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Acta Veterinaria Hungarica
Authors:
Ján Varga
,
Pavel Staško
,
Štefan Tóth
,
Zuzana Pristášová
,
Zuzana Jonecová
,
Jarmila Veselá
, and
Mikuláš Pomfy

Ischaemic/reperfusion (IR) injury of the small intestine may lead to the development of multiple organ failure. Little is known about the morphological changes occurring in the organs during the subacute course of this syndrome. The objective of this study was to observe histopathological features and the role of apoptosis in the jejunal mucosa and lung parenchyma after intestinal IR injury in a long-term experiment. Wistar rats (n = 36) were divided into 4 experimental groups (IR 10 , IR 20 , IR 30 , S). Groups IR 10 , IR 20 and IR 30 (each n = 10) were subjected to 1-hour ischaemia of the cranial mesenteric artery followed by 10, 20 or 30 days of reperfusion, respectively. The control group S (n = 6) was not subjected to ischaemia. The jejunal mucosa remained intact after all periods of reperfusion. Apoptotic cells were found particularly in the lamina propria, with the most significant difference observed in the IR 30 group (P < 0.01). The lung parenchyma had lower regenerative capacity, which was confirmed by a high index of histological damage after 30 days of reperfusion (P < 0.01) and by the presence of an increased number of apoptotic cells, especially in the pulmonary interstitium. The number of apoptotic cells was ten times higher than in the control group (P < 0.001).

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In a recent study (Comp. Biochem. Physiol. B. (2010)155: 301–308) we reported that the fatty acids (FA) of the avian (7 species) total lung phospholipids (PL) (i.e. lung parenchyma and surfactant together) provide allometric properties. To test whether this allometric scaling also occurs in either of the above components, in six gallinaceous species, in a body weight range from 150 g (Japanese quail, Coturnix coturnix japonica) to 19 kg (turkey, Meleagris gallopavo) the PL FA composition (mol%) was determined in the pulmonary surfactant, in native and in thoroughly lavaged lungs (referred to as lung parenchyma). In all three components docosahexaenoic acid (DHA) showed significant and negative allometric scaling (B = −0.056, −0.17 and −0.1, respectively). Surfactant PLs provided further negative allometry for palmitic acid and the opposite was found for palmitoleate and arachidonate. In the lung parenchymal PLs increasing body weight was matched with shorter chain FAs (average FA chain length) and competing n6 and n3 end-product fatty acids (positive allometry for arachidonic acid and negative for DHA). Negative allometric scaling was found for the tissue malondialdehyde concentration in the native and lavaged lungs (B = −0.1582 and −0.1594, respectively). In these tissues strong correlation was found between the MDA concentration and DHA proportion (r = 0.439 and 0.679, respectively), denoting the role of DHA in shaping the allometric properties and influencing the extent of in vivo lipid peroxidation of membrane lipids in fowl lungs.

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lower lobe, representing early honeycombing. Ill-defined branching calcific densities were present in bilateral lung parenchyma along thickened interlobular septa and reticular opacities, having HU values in the range of 435–536. Confluent areas of

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Genetic effects that contribute to the risk of developing chronic obstructive pulmonary disease (COPD) have been reported. Our purpose was to estimate the possible genetic influence on CT features related to COPD in twins.

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Magyar Sebészet
Authors:
László István Kecskés
,
Győző Bátor
,
Árpád Füredi
,
Pál Gehér
,
Béla Kiss
, and
Péter Stankovics

H Kutlay 2010 Segmental Bronchial Sleeve Resection: Preserving All Lung Parenchyma for Benign/Low-Grade Neoplasms Ann Thorac Surg 89 6

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Abstract

We present the case of a 20-year-old man with hemoptysis for 3 years. Chest radiography revealed increased pulmonary vascular opacities in the left lower lung field. Computed tomography showed an anomalous systemic artery arising from descending aorta supplying the basal segments of the left lower lobe. Bronchial tree was normal. Pulmonary artery angiogram revealed a hypoplastic inferior lobar branch of the left pulmonary artery. There was no direct communication between anomalous artery and pulmonary veins. We diagnosed our case as aortopulmonary collateral with normal lung parenchyma. Coil embolization of the anomalous systemic artery was performed. The patient survived well without evidence of hemoptysis for 18 months after coil embolization.

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Orvosi Hetilap
Authors:
Zoltán Mátrai
,
László Tóth
,
Zoltán Szentirmay
,
János Papp
,
Imre Antal
,
Pál Vadász
,
Alexandra Bartal
, and
Miklós Kásler

A mellkasi desmoid tumorok ritka, borderline daganatok. A tumor elsődleges kezelése a radikális sebészi eltávolítás. A mikroszkóposan ép sebészi szél elérése gyakran komoly műtéttechnikai kihívást jelent, mivel a tumor infiltrálhatja a csontos mellkasfalat, a vállöv csontjait, a tüdőparenchymát, a plexus brachialist, valamint a mediastinum vitális képleteit. A mellkas stabilitásának megőrzése, az optimális funkcionális és esztétikai eredmény elérése szintetikus hálók beültetését, illetve autológ szövettel történő plasztikai rekonstrukciókat tehet szükségessé. A multidiszciplináris műtétek még speciális centrumokban is magas morbiditással járhatnak. A szerzők közleményükben multicentrikus retrospektív feldolgozás keretében sporadikus mellkasfali, illetve intrathoracalis desmoid tumorok sebészi ellátásának technikáját elemzik, illetve irodalmi összehasonlítást folytatnak. Orv. Hetil., 2011, 152, 3–13.

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Absztrakt

A kötőszöveti betegségek tekintetében a pulmonalis manifesztáció megjelenése szisztémás lupus erythematosusban az egyik leggyakoribb. Lupusban bármely szervrendszer érintett lehet, mégis a tüdőérintettség az esetek döntő többségében kialakul, és jelentős hatással van a betegség lefolyására. Szisztémás lupus erythematosusban a pulmonalis manifesztációkat az anatómiai érintettség alapján öt csoportba lehet sorolni: pleura, tüdőparenchyma, bronchusok és bronchiolusok, pulmonalis vasculatura, illetve a légzőizmok érintettsége. A leggyakoribb pulmonalis érintettség a pleuritis, amely pleuralis folyadékkal vagy a nélkül is előfordulhat, gyakori a pulmonalis vascularis és a felső és alsó légúti érintettség, a tüdőparenchyma-eltérések és a diaphragmadiszfunkció (shrinking lung szindróma). A szerzők a közlemény kapcsán a lupusban szenvedő betegek pulmonalis eltéréseire, ezek diagnosztikájára, a kezelésükre és a prognózisra szeretnék felhívni a figyelmet. Orv. Hetil., 2016, 157(29), 1154–1160.

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Abstract

Introduction

Thorax injuries are to be found in approximately 78% amongst all accident victims. Moreover, they implicate an increase in mortality rate. Consequently, an adequate contemporary treatment has to begin preclinically, even if the conditions are less comfortable than in a clinical setting. Emergency doctors need to be familiar with the placement of chest tubes.

Materials and Methods

From January 1, 2007 to December 31, 2010, emergency doctors of the rescue helicopter site Christoph 20 had to place chest tubes directly at the scene of an accident in 49 patients. These patients were now reidentified, and their clinical course was reevaluated. By means of apparative diagnostics, it was possible to analyze the location of the tubes tip. Following a comparison of the patient, outcome versus the quality of preclinical thoracic discharge could be made.

Results

The preclinical placement of a chest tube became necessary mainly because of a blunt thoracic trauma. This was predominantly related to victims of traffic accidents, whereas male victims clearly dominated. Forty-two of those patients received further treatment at the Klinikum Bayreuth hospital, enabling an analysis of the tubes location by CAT (computed axial tomography) scan. Six patients had been discharged on both sides, contributing to 48 tube tips that could be examined concerning their location. Of the 48 chest tubes, 46 had been placed from a lateral approach. The ventral access by Monaldi had only been chosen in two cases. Altogether, nine incorrect placements, mainly within the right interlobe gap, had been detected.

Conclusions

The study collective showed a significant preference to the lateral approach when placing a chest tube at the emergency scene of an accident. In total, a prevalence of 19% incorrect placements could be revealed, meaning the chest tube had either been placed within the lung parenchyma, the interlobe gap, or extrathoracically. Concerning the patient outcome, no statistically significant difference regarding the clinical course after incorrect chest tube placement could be identified.

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Videoasszisztált minithoracotomiából elvégzett lobectomia mint új műtéti eljárás klinikai gyakorlatunkban

Lobectomy performed through a video-assisted mini thoracotomy, as a new technique in our clinical practice

Magyar Sebészet
Authors:
József Furák
,
Ervin Bács
,
Radek Grochulski
,
Antal Wolfárd
,
Tamás Szőke
,
Imre Troján
,
Edina Csernay
, and
György Lázár

Absztrakt

Retrospektív tanulmányunkban az osztályunkon 2006-ban bevezetett, videoasszisztált minithoracotomiából (VAMT) végzett lobectomiákkal szerzett tapasztalatainkról számolunk be. 2006 első félévében 10 betegnél végeztünk minimálisan invazív technikával lobectomiát. A 8 nő- és 2 férfibeteg átlagéletkora 61,4 év (47–68) volt. A műtéti indikációt 3 betegnél jóindulatú daganat, 6 betegnél igazolt T1N0 laphámcarcinoma, 1 esetben a CT-kép alapján feltételezett, T1N0 stádiumú malignus folyamat képezte. Izolált intubálást követően történt a videothoracoscopos exploratio, majd a lapocka csúcsa alatt egy 6–8 cm-es minithoracotomiát végzünk. A bordák 2 cm-es felterpesztését követően végezzük el a tüdő áttapintását, a resectiót és malignus esetekben a mediastinalis blokkdissectiót. 5 alsólebeny-, 4 felsőlebeny-lobectomiát és 1 felső bilobectomiát végeztünk. Műtéti mortalitás vagy lényeges morbiditás nem volt. Az átlagos műtéti idő 130 perc (80–200) volt. A 3 benignoma hamartochondromának bizonyult. A szövettani vizsgálat 4 esetben T1N0, 2 esetben T2N2 laphámcarcinomát és 1 esetben T1N2 kissejtes tüdőrákot (műtét előtt laphámráknak diagnosztizálták) igazolt. A videoasszisztált minithoracotomiából végzett lobectomia biztonsággal alkalmazható műtéti eljárás. A tüdőállomány áttapintása és resectiója, valamint a mediastinalis blokkdissectio a nyitott műtétekhez hasonlóan kivitelezhető.

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