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Nobuhisa Ishii, Kazuhide Tomita, Shinsuke Suetake, Yukako Okuno, Kenta Kawamura, Reiko Takeshima, Hirotaka Ohse, Shigeyuki Imura
[Purpose] It is unclear whether diaphragmatic breathing (DB) results in lower respiratory muscle oxygen consumption during dynamic exercise. The purpose of this study was to compare oxygen consumption in the respiratory muscles (VO2 rm) with thoracic breathing (TB) and with DB, in healthy males during hyperventilation. [Subjects and Methods] Ten healthy men participated in this study. The subjects sat on a chair with the backrest reclined at an angle of 60 degrees. Respiratory parameters were measured breath by breath, using an expired gas analyzer...
February 2018: Journal of Physical Therapy Science
Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
Xin Yang, Xiang-Chen Dai, Jie-Chang Zhu, Yu-Dong Luo, Hai-Lun Fan, Zhou Feng, Yi-Wei Zhang, Fan-Guo Hu
Despite being widely used for several years, the endovascular aortic repair (EVAR) of a thoracoabdominal aneurysm (TAAA) remains challenging, particularly the revascularization of the abdominal aortic visceral branches. A 66-year-old male was admitted to hospital with abdominal bloating and pain. Computed tomographic angiography (CTA) confirmed a Crawford type III TAAA from the distal descending aorta to the suprarenal abdominal aorta that involved the celiac axis, accompanied with an occlusion of the left subclavian artery...
January 1, 2018: Journal of International Medical Research
Brian I Shaw, Lyle J Burdine, Hillary J Braun, Nancy L Ascher, John P Roberts
Background: With the use of split liver grafts as well as living donor liver transplantation (LDLT) it is imperative to know the minimum graft volume to avoid complications. Most current formulas to predict standard liver volume (SLV) rely on weight-based measures that are likely inaccurate in the setting of cirrhosis. Therefore, we sought to create a formula for estimating SLV without weight-based covariates. Methods: LDLT donors underwent computed tomography scan volumetric evaluation of their livers...
December 2017: Transplantation Direct
M N Arslan, Ç Kertmen, I Esen Melez, D O Melez
Traumatic asphyxia is a rare clinical syndrome usually caused by sudden and severe thoracic and/or thoracoabdominal compression. It presents with craniofacial cyanosis, petechiae, and subconjunctival haemorrhages. The present study employed a postmortem retrospective methodology to analyse autopsy findings and accompanying injuries in cases of death due to traumatic asphyxia. Four years of case files from a morgue department at a forensic medicine institute were searched and 53 cases of lethal traumatic asphyxia were found...
March 6, 2018: Journal of Forensic and Legal Medicine
Lidija Kocbek, Mateja Rakuša
PURPOSE: A common trunk of the posterior intercostal arteries originating from the descending thoracic aorta is normally an anatomical variation. A search through the literature disclosed the frequencies of common trunks variations among population, but no information relates to particular topic of simultaneous multiple common trunks of the PIA present in individuals. METHODS: A total of 396 intercostal spaces were dissected in 44 cadavers from the vertebral body to the mid-axillary line to observe a common trunk of the paired posterior intercostal artery at the level from T2 to T11 intercostal space...
March 12, 2018: Surgical and Radiologic Anatomy: SRA
Pierre Durieux, Pierre Alain Gevenois, Alain Van Muylem, Nigel Howarth, Caroline Keyzer
OBJECTIVE: The purpose of this study is to investigate the magnitude of differences between attenuation values measured on virtual unenhanced images and true unenhanced images obtained using third-generation dual-source dual-energy CT (DECT). SUBJECTS AND METHODS: A total of 83 patients requiring thoracoabdominal CT for cancer workup were included in this prospective study. CT examinations included true unenhanced acquisitions (tube potential, 120 kVp) and arterial and portal phase dual-energy CT (DECT) acquisitions (tube potential, 100 kVp and Sn 150 kVp [where Sn denotes the interposition of a tin filter in the high-energy beam]; tube current-exposure time product, 190 and 95 mAs)...
March 12, 2018: AJR. American Journal of Roentgenology
Smita Kaushik, Warren J Gasper, Bala Ramanan, Shant M Vartanian, Linda M Reilly, Timothy A M Chuter, Jade S Hiramoto
OBJECTIVE: The purpose of this study was to evaluate the impact of prior aortic surgery on outcomes after multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs). METHODS: From July 2005 to October 2016, there were 153 patients who underwent elective endovascular repair of TAAA and PRAA using multibranched stent grafts. Data on demographics, procedural details, and outcomes were collected prospectively...
March 6, 2018: Journal of Vascular Surgery
Katsuhiro Yamanaka, Mohamed Eldeiry, Muhammad Aftab, Joshua Mares, Thomas J Ryan, Xianzhong Meng, Michael J Weyant, Joseph C Cleveland, David A Fullerton, T Brett Reece
BACKGROUND: Paraplegia remains the most feared complication of complex thoracoabdominal aortic intervention. Although erythropoietin (EPO) has demonstrated neuroprotective effects in spinal cord ischemia, it does not work until expression of the beta common receptor subunit of the EPO receptor (βcR) is induced by ischemia. We hypothesized that the βcR can be induced by diazoxide (DZ), amplifying the neuroprotective effects of EPO in spinal cord ischemia-reperfusion injury. METHODS: For the DZ time trial, adult male C57/BL6 mice received DZ (20 mg/kg) by oral gavage...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Stojan Potrc, Arpad Ivanecz, Bojan Krebs, Urska Marolt, Bojan Iljevec, Tomaz Jagric
Background: Adenocarcinomas at the cardia are biologically aggressive tumors with poor long-term survival following curative resection. For resectable adenocarcinoma of the cardia, mostly esophagus extended total gastrectomy or esophagus extended proximal gastric resection is performed; however, the surgical approach, transhiatal or transthoracic, is still under discussion. Postoperative morbidity, mortality and long-term survival were analyzed to evaluate the potential differences in clinically relevant outcomes...
March 2018: Radiology and Oncology
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
March 6, 2018: Cardiovascular and Interventional Radiology
Ivan Kuang Hsin Huang, Seyed Ameli Renani, Robert A Morgan
The application of endovascular strategies to treat aneurysms involving the abdominal and thoracoabdominal aorta has evolved significantly since the inception of endovascular aneurysm repair. Advances in endograft technology and operator experience have enabled the management of a wider spectrum of challenging aortic anatomy. Fenestrated endovascular and branched endovascular aneurysm repair represent two technical innovations, which have expanded endovascular treatment options to include patients with paravisceral and thoracoabdominal aortic aneurysms...
March 6, 2018: Cardiovascular and Interventional Radiology
Grace J Wang, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Philip P Goodney, Rachel R Kelz, Christopher Wirtalla, Ronald M Fairman
OBJECTIVE: The advent of endovascular repair for both thoracic aortic aneurysm and type B dissection has transformed the management of these disease processes. This study was undertaken to better define, compare, and contrast the national trends in hospital admissions, invasive treatments, and inpatient mortality of patients with thoracic aortic aneurysm and type B dissection in the National Inpatient Sample. METHODS: The cohort was derived from International Classification of Diseases, Ninth Revision diagnosis codes for thoracic aortic dissection and thoracic aortic or thoracoabdominal aortic aneurysm...
March 2, 2018: Journal of Vascular Surgery
Luca Bertoglio, Daniele Mascia, Tommaso Cambiaghi, Andrea Kahlberg, Germano Melissano, Roberto Chiesa
OBJECTIVE: The aim of this study was to assess the safety and effectiveness of upper extremity access (UEA) with percutaneous closure of the axillary artery (AxA) during endovascular treatment of thoracoabdominal aortic aneurysms with fenestrated and branched endografts. METHODS: Between January 2014 and 2017, 34 out of 37 patients (92%) required UEA during a staged branched and fenestrated endovascular approach. A percutaneous AxA (pAxA) approach was used in 14 consecutive patients (41%) with the off-label use of two Perclose ProGlide (Abbott Vascular, Santa Clara, Calif) devices...
March 1, 2018: Journal of Vascular Surgery
Sahadev T Reddy, Ngoc L Thai, Jose Oliva, Kusum B Tom, Michael K Dishart, Mark Doyle, June A Yamrozik, Ronald B Williams, Moneal Shah, Adil Wani, Anil Singh, Rishi Maheswary, Robert W W Biederman
BACKGROUND: The preoperative workup of orthotopic liver transplantation (OLT) patents is practically complex given the need for multiple imaging modalities. We recently demonstrated in our Proof-of-Concept study the value of a One-Stop-Shop approach using Cardiovascular MRI (CMR) to address this complex problem. However, this approach requires further validation in a larger cohort, as detection of HCC as well as cardiovascular risk assessment is critically important in these patients...
March 2, 2018: Clinical Transplantation
Stefan Fritz, Katharina Feilhauer, André Schaudt, Hansjörg Killguss, Eduard Esianu, René Hennig, Jörg Köninger
BACKGROUND: Pylorotomy and pyloroplasty in thoracoabdominal esophagectomy are routinely performed in many high-volume centers to prevent delayed gastric emptying (DGE) due to truncal vagotomy. Currently, controversy remains regarding the need for these practices. The present study aimed to determine the value and role of pyloric drainage procedures in esophagectomy with gastric replacement. METHODS: A retrospective review of prospectively collected data was performed for all consecutive patients who underwent thoracoabdominal resection of the esophagus between January 2009 and December 2016 at the Katharinenhospital in Stuttgart, Germany...
March 1, 2018: BMC Surgery
Maria Zerkaoui, Fatima Zahra Laarabi, Yousra Ajhoun, Bouchra Chkirate, Abdelaziz Sefiani
BACKGROUND: Familial Mediterranean fever is an autoinflammatory disease of unknown etiology, characterized clinically by recurrent attacks of sudden-onset fever with arthralgia and/or thoracoabdominal pain and pathogenetically by autosomal recessive inheritance due to a mutation in the MEFV gene. Behçet's disease is an inflammatory disease characterized by recurrent oral and genital aphthous ulcerations, uveitis, and skin lesions. Preliminarily, our literature review suggested that patients with familial Mediterranean fever who also have Behçet's disease have only a single mutated familial Mediterranean fever gene...
March 1, 2018: Journal of Medical Case Reports
Claudia Frellesen, Mehrnoush Azadegan, Simon S Martin, Katharina Otani, Tommaso DʼAngelo, Christian Booz, Katrin Eichler, Bita Panahi, Moritz Kaup, Ralf W Bauer, Thomas J Vogl, Julian L Wichmann
PURPOSE: The aim of this study was to evaluate the diagnostic performance of virtual noncalcium (VNCa) dual-energy computed tomography (DECT) reconstructions enabling visualization of bone marrow edema for characterization of incidental thoracolumbar compression fractures in routine thoracoabdominal staging computed tomography (CT). MATERIALS AND METHODS: We retrospectively analyzed 51 oncological patients without suspected fracture or indicative complaints presenting at least 1 thoracolumbar compression fracture on routine thoracoabdominal staging DECT who had been examined between October 2015 and June 2017 using third-generation dual-source CT, had a previous CT within 3 months before, and also had undergone additional magnetic resonance imaging within 14 days, which served as the standard of reference...
February 27, 2018: Investigative Radiology
Jiao Wei, Tanja Herrler, Bin Gu, Mei Yang, Qingfeng Li, Chuanchang Dai, Feng Xie
BACKGROUND: The repair of extensive upper limb skin lesions in pediatric patients is extremely challenging due to substantial limitations of flap size and donor-site morbidity. We aimed to create an oversize preexpanded flap based on intercostal artery perforators for large-scale resurfacing of the upper extremity in children. METHOD: Between March 2013 and August 2016, 11 patients underwent reconstructive treatment for extensive skin lesions in the upper extremity using a preexpanded intercostal artery perforator flap...
February 26, 2018: Journal of Craniofacial Surgery
Jana Taron, Christina Schraml, Christina Pfannenberg, Matthias Reimold, Nina Schwenzer, Konstantin Nikolaou, Petros Martirosian, Ferdinand Seith
OBJECTIVES: The aim of this study was to compare the diagnostic performance of simultaneous multislice diffusion-weighted imaging (DWI-SMS) with that of standard DWI (DWI-STD) in whole-body 3-T PET/MRI examination protocols in oncological patients. METHODS: In a phantom study, we evaluated the apparent diffusion coefficients (ADC) from the two techniques. In ten volunteers, we assessed ADC values in different organs. In 20 oncological patients, we evaluated subjective image quality (Likert scale, 5 indicating excellent) and artefacts in different body regions...
February 26, 2018: European Radiology
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