chylothorax in adult occurs most commonly in the wake of cardiac and thoracic procedures. injuries to the  common thoracic duct in the thorax or its branches in the mediastinum, injuries to the thymus tissues, dissection of the superior vena cava or ascending aorta, dissection of the aortic arch, disruption of the accessory lymphatics in the left or right thorax, and increased pressure in the s...

Pulmonary hypertension refers to a group of diseases that is characterised by high pressure in the pulmonary artery, and pulmonary vascular resistance. Persistent pulmonary hypertension in the newborn is a condition in which the pulmonary artery pressure does not decrease after birth. It may occur in as many as 6.8 in 1 000 live births. Phosphodiesterase type 5 (PDE5) is the predominant phospho...

Pulmonary arterial hypertension (PAH) management has been transformed in recent times with the advent of cheap and effective diagnostic tools and therapy. Sildenafil, a phosphodiesterase-V inhibitor, has been at the centre of this treatment, and its success in treating PAH has led to its widespread uptake in adult and paediatric pulmonary hypertension (PH), as a first line treatment choice. Thi...

1. Describe the factors that modulate the transition of pulmonary circulation from in utero to after birth. 2. Delineate temporal changes in pulmonary vascular resistance during fetal life. 3. List the substances that play a role in vasoregulation of normal fetal pulmonary circulation. 4. Delineate the role of nitric oxide in increasing pulmonary blood flow at birth. 5. Describe the common phys...

Pulmonary arterial hypertension affects the distal pulmonary vasculature causing intimal, medial, adventitial fibrosis, thickening and periadventitial changes leading to progressive increase in pulmonary vascular resistance and pulmonary arterial pressure [1]. Pulmonary hypertension (PH) is defined as mean pulmonary artery pressure equal to or greater than 25 mm Hg at rest. PH is classified int...

STUDY OBJECTIVE Human plasma L-arginine serves as a substrate pool for endothelial-derived nitric oxide (NO) synthase. In this pilot study, we tested the hypothesis that plasma L-arginine and other metabolites of the L-arginine NO pathway could correlate with postoperative pulmonary hypertension after cardiopulmonary bypass (CPB). DESIGN Forty-two patients (median age, 0.5 years; range, 0.1 t...

BACKGROUND Limited data are available describing paediatric pulmonary arterial hypertension. AIMS To characterize the epidemiology, management and impact on quality of life and outcome of paediatric pulmonary arterial hypertension, excluding persistent pulmonary hypertension of the newborn and pulmonary arterial hypertension caused by congenital heart disease. METHODS In this multicentre st...