The management of postthoracotomy chylothorax is controversial.[2-3] The rarity of the syndrome, coupled with the lack of controlled studies, limits authoritative recommendations.[4-6] Some experts advocate immediate thoracotomy for thoracic duct repair or pleuroperitoneal shunting to prevent ongoing loss of chyle
and eventual nutritional and immunologic deterioration.
(1) Once an oral diet or enteral feeding has been initiated, chyle
assumes its characteristic appearance and can easily be diagnosed.
is an opaque milky white fluid consisting of protein, fat, lymphocytes, and electrolytes absorbed through the gut into the lymph channels of the gastrointestinal tract.
underwent two thoracenteses in the pediatric intensive care unit (PICU) with removal of one liter of pleural fluid (chyle
) on each occasion and relief of respiratory symptoms.
"Cakrapani's commentary explains the word "physique" of the text with "equilibrium of wind, etc., and chyle
, etc." (prakrtim vatadinam rasadinam ca samyavastham).
Depending on the clinical need, strategies to reduce chyle
production can involve a low-fat, high-protein diet, supplemented with medium-chain fatty acids or, if the former fails, total parental nutrition.
Whitman uses a digestive figure (food into chyle
into blood) to mark his material difference from, and rejection of, Emerson's writing; but this same, complex figure for poetry's embodiment, I hypothesize, is assimilated from Emerson's poetics.
, a turbid milky fluid, is made up of lymph fluid and emulsified fat, triglycerides, proteins (mostly albumin), and glucose.
The pathological features include the proliferation of benign-looking LAM cells and the existence of abundant lymphatic vessels that are associated with clinical conditions such as chyle
Lymphatic obstruction leads to formation of a lymphaticourinary fistula, causing excretion of chyle
into the urinary tract.
Using serum pools containing low, middle, and high insulin concentrations to measure interference, we detected no interference from free and complex bilimbin (up to 194 mg/L), hemoglobin (up to 7650 mg/L), or chyle
(up to 2800 formazine turbity units).
Various substances (final concentrations: bilirubin F, 34-170 mg/L; bilirubin C, 42-210 mg/L; hemolytic hemoglobin, 1-5 g/L; chyle
, 392-1960 FTU; Interference check-A; International Reagent Corp.) in the calibrator samples (50 [micro]g/L) did not interfere with the ELISA.