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Bogdan Andrei Suciu, Ioana Halmaciu, Vasile Bud, Decebal Fodor, Vlad Vunvule, Klara Brinzaniuc, Constantin Copotoiu, Calin Molnar
The tracheo-oesophageal fistula is a severe condition endangering the patients' live. The main cause of this condition is the prolonged ventilation. The purpose of this paper is to present an innovative technique in treating this affection. CASE REPORT: We present the case of a 32 years old female patient with multiple trauma due to traffic accident. The patient was hospitalized with the diagnosis of brain injury, subarachnoid hemorrhage, and fractured femur. After 11 days of mechanical ventilation and intubation via endotracheal route, the patient was diagnosed with a large (7x3 cm) tracheo-oesophageal fistula with dilaceration of the membranous wall of the trachea...
July 10, 2018: Annali Italiani di Chirurgia
Chun-Chien Shieh, Jeffrey Barber, William Counter, Jonathan R Sykes, Peter Bennett, Soo-Min Heng, Paul White, Stéphanie Corde, Michael Jackson, Verity Ahern, Ilana J Feain, Ricky T O'Brien, Paul J Keall
Fixed-gantry cone-beam computed tomography (CBCT), where the imaging hardware is fixed while the subject is continuously rotated 360$\degree$ in the horizontal position, has implications for building compact and affordable fixed-gantry linear accelerators (linacs). Fixed-gantry imaging with a rotating subject presents a challenging image reconstruction problem where the gravity-induced motion is coupled to the subject's rotation angle. This study is the first to investigate the feasibility of fixed-gantry CBCT using imaging data of three live rabbits in an ethics-approved study...
September 17, 2018: Physics in Medicine and Biology
Hongwu Wang, Mingyao Ke, Wen Li, Zikai Wang, Hui Li, Minghua Cong, Yiming Zeng, Liangan Chen, Guoxiang Lai, Baosong Xie, Nan Zhang, Wangping Li, Hongmei Zhou, Xiaoping Wang, Dianjie Lin, Yunzhi Zhou, Huaping Zhang, Dongmei Li, Xiaolian Song, Juan Wang, Shiman Wu, Meimei Tao, Zhengbu Sha, Qiang Tan, Xinwei Han, Lingfei Luo, Hongming Ma, Zhiqiang Wang
Acquired respiratory-digestive tract fistulas occur with abnormal communication between the airways and digestive tract, causing the interflow of gas and liquid. Despite advances in surgical methods and the development of multimodal therapy in recent years, patients with acquired respiratory-digestive tract fistulas continue to exhibit unfavorable clinical outcomes. Therefore, in order to guide clinical practice in China, the Respiratory and Cancer Intervention Alliance of the Beijing Health Promotion Association organized a group of experienced experts in the field to develop this consensus document...
September 17, 2018: Thoracic Cancer
Zhi Guo, Hong Shi, Wentao Li, Dongmei Lin, Changli Wang, Chen Liu, Min Yuan, Xia Wu, Bin Xiong, Xinhong He, Feng Duan, Jianjun Han, Xueling Yang, Haipeng Yu, Tongguo Si, Linfeng Xu, Wenge Xing, Huang Jinhua, Yingjuan Wang, Hui Xie, Li Cui, Wei Gao, Dongfeng He, Changfu Liu, Zhou Liu, Chunhua Ma, Jie Pan, Haibo Shao, Qiang Tu, Li Yong, Yan Xu, Zhang Weihao, Zou Qiang, Sen Wang
Biopsy has been used to diagnose thoracic diseases for more than a century. Percutaneous needle biopsy plays a crucial role in the diagnosis, staging, and treatment planning for tumors in the lungs, thoracic wall, hilum, and mediastinum. With the continuous improvement in imaging techniques, the range of clinical applications for percutaneous needle biopsy is also expanding. It has become important to improve Chinese professionals' and technicians' understanding of percutaneous transthoracic needle biopsy (PTNB) in order to standardize operating procedures and to strengthen perioperative management...
September 17, 2018: Thoracic Cancer
W Pan, Z Liu, Z H Zhao, J Li, C C Zeng, Z Z Zhu, B Wang, B P Qian, Y Yu, Y Qiu
Objective: To analyze the long-term results and the influence factors of spontaneous correction of unfused thoracic curves in anterior and posterior selective fusions in Lenke type 5C adolescent idiopathic scoliosis (AIS). Methods: From January 2005 to December 2011, 89 Lenke type 5C AIS patients with a minimum of 5-year follow-up who underwent thoracolumbar/lumbar (TL/L) selective fusion in Spine Surgery of Nanjing Drum Tower Hospital were reviewed.Forty-six patients underwent anterior fusion (anterior group), while 46 underwent posterior fusion (posterior group)...
September 4, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Masanobu Nakajima, Hiroto Muroi, Maiko Kikuchi, Satoru Yamaguchi, Kinro Sasaki, Takashi Tsuchioka, Yusuke Takei, Ikuko Shibasaki, Hirotsugu Fukuda, Hiroyuki Kato
OBJECTIVE: Definitive chemoradiotherapy is useful for locally advanced esophageal cancer. However, salvage esophagectomy is required when residual or recurrent tumor is evident after chemoradiotherapy. We performed salvage esophagectomy combined with partial aortic wall resection after thoracic endovascular aortic repair for aortic invasion, and we evaluated the results. METHODS: Four patients underwent esophagectomy combined with aortic wall resection after thoracic endovascular aortic repair because the lesion was diagnosed as stage T4b...
September 15, 2018: General Thoracic and Cardiovascular Surgery
Marthony Robins, Jayashree Kalpathy-Cramer, Nancy A Obuchowski, Andrew Buckler, Maria Athelogou, Rudresh Jarecha, Nicholas Petrick, Aria Pezeshk, Berkman Sahiner, Ehsan Samei
RATIONALE AND OBJECTIVES: To evaluate a new approach to establish compliance of segmentation tools with the computed tomography volumetry profile of the Quantitative Imaging Biomarker Alliance (QIBA); and determine the statistical exchangeability between real and simulated lesions through an international challenge. MATERIALS AND METHODS: The study used an anthropomorphic phantom with 16 embedded physical lesions and 30 patient cases from the Reference Image Database to Evaluate Therapy Response with pathologically confirmed malignancies...
September 12, 2018: Academic Radiology
Matthew J Farrell, Jehan B Yahya, Catherine Degnin, Yiyi Chen, John M Holland, Mark A Henderson, Jerry J Jaboin, Matthew M Harkenrider, Charles R Thomas, Timur Mitin
BACKGROUND: Thoracic radiotherapy (TRT) with concurrent chemotherapy is standard for limited-stage small-cell lung cancer (LS-SCLC). However, the optimal dosing and fractionation remain unclear. The National Comprehensive Cancer Network guidelines have recommended either 45 Gy delivered twice daily (BID) or 60 to 70 Gy delivered once daily (QD). However, the current practice patterns among US radiation oncologists are unknown. MATERIALS AND METHODS: We surveyed US radiation oncologists using an institutional review board-approved questionnaire...
August 22, 2018: Clinical Lung Cancer
Jun-Soon Kim, Myoung-Jin Jang, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim, Sung-Min Kim, Kyung Seok Park
OBJECTIVE: To identify factors associated with the failure to generate baseline muscle motor evoked potentials (mMEPs) during spinal surgery, and to determine the association between baseline mMEP generation and postoperative outcomes. METHODS: A total of 345 patients who underwent spine surgery with intraoperative mMEP monitoring were included, and we retrospectively reviewed their demographic/clinical parameters, and mMEP recording results according to lesion locations...
August 22, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Hoi Tung Lam, Joy Melody Kwong, Pak Lun Lam, Wai Lok Yeung, Yiu Che Chan
PURPOSE: Embolic stroke is a formidable complication of transcatheter aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR). Mechanical strategies to reduce the risk of ischemic embolic lesions include embolic protection devices (EPD) and carbon dioxide flushing (CDF). This study aims to assess the efficacy for EPD and CDF uses in TAVI and TEVAR. METHODS: A literature review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA)...
September 12, 2018: Annals of Vascular Surgery
Katsuyoshi Ando, Mikihiro Fujiya, Toshikatsu Okumura
An 84-year-old man with a history of distal gastrectomy for the treatment of gastric cancer presented with epigastric pain and underwent esophagogastroduodenoscopy. Visualization showed a large tumor in the esophagus (Figure 1A) and minute elevation with whitish granules in the duodenum (Figure 1B). Narrow-band imaging with magnified endoscopy (NBI-ME) showed enlarged villous structures with white vesicles and enlarged and meandering superficial vessels without irregularity (Figure 1C). This article is protected by copyright...
September 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Christopher Reiff, Sergey Gurevich, Stefan Bertog, Paul Sorajja, Rosemary Kelly, Santiago Garcia
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) transcatheter valve therapy (TVT) transcatheter aortic valve replacement (TAVR) score was developed to predict in-hospital mortality in patients undergoing commercial TAVR in the United States. Veterans Affairs (VA) hospitals are not included in the TVT registry. METHODS: The STS/ACC TVT-TAVR score was estimated in 195 veterans undergoing TAVR from 2015-2017. Discrimination was estimated by calculating the area under the receiver operating characteristics curve (AUC) for two outcomes of interest: in-hospital and 30-day mortality...
September 15, 2018: Journal of Invasive Cardiology
Ningning Lv, Shi Gao, Lin Bai, Bin Ji, Jinru Xue, Xiaoguang Ge, Bin Chen
BACKGROUND: Our study was designed to compare the diagnostic efficacies of integrated 99m Tc-HYNIC-PEG4-E[PEG4-c(RGDfK)]2 (99m Tc-3PRGD2 ) single-photon emission computed tomography (SPECT) images and computed tomography (CT) images in lymph node metastasis in the patients with esophageal cancer. METHODS: From September 2015 and May 2018, 32 patients with histologically proven primary esophageal carcinoma underwent both 99m Tc-3PRGD2 SPECT and CT scans followed by esophagectomy with lymph node dissection...
September 14, 2018: Annals of Nuclear Medicine
Zhao Xiaobing, Li Xingchen, Zhou Honggang, Cao Xiaoqiang, Yuan Qidong, Ma Haijun, Yang Hejun, Wang Bisheng
PURPOSES: To describe the rationale, surgical technique, and short-term follow-up results of a new minimally invasive treatment for thoracic spinal stenosis (TSS) caused by herniation, ossification of the ligamentum flavum (OLF), and/or ossification of the posterior longitudinal ligament (OPLL) with a "U" route transforaminal percutaneous endoscopic thoracic discectomy (PETD). METHODS: Fourteen patients, including seven males and seven females, underwent "U" route PETD...
September 15, 2018: International Orthopaedics
Marco Crostelli, Osvaldo Mazza, Massimo Mariani, Dario Mascello, Carlo Iorio
PURPOSE: Mucopolysaccharidosis (MPS) are rare inherited metabolic diseases, causing lysosomal storage of mucopolysaccharides; clinical presentation involves skeletal system and particularly the spine. Anomalies include developing kyphosis at thoracolumbar junction, that can causes nervous symptoms, and dens hypoplasia with associated atlantoaxial subluxation that can cause myelopathy. We present our experience in the treatment of spine pathology in MPS. METHODS: Medical treatments of MPS seem to have little impact on spine disease: treatment of cervical instability often includes surgical decompression and stabilization, as in patient MPS1 that we present, while thoracic lumbar kyphosis is treated by bracing and, in severe cases, with surgery...
September 14, 2018: International Orthopaedics
S Richner-Wunderlin, A F Mannion, A Vila-Casademunt, F Pellise, M Serra-Burriel, B Seifert, E Aghayev, E Acaroglu, A Alanay, F J S Pérez-Grueso, I Obeid, F Kleinstück
PURPOSE: The aim of this study was to evaluate factors that distinguish between patients with adult spinal deformity (ASD) with and without an indication for surgery, irrespective of their final treatment. METHODS: Baseline variables (demographics, medical history, outcome measures, coronal, sagittal and neurologic parameters) were evaluated in a multicentre, prospective cohort of patients with ASD. Multivariable analyses were carried out for idiopathic and degenerative patients separately with the dependent variable being "indication for surgery" and baseline parameters as independent variables...
September 14, 2018: European Spine Journal
Yawen Zheng, Linlin Wang, Weichong Zhao, Yan Dou, Wei Lv, Hongyan Yang, Yuping Sun, Ligang Xing
BACKGROUND: This study aimed to determine the risk factors for brain metastasis (BM) and the prognostic factors for overall survival (OS) in patients with small cell lung cancer without prophylactic cranial irradiation (PCI). PATIENTS AND METHODS: Limited stage small cell lung cancer (LS-SCLC) patients achieving a complete response (CR) or partial response (PR) were enrolled into this study between January 2010 and December 2016. We retrospectively evaluated the influencing factors for time to BM and overall survival (OS)...
September 14, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Thomas J Buell, Ching-Jen Chen, John C Quinn, Avery L Buchholz, Marcus D Mazur, Jeffrey P Mullin, James H Nguyen, Davis G Taylor, Shay Bess, Breton G Line, Christopher P Ames, Frank J Schwab, Virginie Lafage, Christopher I Shaffrey, Justin S Smith
OBJECTIVE: The aims of this retrospective cohort study were to: 1) identify new alignment risk factors for proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients with lower thoracic upper instrumented vertebra (UIV); and 2) determine the effect of junctional tethers on PJK and UIV alignment. METHODS: We analyzed consecutive ASD patients who underwent posterior instrumented fusion with lower thoracic UIV (T9-T11). Posteriorly-anchored junctional tethers were utilized more recently for ligamentous augmentation to prevent PJK...
September 11, 2018: World Neurosurgery
Tanner I Kim, Timur P Sarac, Kristine C Orion
INTRODUCTION: Venous thoracic outlet syndrome (vTOS) is a rare disease with no defined guidelines regarding treatment. Patients with first rib resection and anterior scalenectomy (FRRS) often have residual subclavian vein stenosis. The aim of this study was to evaluate the utility of intravascular ultrasound (IVUS) in the treatment of vTOS patients who have been surgically decompressed with FRRS. METHODS: Patients treated with venography post-FRRS for vTOS during 2015-2017 were retrospectively reviewed...
September 11, 2018: Annals of Vascular Surgery
Nathan Belkin, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Venkat Kalapatapu, Michael A Golden, Ronald M Fairman, Rachel R Kelz, Grace J Wang
BACKGROUND: Length of stay (LOS) is a commonly used metric to optimize value in medical care. While pathways have been developed for some procedures in vascular surgery to reduce length of stay (LOS), they do not yet exist for TEVAR. The purpose of this study is to identify and define the risk factors for prolonged LOS in patients undergoing TEVAR to facilitate pathway development. METHODS: We included TEVAR patients in the National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005-2015...
September 11, 2018: Annals of Vascular Surgery
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