52,370 results match your criteria Diaphragmatic Hernias Congenital


Diagnosis of diaphragm injuries using modern 256-slice CT scanners: too early to abandon operative exploration.

Trauma Surg Acute Care Open 2018 26;3(1):e000251. Epub 2018 Nov 26.

Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Background: Missed injury of the diaphragm may result in hernia formation, enteric strangulation, and death. Compounding the problem, diaphragmatic injuries are rare and difficult to diagnose with standard imaging. As such, for patients with high suspicion of injury, operative exploration remains the gold standard for diagnosis. Read More

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November 2018

Impact of Spontaneous Breathing Trial on Work of Breathing Indices Derived From Esophageal Pressure, Electrical Activity of the Diaphragm, and Oxygen Consumption in Children.

Respir Care 2018 Dec 11. Epub 2018 Dec 11.

Pediatric Intensive Care Unit, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montreal, Québec, Canada.

Background: The present study aimed to characterize the behavior of 3 components of respiratory muscle function during mechanical ventilation weaning in children to better understand the respective impact of a spontaneous breathing trial on ventilatory mechanical action (esophageal pressure [P], ventilatory demand (electrical activity of the diaphragm [EA]), and oxygen consumption.

Methods: This was a prospective single-center study. All children ≥ 1 months and <18 y old who were intubated and on mechanical ventilation, and who were hospitalized in the pediatric ICU were eligible. Read More

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December 2018
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Successful arterial switch operation for transposition of the great arteries with intact ventricular septum and congenital diaphragmatic hernia: A case report.

J Cardiol Cases 2014 Jul 17;10(1):39-41. Epub 2014 May 17.

Department of Cardiology, Aichi Children's Health and Medical Center, Obu, Japan.

We report performing a successful arterial switch operation on a full-term male infant with transposition of the great arteries and intact ventricular septum associated with a congenital diaphragmatic hernia. The patient developed severe persistent pulmonary hypertension after successful repair of a left congenital diaphragmatic hernia that restricted pulmonary blood flow into the hypoplastic left lung, and subsequent unilateral pulmonary congestion of the unaffected right lung occurred because of the hemodynamics generated by the transposition of the great arteries. Intravenous epoprostenol with nitric oxide inhalation and mechanical hypoventilation effectively controlled pulmonary vascular resistance before the arterial switch operation was performed. Read More

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Abdominal paradox encountered in neuromuscular disease: A possible clue for cor pulmonale.

J Cardiol Cases 2013 Mar 1;7(3):e71-e73. Epub 2013 Feb 1.

Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 80, Guro-2-dong, Guro-gu, Seoul 152 703, Korea.

Oculopharyngeal muscular dystrophy (OPMD) is an uncommon autosomal dominant disorder that has been characterized by slow progression. Neuromuscular disease is one of several etiologies of pulmonary volume restriction from extrinsic or parenchymatous causes and can lead to pulmonary hypertension and right-sided heart failure, which is consistent with cor pulmonale. Here we describe a case of an OPMD patient with cor pulmonale that was reversed using mechanically-assisted ventilation. Read More

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Expression of Nitric Oxide Synthase Interacting Protein (NOSIP) is Decreased in the Pulmonary Vasculature of Nitrofen-Induced Congenital Diaphragmatic Hernia.

Eur J Pediatr Surg 2018 Dec 10. Epub 2018 Dec 10.

Our Lady's Children's Hospital, National Children's Research Centre, Crumlin, Dublin, Ireland.

Introduction:  Persistent pulmonary hypertension (PPH) is a major cause of morbidity and mortality in newborns with congenital diaphragmatic hernia (CDH). PPH is characterized by increased vascular resistance and smooth muscle cell (SMC) proliferation, leading to obstructive changes in the pulmonary vasculature. Nitric oxide (NO), generated by endothelial NO synthase (eNOS), is an important regulator of vascular tone and plays a key role in pulmonary vasodilatation. Read More

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December 2018

On the feasibility of accessing acute pain-related facial expressions in the human fetus and its potential implications: a case report.

Pain Rep 2018 Sep-Oct;3(5):e673. Epub 2018 Jul 31.

Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.

Introduction: Although pain facial assessment is routinely performed in term and preterm newborns by the use of facial expression-based tools such as the Neonatal Facial Coding System, the assessment of pain during the intrauterine life has not been extensively explored.

Objective: Describe for the first time, an experimental model to assess and quantify responses due to acute pain in fetuses undergoing anaesthesia for intrauterine surgery recorded by high-resolution 4D ultrasound machines.

Methods/results-case Report: A 33-year-old pregnant woman had congenital left diaphragmatic hernia of poor prognosis diagnosed, and her fetus was treated by fetoscopic endotracheal occlusion. Read More

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Lateral approach of exploratory laparotomy through the open chest wall injury.

Trauma Case Rep 2018 Dec 28;18:52-55. Epub 2018 Nov 28.

Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Republic of Korea.

A combined laparotomy and thoracotomy is required in a few trauma patients. The anterior approach is a standard procedure used in such cases; however, a different approach may be required. Recently, we managed a patient who presented with a crush injury to the left side of his chest with associated bowel herniation. Read More

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December 2018

Trapped vessel of abdominal pain with hepatomegaly: A case report.

World J Hepatol 2018 Nov;10(11):887-891

Scripps Center for Organ Transplant, Scripps Green Hospital, La Jolla, CA 92037, United States.

Abdominal pain with elevated transaminases from inferior vena cava (IVC) obstruction is a relatively common reason for referral and further workup by a hepatologist. The differential for the cause of IVC obstruction is extensive, and the most common etiologies include clotting disorders or recent trauma. In some situations the common etiologies have been ruled out, and the underlying process for the patient's symptoms is still not explained. Read More

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November 2018

The genetics of congenital central hypoventilation syndrome: clinical implications.

Appl Clin Genet 2018 15;11:135-144. Epub 2018 Nov 15.

Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA,

Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder of the autonomic nervous system (ANS) and respiratory control. This disorder, formerly referred to as Ondine's curse, is due to a mutation in the gene that affects the development of the neural crest cells. CCHS has an autosomal dominant pattern of inheritance. Read More

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November 2018

De novo variants in congenital diaphragmatic hernia identify MYRF as a new syndrome and reveal genetic overlaps with other developmental disorders.

PLoS Genet 2018 Dec 10;14(12):e1007822. Epub 2018 Dec 10.

Department of Systems Biology, Columbia University Medical Center, New York, New York, United States of America.

Congenital diaphragmatic hernia (CDH) is a severe birth defect that is often accompanied by other congenital anomalies. Previous exome sequencing studies for CDH have supported a role of de novo damaging variants but did not identify any recurrently mutated genes. To investigate further the genetics of CDH, we analyzed de novo coding variants in 362 proband-parent trios including 271 new trios reported in this study. Read More

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December 2018

Diaphragm-protective mechanical ventilation.

Curr Opin Crit Care 2018 Dec 5. Epub 2018 Dec 5.

Interdepartmental Division of Critical Care Medicine, University of Toronto.

Purpose Of Review: Diaphragm dysfunction is common in mechanically ventilated patients and predisposes them to prolonged ventilator dependence and poor clinical outcomes. Mechanical ventilation is a major cause of diaphragm dysfunction in these patients, raising the possibility that diaphragm dysfunction might be prevented if mechanical ventilation can be optimized to avoid diaphragm injury - a concept referred to as diaphragm-protective ventilation. This review surveys the evidence supporting the concept of diaphragm-protective ventilation and introduces potential routes and challenges to pursuing this strategy. Read More

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December 2018

Evaluation of a wearable device to determine cardiorespiratory parameters from surface diaphragm electromyography.

IEEE J Biomed Health Inform 2018 Dec 5. Epub 2018 Dec 5.

The use of wearable devices in clinical routines could reduce healthcare costs and improve the quality of assessment in patients with chronic respiratory diseases. The purpose of this study is to evaluate the capacity of a Shimmer3 wearable device to extract reliable cardiorespiratory parameters from surface diaphragm electromyography (EMGdi). Twenty healthy volunteers underwent an incremental load respiratory test whilst EMGdi was recorded with a Shimmer3 wearable device (EMGdiW). Read More

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December 2018
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Liposomal steroid nano-drug is superior to steroids as-is in mdx mouse model of Duchenne muscular dystrophy.

Nanomedicine 2018 Dec 7. Epub 2018 Dec 7.

Pediatric Neuromuscular Laboratory, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Felsenstein Medical Research Center (FMRC), Schneider Children's Medical Center, Tel-Aviv University, Israel. Electronic address:

Glucocorticosteroids are the most efficacious anti-inflammatory agents and the gold standard treatment in Duchenne muscular dystrophy (DMD). However, their chronic use may lead to severe side effects. We evaluated the use of a novel injectable steroidal nano-drug in mdx mouse model of DMD by comparing the efficacy of nano-liposomes remotely loaded with the steroid prodrug, methylprednisolone hemisuccinate (MPS) with the same steroid as-is, in short (4-weeks) and long-term (58-weeks) treatments. Read More

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December 2018

Minimally Invasive Surgery for Resection of Diaphragm Metastases in Ovarian Cancer.

J Minim Invasive Gynecol 2018 Dec 7. Epub 2018 Dec 7.

Department of Surgical Gynecology, Mayo Clinic Hospital, Phoenix, Arizona.

Study Objective: To estimate pulmonary complications and diaphragm recurrence after resection of diaphragm metastases by minimally invasive surgery (MIS) for epithelial ovarian cancer (EOC).

Design: Retrospective analysis.

Design Classification: III. Read More

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December 2018
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Muscle specific kinase (MuSK) activation preserves neuromuscular junctions in the diaphragm but is not sufficient to provide a functional benefit in the SOD1 mouse model of ALS.

Neurobiol Dis 2018 Dec 4. Epub 2018 Dec 4.

Departments of Neuroscience, Genentech, South San Francisco, CA, USA. Electronic address:

Amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons, is characterized by rapid decline of motor function and ultimately respiratory failure. As motor neuron death occurs late in the disease, therapeutics that prevent the initial disassembly of the neuromuscular junction may offer optimal functional benefit and delay disease progression. To test this hypothesis, we treated the SOD1 mouse model of ALS with an agonist antibody to muscle specific kinase (MuSK), a receptor tyrosine kinase required for the formation and maintenance of the neuromuscular junction. Read More

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December 2018

An Unusual Case of Cardiac Tamponade Secondary to an Elevated Right Hemidiaphragm.

Can J Cardiol 2018 Dec 19;34(12):1688.e21-1688.e23. Epub 2018 Oct 19.

Northern Ontario School of Medicine, Health Sciences North, Sudbury, Ontario, Canada. Electronic address:

Diaphragmatic eventration in old age is a rare phenomenon. Typically, it is thought to originate as a result of failure of development of the muscles of the diaphragm. Less commonly, it can occur secondary to acquired conditions resulting from spinal cord or phrenic nerve injury and is only detected incidentally when the patient presents with dyspnea, chest infection, or cardiac compression symptoms. Read More

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December 2018

Practice patterns of surgery for advanced ovarian cancer: analysis from international surveys.

Jpn J Clin Oncol 2018 Dec 6. Epub 2018 Dec 6.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: We investigated the practice patterns of surgery for advanced ovarian cancer (AOC) through relevant international surveys.

Methods: After searching for 878 studies on surgery for AOC till 2017, we extracted 18 questions with similar query and answer formats from eight studies. Among them, 5 and 13 were classified as comprehensive and procedure information. Read More

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December 2018
4 Reads

Porous diaphragm syndrome with recurrent thymoma.

Respirol Case Rep 2019 Feb 28;7(2):e00391. Epub 2018 Nov 28.

Department of Medical Oncology Izumi City General Hospital Izumi Japan.

Porous diaphragm syndrome describes a defect in the diaphragm in which substances pass from the peritoneal cavity to the pleural space. Defects may be congenital or acquired. Acquired defects are caused by the thinning and eventual splitting of collagen fibres in the tendinous part of the diaphragm. Read More

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February 2019

Intra-amniotic Sildenafil Treatment Modulates Vascular Smooth Muscle Cell Phenotype in the Nitrofen Model of Congenital Diaphragmatic Hernia.

Sci Rep 2018 Dec 5;8(1):17668. Epub 2018 Dec 5.

Department of Pediatric General and Thoracic Surgery, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

The etiology of pulmonary vascular abnormalities in CDH is incompletely understood. Studies have demonstrated improvement in pulmonary vasculature with prenatal therapy in animal models. We hypothesize that prenatal sildenafil may attenuate defective pulmonary vascular development via modulation of vSMC phenotype from undifferentiated, proliferative phenotype to differentiated, contractile phenotype. Read More

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December 2018

Long-Term Performance of a Pneumatically Actuated Soft Pump Manufactured by Rubber Compression Molding.

Soft Robot 2018 Dec 1. Epub 2018 Dec 1.

1 Department of Chemistry and Applied Biosciences, Institute for Chemical and Bioengineering , ETH Zurich, Zurich, Switzerland .

We present a long-term performance study on a pneumatically actuated soft pump (SP). The pump was manufactured by adapting rubber compression technology. Important parameters influencing pump performance (e. Read More

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December 2018
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Anatomic Landmarks in Transoral Oropharyngeal Surgery.

J Craniofac Surg 2018 Nov 30. Epub 2018 Nov 30.

Otolaryngology Section, Head and Neck Surgery, Hospital Universitari Germans Trias i Pujol.

Introduction: Minimally invasive transoral surgery for oropharyngeal cancer is a challenge for head and neck surgeons because of the inside-out anatomic presentation and the confined workspace. This study was performed to describe the main neurovascular and muscular landmarks in a transoral approach. The authors propose an anatomic stratification for this surgery. Read More

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November 2018
2 Reads

Altered biventricular hemodynamic forces in patients with repaired tetralogy of Fallot and right ventricular volume overload because of pulmonary regurgitation.

Am J Physiol Heart Circ Physiol 2018 Dec 28;315(6):H1691-H1702. Epub 2018 Sep 28.

Lund University, Department of Clinical Sciences, Lund, Clinical Physiology, Skåne University Hospital , Sweden.

Intracardiac hemodynamic forces have been proposed to influence remodeling and be a marker of ventricular dysfunction. We aimed to quantify the hemodynamic forces in patients with repaired tetralogy of Fallot (rToF) to further understand the pathophysiological mechanisms as this could be a potential marker for pulmonary valve replacement (PVR) in these patients. Patients with rToF and pulmonary regurgitation (PR) > 20% ( n = 18) and healthy control subjects ( n = 15) underwent MRI, including four-dimensional flow. Read More

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December 2018
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Fetal Body Imaging: When is MRI Indicated?

Authors:
Marie Cassart

J Belg Soc Radiol 2017 Nov 18;101(Suppl 1). Epub 2017 Nov 18.

Hôpitaux Iris et Iris Sud, BE.

Recent improvements in fetal therapies and perinatal care and the multidisciplinary involvement in fetal medicine have increased the demand for more accurate prenatal diagnosis. Fetal Magnetic Resonance Imaging (MRI) is a complementary imaging technique for the assessment of thoraco-abdominal anomalies for which Ultrasonography (US) is not conclusive. It is indicated in selected situations to precise the prognosis in diaphragmatic hernia, to characterise the nature and extension of a pulmonary malformation, to locate a bowel atresia or to better depict an abdominal cystic lesion or tumoural extension. Read More

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November 2017
2 Reads

Phrenic nerve stimulation for diaphragmatic pacing in chronic ventilator-dependent patients.

Neurol India 2018 Nov-Dec;66(6):1834-1837

Department of Neurosurgery, Institute of Neurosciences, Medanta The Medicity, Gurugram, Haryana, India.

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December 2018

Synchronous diaphragmatic contraction associated with dual-chamber transvenous pacing in a dog.

J Vet Cardiol 2018 Nov 28. Epub 2018 Nov 28.

Boston Scientific Corporation, 3 Scimed Place, Maple Grove, MN 55311, USA.

A 3-year-old, 20-kg, spayed female, mix-breed dog received a dual-chamber pacemaker for management of symptomatic 3rd-degree atrioventricular block. Synchronous diaphragmatic contraction was documented to occur with atrial pacing. Various methods to reduce the occurrence of pacemaker-related phrenic nerve stimulation are discussed. Read More

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November 2018
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Changes in the use of effective and long-acting reversible contraception in Vietnam.

Contraception 2018 Nov 29. Epub 2018 Nov 29.

The Ohio State University (OSU), College of Public Health (CPH), Division of Epidemiology, Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA. Electronic address:

Objectives: To calculate the prevalence and identify correlates of unmet need for contraception and to assess whether prevalence of use of effective contraception and long-acting reversible contraception (LARC) has changed over time among married or cohabiting, reproductive-age women in Vietnam.

Methods: Study population was drawn from nationally-representative Multiple Indicator Cluster Surveys conducted in 2000, 2006, 2011, and 2014. Unmet need for contraception was defined as occurring when a fecund, married or cohabiting woman is not using any method of contraception but either does not want children or wants to delay birth for at least one year or until marriage. Read More

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November 2018
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Urethral length in female infants and its relevance in the repair of cloaca.

J Pediatr Surg 2018 Nov 7. Epub 2018 Nov 7.

Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, OH.

Aim Of The Study: The goals of urinary reconstruction in urogenital sinus and cloacal repair include: (1) positioning of the bladder neck above the urogenital diaphragm to maximize future urinary continence, and (2) creating a visible urethra that can be catheterized if needed. A recent algorithm in cloacal reconstruction proposed a urethral length of 1.5 cm as the key determinant in deciding whether to perform a total urogenital mobilization or a urogenital separation, the hypothesis being that a 1. Read More

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November 2018
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Inter- and Intra-rater Reliability of A Grading System for Congenital Diaphragmatic Hernia Defect Size.

J Surg Res 2019 Jan 17;233:82-87. Epub 2018 Aug 17.

Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address:

Background: The Congenital Diaphragmatic Hernia Study Group (CDHSG) registry is a multi-institutional tool to track outcomes of patients with CDH. The CDHSG asks surgeons to categorize diaphragmatic defect sizes as type A-D based on published guidelines. The reported size of the defect has been correlated with patient outcomes, but the reliability of this system has never been studied. Read More

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January 2019
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Respiratory syncytial virus prophylaxis in infants with congenital diaphragmatic hernia in the CARESS registry (2005-2017).

Clin Infect Dis 2018 Nov 30. Epub 2018 Nov 30.

Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Background: Infants with congenital diaphragmatic hernia (CDH) are at increased risk of respiratory morbidity from recurrent respiratory tract infections including those from respiratory syncytial virus (RSV). Data from prospective studies on RSV prophylaxis in CDH infants are limited. The objective was to determine the risk of respiratory illness- and RSV-related hospitalizations (RIH and RSVH, respectively) among infants prophylaxed for CDH, standard indications (SI), and those without increased risk (NR). Read More

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November 2018
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Percutaneous lead extraction and repositioning: An effective and safe therapeutic strategy for early ventricular lead perforation with dislocation both inside and outside the pericardial sac following a cardiac device implantation.

J Cardiovasc Electrophysiol 2018 Dec 5. Epub 2018 Dec 5.

Department of Cardiology, Hippokration General Hospital, 114 Vasilisis Sofias str, Athens, Greece.

Introduction: Cardiac perforation of the right ventricle associated with pacemaker or implantable cardioverter-defibrillator (ICD) leads' implantation is an uncommon, albeit potentially life-threatening, complication. The aim of this study is to further identify the optimal therapeutic strategy especially when lead dislocation has occurred outside the pericardial sac.

Methods And Results: The study population included 10 consecutive patients (6 female, mean age: 66. Read More

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December 2018
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ANNALS EXPRESS: Hematopoietic alterations in neonates with congenital diaphragmatic hernia receiving extracorporeal membrane oxygenation support.

Ann Clin Biochem 2018 Dec 4:4563218820052. Epub 2018 Dec 4.

Department of Neonatology and Pediatric Critical Care Medicine, University of Bonn Children's Hospital.

Background Extracorporeal membrane oxygenation procedure (ECMO) has been established in the therapy of respiratory insufficient infants with congenital diaphragmatic hernia (CDH). In CDH newborns, a delay in transfer to an ECMO center is associated with a sharp increase in mortality. Predictive factors for ECMO support are urgently needed. Read More

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December 2018
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Longitudinal changes in lung size and intrapulmonary artery Doppler during the second half of pregnancy in fetuses with congenital diaphragmatic hernia.

Prenat Diagn 2018 Dec 4. Epub 2018 Dec 4.

Fetal Medicine Mexico Foundation, Department of Fetal Surgery, Children and Women's Specialty Hospital of Queretaro, Mexico.

Objective: To evaluate longitudinal changes in lung size and intrapulmonary artery (IPa) Doppler in fetuses with congenital diaphragmatic hernia (CDH) and assess their contribution in predicting neonatal survival.

Methods: The observed/expected lung-to-head ratio (O/E-LHR) and IPa-Pulsatility Index (PI) and Peak Early Diastolic Reversed Flow (PEDRF) were evaluated in a cohort of left-sided CDH fetuses managed expectantly during pregnancy. Longitudinal changes were analyzed by multilevel analysis, and their value to predict survival using multiple logistic regression and decision-tree analysis was assessed. Read More

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December 2018
3 Reads

Neural Respiratory Drive Measured Using Surface Electromyography of Diaphragm as a Physiological Biomarker to Predict Hospitalization of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients.

Chin Med J (Engl) 2018 Dec;131(23):2800-2807

Chronic Airway Disease Research Office, Department of Respiratory, Geriatric Hospital of Nanjing Medical University, Jiangsu Province Geriatric Hospital, Nanjing, Jiangsu 210024, China.

Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi-electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients.

Methods: COPD patients visiting the outpatient department due to acute exacerbation were enrolled in this study. Read More

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December 2018
2 Reads

[Key anatomies of DeLancey's three levels of vaginal support theory: an observation in laparoscopic surgery].

Zhejiang Da Xue Xue Bao Yi Xue Ban 2018 Feb;47(4):329-337

Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, Department of Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.

Objective: To observe and verify the key anatomies of DeLancey's three levels of vaginal support theory through laparoscopic surgery by space dissection technique.

Methods: The features and stress performance of related anatomies were observed and analyzed in laparoscopic type C hysterectomy and pelvic lymphadenectomy for cervical cancer by natural space exposures.

Results: The main ligament-like structure at level Ⅰ was the uterosacral ligament, which acted as the main apical fixation in the sacral direction, while the cardinal ligament was mainly composed of vascular system, lymph-vessels and loose connective tissue around them, lacking the tough connective tissue structures, which was connected to the internal iliac vascular system. Read More

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February 2018
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Single lumen endotracheal intubation with carbon dioxide insufflation for lung isolation in thoracic surgery.

Surg Endosc 2018 Dec 3. Epub 2018 Dec 3.

Division of Thoracic Surgery, Department of Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Rd, NW, Washington, DC, 20007, USA.

Introduction: Double lumen tube (DLT) intubation is used for lung isolation but is not without disadvantages including increased intubation time, anesthesia expertise, risk of airway trauma, and costs over single lumen tube (SLT) intubation. SLT intubation with CO insufflation can be used as an alternative for lung isolation. We reviewed our experience with this technique during thoracoscopic surgery. Read More

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December 2018
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Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion.

Can Respir J 2018 30;2018:9761583. Epub 2018 Oct 30.

Faculty of Medicine, University of Belgrade, Serbia.

Aim: The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention.

Materials And Methods: This study included 378 patients with pleural effusions. US characteristics of effusions as the echo structure and pleural thickening were analyzed. Read More

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October 2018

Diaphragmatic dysfunction.

Pulmonology 2018 Nov 30. Epub 2018 Nov 30.

Pneumology Service, University Hospital Complex of Santiago, Santiago de Compostela, Spain; Interdisciplinary Research Group in Pulmonology, Institute of Sanitary Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

The diaphragm is the main breathing muscle and contraction of the diaphragm is vital for ventilation so any disease that interferes with diaphragmatic innervation, contractile muscle function, or mechanical coupling to the chest wall can cause diaphragm dysfunction. Diaphragm dysfunction is associated with dyspnoea, intolerance to exercise, sleep disturbances, hypersomnia, with a potential impact on survival. Diagnosis of diaphragm dysfunction is based on static and dynamic imaging tests (especially ultrasound) and pulmonary function and phrenic nerve stimulation tests. Read More

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November 2018

Right intersectional transection plane based on portal inflow in left trisectionectomy.

Surg Radiol Anat 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, Teikyo University Chiba Medical Center, 3246-3, Anesaki, Ichihara, Chiba, 299-0111, Japan.

Purpose: Left trisectionectomy (LT) extending to the segment I with bile duct resection for perihilar cholangiocarcinoma (PHC) is a technically demanding procedure with high morbidity. Liver transection during LT is generally conducted to expose the right hepatic vein (RHV) on the remnant side. In clinical practice, we have often encountered a discrepancy between the theoretical RHV-oriented plane and the actual right intersectional plane. Read More

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November 2018
3 Reads

Mitigating respiratory motion in radiotherapy: rapid, shallow, non-invasive mechanical ventilation for internal thoracic targets.

Int J Radiat Oncol Biol Phys 2018 Nov 26. Epub 2018 Nov 26.

Department of Radiotherapy Physics, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Purpose: Reducing respiratory motion during the delivery of radiotherapy reduces the volume of healthy tissues irradiated and may decrease radiation induced toxicity. The purpose of this study was to assess the potential for rapid shallow non-invasive mechanical ventilation to reduce internal anatomy motion for radiotherapy purposes.

Material And Methods: Ten healthy volunteers (age 22-54years; mean 38years; 6 female and 4 male) were scanned on an MR scanner during normal breathing and at 2 ventilator induced frequencies; 20 and 25 breaths per minute for 3 minutes. Read More

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November 2018
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Changes of diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery: A prospective observational study.

PLoS One 2018 29;13(11):e0207841. Epub 2018 Nov 29.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Major laparoscopic pelvic surgery requires steep Trendelenburg position with pneumoperitoneum for a long time. We investigated the effect of Trendelenburg position with pneumoperitoneum on diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery using M-mode sonography. Twenty patients undergoing elective pelviscopic radical hysterectomy were included in this study. Read More

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November 2018
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The local efficacy and influencing factors of ultrasound-guided percutaneous microwave ablation in colorectal liver metastases: a review of a 4-year experience at a single center.

Int J Hyperthermia 2018 Nov 29:1-8. Epub 2018 Nov 29.

a Department of Medical Ultrasonics , The Sixth Affiliated Hospital of Sun Yat-Sen University , Guangzhou , China.

Purpose: To investigate the clinical effectiveness and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) for colorectal liver metastasis (CRLM) and evaluate the influencing factors of local efficacy.

Methods: From January 2013 to January 2017, 137 CRLM patients accepting US-guided percutaneous MWA were included. The 2450-MHz microwave ablation system and a cooled-shaft antenna were used. Read More

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November 2018

Effect of Abdominal Binding on Diaphragmatic Neuromuscular Efficiency, Exertional Breathlessness, and Exercise Endurance in Chronic Obstructive Pulmonary Disease.

Front Physiol 2018 14;9:1618. Epub 2018 Nov 14.

Clinical Exercise & Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.

We tested the hypothesis that abdominal binding (AB) would reduce breathlessness and improve exercise tolerance by enhancing neuromuscular efficiency of the diaphragm during exercise in adults with chronic obstructive pulmonary disease (COPD). In a randomized, controlled, crossover trial, 20 adults with COPD (mean ± SD FEV, 60 ± 16% predicted) completed a symptom-limited constant-load cycle endurance exercise test at 75% of their peak incremental power output with concomitant measures of the diaphragm electromyogram (EMGdi) and respiratory pressures without (CTRL) vs. with AB sufficient to increase end-expiratory gastric pressure (Pga,ee) by 6. Read More

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November 2018
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Vascular and ventilatory mechanical responses in three different stages of pulmonary development in the rabbit model of congenital diaphragmatic hernia 1.

Acta Cir Bras 2018 Oct;33(10):879-888

Associate Professor, Head, Department of Surgery and Anatomy, Laboratory of Experimental Fetal Surgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, USP, Ribeirao Preto-SP, Brazil. Scientific and intellectual content of the study, manuscript preparation, critical revision, final approval.

Purpose: To evaluate the vascular ventilatory response in different stages of lung development and to compare them to the neonates with congenital diaphragmatic hernia (CDH) in a rabbit model.

Methods: New Zealand rabbits were divided into 8 groups (n=5): E25, E27, E30, and CDH. All groups were ventilated on a FlexiVent (Scireq, Montreal, QC, Canada), compounding the other 4 groups. Read More

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October 2018
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A Multimodality Navigation System for Endoscopic Fetal Surgery: A Phantom Case Study for Congenital Diaphragmatic Hernia.

Surg Innov 2018 Nov 28:1553350618813244. Epub 2018 Nov 28.

2 King's College Hospital, Fetal Medicine Research Institute, London, UK.

This article presents a multi-modality tracking and navigation system achieved by merging optical tracking and ultrasound imaging into a novel navigation software to help in surgical pre-planning and real-time target setting and guidance. Fetal surgeries require extensive experience in coordination of hand-eye-ultrasound-surgical equipment, knowledge, and precise assessment of relative anatomy. While there are navigation systems available for similar constrained working spaces in arthroscopic and cardiovascular procedures, fetal minimally invasive surgery does not yet have a dedicated navigation platform capable of supporting robotic instruments that can be adapted to the set of unique procedures. Read More

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November 2018
1 Read

Imaging of thoracic hernias: types and complications.

Insights Imaging 2018 Dec 27;9(6):989-1005. Epub 2018 Nov 27.

Imaging Science, University of Rochester Medical Center, 601, Elmwood Avenue, Rochester, NY, 14642, USA.

Thoracic hernias are characterised by either protrusion of the thoracic contents outside their normal anatomical confines or extension of the abdominal contents within the thorax. Thoracic hernias can be either congenital or acquired in aetiology. They can occur at the level of the thoracic inlet, chest wall or diaphragm. Read More

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December 2018

Molecular and Serological Detection of in Stray Cats in Shiraz, South-central, Iran.

Iran J Parasitol 2018 Jul-Sep;13(3):430-439

Dept. of Medical Parasitology & Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Toxoplasmosis is a global zoonotic disease that causes critical medical complications in neonates and immunocompromised persons. Infection rates in cats, specifically stray cats, are believed to be the best sentry of the level of in the environment. Therefore, in this study, we surveyed infection in stray cats of Shiraz, one of the metropolises of Iran. Read More

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November 2018
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The First Survey of Isolation and Molecular Typing of by Bioassay and PCR Method in BALB/c Mice in Camels () from Eastern Iran.

Iran J Parasitol 2018 Jul-Sep;13(3):382-391

Dept. of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Background: We isolated from camels by bioassay method in mice model and detect parasitic DNA in brain mice by molecular methods.

Methods: One hundred tissue samples including heart (n=50), and diaphragm (n=50) were collected from camels (n=50) slaughtered in abattoirs from Feb to Oct 2015 in three provinces located in eastern Iran. In first, blood sample from 50 camels was assayed for anti- antibodies by modified agglutination test (MAT) test. Read More

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November 2018

Rapid and robust restoration of breathing long after spinal cord injury.

Nat Commun 2018 11 27;9(1):4843. Epub 2018 Nov 27.

Department of Neurosciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.

There exists an abundance of barriers that hinder functional recovery following spinal cord injury, especially at chronic stages. Here, we examine the rescue of breathing up to 1.5 years following cervical hemisection in the rat. Read More

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November 2018
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Molecular mechanism of fusion pore formation driven by the neuronal SNARE complex.

Proc Natl Acad Sci U S A 2018 Dec 27;115(50):12751-12756. Epub 2018 Nov 27.

Laboratory for Nanoscale Cell Biology, Max Planck Institute for Biophysical Chemistry, 37077 Göttingen, Germany.

Release of neurotransmitters from synaptic vesicles begins with a narrow fusion pore, the structure of which remains unresolved. To obtain a structural model of the fusion pore, we performed coarse-grained molecular dynamics simulations of fusion between a nanodisc and a planar bilayer bridged by four partially unzipped SNARE complexes. The simulations revealed that zipping of SNARE complexes pulls the polar C-terminal residues of the synaptobrevin 2 and syntaxin 1A transmembrane domains to form a hydrophilic core between the two distal leaflets, inducing fusion pore formation. Read More

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December 2018
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