Head injury at Reykjavík Hospital, intensive care unit, 1994-1998

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Reykjavík Hospital is the main trauma hospital in Iceland, receiving all severe head injuries in the country. Incidence of head injury and mortality has been decreasing in the last decades. The aim of this study was to analyse data on admission, treatment and outcome of patients admitted to intensive care unit with severe head injury and compare with other countries. Material and methods: In this study we looked retrospectively at the incidence of severe head injuries admitted to the intensive care unit at Reykjavik Hospital 1994-1998. Number of patients, type of injury, length of stay, length of ventilator treatment. Glasgow Coma Score (GCS), APACHE II (Acute Physiologic and Chronic Health Evaluation) score and mortality was analysed. Results: A total of 236 patients was admitted with an average of 47 patients per year. Traffic accidents were the most common cause of injury and mortality was 11.7%. Ethanol consumption was seen in many cases where fall was the cause of accident, most often in the year 1998 in 75% of cases. Mortality of patients with GCS 8 that was 40% of the patients was must higher or 24.7% compared with patients with GCS >8 where mortality was 3.4%. There was an increase in admissions in 1998, with more severe injuries and significantly longer length of stay and ventilator treatment. Conclusions: Number of patients with head injury was decreasing in comparison with older studies. The results of treatment are rather good in comparison with other countries with relatively low mortality, or 11.7% versus 15-20% in nearby countries. There has been improvement of outcome in patients with the most severe head injury (GCS 8) since 20 years ago, where up to 50% of the patients died but in our study mortality was 24.7%. Alcohol consumption was seen in 46% of cases where fall was the cause of head injury. Those that suffer head trauma are most often young people and preventive measures must continue with full strength in order to decrease the incidence of accidents in our society.Tilgangur: Höfuðáverkum hefur farið fækkandi á síðustu áratugum auk þess sem dánartíðni hefur farið lækkandi. Tilgangur rannsóknarinnar var að athuga hvort slík þróun hefði átt sér stað hér á landi síðastliðin ár. Efniviður og aðferðir: Farið var yfir tölvuskráningu allra sjúklinga sem lögðust inn á gjörgæsludeild Sjúkrahúss Reykjavíkur vegna höfuðáverka á árunum 1994-1998. Athugað var hver slysavaldur var auk þess sem ástand sjúklings við komu var kannað. Einnig var leitað eftir hvernig meðferð þeirra var háttað á gjörgæsludeild og ástand við útskrift. Niðurstöður: Alls lögðust 236 sjúklingar inn á gjörgæsludeild á tímabilinu sem er að meðaltali 47 sjúklingar á ári. Umferðarslys voru algengasta orsök höfuðáverka eða í 43% tilfella og dánartíðni var 11,7%. Ölvun var samverkandi orsök í mörgum tilfellum þar sem um fall var að ræða, mest árið 1998 eða 75%. Dánartíðni þeirra sem voru greindir með alvarlegustu höfuðáverkana, Glasgow Coma Score (GCS) 8 eða minna, sem voru um 40% sjúklinganna, var miklu hærri eða 24,7% á móti 3,4% ef GCS var yfir 8. Sjúklingar sem lögðust inn á árinu 1998 voru með alvarlegri höfuðáverka og meðaltími þeirra sem þurftu að vera í öndunarvél var lengri en árin á undan. Ályktanir: Fjöldi þeirra sem lögðust inn á gjörgæsludeild vegna höfuðáverka fór lækkandi í samanburði við eldri rannsókn sem gerð var hér á landi. Dánartíðni var 11,7% sem er lægri tíðni en meðal nágrannaþjóða okkar en þar er dánartíðni 15-20%. Umtalsverður árangur hefur náðst varðandi meðferð sjúklinga með alvarlegustu höfuðáverkana (GCS 8 eða minna) þar sem dánartíðni hefur lækkað um helming miðað við fyrir 20 árum. Ölvun var samverkandi þáttur í mörgum tilfellum þar sem um fall var að ræða auk þess sem það var vaxandi vandamál á tímabilinu. Aukinn fjöldi sjúklinga með alvarlegri áverka á seinustu tveim árum bendir til að enn sé þörf á öflugu forvarnarstarfi

Central nervous system tumours in Icelandic children; diagnoses, treatment results and late effects

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Tumours in the central nervous system are the second most common malignant diseases in children. With improved treatment, the number of survivors is increasing. Therefore, better knowledge of the long-term effects of the disease and the therapy is needed. The aim of the current study was to find the incidence of central nervous system tumours in Iceland, evaluate the treatment results and study the long-term effects on the individuals. Material and methods: Data on diagnosis and treatment as well as demographic data were gathered from hospital records from the Reykjavik City Hospital and The University Hospital and operating lists at the Department of Neurosurgery were reviewed. On survivors, physical examination was carried out, blood tests and urine-analysis were done and hearing was tested. Social adaptation, school performance, memory, concentration and general well being were studied by a questionnaire. Results: In the years 1970-1995, 57 children, aged 16 and younger, were diagnosed in Iceland with central nervous system tumours, 30 girls and 27 boys. Two children with brain metastases were excluded. Of the 55 individuals, 38 are alive today, 19 girls and 19 boys. Seventeen children had astrocytoma, grade 1 or 2 and seven had astrocytoma of grade 3 or 4. Seven children had medulloblastoma, other tumours were less common. Four patients with benign tumours in the spine were excluded from the study; three are living abroad and three refused participation. Therefore, 28 patients were included in the further study, 15 males and 13 females. The mean age at diagnoses was 7 years and 8 months (7:8) (median 6:7 years, span 0:0-15:11), the mean age at study was 21:4 years (median 20:2 years, span 7:6-39:9) and the mean time from diagnosis until study was 12:8 years (median 11:5 years, span 2:5-26:3). The mean standard deviation score for height (SDS) was -0.63 at the time of study, five of the patients had SDS below two. Five individuals need hormone replacement therapy and one patient has scoliosis. Three patients have disabilities; two of those are incapable of activities of daily life. Three patients have hearing impairment; one of them is also blind. Of five patients who had seizures when diagnosed, two still have convulsions. Of 28 patients, twelve (43%) had learning difficulties in school and ten (36%) needed remedial teaching. Conclusions: The incidence of central nervous tumours in Icelandic children is comparable to what has been reported in other countries. The results of the treatment are similar to what has been found in the other Nordic countries which maybe better than in other countries. The most prominent long-term effects among the survivors are endocrine dysfunctions and specific learning disabilities. Other, severe long-term complications are rare but have considerable effect on the individuals. We emphazise that organised, long-term follow-up is essential for these individuals, paying special attention to learning difficulties and endocrine dysfunction.Inngangur: Æxli í miðtaugakerfi er annar algengasti illkynja sjúkdómurinn í börnum, næst á eftir hvítblæði. Árangur meðferðar hefur farið stöðugt batnandi og því eykst mikilvægi þess að greina möguleg langtímaáhrif og síðkomna fylgikvilla meðferðar. Tilgangur rannsóknarinnar var að finna heildarfjölda sjúklinga á Íslandi, greiningu þeirra og árangur meðferðar og kanna síðkomna fylgikvilla og langtímaáhrif meðferðar á eftirlifandi einstaklinga. Aðferðir: Sjúklingar voru fundnir með leit í sjúkraskrám á Sjúkrahúsi Reykjavíkur og Landspítalanum auk þess sem farið var yfir aðgerðarbækur á SHR. Upplýsingar um sjúkdóminn, greiningu og meðferð var safnað. Allir þátttakendur í rannsókninni komu í viðtal og skoðun, heyrnarmælingu, blóð- og þvagrannsóknir. Spurningalisti varðandi félagslega aðlögun, skólagöngu, minni, einbeitingu og líðan var einnig lagður fyrir þátttakendur. Niðurstöður: Á árunum 1970-1995 greindust 57 börn á Íslandi yngri en 16 ára með æxli í miðtaugakerfi, 30 stelpur og 27 strákar. Tveir sjúklingar með meinvörp í heila voru útilokaðir frá frekari uppvinnslu. Nú eru 38 þessara einstaklinga á lífi, 19 konur og 19 karlar. Sautján sjúklingar höfðu astrocytoma af gráðu 1 eða 2 en sjö sjúklingar astrocytoma af gráðu 3 eða 4. Sjö sjúklingar höfðu greinst með medulloblastoma, aðrar tegundir voru sjaldgæfari. Fjórir sjúklingar með góðkynja æxli í mænu voru útilokaðir frá rannsókn. Þrír búa erlendis og þrír neituðu þátttöku. Því tóku 28 einstaklingar þátt í rannsókninni, 15 karlmenn og 13 konur. Aldur við greiningu var að meðaltali sjö ár og átta mánuðir (7:8) (miðgildi 6:7 ár, bil 0:0-15:11), meðalaldur við rannsókn var 21:4 ár (miðgildi 20:2 ár, bil 7:6-39:9) og meðaltími frá greiningu að rannsókn var 12:8 ár (miðgildi 11:5 ár, bil 2:5-26:3). Hæð þátttakenda við rannsókn var að meðaltali -0,63 staðalfráviksskor (standard deviation score; SDS), fimm þátttakendur eru með -2 eða minna í staðalfráviksskori. Fimm einstaklingar fá hormónameðferð vegna vanstarfsemi innkirtla í kjölfar meðferðar. Einn einstaklingur hefur hryggskekkju sem rekja má til meðferðar. Þrír einstaklingar hafa verulega skerta hreyfifærni sem rekja má til sjúkdómsins og/eða meðferðar og þar af eru tveir ófærir um athafnir daglegs lífs. Þrír einstaklingar eru heyrnarskertir, þar af er einn einnig blindur. Af fimm sjúklingum sem höfðu krampa sem einkenni um sjúkdóminn fá tveir enn krampa. Af 28 sjúklingum áttu 12 (43%) við sérstaka námsörðugleika að stríða í grunnskóla og tíu (36%) fengu stuðningskennslu. Umræður: Tíðni heila- og mænuæxla virðist sú sama hér og þekkist annars staðar. Árangur meðferðar virðist svipaður og á hinum Norðurlöndunum sem er oft betri en í öðrum löndum. Þau langtímaáhrif sem eru mest áberandi hjá einstaklingum sem lifað hafa æxli í miðtaugakerfi í æsku eru vanstarfsemi innkirtla og sértækir námsörðugleikar. Aðrir alvarlegir fylgikvillar eru ekki algengir en skerða þó lífsgæði einstaklingsins. Nauðsynlegt er að bjóða upp á skipulagt og markvisst eftirlit með þessum sjúklingum að meðferð lokinni með áherslu á að greina námsörðugleika og starfstruflanir í innkirtlum

SCANGREEN 2019-2022: Turfgrass species, varieties and seed mixtures for Scandinavian putting greens. Final results from a four-year testing period.

The objective of SCANGREEN 2019-22 was to find species, varieties and seed blends/mixtures of Agrostis, Festuca, Poa and Lolium that are suited for pesticide-free management of putting greens in the two major climatic zones of the Nordic countries and in the northern USA. The four test sites in the Nordic countries were Reykjavik GC, Iceland and NIBIO Apelsvoll in the the northern zone, and NIBIO Landvik, Norway and Smørum GC, Denmark in the southern zone. The two US test sites were located at Troll Turfgrass Research Facility in Massachusetts and at University of Minnesota. The trials included 30 candidate varieties representing eight different species and subspecies from 13 different seed companies/representatives, and three seed mixtures of red fescue and colonial and creeping bentgrass, a seed mixture of creeping bentgrass and perennial ryegrass and a seed blend of red fescue. Monthly evaluations of overall impression, tiller density, winter hardiness, disease and weed coverage etc., were done from three weeks after sowing in June-September 2019 until October 2022. The trial at Smørum GC was established in May 2021. The trials were established according to a split-plot design with three blocks (replicates), species on main plots and varieties on subplots. The experimental greens were mown three times per week – Monday, Wednesday, and Friday and deficit-irrigated to 80% of field capacity three to four times per week in periods without sufficient natural rainfall. Fertilizer (mean N–P–K ratio, 100–22–74) was given as completely balanced compound fertilizers every second week. Each experimental green was divided in different management levels: High and low fertilizer rate and high and low mowing. The two fertilizer rates were 10 and 17 g N m−2 yr−1 and the two mowing heights were 3 and 5 mm. Mixtures were managed at both regimes. There was no use of pesticides or plant growth regulators in any of the trials.SCANGREEN 2019-2022: Turfgrass species, varieties and seed mixtures for Scandinavian putting greens. Final results from a four-year testing period.publishedVersio

Introduction to Graphene

In this report some properties of graphene, a single atomic layer of carbon, are outlined. The structure of graphene is reviewed and its dispersion relation within the tight-binding approximation and the effective mass approximation. The observed half-integer quantum Hall effect in graphene is illustrated and finally bilayer graphene is discussed briefly.Í þessari ritgerð verður fjallað um grafín sem er einnar frumeindar þykkt lag af kolefni. Frumeindirnar í grafíni mynda tvívíða sexhyrningagrind og nota má einfalt tvívítt líkan með víxlverkunum milli næstu og þarnæstu nágranna til að lýsa hegðun rafeinda í grafíni. Einnig verður fjallað um skömmtuð Hallhrif í grafíni og að lokum stuttlega um tveggja laga grafín

The effect of kinesio taping on hamstrings muscle flexibility

Teygjanleiki aftanlærisvöðva Tilgangur rannsóknar: Kanna áhrif kinesio teips á teygjanleika aftanlærisvöðva knattspyrnumanna í 1. deild á Íslandi. Aðferð: Þátttakendur í rannsókninni voru virkir knattspyrnumenn í 1. deild karla á Íslandi. Úrtakið samanstóð af 20 leikmönnum og fengust niðurstöður frá 18 leikmönnum. Tveir þátttakendur duttu út vegna óviðráðanlegra aðstæðna. Teygjanleiki aftanlærisvöðva allra þátttakenda var mældur með „straight leg raise“ (SLR) og „passive knee extension“ (PKE). vöðvalengdarprófum án kinesio teips, 5 mínútum eftir að kinesio teip var sett á húð yfir aftanlærisvöðvum annars læris og svo aftur sólarhring eftir að kinesio teip var sett á. Niðurstöður: Ekki var marktækur munur á teygjanleika aftanlærisvöðva í SLR né PKE vöðvalengdarprófi áður en teip var lagt á, 5 mínútum eftir að teip var lagt á og sólarhring eftir að teip var lagt á. Teygjanleiki í aftanlærisvöðvum á teipaða fótlegg var marktækt minni en á óteipuðum fótlegg í SLR vöðvalengdarprófi, 5 mínútum eftir að teip var lagt á og sólarhring eftir að teip var lagt á. Ekki var marktækur munur á teygjanleika aftanlærisvöðva á teipuðum fótlegg miðað við óteipaðan í PKE vöðvalengdarprófi. Samantekt: Niðurstöður rannsóknarinnar benda til að sú kinesio teip aðferð sem notuð var í þessari rannsókn hafi ekki áhrif til að auka teygjanleika aftanlærisvöðva hjá knattspyrnumönnum í næstefstu deild á Íslandi. Þó er ekki hægt að fullyrði um áhrif teipsins á teygjanleika á þessum tímapunkti þar sem rannsakendum er ekki kunnugt um: (1) neinar aðrar rannsóknir sem framkvæmdar hafa verið á áhrifum kinesio teips á teygjanleika vöðva, (2) neinar rannsóknir sem sýna fram á hvaða aðferðum á að beita til að ná fram auknum teygjanleika með notkun kinesio teips

Smásjáraðgerðir vegna brjóskloss í mjóbaki : árangur af aðgerðum á heila- og taugaskurðdeild Borgarspítalans 1981-1984

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)A self-evaluation request form was sent to 170 patients operated on for lumbar disc herniation by microsurgical technique, from June 1, 1981 to December 31, 1984. One hundred forty six patients replied. Of those 86% rated themselves good to excellent and none rated him-/herself worse. 81.5% returned to former job, but 18.5% had to change jobs because of back symptoms. There was no significant difference between heavy labourers and those who held light jobs. Women fared significantly worse than men. Of those who had residual pain 78% had leg pain but 22% had back pain only, 6 patients had to be reoperated for recurrent disc.Rúmur áratugur er nú liðinn frá því fyrstu niðurstöður birtust um árangur smásjáraðgerða við brjósklosi í mjóbaki, (1-3). Hérlendis voru fyrstu sjúklingarnir skornir upp á þennan hátt á heila- og taugaskurðdeild Borgarspítalans sumarið 1981. Eftir það var skurðsmásjáin notuð í æ ríkari mæli og þykir nú ómissandi við þessar aðgerðir. Í mörg undanfarin ár má segja, að við allar aðgerðir vegna brjóskloss í baki hafi skurðsmásjáin verið notuð. Hér á eftir fara nokkrar helstu niðurstöður könnunar, sem gerð var á hópi sjúklinga er gengust undir umrædda aðgerð á árunum 1981-1984

Head injury at Reykjavík Hospital, intensive care unit, 1994-1998

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Reykjavík Hospital is the main trauma hospital in Iceland, receiving all severe head injuries in the country. Incidence of head injury and mortality has been decreasing in the last decades. The aim of this study was to analyse data on admission, treatment and outcome of patients admitted to intensive care unit with severe head injury and compare with other countries. Material and methods: In this study we looked retrospectively at the incidence of severe head injuries admitted to the intensive care unit at Reykjavik Hospital 1994-1998. Number of patients, type of injury, length of stay, length of ventilator treatment. Glasgow Coma Score (GCS), APACHE II (Acute Physiologic and Chronic Health Evaluation) score and mortality was analysed. Results: A total of 236 patients was admitted with an average of 47 patients per year. Traffic accidents were the most common cause of injury and mortality was 11.7%. Ethanol consumption was seen in many cases where fall was the cause of accident, most often in the year 1998 in 75% of cases. Mortality of patients with GCS 8 that was 40% of the patients was must higher or 24.7% compared with patients with GCS >8 where mortality was 3.4%. There was an increase in admissions in 1998, with more severe injuries and significantly longer length of stay and ventilator treatment. Conclusions: Number of patients with head injury was decreasing in comparison with older studies. The results of treatment are rather good in comparison with other countries with relatively low mortality, or 11.7% versus 15-20% in nearby countries. There has been improvement of outcome in patients with the most severe head injury (GCS 8) since 20 years ago, where up to 50% of the patients died but in our study mortality was 24.7%. Alcohol consumption was seen in 46% of cases where fall was the cause of head injury. Those that suffer head trauma are most often young people and preventive measures must continue with full strength in order to decrease the incidence of accidents in our society.Tilgangur: Höfuðáverkum hefur farið fækkandi á síðustu áratugum auk þess sem dánartíðni hefur farið lækkandi. Tilgangur rannsóknarinnar var að athuga hvort slík þróun hefði átt sér stað hér á landi síðastliðin ár. Efniviður og aðferðir: Farið var yfir tölvuskráningu allra sjúklinga sem lögðust inn á gjörgæsludeild Sjúkrahúss Reykjavíkur vegna höfuðáverka á árunum 1994-1998. Athugað var hver slysavaldur var auk þess sem ástand sjúklings við komu var kannað. Einnig var leitað eftir hvernig meðferð þeirra var háttað á gjörgæsludeild og ástand við útskrift. Niðurstöður: Alls lögðust 236 sjúklingar inn á gjörgæsludeild á tímabilinu sem er að meðaltali 47 sjúklingar á ári. Umferðarslys voru algengasta orsök höfuðáverka eða í 43% tilfella og dánartíðni var 11,7%. Ölvun var samverkandi orsök í mörgum tilfellum þar sem um fall var að ræða, mest árið 1998 eða 75%. Dánartíðni þeirra sem voru greindir með alvarlegustu höfuðáverkana, Glasgow Coma Score (GCS) 8 eða minna, sem voru um 40% sjúklinganna, var miklu hærri eða 24,7% á móti 3,4% ef GCS var yfir 8. Sjúklingar sem lögðust inn á árinu 1998 voru með alvarlegri höfuðáverka og meðaltími þeirra sem þurftu að vera í öndunarvél var lengri en árin á undan. Ályktanir: Fjöldi þeirra sem lögðust inn á gjörgæsludeild vegna höfuðáverka fór lækkandi í samanburði við eldri rannsókn sem gerð var hér á landi. Dánartíðni var 11,7% sem er lægri tíðni en meðal nágrannaþjóða okkar en þar er dánartíðni 15-20%. Umtalsverður árangur hefur náðst varðandi meðferð sjúklinga með alvarlegustu höfuðáverkana (GCS 8 eða minna) þar sem dánartíðni hefur lækkað um helming miðað við fyrir 20 árum. Ölvun var samverkandi þáttur í mörgum tilfellum þar sem um fall var að ræða auk þess sem það var vaxandi vandamál á tímabilinu. Aukinn fjöldi sjúklinga með alvarlegri áverka á seinustu tveim árum bendir til að enn sé þörf á öflugu forvarnarstarfi

Chest wall motion and pulmonary function are more diminished following cardiac surgery when the internal mammary artery retractor is used

To access publisher full text version of this article. Please click on the hyperlink in Additional Links filedOBJECTIVES: Pulmonary complications following cardiac surgery through sternotomy have been widely studied. The duration of these complications, however, has been less studied and the proposed alterations in chest wall mechanism even less. The purpose of this study was to investigate changes in chest wall motion and pulmonary function of cardiac surgery patients, where both the median and the internal mammary artery retractor was used (IMA group) and cardiac surgery patients, where only the median retractor was used (Median group). DESIGN: Subjects were 20 cardiac surgery patients with mean age 65 years (12 in the IMA group and 8 in the Median group). Bilateral respiratory movements (RMs) using the Respiratory Movement Measuring Instrument, lung volumes including vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume (FEV1) using the Vitalograph Alpha were measured and pulmonary radiographs analyzed before, 3 and 12 months after the operation. ANALYSIS: Descriptive statistics, t-tests, Mann-Whitney and Wilcoxon Signed Rank tests were used for analyses, p < or = 0.05. RESULTS: RMs were symmetrical in both groups prior to the operation and the differences in RMs and lung volumes between the groups were not significant. Three and 12 months postoperatively bilateral abdominal respiratory movements (ARM) were significantly less in the IMA group than in the Median group. Average left ARM were significantly less than the average right ARM in the IMA group 3 months postoperatively, while symmetrical in the Median group. Average FVC and FEV1 were significantly less in the IMA group than in the Median group 3 months postoperatively and FVC was still significantly less in the IMA group 12 months after the operation. CONCLUSION: The significantly more reduced ARM and lung volumes 3 months postoperatively in the IMA group than in the Median group suggests that the IMA retractor causes greater injury to the rib cage and the diaphragm

Respiratory movements are altered three months and one year following cardiac surgery

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOBJECTIVE: Pulmonary complications following cardiac surgery through sternotomy are well known, but little is known about the proposed alterations of the chest wall mechanism. The purpose of this study was to examine changes in chest wall motion and pulmonary function after cardiac surgery. DESIGN: The subjects were 20 cardiac surgery patients, 13 men and 7 women, mean age 65 years. Measurements: Bilateral respiratory movements were measured using the Respiratory Movement Measuring Instrument before, 3 and 12 months after the operation. Vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume (FEV1) were measured with the Pulminet III (Gold Godart Ltd Vitalograph Alpha Ltd. Maids Morton, Buckingham, England) preoperatively, 3 and 12 months postoperatively, and radiographs were taken at the same points in time. Analysis: Descriptive statistics, paired sample t-tests, Mann-Whitney and Wilcoxon Signed Rank tests were used for analyses, p < or = 0.05. RESULTS: Average abdominal movements 3 months postoperatively were significantly decreased and the difference between right and left side in upper thoracic and abdominal movements was significant. All pulmonary function measurements except the FEV1/FVC showed a significant decrease and a restrictive pattern compared with preoperative values. Twelve months after the operation the upper thoracic movements were significantly increased. Five patients had an abnormal chest x-ray before the operation, eight 3 months and three 12 months after the operation. CONCLUSION: The motor system of the respiratory organs suffers considerable injury from cardiac surgery, which in part at least can explain the restrictive breathing 3 months postoperatively

Short-term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy

Objective-To study the changes in bilateral respiratory motion and pulmonary function following sternotomy and the relationships between the changes in respiratory movements, spirometry, radiographic analyses, and several intra-operative surgical characteristics. Design-Respiratory motion during deep breathing and lung volumes were measured in 20 patients (mean age 65 years, SD 16) before and after median sternotomy. Chest x-rays were analyzed pre- and postoperatively and a variety of perioperative variables were measured. Results-Average abdominal motion decreased to 57% of preoperative values bilaterally 1 week postoperatively, the average lower thoracic motion decreased to 72%, and the average upper thoracic motion decreased to 87%, whereas the right upper thoracic motion increased 3% compared with preoperative values. Lung volumes decreased to around 60% of preoperative values (p < 0.05). Significant correlations were found between the decrease in pulmonary function and the mean respiratory movements. Abnormal chest radiographs were found in all patients. Conclusion-The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented