of unfolded proteins in vulnerable neurons triggers endoplasmic reticulum (ER) stress. Arginine-rich, mutated in early stage tumors (ARMET) is an ER stress-inducible protein and upregulated in the early stage of cerebral ischemia. The purposes of this study were to investigate the characteristics and implications of ARMET expression induced by focal cerebral ischemia. Focal cerebral ischemia in rats was induced by right middle cerebral artery occlusion w...

  8. Usefulness of Ga-67 citrate whole body imaging, chest spot imaging, and chest SPECT in sarcoidosis

    International Nuclear Information System (INIS)

    Ueno, Kyoichi; Nishi, Koichi; Namura, Masanobu; Kawashima, Yoshio; Kurumaya, Hiroshi

    1999-01-01

    To assess the sensitivity, and the relative role of Ga-67 whole body, chest spot imaging, and chest SPECT, we retrospectively studied 34 cases of sarcoidosis (24 biopsy proven, 10 clinically diagnosed) with Ga-67 (111 MBq), and compared the results of lung (25 cases), muscle (25 cases), skin (3 cases), and myocardial (2 cases) biopsies. Ga-67 chest SPECT (single photon emission CT) were done in 17 cases with Siemens MultiSPECT3. Ga-67 planar imaging visualized only 2 of 12 (16.7%) lung biopsy-positive cases, 5 of 12 (41.6%) muscle biopsy-positive cases, 2 of 3 (66.7%) skin biopsy-positive cases. However, Ga-67 imaging revealed the lesions in 1 of 9 (11.1%) of muscle biopsy-negative cases, in 2 of 3 (66.7%) of skin biopsy-negative cases, and in 1 of 2 myocardial biopsy-negative cases. Ga-67 chest SPECT visualized 14 hilar lymphadenopathy (LN), 3 supraclavicular LN, and 1 myocardial sarcoidosis. Although both SPECT, and planar spot imaging detected the lesions equally, the former showed them more clearly. Compared with various biopsies, the sensitivity of Ga-67 imaging was not so high. However, Ga-67 imaging is non-invasive, easy to perform the whole body imaging, and can detect the activity of the lesions. Ga-67 SPECT showed clear imaging of the hilar, mediastinal LN, and potentially fatal myocardial sarcoidosis. (author)

  9. Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis.

    Science.gov (United States)

    Zhou, Dong; Deng, Xu-Feng; Liu, Quan-Xing; Chen, Qian; Min, Jia-Xin; Dai, Ji-Gang

    2016-05-27

    In this meta-analysis, we conducted a pooled analysis of clinical studies comparing the efficacy of single chest tube versus double chest tube after a lobectomy. According to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of the PubMed, Embase, Cochrane Library and Web of Science databases to identify articles to include in our meta-analysis. A literature search was performed using relevant keywords. A meta-analysis was performed using RevMan© software. Five studies, published between 2003 and 2014, including 630 patients (314 patients with a single chest tube and 316 patients with a double chest tube), met the selection criteria. From the available data, the patients using a single tube demonstrated significantly decreased postoperative pain [weighted mean difference [WMD] -0.60; 95 % confidence intervals [CIs] -0.68-- 0.52; P tube after a pulmonary lobectomy. However, there were no significant differences in postoperative complications [OR 0.91; 95 % CIs 0.57-1.44; P = 0.67] and re-drainage rates [OR 0.81; 95 % CIs 0.42-1.58; P = 0.54]. Our results showed that a single-drain method is effective, reducing postoperative pain, hospitalization times and duration of drainage in patients who undergo a lobectomy. Moreover, the single-drain method does not increase the occurrence of postoperative complications and re-drainage rates.

  10. Pro-apoptotic Effect of Pifithrin-α on Preimplantation Porcine Fertilized Embryo Development

    Directory of Open Access Journals (Sweden)

    Brendan Mulligan

    2012-12-01

    Full Text Available The aim of this study was to investigate the impact of a reported p53 inhibitor, pifithrin-α (PFT-α, on preimplantation porcine in vitro fertilized (IVF embryo development in culture. Treatment of PFT-α was administered at both early (0 to 48 hpi, and later stages (48 to 168 hpi of preimplantation development, and its impact upon the expression of five genes related to apoptosis (p53, bak, bcl-xL, p66Shc and caspase3, was assessed in resulting d 7 blastocysts, using real-time quantitative PCR. Total cell numbers, along with the number of apoptotic nuclei, as detected by the in situ cell death detection assay, were also calculated on d 7 in treated and non-treated control embryos. The results indicate that PFT-α, when administered at both early and later stages of porcine IVF embryo development, increases the incidence of apoptosis in resulting blastocysts. When administered at early cleavage stages, PFT-α treatment was shown to reduce the developmental competence of porcine IVF embryos, as well as reducing the quality of resulting blastocysts in terms of overall cell numbers. In contrast, at later stages, PFT-α administration resulted in marginally increased blastocyst development rates amongst treated embryos, but did not affect cell numbers. However, PFT-α treatment induced apoptosis and apoptotic related gene expression, in all treated embryos, irrespective of the timing of treatment. Our results indicate that PFT-α may severely compromise the developmental potential of porcine IVF embryos, and is a potent apoptotic agent when placed into porcine embryo culture media. Thus, caution should be exercised when using PFT-α as a specific inhibitor of p53 mediated apoptosis, in the context of porcine IVF embryo culture systems.

  11. Molecular characterization and analysis of the porcine NURR1 gene

    Directory of Open Access Journals (Sweden)

    Knud Larsen

    2016-12-01

    Here we report the isolation and characterization of porcine NURR1 cDNA. The NURR1 cDNA was RT-PCR cloned using NURR1-specific oligonucleotide primers derived from in silico sequences. The porcine NURR1 cDNA encodes a polypeptide of 598 amino acids, displaying a very high similarity with bovine, human and mouse (99% NURR1 protein. Expression analysis revealed a differential NURR1 mRNA expression in various organs and tissues. NURR1 transcripts could be detected as early as at 60 days of embryo development in different brain tissues. A significant increase in NURR1 transcript in the cerebellum and a decrease in NURR1 transcript in the basal ganglia was observed during embryo development. The porcine NURR1 gene was mapped to chromosome 15. Two missense mutations were found in exon 3, the first coding exon of NURR1. Methylation analysis of the porcine NURR1 gene body revealed a high methylation degree in brain tissue, whereas methylation of the promoter was very low. A decrease in DNA methylation in a discrete region of the NURR1 promoter was observed in pig frontal cortex during pig embryo development. This observation correlated with an increase in NURR1 transcripts. Therefore, methylation might be a determinant of NURR1 expression at certain time points in embryo development.

  12. Inflammation and the neurovascular unit in the setting of focal cerebral ischemia.

    Science.gov (United States)

    del Zoppo, G J

    2009-02-06

    Responses to focal cerebral ischemia by neurons and adjacent microvessels are rapid, simultaneous, and topographically related. Recent observations indicate the simultaneous appearance of proteases by components of nearby microvessels that are also expressed by neurons in the ischemic territory, implying that the events could be coordinated. The structural relationship of neurons to their microvascular supply, the direct functional participation of glial cells, and the observation of a highly ordered microvessel-neuron response to ischemia suggest that these elements are arranged in and behave in a unitary fashion, the neurovascular unit. Their roles as a unit in the stimulation of cellular inflammation and the generation of inflammatory mediators during focal cerebral ischemia have not been explored yet. However, components of the neurovascular unit both generate and respond to these influences under the conditions of ischemia. Here we briefly explore the potential inter-relationships of the components of the neurovascular unit with respect to their potential roles in ischemia-induced inflammatory responses.

  13. Preoperative chest x-ray findings in peptic ulcer perforation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J. [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

    1981-12-15

    This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings.

  14. Preoperative chest x-ray findings in peptic ulcer perforation

    International Nuclear Information System (INIS)

    Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J.

    1981-01-01

    This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings

  15. Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease.

    Science.gov (United States)

    Jiang, Wei; Samad, Zainab; Boyle, Stephen; Becker, Richard C; Williams, Redford; Kuhn, Cynthia; Ortel, Thomas L; Rogers, Joseph; Kuchibhatla, Maragatha; O'Connor, Christopher; Velazquez, Eric J

    2013-02-19

    The goal of this study was to evaluate the prevalence and clinical characteristics of mental stress-induced myocardial ischemia. Mental stress-induced myocardial ischemia is prevalent and a risk factor for poor prognosis in patients with coronary heart disease, but past studies mainly studied patients with exercise-induced myocardial ischemia. Eligible patients with clinically stable coronary heart disease, regardless of exercise stress testing status, underwent a battery of 3 mental stress tests followed by a treadmill test. Stress-induced ischemia, assessed by echocardiography and electrocardiography, was defined as: 1) development or worsening of regional wall motion abnormality; 2) left ventricular ejection fraction reduction ≥ 8%; and/or 3) horizontal or downsloping ST-segment depression ≥ 1 mm in 2 or more leads lasting for ≥ 3 consecutive beats during at least 1 mental test or during the exercise test. Mental stress-induced ischemia occurred in 43.45%, whereas exercise-induced ischemia occurred in 33.79% (p = 0.002) of the study population (N = 310). Women (odds ratio [OR]: 1.88), patients who were not married (OR: 1.99), and patients who lived alone (OR: 2.24) were more likely to have mental stress-induced ischemia (all p mental stress-induced ischemia (all p Mental stress-induced ischemia is more common than exercise-induced ischemia in patients with clinically stable coronary heart disease. Women, unmarried men, and individuals living alone are at higher risk for mental stress-induced ischemia. (Responses of Myocardial Ischemia to Escitalopram Treatment [REMIT]; NCT00574847). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Effect of a critical coronary stenosis on myocardial neutrophil accumulation during ischemia and early reperfusion in dogs

    International Nuclear Information System (INIS)

    Richard, V.J.; Brooks, S.E.; Jennings, R.B.; Reimer, K.A.

    1989-01-01

    In many experimental models of ischemia and reperfusion, reperfusion is performed abruptly, allowing full reactive hyperemia to occur. In the clinical setting, however, reperfusion after thrombolysis is often limited by residual stenosis. Some experimental models attempt to mimic this situation with a critical stenosis. The purpose of this study was to determine whether preventing reactive hyperemia during the initial phase of reperfusion would modify the transmural distribution of myocardial blood flow or the myocardial accumulation of polymorphonuclear leukocytes (PMNs). The left circumflex artery was occluded for 90 minutes and then reperfused for 60 minutes in anesthetized, open-chest dogs. Autologous PMNs were isolated, labeled with 111In, and reinjected 1 hour before coronary occlusion. 125I-labeled albumin was injected simultaneously to correct for 111In associated with plasma proteins and to permit calculation of the number of PMNs in the inner, middle, and outer thirds of nonischemic and ischemic-reperfused tissue. The presence of a critical stenosis abolished reactive hyperemia during the first 5 minutes of reperfusion, but did not substantially affect blood flow measured after 55 minutes of reperfusion. In both groups, there was a significant accumulation of PMNs in all layers of the ischemic-reperfused bed compared with the nonischemic bed, and the magnitude of this PMN accumulation was not altered by the presence of a critical stenosis. Moreover, infarct size, estimated by triphenyl tetrazolium chloride (TTC) loss after 60 minutes of reperfusion, was not affected by the presence of a critical stenosis. Thus, the presence of a critical stenosis abolished the hyperemic blood flow after reperfusion but did not influence the early PMN response to ischemia and reperfusion or the early loss of TTC staining

  17. Significant Down-Regulation of “Biological Adhesion” Genes in Porcine Oocytes after IVM

    Directory of Open Access Journals (Sweden)

    Joanna Budna

    2017-12-01

    Full Text Available Proper maturation of the mammalian oocyte is a compound processes determining successful monospermic fertilization, however the number of fully mature porcine oocytes is still unsatisfactory. Since oocytes’ maturation and fertilization involve cellular adhesion and membranous contact, the aim was to investigate cell adhesion ontology group in porcine oocytes. The oocytes were collected from ovaries of 45 pubertal crossbred Landrace gilts and subjected to two BCB tests. After the first test, only granulosa cell-free BCB+ oocytes were directly exposed to microarray assays and RT-qPCR (“before IVM” group, or first in vitro matured and then if classified as BCB+ passed to molecular analyses (“after IVM” group. As a result, we have discovered substantial down-regulation of genes involved in adhesion processes, such as: organization of actin cytoskeleton, migration, proliferation, differentiation, apoptosis, survival or angiogenesis in porcine oocytes after IVM, compared to oocytes analyzed before IVM. In conclusion, we found that biological adhesion may be recognized as the process involved in porcine oocytes’ successful IVM. Down-regulation of genes included in this ontology group in immature oocytes after IVM points to their unique function in oocyte’s achievement of fully mature stages. Thus, results indicated new molecular markers involved in porcine oocyte IVM, displaying essential roles in biological adhesion processes.

  18. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  19. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  20. Gastric Tissue Damage Analysis Generated by Ischemia: Bioimpedance, Confocal Endomicroscopy, and Light Microscopy

    Directory of Open Access Journals (Sweden)

    Nohra E. Beltran

    2013-01-01

    Full Text Available The gastric mucosa ischemic tissular damage plays an important role in critical care patients’ outcome, because it is the first damaged tissue by compensatory mechanism during shock. The aim of the study is to relate bioimpedance changes with tissular damage level generated by ischemia by means of confocal endomicroscopy and light microscopy. Bioimpedance of the gastric mucosa and confocal images were obtained from Wistar male rats during basal and ischemia conditions. They were anesthetized, and stain was applied (fluorescein and/or acriflavine. The impedance spectroscopy catheter was inserted and then confocal endomicroscopy probe. After basal measurements and biopsy, hepatic and gastric arteries clamping induced ischemia. Finally, pyloric antrum tissue was preserved in buffered formaldehyde (10% for histology processing using light microscopy. Confocal images were equalized, binarized, and boundary defined, and infiltrations were quantified. Impedance and infiltrations increased with ischemia showing significant changes between basal and ischemia conditions (. Light microscopy analysis allows detection of general alterations in cellular and tissular integrity, confirming gastric reactance and confocal images quantification increments obtained during ischemia.

  1. Diagnosing pulmonary edema: lung ultrasound versus chest radiography.

    Science.gov (United States)

    Martindale, Jennifer L; Noble, Vicki E; Liteplo, Andrew

    2013-10-01

    Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. To evaluate the ability of residents to recognize pulmonary edema on lung ultrasound using chest radiographs as a comparison standard. This is a prospective, blinded, observational study of a convenience sample of resident physicians in the Departments of Emergency Medicine (EM), Internal Medicine (IM), and Radiology. Residents were given a tutorial on interpreting pulmonary edema on both chest radiograph and lung ultrasound. They were then shown both ultrasounds and chest radiographs from 20 patients who had presented to the emergency department with dyspnea, 10 with a primary diagnosis of pulmonary edema, and 10 with alternative diagnoses. Cohen's κ values were calculated to describe the strength of the correlation between resident and gold standard interpretations. Participants included 20 EM, 20 IM, and 20 Radiology residents. The overall agreement with gold standard interpretation of pulmonary edema on lung ultrasound (74%, κ = 0.51, 95% confidence interval 0.46-0.55) was superior to chest radiographs (58%, κ = 0.25, 95% confidence interval 0.20-0.30) (P Radiology residents interpreted chest radiographs more accurately than did EM and IM residents. Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.

  2. Myocardial ischemia in severe aortic regurgitation despite angiographically normal coronary arteries

    International Nuclear Information System (INIS)

    Aksoy, S.; Cam, N.; Guney, M.R.; Gurkan, U.; Oz, D.; Poyraz, E.; Eksik, A.; Agirbasli, M.

    2012-01-01

    Patients with severe aortic regurgitation frequently present with angina pectoris. The exact pathophysiology for angina in aortic regurgitation is not clear. Left ventricular hypertrophy and myocardial blood supply-demand mismatch have been the suggested mechanisms to explain ischemia. However, no conclusive clinical study exists to define the incidence of ischemia in patients with severe aortic regurgitation and normal coronary arteries. We, therefore, investigated the frequency of myocardial ischemia in relation to left ventricular hypertrophy or dilatation in patients with severe aortic regurgitation and normal coronary arteries. We reviewed the medical records of all patients (n=311) with aortic valve replacement due to aortic regurgitation between 2007 and 2010. We selected subjects with normal coronary arteries (n=182) for the study purpose, and we identified 35 patients who underwent myocardial perfusion scintigraphy prior to the coronary angiography (19 female and 16 male subjects; age 45.0±8.9 years). Left ventricular hypertrophy and dilatation were detected in 9 (26%) and 5 (14%) patients, respectively. Myocardial perfusion scintigraphy showed evidence of ischemia in 10 (29%) patients with normal coronary arteries. The presence of ischemia did not relate to the presence of left ventricular hypertrophy and/or dilatation. As a potential mechanism, aortic regurgitation causes backflow of blood from the aorta into the left ventricle, hence disturbs coronary flow dynamics. In conclusion, myocardial ischemia is common (nearly one-third) among patients with severe aortic regurgitation even in the absence of coronary obstruction, left ventricular hypertrophy and/or dilatation. (author)

  3. Repetitive Transient Ischemia-Induced Cardiac Angiogenesis is Mediated by Camkii Activation

    Directory of Open Access Journals (Sweden)

    Zhuobin Chen

    2018-05-01

    Full Text Available Background/Aims: Coronary angiogenesis is an important protective mechanism in response to myocardial ischemia in coronary artery disease. However, the underlying mechanisms remain largely unclear. Here, we investigated the role of CaMKII activation in ischemia-induced cardiac angiogenesis. Methods: Repetitive transient ischemia model was established in C57/BL6 mice by daily multiple episodes (3 times/day of short time (5 min occlusion of the left anterior descending coronary artery for 7 days. Coronary angiogenesis was detected by immunofluorescent staining. RT-qPCR and Western blot analyses were used to detect the mRNA and protein levels of CaMKII, p-CaMKII and VEGF. Primary cardiac microvascular endothelial cells (CMECs were isolated to investigate the effects of KN93 on cell proliferation and migration in hypoxic condition. Results: We found that angiogenesis was induced in the ischemic myocardium and suppressed by chronic intraperitoneal injection of CaMKII inhibitor KN93. RT-qPCR and Western blot analyses showed that myocardial ischemia induced an increased expression and autophosphorylation of CaMKII. VEGF expression was increased in the ischemia model but blunted by KN93. Moreover, KN93 suppressed the proliferation and migration of cardiac endothelial cells in hypoxic condition in which the protein expression of CaMKII, p-CaMKII and VEGF was increased. Conclusion: CaMKII is an important mediator for the ischemia-induced coronary angiogenesis, in which CaMKII-triggered VEGF expression plays a key role.

  4. Diagnostic Value of Procalcitonin Levels in Acute Mesenteric Ischemia

    Directory of Open Access Journals (Sweden)

    Yunus Karaca

    2015-09-01

    Full Text Available Background: Acute mesenteric ischemia (AMI is a potentially fatal disease. Difficulties in diagnosis make it essential to find early biomarkers. Aims: This study investigated the diagnostic value of procalcitonin (PCT levels in AMI. Study Design: Animal experimentation. Methods: Rats were divided into six groups of six animals each. In the experimental group, an experimental ischemia model was established by clamping the superior mesenteric artery from the aortic outflow tract. Blood and tissue specimens were collected from rats in the experimental mesenteric ischemia model at 30 min and 2 and 6 h, and these were compared with specimens from the respective control groups. PCT levels were compared at 30 min and 2 and 6 h. Results: PCT levels were 185.3 pg/mL in the control group and 219.3 pg/mL in the study group, 199.6 pg/mL in the control group and 243.9 pg/mL in the study group, and 201.9 pg/mL in the control group and 286.9 pg/mL in the study group, respectively, at 30 minute, 2 and 6 hours. Significant differences were determined between 6-h control group and ischemia group PCT levels (p=0.005. Conclusion: The absence of a significant increase in PCT levels in the early period, while a significant difference was detected in the later period (6 h, shows that PCT levels rise late in mesenteric ischemia and can be a marker in the late period.

  5. Roentgenologic findings of non-penetrating extracardiac chest injuries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Duck; Ra, Woo Youn [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1975-06-15

    Of the conventional P-A and A-P chest films which have been studied, many roentgenologic signs suggested for chest trauma. In the present study, an effort was designated to further clarify the x-ray findings of the nonpenetrating extracardiac chest injuries and to observe the x-ray findings being a leading maneuver of surgical procedure. Fat embolism and shock lung must be kept in mind on follow up films. The results thus obtained are summarized as follows; 1. Most of cases are visualized between the age of 10 and 50 and more common in male. 2. The denoting rib fracture, hemopneumothorax, and lung contusion are direct roentgenologic signs. 3. In case of serious result which showed pulmonary edema pattern on conventional chest films, we thought fat embolism or shock lung to be the cause of death.

  6. Understanding chest radiographic anatomy with MDCT reformations

    Energy Technology Data Exchange (ETDEWEB)

    Sussmann, A.R. [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States); Ko, J.P., E-mail: jane.ko@nyumc.or [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States)

    2010-02-15

    Chest radiograph interpretation requires an understanding of the mediastinal reflections and anatomical structures. Computed tomography (CT) improves the learning of three-dimensional (3D) anatomy, and more recently multidetector CT (MDCT) technology has enabled the creation of high-quality reformations in varying projections. Multiplanar reformations (MPRs) of varying thickness in the coronal and sagittal projections can be created for direct correlation with findings on frontal and lateral chest radiographs, respectively. MPRs enable simultaneous visualization of the craniocaudal extent of thoracic structures while providing the anatomic detail that has been previously illustrated using cadaveric specimens. Emphasis will be placed on improving knowledge of mediastinal anatomy and reflections including edges, lines, and stripes that are visible on chest radiographs.

  7. Appraisal of the porcine kidney autotransplantation model

    NARCIS (Netherlands)

    Post, Ivo C. J. H.; Dirkes, Marcel C.; Heger, Michal; van Loon, Johannes P. A. M.; Swildens, Bas; Huijzer, Goos M.; van Gulik, Thomas M.

    2012-01-01

    Animal models are extensively used for transplantation related research, especially kidney transplantation. Porcine autotransplantation models are considered to be favorable regarding translatability to the human setting. The key determinants for translatability of the model are discussed,

  8. On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

    Science.gov (United States)

    Kröner, Anke; Binnekade, Jan M; Graat, Marleen E; Vroom, Margreeth B; Stoker, Jaap; Spronk, Peter E; Schultz, Marcus J

    2008-01-01

    Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected. Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P chest CT studies nor the ratio of chest CT studies per patient day changed with the intervention: Before elimination of daily-routine CXR, 52 chest CT studies were obtained from 747 patients; after elimination, 54 CT studies were obtained from 743 patients. Similarly, chest ultrasound practice was not affected by the change of CXR strategy: Before and after elimination, 21 and 27 chest ultrasound studies were performed, respectively. Also, timing of chest CT and ultrasound studies was not different between the two study periods. During the two periods, 40 of 106 chest CT studies (38%) and 18 of 48 chest ultrasound studies (38%) resulted in a change in therapy. The combined therapeutic yield of chest CT and ultrasound studies did not change with elimination of daily-routine CXR. Elimination of daily-routine CXRs may not affect chest CT and ultrasound practice in a multidisciplinary intensive care unit.

  9. Comparison of the effect of fatty alcohols on the permeation of melatonin between porcine and human skin.

    Science.gov (United States)

    Andega, S; Kanikkannan, N; Singh, M

    2001-11-09

    Melatonin (MT) is a hormone secreted by the pineal gland that plays an important role in the regulation of the circadian sleep-wake cycle. It would be advantageous to administer MT using a transdermal delivery system for the treatment of sleep disorders such as delayed sleep syndrome, jet lag in travelers, cosmonauts and shift workers. The porcine skin has been found to have similar morphological and functional characteristics as human skin. The elastic fibres in the dermis, enzyme pattern of the epidermis, epidermal tissue turnover time, keratinous proteins and thickness of epidermis of porcine skin are similar to human skin. However, the fat deposition and vascularisation of the cutaneous glands of porcine skin are different from human skin. In addition, porcine skin has been found to have a close permeability character to human skin. However, the comparative effect of chemical penetration enhancers on the permeation of drugs between porcine and human skin has not been reported. The purpose of this study was to compare the effect of fatty alcohols on the permeability of porcine and human skin using MT as a model compound. The effect of saturated fatty alcohols (octanol, nonanol, decanol, undecanol, lauryl alcohol, tridecanol, myristyl alcohol) and unsaturated fatty alcohols (oleyl alcohol, linoleyl alcohol, linolenyl alcohol) at 5% concentration was tested across dermatomed porcine and human skin. Our studies showed a parabolic relationship between the carbon chain length of saturated fatty alcohols and permeation enhancement of MT with both porcine and human skin. Maximum permeation of MT was observed when fatty alcohol carbon chain length was 10. In general, as the level of unsaturation increased from one to two double bonds, there was an increase in the permeation of MT both in porcine and human skin. However, a decrease in the permeation was observed with three double bonds. Regression analysis using the steady state flux data showed a significant positive

  10. Determinants of Mortality in Chest Trauma Patients

    African Journals Online (AJOL)

    10% of trauma admissions.[1,2] In the United States it is estimated at 12 out of 1 million population per day.[3] Furthermore chest injury is still directly responsible for about 25% of trauma‑related deaths and contribute to death in another 25% of trauma‑related deaths.[1,2,4] Therefore, chest injury directly and indirectly ...

  11. Radiodiagnosis of pulmonary lesions in a severe closed chest trauma

    International Nuclear Information System (INIS)

    Kishkovskij, A.N.; Tyutin, L.A.; Savchenko, B.K.

    1986-01-01

    The results of X-ray examination of 548 persons with a severe closed chest trauma were summed up. Urgent chest X-ray examination included panoramic roentgenography or electroroentgenography of the chest in two projections performed mostly in a special wheelchair without resetting and turning the patients. Dynamic X-ray control was used afterwards. Pulmonary lesions developed most frequently in a closed chest trauma. Roentgenosemiotics of lung contusion was characterized by a variety of symptoms and determined by the nature of a contusion syndrome. Infiltrate like, cavitary, miliary and peribronchial forms of lung contusion should be distinguished by an X-ray picture. In lung rupture, pneumothorax was detected in 33%, pneumohemothorax in 56%, emphysema of the chest soft tissues in 28%, mediastinal emphysema in 4% of the cases

  12. Microdialysis assessment of peripheral metabolism in critical limb ischemia after endovascular revascularization

    OpenAIRE

    Tozzi, Matteo; Muscianisi, Elisa; Piffaretti, Gabriele; Castelli, Patrizio

    2009-01-01

    Abstract Background Critical limb ischemia is a chronic pathologic condition defined by the lack of blood flow in peripheral circulation. Microdialysis is a well-known and sensitive method for the early detection of tissue ischemia. The aim of the present study was to use microdialysis in order to analyse cellular metabolism changes after peripheral endovascular revascularization. Methods Ten patients diagnosed with critical limb ischemia was enrolled. CMA 60 (CMA® - Solna, Sweden) catheter w...

  13. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain

    OpenAIRE

    Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

    2016-01-01

    Background and Objectives A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Subjects and Methods Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were ex...

  14. Prevalence of Ischemia on Myocardial Perfusion Scintigraphy of Pre- and Postmenopausal Women

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniel Augusto Message dos, E-mail: danielmessage@cardiol.br; Navarro, Wendy Yasdin Sierraalta; Alexandre, Leonardo Machado; Cestari, Priscila Feitosa; Smanio, Paola Emanuela Poggio [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-12-15

    In postmenopausal women, the presence of risk factors for coronary artery disease (CAD) increases. However, the difference in prevalence of ischemia between pre- and postmenopausal women with multiple risk factors for CAD has not been well established. To compare the prevalence of ischemia on Tc{sup 99m}-sestamibi myocardial perfusion scintigraphy (MPS) in pre-and postmenopausal women, and to evaluate whether menopause can be considered an independent risk predictor of ischemia in women with multiple risk factors for CAD. This study retrospectively assessed 500 MPS of pre- and postmenopausal women with multiple risk factors for CAD. Statistical analysis was performed by using Fisher exact test and univariate and multivariate analysis, a p value ≤ 0.05 being considered significant. Postmenopausal women represented 55.9% of the sample; 83.3% were hypertensive; 28.9%, diabetic; 32.1%, smokers; 25%, obese; 61.2% had high cholesterol levels; and 34.3% had known CAD. Postmenopausal women were more often hypertensive, diabetic and dyslipidemic, and had lower functional capacity on exercise testing (p = < 0.005). The presence of ischemia on MPS did not significantly differ between the pre- and postmenopausal groups (p = 0.395). The only variable associated with ischemia on MPS was known CAD (p = 0.004). The results suggest that, in women with multiple risk factors for CAD, menopause was not an independent predictor of ischemia on MPS. Those data support the idea that the investigation of ischemia via MPS in women with multiple risk factors for CAD should begin prior to menopause.

  15. Prevalence of Ischemia on Myocardial Perfusion Scintigraphy of Pre- and Postmenopausal Women

    International Nuclear Information System (INIS)

    Santos, Daniel Augusto Message dos; Navarro, Wendy Yasdin Sierraalta; Alexandre, Leonardo Machado; Cestari, Priscila Feitosa; Smanio, Paola Emanuela Poggio

    2013-01-01

    In postmenopausal women, the presence of risk factors for coronary artery disease (CAD) increases. However, the difference in prevalence of ischemia between pre- and postmenopausal women with multiple risk factors for CAD has not been well established. To compare the prevalence of ischemia on Tc 99m -sestamibi myocardial perfusion scintigraphy (MPS) in pre-and postmenopausal women, and to evaluate whether menopause can be considered an independent risk predictor of ischemia in women with multiple risk factors for CAD. This study retrospectively assessed 500 MPS of pre- and postmenopausal women with multiple risk factors for CAD. Statistical analysis was performed by using Fisher exact test and univariate and multivariate analysis, a p value ≤ 0.05 being considered significant. Postmenopausal women represented 55.9% of the sample; 83.3% were hypertensive; 28.9%, diabetic; 32.1%, smokers; 25%, obese; 61.2% had high cholesterol levels; and 34.3% had known CAD. Postmenopausal women were more often hypertensive, diabetic and dyslipidemic, and had lower functional capacity on exercise testing (p = < 0.005). The presence of ischemia on MPS did not significantly differ between the pre- and postmenopausal groups (p = 0.395). The only variable associated with ischemia on MPS was known CAD (p = 0.004). The results suggest that, in women with multiple risk factors for CAD, menopause was not an independent predictor of ischemia on MPS. Those data support the idea that the investigation of ischemia via MPS in women with multiple risk factors for CAD should begin prior to menopause

  16. Rib fixation for severe chest deformity due to multiple rib fractures.

    Science.gov (United States)

    Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

    2012-01-01

    The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

  17. Intestinal ischemia-reperfusion injury augments intestinal mucosal injury and bacterial translocation in jaundiced rats.

    Science.gov (United States)

    Yüksek, Yunus Nadi; Kologlu, Murat; Daglar, Gül; Doganay, Mutlu; Dolapci, Istar; Bilgihan, Ayse; Dolapçi, Mete; Kama, Nuri Aydin

    2004-01-01

    The aim of this study was to evaluate local effects and degree of bacterial translocation related with intestinal ischemia-reperfusion injury in a rat obstructive jaundice model. Thirty adult Sprague-Dawley rats (200-250 g) were divided into three groups; including Group 1 (jaundice group), Group 2 (jaundice-ischemia group) and Group 3 (ischemia group). All rats had 2 laparotomies. After experimental interventions, tissue samples for translocation; liver and ileum samples for histopathological examination, 25 cm of small intestine for mucosal myeloperoxidase and malondialdehyde levels and blood samples for biochemical analysis were obtained. Jaundiced rats had increased liver enzyme levels and total and direct bilirubin levels (p<0.05). Intestinal mucosal myeloperoxidase and malondialdehyde levels were found to be high in intestinal ischemia-reperfusion groups (p<0.05). Intestinal mucosal damage was more severe in rats with intestinal ischemia-reperfusion after bile duct ligation (p<0.05). Degree of bacterial translocation was also found to be significantly high in these rats (p<0.05). Intestinal mucosa is disturbed more severely in obstructive jaundice with the development of ischemia and reperfusion. Development of intestinal ischemia-reperfusion in obstructive jaundice increases bacterial translocation.

  18. Outcomes of Complete Versus Partial Surgical Stabilization of Flail Chest.

    Science.gov (United States)

    Nickerson, Terry P; Thiels, Cornelius A; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J

    2016-01-01

    Rib fractures are common after chest wall trauma. For patients with flail chest, surgical stabilization is a promising technique for reducing morbidity. Anatomical difficulties often lead to an inability to completely repair the flail chest; thus, the result is partial flail chest stabilization (PFS). We hypothesized that patients with PFS have outcomes similar to those undergoing complete flail chest stabilization (CFS). A prospectively collected database of all patients who underwent rib fracture stabilization procedures from August 2009 until February 2013 was reviewed. Abstracted data included procedural and complication data, extent of stabilization, and pulmonary function test results. Of 43 patients who underwent operative stabilization of flail chest, 23 (53%) had CFS and 20 (47%) underwent PFS. Anterior location of the fracture was the most common reason for PFS (45%). Age, sex, operative time, pneumonia, intensive care unit and hospital length of stay, and narcotic use were the same in both groups. Total lung capacity was significantly improved in the CFS group at 3 months. No chest wall deformity was appreciated on follow-up, and no patients underwent additional stabilization procedures following PFS. Despite advances in surgical technique, not all fractures are amenable to repair. There was no difference in chest wall deformity, narcotic use, or clinically significant impairment in pulmonary function tests among patients who underwent PFS compared with CFS. Our data suggest that PFS is an acceptable strategy and that extending or creating additional incisions for CFS is unnecessary.

  19. Isolation and culture of porcine neural progenitor cells from embryos and pluripotent stem cells

    DEFF Research Database (Denmark)

    Rasmussen, Mikkel Aabech; Hall, Vanessa Jane; Hyttel, Poul

    2013-01-01

    from porcine embryos or induced pluripotent stem cells is presented. The neural induction is performed in coculture and the isolation of rosette structures is carried out manually to ensure a homogenous population of NPCs. Using this method, multipotent NPCs can be obtained in approximately 1 month......The isolation and culture of neural progenitor cells (NPCs) from pluripotent stem cells has facilitated in vitro mechanistic studies of diseases related to the nervous system, as well as discovery of new medicine. In addition, NPCs are envisioned to play a crucial role in future cell replacement...... therapy. The pig has become recognized as an important large animal model and establishment of in vitro-derived porcine NPCs would allow for preclinical safety testing by transplantation in a porcine biomedical model. In this chapter, a detailed method for isolation and in vitro culture of porcine NPCs...

  20. Diagnostic problems in chest injuries (angiography)

    International Nuclear Information System (INIS)

    Wenz, W.; Strecker, E.P.; Kloehn, I.

    1979-01-01

    Roentgenography is the simplest and most reliable means to arrive at the diagnosis of chest injury. General roentgenograms are difficult to interpret as they tend to be technically imperfect. Fractures, emphysema, pneumothorax, accumulation of fluid can usually be ascertained directly; but the traumatic origin of changes in the pulmonary parenchyma or of an enlarged heart shadow cannot be reliably deduced from the X-ray appearance. It may provide some differential-diagnostic information but the correct interpretation of the findings depends on further observation. In 6-7% of severe chest trauma with vascular injuries and rupture of the diaphragm angiography is indicated. The evidence to be obtained from chest radiography should not be overestimated: fractures of ribs are sometimes overlocked, even by the expert; parenchymatous lesions may manifest themselves as shadows but their nature remains obscure until they have been related to the clinical and subsequent radiological findings. The same applies to rupture of the diaphragm, bronchi or vessels, if only the immediate posttraumatic roentgenographs are examined. A tent-shaped heart shadow is considered characteristic of the presence of fluid in the pericardium; this is valid only for chronic hydropericardium, but not for the potentially fatal cardiac tamponade; if the pericardium has lost its elasticity a haemorrhage of not more than 150 ml may prove fatal. Nor does the roentgenogram provide information about pulmonary function. Especially in cases of pulmonary shock minor changes in the chest roentgenogram may give a false sense of security when, in fact, blood gas analyses show that a life-endangering situation has developed. The radiologist who is aware of the limitations of the method will derive maximum diagnostic benefit from a chest angiography. No other method is capable of supplying information of such great importance in such a short time. (orig.) [de

  1. Transcription analysis of the porcine alveolar macrophage response to Mycoplasma hyopneumoniae.

    Directory of Open Access Journals (Sweden)

    Li Bin

    Full Text Available Mycoplasma hyopneumoniae is considered the major causative agent of porcine respiratory disease complex, occurs worldwide and causes major economic losses to the pig industry. To gain more insights into the pathogenesis of this organism, the high throughput cDNA microarray assays were employed to evaluate host responses of porcine alveolar macrophages to M. hyopneumoniae infection. A total of 1033 and 1235 differentially expressed genes were identified in porcine alveolar macrophages in responses to exposure to M. hyopneumoniae at 6 and 15 hours post infection, respectively. The differentially expressed genes were involved in many vital functional classes, including inflammatory response, immune response, apoptosis, cell adhesion, defense response, signal transduction, protein folding, protein ubiquitination and so on. The pathway analysis demonstrated that the most significant pathways were the chemokine signaling pathway, Toll-like receptor signaling pathway, RIG-I-like receptor signaling pathway, nucleotide-binding oligomerization domains (Nod-like receptor signaling pathway and apoptosis signaling pathway. The reliability of the data obtained from the microarray was verified by performing quantitative real-time PCR. The expression kinetics of chemokines was further analyzed. The present study is the first to document the response of porcine alveolar macrophages to M. hyopneumoniae infection. The data further developed our understanding of the molecular pathogenesis of M. hyopneumoniae.

  2. Transcription analysis of the porcine alveolar macrophage response to Mycoplasma hyopneumoniae.

    Science.gov (United States)

    Bin, Li; Luping, Du; Bing, Sun; Zhengyu, Yu; Maojun, Liu; Zhixin, Feng; Yanna, Wei; Haiyan, Wang; Guoqing, Shao; Kongwang, He

    2014-01-01

    Mycoplasma hyopneumoniae is considered the major causative agent of porcine respiratory disease complex, occurs worldwide and causes major economic losses to the pig industry. To gain more insights into the pathogenesis of this organism, the high throughput cDNA microarray assays were employed to evaluate host responses of porcine alveolar macrophages to M. hyopneumoniae infection. A total of 1033 and 1235 differentially expressed genes were identified in porcine alveolar macrophages in responses to exposure to M. hyopneumoniae at 6 and 15 hours post infection, respectively. The differentially expressed genes were involved in many vital functional classes, including inflammatory response, immune response, apoptosis, cell adhesion, defense response, signal transduction, protein folding, protein ubiquitination and so on. The pathway analysis demonstrated that the most significant pathways were the chemokine signaling pathway, Toll-like receptor signaling pathway, RIG-I-like receptor signaling pathway, nucleotide-binding oligomerization domains (Nod)-like receptor signaling pathway and apoptosis signaling pathway. The reliability of the data obtained from the microarray was verified by performing quantitative real-time PCR. The expression kinetics of chemokines was further analyzed. The present study is the first to document the response of porcine alveolar macrophages to M. hyopneumoniae infection. The data further developed our understanding of the molecular pathogenesis of M. hyopneumoniae.

  3. Protective Effect of Alpha Lipoic Acid on Rat Sciatic Nerve Ischemia Reperfusion Damage

    Directory of Open Access Journals (Sweden)

    Ozan Turamanlar

    2015-06-01

    Full Text Available Background: Alpha lipoic acid is a potent antioxidant that plays numerous roles in human health. This study examined the effect of ALA on rat sciatic nerve ischemia reperfusion damage. Aims: Protective effect of alpha lipoic acid (ALA on sciatic nerve following ischemia-reperfusion in rats was investigated by using light microscopy and biochemical methods. Provided that the protective effect of ALA on sciatic nerve is proven, we think the damage to the sciatic nerve that has already occurred or might occur in patients for various reasons maybe prevented or stopped by giving ALA in convenient doses. Study Design: Animal experiment. Methods: Forty-two adult male Sprague-Dawley rats (250-300 grams were used in this study. Rats were randomly divided into six groups including one control (Group 1, one sham (Group 2, two ischemia-reperfusion (Groups 3 and 4 and two treatment groups (Groups5 and 6. Doses of 60 and 100 mg/kg ALA were given (Group 5 and 6 intra peritoneally twice, 1 and 24 hours before the ischemia to each treatment group. Ischemia was carried out the abdominal aorta starting from the distal part of the renal vein for two hours followed by reperfusion for three hours. In immunohistochemical methods, fibronectin immunoreactivity was analyzed. For biochemical analyses, the tissues were taken in eppendorf microtubes and superoxide dismutase (SOD and glutathione peroxidase (GSHPx enzyme activities as well as malondialdehyde (MDA and nitricoxide (NO levels were measured. Results: Fibronectin was observed to have increased significantly in the ischemia group; on the other hand, it was observed to have decreased in parallel to the doses in the ALA groups. Biochemical studies showed that SOD and GSHPx declined with ischemia-reperfusion, but the activities of these enzymes were increased in the treatment groups in parallel with the dose. It was found that increased MDA levels with ischemia-reperfusion were decreased in parallel with ALA dose