scholarly journals Further particulars of a case of pneumato-thorax

1833 ◽  
Vol 2 ◽  
pp. 215-216
Keyword(s):  
Carbonic Acid ◽  
Left Lung ◽  
Bronchial Tube ◽  
Atmospheric Air ◽  
Left Pleura ◽  
The Right

About a month after the operation described in Dr. Davy’s former paper, when the patient appeared to be doing well, symptoms of hydrothorax came on, and fluid again collected in the left side of the chest. A second operation therefore was performed, and fourteen ounces of fluid discharged through a perforation in the fifth rib. During the six following weeks not less than twenty pints of fluid ran off through the opening; at first it was transparent, but became gradually more and more purulent, and was mixed with air composed of oxygen, azote and carbonic acid, in various proportions. The patient’s health improved at first progressively, but in about six weeks after the operation he became worse, and expired suddenly. On examination after death, about six ounces of pus were found in the left pleura. The right pleura was healthy, but tubercles and vomicæ were found in the right lung; the left lung was much condensed, and communicated by two small openings with the pleura. Dr. Davy refers the origin of the disease in this case to a communication between the aspera arteria and cavity of the pleura, established by the rupture of a superficial bronchial tube, and the membrane covering it; and concludes the paper with some remarks upon the fluctuating composition of the air from the chest, which he attributes not to the varying quantity of atmospheric air, admitted through the perforation, which was as carefully closed as possible, but to its vitiation by respiration, and by the absorbent power of the pleura.

scholarly journals Observations on air found in the pleura, in a case of pneumatothorax; with experiments on the absorption of different kinds of air introduced into the pleura

1833 ◽  
Vol 2 ◽  
pp. 202-202
Keyword(s):  
Nitrous Oxide ◽  
Carbonic Acid ◽  
The Body ◽  
Detailed Account ◽  
Solubility In Water ◽  
Atmospheric Air ◽  
Healthy State ◽  
Left Pleura ◽  
The Right ◽  
Enormous Quantity

In this paper Dr. Davy gives a detailed account of the symptoms produced by the above disease, and of the appearance after death, in a man of thirty years of age. He also adverts to the composition of the air found in the lungs, which was collected by immersing the body in water, and puncturing the pleura, when it issued in the enormous quantity of 225 cubic inches. It was without smell, and extinguished flame, and was not inflammable. It consisted of 8 carbonic acid, and 92 azotic gas per cent.; and the author considers it as derived from the atmosphere by a morbid communication, which was discovered on dissection, between the pleura and atmosphere through the medium of the lung. To determine the mode in which its change of composition had been effected, Dr. Davy inflated the right pleura of a dog with atmospheric air, and killed the animal after 48 hours. On examining the air, the oxygen was found absorbed in larger proportion than the azote, which accounts for the accumulation of the latter gas in the preceding instance. To ascertain how far carbonic acid is absorbed by the pleura, a mixture of 80 parts of common air, and 20 of carbonic acid, was injected into the right pleura of a dog. After two days the animal appeared well, and a mixture of 75 of air and 25 of carbonic acid was thrown into the left pleura. Twentyfour hours after, the dog was killed, and the result was, that during a sojourn of three days in the pleura the oxygen had been absorbed in greater proportion than the carbonic acid, and the latter in a greater degree than the azote. The power thus exhibited by the pleura of absorbing one kind of gas more than another, without reference to their solubility in water, induced the author to institute some similar experiments with hydrogen, nitrous oxide, and nitrous gas. A mixture of carbonic acid and hydrogen thus applied did not appear to affect the health of the animal. A mixture of azote and nitrous gas killed the animal in five hours. In the former case the hydrogen disappeared, and its place was supplied by a small quantity of azote. As the author’s experiments induce him to believe that no air exists in the pleura in a healthy state, he is led to suppose that its appearance in this case is referrible to secretion.—In a note annexed to this paper, Dr. Davy expresses his doubt as to the existence of any free carbonic acid in the blood; since he could, in two experiments made for the purpose, obtain none by means of the air-pump.

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

RARE CASE OF NODULAR LYMPHOID HYPERPLASIA OF LEFT LUNG IN THE PATIENT WITH PREVIOUS PULMONARY TUBERCULOSIS

2018 ◽  
Vol 40 (4) ◽  
pp. 332-335
Author(s):  
P V Kuzyk ◽  
M A Savchyna ◽  
S G Gychka
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lymphoproliferative Disorder ◽  
Clinical Laboratory ◽  
Left Lung ◽  
Lymphoid Hyperplasia ◽  
Morphological Examination ◽  
Nodular Lymphoid Hyperplasia ◽  
Lymph Nodes Dissection ◽  
The Right ◽  
Immunohistochemical Studies

Aim: To describe the case of rare benign lymphoproliferative disorder — pulmonary nodular lymphoid hyperplasia in the patient with previous pulmonary tuberculosis. Materials and Methods: In the case of pulmonary nodular lymphoid hyperplasia clinical, laboratory, instrumental and morphological examination was performed. Results: 44-year-old woman in 7 years after successfully treated infiltrative drug-susceptible tuberculosis of the right lung, was hospitalized with a suspected tumor of the left lung root. The patient underwent left-sided pneumonectomy with lymph nodes dissection. The results of histopathological and immunohistochemical studies evidenced on nodular lymphoid hyperplasia of the left lung. Conclusion: Pulmonary nodular lymphoid hyperplasia is a rare lymphoproliferative disorder of the lung with favorable prognosis. For the purpose of differential diagnosis, it is necessary to apply immunohistochemistry.

scholarly journals Ventilation/perfusion mismatch during lung aeration at birth

2014 ◽  
Vol 117 (5) ◽  
pp. 535-543 ◽  
Author(s):  
Justin A. R. Lang ◽  
James T. Pearson ◽  
Arjan B. te Pas ◽  
Megan J. Wallace ◽  
Melissa L. Siew ◽  
...  
Keyword(s):  
Pulmonary Arteries ◽  
Left Lung ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Iodine Level ◽  
Pulmonary Shunting ◽  
Left And Right ◽  
Near Term ◽  
The Right

At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 ± 11.6 and 70.3 ± 7.5%·s to 136.3 ± 22.6 and 136.3 ± 23.7%·s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.

scholarly journals Observations on the theory of respiration

1837 ◽  
Vol 3 ◽  
pp. 334-335
Keyword(s):  
Carbonic Acid ◽  
Venous Blood ◽  
Hydrogen Gas ◽  
The Body ◽  
Pure Hydrogen ◽  
Atmospheric Air ◽  
Acid Gas ◽  
Arterial Blood ◽  
Dark Colour ◽  
Oxygen Gas

From the fact that no carbonic acid gas is given out by venous blood when that fluid is subjected to the action of the air-pump, former experimentalists had inferred that this blood contains no carbonic acid. The author of the present paper contends that this is an erroneous inference; first, by showing that serum, which had been made to absorb a considerable quantity of this gas, does not yield it upon the removal of the atmospheric pressure; and next, by adducing several experiments in proof of the strong attraction exerted on carbonic acid both by hydrogen and by oxygen gases, which were found to absorb it readily through the medium of moistened membrane. By means of a peculiar apparatus, consisting of a double-necked bottle, to which a set of bent tubes were adapted, he ascertained that venous blood, agitated with pure hydrogen gas, and allowed to remain for an hour in contact with it, imparts to that gas a considerable quantity of carbonic acid. The same result had, indeed, been obtained, in a former experiment, by the simple application of heat to venous blood confined under hydrogen gas; but on account of the possible chemical agency of heat, the inference drawn from that experiment is less conclusive than from experiments in which the air-pump alone is employed. The author found that, in like manner, atmospheric air, by remaining, for a sufficient time, in contact with venous blood, on the application of the air-pump, acquires carbonic acid. The hypothesis that the carbon of the blood attracts the oxygen of the air into the fluid, and there combines with it, and that the carbonic acid thus formed is afterwards exhaled, appears to be inconsistent with the fact that all acids, and carbonic acid more especially, impart to the blood a black colour; whereas the immediate effect of exposing venous blood to atmospheric air, or to oxygen gas, is a change of colour from a dark to a bright scarlet, implying its conversion from the venous to the arterial character: hence the author infers that the acid is not formed during the experiment in question, but already exists in the venous blood, and is extracted from it by the atmospheric air. Similar experiments made with oxygen gas, in place of atmospheric air, were attended with the like results, but in a more striking degree and tend therefore to corroborate the views entertained by the author of the theory of respiration. According to these views, it is neither in the lungs, nor generally in the course of the circulation, but only during its passage through the capillary system of vessels, that the blood undergoes the change from arterial to venous; a change consisting in the formation of carbonic acid, by the addition of particles of carbon derived from the solid textures of the body, and which had combined with the oxygen supplied by the arterial blood: and it is by this combination that heat is evolved, as well as a dark colour imparted to the blood. The author ascribes, however, the bright red colour of arterial blood, not to the action of oxygen, which is of itself completely inert as a colouring agent, but to that of the saline ingredients naturally contained in healthy blood. On arriving at the lungs, the first change induced on the blood is effected by the oxygen of the atmospheric air, and consists in the removal of the carbonic acid, which had been the source of the dark colour of the venous blood; and the second consists in the attraction by the blood of a portion of oxygen, which it absorbs from the air, and which takes the place of the carbonic acid. The peculiar texture of the lungs, and the elevation of temperature in warm-blooded animals, concur in promoting the rapid production of these changes.

Abstract 12430: Vicious Circle Between Progressive Right Ventricular Dilatation and Pulmonary Regurgitation in Patients After Tetralogy of Fallot Repair? Right Heart Enlargement Promotes Flow Reversal in the Left Pulmonary Artery

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Atsuko Kato ◽  
Christian Drolet ◽  
Shi-Joon Yoo ◽  
Andrew Redington ◽  
Lars Grosse-Wortmann
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Left Lung ◽  
Pulmonary Regurgitation ◽  
Left Pulmonary Artery ◽  
Flow Reversal ◽  
Left Hemithorax ◽  
Forward Flow ◽  
Lung Area ◽  
The Right

Introduction: The left pulmonary artery (LPA) contributes more than the right (RPA) to total pulmonary regurgitation (PR) in patients after tetralogy of Fallot (TOF) repair, but the mechanism of this difference is not well known. We hypothesized that unilaterally increased pulmonary vascular resistance (PVR), resulting from lung compression by the enlarged and levorotated heart leads to greater PR in the LPA. This study aimed to analyze the interplay between heart and lung size, mediastinal geometry, and differential PR. Methods: This is a single-center retrospective analysis of 50 magnetic resonance studies in patients after TOF repair. Patients with more than mild discrete branch pulmonary artery stenosis were excluded. Blood flow was measured by phase-contrast velocity encoding within the branch pulmonary arteries. On the axial image with the largest total cardiac surface area, cardiac angle (α) between the thoracic anterior-posterior line and the interventricular septum, right and left lung areas as well as right and left hemithorax areas were measured (Figure). Results: There was no difference in LPA and RPA diameters. The LPA showed significantly less total forward flow (p=0.04), smaller net forward flow (p=<0.001), and greater RF (p=0.001) than the RPA. Left lung area was smaller than the right (p<0.001). RVEDVi correlated with LPA RF (R=0.48, p<0.001), but not with RPA RF. Larger RVEDVi correlated with a larger α angle (R=0.46, p<0.001), i.e. a more leftward cardiac axis and with smaller left lung area (R=-0.58, p<0.001). LPA RF, but not RPA RF, correlated inversely with left lung area indexed to the left hemithorax area (R=-0.34, p=0.02). Conclusions: An enlarged and levorotated heart - as a result of PR - is associated with smaller left lung size, and augments diastolic flow reversal in the LPA, presumably via increased left PVR. By imposing a further volume load on the RV, LPA regurgitation may thus close a positive feed-back loop of PR and RV dilatation.

scholarly journals Comorbidity between Klinefelter syndrome and diaphragmatic hernia. A case report

2014 ◽  
Vol 132 (5) ◽  
pp. 311-313
Author(s):  
Carolina Melendez Valdez ◽  
Stephan Philip Leonhardt Altmayer ◽  
Adyr Eduardo Virmond Faria ◽  
Aline Weiss ◽  
Jorge Alberto Bianchi Telles ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Ultrasound Examination ◽  
Klinefelter Syndrome ◽  
Age Groups ◽  
Left Lung ◽  
Left Lobe ◽  
Imaging Studies ◽  
Left Hemithorax ◽  
Prenatal Imaging ◽  
The Right

CONTEXT: Intrathoracic cystic lesions have been diagnosed in a wide variety of age groups, and the increasing use of prenatal imaging studies has allowed detection of these defects even in utero.CASE REPORT: A 17-year-old pregnant woman in her second gestation, at 23 weeks of pregnancy, presented an ultrasound with evidence of a cystic anechoic image in the fet al left hemithorax. A morphological ultrasound examination performed at the hospital found that this cystic image measured 3.7 cm x 2.1 cm x 1.6 cm. Polyhydramnios was also present. At this time, the hypothesis of cystic adenomatoid malformation was raised. Fet al echocardiography showed only a dextroposed heart. Fet al magnetic resonance imaging produced an image compatible with a left diaphragmatic hernia containing the stomach and at least the first and second portions of the duodenum, left lobe of the liver, spleen, small intestine segments and portions of the colon. The stomach was greatly distended and the heart was shifted to the right. There was severe volume reduction of the left lung. Fet al karyotyping showed the chromosomal constitution of 47,XXY, compatible with Klinefelter syndrome. In our review of the literature, we found only one case of association between Klinefelter syndrome and diaphragmatic hernia.CONCLUSIONS: We believe that the association observed in this case was merely coincidental, since both conditions are relatively common. The chance of both events occurring simultaneously is estimated to be 1 in 1.5 million births.

Effect of a regional increase in alveolar pressure on pulmonary blood flow

1992 ◽  
Vol 73 (4) ◽  
pp. 1291-1296 ◽  
Author(s):  
L. E. Olson ◽  
R. L. Wardle
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Left Lung ◽  
Dry Weight ◽  
Test Lung ◽  
Test Segment ◽  
Control Segment ◽  
Lung Segment ◽  
Lung Blood Flow ◽  
The Right

We examined whether wedging a catheter (0.5 cm OD) into a subsegmental airway in dog (n = 6) or pig lungs (n = 5) and increasing pressure in the distal lung segment affected pulmonary blood flow. Dogs and pigs were anesthetized and studied in the prone position. Pulmonary blood flow was measured by injecting radiolabeled microspheres (15 microns diam) into the right atrium when airway pressure (Pao) was 0 cmH2O and pressure in the segment distal to the wedged catheter (Ps) was 0, 5, or 15 cmH2O and when Pao = Ps = 15 cmH2O. The lungs were excised, air-dried, and sectioned. Blood flow per gram dry weight normalized to cardiac output to the right or left lung, as appropriate, was calculated for the test segment, a control segment in the opposite lung corresponding anatomically to the test segment, the remainder of the lung containing the test segment (test lung), and the remainder of the lung containing the control segment (control lung). The presence of the catheter reduced blood flow in the test segment compared with that in the control segment and in the test lung. Blood flow was not affected by increasing pressure in the test segment. We conclude that, in studies designed to measure collateral ventilation in dog lungs, the presence of the wedged catheter is likely to have a greater effect on blood flow than the increase in pressure associated with measuring collateral airway resistance.

scholarly journals On the respiration of the leaves of plants

1843 ◽  
Vol 4 ◽  
pp. 466-466
Keyword(s):  
Natural Condition ◽  
Carbonic Acid ◽  
Pure Water ◽  
Atmospheric Air ◽  
Acid Gas ◽  
Series Of Experiments ◽  
As If

The author gives an account of a series of experiments on the products of the respiration of plants, and more particularly of the leaves; selecting, with this view, specimens of plants which had been previously habituated to respire constantly under an inclosure of glass; and employing, for that purpose, the apparatus which he had formerly used in experimenting on the combustion of the diamond, and consisting of two mercurial gasometers, with the addition of two hemispheres of glass closely joined together at their bases, so as to form an air-tight globular receptacle for the plant subjected to experiment. The general conclusions he deduces from his numerous experiments conducted during several years, are, first, that in leaves which are in a state of vigorous health, vegetation is always operating to restore the surrounding atmospheric air to its natural condition, by the absorption of carbonic acid and the disengagement of oxygenous gas: that this action is promoted by the influence of light, but that it continues to be exerted, although more slowly, even in the dark. Secondly, that carbonic acid is never disengaged during the healthy condition of the leaf. Thirdly, that the fluid so abundantly exhaled by plants in their vegetation is pure water, and contains no trace of carbonic acid. Fourthly, that the first portions of carbonic acid gas contained in an artificial atmosphere, are taken up with more avidity by plants than the remaining portions; as if their appetite for that pabulum had diminished by satiety.

Effect of pulmonary artery occlusion and reperfusion on extravascular fluid accumulation

1981 ◽  
Vol 50 (1) ◽  
pp. 102-106 ◽  
Author(s):  
P. S. Barie ◽  
T. S. Hakim ◽  
A. B. Malik
Keyword(s):  
Pulmonary Artery ◽  
Water Content ◽  
Left Atrial ◽  
Left Lung ◽  
Weight Ratio ◽  
Dry Weight ◽  
Left Pulmonary Artery ◽  
Artery Occlusion ◽  
Lung Water ◽  
The Right

We determined the effect of pulmonary hypoperfusion on extravascular water accumulation in anesthetized dogs by occluding the left pulmonary artery for 3 h and then reperfusing it for 24 h. The lung was reperfused either at normal left atrial pressure (Pla) or during increased Pla induced by a left atrial balloon. In each case the extravascular water content-to-bloodless dry weight ratio (W/D) of the left lung was compared with that of the right lung. The W/D of the left lung of 3.26 +/- 0.49 ml/g was not significantly different from the value of 2.87 +/- 0.37 for the right lung after the reperfusion at normal Pla. However, the W/D of the left lung of 5.10 +/- 0.38 ml/g was greater (P less than 0.05) than the value of 4.42 +/- 0.34 for the right lung after reperfusion at Pla of 25 Torr. This difference could not be prevented by pretreatment with heparin, suggesting that the increase in lung water content was not due to activation of intravascular coagulation secondary to stasis occurring during the occlusion. Because the left lung was more edematous than the right one, even though both lungs had been subjected to the same increase in Pla, the results suggest that a period of pulmonary hypoperfusion causes an increase in the interstitial protein concentration.

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