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Sample records for chest porcine ischemia

  1. A Novel Closed-Chest Porcine Model of Chronic Ischemic Heart Failure Suitable for Experimental Research in Cardiovascular Disease

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    Giuseppe Biondi-Zoccai

    2013-01-01

    Full Text Available Cardiac pathologies are among the leading causes of mortality and morbidity in industrialized countries, with myocardial infarction (MI representing one of the major conditions leading to heart failure (HF. Hitherto, the development of consistent, stable, and reproducible models of closed-chest MI in large animals, meeting the clinical realism of a patient with HF subsequent to chronic ischemic necrosis, has not been successful. We hereby report the design and ensuing application of a novel porcine experimental model of closed-chest chronic ischemia suitable for biomedical research, mimicking post-MI HF. We also emphasize the key procedural steps involved in replicating this unprecedented model, from femoral artery and vein catheterization to MI induction by permanent occlusion of the left anterior descending coronary artery through superselective deployment of platinum-nylon coils, as well as endomyocardial biopsy sampling for histologic analysis and cell harvesting. Our model could indeed represent a valuable contribution and tool for translational research, providing precious insights to understand and overcome the many hurdles concerning, and currently quenching, the preclinical steps mandatory for the clinical translation of new cardiovascular technologies for personalized HF treatments.

  2. A patient with recent chest discomfort-ischemia or no ischemia? Postsystolic shortening comes to the rescue.

    Science.gov (United States)

    Fadel, Bahaa M; Al-Amro, Bandar; Al-Admawi, Mohammed; Sergani, Hani; Alsoufi, Bahaaldin; Pergola, Valeria; Di Salvo, Giovanni

    2013-10-01

    The diagnosis of myocardial ischemia in the emergency department can be challenging particularly in a patient in whom the chest discomfort has abated. Symptoms can be atypical, physical exam is often noncontributory, the electrocardiogram is usually nondiagnostic and cardiac enzymes remain normal. Thus, the decision for hospital admission or discharge can be quite difficult. Here, we describe such a patient in whom echocardiography with strain imaging identified the presence of postsystolic shortening (PSS) at the left ventricular apex. This suggested the likelihood of ischemic memory in the territory of the left anterior descending (LAD) artery. At coronary angiography a high grade stenosis was present in the proximal LAD artery. Our report highlights the role of echocardiography in the detection of myocardial ischemia and apical PSS as a marker of ischemic memory. PMID:23822760

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

    OpenAIRE

    Abdou Mohamed

    2011-01-01

    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 rec...

  4. National Heart Attack Alert Program position paper: chest pain centers and programs for the evaluation of acute cardiac ischemia.

    Science.gov (United States)

    Zalenski, R J; Selker, H P; Cannon, C P; Farin, H M; Gibler, W B; Goldberg, R J; Lambrew, C T; Ornato, J P; Rydman, R J; Steele, P

    2000-05-01

    The National Heart Attack Alert Program (NHAAP), which is coordinated by the National Heart, Lung, and Blood Institute (NHLBI), promotes the early detection and optimal treatment of patients with acute myocardial infarction and other acute coronary ischemic syndromes. The NHAAP, having observed the development and growth of chest pain centers in emergency departments with special interest, created a task force to evaluate such centers and make recommendations pertaining to the management of patients with acute cardiac ischemia. This position paper offers recommendations to assist emergency physicians in EDs, including those with chest pain centers, in providing comprehensive care for patients with acute cardiac ischemia. PMID:10783408

  5. Porcine Brain Extract Attenuates Memory Impairments Induced by Focal Cerebral Ischemia

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    Jinatta Jittiwat

    2009-01-01

    Full Text Available Problem statement: Stroke or cerebral ischemia has been recognized as one important problem worldwide. To date, the effectiveness of protective and therapeutic strategies against stroke is still very limited. Therefore, the development of novel strategy is required. Porcine brain is traditional believed to improve brain functions. Recent studies showed that the extract of porcine brain could protect against brain damage related to the oxidative stress, therefore, we hypothesized that it could protect against brain damage in stroke. Approach: To test the potential of porcine brain extract as the novel protective supplement against stroke, various doses of porcine brain extract at doses of 0.5 and 2.5 mg kg-1 b.w. were orally given to male Wistar rats, weighing 300-350 g, at the period of 14 days before and 21 days after the occlusion of right middle cerebral artery. Then, all rats were determined the neurological score, motor performance, cognitive function and brain infarct volume. Moreover, the possible neuroprotective mechanisms of the extract were also determined via the alteration of Malondialdehyde (MDA or lipid peroxidation product and via the activities of scavenger enzymes including Superoxide Dismutase (SOD, Catalase (CAT and Glutathione Peroxides (GPx. Results: The results showed that the low dose of porcine extract decreased the infarct volume and improved brain functions including neurological score, motor performance and memory deficit. In addition, it also decreased MDA but increased the activities of SOD, CAT and GPx. Conclusion: Our results suggested the potential role of porcine brain extract as neuroprotectant. The possible underlying mechanism appeared to be related to the enhanced activities of SOD, CAT and GPx which in turn resulted in the decrease MDA. Moreover, our findings may shed light on the pharmacologic basis for the clinical application of traditional Chinese medicine to protect against stroke.

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

    International Nuclear Information System (INIS)

    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.)

  7. Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model

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    Wagner Henrik

    2011-12-01

    Full Text Available Abstract Background Mechanical chest compressions (CCs have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow, but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the coronary perfusion pressure (CPP. In this study our aim was to correlate average peak coronary flow velocity (APV to CPP during mechanical CCs. Methods In a closed chest porcine model, cardiac arrest was established through electrically induced ventricular fibrillation (VF in eleven pigs. After one minute, mechanical chest compressions were initiated and then maintained for 10 minutes upon which the pigs were defibrillated. Measurements of coronary blood flow in the left anterior descending artery were made at baseline and during VF with a catheter based Doppler flow fire measuring APV. Furthermore measurements of central (thoracic venous and arterial pressures were also made in order to calculate the theoretical CPP. Results Average peak coronary flow velocity was significantly higher compared to baseline during mechanical chests compressions and this was observed during the entire period of mechanical chest compressions (12 - 39% above baseline. The APV slowly declined during the 10 min period of mechanical chest compressions, but was still higher than baseline at the end of mechanical chest compressions. CPP was simultaneously maintained at > 20 mmHg during the 10 minute episode of cardiac arrest. Conclusion Our study showed good correlation between CPP and APV which was highly significant, during cardiac arrest with on-going mechanical CCs in a closed chest porcine model. In addition APV was even higher during mechanical CCs compared to baseline. Mechanical

  8. 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.

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

    DEFF Research Database (Denmark)

    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...... (MAP) minus the intraocular pressure (IOP). It was clamped to 0-30 mm Hg by continuous monitoring of MAP and adjustment of the IOP, which was controlled by cannulation of the anterior chamber. Inner retinal function was assessed by induced multifocal electroretinography (mfERG) with comparisons of the...

  10. Comparative study between trimetazidine and ice slush hypothermia in protection against renal ischemia/reperfusion injury in a porcine model

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    Leonardo de Albuquerque dos Santos Abreu

    2011-10-01

    Full Text Available PURPOSE: The aim of the study was to compare the effects of renal ice slush hypothermia and the use of trimetazidine in the protection against ischemia/reperfusion (I/R injury. MATERIALS AND METHODS: Fifteen farm pigs were submitted to left kidney ischemia and right nephrectomy during the same procedure. Animals were divided into three groups. Group 1 was submitted to warm ischemia; Group 2 was submitted to cold ischemia with ice slush; and Group 3 received trimetazidine 20 mg one day and 4 hours before surgery. Ischemia time was 120 minutes in all three groups. Serum creatinine (SCr and plasma iohexol clearance (CLioh were measured before surgery and on postoperative days (PODs 1,3,7, and 14. Semi-quantitative analyses of histological alterations were performed by a pathologist. A p value of < 0.05 was considered significant. RESULTS: All groups showed elevation of serum creatinine in the first week. Serum creatinine was higher in Group 3 in the first and third postoperative days (Mean Cr: 5.5 and 8.1 respectively. Group 2 showed a lower increase in creatinine and a lower decrease in iohexol clearance than the others. Renal function stabilized in the fourteenth POD in all three groups. Analyses of histological alterations did not reach statistical significance between groups. CONCLUSION: Trimetazidine did not show protection against renal I/R injury in comparison to warm ischemia or hypothermia in a porcine model submitted to 120 minutes of renal ischemia.

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

    DEFF Research Database (Denmark)

    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...... completed the trial. 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...

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

    OpenAIRE

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

    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 cardiop...

  13. 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...

  14. Successful Porcine Renal Transplantation After 60 Minutes of Donor Warm Ischemia: Extracorporeal Perfusion and Thrombolytics.

    Science.gov (United States)

    Demos, David S; Iyengar, Amit; Bryner, Benjamin S; Gray, Brian W; Hoffman, Hayley R; Cornell, Marie S; Wilkinson, John E; Mazur, Daniel E; Bartlett, Robert H; Punch, Jeffrey D; Rojas-Peña, Alvaro

    2015-01-01

    Donation from uncontrolled circulatory determination of death donors (uDCD) is impractical in United States because of the time needed to organize procurement before irreversible organ damage. Salvaging organs after prolonged warm ischemic time (WIT) may address this limitation. We evaluated the combination of extracorporeal support (ECS) and thrombolytics in a porcine uDCD renal transplant model. Nonanticoagulated uDCD sustained 60 min of WIT, and two groups were studied. Rapid recovery (RR)-uDCD renal grafts procured using the standard quick topical cooling and renal flush, and ECS-assisted donation (E-uDCD), 4 hr ECS plus thrombolytics for in situ perfusion before procurement. All kidneys were flushed and cold stored, followed by transplantation into healthy nephrectomized recipients without immunosuppression. Delayed graft function (DGF) was defined as creatinine more than 5.0 mg/dl on any postoperative day. Twelve kidneys in E-uDCD and 6 in RR-uDCD group were transplanted. All 12 E-uDCD recipients had urine production and adequate function in the first 48 hr, but two grafts (16.7%) had DGF at 96 hr. All six recipients from RR-uDCD group had DGF at 48 hr and were killed. Creatinine and blood urea nitrogen (BUN) levels were significantly lower in E-uDCD compared with RR-uDCD group at 24 hr (2.9 ± 0.7 mg/dl vs. 5.2 ± 0.9 mg/dl) and 48 hr (3.2 ± 0.9 mg/dl vs. 7.2 ± 1.0 mg/dl); BUN levels at 24 and 48 hr were 28.3 ± 6.7 mg/dl vs. 39.5 ± 7.5 mg/dl and 23.9 ± 5.0 mg/dl vs. 46 ± 12.9 mg/dl, respectively. Thrombolytics plus ECS precondition organs in situ yielding functional kidneys in a porcine model of uDCD with 60 min of WIT. This procurement method addresses logistical limitations for uDCD use in the United States and could have a major impact on the organ donor pool. PMID:25851315

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

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    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. Quantitative myocardial perfusion imaging in a porcine ischemia model using a prototype spectral detector CT system

    Science.gov (United States)

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

    2016-03-01

    We optimized and evaluated dynamic myocardial CT perfusion (CTP) imaging on a prototype spectral detector CT (SDCT) scanner. Simultaneous acquisition of energy sensitive projections on the SDCT system enabled projection-based material decomposition, which typically performs better than image-based decomposition required by some other system designs. In addition to virtual monoenergetic, or keV images, the SDCT provided conventional (kVp) images, allowing us to compare and contrast results. Physical phantom measurements demonstrated linearity of keV images, a requirement for quantitative perfusion. Comparisons of kVp to keV images demonstrated very significant reductions in tell-tale beam hardening (BH) artifacts in both phantom and pig images. In phantom images, consideration of iodine contrast to noise ratio and small residual BH artifacts suggested optimum processing at 70 keV. The processing pipeline for dynamic CTP measurements included 4D image registration, spatio-temporal noise filtering, and model-independent singular value decomposition deconvolution, automatically regularized using the L-curve criterion. In normal pig CTP, 70 keV perfusion estimates were homogeneous throughout the myocardium. At 120 kVp, flow was reduced by more than 20% on the BH-hypo-enhanced myocardium, a range that might falsely indicate actionable ischemia, considering the 0.8 threshold for actionable FFR. With partial occlusion of the left anterior descending (LAD) artery (FFR  <  0.8), perfusion defects at 70 keV were correctly identified in the LAD territory. At 120 kVp, BH affected the size and flow in the ischemic area; e.g. with FFR ≈ 0.65, the anterior-to-lateral flow ratio was 0.29  ±  0.01, over-estimating stenosis severity as compared to 0.42  ±  0.01 (p  <  0.05) at 70 keV. On the non-ischemic inferior wall (not a LAD territory), the flow ratio was 0.50  ±  0.04 falsely indicating an actionable ischemic condition in a healthy

  17. 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

  18. Comparative study between trimetazidine and ice slush hypothermia in protection against renal ischemia/reperfusion injury in a porcine model

    OpenAIRE

    Leonardo de Albuquerque dos Santos Abreu; Paulo Roberto Kawano; Hamilto Yamamoto; Ronaldo Damião; Oscar Eduardo Hidetoshi Fugita

    2011-01-01

    PURPOSE: The aim of the study was to compare the effects of renal ice slush hypothermia and the use of trimetazidine in the protection against ischemia/reperfusion (I/R) injury. MATERIALS AND METHODS: Fifteen farm pigs were submitted to left kidney ischemia and right nephrectomy during the same procedure. Animals were divided into three groups. Group 1 was submitted to warm ischemia; Group 2 was submitted to cold ischemia with ice slush; and Group 3 received trimetazidine 20 mg one day and 4 ...

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

    DEFF Research Database (Denmark)

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

    2003-01-01

    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...

  20. Mitogen-activated protein kinases in the porcine retinal arteries and neuroretina following retinal ischemia-reperfusion

    DEFF Research Database (Denmark)

    Gesslein, Bodil; Håkansson, Gisela; Carpio, Ronald;

    2010-01-01

    The aim of the present study was to examine changes in the expression of intracellular signal-transduction pathways, specifically mitogen-activated protein kinases, following retinal ischemia-reperfusion.......The aim of the present study was to examine changes in the expression of intracellular signal-transduction pathways, specifically mitogen-activated protein kinases, following retinal ischemia-reperfusion....

  1. 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)

    Purpose: The goal of this study was to evaluate the feasibility of 99mTc-His10-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: 99mTc-His10-annexin V was prepared by one-step direct labeling, and RCP and radiostability were tested. The binding of 99mTc-His10-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. 99mTc-His10-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 99mTc-MIBI was also performed 1 day after His10-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: 99mTc-His10-annexin V had a RCP >98% and high stability 2 h after radiolabeling; it could bind to apoptotic cells with high affinity. Biodistribution of 99mTc-His10-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 His10-annexin V was visualized in the defect which was shown in MPI, whereas in the adenosine group a mild uptake of 99mTc-His10-annexin was found in the risk area which showed no defects in the 99mTc-MIBI image. TUNEL staining and activated caspase-3 confirmed the ongoing apoptosis in RI. Adenosine preconditioning significantly diminished the level of apoptosis. Uptake of His10-annexin V in RI correlated with TUNEL-positive nuclei

  2. Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model

    OpenAIRE

    Wagner Henrik; Madsen Hardig Bjarne; Steen Stig; Sjoberg Trygve; Harnek Jan; Olivecrona Goran K

    2011-01-01

    Abstract Background Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the cor...

  3. Pulse Oximetry: A Non-Invasive, Novel Marker for the Quality of Chest Compressions in Porcine Models of Cardiac Arrest.

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    Jun Xu

    Full Text Available Pulse oximetry, which noninvasively detects the blood flow of peripheral tissue, has achieved widespread clinical use. We have noticed that the better the quality of cardiopulmonary resuscitation (CPR, the better the appearance of pulse oximetry plethysmographic waveform (POP. We investigated whether the area under the curve (AUC and/or the amplitude (Amp of POP could be used to monitor the quality of CPR.Prospective, randomized controlled study.Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.Healthy 3-month-old male domestic swine.34 local pigs were enrolled in this study. After 4 minutes of untreated ventricular fibrillation, animals were randomly assigned into two resuscitation groups: a "low quality" group (with a compression depth of 3cm and a "high quality" group (with a depth of 5cm. All treatments between the two groups were identical except for the depth of chest compressions. Hemodynamic parameters [coronary perfusion pressure (CPP, partial pressure of end-tidal carbon dioxide (PETCO2] as well as AUC and Amp of POP were all collected and analyzed.There were statistical differences between the "high quality" group and the "low quality" group in AUC, Amp, CPP and PETCO2 during CPR (P<0.05. AUC, Amp and CPP were positively correlated with PETCO2, respectively (P<0.01. There was no statistical difference between the heart rate calculated according to the POP (FCPR and the frequency of mechanical CPR at the 3rd minute of CPR. The FCPR was lower than the frequency of mechanical CPR at the 6th and the 9th minute of CPR.Both the AUC and Amp of POP correlated well with CPP and PETCO2 in animal models. The frequency of POP closely matched the CPR heart rate. AUC and Amp of POP might be potential noninvasive quality monitoring markers for CPR.

  4. 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

  5. SPECT imaging of myocardial infarction using {sup 99m}Tc-labeled C2A domain of synaptotagmin I in a porcine ischemia-reperfusion model

    Energy Technology Data Exchange (ETDEWEB)

    Fang Wei [Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 (China); Wang Feng [Nuclear Medicine Department, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006 (China); Ji Shundong [Jiangsu Institute of Hematology, 1st Hospital of Suzhou University, Suzhou 215006 (China); Zhu Xiaoguang [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Meier, Heidi T. [Clinical Veterinarian and Radiology Research, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, WI 53295 (United States); Hellman, Robert S. [Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States); Brindle, Kevin M. [MRC Laboratory of Molecular Biology, Cambridge CB2 2QH (United Kingdom); Davletov, Bazbek [Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA (United Kingdom); Zhao Ming [Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin, WI 53226 (United States)], E-mail: mzhao@mcw.edu

    2007-11-15

    Introduction: The C2A domain of synaptotagmin I recognizes necrotic and apoptotic cells by binding to exposed anionic phospholipids. The goal is to explore the potential imaging utility of {sup 99m}Tc-labeled C2A in the detection of acute cardiac cell death in a porcine model that resembles human cardiovascular physiology. Methods: Ischemia (20-25 min) was induced in pigs (M/F, 20-25 kg) using balloon angioplasty. {sup 99m}Tc-C2A-GST (n=7) or {sup 99m}Tc-BSA (n=2) was injected intravenously 1-2 h after reperfusion. Noninfarct animals were injected with {sup 99m}Tc-C2A-GST (n=4). SPECT images were acquired at 3 and 6 h postinjection. Cardiac tissues were analyzed to confirm the presence of cell death. Results: Focal uptake was detected in five out of seven subjects at 3 h and in all infarct subjects at 6 h postinjection but not in infarct animals injected with {sup 99m}Tc-BSA or in noninfarct animals with {sup 99m}Tc-C2A-GST. Gamma counting of infarct versus normal myocardium yielded a 10.2{+-}5.7-fold elevation in absolute radioactivity, with histologically confirmed infarction. Conclusions: We present data on imaging myocardial cell death in the acute phase of infarction in pigs. C2A holds promise and warrants further development as an infarct-avid molecular probe.

  6. Effect of atrial natriuretic peptide on ischemia-reperfusion injury in a porcine total hepatic vascular exclusion model

    Institute of Scientific and Technical Information of China (English)

    Katsumi Kobayashi; Koshi Matsurnoto; Izumi Takeyoshi; Kiyohiro Oshima; Masato Muraoka; Takahiko Akao; Osamu Totsuka; Hisashi Shimizu; Hiroaki Sato; Kazumi Tanaka; Kenjiro Konno

    2007-01-01

    AIM: To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS: Miniature pigs (mini-pigs) weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animals were divided into two groups. ANP (0.1 μg/kg per min) was administered to the ANP group (n = 7), and vehicle was administered to the control group (n = 7). Either vehicle or ANP was intravenously administered from 30 min before the THVE to the end of the experiment. Arterial blood was collected to measure AST, LDH, and TNF-α. Hepatic tissue blood flow (HTBF) was also measured. Liver specimens were harvested for p38 MAPK analysis and histological study.Those results were compared between the two groups.RESULTS: The AST and LDH levels were lower in the ANP group than in the control group; the AST levels were significantly different between the two groups (60 min: 568.7 ± 113.3 vs 321.6 ± 60.1, P = 0.038 < 0.05,120 min: 673.6 ± 148.2 vs 281.1 ± 44.8, P = 0.004< 0.01). No significant difference was observed in the TNF-α levels between the two groups. HTBF was higher in the ANP group, but the difference was not significant.A significantly higher level of phosphorylated p38 MAPK was observed in the ANP group compared to the control group (0 min: 2.92 ± 1.1 vs 6.38 ± 1.1, P = 0.611 < 0.05).Histological tissue damage was milder in the ANP group than in the control group.CONCLUSION: Our results show that ANP has a protective role in I/R injury with p38 MAPK activation in a porcine THVE model.

  7. 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.

  8. Dose reduction assessment in dynamic CT myocardial perfusion imaging in a porcine balloon-induced-ischemia model

    Science.gov (United States)

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

    2014-03-01

    We investigated the use of an advanced hybrid iterative reconstruction (IR) technique (iDose4, Philips Health- care) for low dose dynamic myocardial CT perfusion (CTP) imaging. A porcine model was created to mimic coronary stenosis through partial occlusion of the left anterior descending (LAD) artery with a balloon catheter. The severity of LAD occlusion was adjusted with FFR measurements. Dynamic CT images were acquired at end-systole (45% R-R) using a multi-detector CT (MDCT) scanner. Various corrections were applied to the acquired scans to reduce motion and imaging artifacts. Absolute myocardial blood flow (MBF) was computed with a deconvolution-based approach using singular value decomposition (SVD). We compared a high and a low dose radiation protocol corresponding to two different tube-voltage/tube-current combinations (80kV p/100mAs and 120kV p/150mAs). The corresponding radiation doses for these protocols are 7.8mSv and 34.3mSV , respectively. The images were reconstructed using conventional FBP and three noise-reduction strengths of the IR method, iDose. Flow contrast-to-noise ratio, CNRf, as obtained from MBF maps, was used to quantitatively evaluate the effect of reconstruction on contrast between normal and ischemic myocardial tissue. Preliminary results showed that the use of iDose to reconstruct low dose images provide better or comparable CNRf to that of high dose images reconstructed with FBP, suggesting significant dose savings. CNRf was improved with the three used levels of iDose compared to FBP for both protocols. When using the entire 4D dynamic sequence for MBF computation, a 77% dose reduction was achieved, while considering only half the scans (i.e., every other heart cycle) allowed even further dose reduction while maintaining relatively higher CNRf.

  9. Chest MRI

    Science.gov (United States)

    Nuclear magnetic resonance - chest; Magnetic resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI ... healthy enough to filter the contrast. During the MRI, the person who operates the machine will watch ...

  10. Silent Ischemia

    Science.gov (United States)

    ... Vulnerable Plaque Silent Ischemia | Share Related terms: ischemia, restricted blood flow Ischemia is a condition where the flow of ... used to diagnose silent ischemia: An exercise stress test can show blood flow through your coronary arteries in response to exercise. ...

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

    DEFF Research Database (Denmark)

    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...

  12. Videodensitometry and chest radiography in the evaluation of pulmonary blood flow and pulmonary oedema in a porcine model of early adult respiratory distress syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Wegenius, G.; Forsgren, P.; Modig, J.

    The adult respiratory distress syndrome was induced in pigs (n=11) by a continuous infusion of E. coli endotoxin in order to evaluate the use of radiographic videodensitometry and chest radiography for assessment of pulmonary circulation and pulmonary oedema. A further aim was to determine the effect of an ionic contrast medium, Urografin 60%, on extravascular lung water (EVLW). The infusion resulted in a decline in arterial oxygen tension. Mean pulmonary arterial pressure increased, and cardiac output decreased, resulting in a marked rise in pulmonary vascular resistance. EVLW increased moderately. The corresponding variables in control animals (saline infusion; n=5) changed very little. Good correlations were found (r=0.87-1.0) between absolute flows as measured by the thermodilution technique and relative flows as determined by videodensitometry in animals with pulmonary damage. In the endotoxin group there was a significant correlation (r=0.75) between the change in EVLW from baseline to the final measurement (at 6 hours) and the corresponding change in radiographic density. Radiographic signs of pulmonary damage were sparse. Only 3 of 11 animals displayed increased radiographic desnity of the lung parenchyma indicative of pulmonary oedema. Pleural effusion developed in 4 animals. Injection of Urografin 60%, 1 mlxkg/sup -1/, caused a slight but significant decrease in EVLW. We propose that at this concentration and dosage the contrast medium acts mainly as an osmotic diuretic.

  13. 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

    Science.gov (United States)

    Zhang, Zhiyong; Haimovich, Beatrice; Kwon, Young Suk; Lu, Tyler; Fyfe-Kirschner, Billie; Olweny, Ephrem Odoy

    2016-01-01

    Purpose 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. Materials and Methods 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. Results 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. Conclusions 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. PMID:27149666

  14. Chest drainage.

    Science.gov (United States)

    Carter, Chris

    2014-07-15

    As an intensive care nurse with experience of caring for critically ill patients in the UK and on deployed operations overseas, I found the CPD article useful in reviewing the pathophysiology of a pneumothorax, use of intrapleural chest drains, observations that should be recorded, and nursing care and management of a patient with an intrapleural chest drain. Reflecting on the time out activities in the CPD article was valuable. PMID:25005418

  15. Effect of angiopoietin-related protein 2 on coronary angiogenesis and myocardial function in a porcine model of acute myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    Shu Meng; Changqian Wang; Fei Wang; Renjian Zhou; Fangbao Ding; Fuxin Chen

    2008-01-01

    Our previous studies have suggested that angiopoietin-related protein 2 (Arp2) may improve rat cardiac function after acute myocardial infarction (AMI) by accelerating angiogenesis.We want to study the efficacy of the adenoviral vector-mediated gene transfer of Arp2 (Ad.Arp2) in inducing angiogenesis and in improving the myocardial perfusion and function in a porcine acute myocardial ischemic model.Methods The minipigs underwent ligation of the proximal circumflex coronary artery (LCx) and were randomly assigned to treatment with Ad.Arp2,adenoviral vectors with no transgene (Ad.Null) or PBS.Four weeks later,the animals were evaluated using echocardiography,cardiac perfusion imaging and pathologic observation.Results Four weeks after treatment,the Arp2 protein was revealed in the myocardium of Ad.Arp2 animals,but was not found in the Ad.Null or PBS animals.Also,a significant revival of myocardial perfusion was found in the ischemic area in Ad.Arp2-treated animals,whose global and regional myocardial function was greatly improved.The quantitation of new capillaries was much greater in the Ad.Arp2 group than in the Ad.Null or PBS groups.Conclusion Treatment with Ad.ARP2 offers the obvious advantage of greatly improving the blood supply and the heart function.(J Geriatr Cardiol 2008;5:230-234)

  16. Hepatic ischemia

    Science.gov (United States)

    Hepatic ischemia is a condition in which the liver does not get enough blood or oxygen, causing injury to ... pressure from any condition can lead to hepatic ischemia. Such conditions may include: Abnormal heart rhythms Dehydration ...

  17. What Is Chest MRI?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Chest MRI? Chest MRI (magnetic resonance imaging) is a safe, noninvasive test. "Noninvasive" means that ... your chest wall, heart, and blood vessels. Chest MRI uses radio waves, magnets, and a computer to ...

  18. The chest

    International Nuclear Information System (INIS)

    Radiographic interpretation of chest films of newborns in respiratory distress remains one of the most difficult aspects of pediatric radiology. Complex pulmonary and cardiac adjustments to extrauterine life are rapidly taking place. The small, fluid-filled fetal lung must rid itself of fluid and fill with air. The high vascular resistance of the fetal pulmonary bed and the open ductus arteriosus allow shunting of blood in both directions. Films taken in this period of time may show lungs that resemble those seen in congestive heart failure or fluid overload. When these findings are observed in infants who may appear dusky or even cyanotic, the result may be the diagnosis of disease in normal infants passing through a stormy transition period. To make things worse, the films are taken as portable surpine films, usually in an isolette in the intensive care unit (ICU). The phase of respiration is difficult, if not impossible, to control, and lateral films are usually not obtained. Many of the infants are on assisted ventilation either by tube or nasal prongs-nasal continuous positive airway pressure (CPAP)-and lungs can appear over-inflated or whited out, depending on the pressures used and the phase of the respiratory cycle. Prolonged crying itself can make lungs appear semiopaque; the next breath may show such a dramatic reinflation that it is hard to believe the two films are of the same infant, made only seconds apart. Is the heart large? Or is it the thymus? Are the lungs ''wet''? Is there infection? Is there pulmonary vascular engorgement? Why are these films so hard to interpret? They have no easy answers. The radiologist must realize that the neonatal intensive care personnel, armed though they may be with blood gas values, are no better at interpreting films. If anything, they read into them what they wish to see

  19. 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 ...

  20. Electrocardiographically and symptomatically silent myocardial ischemia during exercise testing

    International Nuclear Information System (INIS)

    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)

  1. Chest X-Ray

    Medline Plus

    Full Text Available ... chest x-ray is used to evaluate the lungs, heart and chest wall and may be used ... diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A ...

  2. Chest x-ray

    Science.gov (United States)

    Chest radiography; Serial chest x-ray; X-ray - chest ... You stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken. Two images are usually taken. You will ...

  3. Hypoxia-inducible factor and vascular endothelial growth factor in the neuroretina and retinal blood vessels after retinal ischemia

    DEFF Research Database (Denmark)

    Håkansson, Gisela; Gesslein, Bodil; Gustafsson, Lotta;

    2010-01-01

    Retinal ischemia arises from circulatory failure. As the retinal blood vessels are key organs in circulatory failure, our aim was to study the retinal vasculature separately from the neuroretina to elucidate the role of hypoxia-inducible factor (HIF) 1α and 1β and vascular endothelial growth factor...... (VEGF) in retinal ischemia. Retinal ischemia was induced in porcine eyes by applying an intraocular pressure, followed by 12 h of reperfusion. HIF-1α mRNA expression was not affected by ischemia, while immunofluorescence staining was higher after ischemia in the neuroretina. HIF-1β immunoreactivity and...

  4. 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...

  5. Chest X-Ray

    Medline Plus

    Full Text Available ... this Site RadiologyInfo.org is produced by: Image/Video Gallery Your radiologist explains chest x-ray. Transcript ... time! Spotlight Recently posted: Pediatric MRI Intravascular Ultrasound Video: Chest CT Video:Thyroid Ultrasound Video: Head CT ...

  6. Porcine retrovirus: hybridization studies

    International Nuclear Information System (INIS)

    Tritium-labeled porcine retrovirus (PoRV) was isolated and purified, and kinetics of hybridization of this RNA with DNA from various sources was determined. Results indicate that PoRV is an endogenous porcine virus

  7. 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....

  8. Chest X-Ray

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    Full Text Available ... the most commonly performed x-ray exams and use a very small dose of ionizing radiation to ... to your health. While a chest x-ray use a tiny dose of ionizing radiation, the benefit ...

  9. 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.

  10. Digital chest radiography

    DEFF Research Database (Denmark)

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

    2015-01-01

    Purpose: Quality improvement of basic radiography focusing 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 of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance of...... conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  11. Digital chest radiography

    DEFF Research Database (Denmark)

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

    2015-01-01

    Background: Chest radiography is one of the most common examinations in radiology departments. In 2013 approximately 80,000 chest x-rays were performed on women in the fertile age. Even low dose for the examinationCorrect collimation Purpose: Quality improvement of basic radiography focusing 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...... of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance of clinical supervisors. Optimal collimation is determined by European...

  12. 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. ...

  13. 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. ...

  14. Management of chest keloids

    Directory of Open Access Journals (Sweden)

    Kim June Kyu

    2011-04-01

    Full Text Available Abstract Keloid formation is one of the most challenging clinical problems in wound healing. With increasing frequency of open heart surgery, chest keloid formations are not infrequent in the clinical practice. The numerous treatment methods including surgical excision, intralesional steroid injection, radiation therapy, laser therapy, silicone gel sheeting, and pressure therapy underscore how little is understood about keloids. Keloids have a tendency to recur after surgical excision as a single treatment. Stretching tension is clearly associated with keloid generation, as keloids tend to occur on high tension sites such as chest region. The authors treated 58 chest keloid patients with surgical excision followed by intraoperative and postoperative intralesional steroid injection. Even with minor complications and recurrences, our protocol results in excellent outcomes in cases of chest keloids.

  15. Chest X-Ray

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    Full Text Available ... Angioplasty & vascular stenting Video: Arthrography Video: Contrast Material Radiology and You Take our survey About this Site ... radiologist explains chest x-ray. Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  16. Chest X-Ray

    Medline Plus

    Full Text Available ... of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot org. Thank you for your time! ...

  17. Chest X-Ray

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    Full Text Available ... Site Index A-Z Spotlight June is Men's Health Month Recently posted: Focused Ultrasound for Uterine Fibroids ... to consider the likelihood of benefit to your health. While a chest x-ray use a tiny ...

  18. Mesenteric artery ischemia

    Science.gov (United States)

    Mesenteric artery ischemia occurs when there is a narrowing or blockage of one or more of the three major arteries that ... that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines ...

  19. [Imaging of intestinal ischemia].

    Science.gov (United States)

    Van Beers, B E; Danse, E; Hammer, F; Goffette, P

    2004-04-01

    Ischemic bowel disease includes acute and chronic mesenteric ischemia, and colon ischemia. Cross-sectional imaging, and more particularly computed tomography, has an increasing role in the detection of acute and chronic mesenteric ischemia. Vascular obstructions or stenoses and changes in the bowel wall can be observed. Functional information can be added with MRI by using sequences that are sensitive to oxygen saturation in the superior mesenteric vein. Arteriography remains the reference examination in patients with acute mesenteric ischemia. PMID:15184799

  20. Expression of recombinant porcine preprorelaxin in Nicotiana tabacum

    OpenAIRE

    Buswell, Walter Scott

    2006-01-01

    Relaxin is a small peptide hormone that has demonstrated potential therapeutic actions for cardiovascular disease and fibrosis. Additionally, relaxin has demonstrated the ability to protect the heart from injuries caused by ischemia and reperfusion, promote the healing of ischemic ulcers, and counteract allergic responses. The objective of this research was to express fully processed porcine relaxin in transgenic tobacco plants, as an alternative to current methods of producing relaxin. ...

  1. CHEST PHYSIOTHERAPY FOR INFANTS

    Directory of Open Access Journals (Sweden)

    Preeti S. Christian (M.P.T Cardiopulmonary Conditions

    2014-10-01

    Full Text Available In the normal lung, secretions are removed by Mucociliary activity, normal breathing cycles, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce the ability to clear secretions, and may increase exacerbations and infections. Many chest physiotherapy techniques like postural drainage, percussion and vibration are used since many years. These techniques are derived from adult studies but these techniques are quite stressful for the infants as the infant respiratory system is different from the adult respiratory system. Advance chest physiotherapy techniques were developed specifically for infants; in accordance with their physiological characteristics. So this review is to introduce some new chest physiotherapy helpful for newborn infants.

  2. Chest X-Ray

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    Full Text Available ... Pediatric Ultrasound Video: Angioplasty & vascular stenting Video: Arthrography Radiology and You About this Site RadiologyInfo.org is ... radiologist explains chest x-ray. Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  3. Chest X-Ray

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    Full Text Available ... this Site RadiologyInfo.org is produced by: Image/Video Gallery Your radiologist explains chest x-ray. Transcript ... Recently posted: Focused Ultrasound for Uterine Fibroids Dementia Video: General Ultrasound Video: Pediatric Nuclear Medicine Radiology and ...

  4. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    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

  5. Sandstorm in the chest?

    Directory of Open Access Journals (Sweden)

    Talluri MR

    2011-07-01

    Full Text Available A 32 year old female presented with dry cough and progressive breathlessness of one year duration. There was no history suggestive of collagen vascular disease, lung parenchymal infection or allergic airway disease. Clinical evaluation showed basal fine inspiratory crepitations. Radiographic examination of the chest revealed a black pleura line and lung parenchymal calcification. CT scan of the chest demonstrated nodular calcification of lung parenchyma with a “crazy pavement” pattern, which is suggestive of alveolar calcification. Pulmonary function test showed a severe restrictive defect. On transbronchial lung biopsy calcific spherules suggestive of the alveolar microlithiasis were seen. Diagnosis of pulmonary alveolar microlithiasis was made and symptomatic treatment was given, as there is no specific therapy available. The case illustrates an unusual cause of shortness of breath in a young female with striking radiographic features.

  6. CHEST PHYSIOTHERAPY FOR INFANTS

    OpenAIRE

    Preeti S. Christian (M.P.T Cardiopulmonary Conditions)

    2014-01-01

    In the normal lung, secretions are removed by Mucociliary activity, normal breathing cycles, and cough. In disease, increased secretion viscosity and volume, dyskinesia of the cilia, and ineffective cough combine to reduce the ability to clear secretions, and may increase exacerbations and infections. Many chest physiotherapy techniques like postural drainage, percussion and vibration are used since many years. These techniques are derived from adult studies but these techniques are quite str...

  7. 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 ischemia

  8. Ischemia-Reperfusion Damage

    OpenAIRE

    Yapca, Omer E.; Borekci, Bunyamin; Suleyman, Halis

    2013-01-01

    Ischemia-reperfusion damage is a complex pathological process that begins with tissue anoxia and continues with the production of free oxygen radicals, expanding with the inflammatory response. The literature suggests the importance of antioxidant and anti-inflammatory treatment to treat ischemia-reperfusion-related tissue damage.

  9. Delayed effects of sublethal ischemia on the acquisition of tolerance to ischemia.

    Science.gov (United States)

    Kuzuya, T; Hoshida, S; Yamashita, N; Fuji, H; Oe, H; Hori, M; Kamada, T; Tada, M

    1993-06-01

    The infarct-limiting effect of ischemic preconditioning is believed to be a transient phenomenon. We examined the delayed effects of repetitive brief ischemia on limiting infarct size in an open-chest dog model by an occlusion (90 minutes) of the left anterior descending coronary artery (LAD) followed by reperfusion (5 hours). The dogs were preconditioned with four brief repeated ischemic episodes induced by 5-minute LAD occlusions with subsequent reperfusion. The size of infarcts initiated by a sustained occlusion immediately or 24 hours after preconditioning was significantly smaller when compared with infarcts in sham-operated dogs (for the immediate occlusion, 14.4 +/- 2.0% versus 39.0 +/- 3.7%, respectively [p pressure products between the two groups. These results indicate that an infarct-limiting effect of brief repeated ischemia can be observed 24 hours after sublethal preconditioning. PMID:8495557

  10. Immunohistochemistry of porcine skin.

    Science.gov (United States)

    Wollina, U; Berger, U; Mahrle, G

    1991-01-01

    The present paper reports immunohistological findings in porcine skin, which were obtained by use of mono- and polyclonal antihuman antibodies and either alkaline phosphatase anti-alkaline phosphatase (APAAP) or peroxidase (POX) technique. Epidermal staining was observed with antibodies to keratins (K 8.12, RSKE 60), filaggrin, and calmodulin (ACAM). Staining of connective tissue and vessels was achieved using antibodies to vimentin (V9(1)), collagen type IV, and fibronectin. In general, these antibodies gave a staining pattern similar to that of normal human skin. The similarities of immunoreactivity to poly- and monoclonal antihuman antibodies in porcine and human skin render porcine skin a reliable model in biomedical research. PMID:1710864

  11. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  12. The neonatal chest

    International Nuclear Information System (INIS)

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented

  13. Evidence of a heterogeneous tissue oxygenation: renal ischemia/reperfusion injury in a large animal model

    Science.gov (United States)

    Crane, Nicole J.; Huffman, Scott W.; Alemozaffar, Mehrdad; Gage, Frederick A.; Levin, Ira W.; Elster, Eric A.

    2013-03-01

    Renal ischemia that occurs intraoperatively during procedures requiring clamping of the renal artery (such as renal procurement for transplantation and partial nephrectomy for renal cancer) is known to have a significant impact on the viability of that kidney. To better understand the dynamics of intraoperative renal ischemia and recovery of renal oxygenation during reperfusion, a visible reflectance imaging system (VRIS) was developed to measure renal oxygenation during renal artery clamping in both cooled and warm porcine kidneys. For all kidneys, normothermic and hypothermic, visible reflectance imaging demonstrated a spatially distinct decrease in the relative oxy-hemoglobin concentration (%HbO2) of the superior pole of the kidney compared to the middle or inferior pole. Mean relative oxy-hemoglobin concentrations decrease more significantly during ischemia for normothermic kidneys compared to hypothermic kidneys. VRIS may be broadly applicable to provide an indicator of organ ischemia during open and laparoscopic procedures.

  14. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... surgery is needed. Acute mesenteric ischemia has multiple causes. The most common are Arterial embolism Arterial thrombus ...

  15. Migraine and ischemia

    OpenAIRE

    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 ischemia: the effect of anticoagulants on migraine, the possible relationship between cardiac right-to-left shunts (RLS) and migraine, and antimigraine drug use in relation to ischemic complications and ca...

  16. Induced coronary spasm without electrocardiographic signs or symptoms of myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Cipriano, P.R.

    1983-03-01

    Angiographic studies have shown that coronary artery spasm can be induced with ergonovine maleate. Coronary artery spasm induced by ergonovine maleate in these studies was nearly always accompanied by chest pain and electrocardiographic changes of myocardial ischemia. This report demonstrates that coronary artery spasm induced by ergonovine maleate may be diagnosed by angiography in the absence of these signs or symptoms.

  17. 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.

  18. Fluorometry of ischemia reperfusion injury in rat lungs in vivo

    Science.gov (United States)

    Sepehr, R.; Staniszewski, K.; Jacobs, E. R.; Audi, S.; Ranji, Mahsa

    2013-02-01

    Previously we demonstrated the utility of optical fluorometry to evaluate lung tissue mitochondrial redox state in isolated perfused rats lungs under various chemically-induced respiratory states. The objective of this study was to evaluate the effect of acute ischemia on lung tissue mitochondrial redox state in vivo using optical fluorometry. Under ischemic conditions, insufficient oxygen supply to the mitochondrial chain should reduce the mitochondrial redox state calculated from the ratio of the auto-fluorescent mitochondrial metabolic coenzymes NADH (Nicotinamide Adenine Dinucleotide) and FAD (Flavoprotein Adenine Dinucleotide). The chest of anesthetized, and mechanically ventilated Sprague-Dawley rat was opened to induce acute ischemia by clamping the left hilum to block both blood flow and ventilation to one lung for approximately 10 minutes. NADH and FAD fluorescent signals were recorded continuously in a dark room via a fluorometer probe placed on the pleural surface of the left lung. Acute ischemia caused a decrease in FAD and an increase in NADH, which resulted in an increase in the mitochondrial redox ratio (RR=NADH/FAD). Restoration of blood flow and ventilation by unclamping the left hilum returned the RR back to its baseline. These results (increase in RR under ischemia) show promise for the fluorometer to be used in a clinical setting for evaluating the effect of pulmonary ischemia-reperfusion on lung tissue mitochondrial redox state in real time.

  19. Research Advancements in Porcine Derived Mesenchymal Stem Cells.

    Science.gov (United States)

    Bharti, Dinesh; Shivakumar, Sharath Belame; Subbarao, Raghavendra Baregundi; Rho, Gyu-Jin

    2016-01-01

    In the present era of stem cell biology, various animals such as Mouse, Bovine, Rabbit and Porcine have been tested for the efficiency of their mesenchymal stem cells (MSCs before their actual use for stem cell based application in humans. Among them pigs have many similarities to humans in the form of organ size, physiology and their functioning, therefore they have been considered as a valuable model system for in vitro studies and preclinical assessments. Easy assessability, few ethical issues, successful MSC isolation from different origins like bone marrow, skin, umbilical cord blood, Wharton's jelly, endometrium, amniotic fluid and peripheral blood make porcine a good model for stem cell therapy. Porcine derived MSCs (pMSCs have shown greater in vitro differentiation and transdifferention potential towards mesenchymal lineages and specialized lineages such as cardiomyocytes, neurons, hepatocytes and pancreatic beta cells. Immunomodulatory and low immunogenic profiles as shown by autologous and heterologous MSCs proves them safe and appropriate models for xenotransplantation purposes. Furthermore, tissue engineered stem cell constructs can be of immense importance in relation to various osteochondral defects which are difficult to treat otherwise. Using pMSCs successful treatment of various disorders like Parkinson's disease, cardiac ischemia, hepatic failure, has been reported by many studies. Here, in this review we highlight current research findings in the area of porcine mesenchymal stem cells dealing with their isolation methods, differentiation ability, transplantation applications and their therapeutic potential towards various diseases. PMID:26201864

  20. Evaluation and risk stratification of patients with chest pain in the emergency department. Predictors of life-threatening events.

    Science.gov (United States)

    Zalenski, R J; Shamsa, F; Pede, K J

    1998-08-01

    While assessing chest pain in the emergency department, physicians must first estimate the probability of acute ischemic states in the patient. This first estimate is based on the patient's history, physical examination, and electrocardiogram. Patients who meet the threshold for acute cardiac ischemia are further evaluated to confirm or exclude this diagnosis, while other life-threatening factors are excluded. PMID:9739772

  1. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    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.)

  2. 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.

  3. Diagnosis of acute cardiac ischemia.

    Science.gov (United States)

    Pope, J Hector; Selker, Harry P

    2003-02-01

    A better understanding of coronary syndromes allow physicians to appreciate UAP and AMI as part of a continuum of ACI. ACI is a life-threatening condition whose identification can have major economic and therapeutic importance as far as threatening dysrhythmias and preventing or limiting myocardial infarction size. The identification of ACI continues to challenge the skill of even experienced clinicians, yet physicians continue (appropriately) to admit the overwhelming majority of patients with ACI; in the process, they admit many patients without acute ischemia [2], overestimating the likelihood of ischemia in low-risk patients because of magnified concern for this diagnosis for prognostic and therapeutic reasons. Studies of admitting practices from a decade ago have yielded useful clinical information but have shown that neither clinical symptoms nor the ECG could reliably distinguish most patients with ACI from those with other conditions. Most studies have evaluated the accuracy of various technologies for diagnosing ACI, yet only a few have evaluated the clinical impact of routine use. The prehospital 12-lead ECG has moderate sensitivity and specificity for the diagnosis of ACI. It has demonstrated a reduction of the mean time to thrombolysis by 33 minutes and short-term overall mortality in randomized trials. In the general ED setting, only the ACI-TIPI has demonstrated, in a large-scale multicenter clinical trial, a reduction in unnecessary hospitalizations without decreasing the rate of appropriate admission for patients with ACI. The Goldman chest pain protocol has good sensitivity for AMI but was not shown to result in any differences in hospitalization rate, length of stay, or estimated costs in the single clinical impact study performed. The protocol's applicability to patients with UAP has not been evaluated. Single measurement of biomarkers at presentation to the ED has poor sensitivity for AMI, although most biomarkers have high specificity. Serial

  4. Chest radiographic findings of leptospirosis

    International Nuclear Information System (INIS)

    1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases, 8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever. 2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2, massive confluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinar nodular type 3, massive confluent consolidation type 1, and increased interstitial markings type 1 respectively. 3. It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especially the case combined with Korean hemorrhagic fever.

  5. Chest radiographic findings of leptospirosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mee Hyun; Jung, Hee Tae; Lee, Young Joong; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1986-04-15

    1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases, 8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever. 2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2, massive confluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinar nodular type 3, massive confluent consolidation type 1, and increased interstitial markings type 1 respectively. 3. It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especially the case combined with Korean hemorrhagic fever.

  6. Radiology illustrated. Chest radiology

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Radiology; Han, Joungho [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Pathology; Chung, Man Pyo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of). Dept. of Medicine; Jeong, Yeon Joo [Pusan National Univ. Hospital, Busan (Korea, Republic of). Dept. of Radiology

    2014-04-01

    Pattern approach to the diagnosis of lung diseases based on CT scan appearances. Guide to quick and reliable differential diagnosis. CT-pathology correlation. Emphasis on state-of-the-art MDCT. The purpose of this atlas is to illustrate how to achieve reliable diagnoses when confronted by the different abnormalities, or ''disease patterns'', that may be visualized on CT scans of the chest. The task of pattern recognition has been greatly facilitated by the advent of multidetector CT (MDCT), and the focus of the book is very much on the role of state-of-the-art MDCT. A wide range of disease patterns and distributions are covered, with emphasis on the typical imaging characteristics of the various focal and diffuse lung diseases. In addition, clinical information relevant to differential diagnosis is provided and the underlying gross and microscopic pathology is depicted, permitting CT-pathology correlation. The entire information relevant to each disease pattern is also tabulated for ease of reference. This book will be an invaluable handy tool that will enable the reader to quickly and easily reach a diagnosis appropriate to the pattern of lung abnormality identified on CT scans.

  7. 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 intr...

  8. 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 in...

  9. Chest Pain (Beyond the Basics)

    Science.gov (United States)

    ... number of problems related to the stomach and intestines can cause pain that spreads to or even begins in the chest, including ulcers, gallbladder disease, pancreatitis, and irritable bowel syndrome. (See "Patient information: Peptic ulcer disease (Beyond the ...

  10. 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.

  11. Lymphomas presenting as chest wall tumors

    OpenAIRE

    Witte, Biruta; Hürtgen, Martin

    2006-01-01

    Four cases of thoracic lymphoma mimicking chest wall tumors are presented. As resection is not the treatment of first choice in lymphomas, pretherapeutical evaluation of chest wall tumors should include a thoroughly staging and a biopsy for histopathological diagnosis. Chest wall destruction due to an anterior mediastinal mass, or a chest wall tumor associated with mediastinal lymph node enlargement, could be suspicious of thoracic lymphoma. Lymphoma with chest wall involvement mostly turns o...

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

    International Nuclear Information System (INIS)

    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)

  13. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    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.)

  14. Imaging of blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A. [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland). Dept. of Radiology

    2000-10-01

    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.)

  15. 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

    1992-01-01

    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 in

  16. The evolving concept of physiological ischemia training vs. ischemia preconditioning.

    Science.gov (United States)

    Ni, Jun; Lu, Hongjian; Lu, Xiao; Jiang, Minghui; Peng, Qingyun; Ren, Caili; Xiang, Jie; Mei, Chengyao; Li, Jianan

    2015-11-01

    Ischemic heart diseases are the leading cause of death with increasing numbers of patients worldwide. Despite advances in revascularization techniques, angiogenic therapies remain highly attractive. Physiological ischemia training, which is first proposed in our laboratory, refers to reversible ischemia training of normal skeletal muscles by using a tourniquet or isometric contraction to cause physiologic ischemia for about 4 weeks for the sake of triggering molecular and cellular mechanisms to promote angiogenesis and formation of collateral vessels and protect remote ischemia areas. Physiological ischemia training therapy augments angiogenesis in the ischemic myocardium by inducing differential expression of proteins involved in energy metabolism, cell migration, protein folding, and generation. It upregulates the expressions of vascular endothelial growth factor, and induces angiogenesis, protects the myocardium when infarction occurs by increasing circulating endothelial progenitor cells and enhancing their migration, which is in accordance with physical training in heart disease rehabilitation. These findings may lead to a new approach of therapeutic angiogenesis for patients with ischemic heart diseases. On the basis of the promising results in animal studies, studies were also conducted in patients with coronary artery disease without any adverse effect in vivo, indicating that physiological ischemia training therapy is a safe, effective and non-invasive angiogenic approach for cardiovascular rehabilitation. Preconditioning is considered to be the most protective intervention against myocardial ischemia-reperfusion injury to date. Physiological ischemia training is different from preconditioning. This review summarizes the preclinical and clinical data of physiological ischemia training and its difference from preconditioning. PMID:26664354

  17. Frequency and characteristics of myocardial ischemia recorded during stress echocardiography in patients with high coronary risk

    Directory of Open Access Journals (Sweden)

    Ilić Stevan

    2011-01-01

    Full Text Available Background/Aim. Ischemic heart disease is the major cause of morbidity and mortality in the world as well as in our country. Ischemic heart disease has the multifactorial origin and the presence of several risk factors increases the risk of myocardial ischemia. The aim of the study was to evaluate the frequency and characteristics of myocardial ischemia in asymptomatic subjects with two or more risk factors for coronary artery disease during stress echocardiography. Methods. In 240 high risk asymptomatic subjects (an absolute risk of fatal cardiovascular disease of more than 5%, according to the Systemic Coronary Risk Evaluation Chart, the exercise stress echocardiography test was performed. The criterion for myocardial ischemia was the appearance of transient segmental wall motion abnormality (WMA. The wall motion score index was calculated before and after the exercise stress echocardiography. Results. During exercise stress echocardiography, in 36 (15% subjects WMA occurred. Out of 36 subjects with myocardial ischemia, in 10 (27.8% subjects WMA and ST segment depression were accompanied with the first occurrence of chest pain (the subgroup with symptomatic myocardial ischemia, in 20 (55.6% subjects WMA and ST segment depression were detected and in 6 (16.6% subjects only WMA occurred (the subgroup with silent myocardial ischemia. There were no significant differences between the subgroups with symptomatic and silent myocardial ischemia with regard to exercise tolerance, heart rate at the onset of WMA, and time to the onset of WMA, but the wall motion score index was significantly higher in the subjects with symptomatic myocardial ischemia (p < 0.01. In all the individuals with symptomatic myocardial ischemia, significant stenosis of the coronary arteries was found by coronary angiography. Out of 26 subjects with asymptomatic myocardial ischemia, coronary angiography was performed in 18 and significant stenosis of the coronary arteries was

  18. 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...... of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the...... radical scavenger α-PBN on the periinfarct depolarizations and infarct volume was investigated. In study number six, the activity of the mitochondrial electron transport complexes I, II and IV was evaluated histochemically during reperfusion after MCAO in order to assess the possible role of mitochondrial...

  19. Chest Wall tumor: combined management

    International Nuclear Information System (INIS)

    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

  20. Contemporary management of flail chest.

    Science.gov (United States)

    Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A

    2014-06-01

    Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management. PMID:24887787

  1. Gunshot wounds to the chest

    OpenAIRE

    Holmen, Lillian Beate

    2013-01-01

    Introduction: This is a review of gunshot wounds to the chest. Although uncommon in Norway, they represent a big health problem in other parts of the world and in war situations. Method: A systematic literature search using PubMed and McMaster+. Results: Gunshot wounds to the chest can be highly lethal. Depending on the injured organ, a large percentage of the patients die before reaching the hospital. There is a big difference between low-velocity and high-velocity weapons. Low velocity inju...

  2. Radiological Evaluation of Bowel Ischemia.

    Science.gov (United States)

    Dhatt, Harpreet S; Behr, Spencer C; Miracle, Aaron; Wang, Zhen Jane; Yeh, Benjamin M

    2015-11-01

    Intestinal ischemia, which refers to insufficient blood flow to the bowel, is a potentially catastrophic entity that may require emergent intervention or surgery in the acute setting. Although the clinical signs and symptoms of intestinal ischemia are nonspecific, computed tomography (CT) findings can be highly suggestive in the correct clinical setting. In our article, we review the CT diagnosis of arterial, venous, and nonocclusive intestinal ischemia. We discuss the vascular anatomy, pathophysiology of intestinal ischemia, CT techniques for optimal imaging, key and ancillary radiological findings, and differential diagnosis. PMID:26526436

  3. Sonographic Findings of Variable Chest Wall Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Mi Suk; Kim, Ji Young; Cho, Woo Ho; Kim, Joung Sook; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Jae Hyung; Kim, Soo Hyun; Jun, Woo Sun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    Variable chest wall disorders include hemorrhage, inflammation and a tumor on the chest wall. Especially in females, abnormal anterior chest wall findings can appear as breast lesions due to the anatomic relationship between the chest wall and the breast. Sonography is the first diagnostic tool to utilize for chest wall disorders and has an important role for the differential diagnosis. In this study, we introduce sonographic findings of the various chest wall disorders that are discovered incidentally during an examination for a palpable mass or pain in the breast. We also describe sonographic findings that additionally performed of sonography-guided core needle biopsy

  4. 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

    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...... injected indicator molecules in an extracted and a transmitted fraction of molecules. In open chest dog hearts measurements performed during normal physiological conditions gave mean capillary extraction values of 43.5-47.5% and the corresponding calculated PdS values were 47.1 - 57.5 ml.(100g.min)-1. From...

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

    OpenAIRE

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

    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 ...

  6. 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.

  7. Actinomycosis involving the chest wall: CT findings

    International Nuclear Information System (INIS)

    Two cases of pulmonary actinomycosis with extension to involve the chest wall that were evaluated using computerized tomography are reported. In both cases, the relation of pulmonary and chest wall disease was best shown using CT

  8. ACR Appropriateness Criteria chronic chest pain-low to intermediate probability of coronary artery disease.

    Science.gov (United States)

    Woodard, Pamela K; White, Richard D; Abbara, Suhny; Araoz, Philip A; Cury, Ricardo C; Dorbala, Sharmila; Earls, James P; Hoffmann, Udo; Hsu, Joe Y; Jacobs, Jill E; Javidan-Nejad, Cylen; Krishnamurthy, Rajesh; Mammen, Leena; Martin, Edward T; Ryan, Thomas; Shah, Amar B; Steiner, Robert M; Vogel-Claussen, Jens; White, Charles S

    2013-05-01

    Chronic chest pain can arise from a variety of etiologies. However, of those potential causes, the most life-threatening include cardiac disease. Chronic cardiac chest pain may be caused either by ischemia or atherosclerotic coronary artery disease or by other cardiac-related etiologies, such as pericardial disease. To consider in patients, especially those who are at low risk for coronary artery disease, are etiologies of chronic noncardiac chest pain. Noncardiac chest pain is most commonly related to gastroesophageal reflux disease or other esophageal diseases. Alternatively, it may be related to costochondritis, arthritic or degenerative diseases, old trauma, primary or metastatic tumors, or pleural disease. Rarely, noncardiac chest pain may be referred pain from organ systems below the diaphragm, such as the gallbladder. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:23542027

  9. Ischemia causes muscle fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P ischemia leading to a 7% or greater reduction in muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  10. Partial Liver Ischemia Is Followed by Metabolic Changes in the Normally Perfused Part of the Liver during Reperfusion

    DEFF Research Database (Denmark)

    Kannerup, Anne-Sofie; Grønbæk, Henning; Funch-Jensen, Peter; Karlsen, S.; Mortensen, Frank Viborg

    2010-01-01

    Background: Temporary vascular in- and outflow occlusion is an effective technique for bleeding control during liver resection. However, occlusion can result in ischemia/reperfusion (I/R) injury to the liver. The aim of this study in a porcine model was to investigate the effect of in- and outflo...... continuous decreases in lactate and pyruvate levels in the whole liver, even though the ischemic insult was not detectable in transaminase levels....

  11. Nuclear imaging of the chest

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Y.W. [Samsung Cheil General Hospital, Seoul (Korea, Republic of). Dept. of Radiology; Kim, E.E. [Texas Univ., Houston, TX (United States). Cancer Center; Isawa, T. [Yokohama Higashi National Hospital (Japan)

    1998-01-01

    This book provides up-to-the minute information on the diagnostic nuclear imaging of chest disorders. The authors have endeavored to integrate and consolidate the many different subspecialities in order to enable a holistic understanding of chest diseases from the nuclear medicine standpoint. Highlights of the book include in addition to the cardiac scan the description of aerosol lung imaging in COPD and other important pulmonary diseases and the updates on breast and lung cancer imaging, as well as imaging of the bony thorax and esophagus. It is required reading not only for nuclear medicine practitioners and researchers but also for all interested radiologists, traumatologists, pulmonologists, oncologists and cardiologists. (orig.) 217 figs., 25 tabs.

  12. Ischemia causes muscle fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  13. Chest shape in preterm newborn infants

    International Nuclear Information System (INIS)

    The suggestion that thoracic shape of anteroposterior radiographs reflects lung compliance was examined in 62 preterm newborn infants (none with pulmonary hypoplasia) by measuring ratios of upper to lower chest widths. Chest shape did not vary significantly with the presence of respiratory distress syndrome (RDS) or with gender, Apgar score, endotracheal intubation, radiographic severity of RDS, or age at radiography. However, decreased maturity was associated with a relatively wide upper chest and narrow lower chest. Developmental factors may be more important than lung compliance (and the other factors noted) in determining the radiographic configuration of the infantile chest

  14. Radiology of occupational chest disease

    International Nuclear Information System (INIS)

    Radiologic manifestations of occupational lung disease are summarized and classified in this book according to the ILO system. The interpretation of chest roentgenograms outlines the progression of each disease and is accompanied with clinically-oriented explanations. Some of the specific diseases covered include asbestosis, coal worker's pneumoconiosis, silicosis, non-mining inhalation of silica and silicates, beryllium induced disease, inhalation of organics and metallics, and occupationally induced asthma

  15. [Transesophageal atrial stimulation--a test for myocardial ischemia].

    Science.gov (United States)

    Jović, A; Nekić-Borcilo, M; Troskot, R; Nekić, D; Knezević, A; Rados, G

    1994-01-01

    The aim of the present study was to determine clinical value and the feasibility of transesophageal atrial pacing (TAP) in diagnosing myocardial ischemia in patients with coronary artery disease (CAD). Forty patients with CAD and with significant ST-segment depression in a standard 12-lead ECG during bicycle-stress testing underwent TAP. Rapid atrial stimulation was performed by using a very flexible six-polar polyurethane pacing lead introduced through the nares into the esophagus and connected to the stimulator allowing selection of rate, output voltage and pulse duration. The satisfactory atrial pacing was obtained by 28 +/- 6 V output and 7 +/- 1 ms pulse duration. Of 40 patients who underwent TAP, ischemic ECG changes were induced in 35 (u = 2,24 p pressure products. This suggests comparable sensitivity of TAP and bicycle-stress testing in discovering myocardial ischemia in CAD patients. Four patients had negative test for myocardial ischemia and in one TAP was discontinued because of intolerable chest discomfort. In conclusion, TAP is a reliable alternative technique for the assessment of coronary artery disease. In combination with some other noninvasive methods (echocardiography, scintigraphy, i.v. digital angiography), it has become a routine diagnostic procedure in cardiac patients. PMID:8028438

  16. Peak systolic blood pressure in exercise testing is associated with scintigraphic severity of myocardial ischemia in patients with exercise-induced ST-segment depression

    International Nuclear Information System (INIS)

    Some electrocardiographic variables, including the degree of maximal ST-segment depression (STD), may not necessarily indicate the severity of exercise-induced myocardial ischemia. The present study examined whether maximal STD correlates with the severity and extent of exercise-induced myocardial ischemia, as assessed by thallium-201 (201Tl) imaging, and which parameter of exercise testing reflects scintigraphic severity and extent in 270 patients who had a 1 mm or greater horizontal or down-sloping STD on exercise 201Tl imaging. The scintigraphic severity and extent of exercise-induced ischemia was assessed and correlated with maximal STD, number of positive leads, workload, peak heart rate, peak systolic blood pressure (SBP), rate-pressure product, chest pain and the Duke treadmill score. Most of the scintigraphic markers of the severity and extent of ischemia had significant but weak correlation with all of those parameters. Multivariate analysis demonstrated that peak SBP and the Duke treadmill score (chest pain in only simple variables model) correlated independently with scintigraphic severity and extent of ischemia. Furthermore, most of the patients with a peak SBP of 200 mmHg or more had milder and less extensive ischemia. In patients with exercise-induced STD, the scintigraphic severity and extent of ischemia may be estimated by peak SBP and the Duke treadmill score. (author)

  17. Gastric tumors on chest radiographs

    International Nuclear Information System (INIS)

    Gastric neoplasms of three patients protruded into their gas-containing fornices and were first visualized on plain chest radiographs. Endoscopy and/or surgery confirmed these to be a polyp, a leiomyoma, and an adenocarcinoma. The polyp, 1.3 cm in diameter, was the smallest of these three, but smaller lesions may be detectable under suitable conditions. Adequate technique and positioning, sufficiently large lesions in the upper portion of the stomach, a central beam tangential to the tumor, sufficient gas in the stomach, and careful scrutiny by the observer are required. Lesions may be more readily visualized during chest radiography when oral sodium bicarbonate is used to distend the stomach. In chest radiography, exposure limited to the lung fields has been advocated for economy and dose reduction. However, too small an exposure field may result in loss of information potentially beneficial to the patient. Using the smaller of two popular film sizes (35 x 43 cm and 35 x 35 cm), the saving in surface and bone marrow doses is negligible, and the saving in gonad dose may be nil over that when shielding is used. The interest of the observer may be absorbed by a concomitant cardiac or pulmonary lesion. Careful scrutiny of the entire radiograph is therefore essential. (author)

  18. Pretest probability assessment for selective rest sestamibi scans in stable chest pain patients.

    Science.gov (United States)

    Welch, R D; Zalenski, R J; Shamsa, F; Waselewsky, D R; Kosnik, J W; Compton, S

    2000-11-01

    The objective of this study was to determine whether pretest probability assessments permit more selective testing of chest pain patients with technetium-99m sestamibi scanning. Pretest probabilities of cardiac ischemia were measured both objectively (Acute Cardiac Ischemia Time-Insensitive Predictive Instrument [ACI-TIPI]) and subjectively (physician's estimate of the probability of unstable angina). Two groups were defined: patients whose postsestamibi scan led to a "downgrade" of the intensity of monitoring and those that resulted in no change in monitoring intensity. Sixty-five patients met study criteria; 25 had a disposition downgrade and 40 had no change. Pretest ACI-TIPI scores were similar in the two groups (29% +/- 18% versus 27% +/- 11%, mean +/- standard deviation; P = .95) as were the physician's assessment of unstable angina (39% +/- 22% versus 40% +/- 24%; P = .75). Objective or subjective pretest probabilities are not significantly different in patients who are likely to have their disposition altered by sestamibi scanning. PMID:11103730

  19. Reproducible simulation of respiratory motion in porcine lung explants

    International Nuclear Information System (INIS)

    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.)

  20. 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

  1. Myocardial ischemia in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    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)

  2. A Bridge to a Woman's Heart as the Cause of Recurrent Chest Pain: A Case on Myocardial Bridge.

    Science.gov (United States)

    Afzal, Ashwad; Korniyenko, Aleksandr; Haq, Salman

    2016-01-01

    Myocardial bridge is a congenital structural variant of the coronary arteries where a segment of the epicardial vessel is surrounded by the myocardium. It is an uncommon entity that may go unnoticed in patients with recurrent chest pain. We present a case on a 36-year-old woman with recurrent chest pain. Initial workup revealed normal routine laboratory test results, cardiac biomarkers, electrocardiogram, and an echocardiogram showing preserved ejection fraction with no valvulopathies. A dobutamine myocardial perfusion stress test was performed; this induced chest pain in the patient with electrocardiogram changes evident for 1-mm ST segment elevation in lead V5 and V6 consistent with myocardial ischemia. Perfusion imaging revealed a small fixed myocardial perfusion defect of the apical inferior wall. A cardiac catheterization revealed moderate-to-severe myocardial bridging involving the middle left anterior descending artery. Treatment with metoprolol and ranolazine resolved her symptoms. This case portrays the importance of recognizing myocardial bridge as the potential cause of recurrent chest pain and its ability to cause myocardial ischemia under stress. PMID:25723365

  3. Sirt1 in cerebral ischemia

    OpenAIRE

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern seve...

  4. Comparison of robotic thyroidectomy through the trans-axillary and the anterior chest approach in a por-cine model%单腋窝和胸前径路达芬奇机器人猪甲状腺切除的对照研究

    Institute of Scientific and Technical Information of China (English)

    贺青卿; 肖蕾; 张海涛; 张鲁; 庄大勇; 范子义; 周鹏; 郑鲁明; 朱见; 侯蕾; 于芳; 李燕宁

    2014-01-01

    目的:达芬奇机器人( da Vinci Si )外科手术系统下单腋窝切口和胸前径路行猪甲状腺切除术,观察其安全性并积累手术操作经验。方法 da Vinci Si外科手术系统包括医生操控系统、床旁机械臂系统和成像系统。手术器械凭借腋窝/胸壁的切口连接到机器人的机械臂。术者坐于操控台前将手指分别放入操作手柄的指套内联合双脚控制手术器械和双目内窥镜,它可将外科医生的动作转换传递到手术器械的尖端。内置模拟手腕系统( EndoWrist )技术可使机械手进行上下左右旋转等7个自由的连续动作,超过了人手在开放手术时的灵活性。本组选用2头小型猪做da Vinci Si外科手术系统不同径路的甲状腺切除动物模型。采用气管插管全身麻醉。结果在da Vinci Si外科手术系统下完成2例不同径路的猪甲状腺切除和胸腺切除术。无中转开放或腔镜手术。手术时间分别为61 min和50 min。结论有开放性甲状腺外科手术经验的专科医师经短期da Vinci Si外科手术系统培训即可实施甲状腺腺叶切除术。在da Vinci Si外科手术系统辅助下行甲状腺切除术的学习曲线短。%Objective To evaluate the safety of the da Vinci Si surgical system in thyroid surgery and to accumulate operation experience .Methods The da Vinci Si surgical system consists of a surgeon's console, a patient-side robotic cart, and high-definition 3D vision system.The robot arm tips were introduced via a single axillary incision or small chest wall ports and attached to the arms of the robot .The surgeon , sitting at the con-sole, manipulated the EndoWrist instruments and endoscope view that transfer the surgeon 's movements to the arm tips.The so called EndoWrist'technology offers seven degrees of movements ( up, down, left, right, twist, et al) , thus exceeding the capacity of a surgeon's hand in open surgery .The da Vinci Si surgical system was

  5. Surgery of chest wall deformities

    OpenAIRE

    Matos, AC; Bernardo, JE; Fernandes, LE; Antunes, MJ

    1997-01-01

    OBJECTIVE: To evaluate the medium-term results of 77 surgical corrections in patients with chest wall deformities, 53 (68.8%) with pectus excavatum and 24 with pectus carinatum, operated upon from 1985 to 1994. METHODS: The mean age of the patients was 14.7 years (4-39 years) and 77% were younger than 15 years of age. There were 59 male (76.7%) and 18 female patients. Only four had a family history of the malformation. Seven patients (9.1%) presented with asthma-like symptoms, and 13 (16....

  6. Imaging of fetal chest masses

    Energy Technology Data Exchange (ETDEWEB)

    Barth, Richard A. [Lucile Packard Children' s Hospital, Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2012-01-15

    Prenatal imaging with high-resolution US and rapid acquisition MRI plays a key role in the accurate diagnosis of congenital chest masses. Imaging has enhanced our understanding of the natural history of fetal lung masses, allowing for accurate prediction of outcome, parental counseling, and planning of pregnancy and newborn management. This paper will focus on congenital bronchopulmonary malformations, which account for the vast majority of primary lung masses in the fetus. In addition, anomalies that mimic masses and less common causes of lung masses will be discussed. (orig.)

  7. Impalement Injuries of the Chest

    OpenAIRE

    Edwin, F; Tettey, M; Sereboe, L; Aniteye, E; Kotei, D; Tamatey, M; Entsuamensah, K; Delia, I; Frimpong-Boateng, K

    2009-01-01

    Impalement injuries of the chest are uncommon in civilian practice with few reports in the literature. We report three cases of thoracic impalement seen over a 5 year period with unusual underlying mechanisms. In two of the cases, the impalement was obvious; in the third, the impalement was concealed having occurred 5 months earlier. In Case 1, the underlying mechanism was a high-speed road traffic accident. The patient was impaled by a metallic square pipe piled by the roadside. In Case 2, t...

  8. [Cerebral ischemia in young adults].

    Science.gov (United States)

    Berlit, P; Endemann, B; Vetter, P

    1991-08-01

    An overview is given over etiology and prognosis of cerebral ischemias until the age of 40. In a time period of 19 years, 168 patients were diagnosed with cerebral ischemia until the age of 40 (91 females, 77 males). The most frequent etiology is premature atherosclerosis in patients with vascular risk factors (up to 50%). Cardiogenic embolism is responsible for 1 to 34% of the cases: cardiac valve diseases and endocarditis being the most frequent sources. In 2 to 19% a vasculitis is diagnosed. While infectious arteritis is especially frequent in countries of the third world, immunovasculitides are common in Europe and the USA. Noninflammatory vasculopathies include spontaneous or traumatic dissection, fibromuscular dysplasia and vascular malformations. A migrainous stroke is especially frequent in female smokers with intake of oral contraceptives. During pregnancy both sinus thrombosis and arterial ischemia occur. Hematologic causes for ischemia are polycythemia, thrombocytosis and genetic diseases (sickle cell anemia, AT3-deficiency). Cerebral ischemia may occur in connection with the ingestion of ergot-derivates. The prognosis of cerebral ischemia in young adults is better than in older stroke-patients. PMID:1937340

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

    International Nuclear Information System (INIS)

    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)

  10. 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...

  11. Porcine models of digestive disease: the future of large animal translational research.

    Science.gov (United States)

    Gonzalez, Liara M; Moeser, Adam J; Blikslager, Anthony T

    2015-07-01

    There is increasing interest in nonrodent translational models for the study of human disease. The pig, in particular, serves as a useful animal model for the study of pathophysiological conditions relevant to the human intestine. This review assesses currently used porcine models of gastrointestinal physiology and disease and provides a rationale for the use of these models for future translational studies. The pig has proven its utility for the study of fundamental disease conditions such as ischemia-reperfusion injury, stress-induced intestinal dysfunction, and short bowel syndrome. Pigs have also shown great promise for the study of intestinal barrier function, surgical tissue manipulation and intervention, as well as biomaterial implantation and tissue transplantation. Advantages of pig models highlighted by these studies include the physiological similarity to human intestine and mechanisms of human disease. Emerging future directions for porcine models of human disease include the fields of transgenics and stem cell biology, with exciting implications for regenerative medicine. PMID:25655839

  12. 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

  13. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  14. Potential of ultrasound in the pediatric chest

    International Nuclear Information System (INIS)

    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

  15. 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.

  16. 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

    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 ...

  17. 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

  18. 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...

  19. Why x-ray chests

    International Nuclear Information System (INIS)

    In order to assess the validity of screening chest radiography at Chalk River Nuclear Laboratories, the yield of occult major disease and its significance to the afflicted employees have been examined over a ten year period. The study suggests that the incidence rate of occult disease which in retrospect proved to have been of major or life-threatening importance to the afflicted employee approximates 1 per 1000 population per annum. Major benefit accrued only to about 1 in 3 of these employees, the remainder gaining little more than that which would have followed treatment had their diseases presented symptomatically. These results are considered in relation to the health surveillance needs of a population generally and selectively exposed to diverse health hazards within the nuclear industry. (auth)

  20. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    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...

  1. [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." PMID:25734676

  2. In search of optimum chest radiography techniques

    International Nuclear Information System (INIS)

    A nation-wide study of chest radiography in Sweden previously revealed a large variation in the physical and technical factors involved, in particular radiation dose. In this study image quality could not be assessed unambiguously. The aim was to try to establish correlation between visual grading of radiographs and physical and technical factors in order to find the optimum chest X-ray system. The physical and technical performance of 24 chest units was evaluated. Radiographs were taken of an anthropomorphic chest phantom supplied with test structures simulating various pathologies. Image quality was assessed by visual grading analysis of the radiographs. The physical and technical parameters of the units rated best were used to exemplify good radiographic practice. Results were in agreement with the recommendations issued by the Commission of the European Communities (CEC). It was also shown that low radiation dose is compatible with high-quality radiographic imaging of the chest. (Author)

  3. Solitary Plasmacytoma of the Chest Wall

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-03-01

    Full Text Available A previously healthy 55-year-old man with right sided lateral chest pain admitted to clinic. It was found a solid and painful mass at the right 4th rib in physical examination. Chest X-ray and thoracic computarized tomography showed an opacity measured 60x33 mm within the right chest wall destructing the 4th rib. Needle aspiration was performed from tumor and cytologic examination showed atypic plasma cell infiltration. The patient was scheduled for a chest wall resection and reconstructive surgery. Examination of a permanent section showed that the chest wall tumor was solitary plasmacytoma. There was no evidence of multiple myeloma recurrence after two years from the operation.

  4. 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.

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

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; 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...... 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...... fraction and PS values seen in the control group suggest an increased capillary permeability after ischemia and reperfusion. Superoxide anions seem to participate, directly or indirectly, in this response....

  6. CT of blunt chest trauma in children

    International Nuclear Information System (INIS)

    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.)

  7. 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

  8. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    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

  9. Impacts to the chest of PMHSs - Influence of impact location and load distribution on chest response.

    Science.gov (United States)

    Holmqvist, Kristian; Svensson, Mats Y; Davidsson, Johan; Gutsche, Andreas; Tomasch, Ernst; Darok, Mario; Ravnik, Dean

    2016-02-01

    The chest response of the human body has been studied for several load conditions, but is not well known in the case of steering wheel rim-to-chest impact in heavy goods vehicle frontal collisions. The aim of this study was to determine the response of the human chest in a set of simulated steering wheel impacts. PMHS tests were carried out and analysed. The steering wheel load pattern was represented by a rigid pendulum with a straight bar-shaped front. A crash test dummy chest calibration pendulum was utilised for comparison. In this study, a set of rigid bar impacts were directed at various heights of the chest, spanning approximately 120mm around the fourth intercostal space. The impact energy was set below a level estimated to cause rib fracture. The analysed results consist of responses, evaluated with respect to differences in the impacting shape and impact heights on compression and viscous criteria chest injury responses. The results showed that the bar impacts consistently produced lesser scaled chest compressions than the hub; the Middle bar responses were around 90% of the hub responses. A superior bar impact provided lesser chest compression; the average response was 86% of the Middle bar response. For inferior bar impacts, the chest compression response was 116% of the chest compression in the middle. The damping properties of the chest caused the compression to decrease in the high speed bar impacts to 88% of that in low speed impacts. From the analysis it could be concluded that the bar impact shape provides lower chest criteria responses compared to the hub. Further, the bar responses are dependent on the impact location of the chest. Inertial and viscous effects of the upper body affect the responses. The results can be used to assess the responses of human substitutes such as anthropomorphic test devices and finite element human body models, which will benefit the development process of heavy goods vehicle safety systems. PMID:26687541

  10. 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.

  11. Technique for chest radiography for pneumoconiosis

    International Nuclear Information System (INIS)

    Routine radiographic chest examinations have been performed using a variety of techniques. Although chest radiography is one of the most commonly performed radiographic examinations, it is often difficult to obtain consistently good quality roentgenograms. This publication provides a simple guide and relatively easy solution to the many problems that radiologic technologists might encounter. The language is purposely relatively simple and care has been taken to avoid difficult mathematical and physical explanations. The intent is to provide an easily referrable text for those who may encounter difficulties in producing acceptable chest radiographs

  12. Chest pain of cardiac and noncardiac origin.

    Science.gov (United States)

    Lenfant, Claude

    2010-10-01

    Chest pain is one of the most common symptoms driving patients to a physician's office or the hospital's emergency department. In approximately half of the cases, chest pain is of cardiac origin, either ischemic cardiac or nonischemic cardiac disease. The other half is due to noncardiac causes, primarily esophageal disorder. Pain from either origin may occur in the same patient. In addition, psychological and psychiatric factors play a significant role in the perception and severity of the chest pain, irrespective of its cause. Chest pain of ischemic cardiac disease is called angina pectoris. Stable angina may be the prelude of ischemic cardiac disease; and for this reason, it is essential to ensure a correct diagnosis. In most cases, further testing, such as exercise testing and angiography, should be considered. The more severe form of chest pain, unstable angina, also requires a firm diagnosis because it indicates severe coronary disease and is the earliest manifestation of acute myocardial infarction. Once a diagnosis of stable or unstable angina is established, and if a decision is made not to use invasive therapy, such as coronary bypass, percutaneous transluminal coronary angioplasty, or stent insertion, effective medical treatment of associated cardiac risk factors is a must. Acute myocardial infarction occurring after a diagnosis of angina greatly increases the risk of subsequent death. Chest pain in women warrants added attention because women underestimate their likelihood to have coronary heart disease. A factor that complicates the clinical assessment of patients with chest pain (both cardiac and noncardiac in origin) is the relatively common presence of psychological and psychiatric conditions such as depression or panic disorder. These factors have been found to cause or worsen chest pain; but unfortunately, they may not be easily detected. Noncardiac chest pain represents the remaining half of all cases of chest pain. Although there are a number of

  13. Classification of chest wall diseases.

    Science.gov (United States)

    Pozzi, E; Gulotta, C

    1993-01-01

    Several disorders of the thoracic cage are known to cause respiratory failure, by means of relatively simple mechanisms, such as the increased work of breathing, which results in alveolar hypoventilation. A variety of pathogenic mechanisms may be considered, as functions of the types of thoracic disorders present. As causes of these additional potential mechanisms, we considered the following: 1) ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation or acquired defect of the respiratory centres; and 4) excess blood volume and fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of these disorders can be grouped into two major categories (which nevertheless have some of the pathophysiology in common): the mechanical syndrome and the neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases falling into the first category; namely, kyphoscoliosis, fibrothorax, thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital deformities of the thoracic cage, which do not have important effects on ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also considered. PMID:8472068

  14. The interferon sensitivity of selected porcine viruses.

    OpenAIRE

    Derbyshire, J. B.

    1989-01-01

    The objective of this study was to compare the sensitivity of 11 porcine viruses to the antiviral effects of porcine interferon-alpha in serum from piglets which had been infected 19 h previously with transmissible gastroenteritis virus, and of porcine interferon-beta prepared in PK-15 cells by induction with polyinosinic:polycytidylic acid, in yield reduction assays in pig kidney cells which were treated with interferon before virus challenge, and both before and after virus challenge. The m...

  15. Porcine Ex Vivo intestinal segment model

    OpenAIRE

    Ripken, D.; Hendriks, H.F.J.

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Compared to the Ussing chamber (Chap. 24) the porcine ex vivo small intestinal segment model is a relatively simple to use intestinal tissue model. The main difference being that the tissue segment is not...

  16. Clinical and analytical review of ischemia-modified albumin measured by the albumin cobalt binding test.

    Science.gov (United States)

    Apple, Fred S

    2005-01-01

    IMA measured by the ACB test is proposed as a novel marker that appears sensitive to cardiac ischemia. It has the potential to become a triage tool in suspected ACS patients, especially to rule out ACS, and might also find utility in stroke, stress testing, nuclear imaging, and states of noncardiac ischemia and oxidative stress. Rapid-testing platforms will be necessary to achieve the optimal goal of assisting in the triage of chest (ACS) patients that present to EDs. However, it does not appear to be highly tissue or clinically specific. There is a continued need to improve the clinical and analytical evidence base of IMA to substantiate its clinical use in diagnostics and outcomes assessment. The search for a marker, whether IMA or another marker that establishes an evidence base, that would effectively rule in as well as rule out early cardiac ischemia continues. The ACB test has barely begun the exploration of the exciting challenges and discoveries that lie ahead in assisting clinicians in the early detection of myocardial ischemia to assist and improve patient triage, therapy, and management. PMID:16013666

  17. An unusual cause of spinal cord ischemia after thoracic endovascular repair.

    Science.gov (United States)

    Koleilat, Issam; Moore, Erin; Hanover, Tod; Eidt, John

    2016-04-01

    A 59-year-old left-handed man presented with chest pain and hypertension and was found to have an acute descending aortic dissection on imaging. After thoracic endovascular repair of the dissection, he developed left arm weakness and ischemia. Despite carotid-subclavian transposition, the patient was found to have persistent left triceps weakness as well as bilateral leg paresis. An urgent spinal drain was placed that improved his lower extremity deficit but did not greatly change his arm symptoms. Magnetic resonance imaging of the spine revealed previously undiagnosed severe multilevel spinal stenosis requiring operative decompression. To our knowledge, this is the first report of the contribution of cervical spinal stenosis to post-thoracic endovascular repair spinal ischemia. PMID:25564598

  18. [Dedifferentiated Chondrosarcoma of the Chest Wall].

    Science.gov (United States)

    Saitoh, Genkichi; Yoneshima, Yasuto; Nakamura, Toshihiko; Kitagawa, Dai; Kinjo, Nao; Ohgaki, Kippei; Maehara, Shinichiro; Teramoto, Seiichi; Adachi, Eisuke; Ikeda, Yoichi; Mine, Mari

    2016-08-01

    A 79-year-old man complaining of an anterior chest mass with pain had an abnormal shadow on chest X-ray. A mass, 7 cm in size, with destruction of the right 4th rib was found on chest computed tomography. A F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) corresponding to the lesion showed an abnormal accumulation of FDG with the standardized uptake value(SUV) max=16.19. A malignant tumor of the chest wall origin was suspected and the tumor was resected with the 3th, 4th, and 5th ribs. Histologically, the tumor was diagnosed as dedifferentiated chondrosarcoma. He died of local recurrence about 5 months after the operation. PMID:27476566

  19. Digital chest radiography: collimation and dose reduction

    DEFF Research Database (Denmark)

    Debess, Jeanne; Johnsen, Karen Kirstine; Vejle-Sørensen, Jens Kristian;

    Purpose: Quality improvement of basic radiography focusing 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 of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance of...... conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  20. Common Acupoints in Chest and Abdomen

    Institute of Scientific and Technical Information of China (English)

    Journal of Acupuncture and Tuina Science Editor; CUI Xue-jun

    2003-01-01

    @@ Tiantu (CV 21) Location: In the center of the suprasternal fossa(Fig. l ). Indications: Cough, dyspnea, chest pain, pharyngolaryngeal swelling and pains, sudden hoarseness of the voice, goiter, globus hystericus, and dysphagia.

  1. Angina - when you have chest pain

    Science.gov (United States)

    ... or having sex. How to treat your chest pain Sit, stay calm, and rest. Your symptoms will often go away soon after you stop activity. If you are lying down, sit up in bed. Try deep breathing to ...

  2. Chest CT in infants and children

    International Nuclear Information System (INIS)

    Computed tomography (CT) is a powerful and irreplaceable imaging technique in the evaluation of thoracic disease in infants and children. Recent advances in CT technology, with multi-detector equipment now widely available in most institutions, allowing a highly detailed evaluation of the chest in a short time period has resulted in expanding indications of chest CT in paediatric patients. Its improved diagnostic yield along with a widespread availability has also resulted in an increased number of CT examinations in children, not always with beneficial impact on patient management and outcome. Accordingly with the ALARA concept, a judicious and correct use of CT is strongly advisable in order to reduce unnecessary high dose radiation exposure. The objective of this paper is to review the use of chest CT in paediatric patients focused mainly on basic technical aspects and clinical applications in the evaluation of the lungs, mediastinum and chest wall

  3. Open-Chest Management after Heart Transplantation

    OpenAIRE

    Takayama, Hiroo; Leone, Richard J.; Aldea, Gabriel S.; Fishbein, Daniel P.; Verrier, Edward D.; Salerno, Christopher T.

    2006-01-01

    Postcardiotomy open-chest management has been widely used in cardiac surgery. Although this strategy can be applied to heart transplantation, the use of immunosuppressants in transplant recipients raises particular concerns about sternal wound infection and impaired healing.

  4. Aspergillosis - chest x-ray (image)

    Science.gov (United States)

    ... usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung ... are usually seen as black areas on an x-ray. The cloudiness on the left side of this ...

  5. Thymic carcinoma presenting as atypical chest pain.

    Science.gov (United States)

    Siddiqui, Sadiq; Connelly, Tara; Keita, Luther; Blazkova, Sylvie; Veerasingam, Dave

    2015-01-01

    A 58-year-old woman with a 2-month history of atypical chest pain was referred to the chest pain clinic by the general practitioner. Exercise stress test was positive and subsequent coronary angiogram revealed significant triple vessel disease with left ventricular impairment requiring a coronary artery bypass graft (CABG). The patient had a chest X-ray as part of the preoperative work up. Chest X-ray revealed a large anterior mediastinal mass. Subsequent thorax CT revealed a 7.2 cm anterior mediastinal mass. CT-guided biopsy of the mass revealed the diagnosis of a poorly differentiated thymic basaloid carcinoma. The patient was successfully treated with concomitant surgery involving complete resection of the mass and a CABG procedure. PMID:26607199

  6. Tuberculosis, advanced - chest x-rays (image)

    Science.gov (United States)

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  7. Surface Chest Motion Decomposition for Cardiovascular Monitoring

    OpenAIRE

    Ghufran Shafiq; Kalyana C. Veluvolu

    2014-01-01

    Surface chest motion can be easily monitored with a wide variety of sensors such as pressure belts, fiber Bragg gratings and inertial sensors, etc. The current applications of these sensors are mainly restricted to respiratory motion monitoring/analysis due to the technical challenges involved in separation of the cardiac motion from the dominant respiratory motion. The contribution of heart to the surface chest motion is relatively very small as compared to the respiratory motion. Further, t...

  8. VAC® for external fixation of flail chest

    OpenAIRE

    Rikke Winge; Berg, Jais O.; Rikke Albret; Christen Krag

    2012-01-01

    A large anterior chest wall defect following tumor resection was reconstructed with a Gore- Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient’s need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the ...

  9. Tuberculous spondylitis presenting as severe chest pain

    Directory of Open Access Journals (Sweden)

    Martha A. Kaeser

    2012-04-01

    Full Text Available This case report describes a 32-year-old male who presented to an emergency department with severe chest pain and a history of cough, fever, night sweats, loss of appetite and weight. Chest radiography revealed a left upper lobe consolidation and multiple compression deformities in the thoracic spine. Magnetic resonance imaging demonstrated significant kyphosis and vertebral plana at two thoracic levels. Anterior compression of the spinal cord and adjacent soft tissue masses were also noted.

  10. Psychiatric syndromes associated with atypical chest pain

    OpenAIRE

    Nikolić Gordana; Tasić Ivan; Manojlović Snežana; Samardžić Ljiljana; Tošić Suzana; Ćirić Zoran

    2010-01-01

    Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events expos...

  11. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    OpenAIRE

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours.

  12. Results of Thoracotomy in Penetrating Chest Trauma

    OpenAIRE

    Mahmood Aghaei-Afshar; Foroogh Mangeli; Sara Farifteh

    2012-01-01

    Background: Thoracotomy is a surgical procedure to access the chest components, which is often performed after severe bleeding caused by heart damage, lung laceration and other similar injuries.Materials and Methods: This is a cross-sectional study which was conducted on all patients with penetrating chest trauma during April 2000 to October 2008.Results: In 5% of cases, thoracotomy was used for treatment in which severe bleeding was the main surgical indication. It was the most common findin...

  13. Treatment of 336 cases of chest trauma

    OpenAIRE

    Jing ZHANG; Xiang-yang CHU; Liu, Yi; Wang, Yun-Xi

    2012-01-01

    【Abstract】Objective: To summarize the clinical features, diagnosis and treatment of chest trauma. Methods: A retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011. Results: Out of all cases, 325 were cured, accounting for 96.7%; 11 died, accounting for 3.3%. Among the dead cases, one died of hemorrhagic shock, three of acute respi-ratory distress syndrome, three of multiple organ failure, and ...

  14. Late clotted haemothorax after blunt chest trauma.

    OpenAIRE

    Sinha, P; Sarkar, P

    1998-01-01

    A clotted haemothorax can develop any time after blunt chest trauma. Two cases are described in which late clotted haemothoraces developed which were treated by limited thoracotomy and evacuation of clots. Late clotted haemothorax may occur even in the absence of any abnormal initial clinical findings. Early detection and treatment is important to avoid the complications of fibrothorax and empyema with permanent pulmonary dysfunction. After blunt chest trauma patients should be advised to ret...

  15. Correlation between lipid profile and troponin I test results in patients with chest pain in Nepal

    Institute of Scientific and Technical Information of China (English)

    Arun Kumar; Brijesh Sathian

    2013-01-01

    To study the usefulness of traditional lipid profile levels in screening subjects who had developed chest pain due to cardiac event as indicated by a positive troponin I test. Methods: In this retrospective study data of the 430 patients presented to the emergency department with symptoms of cardiac ischemia who underwent both troponin and lipid profiles tests were compared with the lipid profiles of 165 normal healthy subjects (controls). The troponin was detected qualitatively when a specimen contains troponin I (cTnI) above the 99th percentile (TnI>0.5 ng/mL). The total cholesterol, high density lipoproteins cholesterol, very low density lipoproteins and triacyl glycerol levels were also analyzed and low density lipoprotein level was calculated using Friedewald’s formula. Results: Patients with chest pain and positive troponin test (with confirmed cardiac event) were found to have significantly elevated levels of total cholesterol, triacyl glycerol levels, low density lipoprotein level and significantly reduced high density lipoproteins cholesterol levels when compared to the patients who experienced only chest pain (negative troponin) and healthy controls. Conclusions: Traditional lipid profile levels is still can be used in screening populations to identify the subjects with high risk of developing cardiac event in case if the laboratory set up has not troponin test facilities.

  16. How to remove a chest drain.

    Science.gov (United States)

    Allibone, Elizabeth

    2015-10-01

    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 . PMID:26443174

  17. Management of chest trauma: a review.

    Science.gov (United States)

    Adebonojo, S A

    1993-01-01

    The incidence of chest trauma has increased significantly since the turn of the century especially in developed countries where rapid means of transportation has become part of daily life. Although gunshot wounds (GSWs) were the commonest causes of chest trauma in wartime, road traffic accidents (RTAs) have become the scourge of peacetime and modern civilization. Chest trauma is more common in males during the 2nd to the 5th decades of life with an average age of 40 years reducing their life expectancy by another 40 years at the most productive and active period of their lives. Despite improvement in ambulance service and rapid mobilization of victims from the scene of accident, about 10% of chest injured patients will die on the spot and another 5% die within an hour of reaching the hospital. Of the remaining 85%, five percent will require emergency thoracotomy for various reasons while 80% will respond to resuscitative measures and tube thoracostomy drainage alone. The primary aims in the management of chest trauma are prompt restoration of normal cardiorespiratory functions, control of haemorrhage, treatment of associated injuries and prevention of sepsis. Although the overall survival rate of trauma has improved in recent years, deaths are often due to airway obstruction, exsanguinating haemorrhage, flail chest, tension pneumothorax, cardiac tamponade and associated intracranial, intraabdominal and skeletal injuries. PMID:8398932

  18. Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death.

    Science.gov (United States)

    Liu, Q; Nassar, A; Farias, K; Buccini, L; Mangino, M J; Baldwin, W; Bennett, A; O'Rourke, C; Iuppa, G; Soliman, B G; Urcuyo-Llanes, D; Okamoto, T; Uso, T D; Fung, J; Abu-Elmagd, K; Miller, C; Quintini, C

    2016-03-01

    The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs. PMID:26663737

  19. Psychiatric syndromes associated with atypical chest pain

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events exposure and characteristic of chest pain expression in persons with atypical chest pain and coronary patients, as well as to define predictive parameters for atypical chest pain. Method. We compared 30 patients with atypical chest pain (E group to 30 coronary patients (K group, after cardiological and psychiatric evaluation. We have applied: Mini International Neuropsychiatric Interview (MINI, The Symptom Checklist 90-R (SCL-90 R, Beck Anxiety Inventory (BAI, Holms-Rahe Scale of stress life events (H-R, Questionnaire for pain expression Pain-O-Meter (POM. Significant differences between groups and predictive value of the parameters for atypical chest pain were determined. Results. The E group participants compared to the group K were younger (33.4 ± 5.4 : 48.3 ± 6,4 years, p < 0.001, had a moderate anxiety level (20.4 ± 11.9 : 9.6 ± 3.8, p < 0.001, panic and somatiform disorders were present in the half of the E group, as well as eleveted somatization score (SOM ≥ 63 -50% : 10%, p < 0.01 and a higher H-R score level (102.0 ± 52.2 : 46.5 ± 55.0, p < 0.001. Pain was mild, accompanied with panic. The half of the E group subjects had somatoform and panic disorders. Conclusion. Somatoform and panic disorders are associated with atypical chest pain. Pain expression is mild, accompained with panic. Predictive factors for atypical chest pain are: age under 40, anxiety level > 20, somatization ≥ 63, presence of panic and somatoform disorders, H-R score > 102

  20. Chest injuries associated with head injury

    Directory of Open Access Journals (Sweden)

    Wilfred Chukwuemeka Mezue

    2012-01-01

    Full Text Available Background: Although there have been significant advances in the management of traumatic brain injury (TBI, associated severe injuries, in particular chest injuries, remain a major challenge. This paper analyses the contribution of chest injuries to the outcome of head injuries in the University of Nigeria Teaching Hospital (UNTH and the Memfys Hospital for Neurosurgery (MHN in Enugu, Nigeria. Materials and Methods: This is a retrospective review of the medical records, operative notes, and radiological findings of all patients admitted for head injury who had associated significant chest injuries in the MHN from 2002 to 2009 and the UNTH between 2007 and 2010. Patients with only head injury and other extracranial injury not affecting the chest were excluded. Patients who were inadequately investigated were also excluded. Results: Nineteen patients from the MHN and 11 patients from the UNTH were analyzed. Ages ranged from 9 to 65 years and the male:female ratio was 3:1. Injuries were most common between 30 and 50 years and road traffic accident accounted for 60%. Barotrauma from ventilation was documented in 2 patients. The commonest types of intrathoracic injuries are pneumothorax and hemothorax. Chest wall injuries are more common but carry less morbidity and mortality. Only 20% of patients presented within 48 hours of injury. Management of the associated chest trauma commenced in the referring hospitals only in 26.4% of the patients. All patients with hemo-pneumothorax had tube thoracostomy as did 96% of patients with pneumothorax. 10% of patients with haemothorax needed thoracotomy. Mortality is 43%, which is higher than for patients with only TBI with comparable Glasgow coma scale. Outcome is influenced by the time to admission and the GCS on admission. Conclusion: Associated chest injuries result in higher mortality from head injuries. This association is more likely in the young and more productive. All patients presenting with head and

  1. Experimental myocardial ischemia. Pt. 2

    International Nuclear Information System (INIS)

    The comparative effects of meglumine sodium diatrizoate (MSD), sodium meglumine calcium metrizoate (SMCM), and metrizamide (M) were studied in an isolated canine heart preparation. The parameters observed were coronary blood flow (CBF), myocardial contractile force (MCF), positive and negative dF/dt, and perfusion pressure during normal and ischemic perfusion conditions. MSD had an initial negative inotropic effect but baseline MCF returned in 1 min during normal perfusion and 2 min under ischemic conditions. SMCM and M had only a positive inotropic effect under normal perfusion. However, during ischemia, the positive effect of SMCM was followed by a decrease in contractile force. M showed only a positive effect on force during ischemia. Our results indicate that calcium additive may increase the risk of coronary arteriography in patients with severe coronary artery disease. (orig.)

  2. Myocardial ischemia in Kawasaki disease

    International Nuclear Information System (INIS)

    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)

  3. Clinical Neuroimaging of cerebral ischemia

    International Nuclear Information System (INIS)

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

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

    International Nuclear Information System (INIS)

    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. Porcine Ex Vivo intestinal segment model

    NARCIS (Netherlands)

    Ripken, D.; Hendriks, H. F J

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Compare

  6. Porcine Ex Vivo intestinal segment model

    NARCIS (Netherlands)

    Ripken, D.; Hendriks, H.F.J.

    2015-01-01

    This chapter describes the use of the porcine ex vivo intestinal segment model. This includes the advantages and disadvantages of the segment model and a detailed description of the isolation and culture as well as the applications of the porcine ex vivo intestinal segment model in practice. Comp

  7. Preservation of canine myocardial high-energy phosphates during low-flow ischemia with modification of hemoglobin-oxygen affinity.

    Science.gov (United States)

    Weiss, R G; Mejia, M A; Kass, D A; DiPaula, A F; Becker, L C; Gerstenblith, G; Chacko, V P

    1999-03-01

    Conventional approaches for the treatment of myocardial ischemia increase coronary blood flow or reduce myocardial demand. To determine whether a rightward shift in the hemoglobin-oxygen saturation curve would reduce the metabolic and contractile effects of a myocardial oxygen-supply imbalance, we studied the impact of a potent synthetic allosteric modifier of hemoglobin-oxygen affinity, a 2-[4-[[(3,5-disubstituted anilino)carbonyl]methyl] phenoxy] -2-methylproprionic acid derivative (RSR13), during low-flow ischemia. Changes in myocardial high-energy phosphate levels and pH were studied by 31P nuclear magnetic resonance (NMR) spectroscopy in 12 open-chest dogs randomized to receive RSR13 or vehicle control during a reversible reduction of left anterior descending (LAD) coronary artery blood flow. Changes in cardiac metabolites and regional ventricular function studied by pressure segment-length relations were also investigated in additional animals before and after RSR13 administration during low-flow LAD ischemia. The intravenous administration of RSR13 before ischemia resulted in a substantial increase in the mean hemoglobin p50 and attenuated the decline in cardiac creatine phosphate/adenosine triphosphate (PCr/ATP), percent PCr, and pH during ischemia without a change in regional myocardial blood flow, heart rate, or systolic blood pressure. RSR13 given after the onset of low-flow ischemia also improved cardiac PCr/ATP ratios and regional function as measured by fractional shortening and regional work. Thus, synthetic allosteric reduction in hemoglobin-oxygen affinity may be a new and important therapeutic strategy to ameliorate the metabolic and functional consequences of cardiac ischemia. PMID:10074492

  8. A Review of Esophageal Chest Pain.

    Science.gov (United States)

    Coss-Adame, Enrique; Rao, Satish S C

    2015-11-01

    Noncardiac chest pain is a term that encompasses all causes of chest pain after a cardiac source has been excluded. This article focuses on esophageal sources for chest pain. Esophageal chest pain (ECP) is common, affects quality of life, and carries a substantial health care burden. The lack of a systematic approach toward the diagnosis and treatment of ECP has led to significant disability and increased health care costs for this condition. Identifying the underlying cause(s) or mechanism(s) for chest pain is key for its successful management. Common etiologies include gastroesophageal reflux disease, esophageal hypersensitivity, dysmotility, and psychological conditions, including panic disorder and anxiety. However, the pathophysiology of this condition is not yet fully understood. Randomized controlled trials have shown that proton pump inhibitor therapy (either omeprazole, lansoprazole, or rabeprazole) can be effective. Evidence for the use of antidepressants and the adenosine receptor antagonist theophylline is fair. Psychological treatments, notably cognitive behavioral therapy, may be useful in select patients. Surgery is not recommended. There remains a large unmet need for identifying the phenotype and prevalence of pathophysiologic mechanisms of ECP as well as for well-designed multicenter clinical trials of current and novel therapies. PMID:27134590

  9. Drop attack during chest radiography: Case report

    International Nuclear Information System (INIS)

    Chest radiography is the first line of thoracic imaging performed in patients with thoracic diseases. It is probably the most frequently performed type of X-ray examination. It is recommended to be performed in the full upright position except where the patient's condition will not permit. This is because the erect technique allows full expansion of the lungs, prevents engorgement of pulmonary vessels and also helps in fluid level evaluation. However, little is reported on the negative effects associated with erect radiography. Herein, we present a case of drop attack during erect chest radiography. - Highlights: • Radiographers should be aware of the possibilities of drop attach during erect chest radiography. • A patient's determination to stand for chest radiograph may not always relate with the ability. • The causes of some drop attacks may be unknown. • Watching patients during radiographic exposure is essential. • Being alert and working very fast during erect chest examinations is important

  10. Chest trauma in children: A local experience

    International Nuclear Information System (INIS)

    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)

  11. Classification and management of chest trauma

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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.)

  13. Even Four Minutes of Poor Quality of CPR Compromises Outcome in a Porcine Model of Prolonged Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Heng Li

    2013-01-01

    Full Text Available Objective. Untrained bystanders usually delivered suboptimal chest compression to victims who suffered from cardiac arrest in out-of-hospital settings. We therefore investigated the hemodynamics and resuscitation outcome of initial suboptimal quality of chest compressions compared to the optimal ones in a porcine model of cardiac arrest. Methods. Fourteen Yorkshire pigs weighted 30 ± 2 kg were randomized into good and poor cardiopulmonary resuscitation (CPR groups. Ventricular fibrillation was electrically induced and untreated for 6 mins. In good CPR group, animals received high quality manual chest compressions according to the Guidelines (25% of animal’s anterior-posterior thoracic diameter during first two minutes of CPR compared with poor (70% of the optimal depth compressions. After that, a 120-J biphasic shock was delivered. If the animal did not acquire return of spontaneous circulation, another 2 mins of CPR and shock followed. Four minutes later, both groups received optimal CPR until total 10 mins of CPR has been finished. Results. All seven animals in good CPR group were resuscitated compared with only two in poor CPR group (P<0.05. The delayed optimal compressions which followed 4 mins of suboptimal compressions failed to increase the lower coronary perfusion pressure of five non-survival animals in poor CPR group. Conclusions. In a porcine model of prolonged cardiac arrest, even four minutes of initial poor quality of CPR compromises the hemodynamics and survival outcome.

  14. Results of Thoracotomy in Penetrating Chest Trauma

    Directory of Open Access Journals (Sweden)

    Mahmood Aghaei-Afshar

    2012-04-01

    Full Text Available Background: Thoracotomy is a surgical procedure to access the chest components, which is often performed after severe bleeding caused by heart damage, lung laceration and other similar injuries.Materials and Methods: This is a cross-sectional study which was conducted on all patients with penetrating chest trauma during April 2000 to October 2008.Results: In 5% of cases, thoracotomy was used for treatment in which severe bleeding was the main surgical indication. It was the most common finding followed by lung laceration thoracotomy.Conclusion: Most urban injuries are treatable by chest tube. About 3 to 10 percent of cases may require a thoracotomy in which severe bleeding is the most common indication of surgery.

  15. 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.

  16. VAC® for external fixation of flail chest.

    Science.gov (United States)

    Winge, Rikke; Berg, Jais O; Albret, Rikke; Krag, Christen

    2012-05-29

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient's need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU). This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation. PMID:24765464

  17. Imaging of Chest Wall Lesions in Children

    Directory of Open Access Journals (Sweden)

    A. Hekmatnia

    2008-01-01

    Full Text Available Chest wall lesions in childhood include a wide range of pathologies; Benign lesions include lipoma, neurofibroma, lymphangioma, hemangioma, and mesenchymal hamartoma."nMalignant lesions include Neuroblastoma, Rhabdo-myosarcoma, Ewing sarcoma, and Askin tumor."nSystemic diseases such as leukemia, lymphoma, Langerhans cell histiocytosis, and also infections such as tuberculosis, and actinomycosis may also cause chest wall lesions."nThe imaging characteristics of these lesions are re-viewed, but only a minority of the lesions shows diagnostic imaging features, and most of lesions re-quire biopsy and histopathological examination for "ndefinitive diagnosis."nThe role of different modalities is discussed with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread. Computed tomography and neuclear medicine being used mainly to assess remote disease."nIn this lecture, we discuss about imaging of chest wall lesions in children.

  18. 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.

  19. Chest pain related to crack cocaine smoking

    International Nuclear Information System (INIS)

    The chest radiographs of 80 patients coming to emergency room because of chest pain and/or shortness of breath following the smoking of highly potent crack cocaine were retrospectively reviewed. Four showed intrathoracic free air (pneumomediastinum in two, hemopneumothorax in one, and pneumothorax in one). Four other patients showed subsegmental atelectasis or parenchymal infiltrate. Radiographic detection of these abnormalities was of importance in the clinical management of the patients. This spectrum of findings is presented with a discussion of the pathophysiologic mechanisms and other potential complications of this form of drug abuse

  20. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  1. 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

  2. Myocardial ischemia and angina pectoris

    International Nuclear Information System (INIS)

    Ambulatory monitoring of ST segment changes was performed in 60 patients presenting with angina, positive ECG stress tests and coronary artery disease, 85% of ischemic ECG events were asymptomatic, 37% occurred with no increase in heart rate and 15% of episodes either lasted 20 minutes or more or fluctuated in severity. A controlled pilot study in ten patients showed depression. Radionuclide studies in 50 patients with angina and coronary artery disease have shown that stress (i.e., atrial pacing) produced different patterns of disturbed regional myocardial perfusion related to the patient's exercise capacity and eventually leading to a decrease in regional myocardial perfusion during the ischemic episode. ST segment depression appeared only after the decrease in regional myocardial perfusion. These findings combined with past research suggest that patients with angina and coronary artery disease can suffer frequent asymptomatic disturbances of the regional myocardial perfusion. The frequency of these episodes and the time course for the recovery of the metabolic consequences mean that segments of ventricular myocardium may be constantly abnormal. The relative importance of changes in coronary tone and malfunction of platelets in the diseased coronary tree needs to be examined in clinical research. Pilot studies of antiplatelet agents have shown a significant beneficial effect on episodes of ischemia occurring at night and those occurring without any increase in heart rate. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechnisms. Further research using objective methods is required to discover the causes of ischemia and to rationalize treatment. (orig./MG)

  3. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction the...... prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring in the...

  4. VAC® for external fixation of flail chest

    DEFF Research Database (Denmark)

    Winge, Rikke; Berg, Jais O; Albret, Rikke;

    2012-01-01

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure...

  5. Optimal beam quality for chest digital radiography

    International Nuclear Information System (INIS)

    To investigate the optimal beam quality for chest computed radiography (CR), we measured the radiographic contrast and evaluated the image quality of chest CR using various X-ray tube voltages. The constant between lung and rib or heart increased on CR image obtained by lowering the tube voltage from 140 to 60 kV, but the degree of increase was less. Scattered radiation was reduced on CR images with a lower tube voltage. The Wiener spectrum of CR images with a low tube voltage showed a low value under identical conditions of amount of light stimulated emission. The quality of chest CR image obtained using a lower tube voltage (80 kV and 100 kV) was evaluated as being superior to those obtained with a higher tube voltage (120 kV and 140 kV). Considering the problem of tube loading and exposure in clinical applications, a tube voltage of 90 to 100 kV (0.1 mm copper filter backed by 0.5 mm aluminum) is recommended for chest CR. (author)

  6. Radiography of the chest and upper airway

    International Nuclear Information System (INIS)

    The techniques of radiography of the chest in all pediatric-age groups differ only slightly from those used in adult radiography. The technologist's principal challenge, however, relates to optimum handling of the patient with respect to positioning and radiation protection. The hints provided in this chapter should permit the conscientious radiographer to obtain high quality radiographs on all pediatric patients

  7. The HEART score for chest pain patients

    NARCIS (Netherlands)

    Backus, B.E.

    2012-01-01

    The HEART score was developed to improve risk stratification in chest pain patients in the emergency department (ED). This thesis describes series of validation studies of the HEART score and sub studies for individual elements of the score. The predictive value of the HEART score for the occurrence

  8. Chest injury in victims of Bam earthquake

    Institute of Scientific and Technical Information of China (English)

    Seyed Mohammad Ghodsi; Moosa Zargar; Ali Khaji; Mojgan Karbakhsh

    2006-01-01

    Objective: To analyze the data of trauma patients with thoracic injury in the earthquake of Bam admitted to hospitals of Tehran University of Medical Science (TUMS)for better understanding the type and consequence of thoracic injuries in a major earthquake.Methods: After Bam earthquake registering 6.5 on the Richter scale, 526 trauma patients were admitted to hospitals of TUMS. Among them, 53 patients sustained thoracic injury.Results: This group was composed of 21 females (39.6%) and 32 males (60.4%). Fifteen patients (28.3%) had isolated chest injuries. Rib fracture (36.4%) was the most common injury in our patients and haemo/pneumothorax (25.5%) followed. Superficial injury was the most common accompanying injury. Multipletrauma patients with chest injury had higher injury severity score (ISS) versus patients with isolated chest injury (P =0.003).Conclusions: Chest wall injuries and haemo/pneumothorax comprise a considerable number of injuries in survival victims of earthquakes. Consequently, the majority of these patients can be treated with observation or tube thoracostomy. We should train and equip the health workers and members of rescue teams to treat and manage these patients in the field.

  9. Coccidioidomycosis - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows the affects of a fungal infection, coccidioidomycosis. In the middle of the left lung (seen on the ... defined borders. Other diseases that may explain these x-ray findings include lung abscesses, chronic pulmonary tuberculosis, chronic ...

  10. Cardiac injuries in blunt chest trauma

    OpenAIRE

    Tobon-Gomez Catalina; Huguet Marina; Bijnens Bart H; Frangi Alejandro F; Petit Marius

    2009-01-01

    Abstract Blunt chest traumas are a clinical challenge, both for diagnosis and treatment. The use of Cardiovascular Magnetic Resonance can play a major role in this setting. We present two cases: a 12-year-old boy and 45-year-old man. Late gadolinium enhancement imaging enabled visualization of myocardial damage resulting from the trauma.

  11. Adenocarcinoma - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

  12. Algorithm of chest wall keloid treatment.

    Science.gov (United States)

    Long, Xiao; Zhang, Mingzi; Wang, Yang; Zhao, Ru; Wang, Youbin; Wang, Xiaojun

    2016-08-01

    Keloids are common in the Asian population. Multiple or huge keloids can appear on the chest wall because of its tendency to develop acne, sebaceous cyst, etc. It is difficult to find an ideal treatment for keloids in this area due to the limit of local soft tissues and higher recurrence rate. This study aims at establishing an individualized protocol that could be easily applied according to the size and number of chest wall keloids.A total of 445 patients received various methods (4 protocols) of treatment in our department from September 2006 to September 2012 according to the size and number of their chest wall keloids. All of the patients received adjuvant radiotherapy in our hospital. Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment effect by both doctors and patients. With mean follow-up time of 13 months (range: 6-18 months), 362 patients participated in the assessment of POSAS with doctors.Both the doctors and the patients themselves used POSAS to evaluate the treatment effect. The recurrence rate was 0.83%. There was an obvious significant difference (P keloids. This algorithm could play a guiding role for surgeons when dealing with chest wall keloid treatment. PMID:27583896

  13. Chest trauma in childhood. Radiological findings

    International Nuclear Information System (INIS)

    Blunt thoracic trauma is frequently associated with further injuries (head and/or blunt abdominal trauma). The prognosis also depends on the concurrent injuries. The initial evaluation of an injured child is based on the chest X-ray and abdominal ultrasound examination. Additional information can be obtained by a CT scan in mediastinal injuries. (orig./MG)

  14. Treatment of 336 cases of chest trauma

    Directory of Open Access Journals (Sweden)

    ZHANG Jing

    2012-06-01

    Full Text Available 【Abstract】Objective: To summarize the clinical features, diagnosis and treatment of chest trauma. Methods: A retrospective analysis was conducted among 336 cases of chest trauma admitted to our hospital from January 2009 to May 2011. Results: Out of all cases, 325 were cured, accounting for 96.7%; 11 died, accounting for 3.3%. Among the dead cases, one died of hemorrhagic shock, three of acute respi-ratory distress syndrome, three of multiple organ failure, and four of severe multiple traumas. Conclusions: (1 For patients with severe chest trauma, early emergency treatment is crucial to save life. (2 Open thoracic surgery is needed for acute cardiac tamponade, intrapulmonary vascular injuries, progressive intrathoracic bleeding, lung laceration, tracheal breakage, and diaphrag-matic injury. In addition, operative timing and method should be well chosen. (3 Pulmonary contusion is one of common complications in chest trauma, for which the com-bination of strong anti-infection therapy and mechanical ventilation is an effective treatment strategy. Key words: Thoracic injuries; Thoracotomy; Emer-gency treatment

  15. Detection of porcine circovirus type 1 in commercial porcine vaccines by loop-mediated isothermal amplification

    OpenAIRE

    Wang, Chun; Pang, Victor Fei; Jeng, Chian-Ren; LEE, Fan; Huang, Yu-Wen; Lin, Yeou-Liang; Hsiao, Shih-Hsuan; Lai, Shiow-Suey

    2011-01-01

    A loop-mediated isothermal amplification (LAMP) method with a real-time monitoring system was developed for the detection of porcine circovirus type 1 (PCV1) in commercial swine vaccines. This method was highly specific for PCV1. No cross-reaction to porcine circovirus type 2, porcine parvovirus, pseudorabies virus, classical swine fever virus, and porcine reproductive and respiratory syndrome virus was observed. The analytical sensitivity of the LAMP for PCV1 DNA was 10 copies/μl in the case...

  16. Experimental early detection of acute mesenteric ischemia with functional MRI (DWI) and parallel imaging; Experimentelle Fruehdiagnostik der akuten mesenterialen Ischaemie mittels diffusionsgewichteter MRT (DWI) und paralleler Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, C.A.; Haage, P. [HELIOS Klinikum Wuppertal, Klinikum der Privaten Univ. Witten/Herdecke (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Hohl, C. [HELIOS Klinikum Siegburg (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie

    2012-06-15

    Purpose: To evaluate the feasibility of diagnosing in statu nascendi mesenteric ischemia using diffusion-weighted imaging (DWI) in a porcine model. All experiments were approved by the animal care committee at the district administration. Materials and Methods: Mesenteric blood supply was studied in ten healthy female pigs (weight {proportional_to}50 kg) with artificially induced mesenteric ischemia. In the DSA technique a branch of the superior mesenteric artery was embolized with tissue glue or small particles. DWI was performed using a 1.5 T MR scanner before embolization and 30 and 60 minutes after embolization using a 32-channel receiver coil. ADC maps were calculated for all animals. The findings were correlated to angiographic and autoptic findings. The image quality of DWI was assessed by means of SNR measurements and diagnostic impact by CNR measurements. Results: Embolization of the mesenteric branches was technically successful in all cases. DWI of the bowel was feasible with the applied sequences. In all animals, DWI displayed distinct cytotoxic edema as the earliest sign of ischemia thirty minutes after induction of ischemia. Furthermore, DWI yielded a distinct reduction in the water diffusion coefficient in all animals. Variance analysis showed good correlation between CNR measurements and infarction areas. Autoptic findings could confirm the detected infarction areas by DWI. Conclusion: DWI using parallel imaging techniques is feasible for the early detection of acute mesenteric ischemia. The presented DWI results offer encouraging prospects regarding more rapid disease diagnosis. (orig.)

  17. Get Smart: Know When Antibiotics Work - Bronchitis (Chest Cold)

    Science.gov (United States)

    ... Farm Get Smart About Antibiotics Week Bronchitis (Chest Cold) Language: English Español (Spanish) Recommend on Facebook Tweet ... types—acute bronchitis. Causes Acute bronchitis, or chest cold, often occurs after an upper respiratory infection like ...

  18. Metabolic Adaptation to Muscle Ischemia

    Science.gov (United States)

    Cabrera, Marco E.; Coon, Jennifer E.; Kalhan, Satish C.; Radhakrishnan, Krishnan; Saidel, Gerald M.; Stanley, William C.

    2000-01-01

    Although all tissues in the body can adapt to varying physiological/pathological conditions, muscle is the most adaptable. To understand the significance of cellular events and their role in controlling metabolic adaptations in complex physiological systems, it is necessary to link cellular and system levels by means of mechanistic computational models. The main objective of this work is to improve understanding of the regulation of energy metabolism during skeletal/cardiac muscle ischemia by combining in vivo experiments and quantitative models of metabolism. Our main focus is to investigate factors affecting lactate metabolism (e.g., NADH/NAD) and the inter-regulation between carbohydrate and fatty acid metabolism during a reduction in regional blood flow. A mechanistic mathematical model of energy metabolism has been developed to link cellular metabolic processes and their control mechanisms to tissue (skeletal muscle) and organ (heart) physiological responses. We applied this model to simulate the relationship between tissue oxygenation, redox state, and lactate metabolism in skeletal muscle. The model was validated using human data from published occlusion studies. Currently, we are investigating the difference in the responses to sudden vs. gradual onset ischemia in swine by combining in vivo experimental studies with computational models of myocardial energy metabolism during normal and ischemic conditions.

  19. Investigation of the Chest-Ear Radio Propagation Channel

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Jakobsen, Kaj Bjarne

    2010-01-01

    The path gain (|S21|) between antennas on the chest and at the ear is presented as a function of the position of the antenna on the chest. A monopole antenna and a printed Inverted-F Antenna (IFA) are considered for placement on the chest. The path gain is found by HFSS simulations as well as...

  20. Temporal and spatial characteristics of evolving cell injury during regional myocardial ischemia in the dog: the ''border zone'' controversy

    International Nuclear Information System (INIS)

    An open chest dog heart with multiple coronary ligations was used to define the temporal and spatial characteristics of injury evolving during regional ischemia. With the use of a multiple (40 sample) biopsy device, adjacent transmural biopsy specimens were obtained from the transition zone between normal and ischemic tissue after 5, 30, 45, 60 and 120 minutes of ischemia. The first 1.8 mm of epicardial tissue was taken for the analysis of flow and metabolites. The results confirmed the existence of a sharp interface of flow and metabolism in the epicardial lateral plane at the boundary of the ischemic zone. There was no significant zone of intermediate injury (flow and metabolism being depressed uniformly throughout the ischemic area). Comparison of the distribution of flow determined by radiolabeled gadolinium-153 at onset of ischemia with that indicated by radiolabeled tin-113 microspheres given at the end of various periods of ischemia revealed no change in the position or steepness of the flow interface at any time during the first 2 hours of ischemia. This observation, together with the absence of any major redistribution or enhancement of residual flow to the ischemic zone, indicated that there was little or no significant collateralization between 5 and 120 minutes. Analysis of the adenosine triphosphate (ATP) content revealed a rapid depletion during the first 5 minutes of ischemia; the content then remained essentially unchanged until 30 minutes, after which time a second phase of accelerated ATP depletion was observed until 45 minutes. ATP content then remained relatively constant up to 2 hours

  1. Characterization of an antigenically distinct porcine rotavirus.

    OpenAIRE

    Bridger, J C; Clarke, I. N.; McCrae, M A

    1982-01-01

    A porcine virus with rotavirus morphology, which was antigenically unrelated to previously described rotaviruses, is described. Particles with an outer capsid layer measured 75 nm and those lacking the outer layer were 63 nm in diameter. Particles which resembled cores were also identified. The virus was shown to be antigenically distinct from other rotaviruses as judged by immunofluorescence and immune electron microscopy, and it failed to protect piglets from challenge with porcine rotaviru...

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

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, H.; Kim, K.; Kim, J. M.; Lee, Y. H.; Kim, T. E.; Lim, H. K.; Park, Y. K. [Biomagnetism Research Center, Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of); Ko, Y. G.; Chung, N. [Cardiovascular Center, College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2006-10-15

    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.

  3. 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.

  4. Endovascular interventional therapy for acute limb ischemia

    International Nuclear Information System (INIS)

    Acute limb ischemia is an urgent and common clinical condition which occurs when the blood flow to a certain extremity is suddenly blocked b either embolic agent or thrombotic vascular lesion. Prompt restoration of perfusion through early intervention can significantly decrease the incidence of amputation and mortality. The main therapeutic methods include surgical operation and endovascular interventional technique. For recent years, considerable progress in treating acute limb ischemia with endovascular interventional technique has been achieved. This article aims to make a comprehensive review in respect of the endovascular intervention therapy for acute limb ischemia. (authors)

  5. Dopaminergic neurotransmission triggers ischemia-induced hyperactivity in Mongolian gerbils.

    Directory of Open Access Journals (Sweden)

    Yamamoto T

    2001-10-01

    Full Text Available It is recognized that sustained ischemia-induced hyperactivity is related to abnormalities in dopamine function. However, it is unclear that dopaminergic neurotransmission triggers such ischemia-induced hyperactivity. Therefore, the relationship between dopaminergic neurotransmission and ischemia-induced hyperactivity was investigated in an animal model using Mongolian gerbils. When haloperidol 2 mg/kg was administered i.p. 30 min after ischemia, the ischemia-induced hyperactivity at 24 h after ischemia was blocked. General behavior was similar to that of sham-operated animals. Haloperidol at doses of 0.1 and 0.2 mg/kg had no effect on locomotor activity in sham-operated animals and decreased ischemia-induced hyperactivity when the drug was administered 24 h after ischemia; these doses did not have any effect on ischemia-induced hyperactivity when the drug was administered 30 min after ischemia. On the other hand, when the animal was confined to a small, restrictive cage for the 24 h period immediately following ischemic injury, locomotor activity at 24 h after ischemia increased. Such behavior also increased in animals when they were returned to their original more permissive cages immediately after ischemia. It is conceivable that the decrease in the level of activity was not related to ischemia-induced hyperactivity. These data suggested that the inhibition of ischemia-induced hyperactivity can be induced by complete blockage of dopaminergic receptors immediately after ischemia.

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

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.; Bøtner, Anette; Ladekjær-Mikkelsen, A.S.; Vincent, I.; Herrmann, Brigitte; Sanchez, R.; Rhodes, C.

    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 assay...

  7. [NECROTIZING FASCIITIS OF THE CHEST WALL].

    Science.gov (United States)

    Farah, Raymond; Asla, Husam

    2016-04-01

    Necrotizing fasciitis (NF) is a bacterial dermo-hypodermitis affecting the soft tissue and muscular fascia. It is an uncommon and severe infection caused by microorganisms called 'flesh eating bacteria', mainly represented by group A beta-haemolytic streptococcus. NF remains a life-threatening condition associated with a high mortality rate. Its location on the chest wall is extremely rare. The few reported cases are subsequent to thoracic drainage, lung surgery or esophageal resection. This is a case report of an 80-year old female with comorbidity of heart disease, a past history of coronary artery by-pass and diabetes. She was admitted to the emergency room with acute NF of the chest and shortly after diagnosis, the patient died. Due to the fast decline observed in this disease, we would like to emphasize the importance of early recognition and diagnosis. PMID:27323534

  8. Hemoperfusion with polymyxin B-immobilized fiber column improves liver function after ischemia-reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Hiroaki Sato; Kiyohiro Oshima; Katsumi Kobayashi; Hodaka Yamazaki; Yujin Suto; Izumi Takeyoshi

    2009-01-01

    AIM: To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX therapy) for warm hepatic ischemia-reperfusion (I/R) injury after total hepatic vascular exclusion (THVE) using a porcine model.METHODS: Eleven Mexican hairless pigs weighing 22-38 kg were subjected to THVE for 120 min and then observed for 360 min. The animals were divided into two groups randomly: the DHP-PMX group (n = 5) underwent DHP-PMX at a flow rate of 80 mL/min for 120 min (beginning 10 min before reperfusion), while the control group did not (n = 6). The rate pressure product (RPP): heart rate × end-systolic arterial blood pressure,hepatic tissue blood flow (HTBF), portal vein blood flow (PVBF), and serum aspartate aminotransferase (AST) levels were compared between the two groups. RESULTS: RPP and HTBF were significantly (P < 0.05) higher in the DHP-PMX group than in the control group 240 and 360 min after reperfusion. PVBF in the DHP-PMX group was maintained at about 70% of the flow before ischemia and differed significantly (P < 0.05) compared to the control group 360 min after reperfusion. The serum AST increased gradually after reperfusion in both groups, but the AST was significantly (P < 0.05) lower in the DHP-PMX group 360 min after reperfusion. CONCLUSION: DHP-PMX therapy reduced the hepatic warm I/R injury caused by THVE in a porcine model.

  9. Extracardiac chest sonography in children: Radiographic and clinical implications

    International Nuclear Information System (INIS)

    Thirty-nine infants and children underwent high-resolution chest US for chest masses, opaque hemithorax identified on chest radiographs, and for documentation and localization of pleural fluid. Masses included cystic hygromas, thymic cysts, diaphragmatic eventration, round pneumonia, lung abscesses, and pleural pseudotumors. Complete chest opacification was due to pneumonia, pleural fluid, pulmonary hypoplasia, pleural metastasis, and bronchial foreign bodies. Sonographic examination of pleural disease allowed differentiation of pleural thickening from free fluid and guided aspiration of pockets of loculated fluid. Therapeutic decisions were changed in 29 of 39 patients based on the results of the chest US examinations

  10. Chest radiograph interpretation by medical students

    International Nuclear Information System (INIS)

    AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK

  11. Chest x-ray following heart transplantation

    International Nuclear Information System (INIS)

    In the cardio vascular Surgery Departiment of the University of Padua, where the first heart transplant operation in Italy took place in November, 14, 1985, in a period of six months, nine heart transplants have been performed. The post-operative follow-up of these patients included, among other tests, a chest X-ray, which has given us many morphological and functional data concerning both the circulatory and the pulmonary systems

  12. Injuries of the chestFNx01

    Directory of Open Access Journals (Sweden)

    Deodhar S

    1979-01-01

    Full Text Available Thirty cases of chest injuries were admitted in the Department of Surgery, K.E.M. Hospital, Bombay. These injuries seem to be fairly common. Detailed examination at the time of admission is necessary to assess the clinical presentation and the presence of major complications. Institution of intra-peritoneal drainage, restoration of negative intra-pleural pressure and active respiratory physiotherapy constitute an important part of the treatment. The literature on this subject is briefly reviewed

  13. Primary Burkitt Lymphoma of the Chest Wall

    OpenAIRE

    Rommel Lu

    2012-01-01

    Burkitt lymphoma (BL) originating in the skin and soft tissue at any site is exceedingly rare. This paper is about a case of primary sporadic BL that presented as an isolated, rapidly enlarging chest wall mass arising from skin and/or soft tissue in an adult. As with other BL presentations, this patient was treated with aggressive chemotherapy with central nervous system (CNS) chemoprophylaxis, but he later died because of sepsis.

  14. Primary Burkitt Lymphoma of the Chest Wall

    Directory of Open Access Journals (Sweden)

    Rommel Lu

    2012-01-01

    Full Text Available Burkitt lymphoma (BL originating in the skin and soft tissue at any site is exceedingly rare. This paper is about a case of primary sporadic BL that presented as an isolated, rapidly enlarging chest wall mass arising from skin and/or soft tissue in an adult. As with other BL presentations, this patient was treated with aggressive chemotherapy with central nervous system (CNS chemoprophylaxis, but he later died because of sepsis.

  15. Idiopathic Thoracic Epidural Lipomatosis with Chest Pain

    OpenAIRE

    Lee, Sang-Beom; Park, Hyung-Ki; Chang, Jae-Chil; Jin, So-Young

    2011-01-01

    Spinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components. Idiopathic SEL in non-obese patients is exceptional. Idiopathic SEL can result in thoracic myelopathy and lumbar radiculopathy. A thoracic radiculopathy due to idiopathic SEL has not been reported yet. We report a case of idiopathic SEL with intractable chest pain and paresthes...

  16. Salmonella typhimurium abscess of the chest wall

    OpenAIRE

    Tonziello, Gilda; Valentinotti, Romina; Arbore, Enrico; Cassetti, Paolo; Luzzati, Roberto

    2013-01-01

    Patient: Male, 73 Final Diagnosis: Salmonella typhimurium abscess of the chest wall Symptoms: — Medication: Ciprofloxacin Clinical Procedure:— Specialty: Infectious Diseases Objective: Unusual clinical course Background: Non-typhoid Salmonella extra-intestinal infections usually develop in infants and in adult patients with pre-existing predisposing conditions. Blood stream infections and urinary tract infections are the most common clinical presentations, but other sites of infection may be ...

  17. Reconstruction of chest, abdominal walls and perineum

    OpenAIRE

    Vijaykumar D; Vijayaraghavan Sundeep

    2007-01-01

    The structural integrity of the chest and abdominal walls and perineum is frequently altered by cancer extirpation. Advances in reconstructive surgery and the availability of innovative techniques have helped the cancer surgeon to proceed with radical excisions with minimum morbidity. The ability to harvest flaps from distant sites and the availability of good prosthetic materials have now become part of the routine armamentarium of the plastic surgeon engaged in reconstructive surgery of the...

  18. Effective dose from chest tomosynthesis in children

    International Nuclear Information System (INIS)

    Tomosynthesis (digital tomography) is a recently introduced low-dose alternative to CT in the evaluation of the lungs in patients with cystic fibrosis and pulmonary nodules. Previous studies have reported an adult effective dose of 0.12-0.13 mSv for chest tomosynthesis. The aim of this study was to determine the paediatric effective dose from the dose-area-product. During a 3-y period, 38 children with cystic fibrosis and 36 paediatric oncology patients were examined with chest tomosynthesis, totally 169 posteroanterior and 17 anteroposterior examinations (40 boys and 34 girls, mean age 13.7 y, range 7-20 y). Using recently reported paediatric chest tomosynthesis conversion factors (0.23-1.09 mSv Gy cm-2) corrected for sex, age and energy, the mean posteroanterior effective dose calculated was 0.17 mSv; using the proposed simplified conversion factors of 0.6 (8-10 y), 0.4 (11-14 y) and 0.3 mSv Gy cm-2 (15-19 y), the mean posteroanterior effective dose calculated was 0.15 mSv. As the difference in the calculated effective dose was minor, it is recommendable to use the simplified conversion factors. Using the conversion factor for adult chest tomosynthesis (0.26 mSv Gy cm-2), the mean effective dose was 0.11 mSv. Anteroposterior exposures had considerably higher effective dose. By using conversion factors adapted for children, the calculated risks from radiologic procedures will be more accurate. (authors)

  19. Revisit image control for pediatric chest radiography

    International Nuclear Information System (INIS)

    The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

  20. Surface Chest Motion Decomposition for Cardiovascular Monitoring

    Science.gov (United States)

    Shafiq, Ghufran; Veluvolu, Kalyana C.

    2014-05-01

    Surface chest motion can be easily monitored with a wide variety of sensors such as pressure belts, fiber Bragg gratings and inertial sensors, etc. The current applications of these sensors are mainly restricted to respiratory motion monitoring/analysis due to the technical challenges involved in separation of the cardiac motion from the dominant respiratory motion. The contribution of heart to the surface chest motion is relatively very small as compared to the respiratory motion. Further, the heart motion spectrally overlaps with the respiratory harmonics and their separation becomes even more challenging. In this paper, we approach this source separation problem with independent component analysis (ICA) framework. ICA with reference (ICA-R) yields only desired component with improved separation, but the method is highly sensitive to the reference generation. Several reference generation approaches are developed to solve the problem. Experimental validation of these proposed approaches is performed with chest displacement data and ECG obtained from healthy subjects under normal breathing and post-exercise conditions. The extracted component morphologically matches well with the collected ECG. Results show that the proposed methods perform better than conventional band pass filtering.

  1. Lung involvement quantification in chest radiographs

    International Nuclear Information System (INIS)

    Tuberculosis (TB) caused by Mycobacterium tuberculosis, is an infectious disease which remains a global health problem. The chest radiography is the commonly method employed to assess the TB's evolution. The methods for quantification of abnormalities of chest are usually performed on CT scans (CT). This quantification is important to assess the TB evolution and treatment and comparing different treatments. However, precise quantification is not feasible for the amount of CT scans required. The purpose of this work is to develop a methodology for quantification of lung damage caused by TB through chest radiographs. It was developed an algorithm for computational processing of exams in Matlab, which creates a lungs' 3D representation, with compromised dilated regions inside. The quantification of lung lesions was also made for the same patients through CT scans. The measurements from the two methods were compared and resulting in strong correlation. Applying statistical Bland and Altman, all samples were within the limits of agreement, with a confidence interval of 95%. The results showed an average variation of around 13% between the two quantification methods. The results suggest the effectiveness and applicability of the method developed, providing better risk-benefit to the patient and cost-benefit ratio for the institution. (author)

  2. VAC® for external fixation of flail chest

    Directory of Open Access Journals (Sweden)

    Rikke Winge

    2012-06-01

    Full Text Available A large anterior chest wall defect following tumor resection was reconstructed with a Gore- Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC® resulted in immediate chest wall stability and a decrease in the patient’s need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU. This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation.

  3. Experimental Study of the Effect of Autonomic Nervous System on the Transmural Dispersion of Ventricular Repolarization under Acute Myocardial Ischemia in Vivo

    Institute of Scientific and Technical Information of China (English)

    张存泰; 徐大文; 李泱; 刘念; 钟江华; 王琳; 陆再英

    2002-01-01

    Summary: The effect of the autonomic nerves on the transmural dispersion of ventricular repolariza tion (TDR) under acute myocardial ischemia in intact canine was investigated. Using the monophasic action potential (MAP) recording technique, MAPs of the epicardium (Epi), midmyocardium (Mid) and endocardium (Endo) were recorded simultaneously by specially designed plunge-needle electrodes at the left ventricular free wall under acute myocardial ischemia in 12 open-chest dogs.MAPD90 and TDR among three myocardial layers as well as the incidence of the early afterdepolar ization (EAD) before autonomic nervous stimulation and during autonomic nervous stimulation were compared. It was found that 10 min after acute myocardial I~hemia, TDR was increased from 55±8.ms to 86± 15 ms during sympathetic stimulation (P<0. 01). The TDR (53± 9 ms) during parasympathetic stimulation was not significantly different from that of the control (55±8 ms) (P>0.05). The EAD was elicited in the Mid of 2 dogs (16 %) 10 min after acute myocardial ischemia,but the EAD were elicited in the Mid of 7 dogs (58 %) during sympathetic stimulation (P<0. 01).It was concluded that: (1) Sympathetic stimulation can increase the transmural dispersion of repolari zation and induce early afterdepolarizations in the Mid under acute myocardial ischemia, which pro-vide the opportunity for the ventricular arrhythmia developing; (2) Parasympathetic stimulation has no significant effect on the transmural dispersion of repolarization under myocardial ischemia.

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

    International Nuclear Information System (INIS)

    For detection of cardiac ischemia based on regional pCO2 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 pCO2 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 pCO2, the drift-corrected pCO2 (ΔpCO2) and its time-derivative (TDpCO2) were compared with respect to detection ability. Baseline stability in the ΔpCO2 led to earlier, more accurate detection. The TDpCO2 featured the earliest sensitivity, but with a lower specificity. Combining ΔpCO2 and TDpCO2 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 pCO2 sensor together with parameterization methods

  5. Lentiviral vector gene transfer to porcine airways.

    Science.gov (United States)

    Sinn, Patrick L; Cooney, Ashley L; Oakland, Mayumi; Dylla, Douglas E; Wallen, Tanner J; Pezzulo, Alejandro A; Chang, Eugene H; McCray, Paul B

    2012-01-01

    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).Molecular Therapy - Nucleic Acids (2012) 1, e56; doi:10.1038/mtna.2012.47; published online 27 November 2012. PMID:23187455

  6. Expression of somatostatin mRNA and peptide in rat hippocampus after cerebral ischemia

    DEFF Research Database (Denmark)

    Bering, Robert; Johansen, Flemming Fryd

    Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology......Somatostatin, ischemia, hippocampus, rat, in situ hybridisation, immunocytochemistry, neuropathology...

  7. Effect of different resuscitation strategies on post-resuscitation brain damage in a porcine model of prolonged cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Gu Wei; Hou Xiaomin; Li Chunsheng

    2014-01-01

    Background The choice of a defibrillation or a cardiopulmonary resuscitation (CPR)-first strategy in the treatment of prolonged cardiac arrest (CA) is still controversial.The purpose of this study was to compare the effects of defibrillation or CPR administered first on neurological prognostic markers in a porcine model of prolonged CA.Methods After 8 minutes of untreated ventricular fibrillation (VF),24 inbred Chinese Wuzhishan minipigs were randomized to receive either defibrillation first (ID group,n=12) or chest compression first (IC group,n=12).In the ID group,a shock was delivered immediately.If defibrillation failed to attain restoration of spontaneous circulation (ROSC),manual chest compressions were rapidly initiated at a rate of 100 compressions/min and a compression-to-ventilation ratio of 30:2.If VF persisted after five cycles of CPR,a second defibrillation attempt was made.In the IC group,chest compressions were delivered first,followed by a shock.After successful ROSC,hemodynamic status and blood samples were obtained at 0.5,1,2,4,6,and 24 hours after ROSC.Porcine-specific neuron-specific enolase (NSE) and S100B were measured from sera using enzyme-linked immunosorbent assays.Porcine cerebral performance category scores were used to evaluate preliminary neurological function following 24 hours recovery.Surviving pigs were sacrificed at 24 hours after ROSC and brains were removed for electron microscopy analysis.Results The number of shocks,total defibrillation energy,and time to ROSC were significantly lower in the ID group compared with the IC group.Compared with the IC group,S100B expression was decreased at 2 and 4 hours after ROSC,and NSE expression decreased at 6 and 24 hours after ROSC in the ID group.Brain tissue analysis showed that injury was attenuated in the ID group compared with the IC group.There were no significant differences between 6 and 24 hours survival rates.Conclusion Defibrillation first may result in a shorter time to ROSC and

  8. Porcine model of hemophilia A.

    Directory of Open Access Journals (Sweden)

    Yuji Kashiwakura

    Full Text Available Hemophilia A is a common X chromosome-linked genetic bleeding disorder caused by abnormalities in the coagulation factor VIII gene (F8. Hemophilia A patients suffer from a bleeding diathesis, such as life-threatening bleeding in the brain and harmful bleeding in joints and muscles. Because it could potentially be cured by gene therapy, subhuman animal models have been sought. Current mouse hemophilia A models generated by gene targeting of the F8 have difficulties to extrapolate human disease due to differences in the coagulation and immune systems between mice and humans. Here, we generated a porcine model of hemophilia A by nuclear transfer cloning from F8-targeted fibroblasts. The hemophilia A pigs showed a severe bleeding tendency upon birth, similar to human severe hemophiliacs, but in contrast to hemophilia A mice which rarely bleed under standard breed conditions. Infusion of human factor VIII was effective in stopping bleeding and reducing the bleeding frequency of a hemophilia A piglet but was blocked by the inhibitor against human factor VIII. These data suggest that the hemophilia A pig is a severe hemophilia A animal model for studying not only hemophilia A gene therapy but also the next generation recombinant coagulation factors, such as recombinant factor VIII variants with a slower clearance rate.

  9. Coincidental detection of genomes of porcine parvoviruses and porcine circovirus type 2 infecting pigs in Japan

    OpenAIRE

    Saekhow, Prayuth; KISHIZUKA, Shingo; SANO, Natsuha; MITSUI, HIROKO; AKASAKI, Hajime; MAWATARI, Takahiro; Ikeda, Hidetoshi

    2015-01-01

    The infection status of 15 viruses in 120 pigs aged about 6 months was investigated based on tonsil specimens collected from a slaughterhouse. Only 5 species of porcine parvoviruses and porcine circovirus type 2 (PCV2) were detected at high frequencies; 67% for porcine parvovirus (PPV) (PPV-Kr or -NADL2 as the new abbreviation), 58% for PPV2 (CnP-PARV4), 39% for PPV3 (P-PARV4), 33% for PPV4 (PPV4), 55% for PBo-likeV (PBoV7) and 80% for PCV2. A phylogenetic analysis of PPV3 suggested that Japa...

  10. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  11. 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

    OpenAIRE

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

    2015-01-01

    Background 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 boca...

  12. Practical pediatric chest radiology for general radiologists

    International Nuclear Information System (INIS)

    This paper reviews practical problems in the radiologic study of infants and children, provides helpful hints for daily practice, and brings the application of newer imaging modalities up to date for specific clinical problems. The discussion attends to normal variants, diagnostic pitfalls, and iatrogenic problems. The authors cover three major areas: (1) Emphysema in infants and children, including bilateral, unilateral, and localized emphysema. (2) The borderlands of the lungs, including evaluation of diaphragmatic abnormalities, mediastinal and pleural lesions, and air leak phenomena, (3) Newborn chest radiology, with an emphasis on differential diagnosis, natural history of disease processes, and therapeutic complications

  13. Radiological diagnosis and therapy of chest pain

    International Nuclear Information System (INIS)

    The causes and localization of chest pain are numerous. They can derive from infections, traumas, or tumors. Possible sites of origin are: skeletal portions, vertebral column, ribs, and sternum, as well as mediastinum and pleura. In women, occurrence tends to be cyclic and affect the mamma region. Radiological diagnosis includes radiography, nuclear techniques as well as whole body computer-tomography. Radiation therapy is indicated in cases of mediastinal tumor formation. Radiation of painful osteolytic vertebral metastases and rib destructions proves to be an efficient palliative measure. (orig.)

  14. Effectiveness of chest physiotherapy in the management of bronchiectasis

    International Nuclear Information System (INIS)

    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. 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.

  16. Late sensory changes following chest drain insertion during thoracotomy

    DEFF Research Database (Denmark)

    Wildgaard, K; Ringsted, T K; Ravn, J; Werner, M U; Kehlet, H

    2013-01-01

    BACKGROUND: It is well known that chest drains are associated with severe movement-related acute pain. These noxious stimuli could play a significant role in development and maintenance of persistent post-operative pain. Therefore we studied chest drain sites in post-thoracotomy pain syndrome (PTPS......) patients, in regard to pain and sensory dysfunction. METHODS: We quantified thermal and pressure thresholds on both the chest drain side and the contralateral side in 11 PTPS patients and 10 pain-free post-thoracotomy patients 33 months after the thoracotomy. On average, each patient had two chest drains...... inserted during surgery. RESULTS: At follow up, two patients experienced pain at the chest drain sites, but had maximal pain near or at the thoracotomy scar. Comparison between chest drain side and control side for all 21 patients demonstrated significantly elevated thresholds for warmth detection and heat...

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

    International Nuclear Information System (INIS)

    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)

  18. Severe Pulmonary Valve Regurgitation 40 Years After Blunt Chest Trauma.

    Science.gov (United States)

    Fuglsang, Simon; Heiberg, Johan; Hjortdal, Vibeke Elisabeth

    2015-10-01

    Severe pulmonary valve regurgitation caused by a pulmonary valve tear is a rare complication to a blunt chest trauma. In this case report, we present a patient with pulmonary regurgitation originating from a chest trauma 40 years ago. Possible mechanisms are osseous pinch of the pulmonary valve between the anterior chest wall and the vertebral column, and retrograde blowout from severe compression of the lungs. PMID:26434447

  19. Evaluation of radiation doses delivered in different chest CT protocols

    OpenAIRE

    Gorycki, Tomasz; Lasek, Iwona; Kamiński, Kamil; Studniarek, Michał

    2014-01-01

    Summary Background There are differences in the reference diagnostic levels for the computed tomography (CT) of the chest as cited in different literature sources. The doses are expressed either in weighted CT dose index (CTDIVOL) used to express the dose per slice, dose-length product (DLP), and effective dose (E). The purpose of this study was to assess the radiation dose used in Low Dose Computer Tomography (LDCT) of the chest in comparison with routine chest CT examinations as well as to ...

  20. Chest Radiography Findings in Primary Pulmonary Tuberculosis in Children

    OpenAIRE

    Milković, Đurđica; Richter, Darko; Zoričić-Letoja, Ivka; Raos, Miljenko; Koncul, Ivan

    2005-01-01

    Plain chest radiography plays a major role in the diagnosis and follow-up of pulmonary tuberculosis in childhood. The aim of our study was to investigate the distribution of characteristic chest radiographic findings at diagnosis in children with pulmonary tuberculosis. The age of the patients and the type and localization of radiographic changes at admission were retrospectively analyzed. We reviewed chest radiographs in 204 children admitted from January 1, 1991 until June 30, 1994 for newl...

  1. Spectral characteristics of chest wall breath sounds in normal subjects.

    OpenAIRE

    Gavriely, N; Nissan, M.; Rubin, A. H.; Cugell, D. W.

    1995-01-01

    BACKGROUND--This study was carried out to establish a reliable bank of information on the spectral characteristics of chest wall breath sounds from healthy men and women, both non-smokers and smokers. METHODS--Chest wall breath sounds from 272 men and 81 women were measured using contact acoustic sensors, amplifiers, and fast Fourier transform (FFT) based spectral analysis software. Inspiratory and expiratory sounds were picked up at three standard locations on the chest wall during breathing...

  2. Simplified cryopreservation of porcine cloned blastocysts

    DEFF Research Database (Denmark)

    Du, Yutao; Zhang, Yunhai; Li, Juan;

    2007-01-01

    )â€"handmade cloning (HMC)â€"to establish a simplified and efficient cryopreservation system for porcine cloned embryos. In Experiment 1, zonae pellucidae of oocytes were partially digested with pronase, followed by centrifugation to polarize lipid particles. Ninety percent (173/192) oocytes were successfully......). Our results prove that porcine embryos produced from delipated oocytes by PA or HMC can be cryopreserved effectively by ultrarapid vitrification. Further experiments are required to assess the in vivo developmental competence of the cloned-vitrified embryos  ...

  3. Porcine Circovirus Diseases: A review of PMWS

    DEFF Research Database (Denmark)

    Baekbo, P.; Kristensen, C. S.; Larsen, L. E.

    2012-01-01

    This article is a review on post‐weaning multisystemic wasting syndrome (PMWS), the first described disease among the porcine circovirus diseases (PCVD). Post‐weaning multisystemic wasting syndrome has, since its appearance in Canada in 1991, been seen in all major pig producing countries. To...... vaccines against Porcine Circo Virus type 2 have been coming on the market and many studies have shown great benefits of these to control PMWS. Today, sow vaccines as well as piglet vaccines are available in most countries. An extensive meta‐analysis of many of the vaccines has shown a comparable good...

  4. Mesenteric ischemia in acute aortic dissection.

    Science.gov (United States)

    Orihashi, Kazumasa

    2016-05-01

    Mesenteric ischemia complicated by acute aortic dissection (AAD) is uncommon, but serious, as there is no established treatment strategy and it can progress rapidly to multi-organ failure. Diagnosing mesenteric ischemia before necrotic change is difficult, not only for primary care physicians, but even for gastrointestinal or cardiovascular surgeons as it can occur at any time during surgery. Thus, measures need to be in place at the bedside to enable us to obtain information on visceral perfusion. It is often difficult to decide which of laparotomy or aortic repair should be performed first, especially when there is associated shock or malperfusion of other vital organs. The standard surgical procedures for mesenteric ischemia are prompt revascularization of the mesenteric artery and, if needed, resection of necrotic intestine. However, the development of endovascular treatment and the introduction of hybrid ORs have improved the treatment strategies for mesenteric ischemia. This article reviews the issues of "diagnosis" in relation to the mechanism of mesenteric ischemia, and discusses the current "treatment strategies". PMID:26024781

  5. Assessment of Renal Ischemia By Optical Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, J T; Demos, S; Michalopoulou, A; Pierce, J L; Troppmann, C

    2004-01-07

    Introduction: No reliable method currently exists for quantifying the degree of warm ischemia in kidney grafts prior to transplantation. We describe a method for evaluating pretransplant warm ischemia time using optical spectroscopic methods. Methods: Lewis rat kidney vascular pedicles were clamped unilaterally in vivo for 0, 5, 10, 20, 30, 60, 90 or 120 minutes; 8 animals were studied at each time point. Injured and contra-lateral control kidneys were then flushed with Euro-Collins solution, resected and placed on ice. 335 nm excitation autofluorescence as well as cross polarized light scattering images were taken of each injured and control kidney using filters of various wavelengths. The intensity ratio of the injured to normal kidneys was compared to ischemia time. Results: Autofluorescence intensity ratios through a 450 nm filter and light scattering intensity ratios through an 800 nm filter both decreased significantly with increasing ischemia time (p < 0.0001 for each method, one-way ANOVA). All adjacent and non-adjacent time points between 0 and 90 minutes were distinguishable using one of these two modalities by Fisher's PLSD. Conclusions: Optical spectroscopic methods can accurately quantify warm ischemia time in kidneys that have been subsequently hypothermically preserved. Further studies are needed to correlate results with physiological damage and posttransplant performance.

  6. 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)

    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 99mTc-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. 99mTc-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 99mTc-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. 99mTc-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 P99mTc-sestamibi uptake with myocardial blood flow. 99mTc-sestamibi uptake overestimated blood flow to a greater extent in the

  7. 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

    Energy Technology Data Exchange (ETDEWEB)

    Chareonthaitawee, P. [MRC Cyclotron Unit, Hammersmith Hospital, London (United Kingdom); Div. of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN (United States); O' Connor, M.K. [Dept. of Nuclear Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN (United States); Gibbons, R.J.; Christian, T.F. [Div. of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN (United States); Ritman, E.L. [Dept. of Physiology, Mayo Clinic and Mayo Foundation, Rochester, MN (United States)

    2000-05-01

    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 {sup 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. {sup 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 {sup 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. {sup 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<0.0001). There was a significant difference in the regression line intercepts (P<0.0001) and

  8. Cross-chest liposuction in gynaecomastia

    Directory of Open Access Journals (Sweden)

    Biju Murali

    2011-01-01

    Full Text Available Background: Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular tissue. The type of surgery chosen depends on the grade of the condition. Objective: Because gynaecomastia is treated primarily as a cosmetic procedure, we aimed at reducing the invasiveness of the surgery. Materials and Methods: The technique complies with all recommended protocols for different grades of gynaecomastia. It uses liposuction, gland excision, or both, leaving only minimal post-operative scars. The use of cross-chest liposuction through incisions on the edge of the areola helps to get rid of all the fat under the areola without an additional scar as in the conventional method. Results: This is a short series of 20 patients, all with bilateral gynaecomastia (i.e., 40 breasts, belonging to Simon′s Stage 1 and 2, studied over a period of 2 years. The average period of follow-up was 15 months. Post-operative complications were reported in only two cases, with none showing long-term complications or issues specifically due to the procedure. Conclusions : Cross-chest liposuction for gynaecomastia is a simple yet effective surgical tool in bilateral gynaecomastia treatment to decrease the post-operative scars. The use of techniques like incision line drain placement and post-drain removal suturing of wounds aid in decreasing the scar.

  9. Acute chest pain emergencies - spouses' prehospital experiences.

    Science.gov (United States)

    Forslund, Kerstin; Quell, Robin; Sørlie, Venke

    2008-10-01

    The call to the Emergency Medical Dispatch Centre is often a person's first contact with the health-care system in cases of acute illness or injury and acute chest pain is a common reason for calling. The aim was to illuminate how spouses to persons with acute chest pain experienced the alarm situation, the emergency call and the prehospital emergency care. Interviews were conducted with nineteen spouses. A phenomenological-hermeneutic approach was used for the analyses. The themes responsibility and uneasiness emerged as well as an overall theme of aloneness. Being a spouse to a person in need of acute medical and nursing assistance was interpreted as "Being responsible and trying to preserve life" and "Being able to manage the uneasiness and having trust in an uncertain situation." When their partners' life was at risk the spouses were in an escalating spiral of worry, uncertainty, stress, fear of loss, feeling of loneliness and desperation. They had to manage emotional distress and felt compelled to act to preserve life, a challenging situation. PMID:18929341

  10. Errors in chest x-ray interpretation

    International Nuclear Information System (INIS)

    Full text: Reporting of adult chest x-rays by appropriately trained radiographers is frequently used in the United Kingdom as one method to maintain a patient focused radiology service in times of increasing workload. With models of advanced practice being developed in Australia, New Zealand and Canada, the spotlight is on the evidence base which underpins radiographer reporting. It is essential that any radiographer who extends their scope of practice to incorporate definitive clinical reporting perform at a level comparable to a consultant radiologist. In any analysis of performance it is important to quantify levels of sensitivity and specificity and to evaluate areas of error and variation. A critical review of the errors made by reporting radiographers in the interpretation of adult chest x-rays will be performed, examining performance in structured clinical examinations, clinical audit and a diagnostic accuracy study from research undertaken by the authors, and including studies which have compared the performance of reporting radiographers and consultant radiologists. overall performance will be examined and common errors discussed using a case based approach. Methods of error reduction, including multidisciplinary team meetings and ongoing learning will be considered

  11. Catastrophic chest pain: blinded by cardiopulmonary disease.

    Science.gov (United States)

    Barreiro, Timothy John; Asiimwe, Denis D; Gemmel, David; Brine, Patrick

    2015-01-01

    A 53-year-old man with a history of diabetic foot ulcer, osteomyelitis, coronary artery disease, hypertension and hyperlipidaemia, presented with chest pain of 3 weeks duration. Eleven days earlier, the patient had had a drug-eluting stent (DES) placed in a branch of the right coronary artery (RCA) after similar chest pain, leading to the findings of a positive nuclear stress test. Since discharge, he was not compliant with taking clopidegrel (Plavix), a concern for in-stent thrombosis with recurrent myocardial ischaemia; but work up was negative and medications were restarted. Within 24 h of admission, he developed bilateral flaccid leg weakness, urine retention and loss of sensation from the umbilicus level down. MRI revealed a T4-T6 epidural abscess. Emergent decompression laminectomy and abscess drainage was completed. Neurological symptoms improved hours after surgery with complete resolution of sensory deficits. Cultures grew Streptococcus sp., treated with intravenous nafcillin for 8 weeks. He regained leg strength with continued improvement seen in rehabilitation. PMID:26135489

  12. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    Directory of Open Access Journals (Sweden)

    João Palas

    2014-01-01

    Full Text Available Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  13. Biometric estimation of chest wall thickness of females

    International Nuclear Information System (INIS)

    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

  14. Staphylococcus aureus sternal osteomyelitis: a rare cause of chest pain

    Directory of Open Access Journals (Sweden)

    Kaur M

    2015-10-01

    Full Text Available Chest pain is a common presenting symptom with a broad differential. Life-threatening cardiac and pulmonary etiologies of chest pain should be evaluated first. However, it is critical to perform a thorough assessment for other sources of chest pain in order to limit morbidity and mortality from less common causes. We present a rare case of a previously healthy 45 year old man who presented with focal, substernal, reproducible chest pain and Staphylococcus aureus bacteremia who was later found to have primary Staphylococcus aureus sternal osteomyelitis.

  15. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    International Nuclear Information System (INIS)

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  16. 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.

  17. Magnetic resonance spectroscopy and imaging in cerebral ischemia

    International Nuclear Information System (INIS)

    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

  18. Hygienic aspects of porcine gullets.

    Science.gov (United States)

    Bijker, P G; Mossel, D A; van Logtestijn, J G

    1985-01-01

    In an attempt to elaborate good manufacturing practices, including the collection, processing and storage of porcine gullets, their bacterial condition immediately after collection (100 samples), as well as that of deep frozen gullets just before incorporation into meat products (40 samples), was assessed. Fresh gullets were found to be contaminated to a high degree: poured plate colony count at 30°C (PPCC) approximately 10(6) to 10(7) and Enterobacteriaceae approximately 10(3) to 10(4) cfu g(-1). Deep frozen gullets showed even higher counts: PPCC approximately 10(7) to 10(8) and Enterobacteriaceae approximately 10(4) to 10(5) cfu g(-1). Hygiene during collection was visually assessed in six abattoirs and found to be satisfactory in two, moderate in three and poor in one. The effects of processing, by cleaning or removal of the mucus membrane, on bacterial condition, pH, colour and odour were assessed before and during storage at 4°C and 20°C. Both cleaning and removal of the mucus membrane resulted in up to approximately a tenfold reduction of colony counts. After 7 days' storage at 4°C these were significantly lower than those of unprocessed gullets (P < 0·01). Processed gullets stored at 4°C were no longer fit for consumption after 4 days' storage. It being impossible to achieve a marked improvement in the bacteriological condition of gullets, the incorporation of these products into sausages should be discouraged and their use in petfoods only allowed under reasonable conditions of hygiene and chilling. PMID:22055164

  19. Transcription analysis of the porcine alveolar macrophage response to porcine circovirus type 2

    OpenAIRE

    Li, Wentao; Liu, Shuqing; Wang, Yang; Deng, Feng; Yan, Weidong; YANG Kun; Chen, Huanchun; He, Qigai; Charreyre, Catherine; Audoneet, Jean-Christophe

    2013-01-01

    Background Porcine circovirus type 2 (PCV2) is the causal agent of postweaning multisystemic wasting syndrome (PMWS), which has severely impacted the swine industry worldwide. PCV2 triggers a weak and atypical innate immune response, but the key genes and mechanisms by which the virus interferes with host innate immunity have not yet been elucidated. In this study, genes that control the response of primary porcine alveolar macrophages (PAMs), the main target of PCV2, were profiled in vitro. ...

  20. Infrared laser hemotherapy in cerebral ischemia modeling

    Science.gov (United States)

    Musienko, Julia I.; Nechipurenko, Natalia I.

    2003-10-01

    Use of intravenous laser irradiation of blood (ILIB) is considered to be the most effective method of laser therapy and its application is expedient pathogenetically in the ischemic disturbances. The aim of this study is to investigate ILIB influence with infrared laser (IL) with 860 nm wavelength on hemostasis, acid-base status (ABS) of blood in normal rabbits and after modeling of local ischemia of brain (LIB). Experimental cerebral ischemia is characterized by development of hypercoagulation syndrom and metabolic acidosis. ILIB with infrared radiation of 2.0 mW power provokes hypocoagulation in intact animals. Application of ILIB in rabbits after LIB contributes for hemostasis and acid-base status normalizing compared to operated animals. IL radiation with 8,5 mW power results in marked hemostatic activation in all animals. Therefore, beneficial effect of low power laser radiation (LPLR) manifests in narrow power diapason in experimental brain ischemia.

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

    International Nuclear Information System (INIS)

    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)

  2. Evaluation of radiation dosage in chest digital tomosynthesis

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility of chest digital tomosynthesis (DTS) for lung lesion screening by comparing the effective dose of chest DTS with chest digital radiography (DR), low-dose MSCT and MSCT examinations. Methods: The Fluke lung/chest phantom underwent posterior-anterior (PA), left lateral (LAT) chest DR and DTS with automatic exposure control technique. Using RTI DoseGuard and WinODS, the dose area product (DAP) and effective dose of PA, LAT and total DTS were calculated. CareDose technique was used for MSCT and low-dose MSCT scans, the dose length products (DLP) was acquired.According to the DLP to E (k) conversion coefficient in ICRP 103, the effective dose of low-dose MSCT and MSCT were calculated. Paired t test was used for comparison of the mean effective dose of DTS, DR and low-dose MSCT. Results: The mean effective dose was 0.13 mSv for chest DR and 0.11 mSv for DTS examination. The mean effective dose of low-dose MSCT and MSCT scans were 1.13 mSv and 6.38 mSv. The effective dose of chest DTS was comparable to that of chest DR, and was approximately 1/10 and 1/60 times lower than that of low-dose MSCT and MSCT scans. There was no statistical difference between chest DTS and DR (t=3.514, P>0.01), and there was a significant difference between chest DTS and low-dose MSCT (t=178.769, P<0.01). Conclusion: DTS is a new X-ray tomography which has the advantage of low radiation dosage in chest examination for lung lesion screening comparing with low-dose MSCT. (authors)

  3. 7 CFR 1230.18 - Porcine animal.

    Science.gov (United States)

    2010-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PORK PROMOTION, RESEARCH, AND CONSUMER INFORMATION Pork Promotion, Research, and Consumer Information Order Definitions § 1230.18 Porcine... purposes as seed stock and included in the breeding herd; and (c) a market hog, slaughtered by the...

  4. Occupational asthma due to porcine pancreatic amylase

    OpenAIRE

    1997-01-01

    A case of occupational asthma in a 41 year old histopathology laboratory technician attributable to a powder preparation of the porcine pancreatic enzyme amylase is reported. The diagnosis was confirmed by a double blind, placebo controlled, inhalation challenge study which showed immediate and late asthmatic reactions associated with a significant increase in airway responsiveness to methacholine.

  5. Splicing variants of porcine synphilin-1

    Directory of Open Access Journals (Sweden)

    Knud Larsen

    2015-09-01

    Full Text Available Parkinson's disease (PD, idiopathic and familial, is characterized by degradation of dopaminergic neurons and the presence of Lewy bodies (LB in the substantia nigra. LBs contain aggregated proteins of which α-synuclein is the major component. The protein synphilin-1 interacts and colocalizes with α-synuclein in LBs. The aim of this study was to isolate and characterize porcine synphilin-1 and isoforms hereof with the future perspective to use the pig as a model for Parkinson's disease. The porcine SNCAIP cDNA was cloned by reverse transcriptase PCR. The spatial expression of SNCAIP mRNA was investigated by RNAseq. The presented work reports the molecular cloning and characterization of the porcine (Sus scrofa synphilin-1 cDNA (SNCAIP and three splice variants hereof. The porcine SNCAIP cDNA codes for a protein (synphilin-1 of 919 amino acids which shows a high similarity to human (90% and to mouse (84% synphilin-1. Three shorter transcript variants of the synphilin-1 gene were identified, all lacking one or more exons. SNCAIP transcripts were detected in most examined organs and tissues and the highest expression was found in brain tissues and lung. Conserved splicing variants and a novel splice form of synhilin-1 were found in this study. All synphilin-1 isoforms encoded by the identified transcript variants lack functional domains important for protein degradation.

  6. The Porcine Immunology and Nutrition Resource Database

    Science.gov (United States)

    Diverse genomics-based databases have been developed to facilitate research with human and rodent models. Current porcine gene databases, however, lack the nutritional and immunological orientation and robust annotation to design effective molecular tools to study relevant pig models. To address t...

  7. Helical CT findings in mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hoon; Lim, Hyo Keun; Lee, Won Jae; Choi, Sang Hee; Lee, Soon Jin; Cho, Jae Min; Kim, Kyung Ah; Lee, Yon Ok [Sungkyunkwan Univ. College of Medicine. Samsung Medical Center, Seoul (Korea, Republic of)

    1998-08-01

    Ischemic bowel disease is one of the common causes of acute abdomen, which results from insufficient blood flow to the small bowel and colon caused by arterial or venous occlusion or mesenteric vasoconstriction. Early diagnosis by clinical, laboratory, and radiologic findings is often difficult and delay in adequate therapy results in substantial morbidity and mortality. CT is known to be useful for the evaluation of patients with suspected bowel ischemia or infarction. This study describes the spectrum of helical CT findings in acute and chronic mesenteric ischemia due to various causes, and explains the value of CT findings for specific diagnosis.

  8. An unusual cause for recurrent chest infections.

    LENUS (Irish Health Repository)

    Lobo, Ronstan

    2012-10-01

    We present a case of an elderly non-smoking gentleman who, since 2005, had been admitted multiple times for recurrent episodes of shortness of breath, wheeze, cough and sputum. The patient was treated as exacerbations of chronic obstructive pulmonary disease (COPD) and\\/or lower respiratory tract infections. Bronchoscopy was done which revealed multiple hard nodules in the trachea and bronchi with posterior tracheal wall sparing. Biopsies confirmed this as tracheopathia osteochondroplastica (TO). He had increasing frequency of admission due to methicillin-resistant Staphylococcus aureus and pseudomonas infections, which failed to clear despite intravenous, prolonged oral and nebulised antibiotics. The patient developed increasing respiratory distress and respiratory failure. The patient died peacefully in 2012. This case report highlights the typical pathological and radiological findings of TO and the pitfalls of misdiagnosing patients with recurrent chest infections as COPD.

  9. Observer accuracy in reading chest films

    International Nuclear Information System (INIS)

    Four board-certified radiologists have read and reread four groups of 40 chest radiographs containing nodule and infiltrate images to investigate interreader and intrareader variation. Responses were recorded using a six-point confidence level scale. Accuracy was determined from the area under the receiver operating characteristic (ROC) curve. Accuracies ranged from 0.78 to 0.98, with an average of 0.83 and a mean uncertainty of 8.2%. Intraobserver uncertainties varied from 0.5% to 16%, with a mean of 5.9%. The data were analyzed for the significance of accuracy differences using correlated ROC techniques, the kappa statistic, and the Bonnferoni criteria. Implications for using reader performance as a recertification measure are discussed

  10. Chest magnetic resonance imaging: a protocol suggestion

    Directory of Open Access Journals (Sweden)

    Bruno Hochhegger

    2015-12-01

    Full Text Available Abstract In the recent years, with the development of ultrafast sequences, magnetic resonance imaging (MRI has been established as a valuable diagnostic modality in body imaging. Because of improvements in speed and image quality, MRI is now ready for routine clinical use also in the study of pulmonary diseases. The main advantage of MRI of the lungs is its unique combination of morphological and functional assessment in a single imaging session. In this article, the authors review most technical aspects and suggest a protocol for performing chest MRI. The authors also describe the three major clinical indications for MRI of the lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.

  11. Digital luminescence radiography of the chest

    International Nuclear Information System (INIS)

    The aim of the present study was to evaluate the efficacy of a digital system in chest radiology compared to the conventional film-screen system. The first studies (1-3) were purely clinical, had two parts, one clinical and one using phantoms, and the 5:th used solely phantoms. Except for the first - pilot - study, the studies were performed as receiver operating characteristic (ROC) analysis. From one exposure, two digital radiographs were obtained, one simulating the film-screen radiograph and one enhanced, using an unsharp mask. The conventional radiograph was compared to this double-image, but in addition to this, even to the simulated normal and enhanced separately (1-3). To evaluate the value of inverted (positive) radiographs, the original digital (negative) radiographs were inverted, and then compared to the originals (4). As digitzation means easy storing and transfer of data and possibility of electronic display, the diagnostic performance of an interactive workstation was assessed (5). In the clinical studies, a variety of chest affections were used: atelectasis, tumor, pneumothorax, fibrosis, mediastinal and bony changes, tuberculosis, incompensations and enlargement of the heart (1), pneumothorax (2), fibrosis (3), and tumor (4). In the phantom studies, test objects simulating tumors (4) and pneumothorax (5) were used. In no study was statistical significant difference seen between the digital and conventional system (p>0.05). Neither in the clinical nor the phantom study did inversion of the radiographs improve diagnostic performance. The workstation performed almost equally well as the radiographs even with a resolution of 1.25 1p/mm compared to the digital radiographs 2.5 and film-screen radiographs 5 1p/mm. (au) (50 refs.)

  12. 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. PMID:27048219

  13. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John; Hammershøi, Dorte; Rubak, Per

    When a stethoscope is placed on the surface of the chest, the coupler picks up sound from heart and lungs transmitted through the tissues of the ribcage and from the surface of the skin. If the acoustic impedance of the chest surface is known, it is possible to optimize the coupler for picking up...

  14. Resuscitation, prolonged cardiac arrest, and an automated chest compression device

    DEFF Research Database (Denmark)

    Risom, Martin; Jørgensen, Henrik; Rasmussen, Lars S;

    2010-01-01

    The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest.......The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest....

  15. Sexual, Physical, Verbal/Emotional Abuse and Unexplained Chest Pain

    Science.gov (United States)

    Eslick, Guy D.; Koloski, Natasha A.; Talley, Nicholas J.

    2011-01-01

    Objectives: Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained…

  16. Lung mass, right upper lung - chest x-ray (image)

    Science.gov (United States)

    This picture is a chest x-ray of a person with a lung mass. This is a front view, where the lungs are the two dark areas and ... visible in the middle of the chest. The x-ray shows a mass in the right upper lung, ...

  17. Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Ritesh Agarwal

    2012-01-01

    Full Text Available AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT chest manifestations in glucocorticoid-naïve allergic bronchopulmonary aspergillosis (ABPA patients. METHODS: This is a prospective observational study and includes 60 consecutive glucocorticoid-naïve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm in the routine diagnostic workup for ABPA. RESULTS: Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency. CONCLUSION: Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.

  18. Measurement of characteristic leap interval between chest and falsetto registers

    NARCIS (Netherlands)

    Miller, DG; Svec, JG; Schutte, HK

    2002-01-01

    A markedly smaller time constant distinguishes a chest-falsetto leap from the more usual execution of a sung interval by muscular adjustments in the length and tension of the vocal folds. The features of such a chest-falsetto leap are examined in detail with respect to F-0, peak-to-peak amplitude of

  19. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John;

    2011-01-01

    When a stethoscope is placed on the surface of the chest, the coupler picks up sound from heart and lungs transmitted through the tissues of the ribcage and from the surface of the skin. If the acoustic impedance of the chest surface is known, it is possible to optimize the coupler for picking up...

  20. Myocardial contrast echocardiography to assess perfusion in a mouse model of ischemia/reperfusion injury

    Science.gov (United States)

    Hossack, John A.; Li, Yinbo; Christensen, Jonathan P.; Yang, Zequan; French, Brent A.

    2004-04-01

    Noninvasive approaches for measuring anatomical and physiological changes resulting from myocardial ischemia / reperfusion injury in the mouse heart have significant value since the mouse provides a practical, low-cost model for modeling human heart disease. In this work, perfusion was assessed before, during and after an induced closed- chest, coronary ischemic event. Ultrasound contrast agent, similar to MP1950, in a saline suspension, was injected via cannulated carotid artery as a bolus and imaged using a Siemens Sequoia 512 scanner and a 15L8 intraoperative transducer operating in second harmonic imaging mode. Image sequences were transferred from the scanner to a PC for analysis. Regions of interest were defined in septal and anterior segments of the myocardium. During the ischemic event, when perfusion was diminished in the anterior segment, mean video intensity in the affected segment was reduced by one half. Furthermore, following reperfusion, hyperemia (enhanced blood flow) was observed in the anterior segment. Specifically, the mean video intensity in the affected segment was increased by approximately 50% over the original baseline level prior to ischemia. Following the approach of Kaul et al., [1], gamma variate curves were fitted to the time varying level of mean video intensity. This foundation suggests the possibility of quantifying myocardial blood flow in ischemic regions of a mouse heart using automated analysis of contrast image data sets. An improved approach to perfusion assessment using the destruction-reperfusion approach [2] is also presented.

  1. Detecting myocardial ischemia with 2-D CVIB imaging method--an in vivo animal experiment study

    Institute of Scientific and Technical Information of China (English)

    JIANG Yong; BAI Jing; YING Kui; CHENG Kezheng; YU Can

    2004-01-01

    A 2-D cyclic variation of integrated backscatter (CVIB) imaging method was established for detecting myocardial ischemia. To demonstrate the feasibility and validity of this method, animal experiments were conducted. Acute myocardial ischemia was induced by occluding left anterior descending coronary artery in 10 anesthetized open-chest dogs. While scanning the normal hearts and the ischemic hearts with a B scanner, digital radiofrequency data were acquired by a real-time acquisition system in synchronism. The offline analysis to the radio-frequency signal with the 2-D CVIB imaging method was performed to verify the consistency between the imaging result and the design of the experiment. In addition, 4 dogs in experiment were treated with the heart pacemaker in order to investigate the influence of changing in heart rate on the detection of ischemic myocardium with the proposed method. The experimental result showed that the 2-D CVIB imaging method succeeded in detecting the ischemic myocardium and is a new non-invasive way for the cardiologists to both quantitatively and visually evaluate the contractile performance of the myocardium.

  2. Electronic versus traditional chest tube drainage following lobectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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.......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...

  3. Ordering chest X-rays in Australian general practice.

    Science.gov (United States)

    Gordon, Julie; Miller, Graeme; Pan, Ying

    2015-08-01

    Data from the BEACH program between 2012–14 were used to examine general practice encounters where chest X-rays were ordered. This included the most common problems associated with chest X-ray ordering and patient characteristics. Changes in ordering between 2004–05 and 2013–14 were also investigated. The rate of chest X-ray ordering between 2004–05 and 2013–14 decreased significantly. In 2012–14, chest X-rays were most often ordered in the management of acute bronchitis/bronchiolitis, cough and pneumonia. Pleurisy/pleural effusion had the highest likelihood of resulting in a chest X-ray order, followed by shortness of breath/dyspnoea and pneumonia. PMID:26510138

  4. Genetic Stability of a Genetically-Engineered Chimeric Porcine Circovirus (PCV) Vaccine, PCV1-2

    OpenAIRE

    Gillespie, Jennifer Ann

    2009-01-01

    Porcine circovirus type 2 (PCV2) is the primary causative agent of porcine circovirus associated disease (PCVAD), an economically important swine disease that causes wasting in pigs 5-18 weeks of age. There exist two different types of porcine circoviruses: porcine circovirus type 1 (PCV1) was discovered as a contaminant of porcine kidney (PK-15) cells and was determined to be nonpathogenic in swine; whereas porcine circovirus type 2 (PCV2) is pathogenic. A recently released vaccine for PCVA...

  5. [Platelets, atherothrombosis, antiplatelet drugs and cerebral ischemia].

    Science.gov (United States)

    Bousser, Marie-Germaine

    2013-02-01

    Platelets play a much more important role in myocardial ischemia than in cerebral ischemia, because atherothrombosis - the underlying cause of the vast majority of myocardial infarcts - is responsible for only 25-30% of cerebral infarcts. Aspirin is the only effective antiplatelet drug for primary prevention of ischemic events, especially those affecting the heart. For secondary prevention of cerebral infarction, clopidogrel and the combination of aspirin with extended-release dipyridamole are both marginally better than aspirin alone, but aspirin remains the gold standard worldwide because of its remarkable cost/benefit/tolerability ratio. The clopidogrel-aspirin combination is to be avoided because of the risk of hemorrhage, particularly in the brain and gastrointestinal tract. Revascularization strategies and the choice of antiplatelet drugs for the acute phase of myocardial and cerebral ischemia are very different, consisting of endovascular treatment and aggressive platelet inhibition for coronary infarcts, versus intravenous thrombolysis and / or aspirin for cerebral infarcts. None of the new antiplatelet drugs used in acute coronary syndromes has so far been studied in acute cerebral ischemia. PMID:24919368

  6. Brown fat distribution in the chest wall of infants - normal appearance, distribution and evolution on CT scans of the chest

    International Nuclear Information System (INIS)

    While reviewing chest CT scans of infants, we repeatedly observed hyperdense enhancing tissue in the chest wall that is not well described in radiology literature. This study was undertaken to describe the imaging features of this tissue in chest walls of infants. CT scans of the chest conducted on all infants between April 2008 and October 2009 were retrospectively reviewed. CT studies with any deviation from normal radiation or contrast dose or those with chest wall anatomical distortion were excluded. One hundred eighty-eight infants were scanned, with 202 MDCTs, of which 180 (89.1%) received contrast agent. Fifty-four of 180 (30%) cases revealed focal areas of hyperdensity in various locations. All positive cases ranged between 2 days and 9 months of age. The areas of distribution of hyperdensity had excellent correlation with known areas of brown fat in the chest wall, known from nuclear medicine studies, and hence we concluded these to represent the same. Brown fat in the chest wall can be seen as enhancing tissue on contrast CT scans done on infants. This is a normal morphological component with the brown fat converting to normal fat. It is important to recognize it in the chest wall of infants to avoid misinterpretation. (orig.)

  7. Brown fat distribution in the chest wall of infants - normal appearance, distribution and evolution on CT scans of the chest

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Priya; Babyn, Paul S.; Shammas, Amer; Miller, Stephen F. [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada)

    2011-08-15

    While reviewing chest CT scans of infants, we repeatedly observed hyperdense enhancing tissue in the chest wall that is not well described in radiology literature. This study was undertaken to describe the imaging features of this tissue in chest walls of infants. CT scans of the chest conducted on all infants between April 2008 and October 2009 were retrospectively reviewed. CT studies with any deviation from normal radiation or contrast dose or those with chest wall anatomical distortion were excluded. One hundred eighty-eight infants were scanned, with 202 MDCTs, of which 180 (89.1%) received contrast agent. Fifty-four of 180 (30%) cases revealed focal areas of hyperdensity in various locations. All positive cases ranged between 2 days and 9 months of age. The areas of distribution of hyperdensity had excellent correlation with known areas of brown fat in the chest wall, known from nuclear medicine studies, and hence we concluded these to represent the same. Brown fat in the chest wall can be seen as enhancing tissue on contrast CT scans done on infants. This is a normal morphological component with the brown fat converting to normal fat. It is important to recognize it in the chest wall of infants to avoid misinterpretation. (orig.)

  8. Feasibility study of the diagnosis and monitoring of cystic fibrosis in pediatric patients using stationary digital chest tomosynthesis

    Science.gov (United States)

    Potuzko, Marci; Shan, Jing; Pearce, Caleb; Lee, Yueh Z.; Lu, Jianping; Zhou, Otto

    2015-03-01

    Digital chest tomosynthesis (DCT) is a 3D imaging modality which has been shown to approach the diagnostic capability of CT, but uses only one-tenth the radiation dose of CT. One limitation of current commercial DCT is the mechanical motion of the x-ray source which prolongs image acquisition time and introduces motion blurring in images. By using a carbon nanotube (CNT) x-ray source array, we have developed a stationary digital chest tomosynthesis (s- DCT) system which can acquire tomosynthesis images without mechanical motion, thus enhancing the image quality. The low dose and high quality 3D image makes the s-DCT system a viable imaging tool for monitoring cystic fibrosis (CF) patients. The low dose is especially important in pediatric patients who are both more radiosensitive and have a longer lifespan for radiation symptoms to develop. The purpose of this research is to evaluate the feasibility of using s-DCT as a faster, lower dose means for diagnosis and monitoring of CF in pediatric patients. We have created an imaging phantom by injecting a gelatinous mucus substitute into porcine lungs and imaging the lungs from within an anthropomorphic hollow chest phantom in order to mimic the human conditions of a CF patient in the laboratory setting. We have found that our s-DCT images show evidence of mucus plugging in the lungs and provide a clear picture of the airways in the lung, allowing for the possibility of using s- DCT to supplement or replace CT as the imaging modality for CF patients.

  9. Diagnosis and management of splanchnic ischemia

    Institute of Scientific and Technical Information of China (English)

    Jeroen J Kolkman; Marloes Bargeman; Ad B Huisman; Robert H Geelkerken

    2008-01-01

    Splanchnic or gastrointestinal ischemia is rare and randomized studies are absent.This review focuses on new developments in clinical presentation,diagnostic approaches,and treatments.Splanchnic ischemia can be caused by occlusions of arteries or veins and by physiological vasoconstriction during low-flow states.The prevalence of significant splanchnic arterial stenoses is high,but it remains mostly asymptomatic due to abundant collateral circulation.This is known as chronic splanchnic disease (CSD).Chronic splanchnic syndrome (CSS) occurs when ischemic symptoms develop.Ischemic symptoms are characterized by postprandial pain,fear of eating and weight loss.CSS is diagnosed by a test for actual ischemia.Recently,gastro-intestinal tonometry has been validated as a diagnostic test to detect splanchnic ischemia and to guide treatment.In singlevessel CSD,the complication rate is very low,but some patients have ischemic complaints,and can be treated successfully.In multi-vessel stenoses,the complication rate is considerable,while most have CSS and treatment should be strongly considered.CT and MR-based angiographic reconstruction techniques have emerged as alternatives for digital subtraction angiography for imaging of splanchnic vessels.Duplex ultrasound is still the first choice for screening purposes.The strengths and weaknesses of each modality will be discussed.CSS may be treated by minimally invasive endoscopic treatment of the celiac axis compression syndrome,endovascular antegrade stenting,or laparotomy-assisted retrograde endovascular recanalization and stenting.The treatment plan is highly individualized and is mainly based on precise vessel anatomy,body weight,comorbidity and severity of ischemia.

  10. Coincidental detection of genomes of porcine parvoviruses and porcine circovirus type 2 infecting pigs in Japan.

    Science.gov (United States)

    Saekhow, Prayuth; Kishizuka, Shingo; Sano, Natsuha; Mitsui, Hiroko; Akasaki, Hajime; Mawatari, Takahiro; Ikeda, Hidetoshi

    2016-01-01

    The infection status of 15 viruses in 120 pigs aged about 6 months was investigated based on tonsil specimens collected from a slaughterhouse. Only 5 species of porcine parvoviruses and porcine circovirus type 2 (PCV2) were detected at high frequencies; 67% for porcine parvovirus (PPV) (PPV-Kr or -NADL2 as the new abbreviation), 58% for PPV2 (CnP-PARV4), 39% for PPV3 (P-PARV4), 33% for PPV4 (PPV4), 55% for PBo-likeV (PBoV7) and 80% for PCV2. A phylogenetic analysis of PPV3 suggested that Japanese PPV3s showed a slight variation, and possibly, there were farms harboring homogeneous or heterogeneous PPV3s. Statistical analyses indicated that the detection of PCV2 was significantly coincidental with each detection of PPV, PPV2 and PPV3, and PPV and PPV4 were also coincidentally detected. The concurrent infection with PCV2 and porcine parvoviruses in the subclinically infected pigs may resemble the infection status of pigs with the clinical manifestations of porcine circovirus associated disease which occurs in 3-5 months old pigs and is thought to be primarily caused by the PCV2 infection. PMID:26166811

  11. Measurement of chest wall displacement based on terahertz wave

    Science.gov (United States)

    Li, Hui; Lv, Hao; Jiao, Teng; Lu, Guohua; Li, Sheng; Li, Zhao; Liu, Miao; Jing, Xijing; Wang, Jianqi

    2015-02-01

    Measurement of chest wall displacement is an important approach for measuring mechanics of chest wall, which has considerable significance for assessing respiratory system and diagnosing pulmonary diseases. However, existing optical methods for measuring chest wall displacement are inconvenient for some specific patients such as the female patients and the patients with bandaged chest. In this letter, we proposed a method for measuring chest wall displacement based on terahertz wave and established corresponding mathematic model and set up a terahertz measurement system. The main advantages of this method are that it can measure the chest wall displacement of the subjects without taking off clothes or arranging any markers. To validate this method and assess the performance of the terahertz system, in vitro, the displacement of a water module driven by a linear guide rail was measured by the terahertz system and compared with the actual displacement of the water module. The results showed that the waveforms measured with two methods have a good agreement, and the relative error is less than 5% and sufficiently good for measurement demands. In vivo, the synchronous experiment was performed on five human volunteers with the terahertz system and a respiratory belt transducer. The results demonstrate that this method has good performance and promising prospects for measuring chest wall displacement.

  12. Age-related changes in chest geometry during cardiopulmonary resuscitation.

    Science.gov (United States)

    Dean, J M; Koehler, R C; Schleien, C L; Michael, J R; Chantarojanasiri, T; Rogers, M C; Traystman, R J

    1987-06-01

    We studied alterations of chest geometry during conventional cardiopulmonary resuscitation in anesthetized immature swine. Pulsatile force was applied to the sternum in increments to determine the effects of increasing compression on chest geometry and intrathoracic vascular pressures. In 2-wk- and 1-mo-old piglets, permanent changes in chest shape developed due to incomplete recoil of the chest along the anteroposterior axis, and large intrathoracic vascular pressures were generated. In 3-mo-old animals, permanent chest deformity did not develop, and large intrathoracic vascular pressures were not produced. We propose a theoretical model of the chest as an elliptic cylinder. Pulsatile displacement along the minor axis of an ellipse produces a greater decrease in cross-sectional area than displacement of a circular cross section. As thoracic cross section became less circular due to deformity, greater changes in thoracic volume, and hence pressure, were produced. With extreme deformity at high force, pulsatile displacement became limited, diminishing pressure generation. We conclude that changes in chest geometry are important in producing intrathoracic intravascular pressure during conventional cardiopulmonary resuscitation in piglets. PMID:3610916

  13. Genomic analysis of porcine circovirus type-2 isolates in Alberta pigs demonstrating clinical porcine circovirus associated disease (PCVAD)

    OpenAIRE

    McIntyre, Leila; Chaiyakul, Mark; Clark, Edward G.; Marshall, Frank; Czub, Markus

    2010-01-01

    Nineteen pigs with clinical signs of porcine circovirus associated diseases (PCVAD) on 5 Alberta pig farms were examined pathologically, including gross pathology, histopathology, and immunohistochemistry. Polymerase chain reaction (PCR) for porcine circovirus type-2 (PCV-2) and sequence analysis was performed on tissue samples of 12 animals. Results showed that new strains of porcine circovirus type-2 genogroup b were present in most pigs that were positive for PCV-2. Furthermore, a mixed in...

  14. Porcine hokovirus in wild boar in Portugal.

    Science.gov (United States)

    Miranda, Carla; Coelho, Catarina; Vieira-Pinto, Madalena; Thompson, Gertrude

    2016-04-01

    Porcine hokovirus (PHoV), also referred to as porcine parvovirus 4 (P-PARV4), a recently discovered parvovirus of swine that is closely related to human parvovirus 4/5 (H-PARV4/5), was first described in Hong Kong. To evaluate the occurrence of P-PARV4 in Portuguese wild boars in the hunting season of 2011/2012, liver and serum samples were tested. P-PARV4 was detected in 24 % of the wild boars analyzed. Phylogenetic analysis showed a close relationship between the P-PARV4 isolates and other P-PARV4 reference strains. This virus appears to be emerging, with yet unknown implications for public health. PMID:26711454

  15. Porcine SLITRK1: Molecular cloning and characterization

    Directory of Open Access Journals (Sweden)

    Knud Larsen

    2014-01-01

    Full Text Available 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 introns, as does its human and mouse counterparts. RT-PCR cloning revealed two SLITRK1 transcripts: a full-length mRNA and a transcript variant that results in a truncated protein. The encoded SLITRK1 protein, consisting of 695 amino acids, displays a very high homology to human SLITRK1 (99%. The porcine SLITRK1 gene is expressed exclusively in brain tissues.

  16. Splicing variants of porcine synphilin-1

    DEFF Research Database (Denmark)

    Larsen, Knud Erik; Madsen, Lone Bruhn; Farajzadeh, Leila;

    2015-01-01

    (90%) and to mouse (84%) synphilin-1. Three shorter transcript variants of the synphilin-1 gene were identified, all lacking one or more exons. SNCAIP transcripts were detected in most examined organs and tissues and the highest expression was found in brain tissues and lung. Conserved splicing......RNA was investigated by RNAseq. The presented work reports the molecular cloning and characterization of the porcine (Sus scrofa) synphilin-1 cDNA (SNCAIP) and three splice variants hereof. The porcine SNCAIP cDNA codes for a protein (synphilin-1) of 919 amino acids which shows a high similarity to human...... variants and a novel splice form of synhilin-1 were found in this study. All synphilin-1 isoforms encoded by the identified transcript variants lack functional domains important for protein degradation....

  17. An uncommon cause of chest pain - penetrating atherosclerotic aortic ulcer

    OpenAIRE

    Kyaw, Htoo; Sadiq, Sanah; Chowdhury, Arnab; Gholamrezaee, Rashin; Yoe, Linus

    2016-01-01

    Chest pain is a very common symptom and can be of cardiac or non-cardiac origin. It accounts for approximately 5.5 million annual emergency room visits in the United States, according to 2011 CDC data. Penetrating atherosclerotic aortic ulcer (PAU), an uncommon condition, is also a potential cause of chest pain. We here report the case of a 65-year-old woman who presented with atypical chest and back pain. The pain persisted for 4 weeks necessitating two emergency room visits. Initial tests w...

  18. Non-lethal? Penetrating chest injury due to beanbag bullet

    OpenAIRE

    Thakur, Sanjay; Teloken, Patrick Ely; Gilfillan, Ian; Sharma, Sanjay

    2013-01-01

    We report a case of serious lung injury from beanbag bullet. A 46-year-old gentleman, shot with beanbag bullets was brought to the emergency department. Upon arrival he was in obvious respiratory distress and complained of severe pain in the right chest. A 3.0×3.5 cm entry wound on the right parasternal area was identified. Chest x-ray revealed a right haemopneumothorax, parenchymal changes at the right lung base and a radiopaque foreign body. A right-sided intercostal chest tube was inserted...

  19. Chest X-ray in newborns and infants

    International Nuclear Information System (INIS)

    Chest X-ray in newborns and infants shows great differences to that in adults. Therefore all radiologists, who engage in X-rays in this age group, must be familiar with the special features. At the beginning specific items of examination methods are explained, which must be strictly followed due to radiological protection. Focus of the paper is the discussion of the important chest diseases in newborn and infants, which are mostly unknown in chest diagnosis in adults. Many of them can be life-threatening, thus their knowledge is essential. Pathophysiological explanations shall make the special radiological signs understandable. (orig.)

  20. Dose profile in computed tomography chest scan

    International Nuclear Information System (INIS)

    For the optimization of the patient dose in computed tomography (CT), the Brazilian legislation only established the diagnostic reference levels (DRL's) in terms of Multiple Scan Average Dose (MSAD) in a typical adult as a parameter of quality control of CT scanners. Conformity to the DRL's can be verified by measuring the dose distribution in CT scans and MSAD determination. An analysis of the quality of CT scans of the metropolitan region of Belo Horizonte is necessary by conducting pertinent tests to the study that are presented in the ANVISA (National Agency of Sanitary Vigilance) Guide. The purpose of this study is to investigate, in a chest scan, the variation of dose in CT. To measure the dose profile are used lithium fluoride thermoluminescent dosimeters (TLD-100 Rod) distributed in cylinders positioned in peripheral and central regions of a phantom of polymethylmethacrylate (PMMA). The data obtained allow us to observe the variation of the dose profile inside the phantom. The peripheral region shows higher dose values than the central region. The longitudinal variation can be observed and the maximum dose was recorded at the edges of the phantom (41,58±5,10) mGy at the midpoint of the longitudinal axis. The results will contribute to disseminate the proper procedure and optimize the dosimetry and the tests of quality control in CT, as well as make a critical analysis of the DRL's. (author)

  1. Nodule detection by CT screening of chest

    International Nuclear Information System (INIS)

    Lung cancer screening using helical computed tomography (CT) has been carried out at the ''Anti-lung cancer association, Tokyo'' since 1993. We found 43 lung cancer cases (0.163%) during the 18-year period before introducing helical CT, but 76 lung cancer cases (0.436%) in 11 years after introducing helical CT. Among the cases detected in the screening period using helical CT, 74% were in stage IA, and the average size of the primary tumors was 17.3 mm. These data were better than in the screening period without helical CT. Of the 76 lung cancer cases detected after the introduction of helical CT, 19 cases (25%) were visible chest X-ray films, but 70 cases (92%) were visible on CT. We had 52 cases detected on repeated CT screenings, 41 cases (79%) of these cases were retrospectively found to have had a primary tumor overlooked previous CT screening images. In this seminar, former CT screening images of lung cancer cases were presented and we discussed how to improve earlier diagnosis. (author)

  2. The ontogeny of the porcine immune system

    Czech Academy of Sciences Publication Activity Database

    Šinkora, Marek; Butler, J. E.

    2009-01-01

    Roč. 33, č. 3 (2009), s. 273-283. ISSN 0145-305X R&D Projects: GA ČR GA524/07/0087; GA ČR GA523/07/0088 Institutional research plan: CEZ:AV0Z50200510 Keywords : ontogeny of the porcine immune system * swine adaptive immunity * development of alpha beta and gamma delta T cells Subject RIV: EC - Immunology Impact factor: 3.290, year: 2009

  3. Studies on genetic properties of porcine parvoviruses

    OpenAIRE

    Streck, André Felipe

    2013-01-01

    Porcine parvovirus (PPV) is considered to be one of the most important causes of reproductive failure in swine. Fetal death, mummification, stillbirths and delayed return to estrus are some of the clinical signs commonly associated with PPV infection in a herd. The virus genome is considered to be conservative, with substitution rates near to that of their host. However, it has been shown that some parvoviruses exhibit a substitution rate close to that commonly determined for RNA viruses. In ...

  4. KBSH parvovirus: comparison with porcine parvovirus.

    OpenAIRE

    Molitor, T W; Joo, H S; Collett, M S

    1985-01-01

    We compared the molecular, antigenic, and pathogenic properties of KBSH parvovirus to those of porcine parvovirus (PPV) isolate NADL-8. KBSH, propagated in swine testes cells in culture, possessed two major capsid polypeptides of 83 and 64 kilodaltons that were similar in size to those of PPV. KBSH-infected cells also contained an 86-kilodalton nonstructural polypeptide that was identical in size to the PPV nonstructural polypeptide (NS-1). The KBSH polypeptides were structurally similar but ...

  5. Mitochondrially targeted Endonuclease III has a powerful anti-infarct effect in an in vivo rat model of myocardial ischemia/reperfusion

    OpenAIRE

    Yang, Xi-Ming; Cui, Lin; White, James; Kuck, Jamie; Ruchko, Mykhaylo V.; Wilson, Glenn L.; Alexeyev, Mikhail; Gillespie, Mark N.; Downey, James M.; Cohen, Michael V.

    2015-01-01

    Recent reports indicate that elevating DNA glycosylase/AP lyase repair enzyme activity offers marked cytoprotection in cultured cells and a variety of injury models. In this study, we measured the effect of EndoIII, a fusion protein construct that traffics Endonuclease III, a DNA glycosylase/AP lyase, to the mitochondria, on infarct size in a rat model of myocardial ischemia/reperfusion. Open-chest, anesthetized rats were subjected to 30 min of occlusion of a coronary artery followed by 2 h o...

  6. Severe cardiac trauma or myocardial ischemia? Pitfalls of polytrauma treatment in patients with ST-elevation after blunt chest trauma

    OpenAIRE

    Orkun Özkurtul; Andreas Höch; Andreas Reske; Carsten Hädrich; Christoph Josten; Jörg Böhme

    2015-01-01

    Introduction: Thoracic injuries are the third most common injuries in polytrauma patients. The mechanism of injury and the clinical presentation are crucially important for adequate emergency treatment. Presentation of case: Here we present a case of a 37-year-old male who was admitted to our level-1 trauma center after motor vehicle accident. The emergency physician on scene presented the patient with a myocardial infarction. During initial clinical trauma assessment the patient developed...

  7. Severe cardiac trauma or myocardial ischemia? Pitfalls of polytrauma treatment in patients with ST-elevation after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Orkun Özkurtul

    2015-09-01

    Conclusion: This case outlines the importance of understanding the key mechanism of injury and the importance of communication at each stage of healthcare transfer. A transesophageal echocardiography can help to identify injuries after myocardial contusion.

  8. Myocardial perfusion scintigraphy in patients with mitral valve prolapse: its advantage over stress electrocardiography in diagnosing associated coronary artery disease and its implications for the etiology of chest pain

    International Nuclear Information System (INIS)

    Patients with mitral valve prolapse (MVP) frequently experience chest pain which may, especially in older subjects and males, be difficult to differentiate from angina pectoris. Electrocardiographic (ECG) changes, ventricular arrhythmias, metabolic abnormalities and rare reports of myocardial infarction and sudden death further suggest the presence of an ischemic process in these patients. The recognition of accompanying coronary artery disease (CAD) and exclusion of other causes of ischemia, therefore, may be important in determining the prognosis and appropriate therapy for such patients. We performed stress ECGs and perfusion scintigrams in 25 patients with confirmed MVP who underwent cardiac catheterization for evaluation of chest pain. Stress ECGs were not helpful in diagnosing assosiated CAD, primarily because of a high incidence (53%, 10/19) of false positive tests, and had only a 48% overall accuracy. Scintigraphy was more accurate (p < 0.001), correctly classifying all patients. Scintigraphy was uniformly negative in patients with normal coronary arteriograms, suggesting that ischemia, if present as the cause of chest pain and ECG changes, must be either very localized or generalized

  9. 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. PMID:26883152

  10. Posterior repair with perforated porcine dermal graft

    Directory of Open Access Journals (Sweden)

    G. Bernard Taylor

    2008-02-01

    Full Text Available OBJECTIVE: To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared. MATERIALS AND METHODS: This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (PelvicolTM CR Bard Covington, GA USA. The incidence of postoperative vaginal incision separation (dehiscence was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. RESULTS: Seventeen percent of patients (21/127 who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71 of patients who received perforated grafts (p = 0.078. Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively. There was no difference in the flexibility of the two grafts (p = 0.20. CONCLUSION: Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

  11. Studies on porcine pancreatic elastase activity, 1

    International Nuclear Information System (INIS)

    An improved method of radioimmunoassay was devised to offer a successful formula for determining blood concentration of elastase. With porcine pancreatic elastase as the antigen, rabbits were immunized to obtain antiserum. Iodinated elastase labeled by the chloramine-T procedure using 131I (or 125I) had a specific activity of 200 - 300 mCi/mg. The double antibody method was used for BF separation. While the usual method of radioimmunoassay was not always successful in obtaining accurate serum concentration of elastase, the use of diisopropyl fluorophosphate (DFP) was able to eliminate the disturbing influence of intra-serous inhibitors, α1-AT and α2-M, eventually producing satisfactory results. With the use of DFP, the elastase standard curve and the porcine serum dilution curve had a statistically significant correlation; precision and recovery were both satisfactory; cross-reactivity of the antiserum with trypsin and chymotrypsin was less than 0.001%. The minimal detectable concentration of elastase was 5 ng/ml, and the range of normal fasting porcine serum level was 70 - 100 ng/ml. (author)

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

    DEFF Research Database (Denmark)

    McNair, I.; Marshall, M.; McNeilly, F.; Bøtner, Anette; Ladekjær-Mikkelsen, A.S.; Vincent, I.; Herrmann, Brigitte; Sanchez, R.; Rhodes, C.

    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 assay...... (IPMA), and to determine the titer of each serum. Results from all centers were then compiled and correlated. They demonstrate a wide variation in the titers obtained between laboratories. These differences were dependent on the assay used and the choice of fixative. In general, IPMA gave higher titers...

  13. Differential expression of micrornas in porcine parvovirus infected porcine cell line

    OpenAIRE

    Li, Xinqiong; Zhu, Ling; Liu, Xiao; Sun, Xiangang; Zhou, Yuanchen; Lang, Qiaoli; Li, Ping; Cai, Yuhan; Qiao, Xiaogai; XU, ZHIWEN

    2015-01-01

    Background Porcine parvovirus (PPV), a member of the Parvoviridae family, causes great economic loss in the swine industry worldwide. MicroRNAs (miRNAs) are a class of non-protein–coding genes that play many diverse and complex roles in viral infections. Finding Aiming to determine the impact of PPV infections on the cellular miRNAome, we used high-throughput sequencing to sequence two miRNA libraries prepared from porcine kidney 15 (PK-15) cells under normal conditions and during PPV infecti...

  14. Genetic Characterization of Porcine Circovirus Type 2 from Pigs with Porcine Circovirus Associated Diseases in Argentina

    OpenAIRE

    Pereda, Ariel; Piñeyro, Pablo; Bratanich, Ana; Quiroga, María Alejandra; Bucafusco, Danilo; Craig, María Isabel; Cappuccio, Javier; Machuca, Mariana; Rimondi, Agustina; Dibárbora, Marina; Sanguinetti, Hector Ramón; Perfumo, Carlos Juan

    2011-01-01

    Porcine circovirus type 2 (PCV-2) has been associated with syndromes grouped by the term porcine circovirus associated diseases (PCVAD). The PCV-2 isolates have been grouped into two major groups or genotypes according to their nucleotide sequence of whole genomes and/or ORF-2: PCV-2b, which have, in turn, been subdivided into three clusters (1A–1C), and PCV-2a, which has been subdivided into five clusters (2A–2E). In the present study, we obtained 16 sequences of PCV-2 from different farms f...

  15. Response to the argument on the risk of cancer with chest CT screening. Is low-dose chest CT safe?

    International Nuclear Information System (INIS)

    The steady increase in the annual number of chest CT screening has become a worldwide concern because of its associated risk of lung cancer. Epidemiological studies, however, have shown that repeated exposure to low-dose radiation does not increase the risk of lung cancer. In addition, a recent randomized controlled study on chest CT screening has shown its usefulness for reducing lung cancer mortality. We reviewed the risk of lung cancer after repeated exposure to low-dose radiation, the efficacy of chest CT screening, and device technology for reducing the irradiation dose. (author)

  16. Chest trauma: A case for single lung ventilation

    Directory of Open Access Journals (Sweden)

    Nagaraj Pandharikar

    2016-01-01

    Full Text Available Chest trauma is one of the important causes of mortality and morbidity in pediatric trauma patients. The complexity, magnitude, and type of lung injury make it extremely challenging to provide optimal oxygenation and ventilation while protecting the lung from further injury due to mechanical ventilation. Independent lung ventilation is used sporadically in these patients who do not respond to these conventional ventilatory strategies using double-lumen endotracheal tubes, bronchial blocker balloons, etc. However, this equipment may not be easily available in developing countries, especially for pediatric patients. Here, we present a case of severe chest trauma with pulmonary contusion, flail chest, and bronchopleural fistula, who did not respond to conventional lung protective strategies. She was successfully managed with bronchoscopy-guided unilateral placement of conventional endotracheal tube followed by single lung ventilation leading to resolution of a chest injury.

  17. Evaluation of different imaging chains in clinical chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Manninen, H.; Terho, E.O.; Wiljasalo, M.; Wiljasalo, S.; Soimakallio, S. (Kuopio Central Hospital (Finland))

    1984-11-01

    Six imaging techniques in clinical chest radiography have been evaluated: four film-screen combinations in the conventional grid technique and two combinations in the air gap technique. Five parameters characterising the quality of a chest radiograph were evaluated by three radiologists and one chest physician by using a nominal grading scale from -2 to +2 compared with the standard technique. The quality parameters judged were: the visibility of peripheral lung vessels, lung parenchyme, the pulmonary hilum, and lung structure behind the heart shadow, as well as the visibility of miscellaneous findings of clinical interest. The air gap technique was shown to be superior to the ordinary grid technique. The diagnostic quality of chest radiography does not necessarily deteriorate with the screen speed. However, statistically significant differences were noticed, even between techniques which had equal speed and physical resolution.

  18. Routine chest X-ray in the allergy clinic

    International Nuclear Information System (INIS)

    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. The chest pain center in the emergency department.

    Science.gov (United States)

    Zalenski, R J; Grzybowski, M

    2001-05-01

    Despite the improvement of medical treatment for acute coronary syndromes throughout the 20th century, the authors believe that many cases of life-threatening coronary events could be avoided through early detection of CAD and the use of preventive strategies. Establishing chest pain units that are linked to the ED is one excellent strategy to risk-stratify patients with symptoms who are at risk for sustaining an AMI or having lethal arrhythmias. There is a need for more research on chest pain units to determine the value for cost and to further optimize strategies for ACI detection and screening. In EDs with high volumes of chest pain patients, or high pressures to avoid hospital admissions, a planned, systematic, and rapid approach to the treatment of AMI and the diagnosis of chest pain is a rewarding necessity. PMID:11373990

  20. Can the Physicians or Surgions Do without Chest Radiograph?

    Directory of Open Access Journals (Sweden)

    Mehrdad Bakhshayeshkaram

    2009-01-01

    Full Text Available   "nThe question is how much information is there in chest radiographs ? "nWe can consider the approximate heart size. Rough quantification of heart failure, very basic anatomy of the heart. The chest radiograph is widely available, cheap and very low long term risk of radiation. Chest radiographs are required in the initial consultation of heart or lung diseases. Follow-up radiographs are only required in certain situations. Chest radiographs contain significant information. But nowadays we look less critically, because it is easy to order echo, CT or MRI. Examples of frequently encountered abnormalities seen in our daily practice: "n-Change in hilar size or adenopathy "n-Alteration in hilar contour "n-Bronchial wall thickening "n-Obscuration of normal hilar structures "n   

  1. Chest X ray examination of workers exposed to pneumoconiosis risk

    International Nuclear Information System (INIS)

    Chest X-ray examination of workers exposed to pneumoconiosis risk: critical analysis of legal and radiation protection aspects. Chest X-ray examination is one of the most common radiological examinations practised in Italy. According to Presidential Decree 1124/65, workers exposed to risk of asbestosis and silicosis must undergo a chest radiography once a year, on occasion of the periodic medical examination. Basic requirements aimed at the radiation protection of the patient must therefore be complied with, and optimization of the chest radiography execution procedures is required. This paper illustrates the results obtained with the implementation of the NEXT programme in Italy for this kind of X-ray examination. The main objective of the NEXT programme is the optimization of radiological techniques. On the basis of the most recent publications in the field of radiation protection, a critical analysis is made of the laws in force in Italy

  2. Endoplasmic reticulum stress in brain ischemia.

    Science.gov (United States)

    Su, Yingchao; Li, Feng

    2016-08-01

    Endoplasmic reticulum (ER) stress is an intricate mechanism that mediates numerous responses during brain ischemia, thus being essential to determine the fate of neurons. In recent years, studies of the mechanisms of brain ischemic injury have centered on ER stress, glutamate excitotoxicity, dysfunction of mitochondria, inflammatory reactions, calcium overload and death receptor pathways. The role of ER stress is highly important. In addition to resulting in neuronal cell death through calcium toxicity and apoptotic pathways, ER stress also triggers a series of adaptive responses including unfolded protein response (UPR), autophagy, the expression of pro-survival proteins and the enhancement of ER self-repair ability, leading to less ischemic brain damage. This paper provides an overview of recent advances in understanding of the relations between ER stress and brain ischemia. PMID:26289799

  3. Ischemia detection using Isoelectric Energy Function.

    Science.gov (United States)

    Kumar, Amit; Singh, Mandeep

    2016-01-01

    A novel method has been proposed for the detection of ischemia using an isoelectric energy function (IEEF) resulting from ST segment deviations in ECG signals. The method consists of five stages: pre-processing, delineation, measurement of isoelectric energy, a beat characterization algorithm and detection of ischemia. The isoelectric energy threshold is used to differentiate ischemic beats from normal beats for ischemic episode detection. Then, ischemic episodes are classified as transmural or subendocardial. The method is validated for recordings of the annotated European ST-T database (EDB). The results show 98.12% average sensitivity (SE) and 98.16% average specificity (SP). These results are significantly better than those of existing methods cited in the literature. The advantage of the proposed method includes simplicity, ruggedness and automatic discarding of noisy beats. PMID:26623944

  4. Caffeine reduces dipyridamole-induced myocardial ischemia

    International Nuclear Information System (INIS)

    The mechanism of action of coronary vasodilation after dipyridamole may be based on inhibition of cellular uptake of circulating endogenous adenosine. Since caffeine has been reported to be a competitive antagonist of adenosine we studied the effect of caffeine on the outcome of dipiridamole-201Tl cardiac imaging in one patient. During caffeine abstinence dipyridamole induced myocardial ischemia with down-slope ST depressions on the ECG, and reversible perfusion defects on the scintigrams. When the test was repeated 1 wk later on similar conditions, but now shortly after infusion of caffeine (4 mg/kg), the ECG showed nodepressions, and the scintigrams only slight signs of ischemia. We conclude that when caffeine abstinence is not sufficient, the widespread use of coffee and related products may be responsible for false-negative findings in dipyridamole-201Tl cardiac imaging

  5. Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

    Science.gov (United States)

    Qiu, Caiwei; Sheng, Bo; Wang, Shurong; Liu, Jin

    2013-08-15

    Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, followed by induction of permanent cerebral ischemia. Results demonstrated that 30- and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute lurane preconditioning additionally reduced the number of TUNEL- and caspase-3-positive cells in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings indicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis. PMID:25206521

  6. Effects of Ischemia on Lung Macrophages

    OpenAIRE

    Aigul Moldobaeva; Nico van Rooijen; Wagner, Elizabeth M.

    2011-01-01

    Angiogenesis after pulmonary ischemia is initiated by reactive O(2) species and is dependent on CXC chemokine growth factors, and its magnitude is correlated with the number of lavaged macrophages. After complete obstruction of the left pulmonary artery in mice, the left lung is isolated from the peripheral circulation until 5-7 days later, when a new systemic vasculature invades the lung parenchyma. Consequently, this model offers a unique opportunity to study the differentiation and/or prol...

  7. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  8. Cardiac tolerance to ischemia in neonatal SHR

    Czech Academy of Sciences Publication Activity Database

    Chvojková, Zuzana; Ošťádalová, Ivana; Kuneš, Jaroslav; Zicha, Josef; Ošťádal, Bohuslav

    Antalya: NATO Security Through Science, 2005. s. P9-P9. [NATO Advanced research workshop "Stress induced biochanges in the heart:From genes to bedside".. 02.02.2005-07.02.2005, Antalya] R&D Projects: GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : cardiac tolerance to ischemia * neonatal SHR * ischemic preconditioning Subject RIV: ED - Physiology

  9. Urticarial Vasculitis-Associated Intestinal Ischemia

    Directory of Open Access Journals (Sweden)

    Uni Wong

    2016-01-01

    Full Text Available Urticarial vasculitis (UV is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia.

  10. Urticarial Vasculitis-Associated Intestinal Ischemia.

    Science.gov (United States)

    Wong, Uni; Yfantis, Harris; Xie, Guofeng

    2016-01-01

    Urticarial vasculitis (UV) is a rare small vessel vasculitis. UV is often idiopathic but can also present in the context of autoimmune disorders such as systemic lupus erythematosus, drug reactions, infections, or a paraneoplastic syndrome. Extracutaneous complications include intestinal ischemic injuries, in UV patients with nonspecific gastrointestinal symptoms such as abdominal pain and nausea. Prompt recognition and treatment can minimize morbidity and mortality. This paper describes a case of urticarial vasculitis-associated intestinal ischemia. PMID:27190661

  11. Critical Limb Ischemia: Advanced Medical Therapy

    OpenAIRE

    Davies, Mark G.

    2012-01-01

    Systemic atherosclerosis and its risk factors are present in the majority of patients with critical limb ischemia. Aggressive medical therapy is an immediate and necessary part of the work-up and management of these patients and will involve a multidisciplinary approach. Risk stratification based on a patient’s current clinical cardiovascular condition is important in determining the most appropriate and safe intervention and will allow both the patient and physician to make an informed decis...

  12. Colonic urticaria pattern due to early ischemia

    International Nuclear Information System (INIS)

    The unusual radiographic pattern of bleb-like mounds on the surface of the colon mucosa, previously described as colonic urticaria, was seen in 3 patients in whom no allergic state was present. This urticaria-like pattern was due to colonic distention in all 3, and represented only submucosal edema on the gross and microscopic specimens. We hypothesize that this pattern is due to early changes of ischemia caused by colon distention. (orig.)

  13. Chest drain care bundle: Improving documentation and safety

    OpenAIRE

    Hutton, Joe; Graham, Selina

    2015-01-01

    Chest drain insertion is a common advanced procedure with a significant associated risk of pain, distress, and complications. Nationally, audit and recommendations from leading bodies have highlighted a number of safety concerns around chest drain insertion. Audit work has demonstrated poor levels of documentation; particularly around use of premedication, use of ultrasound guidance and consent. This has obvious potential consequences for patient safety and thus is an important target for imp...

  14. Chest Wall Involvement as a Manifestation of Brucellosis

    OpenAIRE

    K Rahmdel; R Golsha; Golshah, E; R Rezaie Shirazi; N Sadre Momtaz

    2011-01-01

    Brucellosis continues to be a common infectious disease in some parts of the world. Although the disease has different presentations, but chest wall involvement, as a manifestation of brucellosis is rare. In this study, we report three cases of chest wall involvement as manifesting feature of Brucellosis in Iran. They presented with a history of parasternal masses revealed to a diagnosis of Brucellosis and responded well to the treatment. Brucellosis may present with strange and unpredictable...

  15. Atypical chest pain in a rehabilitation setting: a case study

    OpenAIRE

    Oliva, Joseph S

    2001-01-01

    This case represents an individual who develops chest pain in a rehabilitation setting. It provides a description of possible assessments and investigations to screen for cardiovascular health. A thorough history and investigation can present a challenge in determining a definite diagnosis. Chiropractors who encounter patients in a rehabilitation program that develop chest pain must address the cardiac versus non-cardiac nature of the condition.

  16. Computer-aided recognition of emphysema on digital chest radiography.

    OpenAIRE

    Miniati, Massimo; Coppini, Giuseppe; Monti, Simonetta; Bottai, Matteo; Paterni, Marco; Ferdeghini, Ezio Maria

    2011-01-01

    Background Computed tomography (CT) is the benchmark for diagnosis emphysema, but is costly and imparts a substantial radiation burden to the patient. Objective To develop a computer-aided procedure that allows recognition of emphysema on digital chest radiography by using simple descriptors of the lung shape. The procedure was tested against CT. Methods Patients (N=225), who had undergone postero-anterior and lateral digital chest radiographs and CT for diagnostic purposes, were studied and ...

  17. Young Woman with a Fever and Chest Pain

    Directory of Open Access Journals (Sweden)

    Kristin H. Dwyer, MD, MPH

    2016-03-01

    Full Text Available A 26-year-old female presented to the emergency department with three days of subjective fevers, dry cough and pleuritic chest discomfort. On exam, her vital signs were significant for a heart rate of 106/minute and oxygen saturation of 95% on room air. Her lung exam revealed decreased breath sounds at the right base. A bedside lung ultrasound and a chest radiograph were performed (Figure 1a, Figure 2, and Video.

  18. Incidentally Detected Enhancing Breast Lesions on Chest Computed Tomography

    OpenAIRE

    Lin, Wen-Chiung; Hsu, Hsian-He; Li, Chao-Shiang; Yu, Jyh-Cherng; Hsu, Giu-Cheng; Yu, Cheng-Ping; Chang, Tsun-Hou; Huang, Guo-Shu

    2011-01-01

    Objective To evaluate the nature and imaging appearance of incidental enhancing breast lesions detected on a routine contrast-enhanced chest CT. Materials and Methods Twenty-three patients with incidental enhancing breast lesions on contrast-enhanced chest CT were retrospectively reviewed. The breast lesions were reviewed by unenhanced and enhanced CT, and evaluated by observing the shapes, margins, enhancement patterns and backgrounds of breast lesions. A histopathologic diagnosis or long-te...

  19. The molecular fingerprint of lung inflammation after blunt chest trauma

    OpenAIRE

    Ehrnthaller, Christian; Flierl, Michael; Perl, Mario; Denk, Stephanie; Unnewehr, Heike; Ward, Peter A.; Radermacher, Peter; Ignatius, Anita; Gebhard, Florian; Chinnaiyan, Arul; Huber-Lang, Markus

    2015-01-01

    Background After severe blunt chest trauma, the development of an acute lung injury (ALI) is often associated with severe or even lethal complications. Especially in multiple injured patients after blunt chest trauma ALI/ARDS [acute respiratory distress syndrome (ARDS)] is frequent. However, in the initial posttraumatic phase, inflammatory clinical signs are often not apparent and underlying changes in gene-expression profile are unknown. Methods Therefore, inflammation in lung tissue followi...

  20. Cost effectiveness of chest pain unit care in the NHS

    OpenAIRE

    Oluboyede, Yemi; Goodacre, Steve; Wailoo, Allan; ,

    2008-01-01

    Background Acute chest pain is responsible for approximately 700,000 patient attendances per year at emergency departments in England and Wales. A single centre study of selected patients suggested that chest pain unit (CPU) care could be less costly and more effective than routine care for these patients, although a more recent multi-centre study cast doubt on the generalisability of these findings. Methods Our economic evaluation involved modelling data from the ESCAPE multi-centre trial al...

  1. Quick identification of acute chest pain patients study (QICS

    Directory of Open Access Journals (Sweden)

    van der Horst Iwan CC

    2009-06-01

    Full Text Available Abstract Background Patients with acute chest pain are often referred to the emergency ward and extensively investigated. Investigations are costly and could induce unnecessary complications, especially with invasive diagnostics. Nevertheless, chest pain patients have high mortalities. Fast identification of high-risk patients is crucial. Therefore several strategies have been developed including specific symptoms, signs, laboratory measurements, and imaging. Methods/Design The Quick Identification of acute Chest pain Study (QICS will investigate whether a combined use of specific symptoms and signs, electrocardiography, routine and new laboratory measures, adjunctive imaging including electron beam (EBT computed tomography (CT and contrast multislice CT (MSCT will have a high diagnostic yield for patients with acute chest pain. All patients will be investigated according a standardized protocol in the Emergency Department. Serum and plasma will be frozen for future analysis for a wide range of biomarkers at a later time point. The primary endpoint is the safe recognition of low-risk chest pain patients directly at presentation. Secondary endpoint is the identification of a wide range of sensitive predictive clinical markers, chemical biomarkers and radiological markers in acute chest pain patients. Chemical biomarkers will be compared to quantitative CT measurements of coronary atherosclerosis as a surrogate endpoint. Chemical biomarkers will also be compared in head to head comparison and for their additional value. Discussion This will be a very extensive investigation of a wide range of risk predictors in acute chest pain patients. New reliable fast and cheap diagnostic algorithm resulting from the test results might improve chest pain patients' prognosis, and reduce unnecessary costs and diagnostic complications.

  2. Pleuritic Chest Pain; Where Should We Search for?

    Directory of Open Access Journals (Sweden)

    Mohammad-Hassan Moradinejad

    2011-12-01

    Full Text Available Pleuritic pain is not an unusual problem in children. Other concomitant symptoms should be considered for diagnostic approach in a child with pleuritic chest pain. In this report we discuss chest pain in a 6-year-old child with regard to other signs and symptoms. Finally, we found a rare life-threatening complication of juvenile systemic lupus erythematosus (JSLE in our patient.

  3. Classification of chronic obstructive pulmonary disease based on chest radiography

    OpenAIRE

    Leilane Marcos; Gerson Linck Bichinho; Emmanuel Alvarenga Panizzi; Keidy Karla Goncalves Storino; Davi Carpintero Pinto

    2013-01-01

    Objective Quantitative analysis of chest radiographs of patients with and without chronic obstructive pulmonary disease (COPD) determining if the data obtained from such radiographic images could classify such individuals according to the presence or absence of disease. Materials and Methods For such a purpose, three groups of chest radiographic images were utilized, namely: group 1, including 25 individuals with COPD; group 2, including 27 individuals without COPD; and group 3 (utilized fo...

  4. Monsters do exist: an unusual case of chest pain

    OpenAIRE

    Thomas, Mari Lluon

    2014-01-01

    A 19-year-old man presented to the emergency department with a 3-week history of chest pain. Despite normal examination, bloods and observations of his chest X-ray revealed a large opacity in the middle and lower right zone. Further imaging revealed a multicystic mediastinal teratoma. He was admitted under the respiratory physicians who arranged further investigations and discussed his case with the lung and testicular multidisciplinary team. He was started on neoadjuvant chemotherapy with a ...

  5. Histiocytic disorders of the chest: imaging findings.

    Science.gov (United States)

    Ahuja, Jitesh; Kanne, Jeffrey P; Meyer, Cristopher A; Pipavath, Sudhakar N J; Schmidt, Rodney A; Swanson, Jonathan O; Godwin, J David

    2015-01-01

    Histiocytic disorders of the chest comprise a broad spectrum of diseases. The lungs may be involved in isolation or as part of systemic disease. Some of these disorders are primary and have unknown etiology, and others result from a histiocytic response to a known cause. Among primary histiocytic disorders, pulmonary Langerhans cell histiocytosis (PLCH) is the most common; others include Erdheim-Chester disease and Rosai-Dorfman disease. Adult PLCH occurs almost exclusively in adults aged 20-40 years who smoke. Pediatric PLCH is extremely rare and typically occurs as part of multisystemic disease. Erdheim-Chester disease affects middle-aged and older adults; thoracic involvement usually occurs as part of systemic disease. Rosai-Dorfman disease affects children and young adults and manifests as painless cervical lymphadenopathy. Examples of secondary histiocytic disorders are storage diseases such as Gaucher disease, Niemann-Pick disease, and Fabry disease; pneumoconiosis such as silicosis and coal workers' pneumoconiosis; and infections such as Whipple disease and malakoplakia. These disorders are characterized at histopathologic examination on the basis of infiltration of alveoli or the pulmonary interstitium by histiocytes, which are a group of cells that includes macrophages and dendritic cells. Dendritic cells are a heterogeneous group of nonphagocytic antigen-presenting immune cells. Immunohistochemical markers help to distinguish among various primary histiocytic disorders. Characteristic radiologic findings in the appropriate clinical context may obviate biopsy to establish a correct diagnosis. However, in the absence of these findings, integration of clinical, pathologic, and radiologic features is required to establish a diagnosis. PMID:25763722

  6. Tribulosin protects rat hearts from ischemia/reperfusion injury

    OpenAIRE

    Zhang, Shuang; Li, Hong; Yang, Shi-Jie

    2010-01-01

    Aim: To investigate the protective effect of tribulosin, a monomer of the gross saponins from Tribulus terrestris, against cardiac ischemia/reperfusion injury and the underlying mechanism in rats. Methods: Isolated rat hearts were subjected to 30 min of ischemia followed by 120 min of reperfusion using Langendorff's technique. The hearts were assigned to seven groups: control, ischemia/reperfusion (I/R), treatment with gross saponins from Tribulus terrestris (GSTT) 100 mg/L, treatment with tr...

  7. 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.

  8. Modulation of cardiac metabolism during myocardial ischemia.

    Science.gov (United States)

    Chagas, Antonio C P; Dourado, Paulo M M; Galvão, Tatiana de Fátima Gonçalves

    2008-01-01

    Metabolic modulation during myocardial ischemia is possible by the use of specific drugs, which may induce a shift from free fatty acid towards predominantly glucose utilization by the myocardium to increase ATP generation per unit oxygen consumption. Three agents (trimetazidine, ranolazine, and perhexiline) have well-documented anti-ischaemic effects. However, perhexiline, the most potent agent currently available, requires plasma-level monitoring to avoid hepato-neuro-toxicity. Besides, the long-term safety of trimetazidine and ranolazine has yet to be established. In addition to their effect in ischemia, the potential use of these drugs in chronic heart failure is gaining recognition as clinical and experimental data are showing the improvement of myocardial function following treatment with several of them, even in the absence of ischemia. Future applications for this line of treatment is promising and deserves additional research. In particular, large, randomised, controlled trials investigating the effects of these agents on mortality and hospitalization rates due to coronary artery disease are needed. PMID:18991673

  9. Multiple molecular penumbras after focal cerebral ischemia.

    Science.gov (United States)

    Sharp, F R; Lu, A; Tang, Y; Millhorn, D E

    2000-07-01

    Though the ischemic penumbra has been classically described on the basis of blood flow and physiologic parameters, a variety of ischemic penumbras can be described in molecular terms. Apoptosis-related genes induced after focal ischemia may contribute to cell death in the core and the selective cell death adjacent to an infarct. The HSP70 heat shock protein is induced in glia at the edges of an infarct and in neurons often at some distance from the infarct. HSP70 proteins are induced in cells in response to denatured proteins that occur as a result of temporary energy failure. Hypoxia-inducible factor (HIF) is also induced after focal ischemia in regions that can extend beyond the HSP70 induction. The region of HIF induction is proposed to represent the areas of decreased cerebral blood flow and decreased oxygen delivery. Immediate early genes are induced in cortex, hippocampus, thalamus, and other brain regions. These distant changes in gene expression occur because of ischemia-induced spreading depression or depolarization and could contribute to plastic changes in brain after stroke. PMID:10908035

  10. The effect of vaccination against Porcine reproductive and respiratory syndrome virus (PRRSV) on the Porcine circovirus-2 (PCV-2) load in porcine circovirus associated disease (PCVAD) affected pigs

    OpenAIRE

    Genzow, Marika; Schwartz, Kent; Gonzalez, Glenda; Anderson, Gail; Chittick, Wayne

    2009-01-01

    A diagnostic project was initiated across the United States in 2006 to improve the understanding of porcine circovirus associated diseases (PCVAD) as well as to identify co-factors in PCVAD-affected farms. A Porcine circovirus-2 (PCV-2) DNA real-time polymerase chain reaction quantitation (qPCR) was established according to a published method and sera from a total of 23pig farms across the United States were examined for viral loads for PCV-2 and analyzed for any possible effects of Porcine r...

  11. Porcine skin as human body phantom at 60 GHz

    OpenAIRE

    Petrillo, Luca; Mavridis, Theodoros; De Doncker, Philippe; Sarrazin, Julien; Benlarbi-Delai, Aziz

    2015-01-01

    This communication presents the results of an experimental campaign carried out at 60 GHz to demonstrate that porcine skin can be used at 60 GHz as a phantom for the human body. Norton formulations above a flat human body are verified using porcine skin.

  12. Changes in enzyme activities of porcine erythrocytes exposed to radiation

    International Nuclear Information System (INIS)

    Changes in activities of superoxide dismutase, catalase, peroxidase and acetylcholinesterase were observed in porcine erythrocytes for doses of 5 - 30 kGy. These enzymes are capable of performing their functions also in irradiated porcine erythrocytes, which seem to be more radioresistant in this respect than bovine erythrocytes investigated previously. (author)

  13. Porcine artery elastin preparation reduces serum cholesterol level in rats

    OpenAIRE

    Liyanage, Ruvini; Nakamura, Yumi; Shimada, Ken-ichiro; SEKIKAWA, Mitsuo; Jayawardana, Barana Chaminda; HAN, Kyu-Ho; Tomoko, Okada; Ohba, Kiyoshi; Takahata, Yoshihisa; Morimatsu, Fumiki; FUKUSHIMA, Michihiro; 福島, 道広; 島田, 謙一郎; 関川, 三男; 韓, 圭鎬

    2009-01-01

    The effect of porcine artery elastin on serum cholesterol level was investigated in rats fed a cholesterol-free diet. Rats were fed for 4 weeks, with a diet (ED) containing 15% casein and 5% of porcine artery elastin in comparison with a diet (CD) containing 20% casein. The total serum and non-HDL-cholesterol concentrations were lower (P

  14. Growth of cultured porcine retinal pigment epithelial cells

    DEFF Research Database (Denmark)

    Wiencke, A.K.; Kiilgaard, Jens Folke; Nicolini, Jair;

    2003-01-01

    To establish and characterize cultures of porcine retinal pigment epithelial (pRPE) cells in order to produce confluent monolayers of cells for transplantation.......To establish and characterize cultures of porcine retinal pigment epithelial (pRPE) cells in order to produce confluent monolayers of cells for transplantation....

  15. Chest wall segmentation in automated 3D breast ultrasound scans.

    Science.gov (United States)

    Tan, Tao; Platel, Bram; Mann, Ritse M; Huisman, Henkjan; Karssemeijer, Nico

    2013-12-01

    In this paper, we present an automatic method to segment the chest wall in automated 3D breast ultrasound images. Determining the location of the chest wall in automated 3D breast ultrasound images is necessary in computer-aided detection systems to remove automatically detected cancer candidates beyond the chest wall and it can be of great help for inter- and intra-modal image registration. We show that the visible part of the chest wall in an automated 3D breast ultrasound image can be accurately modeled by a cylinder. We fit the surface of our cylinder model to a set of automatically detected rib-surface points. The detection of the rib-surface points is done by a classifier using features representing local image intensity patterns and presence of rib shadows. Due to attenuation of the ultrasound signal, a clear shadow is visible behind the ribs. Evaluation of our segmentation method is done by computing the distance of manually annotated rib points to the surface of the automatically detected chest wall. We examined the performance on images obtained with the two most common 3D breast ultrasound devices in the market. In a dataset of 142 images, the average mean distance of the annotated points to the segmented chest wall was 5.59 ± 3.08 mm. PMID:23273891

  16. Chest X ray effective doses estimation in computed radiography

    International Nuclear Information System (INIS)

    Conventional chest radiography is technically difficult because of wide in tissue attenuations in the chest and limitations of screen-film systems. Computed radiography (CR) offers a different approach utilizing a photostimulable phosphor. photostimulable phosphors overcome some image quality limitations of chest imaging. The objective of this study was to estimate the effective dose in computed radiography at three hospitals in Khartoum. This study has been conducted in radiography departments in three centres Advanced Diagnostic Center, Nilain Diagnostic Center, Modern Diagnostic Center. The entrance surface dose (ESD) measurement was conducted for quality control of x-ray machines and survey of operators experimental techniques. The ESDs were measured by UNFORS dosimeter and mathematical equations to estimate patient doses during chest X rays. A total of 120 patients were examined in three centres, among them 62 were males and 58 were females. The overall mean and range of patient dosed was 0.073±0.037 (0.014-0.16) mGy per procedure while the effective dose was 3.4±01.7 (0.6-7.0) mSv per procedure. This study compared radiation doses to patients radiographic examinations of chest using computed radiology. The radiation dose was measured in three centres in Khartoum- Sudan. The results of the measured effective dose showed that the dose in chest radiography was lower in computed radiography compared to previous studies.(Author)

  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. Ex-vivo injection technique for implanting solid pulmonary nodules into porcine lungs for multi-slice CT

    International Nuclear Information System (INIS)

    Purpose: To develop a method for generating realistic pulmonary nodules that equal small pulmonary metastases and granulomas. Materials and Methods: A total of 70 artificial lesions were introduced into 5 inflated porcine lungs inside a dedicated chest phantom by high pressure injection of a fat-wax-Lipiodol mixture and scanned with 16-slice computed tomography (CT). Image evaluation by two experienced radiologists included analysis of morphology, nodule size and density. Results: The median nodule density was 78.8 Hounsfield units (HU), with 54 of 70 nodules (77.14%) judged typical of small lung metastases. Conclusion: Without inducing visible damage of lung parenchyma, the injection technique produces highly realistic pulmonary nodules for morphometry or nodule detection with CT. (orig.)

  19. Adult midgut malrotation presented with acute bowel obstruction and ischemia

    Directory of Open Access Journals (Sweden)

    Akile Zengin

    2016-01-01

    Conclusion: Malrotation should be considered in differential diagnosis in patients presented with acute abdomen and intestinal ischemia. Surgical intervention should be prompt to limit morbidity and mortality.

  20. Inhibition of Porcine Small Intestinal Sucrase by Validamine

    Institute of Scientific and Technical Information of China (English)

    郑裕国; 申屠旭萍; 沈寅初

    2005-01-01

    As an important medicinal intermediate with broad uses, validamine, an aminocyclitol, isolated from the enzymolysis broth of validamycins, has gained more and more attention. The absolute configuration of validamine is similar to that of α-D-glucose, and it demonstrates powerful inhibition activity on glycosidase. In this paper, the inhibitory effect of validamine on porcine small intestinal sucrase was investigated. Validamine was found to be a potent, competitive inhibitor to porcine small intestinal sucrase in vitro with an IC50 value of 6.85 × 10-4 mol·L-1. Validamine exhibited a dose-dependent inhibition effect on porcine small intestinal sucrase, whereby the inhibition interaction of validamine and porcine small intestinal sucrase was a fast binding process. The inhibition of validamine on porcine small intestinal sucrase was pH-dependent.

  1. Ineffective Ventilation During Conscious Sedation Due to Chest Wall Rigidity After Intravenous Midazolam and Fentanyl

    OpenAIRE

    Ackerman, William E.; Phero, James C; Theodore, Gregg T.

    1990-01-01

    Chest wall rigidity has been reported after the administration of high-dose intravenous fentanyl. This case report supports the observation that low-dose intravenous fentanyl may also cause chest wall rigidity. The treatment of chest wall rigidity with naloxone or neuromuscular blocking agents is controversial. A discussion of the management of fentanyl-induced chest wall rigidity is presented.

  2. Synthesis of biologically active porcine secretin and [ITyr10] porcine secretin

    DEFF Research Database (Denmark)

    Kofod, Hans

    1991-01-01

    Porcine secretin, [Tyr10] secretin, and [Tyr13] secretin were synthesized by solid phase methodology and purified by stepwise gradient elution from a short reversed-phase column with ethanol and acetic acid as organic modifiers. [Tyr10] secretin and [Tyr13] secretin were iodinated by the chloramine...

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

    International Nuclear Information System (INIS)

    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.

  4. Chest radiograph usefulness in the diagnosis of acute aortic dissection

    Institute of Scientific and Technical Information of China (English)

    Nancy Welch; Chat Dang; Carlton Allen; Robert Cook

    2005-01-01

    Objective To assess the diagnostic value of chest radiographs in patients presenting to a busy inner-city Emergency Department with subsequently proven acute aortic dissection. Methods A retrospective review of initial chest radiographs and charts of patients with the confirmed diagnosis of acute aortic dissection was done for a period of 5 years from 1998 to 2003. A comparison was made between the initial readings of chest radiographs prior to confirmation of the aortic dissection, and a retrospective review of the same radiographs by two board-certified radiologists with special attention to the classic findings of acute aortic dissection identifiable on plain films. Results The charts of nine patients (four men, five women) with proven acute aortic dissection were reviewed. All nine patients were suspected of having acute aortic dissection based on presenting history and symptoms of chest pain (66% ), migratory pain (89% ), back pain (89% ), and the abruptness of onset of pain (89% ). Initial plain portable chest X-rays were obtained in the Emergency Department in all nine patients. Six of nine (67%) radiographs were read as normal, while three (33%) demonstrated a widened mediastinum (> 8.0cm), two (22%) showed an abnormal aortic contour, with one ( 11% ) displaying an apical cap. Confirmation of the diagnosis was obtained with either a spiral CT angiogram or transesophageal echocardiography (TEE). All nine plain radiographs were retrospectively reviewed by two board-certified radiologists aware of the diagnosis of acute dissection without a change in the readings. Conclusions Plain portable chest radiographs are of limited usefulness for the screening of acute aortic dissection. Further radiologic evaluation should be dictated by the clinical presentation and an awareness of the low sensitivity of portable chest X- rays.

  5. Dose and perceived image quality in chest radiography

    International Nuclear Information System (INIS)

    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.

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

    International Nuclear Information System (INIS)

    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.)

  7. 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.)

  8. 31P-nuclear magnetic resonance studies of chronic myocardial ischemia in the Yucatan micropig.

    Science.gov (United States)

    Rath, D P; Bailey, M; Zhang, H; Jiang, Z; Abduljalil, A M; Weisbrode, S; Hamlin, R L; Robitaille, P M

    1995-01-01

    In this work, an x-irradiation/high fat/high cholesterol diet-induced atherogenic model was invoked to examine the effects of severe diffuse atherosclerosis on myocardial metabolism in the in vivo porcine heart. This model was studied using spatially localized 31P-nuclear magnetic resonance (NMR) to monitor pH and the levels of inorganic phosphate, phosphomonoesters, creatine phosphate, and adenosine triphosphate as a function of workload transmurally in control swine and in animals suffering from chronic ischemic heart disease. These preliminary studies revealed that the development of severe atherosclerosis and the accompanying chronically diseased state produce changes in high energy phosphates and that increases in rate pressure products result in demonstrable signs of ischemia in the myocardium which span the entire left ventricular wall. Ischemic changes include a global increase in inorganic phosphate and corresponding decreases in creatine phosphate, ATP, and pH. Importantly, changes in intracellular pH are noted with even the slightest increase in workload suggesting that these diseased hearts display elevated glycolytic activity. By challenging these animals with increased cardiac workload, we directly visualize how the chronically compromised heart responds to severe oxygen challenges in a clinically relevant model of this situation. PMID:7814609

  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)

    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. Hypothermia ameliorates gastrointestinal ischemic injury sustained in a porcine cardiac arrest model

    Institute of Scientific and Technical Information of China (English)

    LU Yi; WANG Shuo; LI Chun-sheng

    2012-01-01

    Background During cardiac arrest,the gastrointestinal tract is sensitive to ischemia.Protection of the gastrointestinal tract is a critical factor in determining prognosis following cardiopulmonary resuscitation (CPR).This study seeks to determine the extent of gastrointestinal tract injury and the potential protective effect of inducing hypothermia following a porcine cardiac arrest model and CPR.Methods Ventricular fibrillation was induced by programmed electrical stimulation in 16 male domestic pigs (n=8 per group).Four minutes after ventricular fibrillation,CPR was performed.Pigs that successfully restored spontaneous circulation then received intravenous infusions of saline at either 4C or room temperature to produce hypothermic and control conditions respectively.Serum diamine oxidase and gastrointestinal adenosine triphosphate enzyme activity were determined and histopathology of the gastrointestinal tract was performed by light microscopy and electron microscopy.Results Significant injury of the gastrointestinal tract after CPR was found.Na+-K+ and Ca2+ adenosine triphosphate enzyme activity in the gastric tissue were significantly high in animals receiving hypothermia treatment compared to controls.Hypothermia also significantly reduced serum diamine oxidase after CPR compared to the control group.Moreover,severe injury sustained by the gastrointestinal tissue was significantly ameliorated under hypothermic conditions compared to controls.Conclusions Gastrointestinal injury and abnormal energy metabolism are strikingly evident following CPR.Hypothermia,which is induced by an infusion of 4C saline,can rapidly reduce internal body temperature,improve energy metabolism,and ameliorate injury to the gastrointestinal mucosa after CPR.

  11. Massive chest wall resection and reconstruction for malignant disease

    Science.gov (United States)

    Foroulis, Christophoros N; Kleontas, Athanassios D; Tagarakis, George; Nana, Chryssoula; Alexiou, Ioannis; Grosomanidis, Vasilis; Tossios, Paschalis; Papadaki, Elena; Kioumis, Ioannis; Baka, Sofia; Zarogoulidis, Paul; Anastasiadis, Kyriakos

    2016-01-01

    Objective Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes. Methods Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males) was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted. Results The median maximum diameter of tumors was 10 cm (5.4–32 cm). Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2). Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%), most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh) in nine cases of large anterior defects or by using a 2 mm polytetrafluoroethylene (e-PTFE) mesh in nine cases of lateral or posterior defects. Support from a plastic surgeon was necessary to cover the full-thickness chest wall defects in seven cases. Adjuvant oncologic treatment was administered in 13 patients. Local recurrences were observed in five cases where surgical reintervention was finally necessary in two cases. Recurrences were associated with larger tumors, histology of malignant fibrous histiocytoma, and initial incomplete resection or misdiagnosis made by nonthoracic surgeons. Three patients died

  12. Differential diagnosis of solitary pulmonary nodule : chest radiography vs CT

    International Nuclear Information System (INIS)

    The purpose of this study was to compare the diagnostic accuracies of chest radiographs and chest CT in the diagnosis of a solitary pulmonary nodule(SPN), and to determine the role of CT and CT findings which aid in the differential diagnosis of nodules. A retrospective study was done on 54 patients in whom SPN was found on chest radiographs and chest CT was carried out. The study involved 25 benign and 29 malignant nodules, confirmed histopathologically and clinically. Chest radiographs and CT scans were reviewed separately in randomized order by two chest radiologists who for each film listed the three most likely diagnoses in descending order. The radiologists recorded the confidence value of the most probable diagnosis, and also the marginal and internal characteristics of nodules and their size, as nodules seen on chest CT scans. Diagnostic rates in the differential diagnosis of benign and malignant nodules were 65.7% by radiography and 77.8% by CT. Correct first-choice diagnosis was by radiography in 30.6% of cases, and by CT in 41.7%. Using radiographs, and the correct diagnosis was among the top-three choices in 61.1% of cases;with CT, the corresponding figure was 76.8%. Overall, a confident diagnosis was reached more often with the CT(41.7%) than with the chest radiograph(21.4%); diagnostic accuracy was 60.0% and 52.2%, respectively. CT findings which imply a benign nodule include smooth margins and diffuse internal calcifications, whereas marginal lobulations, air-bronchograms, internal low density without cavitation, eccentric calcifications, and large size suggest malignancy. We found that CT findings such as well-defined margins, spiculations, pleural tail or internal homogeneity did not contribute in the differentiation between benign and malignant nodules. CT is superior to chest radiography in the differential diagnosis of the solitary pulmonary nodule. Using CT, diagnosis was accurate and made with a high level of confidence, especially with the

  13. 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.

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

    International Nuclear Information System (INIS)

    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

  15. Silent myocardial ischemia evaluated by ambulatory left ventricular function monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Kamon; Yumikura, Sei; Araki, Yasushi; Ando, Tatsuo; Saito, Satoshi; Ozawa, Yukio; Hatano, Michinobu; Kamata, Rikisaburo (Nihon Univ., Tokyo (Japan). School of Medicine)

    1989-12-01

    To determine whether left ventricular function is less disturbed in asymptomatic ischemia than in symptomatic ischemia, exercise-induced left ventricular function was measured in beat-to-beat using an ambulatory left ventricular function monitoring system. The study subjects were 22 patients with coronary artery disease. Supine and sitting ergometer exercise tests were performed. Of 44 exercise tests, 33 showed significant ST depression on electro-cardiograms. Among these 33, 17 were asymptomatic: 16, symptomatic. The left ventricular functions during exercise of these 33 were analyzed and compared with those of five normal controls. The changes in end-diastolic volume were not so significant either in controls or in the asymptomatic and symptomatic groups, but the changes in end-systolic volume were reversed in the diseased group, particularly in the symptomatic group. The changes in ejection fraction (EF), therefore, were significantly negative in the diseased group, particularly in the symptomatic group. The correlation between exercise-induced left ventricular dysfunction and symptoms was evaluated among the 33 patients. Symptoms were present in 35% (6/17) in <10% decrease in EF, 44% (4/9) in 10{approx}15% decrease, and 85% (6/7)in {ge}15% decrease, respectively. Thus, asymptomatic ischemia represents a lesser degree of myocardial ischemia as indicated by mild left ventricular dysfunction, compared with symptomatic ischemia. However, some cases of severe myocardial ischemia did not develop symptoms. We concluded that silent myocardial ischemia is responsible for a lesser degree of myocardial ischemia and decreased pain perception. (author).

  16. Review on herbal medicine on brain ischemia and reperfusion

    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.

  17. Ergotamine-Induced Upper Extremity Ischemia: A Case Report

    OpenAIRE

    Kim, Man Deuk; Lee, Gun; Shin, Sung Wook

    2005-01-01

    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.

  18. 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.

  19. Chest physiotherapy in children with acute bacterial pneumonia

    Directory of Open Access Journals (Sweden)

    Lieselotte Corten

    2015-04-01

    Full Text Available Background: Pneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.Objective: The present review aimed to determine the efficacy of different chest physiotherapy techniques compared with no physiotherapy or other chest physiotherapy treatments in hospitalised children with bacterial pneumonia.Method: Six electronic databases (PubMed, Medline, Cochrane Library, PEDro, CINAHL and Africa-wide information, clinicaltrials.gov and pactr.org were searched for eligible studies.Results: Two randomised controlled trials and one ongoing study were identified. Neither completed trial reported differences between the control and intervention groups, although one study reported a longer duration of coughing (p = 0.04 and rhonchi (p = 0.03 in the intervention group.Conclusion: Because of the limited number of included articles and different presentations of outcome measures, we could not reject or accept chest physiotherapy as either an effective or harmful treatment option in this population.

  20. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    International Nuclear Information System (INIS)

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  1. Computer-aided recognition of emphysema on digital chest radiography

    International Nuclear Information System (INIS)

    Background: Computed tomography (CT) is the benchmark for diagnosis emphysema, but is costly and imparts a substantial radiation burden to the patient. Objective: To develop a computer-aided procedure that allows recognition of emphysema on digital chest radiography by using simple descriptors of the lung shape. The procedure was tested against CT. Methods: Patients (N = 225), who had undergone postero-anterior and lateral digital chest radiographs and CT for diagnostic purposes, were studied and divided in a derivation (N = 118) and in a validation sample (N = 107). CT images were scored for emphysema using the picture-grading method. Simple descriptors that measure the bending characteristics of the lung profile on chest radiography were automatically extracted from the derivation sample, and applied to train a neural network to assign a probability of emphysema between 0 and 1. The diagnostic performance of the procedure was described by the area under the receiver operating characteristic curve (AUC). Results: AUC was 0.985 (95% confidence interval, 0.965-0.998) in the derivation sample, and 0.975 (95% confidence interval, 0.936-0.998) in the validation sample. At a probability cutpoint of 0.55, the procedure yielded 92% sensitivity and 96% specificity in the derivation sample; 90% sensitivity and 97% specificity in the validation sample. False negatives on chest radiography had trace or mild emphysema on CT. Conclusions: The computer-aided procedure is simple and inexpensive, and permits quick recognition of emphysema on digital chest radiographs.

  2. Computer-aided recognition of emphysema on digital chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Miniati, Massimo, E-mail: Massimo.Miniati@unifi.it [Department of Medical and Surgical Critical Care, University of Florence, 50134 Florence (Italy); Coppini, Giuseppe; Monti, Simonetta [Institute of Clinical Physiology, National Research Council, 56124 Pisa (Italy); Bottai, Matteo [Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm (Sweden); Division of Biostatistics, Arnold School of Public Health, University of South Carolina, 29208 Columbia, SC (United States); Paterni, Marco; Ferdeghini, Ezio Maria [Institute of Clinical Physiology, National Research Council, 56124 Pisa (Italy)

    2011-11-15

    Background: Computed tomography (CT) is the benchmark for diagnosis emphysema, but is costly and imparts a substantial radiation burden to the patient. Objective: To develop a computer-aided procedure that allows recognition of emphysema on digital chest radiography by using simple descriptors of the lung shape. The procedure was tested against CT. Methods: Patients (N = 225), who had undergone postero-anterior and lateral digital chest radiographs and CT for diagnostic purposes, were studied and divided in a derivation (N = 118) and in a validation sample (N = 107). CT images were scored for emphysema using the picture-grading method. Simple descriptors that measure the bending characteristics of the lung profile on chest radiography were automatically extracted from the derivation sample, and applied to train a neural network to assign a probability of emphysema between 0 and 1. The diagnostic performance of the procedure was described by the area under the receiver operating characteristic curve (AUC). Results: AUC was 0.985 (95% confidence interval, 0.965-0.998) in the derivation sample, and 0.975 (95% confidence interval, 0.936-0.998) in the validation sample. At a probability cutpoint of 0.55, the procedure yielded 92% sensitivity and 96% specificity in the derivation sample; 90% sensitivity and 97% specificity in the validation sample. False negatives on chest radiography had trace or mild emphysema on CT. Conclusions: The computer-aided procedure is simple and inexpensive, and permits quick recognition of emphysema on digital chest radiographs.

  3. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  4. 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

  5. Magnetic resonance imaging of experimental cerebral ischemia

    International Nuclear Information System (INIS)

    In the spectroscopic experiment on excised rat brain (cortex, white matter, hippocampus and thalamus for normal and ischemia-laden brain), T1 and T2 relaxation times and water content were determined. The ischemic insult was induced for 60 min by the method of Pulsinelli followed by 60 min of reperfusion. All of the T1, T2, and water content significantly increased in the ischemic tissue. Gray-white difference was evident in T1 and T1 was linearly correlated with the water content of the tissue. T2 way by far prolonged in the ischemic tissue compared with the increase in the water content, showing greater sensitivity of T2 for detection of ischemia. In the imaging experiment, coronal NMR imaging at 0.5 tesla was performed employing proton density-weighted saturation recovery (TR = 1.6 s, TE = 14 ms), T1-weighted inversion recovery (TR = 1.6 s, TI = 300 ms, TE = 14 ms) and T2-weighted spin echo (TR = 1.6 s, TE = 106 ms) pulse sequences. Spatial resolution of the images was excellent (0.3 - 0.5 mm) and the imaging of a gerbil brain clearly delineated anatomy separating cortex, white matter, hippocampus and thalamus. Hemispheric ischemia of a gerbil brain was detected as early as 30 min after occlusion of the carotid artery in T2-weighted images and the evolution of the lesion was clearly picturized in T1- and T2-weighted images. On the other hand. SR images were far less sensitive. Caluculated T1 and T2 relaxation times by the pixel-to-pixel computation indicated progress of the lesion and excellently correlated with the water content of the tissue (r = 0.892 and 0.744 for T1 and T2, respectively). (J.P.N.)

  6. Telomere reprogramming and maintenance in porcine iPS cells.

    Directory of Open Access Journals (Sweden)

    Guangzhen Ji

    Full Text Available Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells. Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  7. Transient myocardial ischemia of the newborn infant

    International Nuclear Information System (INIS)

    Ten full-term newborn infants with transient myocardial ischemia developed radiographic evidence of cardiomegaly and pulmonary venous congestion within the first few hours of life. In five patients, radiographic findings returned to normal during the first week of life. In the remaining five patients radiographic findings improved within the second week and eventually became normal. Echocardiography done on six patients demonstrated left ventricular dysfunction in all six patients. Those infants with documented perinatal insults tend to have a protracted clinical course with eventual recovery. Pathophysiology and clinical course are discussed. (orig.)

  8. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G

    2011-07-25

    Cocaine-associated thrombosis has been reported in the literature with reports of vascular injuries to cardiac, pulmonary, intestinal, placental, and musculoskeletal vessels; however, injury of the pedal vessels is rare. We report on a 31-year-old man who presented 2 months following a cocaine binge with limb-threatening ischemia without an otherwise identifiable embolic source. Angiography confirmed extensive occlusive disease of the tibioperoneal vessels. The patient improved following therapy with heparin and a prostacyclin analogue. Cocaine-induced thrombosis should be considered in patients presenting with acute arterial insufficiency in the lower limb without any other identifiable cause.

  9. Intracoronary levosimendan during ischemia prevents myocardial apoptosis.

    Directory of Open Access Journals (Sweden)

    MarkusMalmberg

    2012-02-01

    Full Text Available Background. Levosimendan is a calcium-sensitizing inotropic agent that prevents myocardial contractile depression following cardiac surgery. Levosimendan has also anti-apoptotic properties, but the role of this mechanism is not clear. We studied whether levosimendan prevents cardiomyocyte apoptosis and post-operative stunning after either intracoronary administration or intravenous infusion in an experimental model. Methods. Pigs (n=24 were subjected to 40 minutes of global, cardioplegic ischemia under cardiopulmonary bypass and 240 minutes of reperfusion. L-IV group received intravenous infusion of levosimendan (65 μg/kg 40 minutes before ischemia and L-IC group received levosimendan (65 μg/kg during ischemia administered intracoronary. Control group was operated without levosimendan. Echocardiography was performed to all animals. Apoptosis was determined from transmyocardial biopsies taken from left ventricle using TUNEL assay and immunohistochemistry of active caspace-3. Results. Apoptosis was induced after ischemia-reperfusion in all groups (pre L-IV 0.002±0.004 % vs. post L-IV 0.020±0.017 % p=0.02, pre L-IC 0.001±0.004 % vs. post L-IC 0.020±0.017 % p<0.001, pre control 0.007±0.013 % vs. post control 0.062±0.044 % p=0.01. The amount of apoptosis was higher in the controls, compared with the L-IV (p=0.03 and the L-IC (p=0.03 groups. Longitudinal left ventricular contraction was significantly reduced in the L-IC and the control groups when compared to the L-IV group (L-IV 0.75±0.12 mm vs. L-IC 0.53±0.11 mm p=0.003, L-IV vs. control 0.54±0.11 p=0.01. Conclusions. Both intracoronary administration and pre-ischemic intravenous infusion of levosimendan equally prevented apoptosis, but intravenous administration was required for optimal preservation of the post-operative systolic left ventricle function.

  10. Repeated early thrombolysis in cervical spinal cord ischemia.

    Science.gov (United States)

    Etgen, Thorleif; Höcherl, Constanze

    2016-07-01

    Specific therapy of acute spinal ischemia is not established. We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery. Three days later she developed again a severe right-sided sensorimotor hemiparesis and a second off-label intravenous thrombolysis was repeated. Magnetic resonance imaging revealed a right-sided posterior-lateral cervical spinal ischemia. Spinal ischemia may clinically present with a cerebral-stroke-like picture challenging diagnostic and therapeutic procedure. Systemic thrombolysis might be a treatment option in acute spinal ischemia. In addition, early repeated systemic thrombolysis may be considered in selected strokes. PMID:26762860

  11. Microdialysis in the assessment of regional intestinal ischemia

    DEFF Research Database (Denmark)

    Sommer, Thorbjørn

     The Ph.D.thesis “Microdialysis in the assessment of regional intestinal ischemia” is based on three scientific papers. The diagnosis of intestinal ischemia remains a diagnostic challenge, since no technique has been able to monitor the intestinal perfusion continuously with a high sensitivity and...... specificity. This thesis aimed to explore the possibility of using the microdialysis technique in the detection of regional, intestinal ischemia. A pig model was chosen and microdialysis performed during regional intestinal ischemia. In study I it was demonstrated that regional, intestinal ischemia could be...... technique. Using a 60 % cut off and excluding catheters in which technical failures were observed, a predictive value of a positive test of 1 was observed for lactate and subsequently lower values for the other metabolites measured. In study III it was demonstrated that intestinal ischemia could be detected...

  12. Nursing supports neonatal porcine testicular development.

    Science.gov (United States)

    Rahman, K M; Lovich, J E; Lam, C; Camp, M E; Wiley, A A; Bartol, F F; Bagnell, C A

    2014-07-01

    The lactocrine hypothesis suggests a mechanism whereby milk-borne bioactive factors delivered to nursing offspring affect development of neonatal tissues. The objective of this study was to assess whether nursing affects testicular development in neonatal boars as reflected by: (1) Sertoli cell number and proliferation measured by GATA-4 expression and proliferating cell nuclear antigen immunostaining patterns; (2) Leydig cell development and steroidogenic activity as reflected by insulin-like factor 3 (INSL3), and P450 side chain cleavage (scc) enzyme expression; and (3) expression of estrogen receptor-alpha (ESR1), vascular endothelial growth factor (VEGF) A, and relaxin family peptide receptor (RXFP) 1. At birth, boars were randomly assigned (n = 6-7/group) to nurse ad libitum or to be pan fed porcine milk replacer for 48 h. Testes were collected from boars at birth, before nursing and from nursed and replacer-fed boars at 50 h on postnatal day (PND) 2. Sertoli cell proliferating cell nuclear antigen labeling index increased (P relaxin family peptide receptor 1 (RXFP1) levels increased (P < 0.01) with age and were greater in replacer-fed boars on PND 2. Results suggest that nursing supports neonatal porcine testicular development and provide additional evidence for the importance of lactocrine signaling in pigs. PMID:24906933

  13. Analysis of porcine MHC expression profile

    Institute of Scientific and Technical Information of China (English)

    JIANG Fanbo; CHEN Chen; DENG Yajun; YU Jun; HU Songnian

    2005-01-01

    The porcine major histocompatibility complex (MHC, also named swine leukocyte antigen, SLA) is associated not only with immune responsibility and disease susceptibility, but also with some reproductive and productive traits such as growth rate and carcass composition. As yet systematical research on SLA expression profile is not reported. In order to illustrate SLA expression comprehensively and deepen our understanding of its function, we outlined the expression profile of SLA in 51 tissues of Landrace by analyzing a large amount of ESTs produced by "Sino-Danish Porcine Genome Project". In addition, we also compared the expression profile of SLA in several tissues from different development stages and from another breed (Erhualian). The result shows: (i) classical SLA genes are highly expressed in immune tissues and middle part of intestine; (ii) although SLA-3 is an SLA Ia gene, its expression abundance and pattern are quite different from those of the other two SLA Ia genes. The same phenomenon is seen in HLA-C expression, suggesting that the two genes may function similarly and undergo convergent evolution; (iii) except in jejunum, the antigen presenting genes are more highly expressed in breed Erhualian than in Landrace. The difference might associate with the higher resistance to bad conditions (including pathogens) of Erhualian and higher growth rates of Landrace.

  14. Phylogeny and evolution of porcine parvovirus.

    Science.gov (United States)

    Ren, Xiaofeng; Tao, Ye; Cui, Jin; Suo, Siqingaowa; Cong, Yingying; Tijssen, Peter

    2013-12-26

    Porcine parvovirus (PPV), a member of the genus Parvovirus, family Parvoviridae, is a significant causative agent in porcine reproductive failure, causing serious economic losses in the swine industry. Previous phylogenetic studies based on the NS1 or VP2 genes indicated that current PPV strains diverged 30 years ago and that VP2 was under neutral or positive selection. Our analysis of NS1, VP2 and complete ORFs indicated that the most recent common ancestor of PPV strains existed about 250 years ago and that the 127-nt repeat in the 3'NTR was present in viruses of some subclades that evolved about 80 years ago. Nucleotide substitution rates of NS1 and VP2 genes were 3.03 × 10(-5) and 1.07 × 10(-4), respectively. Both the NS1 and VP2 proteins were under purifying selection and recombination did not contribute to the genetic diversity of PPV. As expected, surface amino acids are hydrophilic and make up the majority of mutations in the VP2 protein; residues in VP2 interfaces were substituted gradually, often in conjunction with complementary substitutions in the neighboring VP2. PMID:24050995

  15. Molecular epidemiology and evolution of porcine parvoviruses.

    Science.gov (United States)

    Streck, André Felipe; Canal, Cláudio Wageck; Truyen, Uwe

    2015-12-01

    Porcine parvovirus (PPV), recently named Ungulate protoparvovirus 1, is considered to be one of the most important causes of reproductive failure in swine. Fetal death, mummification, stillbirths and delayed return to estrus are predominant clinical signs commonly associated with PPV infection in a herd. It has recently been shown that certain parvoviruses exhibit a nucleotide substitution rate close to that commonly determined for RNA viruses. However, the PPV vaccines broadly used in the last 30 years have most likely reduced the genetic diversity of the virus and led to the predominance of strains with a capsid profile distinct from that of the original vaccine-based strains. Furthermore, a number of novel porcine parvovirus species with yet-unknown veterinary relevance and characteristics have been described during the last decade. In this review, an overview of PPV molecular evolution is presented, highlighting characteristics of the various genetic elements, their evolutionary rate and the discovery of new capsid profiles driven by the currently used vaccines. PMID:26453771

  16. The emergency department ECG and immediately life-threatening complications in initially uncomplicated suspected myocardial ischemia.

    Science.gov (United States)

    Zalenski, R J; Sloan, E P; Chen, E H; Hayden, R F; Gold, I W; Cooke, D

    1988-03-01

    The emergency physician's disposition of patients with suspected myocardial ischemia is currently debated; some physicians believe that a subgroup of patients can be managed safely outside the coronary care unit. Clinical predictors are needed in assessing the patient with suspected myocardial ischemia to help identify this subgroup. Through a retrospective cohort study, we investigated the value of the initial emergency department ECG in discriminating between chest pain patients with low and high risk for immediately life-threatening complications. Two hundred eleven initially uncomplicated consecutive coronary care unit admissions with suspected unstable angina or myocardial infarction were studied. Patient outcome, including the incidence of myocardial infarction, complications, and mechanical and pharmacologic interventions, was reviewed. Immediately life-threatening complications included ventricular fibrillation, ventricular tachycardia, shock, 2 degrees and 3 degrees block, and death. Mechanical interventions included electrocardioversion or defibrillation, endotracheal intubation, intra-aortic balloon pump, Swan-Ganz catheter, or pacemaker insertion. Pressors, antiarrhythmics, and vasodilators were the reviewed pharmacologic interventions. A positive ECG was defined by the presence of ST elevation or depression, T wave inversion, left ventricular hypertrophy, left bundle branch block, paced rhythm, or new Q waves. All other ECG interpretations were considered negative. Patients were divided into two groups based on this initial emergency physician ECG interpretation and their complication incidences compared. Of the 211 patients, 96 had a positive ECG; 115 had negative ECGs. Patients with positive ECGs were older, had a greater history and concurrent incidence of myocardial infarction, and more complications and intensive interventions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3345014

  17. Phenotypic and Functional Analysis of Porcine T Lymphocytes

    Institute of Scientific and Technical Information of China (English)

    李华; 陈应华

    2001-01-01

    Porcine and other higher mammals express clusters of differentiation (CD) antigens on the surface of T lymphocytes, such as CD2, CD3, CD4, CD8, etc. However, in porcine, a high percentage of the CD4+ CD8-T lymphocyte subpopulation exist in the peripheral blood and the ratio of the CD4+ and CD8+ T lymphocyte subpopulations is reversed. These differences bring new challenges to better understanding of the phenotype and function of porcine T lymphocytes in antigen recognition and immune response.

  18. Evaluation of the Human Host Range of Bovine and Porcine Viruses that may Contaminate Bovine Serum and Porcine Trypsin Used in the Manufacture of Biological Products

    OpenAIRE

    Marcus-Sekura, Carol; Richardson, James C.; Rebecca K. Harston; Sane, Nandini; Sheets, Rebecca L.

    2011-01-01

    Current U.S. requirements for testing cell substrates used in production of human biological products for contamination with bovine and porcine viruses are U.S. Department of Agriculture (USDA) 9CFR tests for bovine serum or porcine trypsin. 9CFR requires testing of bovine serum for seven specific viruses in six families (immunofluorescence) and at least 2 additional families non-specifically (cytopathicity and hemadsorption). 9CFR testing of porcine trypsin is for porcine parvovirus. Recent ...

  19. Mangafodipir Protects against Hepatic Ischemia-Reperfusion Injury in Mice

    Science.gov (United States)

    Coriat, Romain; Leconte, Mahaut; Kavian, Niloufar; Bedda, Sassia; Nicco, Carole; Chereau, Christiane; Goulvestre, Claire; Weill, Bernard

    2011-01-01

    Introduction and Aim Mangafodipir is a contrast agent used in magnetic resonance imaging that concentrates in the liver and displays pleiotropic antioxidant properties. Since reactive oxygen species are involved in ischemia-reperfusion damages, we hypothesized that the use of mangafodipir could prevent liver lesions in a mouse model of hepatic ischemia reperfusion injury. Mangafodipir (MnDPDP) was compared to ischemic preconditioning and intermittent inflow occlusion for the prevention of hepatic ischemia-reperfusion injury in the mouse. Methods Mice were subjected to 70% hepatic ischemia (continuous ischemia) for 90 min. Thirty minutes before the ischemic period, either mangafodipir (10 mg/kg) or saline was injected intraperitoneally. Those experimental groups were compared with one group of mice preconditioned by 10 minutes' ischemia followed by 15 minutes' reperfusion, and one group with intermittent inflow occlusion. Hepatic ischemia-reperfusion injury was evaluated by measurement of serum levels of aspartate aminotransferase (ASAT) activity, histologic analysis of the livers, and determination of hepatocyte apoptosis (cytochrome c release, caspase 3 activity). The effect of mangafodipir on the survival rate of mice was studied in a model of total hepatic ischemia. Results Mangafodipir prevented experimental hepatic ischemia-reperfusion injuries in the mouse as indicated by a reduction in serum ASAT activity (P<0.01), in liver tissue damages, in markers of apoptosis (P<0.01), and by higher rates of survival in treated than in untreated animals (P<0.001). The level of protection by mangafodipir was similar to that observed following intermittent inflow occlusion and higher than after ischemic preconditioning. Conclusions Mangafodipir is a potential new preventive treatment for hepatic ischemia-reperfusion injury. PMID:22073237

  20. Mangafodipir protects against hepatic ischemia-reperfusion injury in mice.

    Directory of Open Access Journals (Sweden)

    Romain Coriat

    Full Text Available INTRODUCTION AND AIM: Mangafodipir is a contrast agent used in magnetic resonance imaging that concentrates in the liver and displays pleiotropic antioxidant properties. Since reactive oxygen species are involved in ischemia-reperfusion damages, we hypothesized that the use of mangafodipir could prevent liver lesions in a mouse model of hepatic ischemia reperfusion injury. Mangafodipir (MnDPDP was compared to ischemic preconditioning and intermittent inflow occlusion for the prevention of hepatic ischemia-reperfusion injury in the mouse. METHODS: Mice were subjected to 70% hepatic ischemia (continuous ischemia for 90 min. Thirty minutes before the ischemic period, either mangafodipir (10 mg/kg or saline was injected intraperitoneally. Those experimental groups were compared with one group of mice preconditioned by 10 minutes' ischemia followed by 15 minutes' reperfusion, and one group with intermittent inflow occlusion. Hepatic ischemia-reperfusion injury was evaluated by measurement of serum levels of aspartate aminotransferase (ASAT activity, histologic analysis of the livers, and determination of hepatocyte apoptosis (cytochrome c release, caspase 3 activity. The effect of mangafodipir on the survival rate of mice was studied in a model of total hepatic ischemia. RESULTS: Mangafodipir prevented experimental hepatic ischemia-reperfusion injuries in the mouse as indicated by a reduction in serum ASAT activity (P<0.01, in liver tissue damages, in markers of apoptosis (P<0.01, and by higher rates of survival in treated than in untreated animals (P<0.001. The level of protection by mangafodipir was similar to that observed following intermittent inflow occlusion and higher than after ischemic preconditioning. CONCLUSIONS: Mangafodipir is a potential new preventive treatment for hepatic ischemia-reperfusion injury.

  1. Palpation for muscular tenderness in the anterior chest wall

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Manniche, Claus; Haghfelt, Torben; Hartvigsen, Lisbeth; Høilund-Carlsen, Poul Flemming

    2003-01-01

    OBJECTIVE: To asses the interobserver and intraobserver reliability (in terms of day-to-day and hour-to-hour reliability) of palpation for muscular tenderness in the anterior chest wall. DESIGN: A repeated measures designs was used. SETTING: Department of Nuclear Medicine, Odense University...... Hospital, Denmark. PARTICIPANTS: Two experienced chiropractors examined 29 patients and 27 subjects in the interobserver part, and 1 of the 2 chiropractors examined 14 patients and 15 subjects in the intraobserver studies. INTERVENTION: Palpation for muscular tenderness was done in 14 predetermined areas...... of the anterior chest wall with all subjects sitting. Each dimension was rated as absent or present for tenderness or pain for each location. All examinations were carried out according to a standard written procedure. RESULTS: Based on a pooled analysis of data from palpation of the anterior chest...

  2. Computer-aided diagnosis in chest radiography: Beyond nodules

    Energy Technology Data Exchange (ETDEWEB)

    Ginneken, Bram van [University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)], E-mail: bram@isi.uu.nl; Hogeweg, Laurens; Prokop, Mathias [University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2009-11-15

    Chest radiographs are the most common exam in radiology. They are essential for the management of various diseases associated with high mortality and morbidity and display a wide range of findings, many of them subtle. In this survey we identify a number of areas beyond pulmonary nodules that could benefit from computer-aided detection and diagnosis (CAD) in chest radiography. These include interstitial infiltrates, catheter tip detection, size measurements, detection of pneumothorax and detection and quantification of emphysema. Recent work in these areas is surveyed, but we conclude that the amount of research devoted to these topics is modest. Reasons for the slow pace of CAD development in chest radiography beyond nodules are discussed.

  3. RECURRENT SALMONELLA TYPHI CHEST WALL ABSCESSES IN A DIABETIC LADY

    Directory of Open Access Journals (Sweden)

    Jayasri Helen

    2014-09-01

    Full Text Available : Salmonella enterica serovar typhi causing typhoid fever is common in many parts of the world particularly in developing countries. Extra intestinal manifestations are uncommon and occur in immunocompromised individuals such as patients with diabetes, HIV infection, chronic steroid use, chemotherapy and malignancy. We report a case of Salmonella typhi causing recurrent chest wall abscesses in a lady with uncontrolled diabetes. She was admitted with high grade fever, left sided chest wall abscess and a previous history of two similar chest wall abscesses. After hospitalization prompt incision and drainage was done and aerobic culture of pus grew moderate growth of Salmonella typhi resistant to ciprofloxacin and sensitive to cephalosporins. Based on culture report our patient was treated with oral azithromycin for ten days and parenteral ceftriaxone for six weeks. There was rapid and full recovery and six months follow up revealed no recurrence.

  4. Chest x-ray analysis by computer: final technical report

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate and demonstrate the feasibility of the automated analysis of chest x-rays for the classification of pneumoconiosis films according to the U.I.C.C./Cincinnati standard films. Toward this end, computer programs simulating the proposed systems were prepared. Using these programs, the authors then examined three sets of chest radiographs to determine the extent of pneumoconiosis present. The results of the examinations of these x-rays clearly indicated the feasibility of the proposed system. Based on the outcome of these examinations, a complete set of hardware and software specifications were established for a system which can be used for the large scale automatic analysis of chest x-rays

  5. Practice and regulations of radiological chest screening in Denmark

    International Nuclear Information System (INIS)

    Mass chest screening by means of photofluorography was initiated in Denmark in the first years after World War II. The number of persons examined yearly increased continually to a maximum of 900.000 (a fourth of the whole population) in 1972. At this time efforts were made to reduce mass chest screening to small specific risk groups in the population, resulting in a gradual reduction until 1983 when mass chest screening was totally abolished. The technical provisions for photofluorographic X-ray equipment and for X-ray rooms as well as the provisions for the inspection of the installations are stated. Finally results of surveys regarding exposure measurements on photofluorografic equipment are shown and a maximum permissible level of the exposure measured at the entrance plane of the equipment is recommended. (author)

  6. Sedation versus general anaesthesia in paediatric patients undergoing chest CT

    International Nuclear Information System (INIS)

    Objective: CT of the chest in paediatric patients often requires sedation or general anaesthesia to minimize motion artefacts. Both sedation and general anaesthesia are associated with atelectasis which obscures the underlying pulmonary pathology. We conducted a prospective study to compare these two methods with respect to degree of motion artefacts and extent of atelectasis. Material and Methods: Nineteen patients undergoing 22 chest CT examinations were randomly selected for either sedation or general anaesthesia. The total area of atelectasis and the degree of motion artefacts were measured. Results: The mean percentage of atelectasis was 6.67% for general anaesthesia and 0.01% for sedation (p=0.01). There was no significant difference in the quality of the images between the sedation patients and the general anaesthesia patients. Conclusion: Whenever the clinical condition permits it, sedation rather than general anaesthesia should be given to paediatric patients undergoing chest CT. (orig.)

  7. Line-scanning diode-array digital chest imaging

    International Nuclear Information System (INIS)

    A line scanning diode array digital chest diagnostic x-ray machine has been developed which captures very high detail through the use of self-scanning linear diode arrays. The authors' latest model represents a significant improvement over our previous ones in the following aspects: (1) The U-arm gantry containing the x-ray tube and detector assembly is moved during the scanning and the patient therefore does not move. (2) The digital images can be taken with the patient standing. (3) The field of view has been increased to include the entire chest. (4) The matrix size has been greatly expanded. (5) A newly developed rare earth phosphor screen with much higher resolution and good absorption is used. The images are digitally processed, resulting in a balanced image in which structures in all regions of the chest are simultaneously displayed with optimum contrast

  8. Massive chest wall resection and reconstruction for malignant disease

    Directory of Open Access Journals (Sweden)

    Foroulis CN

    2016-04-01

    Full Text Available Christophoros N Foroulis,1 Athanassios D Kleontas,1 George Tagarakis,1 Chryssoula Nana,1 Ioannis Alexiou,1 Vasilis Grosomanidis,1 Paschalis Tossios,1 Elena Papadaki,2 Ioannis Kioumis,2 Sofia Baka,3 Paul Zarogoulidis,2 Kyriakos Anastasiadis11Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, 2Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 3Oncology Department, European Interbalkan Medical Center, Thessaloniki, GreeceObjective: Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes.Methods: Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted.Results: The median maximum diameter of tumors was 10 cm (5.4–32 cm. Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2. Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%, most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh in nine cases of large anterior defects or by using a 2

  9. Low-dose spiral CT: applicability to paediatric chest imaging

    International Nuclear Information System (INIS)

    Background. Spiral CT of the chest is an imaging technique with unequivocal indications and proven higher sensitivity and specificity than conventional chest X-rays. However, particularly in children, attempts should be made to reduce radiation exposure to a minimum. Objective. To evaluate whether a low-dose technique in spiral CT scanning results in adequate diagnostic information. Materials and methods. In a prospective study, 27 children (range 3 weeks to 14 years, mean 7 years) underwent a low-dose CT examination of the chest for various indications. The tube energy was 12.5 mAs (n = 5), 25 mAs (n = 17), 50 mAs (n = 3), or 75 mAs (n = 2) per slice. Two radiologists evaluated, in consensus, the CT scans with respect to their diagnostic value and comparison was made with 20 standard-dose chest CT examinations of adults (175 mAs per slice, mean age 56 years) with respect to technical image quality (noise and artefacts). In a second part of the study, dose measurements were carried out by means of exposing thermoluminescent dosimeters attached to a water/air phantom simulating a child's chest. Results. All low-dose CT scans were of diagnostic image quality and no additional studies were necessary. The average image noise was significantly higher than in standard-dose CT examinations (SD 39.5 compared with 12.5 for unenhanced soft tissue, P < 0.01), but did not hinder accurate diagnosis. Artefacts were exclusively due to patient motion. Radiation exposure per slice was approx. 4 mGy at 25 mAs and 34 mGy at 250 mAs, regardless of slice thickness. Conclusions. For all indications in paediatric CT scanning of the chest, low-dose technique provides adequate image quality without loss of diagnostic information. The radiation exposure is approximately 5-20 % of a standard-dose CT. (orig.)

  10. Role of small calibre chest tube drainage for iatrogenic pneumothorax.

    OpenAIRE

    Laub, M; Milman, N.; Müller, D.; Struve-Christensen, E

    1990-01-01

    A 2 mm Teflon catheter was used as a chest tube in 28 patients with iatrogenic pneumothorax. Frequent aspirations through the catheter were performed in 16 of the patients. In the remaining 12 patients the catheter was connected to a one way flutter valve. The treatment was successful in 27 of the 28 patients--one patient required a large calibre chest tube. The mean drainage time was 48 hours. The small catheter technique is superior to the use of a large intercostal drain as it is much less...

  11. CYSTIC HYGROMA OF CHEST WALL- 2 Reported Cases

    Directory of Open Access Journals (Sweden)

    Tapan Shah

    2012-07-01

    Full Text Available Hygromas arise in the sites of primitive lymphatic lakes, on the floor of the mouth, under the jaw, in the neck and in the axillae, but they can occur virtually anywhere in the body. Their occurrence on the chest wall is very rare and they progressively grow with age infiltrating into the local tissues, insinuating lymphatic pseudopods and form cysts in and around muscle fibers and nerves, making them difficult and hazardous to remove. Here, we have reported 2 cases of cystic hygroma of chest wall in children

  12. CYSTIC HYGROMA OF CHEST WALL- 2 Reported Cases

    OpenAIRE

    Tapan Shah; Dipen Patel; Yash Vaidhya; Jigar Jadeja; Sharad Patel; Asit Patel

    2012-01-01

    Hygromas arise in the sites of primitive lymphatic lakes, on the floor of the mouth, under the jaw, in the neck and in the axillae, but they can occur virtually anywhere in the body. Their occurrence on the chest wall is very rare and they progressively grow with age infiltrating into the local tissues, insinuating lymphatic pseudopods and form cysts in and around muscle fibers and nerves, making them difficult and hazardous to remove. Here, we have reported 2 cases of cystic hygroma of chest...

  13. Evaluation and Management of Chest Pain in the Elderly.

    Science.gov (United States)

    Gupta, Rohit; Munoz, Robert

    2016-08-01

    Geriatric patients are at increased risk for serious morbidity and mortality from life-threatening causes of chest pain. This article covers 5 life-threatening causes of chest pain in the elderly: acute coronary syndrome, aortic dissection, pulmonary embolism, pneumothorax, and esophageal rupture. Atypical presentations, frailty, and significant comorbidities that characterize the elderly make the diagnosis and treatment of these already complicated conditions even more complicated. The emergency provider must be vigilant and maintain a low threshold to test. When a diagnosis is made, treatment must be aggressive. The elderly benefit from optimal care. PMID:27475013

  14. Quality criteria for chest X-ray image

    International Nuclear Information System (INIS)

    A distinction has to be made between invariable and variable criteria in the determination of chest X-ray picture quality criteria. The invariable criteria are defined by the properties of the object and the psychophysiological laws of perception and cognition, and the variable criteria are determined by the prevailing state of the art of technology. An agreement on these criteria is based on the knowledge of the nature and the technical conditions of X-ray picture production and reproduction. The slogan 'the best picture at the lowest dose' dominates, too, the discussion centering around the X-ray picture of the chest, its quality and criteria. (orig./MG)

  15. Radiodiagnostic measurements radiation load of children by chest

    International Nuclear Information System (INIS)

    With the aim of optimisation of the radiographic examinations in paediatric radiology the entrance surface doses measured by chest examinations, as the most frequent procedure for children in Slovakia were surveyed. In this paper the results of measurements and calculations of doses obtained by paediatric patients with ages ranging from newborn to 15 years, who undergone chest radiodiagnostic examinations during the year 1996 are presented.. The obtained results are compared with dose assessment procedures based on total absorbed dose calculations using the published conversion factors between energy impaired to the patient and and entrance surface doses integrated over the beam area

  16. Radiodiagnostic measurements radiation load of children by chest

    International Nuclear Information System (INIS)

    In the district of Slovak Republic we have tried to estimate the radiation load of children to 15 years by chest radiodiagnostic examinations. Our data were collected using measurements with TLD for 100 patients divided in 5 age categories at six radiodiagnostic departments. The analysis of obtained absorbed doses as a function of age for chest radiodiagnostic examinations has shown, that the investigated Slovak radiodiagnostic centres use rather lower voltage techniques and the entrance surface doses are much higher than the proposed value of European Communities. (authors)

  17. Chest X-ray : a cost-diagnostic benefit analysis

    International Nuclear Information System (INIS)

    Although plain chest radiography is one of the most useful diagnostic tools available to the physician, this procedure has not evolved into a consistent method. Two Large Field of View Image Intensifiers (LFOV-II) became available; the large imaging area makes them suitable for chest imaging. Both modalities supply 100 mm images to the radiologist. In this thesis the 'diagnostic benefits and 'costs' of these modalities are evaluated and related to the 'gold' standard (conventional full-size). The emphasis is on diagnostic image quality using phantoms for observer performance qualities. (author). 170 refs.; 21 figs.; 47 tabs

  18. Computer Analysis Of ILO Standard Chest Radiographs Of Pneumoconiosis

    Science.gov (United States)

    Li, C. C.; Shu, David B. C.; Tai, H. T.; Hou, W.; Kunkle, G. A.; Wang, Y.; Hoy, R. J.

    1982-11-01

    This paper presents study of computer analysis of the 1980 ILO standard chest radiographs of pneumoconiosis. Algorithms developed for detection of individual small rounded and irregular opacities have been experimented and evaluated on these standard radiographs. The density, shape, and size distribution of the detected objects in the lung field, in spite of false positives, can be used as indicators for the beginning of pneumoconiosis. This approach is potentially useful in computer-assisted screening and early detection process where the annual chest radiograph of each worker is compared with his (her) own normal radiograph obtained previously.

  19. Ischemia detection from morphological QRS angle changes.

    Science.gov (United States)

    Romero, Daniel; Martínez, Juan Pablo; Laguna, Pablo; Pueyo, Esther

    2016-07-01

    In this paper, an ischemia detector is presented based on the analysis of QRS-derived angles. The detector has been developed by modeling ischemic effects on the QRS angles as a gradual change with a certain transition time and assuming a Laplacian additive modeling error contaminating the angle series. Both standard and non-standard leads were used for analysis. Non-standard leads were obtained by applying the PCA technique over specific lead subsets to represent different potential locations of the ischemic zone. The performance of the proposed detector was tested over a population of 79 patients undergoing percutaneous coronary intervention in one of the major coronary arteries (LAD (n  =  25), RCA (n  =  16) and LCX (n  =  38)). The best detection performance, obtained for standard ECG leads, was achieved in the LAD group with values of sensitivity and specificity of [Formula: see text], [Formula: see text], followed by the RCA group with [Formula: see text], Sp  =  94.4 and the LCX group with [Formula: see text], [Formula: see text], notably outperforming detection based on the ST series in all cases, with the same detector structure. The timing of the detected ischemic events ranged from 30 s up to 150 s (mean  =  66.8 s) following the start of occlusion. We conclude that changes in the QRS angles can be used to detect acute myocardial ischemia. PMID:27243441

  20. Sildenafil attenuates placental ischemia-induced hypertension.

    Science.gov (United States)

    George, Eric M; Palei, Ana C; Dent, Edward A; Granger, Joey P

    2013-08-15

    Preeclampsia is a complication of pregnancy that is marked by hypertension, proteinuria, and maternal endothelial dysfunction. A central factor in the etiology of the disease is the development of placental hypoxia/ischemia, which releases pathogenic soluble factors. There is currently no effective treatment for preeclampsia, but the phosphodiesterase-5 (PDE-5) inhibitor sildenafil has been suggested, as PDE-5 is enriched in the uterus, and its antagonism could improve uteroplacental function. Here, we report in the reduced uterine perfusion pressure (RUPP) rat model that administration of oral sildenafil is effective in attenuating placental ischemia-induced hypertension during gestation. RUPP animals have significantly elevated arterial pressure compared with control animals (132 ± 3 vs. 100 ± 2 mmHg; P PDE-5/β-actin ratio (1 ± 0.14 vs. 1.63 ± 0.18; P < 0.05) expression with a resulting reduction in renal medullary cGMP (1.5 ± 0.15 vs. 0.99 ± 0.1 pmol/μg protein, P < 0.05) compared with controls. Although sildenafil had no effect on renal medullary cGMP in control animals, it significantly increased cGMP in RUPP animals (1.3 ± 0.1 pmol/μg protein; P < 0.05). These data suggest that sildenafil might provide an effective therapeutic option for the management of hypertension during preeclampsia. PMID:23785075

  1. Autophagy and Liver Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Raffaele Cursio

    2015-01-01

    Full Text Available Liver ischemia-reperfusion (I-R injury occurs during liver resection, liver transplantation, and hemorrhagic shock. The main mode of liver cell death after warm and/or cold liver I-R is necrosis, but other modes of cell death, as apoptosis and autophagy, are also involved. Autophagy is an intracellular self-digesting pathway responsible for removal of long-lived proteins, damaged organelles, and malformed proteins during biosynthesis by lysosomes. Autophagy is found in normal and diseased liver. Although depending on the type of ischemia, warm and/or cold, the dynamic process of liver I-R results mainly in adenosine triphosphate depletion and in production of reactive oxygen species (ROS, leads to both, a local ischemic insult and an acute inflammatory-mediated reperfusion injury, and results finally in cell death. This process can induce liver dysfunction and can increase patient morbidity and mortality after liver surgery and hemorrhagic shock. Whether autophagy protects from or promotes liver injury following warm and/or cold I-R remains to be elucidated. The present review aims to summarize the current knowledge in liver I-R injury focusing on both the beneficial and the detrimental effects of liver autophagy following warm and/or cold liver I-R.

  2. Understanding STAT3 signaling in cardiac ischemia.

    Science.gov (United States)

    O'Sullivan, K E; Breen, E P; Gallagher, H C; Buggy, D J; Hurley, J P

    2016-05-01

    Cardiovascular disease is the leading cause of death worldwide. It remains one of the greatest challenges to global health and will continue to dominate mortality trends in the future. Acute myocardial infarction results in 7.4 million deaths globally per annum. Current management strategies are centered on restoration of coronary blood flow via percutaneous coronary intervention, coronary artery bypass grafting and administration of anti-platelet agents. Such myocardial reperfusion accounts for 40-50 % of the final infarct size in most cases. Signaling transducer and activator of transcription 3 (STAT3) has been shown to have cardioprotective effects via canonical and non-canonical activation and modulation of mitochondrial and transcriptional responses. A significant body of in vitro and in vivo evidence suggests that activation of the STAT3 signal transduction pathway results in a cardio protective response to ischemia and attempts have been made to modulate this with therapeutic effect. Not only is STAT3 important for cardiomyocyte function, but it also modulates the cardiac microenvironment and communicates with cardiac fibroblasts. To this end, we here review the current evidence supporting the manipulation of STAT3 for therapeutic benefit in cardiac ischemia and identify areas for future research. PMID:27017613

  3. Measurement of the QT Dispersion in Patients with Cardiac Syndrome X for the Investigation of Ischemia as an Etiological Factor

    Directory of Open Access Journals (Sweden)

    Ali Metin Esen

    2011-04-01

    Full Text Available Clinical and demographic characteristics of the groups such as age, gender bodymass index, systolic and diastolic blood pressure showed no statistically significant differences between both groups. Although there was no difference in QTd values between groups at baseline (43,28 ± 12,55 msec in the positive ETT group, and 40,28± 11,08 msec in the control group, p=NS, peak exercise QTd was much higher in the positive ETT group than the control group (57,40 ± 13,70 msec and 28,23 ± 5,05 msec, respectively, p< 0.01. Since QTd greater than 60 msec related to ischemia has been previously reported, ETT positive patients were reevaluated in two different subgroups with QTd ≥ 60 msec (34 patients, and QTd < 60 msec(32 patients. The sum of ST depression were much more in the QTd ≥ 60 msec group (7,22 ± 0,74 vs 4,40± 1,78; t: -8,458, p<0.001. Conclusions: As a result, peak exercise QTd have been found to be higher in the group of patients with CSX than the control group, and especially when peak exercise QTd ≥ 60 msec, ischemia due to microvascular dysfunction or spasm must be considered as one of the leading causes of chest pain.

  4. Biological and binding activities of ovine and porcine prolactins in porcine mammary tissue

    International Nuclear Information System (INIS)

    The concentration of prolactin receptors may play a critical role in regulating growth and development of the mammary gland during gestation and tumor development; however, the discrepancy between specific binding of ovine prolactin (oPRL) and porcine prolactin (pPRL) in porcine mammary tissue was disturbing. It was possible that 125I-oPRL may be an unsuitable ligand for the procine prolactin receptor. The validate the use of oPRL in binding assays, the biological and binding activities of oPRL and pPRL were compared. A lactogenic bioassay of pPRL was developed using porcine mammary explants cultured in Medium 199 containing insulin, cortisol, and pPRL. The potencies of oPRL and pPRL were compared using this bioassay. Oxidation of glucose and incorporation of glucose into lipids were similarly enhanced by physiological concentrations of both oPRL and pPRL. However, specific binding of 125I-oPRL was 20%, while less than 1% of 125I-pPRL was bound. 125I-oPRL bound to high affinity sites

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

    International Nuclear Information System (INIS)

    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

  6. 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.

  7. Aged rat hearts are not more susceptible to ischemia-reperfusion injury in vivo: role of glutathione.

    Science.gov (United States)

    Leichtweis, S; Leeuwenburgh, C; Bejma, J; Ji, L L

    2001-05-15

    The current study tested the hypothesis that ischemia-reperfusion (I-R) can cause more severe myocardial dysfunction and oxidative damage in senescent rats than young adult rats. Male Fischer 344 rats at the age of 6 (adult) and 24 (old) months were subjected to an open-chest heart surgery and randomly assigned to one of the following treatments: ischemia only (I), with the occlusion of the main descending branch of the left coronary artery (LCA) for 30 min; I-R, with the release of LCA occlusion for 20 min; or sham (S) operation. Heart mechanical performance was monitored using a fluid-filled catheter inserted in the right carotid artery and advanced to the left ventricle. Ischemia caused similar reductions of left ventricle systolic pressure (LVSP) and contractility (+/-dP/dt) in adult and aged hearts. After I-R, adult hearts regained 82% (Pischemic LVSP, whereas the aged hearts regained 91% (P>0.05) of LVSP. There was no significant difference in the reduction of +/-dP/dt with I-R between adult and aged hearts. Old rats had lower pre-ischemic heart rate than adult rats, however, I-R caused no reduction of heart rate, and a smaller reduction of pressure-rate double product in the aged rats (10%, P>0.05) than the adult rats (23%, P<0.01). Aged rats demonstrated greater myocardial and plasma glutathione (GSH) concentrations prior to surgery, and maintained higher GSH levels and GSH:glutathione disulfide (GSSG) ratio with I-R. Aged hearts also had higher GSH peroxidase, GSH reductase and GSH sulfur-transferase activities than adult hearts, while I-R induced lipid peroxidation was similar. It is concluded that senescent hearts with intact circulatory and neural inputs are not more susceptible to I-R injury than adult hearts during myocardial I-R, partly because they have a greater GSH antioxidant protection. PMID:11295168

  8. Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve

    International Nuclear Information System (INIS)

    A 31/2-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.)

  9. An Evidence-Based Review of Related Metabolites and Metabolic Network Research on Cerebral Ischemia

    Science.gov (United States)

    Liu, Mengting; Tang, Liying; Liu, Xin; Fang, Jing; Zhan, Hao; Wu, Hongwei; Yang, Hongjun

    2016-01-01

    In recent years, metabolomics analyses have been widely applied to cerebral ischemia research. This paper introduces the latest proceedings of metabolomics research on cerebral ischemia. The main techniques, models, animals, and biomarkers of cerebral ischemia will be discussed. With analysis help from the MBRole website and the KEGG database, the altered metabolites in rat cerebral ischemia were used for metabolic pathway enrichment analyses. Our results identify the main metabolic pathways that are related to cerebral ischemia and further construct a metabolic network. These results will provide useful information for elucidating the pathogenesis of cerebral ischemia, as well as the discovery of cerebral ischemia biomarkers. PMID:27274780

  10. 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...

  11. mRNA redistribution during permanent focal cerebral ischemia.

    Science.gov (United States)

    Lewis, Monique K; Jamison, Jill T; Dunbar, Joseph C; DeGracia, Donald J

    2013-12-01

    Translation arrest occurs in neurons following focal cerebral ischemia and is irreversible in penumbral neurons destined to die. Following global cerebral ischemia, mRNA is sequestered away from 40S ribosomal subunits as mRNA granules, precluding translation. Here, we investigated mRNA granule formation using fluorescence in situ histochemistry out to 8 h permanent focal cerebral ischemia using middle cerebral artery occlusion in Long Evans rats with and without diabetes. Neuronal mRNA granules colocalized with PABP, HuR, and NeuN, but not 40S or 60S ribosomal subunits, or organelle markers. The volume of brain with mRNA granule-containing neurons decreased exponentially with ischemia duration, and was zero after 8 h permanent focal cerebral ischemia or any duration of ischemia in diabetic rats. These results show that neuronal mRNA granule response has a limited range of insult intensity over which it is expressed. Identifying the limits of effective neuronal stress response to ischemia will be important for developing effective stroke therapies. PMID:24323415

  12. Porcine Bocavirus: Achievements in the Past Five Years

    OpenAIRE

    Feng Zhou; Haoting Sun; Yuyan Wang

    2014-01-01

    Porcine bocavirus is a recently discovered virus that infects pigs and is classified within the Bocavirus genus (family Parvoviridae, subfamily Parvovirinae). The viral genome constitutes linear single-stranded DNA and has three open reading frames that encode four proteins: NS1, NP1, VP1, and VP2. There have been more than seven genotypes discovered to date. These genotypes have been classified into three groups based on VP1 sequence. Porcine bocavirus is much more prevalent in piglets that ...

  13. A Large Chondroitin Sulfate Proteoglycan, Versican, in Porcine Predentin

    OpenAIRE

    Okahata, Saori; Yamamoto, Ryuji; Yamakoshi, Yasuo; Fukae, Makoto

    2011-01-01

    Proteoglycans and their constituent glycosaminoglycan (GAG) have been proposed to be involved in the inhibition of mineralization in unmineralized tissue, predentin. Among the proteoglycans secreted by odontoblasts, we focused on the large chondroitin sulfate proteoglycan, versican, for its large binding capacity for calcium ions. The aims of this study were the determination of the full-length sequence and splicing variants of the porcine versican, and the detection of versican in the porcin...

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

    International Nuclear Information System (INIS)

    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. (GSE)

  15. A novel porcine bocavirus harbors a variant NP gene

    OpenAIRE

    Yoo, Sung J; Sunwoo, Sun Young; Ko, Seong Sik; Je, Sang H; Lee, Dong Uk; Lyoo, Young S

    2015-01-01

    Background Porcine bocavirus is classified within the genus Bocaparvovirus, family Parvoviridae. Unlike other parvoviruses, the members of genus Bocaparvovirus (bocaparvoviruses) encode an additional open reading frame (NP1). Many strains of PBoVs have been identified in domestic pigs and recognized as a potential emerging pathogen causing respiratory and gastrointestinal disease. Findings A new strain of porcine bocavirus (PBoV) that harbored the shortest NP1 gene among all currently charact...

  16. Structural Determination and Daily Variations of Porcine Milk Oligosaccharides

    OpenAIRE

    Tao, Nannan; Ochonicky, Karen L.; German, J Bruce; Donovan, Sharon M.; Lebrilla, Carlito B.

    2010-01-01

    Free milk oligosaccharides (OS) is a major component of mammalian milk. Swine are important agricultural species and biomedical models. Despite their importance, little is known of the OS profile of porcine milk. Herein, the porcine milk glycome was elucidated and monitored over the entire lactation period by liquid chromatography profiling and structural determination with mass spectrometry. Milk was collected from second parity sows (n=3) at farrowing and on days 1, 4, 7 and 24 of lactation...

  17. A clinical comparison of purified bovine and purified porcine insulins.

    OpenAIRE

    Olczak, S A; Greenwood, R H

    1985-01-01

    Twenty four patients with established insulin dependent diabetes treated with twice daily soluble and isophane bovine insulins were changed to equivalent doses of either purified bovine Neusulin and Neuphane (Wellcome) or purified porcine Actrapid and Monotard (Novo) insulins. After 6 months treatment the porcine group showed a 35% fall in insulin binding antibodies and a 14% reduction in insulin dosage. The group changed to purified bovine insulins showed no significant change in insulin bin...

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

    OpenAIRE

    Guven, Mustafa; 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...

  19. Picture quiz: a case of sudden severe chest pain.

    Science.gov (United States)

    Rabia, Mustafa Abu; Sullivan, P; Stivaros, Stavros M

    2007-01-01

    An 18-year-old male with no previous medical history presented to hospital with sudden onset of acute epigastric pain radiating to the anterior chest wall and both shoulders. There was no history of recent trauma and he had not been vomiting. PMID:21611610

  20. Chest radiographic data acquisition and quality assurance in multicenter studies

    International Nuclear Information System (INIS)

    Background. Multicenter studies rely on data derived from different institutions. Forms can be designed to standardize the reporting process allowing reliable comparison of data. Objective. The purpose of the report is to provide a standardized method, developed as a part of a multicenter study of vertically transmitted HIV, for assessing chest radiographic results. Materials and methods. Eight hundred and five infants and children were studied at five centers; 3057 chest radiographs were scored. Data were entered using a forced-choice, graded response for 12 findings. Quality assurance measures and inter-rater agreement statistics are reported. Results. The form used for reporting chest radiographic results is presented. Inter-rater agreement was moderate to high for most findings, with the best correlation reported for the presence of bronchovascular markings and/or reticular densities addressed as a composite question (kappa = 0.71). The presence of nodular densities (kappa 0.56) and parenchymal consolidation (kappa = 0.57) had moderate agreement. Agreement for lung volume was low. Conclusion. The current tool, developed for use in the pediatric population, is applicable to any study involving the assessment of pediatric chest radiographs for a large population, whether at one or many centers. (orig.)

  1. Assessment of chest impedance in relation to phonocardiography

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hammershøi, Dorte;

    2010-01-01

    transducer (e.g. microphone, force transducer or accelerometer), sensitivity and dynamic range, frequency range, coupling area, coupler geometry etc. for a system to pick up chest sounds. Especially the weak sounds of the heart, e.g. the murmur sounds originating from coronary arteries or the fetal heart...

  2. Scientific use of the chest radiograph in intensive care unit

    International Nuclear Information System (INIS)

    In this paper it is shown that, when properly standardized, the chest x-ray can be used to derive other important clinical information concerning the patient's status of hydration, the early detection of pulmonary edema in cardiacs, the assessment of ARDS severity and the differentiation of hydrostatic from injury lung edema. (author). 20 refs

  3. Radiological placement of chest ports in pediatric oncology patients

    International Nuclear Information System (INIS)

    A single center's procedural and follow-up results of radiological chest port placement in pediatric oncology patients are presented. Between July 2002 and December 2003, 37 children (20 boys, 17 girls; age range, 4 months to 16 years; mean 6.7 years) underwent chest port placement. All patients received only one port through the internal jugular vein access, and all of the implantations were performed in the interventional radiology suite. Our database and electronic charts were retrospectively reviewed to obtain follow-up data. All chest ports were successfully implanted. The mean catheter life was 223 days (range: 15-450 days), with a total of 8,258 catheter days. Twenty-eight ports are still in use, four patient deceased, one port was prematurely removed because of a late infection, and four patients were lost to follow-up. Infection rate was 2.7% (0.12/1,000 catheter days). Malfunction due to partial catheter thrombosis and fibrin sheath formation was observed in three patients (8.1% or 0.36/1,000 catheter days), and all were relieved with rt-TPA dwell. None of the ports were revised or removed because of blockage, malposition or difficulty accessing the port. The peri-procedural complication rate was 0%. Chest ports in children can be inserted in interventional radiology suites under imaging guidance with high rates of technical success. The rates of infection and complications are comparable to that of surgically placed ports. (orig.)

  4. Sudden chest pain and cardiac emergencies in the obstetric patient.

    Science.gov (United States)

    Mabie, W C; Freire, C M

    1995-03-01

    The differential diagnosis and work-up of a patient with chest pain during pregnancy is presented in this article. This is followed by discussions of cardiac emergencies including hypertensive crisis, pulmonary edema, arrhythmias, cardiopulmonary resuscitation, myocardial infarction, and aortic dissection. PMID:7784039

  5. Coal worker's lungs - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows coal worker's lungs. There are diffuse, small, light areas on both sides (1 to 3 mm) in ... the lungs. Diseases that may result in an x-ray like this include: simple coal workers pneumoconiosis (CWP) - ...

  6. Eliminating rib shadows in chest radiographic images providing diagnostic assistance.

    Science.gov (United States)

    Oğul, Hasan; Oğul, B Buket; Ağıldere, A Muhteşem; Bayrak, Tuncay; Sümer, Emre

    2016-04-01

    A major difficulty with chest radiographic analysis is the invisibility of abnormalities caused by the superimposition of normal anatomical structures, such as ribs, over the main tissue to be examined. Suppressing the ribs with no information loss about the original tissue would therefore be helpful during manual identification or computer-aided detection of nodules on a chest radiographic image. In this study, we introduce a two-step algorithm for eliminating rib shadows in chest radiographic images. The algorithm first delineates the ribs using a novel hybrid self-template approach and then suppresses these delineated ribs using an unsupervised regression model that takes into account the change in proximal thickness (depth) of bone in the vertical axis. The performance of the system is evaluated using a benchmark set of real chest radiographic images. The experimental results determine that proposed method for rib delineation can provide higher accuracy than existing methods. The knowledge of rib delineation can remarkably improve the nodule detection performance of a current computer-aided diagnosis (CAD) system. It is also shown that the rib suppression algorithm can increase the nodule visibility by eliminating rib shadows while mostly preserving the nodule intensity. PMID:26775736

  7. Lyme Myocarditis Presenting as Chest Pain in an Adolescent Girl.

    Science.gov (United States)

    Fishe, Jennifer N; Marchese, Ronald F; Callahan, James M

    2016-07-01

    A previously healthy adolescent girl presented to the emergency department with new onset chest and right upper quadrant abdominal pain. Laboratory studies and imaging were consistent with myocarditis. She developed heart block after admission and required stabilization in the cardiac intensive care unit. Lyme serology returned positive, and her condition was diagnosed as Lyme disease-associated myocarditis. PMID:26945194

  8. Lung mass, right upper lung - chest x-ray (image)

    Science.gov (United States)

    ... chest x-ray of a person with a lung mass. This is a front view, where the lungs are the two dark areas and the heart ... ray shows a mass in the right upper lung, indicated with the arrow (seen on the left ...

  9. Cash's textbook of chest, heart and vascular disorders for physiotherapists

    International Nuclear Information System (INIS)

    A very high proportion of the patients treated by physiotherapy will have had a chest radiograph (x-ray) either because their primary disease is pulmonary or there is some long standing heart or lung illness which should be taken into account during the management of an acute problem. This chapter outlines the principles involved in reading the radiograph

  10. Pattern of dose prescription in chest wall irradiation

    International Nuclear Information System (INIS)

    The method described, in this paper, gives a solution to obtain dose uniformity in chest wall. This method can be followed for routine clinical practice. The distribution with the new technique can still be improved with the use of wedge along with breast cone provided the machine is equipped with asymmetric wedge

  11. Chest wall tuberculosis; CT findings in 14 patients

    International Nuclear Information System (INIS)

    To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis

  12. Porcine Reproductive and Respiratory Syndrome Virus (PRRSV)

    DEFF Research Database (Denmark)

    Kvisgaard, Lise Kirstine

    This PhD thesis presents the diversity of Porcine Reproductive and Respiratory Syndrome viruses (PRRSV) circulating in the Danish pig population. PRRS is a disease in pigs caused by the PRRS virus resulting in reproductive failures in sows and gilts and respiratory diseases in pigs . Due to genetic...... heterogeneity, PRRSV is divided into two genotypes, Type 1 and Type 2. Type 1 PRRS viruses are further divided into at least 3 subtypes. The virus evolves rapidly and reports of high pathogenic variants of both Type 1 and Type 2 appearing in Europe, North America, and Asia have been reported within recent years...... viruses showed both a higher diversity to the other Danish viruses and to the vaccine strain and one virus harbored the largest deletion in NSP2 reported in Danish Type 2 PRRSV. Manuscript IV is focusing on an experimental infection study in pigs with a Type 2 PRRS virus causing significant clinical...

  13. Granulométrie et nutrition porcine

    OpenAIRE

    Guillou, D.; Landeau, E.

    2000-01-01

    La description de la granulométrie des aliments ne fait pas l’objet de recommandation en nutrition porcine. Pourtant, de nombreux travaux sur le broyage des graines ont démontré le rôle de la granulométrie comme facteur de variation de la valeur alimentaire ou comme facteur étiologique de troubles digestifs chez le porc. Une base de données quantitatives a été élaborée à partir de 23 études expérimentales pour tenter d’établir des lois de réponse de la valeur alimentaire à la variation de la ...

  14. Panretinal photocoagulation for radiation-induced ocular ischemia

    International Nuclear Information System (INIS)

    We present preliminary findings on the effectiveness of panretinal photocoagulation in preventing neovascular glaucoma in eyes with radiation-induced ocular ischemia. Our study group consisted of 20 patients who developed radiation-induced ocular ischemia following cobalt-60 plaque radiotherapy for a choroidal or ciliary body melanoma. Eleven of the 20 patients were treated by panretinal photocoagulation shortly after the diagnosis of ocular ischemia, but nine patients were left untreated. In this non-randomized study, the rate of development of neovascular glaucoma was significantly lower (p = 0.024) for the 11 photocoagulated patients than for the nine who were left untreated

  15. How Active Are Porcine Endogenous Retroviruses (PERVs?

    Directory of Open Access Journals (Sweden)

    Joachim Denner

    2016-08-01

    Full Text Available Porcine endogenous retroviruses (PERVs represent a risk factor if porcine cells, tissues, or organs were to be transplanted into human recipients to alleviate the shortage of human transplants; a procedure called xenotransplantation. In contrast to human endogenous retroviruses (HERVs, which are mostly defective and not replication-competent, PERVs are released from normal pig cells and are infectious. PERV-A and PERV-B are polytropic viruses infecting cells of several species, among them humans; whereas PERV-C is an ecotropic virus infecting only pig cells. Virus infection was shown in co-culture experiments, but also in vivo, in the pig, leading to de novo integration of proviruses in certain organs. This was shown by measurement of the copy number per cell, finding different numbers in different organs. In addition, recombinations between PERV-A and PERV-C were observed and the recombinant PERV-A/C were found to be integrated in cells of different organs, but not in the germ line of the animals. Here, the evidence for such in vivo activities of PERVs, including expression as mRNA, protein and virus particles, de novo infection and recombination, will be summarised. These activities make screening of pigs for provirus number and PERV expression level difficult, especially when only blood or ear biopsies are available for analysis. Highly sensitive methods to measure the copy number and the expression level will be required when selecting pigs with low copy number and low expression of PERV as well as when inactivating PERVs using the clustered regularly interspaced short palindromic repeats (CRISPR/CRISPR-associated nuclease (CRISPR/Cas technology.

  16. Porcine circovirus diseases: a review of PMWS.

    Science.gov (United States)

    Baekbo, P; Kristensen, C S; Larsen, L E

    2012-03-01

    This article is a review on post-weaning multisystemic wasting syndrome (PMWS), the first described disease among the porcine circovirus diseases (PCVD). Post-weaning multisystemic wasting syndrome has, since its appearance in Canada in 1991, been seen in all major pig producing countries. To diagnose PMWS at herd level typical clinical appearance consisting of wasting and increased mortality must be combined with finding at autopsy of diseased pigs, where typical microscopic findings in the lymphatic tissue must be present. Post-weaning multisystemic wasting syndrome significantly increases the mortality and reduces the daily weight gain in weaner pig and/or in finishing pigs. Post-weaning multisystemic wasting syndrome can be transmitted by pig-to-pig contact and some studies point at airborne transmission as a possibility. Studies in Europe have shown several risk factors that either increase or decrease the risk for a pig herd to be affected by PMWS. At the pig level, studies have shown the importance of maternal immunity as protection for subsequent development of PMWS. To control PMWS, good production management and control of other diseases are crucial. Since 2004, commercial vaccines against Porcine Circo Virus type 2 have been coming on the market and many studies have shown great benefits of these to control PMWS. Today, sow vaccines as well as piglet vaccines are available in most countries. An extensive meta-analysis of many of the vaccines has shown a comparable good efficacy of the vaccines in significantly reducing mortality and increasing weight gain of the pigs. PMID:22252114

  17. Imaging of blunt chest trauma; Bildgebung des stumpfen Thoraxtraumas

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, H. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria); Negrin, L. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Unfallchirurgie, Wien (Austria)

    2014-09-15

    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.) [German] Stumpfe Thoraxtraumen gehen mit einer hohen Morbiditaet und Mortalitaet einher. Daher sollten Patienten mit Verdacht auf ein stumpfes Thoraxtrauma rasch radiologisch untersucht werden, damit die entsprechenden therapeutischen Schritte zeitgerecht eingeleitet werden koennen. Zur Abklaerung von Patienten nach einem stumpfen Thoraxtrauma sind seit Jahren das konventionelle Lungenroentgen und die Computertomographie bewaehrte Verfahren. In den letzten Jahren hat die fokussierte Ultraschalluntersuchung (eFAST, Extended Focused Assessment with Sonography for Trauma) von schwerverletzten Patienten vermehrt an Bedeutung gewonnen. Durch eine eFAST-Untersuchung kann in der Akutphase rasch geklaert werden, ob bei dem Patienten ein therapiebeduerftiger Pneumothorax, Haematoperikard oder Haematothorax vorliegen. Auch das Lungenroentgen wird zur Diagnose eines Pneumothorax oder Haematothorax eingesetzt, wenngleich seine Sensitivitaet deutlich eingeschraenkt ist. Die CT ist das diagnostische Verfahren der Wahl, um v. a. Patienten mit einem schweren Thoraxtrauma abzuklaeren. (orig.)

  18. Early chest tube removal after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Mohsen Mirmohammad-Sadeghi

    2009-01-01

    Full Text Available Background: There is no clear data about the optimum time for chest tube removal after coronary artery bypass surgery. Aim: The aim of this study was to assess the impact of the chest tube removal time following coronary artery bypass grafting surgery on the clinical outcome of the patients. Material and Methods: An analysis of data from 307 patients was performed. The patients were randomized into two groups: in group 1 (N=107 chest tubes were removed within the first 24 hours after surgery, whereas in group 2 (N=200, chest tubes were removed in the second 24 hours after surgery. Demographics, lactate and pH at the beginning, during and after the operation, creatinine, left ventricular ejection fraction, inotropic drugs administration, length of ICU stay, and mortality data were collected. Respiratory rate and pain level was assessed. Results: In these surgeries, the mean± standard deviation for the aortic clamping time was 49.18±17.59 minutes and cardiopulmonary bypass time was 78.39±25.12 minutes. The amount of heparin consumed by the second group was higher (P <0.001 which could be considered as an important factor in increasing the drainage time after the surgery (P =0.047. The pain level evaluated 24 hours post-operation was lower in the first group, and the difference in the pain level between the 2 groups evaluated 30 hours post-operation was significant (P=0.016. The mean time of intensive care unit stay was longer in the second group but it was not statistically significant. Conclusion: Early extracting of chest tubes after coronary artery bypass graft surgery when there is no significant drainage can lead to pain reduction and consuming oxygen is an effective measure after surgery toward healing; it doesn′t increase the risk of creation of plural effusion and pericardial effusion.

  19. Effect of myocardial ischemia and nitroglycerin on systolic time intervals in the segmental myocardium

    Directory of Open Access Journals (Sweden)

    Haraoka,Shoichi

    1978-04-01

    Full Text Available Effects of ischemia and nitroglycerin on systolic time intervals in the segmental myocardial length were studied in anesthetized open-chest dogs. Two strain-gauges were sutured on the surface of the left ventricular wall; one was in the central area perfused by the left circumflex coronary artery (LCX and the other was in the area perfused by the left anterior descending coronary artery. LCX was partially occluded with a screw type constrictor to the degree at which reactive hyperemia after the transient total coronary occlusion almost disappeared. After the hemodynamics stabilized nitroglycerin (20 microgram/kg was injected into the femoral vein. In the ischemic area, contraction time was shortened and precontraction time was prolonged in association with an elongation of end-systolic and early systolic segment-length, respectively. The systolic time intervals in the ischemic segment were improved as a result of the recovery in the segment-length toward the control. The results suggest the usefulness of analyzing the segmental myocardial systolic time intervals for verifying the asynchronous contraction of the ventricle and the favourable effects of nitroglycerin on segmental myocardial function in the ischemic area.

  20. Do antioxidant vitamins reduce infarct size following acute myocardial ischemia/reperfusion?

    Science.gov (United States)

    Bellows, S D; Hale, S L; Simkhovich, B Z; Kay, G L; Kloner, R A

    1995-02-01

    There is controversy concerning the ability of antioxidant vitamins to reduce myocardial infarct size. We sought to determine whether a brief prophylactic treatment of vitamin C or vitamin C plus Trolox (a water-soluble form of vitamin E) could reduce myocardial infarct size in an experimental model. We used an anesthetized open-chest rabbit model in which a branch of the circumflex coronary artery was ligated for 30 minutes followed by 4 hours of reperfusion. Experiments were performed in a randomized and blinded fashion. An IV injection of normal saline pH balanced to 7.4 (control group n = 15), vitamin C (150 mg/kg, n = 14), or vitamin C plus Trolox (150 mg/kg plus 100 mg/kg, respectively, n = 15) was administered prior to coronary occlusion. Collateral blood flow during coronary occlusion was measured by radioactive microspheres, myocardial risk zone (AR) was assessed by blue dye injection, and myocardial infarct size (AN) was assessed by triphenyltetrazolium chloride staining. All rabbits received comparable ischemic insult: Collateral blood flow and AR were similar among all three groups. Infarct size, measured as a percent of AR, did not differ significantly among the controls (21%), vitamin C (29%), or the vitamin C plus Trolox (18%) groups. Therefore, in this ischemia/reperfusion model, antioxidant vitamins did not alter myocardial infarct size. PMID:7540423

  1. Characterisation of manual chest physiotherapy and respiratory response in mechanically ventilated children

    OpenAIRE

    Gregson, Rachael Kathleen

    2008-01-01

    Chest physiotherapy is integral to the management of mechanically ventilated children and previous research has confirmed that chest wall vibrations are the manual techniques used most frequently by physiotherapists in this population. Chest wall vibrations involve the application of a compressive force to the chest during expiration, with the aim of removing accumulated secretions and improving lung aeration. However, these techniques are largely unquantified and may vary grea...

  2. Hippocampal neurogenesis in the new model of global cerebral ischemia

    Science.gov (United States)

    Kisel, A. A.; Chernysheva, G. A.; Smol'yakova, V. I.; Savchenko, R. R.; Plotnikov, M. B.; Khodanovich, M. Yu.

    2015-11-01

    The study aimed to evaluate the changes of hippocampal neurogenesis in a new model of global transient cerebral ischemia which was performed by the occlusion of the three main vessels (tr. brachiocephalicus, a. subclavia sinistra, and a. carotis communis sinistra) branching from the aortic arch and supplying the brain. Global transitory cerebral ischemia was modeled on male rats (weight = 250-300 g) under chloral hydrate with artificial lung ventilation. Animals after the same surgical operation without vessel occlusion served as sham-operated controls. The number of DCX-positive (doublecortin, the marker of immature neurons) cells in dentate gyrus (DG) and CA1-CA3 fields of hippocampus was counted at the 31st day after ischemia modeling. It was revealed that global cerebral ischemia decreased neurogenesis in dentate gyrus in comparison with the sham-operated group (P<0.05) while neurogenesis in CA1-CA3 fields was increased as compared to the control (P<0.05).

  3. 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)

  4. Mechanisms of symptomatic spinal cord ischemia after TEVAR

    DEFF Research Database (Denmark)

    Czerny, Martin; Eggebrecht, Holger; Sodeck, Gottfried; Verzini, Fabio; Cao, Piergiorgio; Maritati, Gabriele; Riambau, Vicente; Beyersdorf, Friedhelm; Rylski, Bartosz; Funovics, Martin; Loewe, Christian; Schmidli, Jürg; Tozzi, Piergiorgio; Weigang, Ernst; Kuratani, Toru; Livi, Ugolino; Esposito, Giampiero; Trimarchi, Santi; van den Berg, Jos C; Fu, Weiguo; Chiesa, Roberto; Melissano, Germano; Bertoglio, Luca; Lönn, Lars; Schuster, Ingrid; Grimm, Michael

    2012-01-01

    To test the hypothesis that simultaneous closure of at least 2 independent vascular territories supplying the spinal cord and/or prolonged hypotension may be associated with symptomatic spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR)....

  5. Mangafodipir Protects against Hepatic Ischemia-Reperfusion Injury in Mice

    OpenAIRE

    Coriat, Romain; Leconte, Mahaut; Kavian, Niloufar; Bedda, Sassia; Nicco, Carole; Chereau, Christiane; Goulvestre, Claire; Weill, Bernard; Laurent, Alexis; Batteux, Frédéric

    2011-01-01

    Introduction and Aim Mangafodipir is a contrast agent used in magnetic resonance imaging that concentrates in the liver and displays pleiotropic antioxidant properties. Since reactive oxygen species are involved in ischemia-reperfusion damages, we hypothesized that the use of mangafodipir could prevent liver lesions in a mouse model of hepatic ischemia reperfusion injury. Mangafodipir (MnDPDP) was compared to ischemic preconditioning and intermittent inflow occlusion for the prevention of hep...

  6. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  7. Effect of minocycline on cerebral ischemia-reperfusion injury★

    OpenAIRE

    Zheng, Yuanyin; Xu, Lijuan; Yin, Jinbao; Zhong, Zhichao; Fan, Hongling; LI, XI; Chang, Quanzhong

    2013-01-01

    Minocylcine, a tetracycline derivate, has been shown to cross the blood-brain barrier and enter the central nervous system. In this study, cerebral ischemia-reperfusion injury models were established using the suture method, and minocycline was immediately injected intraperitoneally after cerebral ischemia-reperfusion (22.5 mg/kg, initially 45 mg/kg) at a 12-hour interval. Results showed that after minocycline treatment, the volume of cerebral infarction was significantly reduced, the number ...

  8. Neuroprotective Effects of Pregabalin on Cerebral Ischemia and Reperfusion

    Science.gov (United States)

    Aşcı, Sanem; Demirci, Serpil; Aşcı, Halil; Doğuç, Duygu Kumbul; Onaran, İbrahim

    2016-01-01

    Background: Stroke is one of the most common causes of death and the leading cause of disability in adults. Cerebral ischemia/reperfusion injury causes cerebral edema, hemorrhage, and neuronal death. Aims: In post-ischemic reperfusion, free radical production causes brain tissue damage by oxidative stress. Pregabalin, an antiepileptic agent was shown to have antioxidant effects. The aim of this study was to evaluate the neuroprotective and antioxidant effects of pregabalin on ischemia and reperfusion in rat brain injury. Study Design: Animal experimentation. Methods: Male Wistar rats weighing (250–300 g) were randomly divided into six groups, each consisting of 6 rats: control (C), pregabalin (P), ischemia (I), pregabalin + ischemia (PI), ischemia + reperfusion (IR) and ischemia + reperfusion + pregabalin (PIR). Rats were initially pre-treated with 50 mg/kg/d pregabalin orally for two days. Then, animals that applied ischemia in I, PI, IR and PIR groups were exposed to carotid clamping for 30 minutes and 20 minutes reperfusion was performed in the relevant reperfusion groups. Results: NR2B receptor levels were significantly lower in the PIR group in comparison to the IR group. In the PIR group, Thiobarbituric acid reactive substance (TBARS) level had statistically significant decrease compared with IR group. Glutathione peroxidase (GSH-PX) levels were also significantly increased in the PIR group compared with I, IR and control groups. In the PI and PIR groups, catalase (CAT) levels were also significantly increased compared with I and IR groups (p=0.03 and p=0.07, respectively). Conclusion: Pregabalin may protect the damage of oxidative stress after ischemia + reperfusion. This result would illuminate clinical studies in the future.

  9. Pylephlebitis secondary to strangulated umbilical hernia with small bowel ischemia

    Directory of Open Access Journals (Sweden)

    Ennio Bruschi

    2013-08-01

    Full Text Available Pylephlebitis is a septic thrombophlebitis of the portal venous system that infrequently complicates small bowel infarction. We present a case of pylephlebitis with portomesenteric vein gas bubbles secondary to small bowel ischemia caused by a strangulated umbilical hernia, diagnosed on computed tomography (CT and confirmed in the operating theater. This case is an example of the usefulness of CT in early recognition of suggestive radiologic findings of pylephlebitis associated with intestinal ischemia for prompt treatment of the patient.

  10. 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.

  11. The Chemokine System in Arteriogenesis and Hind Limb Ischemia

    OpenAIRE

    Shireman, Paula K.

    2007-01-01

    Chemokines (chemotactic cytokines) are important in the recruitment of leukocytes to injured tissues and as such, play a pivotal role in arteriogenesis and the tissue response to ischemia. Hind limb ischemia represents a complex model with arteriogenesis (collateral artery formation) occurring in tissues with normal perfusion while areas exhibiting ischemic necrosis undergo angiogenesis and skeletal muscle regeneration; monocytes/macrophages play an important role in all three of these proces...

  12. One of the most urgent vascular circumstances: Acute limb ischemia

    OpenAIRE

    Acar, Rezzan D; Sahin, Muslum; Kirma, Cevat

    2013-01-01

    Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability and requires urgent evaluation and management. Most of the causes of acute limb ischemia are thrombosis of a limb artery or bypass graft, embolism from the heart or a disease artery, dissection, and trauma. Assessment determines whether the limb is viable or irreversibly damaged. Prompt diagnosis and revascularization by means of catheter-based thrombolysis or thrombectomy and by surgery reduce the risk o...

  13. Effect of policosanol on cerebral ischemia in Mongolian gerbils

    OpenAIRE

    Molina V; Arruzazabala M.L.; Carbajal D.; Valdés S.; Noa M.; Más R.; Fraga V.; Menéndez R.

    1999-01-01

    Policosanol is a mixture of higher aliphatic primary alcohols isolated from sugar cane wax, whose main component is octacosanol. An inhibitory effect of policosanol on platelet aggregation and cerebral ischemia in animal models has been reported. Thus, the objective of the present study was to evaluate the effect of policosanol on cerebral ischemia induced by unilateral carotid ligation and bilateral clamping and recirculation in Mongolian gerbils. Policosanol (200 mg/kg) administered immedia...

  14. The porcine retinal vasculature accessed using an endovascular approach

    DEFF Research Database (Denmark)

    Morén, Håkan; Undrén, Per; Gesslein, Bodil;

    2009-01-01

    The aim of this study was to examine whether the retinal circulation in the pig can be accessed using interventional neuroradiology and to explore the possibility of creating occlusions that result in experimental retinal ischemia....

  15. Low-dose spiral CT: applicability to paediatric chest imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rogalla, P.; Stoever, B.; Scheer, I.; Juran, R.; Hamm, B. (Department of Diagnostic and Interventional Radiology, Humboldt-Univ. Berlin (Germany)); Gaedicke, G. (Department of Pediatrics, Humboldt-Univ., Berlin (Germany))

    1999-08-01

    Background. Spiral CT of the chest is an imaging technique with unequivocal indications and proven higher sensitivity and specificity than conventional chest X-rays. However, particularly in children, attempts should be made to reduce radiation exposure to a minimum. Objective. To evaluate whether a low-dose technique in spiral CT scanning results in adequate diagnostic information. Materials and methods. In a prospective study, 27 children (range 3 weeks to 14 years, mean 7 years) underwent a low-dose CT examination of the chest for various indications. The tube energy was 12.5 mAs (n = 5), 25 mAs (n = 17), 50 mAs (n = 3), or 75 mAs (n = 2) per slice. Two radiologists evaluated, in consensus, the CT scans with respect to their diagnostic value and comparison was made with 20 standard-dose chest CT examinations of adults (175 mAs per slice, mean age 56 years) with respect to technical image quality (noise and artefacts). In a second part of the study, dose measurements were carried out by means of exposing thermoluminescent dosimeters attached to a water/air phantom simulating a child's chest. Results. All low-dose CT scans were of diagnostic image quality and no additional studies were necessary. The average image noise was significantly higher than in standard-dose CT examinations (SD 39.5 compared with 12.5 for unenhanced soft tissue, P < 0.01), but did not hinder accurate diagnosis. Artefacts were exclusively due to patient motion. Radiation exposure per slice was approx. 4 mGy at 25 mAs and 34 mGy at 250 mAs, regardless of slice thickness. Conclusions. For all indications in paediatric CT scanning of the chest, low-dose technique provides adequate image quality without loss of diagnostic information. The radiation exposure is approximately 5-20 % of a standard-dose CT. (orig.) With 3 figs., 1 tab., 17 refs.

  16. Porcine incisional hernia model: Evaluation of biologically derived intact extracellular matrix repairs

    OpenAIRE

    Monteiro, Gary A; Delossantos, Aubrey I.; Rodriguez, Neil L.; Patel, Paarun; Franz, Michael G.; Wagner, Christopher T.

    2013-01-01

    We compared fascial wounds repaired with non-cross-linked intact porcine-derived acellular dermal matrix versus primary closure in a large-animal hernia model. Incisional hernias were created in Yucatan pigs and repaired after 3 weeks via open technique with suture-only primary closure or intraperitoneally placed porcine-derived acellular dermal matrix. Progressive changes in mechanical and biological properties of porcine-derived acellular dermal matrix and repair sites were assessed. Porcin...

  17. Ketamine inhibits c-Jun protein expression in mouse hippocampus following cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Feng Xiao; Liangzhi Xiong; Qingxiu Wang; Long Zhou; Qingshan Zhou

    2012-01-01

    A model of cerebral ischemia and reperfusion was established in mice. Mice were treated with ketamine via intraperitoneal injection immediately following ischemia or ischemia/reperfusion. Ketamine did not remarkably change infarct volume in mice immediately following ischemia, but injection immediately following ischemia/reperfusion significantly decreased infarct volume. Ketamine injection immediately after ischemia or ischemia/reperfusion inhibited c-Jun protein expression in mouse hippocampus, but nuclear factor kappa B expression was unaltered. In addition, the Longa scale score for neural impairment was not reduced in mice following cerebral ischemia/reperfusion. These results indicate that ketamine can protect mice against cerebral ischemia and reperfusion injury by modulating c-Jun protein expression in mouse hippocampus.

  18. Improved renal ischemia tolerance in females influences kidney transplantation outcomes.

    Science.gov (United States)

    Aufhauser, David D; Wang, Zhonglin; Murken, Douglas R; Bhatti, Tricia R; Wang, Yanfeng; Ge, Guanghui; Redfield, Robert R; Abt, Peter L; Wang, Liqing; Svoronos, Nikolaos; Thomasson, Arwin; Reese, Peter P; Hancock, Wayne W; Levine, Matthew H

    2016-05-01

    Experimentally, females show an improved ability to recover from ischemia-reperfusion injury (IRI) compared with males; however, this sex-dependent response is less established in humans. Here, we developed a series of murine renal ischemia and transplant models to investigate sex-specific effects on recovery after IRI. We found that IRI tolerance is profoundly increased in female mice compared with that observed in male mice and discovered an intermediate phenotype after neutering of either sex. Transplantation of adult kidneys from either sex into a recipient of the opposite sex followed by ischemia at a remote time resulted in ischemia recovery that reflected the sex of the recipient, not the donor, revealing that the host sex determines recovery. Likewise, renal IRI was exacerbated in female estrogen receptor α-KO mice, while female mice receiving supplemental estrogen before ischemia were protected. We examined data from the United Network for Organ Sharing (UNOS) to determine whether there is an association between sex and delayed graft function (DGF) in patients who received deceased donor renal transplants. A multivariable logistic regression analysis determined that there was a greater association with DGF in male recipients than in female recipients. Together, our results demonstrate that sex affects renal IRI tolerance in mice and humans and indicate that estrogen administration has potential as a therapeutic intervention to clinically improve ischemia tolerance. PMID:27088798

  19. Neuroprotective effects of rutaecarpine on cerebral ischemia reperfusion injury**

    Institute of Scientific and Technical Information of China (English)

    Chunlin Yan; Ji Zhang; Shu Wang; Guiping Xue; Yong Hou

    2013-01-01

    Rutaecarpine, an active component of the traditional Chinese medicine Tetradium ruticarpum, has been shown to improve myocardial ischemia reperfusion injury. Because both cardiovascular and cerebrovascular diseases are forms of ischemic vascular disease, they are closely related. We hypothesized that rutaecarpine also has neuroprotective effects on cerebral ischemia reperfusion injury. A cerebral ischemia reperfusion model was established after 84, 252 and 504 µg/kg carpine were given to mice via intraperitoneal injection, daily for 7 days. Results of the step through test, 2,3,5-triphenyl tetrazolium chloride dyeing and oxidative stress indicators showed that rutae-carpine could improve learning and memory ability, neurological symptoms and reduce infarction volume and cerebral water content in mice with cerebral ischemia reperfusion injury. Rutaecarpine could significantly decrease the malondialdehyde content and increase the activities of superoxide dismutase and glutathione peroxidase in mouse brain. Therefore, rutaecarpine could improve neu-rological function fol owing injury induced by cerebral ischemia reperfusion, and the mechanism of this improvement may be associated with oxidative stress. These results verify that rutaecarpine has neuroprotective effects on cerebral ischemia reperfusion in mice.

  20. Distinction between porcine circovirus type 2 enteritis and porcine proliferative enteropathy caused by Lawsonia intracellularis

    DEFF Research Database (Denmark)

    Jensen, Tim Kåre; Vigre, Håkan; Svensmark, B.;

    2006-01-01

    The presence of porcine circovirus type 2 (PCV2) was studied immunohistochemically in formalin-fixed, paraffin wax-embedded samples of intestinal tissue from 80 pigs with a clinical history suggestive of Lawsonia intracellularis-associated diarrhoea. Histopathologically, enteritis of varying...... in the submucosa, lamina propria and crypt epithelium, as well as in the lymphoid tissue of the ileum and colon. Multinucleated giant cells, however, were seen in both infections. PCV2 was about three times more likely to be detected in L. intracellularis-negative than in L. intracellularis...