Articles de revues : « Thoracic index »

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Zhao, Yongzhao, Qian Xiang, Jialiang Lin, Shuai Jiang et Weishi Li. « High Systemic Immune-Inflammation Index and Body Mass Index Are Independent Risk Factors of the Thoracic Ossification of the Ligamentum Flavum ». Mediators of Inflammation 2022 (13 août 2022) : 1–7. http://dx.doi.org/10.1155/2022/4300894.

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Background. Inflammation has been considered to play an important role in the pathogenesis of the thoracic ossification of the ligamentum flavum (OLF). However, the inflammation-related risk factors of thoracic OLF have not been fully investigated to date. Methods. A total of 95 patients (48 in the OLF group and 47 in the control group) were included in this retrospective study to explore the independent risk factors of thoracic OLF. The following demographic and clinical variables were compared between the two groups: gender, age, body mass index (BMI), coexistence of hypertension or diabetes, and inflammation-related variables. Multivariate logistic regression analysis was utilized to determine the independent risk factors. Results. High systemic immune-inflammation index (SII) (≥621) (odds ratio OR = 12.16 , 95% confidence interval CI = 2.95 – 50.17 , p < 0.01 ) and BMI (≥25 kg/m2) ( OR = 9.17 , 95 % CI = 3.22 – 26.08 , p < 0.01 ) were independent risk factors of thoracic OLF. SII ( R = 0.38 , p < 0.01 ) and BMI ( R = 0.46 , p < 0.01 ) were positively associated with OLF score. Conclusion. High SII and BMI were the independent risk factors of thoracic OLF. Multicenter prospective studies with a large population should be conducted in the future to verify our findings.

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Hopkins, D. L., F. D. Shaw, S. Baud et P. J. Walker. « Electrical currents applied to lamb carcasses — effects on blood release and meat quality ». Australian Journal of Experimental Agriculture 46, n^o 7 (2006) : 885. http://dx.doi.org/10.1071/ea05310.

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The amount of collectable blood during the early phase of slaughter was determined for 48 lambs in 4 treatment groups: a control group (no current, no thoracic stick), a thoracic stick group only and groups subjected to a thoracic stick and either an electric current of 14 or 10 Hz frequency. The current was applied to the ‘skin-on’ carcass soon after the stunning/sticking process and subsequent to the thoracic stick, with a view to increasing the volume of blood released at that time. With both frequencies there was a small, but statistically significant (P<0.05), increase in the amount of released blood over non-stimulated treatments. Samples of M. longissimus thoracis et lumborum were aged for 1 and 5 days before freezing. Warner–Bratzler shear force measurements indicated the effectiveness of the current applications in reducing shear force with the 14 Hz waveform being superior to the 10 Hz waveform and in a related way the degradation of myofibrillar proteins was greater in meat subjected to the 14 Hz treatment when examined using the myofibrillar fragmentation index.

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Ruopsa, Niina, Heidi Vastamäki, Leena Ristolainen, Martti Vastamäki et Mikhail Saltychev. « Convergent Validity of Thoracic Outlet Syndrome Index (TOSI) ». Physical Activity and Health 6, n^o 1 (2022) : 16–25. http://dx.doi.org/10.5334/paah.162.

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Yakh’yaev, Ya M., O. L. Nechvolodova et V. N. Merkulov. « Roentgenography of normal thoracic vertebrae in children by age aspect ». N.N. Priorov Journal of Traumatology and Orthopedics 3, n^o 1 (15 mars 1996) : 34–37. http://dx.doi.org/10.17816/vto64076.

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With the purpose of the improvement of the x-ray diagnosis of the thoracic vertebral body compression fractures in children the roentgenometry of the thoracic vertebral bodies was performed in children in norm by age aspect. The main criteria, i.e. wedge-shaped index and discoid coefficient, were calculated for the different segments of the thoracic spine in children from 3 to 15 years.

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Shaibani, Saami J., et Herbert M. Baum. « Comparisons of the thoracic trauma index with other models ». Accident Analysis & ; Prevention 22, n^o 1 (février 1990) : 35–45. http://dx.doi.org/10.1016/0001-4575(90)90005-6.

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Vastamäki, Martti, Niina Ruopsa, Heidi Vastamäki, Katri Laimi, Leena Ristolainen et Mikhail Saltychev. « Validity and internal consistency of the thoracic outlet syndrome index for patients with thoracic outlet syndrome ». Journal of Shoulder and Elbow Surgery 29, n^o 1 (janvier 2020) : 150–56. http://dx.doi.org/10.1016/j.jse.2019.05.034.

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Aguirre-Riofrio, Edgar Lenin, Rodrigo Medardo Abad-Guamán et Melania de Lourdes Uchuari-Pauta. « Morphometric Evaluation of Phenotypic Groups of Creole Cattle of Southern Ecuador ». Diversity 11, n^o 12 (20 novembre 2019) : 221. http://dx.doi.org/10.3390/d11120221.

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The breeding of creole cattle from the southern region of Ecuador, also known as Criollo Lojano, is a source of economic support and work for the communities located in the remote areas of the Andes mountains in this region. These cattle are grouped into four biotypes based on their phenotypic characteristics: Negro Lojano, Encerado, Colorado, and Cajamarca or Pintado. This study analyzes the morphometric variability of these creole cattle using least squares means (LSM) and restricted maximum likelihood Restricted Maximum Likelihood (REML) variance components. The evaluation parameters used to characterize these cattle were live weight plus 15 morphometric characteristics and nine morphometric indexes. The measurements came from 151 adult animals (28 male and 123 females). With the exception of Height at Withers (P = 0.06), the other morphometric characteristics do not show significant difference among these creole biotypes. Sexual dimorphism was found in live weight, thoracic circumference, height at withers, chest width, length of thorax, length of body, depth of thorax, depth of abdomen, length of head, and length of horns (P < 0.05). The adult Creole Lojano has an average live weight of 288 ± 12.9 kg (mean ± standard error), The Cephalic index is 45.6, the Corporal index is 115.9, the Pelvic index is 90.5, the Thoracic index is 58.3, the Proportionality index is 62.6, the Thoracic Capacity index is 2.1, the Lower Leg–Thoracic index is 9.9, the Transverse Pelvic index is 34.7, and the Pelvic Length index is 38.4. This creole bovine breed presents 4 biotypes that are similar; there are differences in the analysis with respect to sex (males are higher in 10 of the 16 characteristics analyzed); and on the basis of the indexes, this animal is small, has a triangular head, is longilinear with a long and narrow hip. It is a dual-purpose milk type with the exception of the Colorado biotype which is a dual purpose meat type.

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Iyengar, Amit, Nicholas J. Goel, John J. Kelly, Jason Han, Chase R. Brown, Fabliha Khurshan, Zehang Chen et Nimesh D. Desai. « Predictors of 30-day readmission and resource utilization after thoracic endovascular aortic repair ». European Journal of Cardio-Thoracic Surgery 58, n^o 3 (9 mai 2020) : 574–82. http://dx.doi.org/10.1093/ejcts/ezaa128.

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Abstract OBJECTIVES The introduction and expansion of thoracic endovascular aortic repair (TEVAR) have revolutionized the treatment of a variety of thoracic aortic diseases. We sought to evaluate the incidence, causes, predictors and costs associated with 30-day readmission after TEVAR in a nationally representative cohort. METHODS Adult patients undergoing isolated TEVAR were identified in the National Readmissions Database from 2010 to 2014. Hospital costs were estimated by converting individual hospital charge data adjusted to 2014 consumer price indices. Multivariable logistic regression was utilized to determine hospital- and patient-level factors associated with readmissions. RESULTS A total of 24 983 TEVARs were noted during the study period; the average age of the patients was 65 ± 16 years; 40% were women. The most common indication was an intact thoracic aneurysm (43.5%), followed by aortic dissection (30.5%). The average cost of the index admission was $63 644 ± $52 312; the average hospital stay was 11 ± 14 days; the index mortality rate was 6.7%. Readmissions within 30 days occurred in 17.4% of patients. Indications for readmission were varied; the most common aetiologies were cardiac (17.8%), infectious (16.0%) and pulmonary (12.1%). On multivariable analysis, the strongest predictor of readmission was the diagnosis, with a ruptured thoraco-abdominal aneurysm having the highest readmission burden (adjusted odds ratio 2.23, 1.17–4.24; P = 0.015). Notably, hospital volume did not predict index hospital length of stay, costs or 30-day readmissions (all P > 0.10). CONCLUSIONS Annual TEVAR volume was not associated with any of the outcomes assessed. Rather, indication for TEVAR was the strongest predictor for many outcomes. As TEVAR becomes increasingly utilized, a focus on cardiac and vascular diseases may reduce readmissions and improve quality of care.

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Juaneda, Ernesto, Danilo Catalfamo, Juan P. Fregapani, Alejandro Peirone, Ignacio Juaneda, Cristian Kreutzer et Sergio Lucino. « Magnetic resonance lymphangiography in group 1 paediatric pulmonary arterial hypertension ». Pulmonary Circulation 11, n^o 2 (30 mars 2021) : 204589402110047. http://dx.doi.org/10.1177/20458940211004777.

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Pulmonary hypertension could have thoracic lymphatic abnormalities caused by right ventricular failure. Since there is no description of such abnormalities, the purpose of this study was to investigate them with magnetic resonance. Prospective review magnetic resonance T2-weighted lymphangiography was performed between January 2017 and October 2019 through quantitative thoracic duct diameter, diameter index and qualitative lymphatic abnormalities types: 1 – little or none abnormalities, 2 – abnormalities in supraclavicular region, 3 – abnormalities extending into the mediastinum and 4 – abnormalities extending into the lung. Five patients with group 1 pulmonary arterial hypertension participated in this study. The mean age was 12.44 ± 4.92 years, three male and two female. The quantitative analysis yielded the following results: mean thoracic duct diameter of 2.92 ± 0.16 mm and thoracic duct index 2.28 ± 1.03 mm/m2. Qualitative lymphangiography abnormalities were type 1 in three patients, type 2 in one, all with low-risk determinants, and type 3 in one with high-risk determinants and right ventricular failure. Magnetic resonance T2-weighted lymphangiography in group 1 paediatric pulmonary arterial hypertension allowed for the identification of the thoracic duct, which was used to perform both quantitative and qualitative analysis of thoracic lymphatic abnormalities, in particular when increased high-risk determinants and right ventricular failure were present. These features represent an extracardiac finding useful to understand systemic venous congestion impact on lymphatic system.

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Huan, Sheng, Jin Dai, Shilian Song, Guining Zhu, Yihao Ji et Guoping Yin. « Stroke volume variation for predicting responsiveness to fluid therapy in patients undergoing cardiac and thoracic surgery : a systematic review and meta-analysis ». BMJ Open 12, n^o 5 (mai 2022) : e051112. http://dx.doi.org/10.1136/bmjopen-2021-051112.

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ObjectiveTo evaluate the reliability of stroke volume variation (SVV) for predicting responsiveness to fluid therapy in patients undergoing cardiac and thoracic surgery.DesignSystematic review and meta-analysis.Data sourcesPubMed, EMBASE, Cochrane Library, Web of Science up to 9 August 2020.MethodsQuality of included studies were assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We conducted subgroup analysis according to different anaesthesia and surgical methods with Stata V.14.0, Review Manager V.5.3 and R V.3.6.3. We used random-effects model to pool sensitivity, specificity and diagnostic odds ratio with 95% CI. The area under the curve (AUC) of receiver operating characteristic was calculated.ResultsAmong the 20 relevant studies, 7 were conducted during thoracic surgery, 8 were conducted during cardiac surgery and the remaining 5 were conducted in intensive critical unit (ICU) after cardiac surgery. Data from 854 patients accepting mechanical ventilation were included in our systematic review. The pooled sensitivity and specificity were 0.73 (95％ CI: 0.59 to 0.83) and 0.62 (95％ CI: 0.46 to 0.76) in the thoracic surgery group, 0.71 (95％ CI: 0.65 to 0.77) and 0.76 (95％ CI: 0.69 to 0.82) in the cardiac surgery group, 0.85 (95％ CI: 0.60 to 0.96) and 0.85 (95％ CI: 0.74 to 0.92) in cardiac ICU group. The AUC was 0.73 (95% CI: 0.69 to 0.77), 0.80 (95% CI: 0.77 to 0.83) and 0.88 (95% CI: 0.86 to 0.92), respectively. Results of subgroup of FloTrac/Vigileo system (AUC=0.80, Youden index=0.38) and large tidal volume (AUC=0.81, Youden index=0.48) in thoracic surgery, colloid (AUC=0.85, Youden index=0.55) and postoperation (AUC=0.85, Youden index=0.63) in cardiac surgery, passive leg raising (AUC=0.90, Youden index=0.72) in cardiac ICU were reliable.ConclusionSVV had good predictive performance in cardiac surgery or ICU after cardiac surgery and had moderate predictive performance in thoracic surgery. Nevertheless, technical and clinical variables may affect the predictive value potentially.

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Ohrt-Nissen, Søren, Hideki Shigematsu, Jason Pui Yin Cheung, Keith D. K. Luk et Dino Samartzis. « Predictability of Coronal Curve Flexibility in Postoperative Curve Correction in Adolescent Idiopathic Scoliosis : The Effect of the Sagittal Profile ». Global Spine Journal 10, n^o 3 (17 septembre 2019) : 303–11. http://dx.doi.org/10.1177/2192568219877862.

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Study Design: Retrospective cohort study. Objectives: To assess how the thoracic kyphosis affects the ability of the fulcrum bending radiograph (FBR) to predict the coronal thoracic curve correction. Methods: A retrospective study of prospectively collected data was conducted of 107 consecutive patients with thoracic adolescent idiopathic scoliosis (AIS) treated with a standard screw-fixation protocol. Radiographic variables were assessed preoperatively and at 2-year follow-up. Curve flexibility was determined based on the FBR and the Fulcrum Bending Flexibility Index (FBCI). Radiographic variables included preoperative Cobb angle, T5-T12 kyphosis, T12-S1 lordosis, sagittal vertical axis, list, T1-T12 length, truncal shift, and radiographic shoulder height. Patients were also categorized as hypo-, normo-, or hyperkyphotic. Results: Based on multivariate modeling, an increase in FBR Cobb angle and thoracic kyphosis were significantly associated with an increase in FBCI (increased mismatch between the FBR and postoperative Cobb angles) at 2-year follow-up ( P < 0.001). In patients with hyperkyphosis, a longer instrumented length existed despite similar curve size and shorter curve length than the hypo- and normokyphotic groups. Based on these findings, we developed a new predictive postoperative curve correction index, known as the Multiprofile Flexibility Index (MFI). Conclusions: Our results show that an increase in preoperative thoracic kyphosis is associated with an increased difference between the preoperative coronal curve flexibility and the postoperative coronal curve correction. Our findings broaden the understanding of curve flexibility and indicate that selection of fusion levels may need to take into consideration the sagittal profile to improve clinical decision making and optimize outcome.

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Saval, M. A., W. J. Armstrong, T. N. Ziegenfuss et J. K. Ehrman. « REPRODUCIBILITY OF THORACIC ELECTRICAL BIOIMPEDANCE (TEB) DERIVED STROKE INDEX (SI) ». Medicine & ; Science in Sports & ; Exercise 33, n^o 5 (mai 2001) : S209. http://dx.doi.org/10.1097/00005768-200105001-01180.

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Melendez, Jose A., et Vittoria Arslan Carlon. « Cardiopulmonary Risk Index Does Not Predict Complications After Thoracic Surgery ». Chest 114, n^o 1 (juillet 1998) : 69–75. http://dx.doi.org/10.1378/chest.114.1.69.

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CASTOR, G., et J. SIMON. « THORACIC ELECTRICAL BIOIMPEDANCE OR THERMODILUTION FOR MEASUREMENT OF CARDIAC INDEX ». British Journal of Anaesthesia 71, n^o 1 (juillet 1993) : 170. http://dx.doi.org/10.1093/bja/71.1.170-a.

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YOUNG, J. D., et P. MCQUILLAN. « THORACIC ELECTRICAL BIOIMPEDANCE OR THERMODILUTION FOR MEASUREMENT OF CARDIAC INDEX ». British Journal of Anaesthesia 71, n^o 1 (juillet 1993) : 170–71. http://dx.doi.org/10.1093/bja/71.1.170-b.

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Hunter, Brian, Diana French, John Warner et Daniel Remick. « Correlation of Body Mass Index with Thoracic and Abdominal Panniculus ». Journal of Forensic Sciences 43, n^o 2 (1 mars 1998) : 16162J. http://dx.doi.org/10.1520/jfs16162j.

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Deeb, A., E. L. Polhemus, D. N. Lee, C. Dumontier, L. N. Frain, M. T. Jaklitsch et S. J. Swanson. « Implementation of the Risk Analysis Index Across Thoracic Surgical Clinics ». Journal of Geriatric Oncology 13, n^o 8 (octobre 2022) : S50. http://dx.doi.org/10.1016/s1879-4068(22)00363-0.

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Thomas, Daniel C., Justin D. Blasberg, Brian N. Arnold, Joshua E. Rosen, Michelle C. Salazar, Frank C. Detterbeck, Daniel J. Boffa et Anthony W. Kim. « Validating the Thoracic Revised Cardiac Risk Index Following Lung Resection ». Annals of Thoracic Surgery 104, n^o 2 (août 2017) : 389–94. http://dx.doi.org/10.1016/j.athoracsur.2017.02.006.

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Mushkambarov, I. N., N. F. Beresten et S. B. Tkachenko. « Age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis ». Medical alphabet, n^o 5 (12 avril 2021) : 34–41. http://dx.doi.org/10.33667/2078-5631-2021-5-34-41.

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Background. Ischemic heart disease (CHD) holds a leading position in the structure of causes of general mortality and in the structure of mortality from cardiovascular diseases. We extended the standard echocardiography with assessment of thoracic aorta elasticity to identify markers of the thoracic aorta elasticity worsen associated with coronary atherosclerosis. When analyzing the data, we identified different clinical characteristics of study participants as one of the main reasons for the difficulty in comparing the data with the results of previous studies, which made it necessary to highlight age and gender characteristics of indicators.Aim. To analyze age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis.Material and methods. An observational analytical cross- sectional clinical trial was conducted from 2016 to 2019. Our study included 109 patients aged 39 to 82 years (mean age 65 ± 9 years, median 66 years), who were divided into 2 groups according to the results of invasive coronarography: 64 patients with coronary atherosclerosis and 45 patients without angiographic signs of coronary atherosclerosis. In the group with coronary atherosclerosis average age was 66 ± 8 years (median 66 years). In the group without coronary atherosclerosis average age was 64 ± 9 years (median 66 years). During transthoracic echocardiography, the following were obtained: coefficient of distensibility, compliance coefficient, elasticity (stiffness) module of Peterson, stiffness index of the ascending thoracic aorta; systolic velocity S, early diastolic velocity E, late diastolic velocity A of the near wall of the ascending aorta, flow velocity propagation (FVP) of the descending thoracic. Analysis of age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis was done.Results. An increase in the stiffness index of the ascending thoracic aorta associated with coronary atherosclerosis occurs in the age group 39–66 years, a decrease in the coefficients of extensibility and compliance, an increase in Peterson’s modulus of elasticity (stiffness) of the as cending thoracic aorta — in the age group 67–82 years. A decrease in the E velocity of the near wall of the ascending thoracic aorta and FVP, associated with coronary atherosclerosis, occurs regardless of belonging to the age group, a decrease in the S velocity — in the age group 39–66 years. A decrease in the compliance coefficient of the ascending thoracic aorta, velocity S of the near wall of the ascending thoracic aorta, associated with coronary atherosclerosis, occurs only in men, an increase in the stiffness index — only in women. A decrease in the extensibility coefficient, an increase in the Peterson’s modulus of elasticity (stiffness), a decrease in the E velocity, and a decrease in CRP associated with coronary atherosclerosis occur regardless of gender.Conclusion. Worsening of the thoracic aorta elasticity in patients with coronary atherosclerosis, assessed using echocardiographic technologies, depends on gender and age.

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Schleifer, Lindsay, Sarah Vogel, Anirudh Arun, Ying Wei Lum, Courtney Lawrence, Ferdinand Hui et Lisa R. Sun. « Stroke Caused by Arterial Thoracic Outlet Syndrome in an Adolescent ». Child Neurology Open 9 (janvier 2022) : 2329048X2211057. http://dx.doi.org/10.1177/2329048x221105743.

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Arterial thoracic outlet syndrome is a rare condition characterized by compression of the subclavian artery, often with post-stenotic aneurysm formation. Artery-to-artery embolic strokes related to thoracic outlet syndrome have been reported in the posterior circulation and in the ipsilateral anterior circulation. We present a case in which a thrombus secondary to thoracic outlet syndrome caused a contralateral anterior circulation stroke in an adolescent and postulate mechanisms of this rare occurrence. This case demonstrates that a subclavian thrombus due to thoracic outlet syndrome can take a circuitous path and cause an anterior circulation stroke contralateral to the diseased subclavian artery. In addition, this case illustrates the importance of a high index of suspicion for thoracic outlet syndrome in patients with stroke and associated arm pain or discoloration.

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Monga, Akhil, Santosh B. Patil, Mathew Cherian, Santhosh Poyyamoli et Pankaj Mehta. « Thoracic Trauma : Aortic Injuries ». Seminars in Interventional Radiology 38, n^o 01 (mars 2021) : 084–95. http://dx.doi.org/10.1055/s-0041-1724009.

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AbstractThoracic aortic injuries caused by high impact trauma are life-threatening and require emergent diagnosis and management. With improvement in the acute care services, an increasing number of such injuries are being managed such that patients survive to undergo definitive therapies. A high index of clinical suspicion is required to order appropriate imaging. Computed tomography angiography is used to classify the injuries and guide treatment strategy. While low-grade injuries might be managed conservatively, high-grade injuries require urgent surgical or endovascular intervention. Over the past decade, endovascular repair of the thoracic aorta with or without a surgical bypass has become the preferred treatment with reduced mortality and morbidity. Rapid advancements in the stent graft technology have reduced the anatomic barriers to endovascular therapy and increased the confidence of the operators. Detailed planning prior to the procedure, understanding of the anatomy, correct choice of hardware, and adherence to technical protocol are essential for a successful endovascular procedure. These patients are often young and the limited data on the long-term outcome of aortic stent grafts make a case for a robust follow-up protocol.

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Saad, Ivete Alonso Bredda, Eduardo Mello De Capitani, Ivan Felizardo Contrera Toro et Lair Zambon. « Clinical variables of preoperative risk in thoracic surgery ». Sao Paulo Medical Journal 121, n^o 3 (2003) : 107–10. http://dx.doi.org/10.1590/s1516-31802003000300004.

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CONTEXT: Pulmonary complications are the most common forms of postoperative morbidity in thoracic surgery, especially atelectasis and pneumonia. The first step in avoiding these complications during the postoperative period is to detect the patients that may develop them. OBJECTIVE: To identify risk variables leading to early postoperative pulmonary complications in thoracic surgery. DESIGN: Prospective study. SETTING: Hospital das Clínicas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. PATIENTS: 145 patients submitted to elective surgery were classified as low, moderate and high risk for postoperative pulmonary complications using a risk assessment scale. PROCEDURES: The patients were followed up for 72 hours after the operation. Postoperative pulmonary complications were defined as atelectasis, pneumonia, tracheobronchitis, wheezing, prolonged intubation and/or prolonged mechanical ventilation. MAIN MEASUREMENTS: Univariate analysis was applied in order to study these independent variables: age, nutritional status, body mass index, respiratory disease, smoking habit, spirometry and surgery duration. Multivariate logistic regression analysis was performed in order to evaluate the relationship between independent and dependent variables. RESULTS: The incidence of postoperative complications was 18.6%. Multivariate logistic regression analysis showed that the variables increasing the chances of postoperative pulmonary complications were wheezing (odds ratio, OR = 6.2), body mass index (OR = 1.15), smoking (OR = 1.04) and surgery duration (OR = 1.007). CONCLUSION: Wheezing, body mass index, smoking and surgery duration increase the chances of postoperative pulmonary complications in thoracic surgery

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Rezende, Marcos Paulo Gonçalves de, Paulo Costa Ferraz, Paulo Luiz Souza Carneiro et Carlos Henrique Mendes Malhado. « Phenotypic diversity in buffalo cows of the Jafarabadi, Murrah, and Mediterranean breeds ». Pesquisa Agropecuária Brasileira 52, n^o 8 (août 2017) : 663–69. http://dx.doi.org/10.1590/s0100-204x2017000800012.

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Abstract: The objective of this work was to estimate the phenotypic diversity in Jafarabadi, Murrah, and Mediterranean buffalo cows (Bubalus bubalis). Thoracic perimeter, withers-and-rump height, body length, and biiliac, external biischiatic, external ilioischiatic, sacropubic, and mean biiliac diameters were measured. The following indexes were calculated: anamorphosis index, pelvic index, withers-to-rump ratio, body index, lateral-body index, relative body index, body capacity indexes 1 and 2, transversal pelvic index, longitudinal pelvic index, and thoracic-perimeter-to-withers ratio index. The effect of breed was evaluated using univariate (mean tests) and multivariate (size-free discriminant analysis and Fisher’s linear discriminant function) analyses. The diversity among the breeds and their correlation with the variables were also evaluated using biplot graphs developed from principal component analysis. The breeds evaluated show a rectilinear, midline body model with similar capacity of muscular tissue development in body parts from which the most valuable cuts are extracted, and intermediate suitability for meat and milk production. The Jafarabadi breed has a larger body size, with a rear portion wider than longer, while the Murrah and Mediterranean breeds show similar biotypes, mainly differentiated in the pelvic region.

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Suemitsu, Ryuichi, Taro Sakoguchi, Keiko Morikawa, Masafumi Yamaguchi, Hiroyuki Tanaka et Sadanori Takeo. « Effect of Body Mass Index on Perioperative Complications in Thoracic Surgery ». Asian Cardiovascular and Thoracic Annals 16, n^o 6 (décembre 2008) : 463–67. http://dx.doi.org/10.1177/021849230801600607.

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Obesity is perceived as a risk factor in general thoracic surgery. We conducted a single-center retrospective evaluation of perioperative complications in 822 patients who underwent thoracic surgery between 2000 and 2005. According to body mass index, 82 were underweight (< 18.5 kg·m−2), 568 were normal (18.5–24.9 kg·m−2), 155 were overweight (25.0–29.9 kg·m−2), and 17 were obese (≥30 kg·m−2). A significant increase in preoperative comorbidity (hypertension and ischemic heart disease) was observed with increasing body mass index. There was no significant difference in operation time or length of stay in the operating room, but extubation time was significantly different among the 4 groups. Of the intraoperative complications, alveolar-arterial oxygen difference increased significantly with increasing obesity, and hypoxia was least common in the normal group. Postoperatively, there was more pulmonary leakage in the underweight group and less pneumonia in the normal group. Both the underweight and the obese are at increased risk of perioperative complications and need to be carefully observed and managed intraoperatively and postoperatively.

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Narisawa, Ayumi, Toshiki Endo, Kenichi Sato, Mika Watanabe, Akira Takahashi et Teiji Tominaga. « Spinal dural arteriovenous shunt presenting with intramedullary hemorrhage ». Journal of Neurosurgery : Spine 20, n^o 3 (mars 2014) : 322–26. http://dx.doi.org/10.3171/2013.12.spine12163.

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The authors report on a 49-year-old man with a thoracic spinal dural arteriovenous shunt (dAVS) in which rupture of a varix caused intramedullary hemorrhage. In the literature, patients with a thoracic dAVS predominantly present with congestive myelopathy; however, the patient featured in this report presented without increased deep tendon reflexes or muscle weakness, but instead with intermittent stabbing chest pain and paresthesia. Magnetic resonance images and angiograms demonstrated tortuous enlargement and the formation of a varix-like structure of the draining veins, features compatible with those of high-flow angiopathy. Recognition of this phenomenon is important in thoracic dAVS because intramedullary hemorrhage dramatically degrades outcome. A high index of clinical suspicion can prevent a similar case of thoracic dAVS from progressing to intramedullary hemorrhage.

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Kakinohana, Manabu, Seiya Nakamura, Tatsuya Fuchigami, Yuji Miyata et Kazuhiro Sugahara. « Influence of the Descending Thoracic Aortic Cross Clamping on Bispectral Index Value and Plasma Propofol Concentration in Humans ». Anesthesiology 104, n^o 5 (1 mai 2006) : 939–43. http://dx.doi.org/10.1097/00000542-200605000-00008.

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Background In this study, the authors investigated changes in Bispectral Index (BIS) values and plasma propofol concentrations (Cp) after aortic cross clamping in the descending thoracic aortic aneurysm repair surgery during propofol anesthesia. Methods Prospectively, in 10 patients undergoing thoracic aortic surgery during total intravenous anesthesia with propofol, BIS values were recorded during cross clamping of the descending thoracic aorta. In this study, the rate of propofol infusion was controlled to keep the BIS value between 30 and 60 throughout surgery. Simultaneously, Cp values in the blood samples taken from the right radial artery (area proximal to cross clamping) and the left femoral artery (area distal to cross clamping) were measured. Results Approximately 15 min after initiating aortic cross clamping, BIS values in all cases started to decrease abruptly. Cp values of samples taken from the radial artery after cross clamping of the aorta were significantly (P < 0.05) increased compared with pre-cross clamp values (1.8 +/- 0.4 microg/ml), and the mean Cp after aortic cross clamping varied between 3.0 and 5.3 microg/ml. In addition, there were significant differences in the Cp values between radial arterial and femoral arterial blood samples throughout aortic cross clamping. Cp values in samples from the radial artery were approximately two to seven times higher than those from the femoral artery. Conclusions This study showed that Cp values increased and BIS values decreased rapidly after aortic cross clamping in thoracic aortic aneurysm repair surgery during propofol anesthesia. These findings suggested that all anesthesiologists should control the infusion rate carefully, taking the abrupt changes in its pharmacokinetics into consideration, especially during cross clamping of the descending thoracic aorta.

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Nimbarte, Ashish D., Fereydoun Aghazadeh et Craig M. Harvey. « Effect of back belt on inter-joint coordination and postural index ». Occupational Ergonomics 5, n^o 4 (14 juin 2006) : 219–33. http://dx.doi.org/10.3233/oer-2005-5403.

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In this investigation posture restriction caused by back belt is studied. Two-dimensional kinematic data was collected from ten participants using nine marker positions. Angular displacement of nine body angles was compared. Effect of the back belt on the lifting posture was studied using postural index values and kinematic relationship hypothesis. Influence of back belt on the lifting technique throughout a lift was understood using the concept of interjoint coordination. Out of the nine body joint angles, five showed decreased flexion, three increased flexion and the remaining one showed no change in the flexion values. Kinematic relationship was found to exist between hip, knee, trunk and lumbar-thoracic joint. The behavior of postural index values supported the kinematic relationship hypothesis. The back belt affected the proximal to distal interjoint coordination between hip, knee, trunk and lumbar-thoracic joint, thus disturbing the natural style of lifting.

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Wang, Luhua. « Helical tomotherapy for advanced esophageal cancer improves target conformity and homogeneity : A comparison with fixed-field intensity-modulated radiotherapy ». JOURNAL OF ADVANCES IN PHYSICS 11, n^o 3 (28 décembre 2015) : 3146–55. http://dx.doi.org/10.24297/jap.v11i3.471.

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Purpose: To evaluate the usefulness of helical tomotherapy (HT) in the treatment of advanced esophageal cancer (EC) and compare target homogeneity, conformity and normal tissue doses between HT and fixed-field intensity-modulated radiotherapy (ff-IMRT).Methods: In all, 23 patients with cT3-4N0-1M0-1a thoracic EC (upper esophagus, 9 patients; middle esophagus, 6; distal esophagus, 6 and esophagogastric junction, 2) who were treated with ff-IMRT (60 Gy in 30 fractions) were re-planned for HT and ff-IMRT with the same clinical requireÂments. Comparisons were performed using the Wilcoxon matched-pair signed-rank test.Results: Compared with ff-IMRT, HT significantly reduced the homogeneity index for thoracic, upper, middle and distal ECs by 38%, 31%, 36% and 33%, respectively (P < 0.05). The conformity index was increased by HT for thoracic, upper and middle ECs by 9%, 9% and 18%, respectively (P < 0.05). Target coverage was improved by 1% with HT (P < 0.05). The mean lung dose was significantly reduced by HT for thoracic and upper ECs (P < 0.05). The V20 (volume receiving at least 20 Gy) and higher dose volumes of the lungs were decreased by HT in all cases, but the differences were significant for thoracic, upper and distal ECs (P < 0.05), with reductions of 2.1%, 3.1% and 2.2%, respectively. HT resulted in a larger lung V5 for thoracic, upper, middle and distal ECs, with increases of 3.5%, 1.5%, 7.2% and 3.2%, respectively. Heart sparing was significantly better with HT than with ff-IMRT in terms of the V30 and V40 for thoracic, upper, middle and distal ECs (P < 0.05).Conclusions: Compared to ff-IMRT, HT provides superior target coverage, conformity and homogeneity, with reduced the volume of high doses to the lungs and heart for advanced EC. HT may be a treatment option for advanced EC, especially upper EC.

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Park, Shin Jun, Seok Hyeon Kim et Soon Hee Kim. « Effects of Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome : A Randomized Controlled Pilot Study ». Healthcare 8, n^o 3 (2 septembre 2020) : 316. http://dx.doi.org/10.3390/healthcare8030316.

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Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned to three groups, the joint mobilization group (n = 10), exercise group (n = 10), and combination group (n = 10). After four weeks of treatment, the measured outcomes included thoracic kyphosis using a manual inclinometer; pectoralis major (PM) and upper trapezius (UT) muscle tone and stiffness using the MyotonPRO®; affected side passive range of motion (ROM) using the goniometer (flexion, abduction, medial rotation, and lateral rotation); and shoulder pain and disability index (SPADI). Results: All three groups had significant improvements in all variables (p < 0.05). Thoracic kyphosis; UT muscle tone; and flexion, medial rotation, and lateral rotation ROM and SPADI were all significantly improved in the combination group compared to the mobilization and exercise groups (p < 0.05). Conclusions: The combination therapy of thoracic mobilization and extension exercise can be regarded as a promising method to improve thoracic alignment and shoulder function in patients with subacromial impingement syndrome.

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Maduri, Rodolfo, Daniele Starnoni, Juan Barges-Coll, Steven David Hajdu et John Michael Duff. « Bone cylinder plug and coil technique for accurate pedicle localization in thoracic spine surgery : A technical note ». Surgical Neurology International 10 (19 juin 2019) : 104. http://dx.doi.org/10.25259/sni-258-2019.

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Background: Intraoperative identification of the correct level during thoracic spine surgery is essential to avoid wrong-level procedures. Despite technological progress, intraoperative imaging modalities for identifying the correct thoracic spine level remain unreliable and often lead to wrong-level surgery. To counter potential wrong-level operations, here, we have proposed a novel pedicle/bone cylinder marking technique for use in the thoracic spine utilizing biplanar fluoroscopy and confirmed with computed tomography (CT). Methods: First, under fluoroscopic guidance, a bone cylinder is removed from the correct thoracic pedicle. Next, endovascular coils are packed into the cancellous bone defect followed by reinsertion of the bony plug. The patient then undergoes a CT scan of the entire thoracolumbosacral spine to precisely identify the marked level before surgery. Results: We utilized this bone cylinder plug/coil technique to identify the T9-T10 level in a 56-year-old female with a soft thoracic disc herniation. The index thoracic pedicle was successfully localized before performing the unilateral minimally invasive laminectomy followed by the transpedicular thoracic disc excision. Conclusion: The bone cylinder plug/coil technique is a safe and effective method for marking the correct level in thoracic spine surgery, while also reducing the operative time.

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Cheon, Ji Hong, Na Na Lim, Geun Su Lee, Ki Hong Won, Sung Hoon Lee, Eun Young Kang, Hyun Kyung Lee et Younkyung Cho. « Differences of Spinal Curvature, Thoracic Mobility, and Respiratory Strength Between Chronic Neck Pain Patients and People Without Cervical Pain ». Annals of Rehabilitation Medicine 44, n^o 1 (29 février 2020) : 58–68. http://dx.doi.org/10.5535/arm.2020.44.1.58.

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Objective To investigate the differences of spinal curvature, thoracic sagittal mobility, and respiratory strength between patients with chronic neck pain (CNP) and people without cervical pain, and to determine the correlation between respiratory strength and thoracic mobility in CNP patients.Methods A total of 78 participants were finally included in this study, of whom 30 had no cervical pain and 48 had CNP. The Neck Disability Index (NDI), cervical lordotic curvature, thoracic kyphotic curvature, thoracic sagittal range of motion (ROM), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured and analyzed.Results In males, thoracic sagittal ROMMEP-MIP and MEP showed a significant difference between the no cervical pain group and the CNP group. In females, thoracic kyphotic curvature, thoracic sagittal ROMMEP-MIP, MIP, and MEP were significantly different between the no cervical pain group and the CNP group. Thoracic kyphotic curvature was significantly correlated with MEP and MIP in all population groups, and significantly correlated with NDI in the female group. Thoracic sagittal ROMMEP-MIP had a significant linear relationship with NDI, MEP, and MIP in all population groups.Conclusion The thoracic mobility during forced respiration was reduced in patients with CNP and was correlated with respiratory strength. Changes in the biomechanics of the cervicothoracic spine and rib cage due to CNP may contribute to impairment of respiratory strength.

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Tuz, Jacek, Adam Maszczyk et Anna Zwierzchowska. « The use of characteristics and indicators of body construction as predictors in the identification of the angle values of the physiological curves of the spine in sequential objective testing - mathematical models ». Baltic Journal of Health and Physical Activity 15, n^o 1 (2023) : Article2. http://dx.doi.org/10.29359/bjhpa.15.1.02.

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Introduction: The physiological curvatures of the spine in the sagittal plane are constantly evolving along with changes in the structure and proportions of the body and physical activity. The aim of this study is to identify and assess the strength of the influence of body features and indices on the values of lumbar lordosis and thoracic kyphosis angles with the use of a mathematical model. In the years 2006–2016, 1,314 female students aged ( ± SD 19.7 ± 0.4) (min.–max. 18.1–22.5) were examined. Materials and Methods. The following measurements were made: body mass (BM), body height (BH), waist circumference (WC), hips circumference (HC), body fat (%Fat), total body water (%TBW), the value of thoracic kyphosis angles (THKA) and lumbar lordosis angles (LLA). The body mass index (BMI), the body adiposity index (BAI), the waist–hip ratio (WHR) and the waist circumference (WC) were analyzed. Results: WC is the predictor for changes in the value of the angle of thoracic kyphosis, and the BAI is a predictor for changes in the value of angle of lumbar lordosis. Conclusion: The presented mathematical models are a method of non-invasive control of the values of the angles of thoracic kyphosis and lumbar lordosis and support the monitoring of the process of compensation, correction and therapy.

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Dave, K. S., Sanjay Kumar, Sandeep Singh, Ravi Agrawal, V. Krishna, J. L. Sahni et A. Dayal. « Physiological and anatomical index in reference to management of thoracic trauma ». Indian Journal of Thoracic and Cardiovascular Surgery 11, n^o 1 (juin 1995) : 27–32. http://dx.doi.org/10.1007/bf02860895.

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Klodell, Charles T., Emilio B. Lobato, Jessica L. Willert et Nikolaus Gravenstein. « Oximetry-Derived Perfusion Index for Intraoperative Identification of Successful Thoracic Sympathectomy ». Annals of Thoracic Surgery 80, n^o 2 (août 2005) : 467–70. http://dx.doi.org/10.1016/j.athoracsur.2005.02.075.

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Ginesu, Giorgio Carlo, Panagiotis Paliogiannis, Claudio F. Feo, Maria Laura Cossu, Antonio Mario Scanu, Alessandro Fancellu, Alessandro Giuseppe Fois et al. « Inflammatory Indexes as Predictive Biomarkers of Postoperative Complications in Oncological Thoracic Surgery ». Current Oncology 29, n^o 5 (8 mai 2022) : 3425–32. http://dx.doi.org/10.3390/curroncol29050276.

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The role of inflammatory responses in predicting outcomes in oncological thoracic surgery is still unclear. The aim of this study was to evaluate a series of blood count inflammation indexes as predicting factors for postoperative complications. We retrospectively studied 249 patients undergoing elective thoracic surgery in our institution between 2008 and 2020. A total of 184 patients underwent open surgery, and 65 underwent VATS. The neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios, Systemic Inflammation Response Index (SIRI) were calculated preoperatively and on the first and fourth postoperative days, as well as a new derivative index, the Aggregate Inflammation Systemic Index (AISI). Univariate correlations evidenced a statistically significant association between the NLR at the fourth postoperative day and the occurrence of surgical complications in the global cohort (rho = 0.15, p = 0.03). A similar significant association with MLR on the fourth postoperative day is found in the open group (rho = −0.15, p = 0.048). NLR and LMR on the fourth postoperative day are associated with postoperative complications in the whole and open groups, respectively. Simple, easy-to-perform and inexpensive, blood cell count indexes may be useful in predicting complications in oncological thoracic surgery. A greater number of broader, prospective, randomized studies are necessary to confirm these findings.

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Nie, Hong-Fei, et Kai-Xuan Liu. « Endoscopic Transforaminal Thoracic Foraminotomy and Discectomy for the Treatment of Thoracic Disc Herniation ». Minimally Invasive Surgery 2013 (2013) : 1–7. http://dx.doi.org/10.1155/2013/264105.

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Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6–41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery.

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Foo, Choong Hoon, Beatrix Yung Siang Hii, Chung Chek Wong et Khin Maung Ohn. « Acute neurological deficit caused by thoracic pseudomeningocele after spinal surgery ». BMJ Case Reports 14, n^o 7 (juillet 2021) : e243788. http://dx.doi.org/10.1136/bcr-2021-243788.

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Postoperative pseudomeningocele usually has a benign course. We report a rare presentation of postoperative acute neurological deficit caused by compressive thoracic pseudomeningocele. This patient had posterior spinal fusion and decompression surgery for thoracic ossification of posterior longitudinal ligament and ligamentum flavum. Intraoperative incidental durotomy was covered with hydrogel dural sealant. She developed acute neurological deterioration 1 week after index surgery. Emergency decompression surgery was performed. One year after the surgery, she showed good neurological recovery.

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Ribeiro, Rafael Paiva, Bárbara Vendramini Marchetti, Eduardo Bojunga de Oliveira et Claúdia Tarragô Candotti. « Kyphosis index obtained in X-ray and with flexicurve assessment in children and young people ». Revista Brasileira de Saúde Materno Infantil 17, n^o 1 (mars 2017) : 79–87. http://dx.doi.org/10.1590/1806-93042017000100005.

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Abstract Objectives: to assess the concurrent validity of kyphosis index measured in the flexicurve from the correlation of X-rays exams, identifying its accuracy and to assess the thoracic spine in children and young people. Methods: 31 young people at an average age of 11.1±3.4 years were evaluated by digital x-rays: (1) Cobb angle (ÂngCobb), (2) Kyphosis index (KIX), and (3) KIX angle (ÂngKIX). These were measured from the flexicurve design on the millimetric graph paper: (1) Kyphosis index (KIFint), obtained from C7 the intersection of kyphosis-lordosis, (2) Kyphosis index (KIFT12), obtained between C7 and T12, and (3) Kyphosis angle (ÂngKIFint and ÂngKIFT12). Statistical analysis: Correlation to Pearson Moment-Product and t test (α<0.05). Results: the angular values (ÂngKIFint, ÂngKIFT12, ÂngKIX) were underestimated in relation to Cobb angle (p<0.05), correlating only to KIX angle and Cobb angle [r=0.698, p<0.001]. The linear values (KIFint, KIFT12, KIX) were similar ( p>0.05) among themselves, correlating only to KIX and Cobb angle [r=0.698, p<0.001] and KIX angle and KIX [r=1; p<0.001]. Conclusions: the KIX and KIX angle presented as an accurate method and valid to be used in the thoracic kyphosis assessment, although KIFint, KIFT12, KIFint angle and KIFT12 angle showed no correlation to the gold standard and not being indicated to assess the thoracic kyphosis in children and young people.

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Lazaro, Bruno C. R., Fatih Ersay Deniz, Leonardo B. C. Brasiliense, Phillip M. Reyes, Anna G. U. Sawa, Nicholas Theodore, Volker K. H. Sonntag et Neil R. Crawford. « Biomechanics of thoracic short versus long fixation after 3-column injury ». Journal of Neurosurgery : Spine 14, n^o 2 (février 2011) : 226–34. http://dx.doi.org/10.3171/2010.10.spine09785.

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Object Posterior screw-rod fixation for thoracic spine trauma usually involves fusion across long segments. Biomechanical data on screw-based short-segment fixation for thoracic fusion are lacking. The authors compared the effects of spanning short and long segments in the thoracic spine. Methods Seven human spine segments (5 segments from T-2 to T-8; 2 segments from T-3 to T-9) were prepared. Pure-moment loading of 6 Nm was applied to induce flexion, extension, lateral bending, and axial rotation while 3D motion was measured optoelectronically. Normal specimens were tested, and then a wedge fracture was created on the middle vertebra after cutting the posterior ligaments. Five conditions of instrumentation were tested, as follows: Step A, 4-level fixation plus cross-link; Step B, 2-level fixation; Step C, 2-level fixation plus cross-link; Step D, 2-level fixation plus screws at fracture site (index); and Step E, 2-level fixation plus index screws plus cross-link. Results Long-segment fixation restricted 2-level range of motion (ROM) during extension and lateral bending significantly better than the most rigid short-segment construct. Adding index screws in short-segment constructs significantly reduced ROM during flexion, lateral bending, and axial rotation (p < 0.03). A cross-link reduced axial rotation ROM (p = 0.001), not affecting other loading directions (p > 0.4). Conclusions Thoracic short-segment fixation provides significantly less stability than long-segment fixation for the injury studied. Adding a cross-link to short fixation improved stability only during axial rotation. Adding a screw at the fracture site improved short-segment stability by an average of 25%.

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Gokon, Yusuke, Yusuke Taniyama, Tadashi Sakurai, Takahiro Heishi, Chiaki Sato, Hiroshi Okamoto, Kai Takaya, Shota Maruyama et Takashi Kamei. « PS01.124 : AN OPTIMAL SURGICAL APPROACH AND THE EXTENT OF LYMPH NODE DISSECTION FOR BARRETT’S ADENOCARCINOMA ». Diseases of the Esophagus 31, Supplement_1 (1 septembre 2018) : 85. http://dx.doi.org/10.1093/dote/doy089.ps01.124.

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Abstract Background An optimal surgical approach and the extent of lymph node dissection for Barrett's adenocarcinoma remain controversial. The standard surgical approach for Barrett's adenocarcinoma at our institution is performing thoracoscopic esophagectomy. Proximal gastrectomy is preferred in cases where distance between the proximal edge of the primary tumor and the esophagogastric junction is < 3 cm. However, some studies suggest a complete resection of Barrett's esophagus. Methods The clinicopathologic data of 36 patients with Barrett's adenocarcinoma who were admitted to our institution between 1994 and 2017 were retrospectively analyzed to assess the efficacy of lymph node dissection at each station using the index of estimated benefit from lymph node dissection (IEBLD). Results The tumor locations were found to be the middle thoracic, lower thoracic, and abdominal esophagus in 2 (5.6%), 17 (47.2%), and 17 (47.2%) cases, respectively. A total of 28 (77.8%), 6 (16.7%), and 2 (5.5%) patients underwent esophagectomy, proximal gastrectomy, and transhiatal esophagectomy, respectively. The overall lymph node metastasis rate was 41.6%. The IEBLD indexes of the middle/lower thoracic lymph and the abdominal lymph nodes were comparable, whereas those of the paraesophageal lymph nodes (#108 and 110) were relatively high. Conversely, the metastasis rates of the upper thoracic lymph nodes were 13.9%, with no IEBLD values. Cervical lymph node metastasis was not identified, and the significance of dissection was unclear. Stratified by the location of tumor, the ILBLD index of middle/lower thoracic lymph node was relatively high in Lt cases. Conversely, those of abdominal lymph nodes were high and those of middle thoracic lymph nodes were not identified in Ae cases. In proximal gastrectomy cases, the complete resection of Barrett's esophagus was not achieved in 2 (40%) cases with LSBE. Lymph node metastasis was identified in one case (#110). The recurrence-free survival rate was 100%. Conclusion The significance of upper thoracic lymph node dissection was unclear, whereas those of middle/lower thoracic lymph and the abdominal lymph nodes were comparable. The selection of an appropriate surgical approach at our institution was acceptable. The efficacy of complete resection of LSBE was not observed. Disclosure All authors have declared no conflicts of interest.

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Berger, Tim, Maximilian Kreibich, Felix Mueller, Bartosz Rylski, Stoyan Kondov, Holger Schröfel, Clarence Pingpoh, Friedhelm Beyersdorf, Matthias Siepe et Martin Czerny. « The frozen elephant trunk technique for aortic dissection is safe after previous aortic repair ». European Journal of Cardio-Thoracic Surgery 59, n^o 1 (10 octobre 2020) : 130–36. http://dx.doi.org/10.1093/ejcts/ezaa288.

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Abstract OBJECTIVES The goal of this study was to evaluate outcomes of aortic arch replacement using the frozen elephant trunk (FET) technique after previous proximal and/or distal open or endovascular thoracic aortic repair. METHODS Sixty-three patients [median age: 63 (55–74) years; 65% men] were operated on for acute or chronic aortic dissection after previous proximal and/or distal open or endovascular thoracic aortic repair. Intraoperative details, clinical outcome and follow-up results were evaluated. RESULTS The median time between the index and the FET procedure was 81 (40–113) months. Fifty-eight (92%) patients had already undergone proximal aortic surgery; supracoronary ascending aortic replacement was the most frequent index procedure [n = 25 (40%)]. Distal aortic interventions had been done in 8 (13%) patients including endovascular thoracic aortic repair in 6 patients (10%). In-hospital mortality was 3% (n = 2). Postoperative strokes occurred in 5 patients (8%); of those, 1 stroke was dissection-related (2%). Subsequent aortic reinterventions after the FET procedure had to be done in 33% (n = 21). CONCLUSIONS Outcomes of aortic arch replacement using the FET technique after previous proximal and/or distal open or endovascular thoracic aortic repair are associated with low mortality and morbidity. Still, postoperative stroke remains an issue. After the successful accomplishments, the approach serves as an ideal platform for the secondary surgical or endovascular downstream aortic procedures, which are frequently needed.

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Hancock, Shelley, Curtis Froehlich, Veronica Armijo-Garcia et Andrew D. Meyer. « Extracorporeal membrane oxygenation support in individuals with thoracic insufficiency ». Perfusion 33, n^o 8 (23 mai 2018) : 696–98. http://dx.doi.org/10.1177/0267659118778173.

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Introduction: Respiratory failure is the leading cause of mortality in individuals with congenital spine and rib deformities. We present a case report of a child with Jeune syndrome surviving respiratory failure using extracorporeal membrane oxygenation (ECMO). We also summarize thoracic insufficiency syndrome cases reported in the Extracorporeal Life Support Organization (ELSO) registry. Case Report: A two-year-old male with a chest circumference less than a third percentile for age was admitted with influenza pneumonia developing a peak oxygenation index of 103.5. The child survived to baseline pulmonary function after nine days of venous-arterial ECMO support. Discussion: The ELSO registry contained 27 individuals with a surrogate diagnosis of thoracic insufficiency (0.05%). There was no significant difference in survival to discharge for thoracic insufficiency patients (52%) compared to a previously healthy population supported with ECMO. Conclusion: ECMO is safe and may be effective in supporting individuals with thoracic insufficiency.

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Gorial, Faiq I., Mohammad Yahya Abdulrazaq et Hayder Adnan Fawzi. « A NOVEL STUDY OF VALIDITY OF LATENT TUBERCULOSIS AS A PREDICTOR TO TUBERCULOSIS OF THORACIC SPINE ». Asian Journal of Pharmaceutical and Clinical Research 11, n^o 9 (7 septembre 2018) : 234. http://dx.doi.org/10.22159/ajpcr.2018.v11i9.26676.

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Objective: The objective of this study is to assess the validity of latent tuberculosis (TB) as a predictor for TB of thoracic spine.Methods: This cross-sectional study involved 31 patients with osteoarticular TB diagnosed on the base of clinical features, magnetic resonance imaging, and tissue biopsy. Patients’ demographic and clinical characteristics of the disease were recorded. Latent TB was diagnosed by tuberculin skin test (TST) >10 mm. Results: The mean age of patients was 44.9 ± 19.0 years. Females were 17 (54.8) and mean body mass index was 24.6 ± 4.9 kg/m2. Thoracic spine was the highest osteoarticular TB site. Then, lumbar spine TB was 3 (9.7%) patients. Third in rank was TB of the knee joints 2 (6.5%). Cervical spine and hip joint TB were each one, 1 (3.2) patients, respectively. Validity of latent TB as a test to predict TB of thoracic spine revealed that if TST was positive, then this test will be accurate in 77.42% and we can establish the diagnosis of TB of the thoracic spine with 90.48% confidence if we had a clinical suspicion of TB of thoracic spine.Conclusion: There was a significant positive correlation between osteoarticular TB and latent TB. Thoracic spine TB was the most common osteoarticular TB infection compared to other sites. Patients who had latent TB have 9.5 times risk of having TB of the thoracic spine. Latent TB was a valid measure to predict TB of thoracic spine.

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Park, Gun-Woo, Jungae An, Sang-Woo Kim et Byoung-Hee Lee. « Effects of Sling-Based Thoracic Active Exercise on Pain and Function and Quality of Life in Female Patients with Neck Pain : A Randomized Controlled Trial ». Healthcare 9, n^o 11 (5 novembre 2021) : 1514. http://dx.doi.org/10.3390/healthcare9111514.

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This study aimed to investigate the effects of sling-based thoracic active exercise on pain, function, and quality of life in female patients with neck pain. A total of 27 female patients with neck pain were divided into the sling-based thoracic active exercise group (n = 14) and the control group (n = 13). The study group performed a sling-based thoracic active exercise with cervical manual therapy for 50 min a day, twice a week for 4 weeks, whereas the control group performed a placebo exercise with cervical manual therapy in the same manner as the study group. Evaluation of the degree of pain before and after treatment was based on the pressure pain threshold and numeric pain rating scale scores. The craniovertebral angle and neck disability index (NDI) were used to evaluate neck function, and quality of life was measured using the Short Form-36. Afterwards, the patients’ pressure pain thresholds were significantly increased, and the numeric pain rating scale score was significantly decreased in both groups (p < 0.05). In terms of function, the craniovertebral angle was significantly increased in both groups (p < 0.05), and neck dysfunction significantly decreased (p < 0.05). The quality of life significantly increased in both groups (p < 0.05). The pressure pain threshold, craniovertebral angle, neck dysfunction index, and quality of life scores (p < 0.05) were significantly different between groups, except the numeric pain scale score. Our results showed that sling-based thoracic active exercise is effective in reducing pain and improving function and quality of life in female patients with neck pain, thus emphasizing the need for thoracic treatment for such patients.

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Dhiman, Monika, et Maman Paul. « Effectiveness of Selected Exercise Programme on Cervical Range of Motion in Patients with Thoracic Kyphosis & ; Forward Head Posture ». International Journal of Physiotherapy and Research 9, n^o 4 (11 juillet 2021) : 3863–69. http://dx.doi.org/10.16965/ijpr.2021.125.

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Background: Altered postural behaviours result in Forward head posture and thoracic kyphosis making it amenable to correction. The biomechanical strain, in presence of reduced strength of the core stabilizing musculature, in particular, if it is repeated or prolonged, is the predominant explanation for symptoms associated with forward head posture and thoracic kyphosis i.e., neck pain and reduced cervical range of motion. Objective: The aim of the present study was to investigate and compare the effect of postural awareness and conventional exercises on the cervical range of motion in patients with thoracic kyphosis and forward head posture. Methodology: This experimental study was conducted on 60 subjects both male and female of age group 20-35yrs. Subjects were randomly divided into two groups consisting of 30 subjects each. Group A received hot pack and postural advice and Group B received hot pack and stretching and strengthening exercises. All the subjects received a total intervention of 4 days (alternate days) per week for 4 weeks. Results: Intra-group significant differences were obtained between pre- and post-treatment for all evaluated variables (p˂0.01) in both groups. The inter-group comparison showed significant differences (p˂0.01) between post-treatment variables of Group A and Group B where, Group B showed greater improvement than Group A. Conclusion: The treatment given to both the groups together can be used to improve cervical range of motion, thoracic kyphosis, and forward head posture. This study may serve as a guideline for physiotherapists when making decisions regarding possible interventions. KEY WORDS: Cervical range of motion, Craniovertebral angle, Forward head posture, Kyphosis index, Neck disability index, Thoracic kyphosis.

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Pape, Andreas, Christian F. Weber, Mohammed Laout, Max Steche, Saskia Kutschker, Oliver Horn, Bernhard Zwissler et Oliver Habler. « Thoracic Epidural Anesthesia with Ropivacaine Does Not Compromise the Tolerance of Acute Normovolemic Anemia in Pigs ». Anesthesiology 121, n^o 4 (1 octobre 2014) : 765–72. http://dx.doi.org/10.1097/aln.0000000000000340.

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Abstract Background: The initial treatment of an acute blood loss with acellular fluids leads to the dilution of the red cell mass remaining in the vasculature, that is, to acute normovolemic anemia. Whether the compensation and, thus, the tolerance of acute anemia, are affected by sympathetic block induced by thoracic epidural anesthesia has not yet been investigated. Methods: Eighteen anesthetized and mechanically ventilated pigs were instrumented with thoracic epidural catheters and randomly assigned to receive an epidural injection of either 5-ml ropivacaine 0.2% (n = 9) aiming for a Th5–Th10 block or saline (n = 9) followed by continuous epidural infusion of 5 ml/h of either fluid. Subsequently, acute normovolemic anemia was induced by replacement of whole blood with 6% hydroxyethyl starch solution until a “critical” limitation of oxygen transport capacity was reached as indicated by a sudden decrease in oxygen consumption. The critical hemoglobin concentration quantified at this time point was the primary endpoint; secondary endpoints were hemodynamic and oxygen transport parameters. Results: Thoracic epidural anesthesia elicited only a moderate decrease in mean arterial pressure and cardiac index and a transient decrease in oxygen extraction ratio. During progressive anemia, the compensatory increases in cardiac index and oxygen extraction ratio were not compromised by thoracic epidural anesthesia. Critical hemoglobin concentration was reached at identical levels in both groups (ropivacaine group: 2.5 ± 0.6 g/dl, saline group: 2.5 ± 0.6 g/dl). Conclusion: Thoracic epidural anesthesia with ropivacaine 0.2% does not decrease the tolerance to acute normovolemic anemia in healthy pigs. The hemodynamic compensation of acute anemia is fully preserved despite sympathetic block, and the critical hemoglobin concentration remains unaffected.

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Prablek, Marc, John McGinnis, Sebastian J. Winocour, Edward M. Reece, Udaya K. Kakarla, Michael Raber, Alexander E. Ropper et David S. Xu. « Failures in Thoracic Spinal Fusions and Their Management ». Seminars in Plastic Surgery 35, n^o 01 (février 2021) : 020–24. http://dx.doi.org/10.1055/s-0041-1723832.

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AbstractInstrumented fixation and fusion of the thoracic spine present distinct challenges and complications including pseudarthrosis and junctional kyphosis. When complications arise, morbidity to the patient can be significant, involving neurologic injury, failure of instrumentation constructs, as well as iatrogenic spinal deformity. Causes of fusion failure are multifactorial, and incompletely understood. Most likely, a diverse set of biomechanical and biologic factors are at the heart of failures. Revision surgery for thoracic fusion failures is complex and often requires revision or extension of instrumentation, and frequently necessitates complex soft tissue manipulation to manage index level injury or to augment the changes of fusion.

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Scapolan, Maíra Benito, Nathália Lins Pontes Vieira, Silvia Stiefano Nitrini, Roberto Saad Junior, Roberto Gonçalves, Jacqueline Arantes Giannini Perlingeiro et Jorge Henrique Rivaben. « Thoracic trauma : analysis of 100 consecutive cases ». Einstein (São Paulo) 8, n^o 3 (septembre 2010) : 339–42. http://dx.doi.org/10.1590/s1679-45082010ao1532.

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ABSTRACT Objective: To analyze thoracic trauma assisted by the Emergency Service of Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo. Methods: One hundred patients with thoracic trauma were assisted throughout six months in 2006. Data from their records were collected and a protocol of thoracic trauma was fulfilled. The Revised Trauma Score was used to evaluate gravity of injury and to calculate the survival index. Results: Prevalence of trauma injury in male from 20 to 29 years old was observed. Out of all patients, 44 had blunt trauma and 56 penetrating trauma (78.6% presented stab wounds and 21.4% gun shots). Up to the settings of injuries, 23% were in the thoracoabdominal transition, 7% in the precordium and 70% in the remainder thoracic area. In those with the thoracoabdominal transition injury, 22.7% were hemodynamically unstable and 77.3% stable. Thoracoabdominal injury patients presented 40.9% of diaphragm wound and all were stable. Of those with precordium wound, 37.5% presented cardiac injury. In cardiac onset, 66.7% presented stable and 33.3% unstable. Thoracic drainage was the most accomplished surgical procedure (71%). Conclusions: The thoracic trauma patient is most prevalently young male with stab wound penetrating injury, without associated injuries, hemodynamically stable, presenting hemothorax, with high probability of survival.

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WANG, FANG, BINGYU WANG, YONG HAN, XIAOQUN HUANG et JIKUANG YANG. « A NUMERICAL STUDY ON CORRELATION OF RIB FRACTURES WITH THORACIC INJURY CRITERIA IN OBLIQUE IMPACT ». Journal of Mechanics in Medicine and Biology 17, n^o 08 (décembre 2017) : 1750113. http://dx.doi.org/10.1142/s0219519417501135.

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Thoracic injury is one of the vital issues in vehicle side crashes. Experiments have been done widely to study thoracic injuries using biological subjects but less virtual tests were made by using Finite Element (FE) models. This study aimed at determining the correlation of the computationally calculated thoracic injury (Number of Rib Fractures NRF) with existing thoracic injury criteria under pure side and oblique impacts. For this purpose, a previously developed thorax FE model was validated by using Post Mortem Human Subject (PMHS) tests in pure side and oblique impacts in this study. The rib fractures were reconstructed and compared with the fractures observed in the PMHS tests. The model was then used to simulate rib fractures in human thorax impactor tests at Principal Direction of Force (PDOF) angles of 90[Formula: see text] to 35[Formula: see text] (total of 12 impacts). Furthermore, the normalized NRF were calculated and analyzed for comparing with normalized simulated injury parameters based on various human thoracic injury criteria, including contact force criterion, thorax deflection criterion, compression criterion, upper spine acceleration criterion and Thoracic Trauma Index (TTI). It is suggested that the TTI criterion has better correlation with the NRF than the other injury criteria.

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Komsta, Renata, Anna Łojszczyk, Piotr Dębiak, Piotr Twardowski et Barbara Lisiak. « Computed tomographic evaluation of pectus excavatum in 14 cats ». PLOS ONE 17, n^o 1 (21 janvier 2022) : e0262866. http://dx.doi.org/10.1371/journal.pone.0262866.

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Pectus excavatum (PE) is one of the most frequently reported chest deformities. However, limited studies are available with regard to its CT scan findings in cats. In the present research computed tomographic images of the thoraxes of 14 cats diagnosed with PE has been reviewed. This is one of the first studies exploring the use of CT to characterise PE in animals. The aim of this study was to present characteristic CT features of PE in cats. The introduction of new criteria for better assessing thoracic wall deformity–a correction index (CI) and an asymmetry index (AI)–was also proposed. The study revealed a high variety of morphological features of PE in cats. It was demonstrated that among the 14 cats: cranial PE (an atypical location) occurred in seven cats while seven cats had typical (caudal) PE, long PE occurred in five cats, while short PE had nine cats. Of the 14 cats included in the study eight showed symmetric PE, and asymmetric PE was found insix. Thoracic asymmetry was found in six cats. Six cats had sternal torsion. Based on the Vertebral Index moderate or severe PE was revealed in 11 animals. In the group of cats studied the CI ranged from 12.20 to 32.11. The magnitude of AI did not exceed 10% in any of the cats studied. The study confirmed statistically significant differences in the CI values between groups of cats with different degrees of PE severity (p = 0.02). CT examination showed many PE features that have not been discussed so far. The main benefit of CT examination is its ability to reveal asymmetric PE, thoracic asymmetry and sternal torsion. CI and AI provided a clinically useful tool to quantify thoracic wall deformity in order to obtain comparable results between cats with PE.

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