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https://www.readbyqxmd.com/read/28318537/cardiac-magnetic-resonance-imaging-in-suspected-blunt-cardiac-injury-a-prospective-pilot-cohort-study
#1
Aidan Jc Burrell, David M Kaye, Mark C Fitzgerald, David J Cooper, James L Hare, Benedict T Costello, Andrew J Taylor
INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohort underwent CMR within 7 days, enrolling 21 patients with evidence of chest injury and an elevated Troponin I compared to 21 patients without chest injury who acted as controls...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28315045/late-onset-chest-wall-abscess-due-to-a-biodegradable-rib-pin-infection-after-lung-transplantation
#2
Yasufumi Goda, Toyofumi F Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space...
March 17, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28304223/metastatic-clival-chordoma-a-case-report-of-multiple-extraneural-metastases-following-resection-and-proton-beam-radiotherapy-in-a-5-year-old-boy
#3
Martin J Rutkowski, Harjus S Birk, Matthew D Wood, Arie Perry, Theodore Nicolaides, Christopher P Ames, Nalin Gupta
The authors report the case of a 5-year-old boy in whom extraneural metastases developed 5 years after he underwent an occipitocervical fusion and transoral approach to treat a clival chordoma without local recurrence. Following primary resection, the patient's postoperative course was complicated by recurrent meningitis secondary to CSF leak, which responded to antibiotics, and communicating hydrocephalus, for which a ventriculoperitoneal shunt was placed. The patient then underwent postoperative proton beam radiotherapy...
March 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#4
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28301367/reconstruction-of-a-long-segment-tracheal-defect-using-an-alloderm-conduit
#5
William D Bolton, Sharon Ben-Or, Allyson L Hale, James E Stephenson
This case describes successful reconstruction of a long-segment tracheal defect using AlloDerm as the conduit for reconstruction. A 38-year-old woman who had undergone a thyroid lobectomy in 2011 presented several months later unable to swallow. Chest computed tomography results revealed a tracheal/esophageal mass and a subsequent bronchoscopy, and esophagogastroduodenoscopy results revealed an upper esophageal/tracheal mass with two areas concerning for fistula. She underwent a bronchoscopy with a tracheal stent and percutaneous endoscopic gastrostomy placement...
March 15, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28299356/an-exome-sequencing-study-of-moebius-syndrome-including-atypical-cases-reveals-an-individual-with-cfeom3a-and-a-tubb3-mutation
#6
Ronak M Patel, David Liu, Claudia Gonzaga-Jauregui, Shalini Jhangiani, James T Lu, V Reid Sutton, Susan D Fernbach, Mahshid Azamian, Lisa White, Jane C Edmond, Evelyn A Paysse, John W Belmont, Donna Muzny, James R Lupski, Richard A Gibbs, Richard Alan Lewis, Brendan H Lee, Seema R Lalani, Philippe M Campeau
Moebius syndrome is characterized by congenital unilateral or bilateral facial and abducens nerve palsies (sixth and seventh cranial nerves) causing facial weakness, feeding difficulties, and restricted ocular movements. Abnormalities of the chest wall such as Poland anomaly and variable limb defects are frequently associated with this syndrome. Most cases are isolated; however, rare families with autosomal dominant transmission with incomplete penetrance and variable expressivity have been described. The genetic basis of this condition remains unknown...
March 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28299230/reconstruction-of-chest-wall-by-cryopreserved-sternal-allograft-after-resection-of-aneurysmal-bone-cyst-of-sternum
#7
Kambiz Sheikhy, Azizollah Abbasi Dezfouli, Farahnaz Sadegh Beigee
A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28298402/early-computed-tomography-modifications-following-bronchial-thermoplasty-in-patients-with-severe-asthma
#8
Marie-Pierre Debray, Marie-Christine Dombret, Marina Pretolani, Gabriel Thabut, Loubna Alavoine, Pierre-Yves Brillet, Camille Taillé, Antoine Khalil, Pascal Chanez, Michel Aubier
Bronchial thermoplasty (BT) is a recent, promising and well-tolerated technique for the treatment of severe asthma. By delivering thermal energy to the airway wall, this procedure can induce early pulmonary opacities seen on computed tomography (CT). We aimed to examine early CT modifications induced by BT and to determine their association with respiratory symptoms.Unenhanced chest CT was performed the day after each BT session in 13 patients with severe asthma, leading to the examination of 38 treated lobes...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28298401/impact-of-tumour-thickness-on-survival-after-radical-radiation-and-surgery-in-malignant-pleural-mesothelioma
#9
Marc de Perrot, Zhi Dong, Penelope Bradbury, Demetris Patsios, Shaf Keshavjee, Natasha B Leighl, Andrew Hope, Ronald Feld, John Cho
Tumour thickness was assessed to determine if this parameter could refine patients' selection for multimodality therapy in malignant pleural mesothelioma.We reviewed 65 consecutive treatment-naïve malignant pleural mesothelioma patients undergoing surgery for mesothelioma after radiation therapy (SMART). Total tumour thickness was determined by measuring the maximal thickness on nine predefined sectors on the chest wall, mediastinum and diaphragm.After a median follow-up of 19 months, 40 patients (62%) developed recurrence and 36 died (55%)...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28297458/translucent-poly-vinyl-alcohol-cryogel-dosimeters-for-simultaneous-dose-buildup-and-monitoring-during-chest-wall-radiation-therapy
#10
Molham M Eyadeh, Mark A Weston, Janos Juhasz, Kevin R Diamond
Chest wall radiation therapy treatment delivery was monitored using a 5 mm thick radiochromic poly(vinyl alcohol) cryogel that also provided buildup material. The cryogels were used to detect positioning errors and measure the impact of shifts for a chest wall treatment that was delivered to a RANDO phantom. The phantom was shifted by ±2,±3, and ±5 mm from the planned position in the anterior/posterior (A/P) direction; these shifts represent setup errors and the uncertainty associated with lung filling during breath-hold...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#11
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297278/dosimetric-assessment-of-brass-mesh-bolus-for-postmastectomy-photon-radiotherapy
#12
Ryan Manger, Adam Paxton, Laura Cerviño
Brass mesh bolus has been shown to be an acceptable substitute for tissue-equivalent bolus to increase superficial dose for chest wall tangent photon radiotherapy. This work investigated the increase in surface dose, the change in the dose at depth, and the safety implications of higher energy photon beams when using brass mesh bolus for postmastectomy chest wall radiotherapy. A photon tangent plan was delivered to a thorax phantom, and the superficial dose ranged from 40%-72% of prescription dose with no bolus...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297062/description-and-early-outcomes-of-the-hybrid-graft-for-dialysis
#13
Luis F Gomez, Eric K Peden
INTRODUCTION: Long-term dialysis access has become more challenging as patient survival has improved in end-stage renal disease. The GORE® Hybrid Vascular Graft (GHVG) has been designed to improve dialysis access outcomes and provide additional access options for challenging patients. In this article, we will review the design of the graft, unique properties and reported outcomes. METHODS: We reviewed data available at our institution and performed a Pubmed search on GORE® Hybrid Vascular graft...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28296326/evaluation-of-target-and-cardiac-position-during-visually-monitored-deep-inspiration-breath-hold-for-breast-radiotherapy
#14
Leigh Conroy, Rosanna Yeung, Elizabeth Watt, Sarah Quirk, Karen Long, Alana Hudson, Tien Phan, Wendy L Smith
A low-resource visually monitored deep inspiration breath-hold (VM-DIBH) technique was successfully implemented in our clinic to reduce cardiac dose in left-sided breast radiotherapy. In this study, we retrospectively characterized the chest wall and heart positioning accuracy of VM-DIBH using cine portal images from 42 patients. Central chest wall position from field edge and in-field maximum heart distance (MHD) were manually measured on cine images and compared to the planned positions based on the digitally reconstructed radiographs (DRRs)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28294860/-coronary-flow-reserve-in-the-left-anterior-and-posterior-descending-arteries-as-an-additional-option-to-dipyridamole-stress-echocardiography-for-detection-of-stenosis
#15
A A Boshchenko, A V Vrublevsky, R S Karpov
AIM: to assess additive diagnostic value of simultaneous evaluation of coronary flow reserve (CFR) in the left anterior descending (LAD) artery and posterior descending artery (PDA) during dipyridamole stress echocardiography (stress-Echo) for detection of LAD and PDA stenoses >50%. METHODS: 108 in-patients (mean age 50+/-11 years) with cardiac chest pain underwent dipyridamole stress-Echo with ECG-analysis, wall motion analysis by 2-dimentional imaging (2D) and coronary flow reserve (CFR) evaluation in both LAD and PDA by pulse-wave Doppler...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28293510/congenital-symmastia-a-3-step-approach
#16
Mohamed Saad Sadaka, Atef A Allam
Congenital symmastia is a medial confluence of the breasts. It is a rare anomaly with few reports in the literature and no standard treatment. In this article, we present a case of congenital symmastia treated by 3 steps: liposuction, fixation of the skin to the chest wall in the area of the intermammary sulcus, and postoperative intermammary compression. A successful result was achieved with normal cleavage between the breasts. So, this is considered the ideal treatment for this condition.
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293012/-synchronous-triple-primary-lung-adenocarcinomas-one-of-which-showing-a-thin-walled-cavity-nodule-report-of-a-case
#17
Takefumi Doi, Toshihiko Sakamoto
A 74-year-old woman was referred to our hospital to investigate a right apical segment (S1)nodule which was increasing gradually. Chest computed tomography (CT) scan showed three lesions in right S1, posterior segment(S2) and superior segment(S6). S6 lesion was a thin-walled cavity enlarging gradually with same appearance. The S1 nodule was diagnosed as adenocarcinoma by CT guided biopsy. Since the possibility of lung cancer couldn't be denied for S6 lesion, right upper lobectomy and S6 segmentectomy with mediastinal lymph node dissection was performed...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28292545/adding-fuel-to-the-fire-coronary-artery-dissection-complicating-blunt-chest-trauma
#18
Ankit Maheshwari, Thenappan Thenappan, Gladwin Das
A 21year-old male presented to the emergency department with 6 h of atypical chest pain after suffering blunt chest trauma. His electrocardiogram revealed 1-1.5mm ST segment elevation in leads V1-V3 with reciprocal depressions in II, III, and aVF. Mid-anterior wall akinesis was observed on echocardiography associated with an estimated left ventricular ejection fraction of 40%. A left main coronary artery dissection was diagnosed and treated surgically with a bypass graft. Although rare, coronary dissections can be a catastrophic complication of chest trauma...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28291926/development-of-a-deep-inspiration-breath-hold-system-for-radiotherapy-utilizing-a-laser-distance-measurer
#19
Christer Andre Jensen, Nils Skottner, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath-hold (DIBH) is a technique for treating left-sided breast cancer (LSBC). In modern radiotherapy, one of the main aims is to exclude the heart from the beam aperture with an individualized beam design for LSBC. A deep inhalation will raise the chest wall while the volume of the lungs increase, this will again push the heart away from the breast to be treated. There are a few commercial DIBH systems, both invasive and noninvasive. We present an alternative noninvasive DIBH system based upon an industrial laser distance measurer...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28287948/spectrum-of-ct-findings-in-thoracic-extranodal-non-hodgkin-lymphoma
#20
Mathew P Bligh, Joy N Borgaonkar, Steven C Burrell, David A MacDonald, Daria Manos
Non-Hodgkin lymphoma (NHL) frequently manifests in extranodal structures in the chest, often in the form of secondary involvement but occasionally as primary disease. Because staging and treatment are affected by the presence of extranodal disease at imaging, radiologists' interpretation and management of suspicious findings are critical to patient care. Unfortunately, owing to considerable imaging overlap with other diseases, primary extranodal lymphoma is difficult to diagnose with imaging alone. Radiologists should have a heightened degree of suspicion in patients at risk (including patients with immune compromise, autoimmune diseases, or a history of stem cell or solid organ transplant) or with particular imaging appearances (including the vertebral wraparound sign, nonresolving consolidation, an infiltrative soft-tissue mass, and lesions demonstrating vascular encasement without invasion)...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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