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Chest wall

Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
A Alaga, Y X Yew, M K Razul
A 47-year-old female, with multiple comorbidities, presented with a cough of two months, loss of weight and appetite. She was treated for pneumonia. A chest X-ray showed bilateral reticulonodular opacities. She was noted to have a vague central abdominal mass and a systolic murmur over the mitral region. Ultrasonography and computed tomography of the abdomen showed an omental mass and loculated ascites. Oesophagoduedenoscopy showed antral gastritis and during colonoscopy the surgical team was unable to advance the scope beyond 40 cm due to external compression...
December 2017: Journal of the Royal College of Physicians of Edinburgh
Maria Kerti, Zsuzsanna Balogh, Krisztina Kelemen, Janos T Varga
Rationale: The relationship of functional parameters such as lung mechanics, chest kinematics, metabolism and peripheral and respiratory muscle function with the level of exercise tolerance remains a controversial subject. While it has been previously shown that pulmonary rehabilitation is capable of improving exercise tolerance in patients afflicted by COPD, as expressed by values of 6-minute walking test (6MWT), the degree of contribution to this change by each of the aforementioned parameters remains unclear...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Wenfeng Chen, Lianxiang He, Liqing Yue, Mijung Park, Haoyu Deng
The purpose of the present study was to examine a new protocol involving the spontaneous correction of the misplaced tip of a peripherally inserted central catheter (PICC). Patients with PICCs misplaced in the jugular or contralateral subclavian veins were recruited. All patients underwent chest X-ray (CXR) after 3 days. In addition, those whose PICC tip still was misplaced and received another CXR after 4 days. The functions of the catheters, the subjective feelings of the patients, and local symptoms of the neck and upper anterior chest wall were recorded...
March 12, 2018: International Journal of Cardiovascular Imaging
Meena Bedi, David M King, Carlos Mendez, Barbara Slawski, John A Charlson, Donald A Hackbarth, John C Neilson
BACKGROUND: Uncontrolled blood glucose impacts key phases of the wound healing process. Various factors have been associated with postoperative wound complications in soft tissue sarcomas; however, the association of postoperative early morning blood glucose with wound complications, if any, remains to be determined. Because blood glucose levels may be modified, understanding whether glucose levels are associated with wound complications has potential therapeutic importance. QUESTIONS/PURPOSES: The purposes of this study were (1) to evaluate if postoperative early morning blood glucose is associated with the development of wound complications in soft tissue sarcomas; (2) to determine a blood glucose cutoff that may be associated with an increased risk of wound complications; and (3) to evaluate if patients with diabetes have higher postoperative blood glucose and an associated increased risk of wound complications...
March 2018: Clinical Orthopaedics and related Research
Yue Yan, Jinzhong Yang, Sam Beddar, Geoffrey S Ibbott, Zhifei Wen, Laurence E Court, Ken-Pin Hwang, Mo Kadbi, Sunil Krishnan, Clifton Fuller, Steven J Frank, James N Yang, Peter A Balter, Rajat J Kudchadker, Jihong Wang
We developed a novel technique to study the impact of geometric distortion of magnetic resonance imaging (MRI) on intensity-modulated radiation therapy treatment planning.
 The measured 3D datasets of residual geometric distortion (a 1.5-T MRI component of an MRI linear accelerator system) was fitted with a second-order polynomial model to map the spatial dependence of geometric distortions. Then the geometric distortion model was applied to computed tomography (CT) image and structure data to simulate the distortion of MRI data and structures...
March 12, 2018: Physics in Medicine and Biology
Abdulraouf H Alghufaili, Luxshan Shanmugarajah, Lalith K Kumaraswamy
Our study aimed to correlate the overall 3-dimensional (3-D) shape of the breast to the compensation depth to produce a homogeneous dose distribution using the electronic tissue compensation (ECOMP) treatment technique. The study involved creating a number of semioval water phantoms with the diameter of the larger axis representing the breast separation and the shorter axis representing the distance from the chest wall to the apex of the breast. Multiple plans with 2 tangential fields were created for each phantom using different transmission penetration depths (TPDs) to determine the optimum TPD value based on the evaluation of dose uniformity and maximum hot spot...
March 7, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Kutsi Tuncer, Berhan Pirimoglu, Hayri Ogul
No abstract text is available yet for this article.
March 7, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Xin Zhang, Yi Rong, Steven Morrill, Jian Fang, Ganesh Narayanasamy, Edvaldo Galhardo, Sanjay Maraboyina, Christopher Croft, Fen Xia, Jose Penagaricano
Robust optimization generates scenario-based plans by a minimax optimization method to find optimal scenario for the trade-off between target coverage robustness and organ-at-risk (OAR) sparing. In this study, 20 lung cancer patients with tumors located at various anatomical regions within the lungs were selected and robust optimization photon treatment plans including intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans were generated. The plan robustness was analyzed using perturbed doses with setup error boundary of ±3 mm in anterior/posterior (AP), ±3 mm in left/right (LR), and ±5 mm in inferior/superior (IS) directions from isocenter...
March 10, 2018: Journal of Applied Clinical Medical Physics
Nicholas R Phillips, Derek E Kunz
While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax...
March 2018: Current Sports Medicine Reports
Abirami Kumaresan, Robert Gerber, Ariel Mueller, Stephen H Loring, Daniel Talmor
BACKGROUND: The effects of prone positioning on esophageal pressures have not been investigated in mechanically ventilated patients. Our objective was to characterize effects of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby assessing the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. METHODS: We studied 16 patients undergoing spine surgery during general anesthesia and neuromuscular blockade...
March 9, 2018: Anesthesiology
Noora Al-Hammadi, Palmira Caparrotti, Carole Naim, Jillian Hayes, Katherine Rebecca Benson, Ana Vasic, Hissa Al-Abdulla, Rabih Hammoud, Saju Divakar, Primoz Petric
Background: During radiotherapy of left-sided breast cancer, parts of the heart are irradiated, which may lead to late toxicity. We report on the experience of single institution with cardiac-sparing radiotherapy using voluntary deep inspiration breath hold (V-DIBH) and compare its dosimetric outcome with free breathing (FB) technique. Patients and methods: Left-sided breast cancer patients, treated at our department with postoperative radiotherapy of breast/chest wall +/- regional lymph nodes between May 2015 and January 2017, were considered for inclusion...
March 2018: Radiology and Oncology
Xiumei Sun, Jianxin Zhou
Esophageal pressure monitoring provides a minimally invasive method to assess the pleural pressure, which can be used to differentiate the lung and chest wall mechanics. The information of transpulmonary pressure, work of breathing, intrinsic positive end-expiratory pressure and respiratory muscle performance can facilitate the proper setting of mechanical ventilation. Esophageal pressure monitoring is still not routinely used in the clinical setting because of difficulty in esophageal balloon catheter placement and data interpretation due to esophageal pressure monitoring has certain technical requirements, and the measurement results are influenced by many factors such as airbag volume, location, esophageal wall elasticity and mediastinal organ weight...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Lobna Ouldamer, Marie Cayrol, Mathilde Vital, Claire Fièvre, Marion Druelles, Flavie Arbion, Gilles Body, Jean Lévêque, Xavier Fritel
PURPOSE: The aim of the study was to investigate the management and prognosis of axillary cancers from unknown primaries (CUPax). METHODS: We included all patients with lesions described as axillary nodal metastases from an unknown primary referred to four French tertiary breast cancer centres between January 1988 and December 2012. The inclusion criteria comprised: no sign of primary breast cancer on clinical examination nor on imaging (mammography, ultrasonography and breast MRI) and no primary tumour identified elsewhere...
February 23, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ingrid M E Desar, Emmy D G Fleuren, Winette T A van der Graaf
Synovial sarcoma (SS) is a rare, yet highly malignant, type of soft tissue sarcoma (STS), for which survival has not improved significantly during the past years. In this review, we focus on systemic treatment in adults. Compared to other STS, SS are relatively chemosensitive. Ifosfamide and ifosfamide combinations are active in different lines of treatment. In high-risk extremity and chest wall STS, neoadjuvant doxorubicin and ifosfamide has shown as much activity as high-dose ifosfamide. There are indications that combination chemotherapy with doxorubicin and ifosfamide in this setting improves outcome...
March 7, 2018: Current Treatment Options in Oncology
Heather Katz, Hassaan Jafri, Thomas Dougherty, Yehuda Lebowicz
Metaplastic breast cancer (MBC) in men is an extremely rare entity. MBC is typically very aggressive with a poor prognosis. In men, it has only been reported three times in the literature. We report a 47-year-old man who presented with right-sided breast erythema and nipple inversion. Mammogram revealed a 2.4 cm spiculated mass. Initial pathology was inconclusive; however, right-sided simple mastectomy showed invasive metaplastic carcinoma with adenosquamous histology. He received adjuvant chemotherapy with 4 cycles of dose dense Adriamycin and cyclophosphamide followed by 12 weeks of paclitaxel and chest wall radiation...
March 7, 2018: BMJ Case Reports
Michele Cox, Darshan Thota, Ruth Trevino
A 71-yr-old male with a medical history significant for chronic obstructive pulmonary disease presented to emergency department for worsening cough, right-sided pleuritic chest pain, and dyspnea. This was the patient's third visit to the emergency department in 4 d. The patient was initially treated for chronic obstructive pulmonary disease exacerbation and subsequently evaluated for congestive heart failure. He was ultimately diagnosed with a spontaneous herniation of the lung parenchyma through the chest wall...
March 1, 2018: Military Medicine
David Boulate, Dominique Fabre, Nathaniel B Langer, Elie Fadel
Surgical strategy and long-term outcomes of patients with rupture of the ascending aorta, aortic arch and supra-aortic vessels following blunt thoracic trauma have been rarely reported. We reviewed our institutional experience between 1995 and 2016. We identified 2 patients with an innominate artery ruptures, 2 with an aortic arch ruptures and 1 with an ascending aorta rupture; all were induced by the posterior displacement of the anterior chest wall. All patients underwent open surgical repair. Cardiopulmonary bypass with antegrade cerebral perfusion was required in 2 cases...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Susanna Nuvoli, Sarah Galassi, Ilaria Gelo, Gaia Rocchitta, Alessandro Fancellu, Pier Andrea Serra, Giuseppe Madeddu, Angela Spanu
The aim of the present study was to investigate the usefulness of molecular breast imaging (MBI) in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy. A consecutive series of 43 female patients with large or locally advanced primary breast cancer, scheduled for surgery following neoadjuvant therapy, was retrospectively reviewed. Prior to surgery, all patients underwent MBI using a high‑resolution semiconductor‑based device for image acquisition. MBI data were correlated with surgical histopathological findings...
March 6, 2018: Oncology Reports
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