Pulmonary and chest wall mechanics in anesthetized paralyzed humans

Pulmonary and chest wall mechanics were studied in 18 anesthetized paralyzed supine humans by use of the technique of rapid airway occlusion during constant-flow inflation. Analysis of the changes in transpulmonary pressure after flow interruption allowed partitioning of the overall resistance of the lung (RL) into two compartments, one (Rint,L) reflecting airway resistance and the other (delta RL) representing the viscoelastic properties of the pulmonary tissues. Similar analysis of the changes in esophageal pressure indicates that chest wall resistance (RW) was due entirely to the viscoelastic properties of the chest wall tissues (delta RW = RW). In line with previous measurements of airway resistance, Rint,L increased with increasing flow and decreased with increasing volume. The opposite was true for both delta RL and delta RW. This behavior was interpreted in terms of a viscoelastic model that allowed computation of the viscoelastic constants of the lung and chest wall. This model also accounts for frequency, volume, and flow dependence of elastance of the lung and chest wall. Static and dynamic elastances, as well as delta R, were higher for the lung than for the chest wall.     

Breast infection due to Dirofilaria repens: report of two new Italian cases and revision of the literature.

Two new cases of human dirofilariasis, occurred in women aged 46 and 52 years, respectively, both living in Lombardy (Northern Italy) are reported. Dirofilaria repens nematodes were localised in the breast in both cases. In one of them the parasite was accidentally extracted while the patient underwent a fine needle aspirate. The international literature records 30 cases of breast Dirofilariasis. Except in rare cases, the parasite was located subcutaneously in the breast, and nested in a nodule. The clinical diagnoses were consistently wrong, the nodule being diagnosed as a suspected tumor of the breast.