Chest
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A bird fancier who had only been exposed to native birds, mostly owls, developed a sever hypersensitivity pneumonitis with a very insidious onset.
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Necrotizing tracheobronchitis and acute airway obstruction from invasive mycosis developed in a patient who had undergone bone marrow transplantation. The infectious process obstructed the airway and disintegrated the walls of the right mainstem bronchus and pulmonary artery. The airway was cleared using rigid bronchoscopy to extract the detritus. The patient died of hemorrhage after rupture of the pulmonary artery through the right mainstem bronchus.
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Comparative Study
Comparison of the derived vectorcardiogram in apparently healthy whites and Chinese.
A total of 2,058 vectorcardiograms derived from the conventional 12-lead electrocardiogram (1,555 whites [884 men and 671 women], aged between 16 and 64 years, and 503 Chinese [248 men and 255 women], aged between 18 and 81 years) were analyzed. The results were assessed to demonstrate the importance of the impact of racial variation on vectorcardiographic appearances. ⋯ Therefore, this indicates that it is necessary to take racial variation into consideration for interpretation of the derived vectorcardiogram. In conclusion, it has been shown in the present study that derived vectorcardiogram diagnostic criteria should not only be age and sex dependent but also race dependent.
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Comparative Study
Bilateral vs single internal thoracic artery grafting for left main coronary artery occlusion.
This study was conducted to compare the coronary flow distributed by single and bilateral internal thoracic artery (ITA) grafts in the setting of the left main coronary occlusion. Ten dogs underwent coronary artery bypass grafting through a left thoracotomy, off pump, using a brief local occlusion to perform the anastomosis. Dogs were randomly assigned to receive either a single left ITA (LITA) graft to the circumflex coronary artery (CFX), or bilateral ITA grafts, with additional placement of the right ITA (RITA) to the left anterior descending artery (LAD). ⋯ When an individual graft was occluded in the bilaterally grafted system, the remaining graft immediately recruited the additional flow, demonstrating that either right or left ITA can support flow demands five to six times higher than in situ chest wall flow (RITA, 21.9 +/- 3.1 mL/min; LITA, 22.3 +/- 4.9 mL/min). These data suggest that in this canine model, a single ITA graft can support the entire flow requirements of the left ventricle. Assuming no intervening stenosis is present in native coronary systems, bilateral ITA grafting may provide a margin of safety, but under resting conditions, provides no perfusion advantages over a single ITA graft.