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chest wall rigidity

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https://www.readbyqxmd.com/read/28047442/su-f-t-92-clinical-benefit-for-breast-and-chest-wall-setup-in-using-a-breast-board
#1
S Li, C Miyamoto, D Serratore, Q Liang, E Dziemianowicz
PURPOSE: To validate benefit of using a breast board (BB) by analyzing the geometry and dosimetry changes of the regions of interest (ROIs) between CT scans with and without BB. METHODS: Seven patients, two chest walls (CW) and five breasts, use BB at CT simulation and no BB at diagnostic CT were included. By using deformable image registration software (Velocity AI), diagnostic CT and planning CT were rigidly co-registered according to the thoracic cage at the target...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046975/su-f-j-130-margin-determination-for-hypofractionated-partial-breast-irradiation
#2
C Geady, B Keller, M Ruschin, E Hahn, N Makhani, S Bosnic, D Vesprini, H Soliman, J Lee, C McCann
PURPOSE: To determine the Planning Target Volume (PTV) margin for Hypofractionated Partial Breast Irradiation (HPBI) using the van Herk formalism (M=2.5∑+0.7σ). HPBI is a novel technique intended to provide local control in breast cancer patients not eligible for surgical resection, using 40 Gy in 5 fractions prescribed to the gross disease. METHODS: Setup uncertainties were quantified through retrospective analysis of cone-beam computed tomography (CBCT) data sets, collected prior to (prefraction) and after (postfraction) treatment delivery...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28018805/three-dimensional-custom-made-titanium-ribs-for-reconstruction-of-a-large-chest-wall-defect
#3
Isabel Simal, Maria Antonia García-Casillas, Julio Arturo Cerdá, Óscar Riquelme, Concepción Lorca-García, Laura Pérez-Egido, Beatriz Fernández-Bautista, Manuel de la Torre, Juan Carlos de Agustín
Reconstruction of large chest wall defects always demand surgeons of having lots of means available (both materials and resourceful) to apply a cover to chest wall defects which can range from a few centimeters to the lack of a few entire ribs. In this study, we present the case of a teenager who suffered from a complete resection of three ribs because of Ewing sarcoma dependent on the sixth rib. Given the size of the defect, a multidisciplinary approach was chosen to provide rigid and soft tissue coverage and minimal functional and aesthetic impact...
December 2016: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/27942408/chest-wall-reconstruction-after-extended-resection
#4
REVIEW
Christopher W Seder, Gaetano Rocco
Extensive chest wall resection and reconstruction is a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeons, plastic surgeons, neurosurgeons, and radiation oncologists. The primary goals of any chest wall reconstruction is to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanics, protect intrathoracic organs, provide soft tissue coverage, minimize deformity, and allow patients to receive adjuvant radiotherapy. Successful chest wall reconstruction requires the re-establishment of skeletal stability to prevent chest wall hernias, avoids thoracoplasty-like contraction of the operated side, protects underlying viscera, and maintain a cosmetically-acceptable appearance...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27788951/magnetic-resonance-image-guided-radiation-therapy-for-external-beam-accelerated-partial-breast-irradiation-evaluation-of-delivered-dose-and-intrafractional-cavity-motion
#5
Sahaja Acharya, Benjamin W Fischer-Valuck, Thomas R Mazur, Austen Curcuru, Karl Sona, Rojano Kashani, Olga Green, Laura Ochoa, Sasa Mutic, Imran Zoberi, H Harold Li, Maria A Thomas
PURPOSE: To use magnetic resonance image guided radiation therapy (MR-IGRT) for accelerated partial-breast irradiation (APBI) to (1) determine intrafractional motion of the breast surgical cavity; and (2) assess delivered dose versus planned dose. METHODS AND MATERIALS: Thirty women with breast cancer (stages 0-I) who underwent breast-conserving surgery were enrolled in a prospective registry evaluating APBI using a 0.35-T MR-IGRT system. Clinical target volume was defined as the surgical cavity plus a 1-cm margin (excluding chest wall, pectoral muscles, and 5 mm from skin)...
November 15, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27788524/insufficient-sedation-and-severe-side-effects-after-fast-administration-of-remifentanil-during-insure-in-preterm-newborns
#6
Ellen H M de Kort, Lidwien M Hanff, Daniella Roofthooft, Irwin K M Reiss, Sinno H P Simons
BACKGROUND: Neonatal intubation is stressful and should be performed with premedication. In the case of an INSURE (intubation/surfactant/extubation) procedure a short duration of action of the premedication used is needed to facilitate fast extubation. Given its pharmacological profile, remifentanil seems a suitable candidate. OBJECTIVES: The aim here was to evaluate the effect and side effects of remifentanil as a premedication for preterm neonates undergoing INSURE...
October 28, 2016: Neonatology
https://www.readbyqxmd.com/read/27747175/nuss-bar-procedure-past-present-and-future
#7
REVIEW
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27747030/hybrid-video-assisted-thoracoscopic-surgery-lobectomy-and-en-bloc-chest-wall-resection-for-non-small-cell-lung-cancer
#8
Edward J Caruana, Pierogiorgio Solli, Aman S Coonar
Chest wall invasion is seen in 5% to 8% of patients presenting with lung cancer. We report a case of complete resection of a 14 cm × 9 cm pT3N0M0 squamous cell carcinoma arising from the right lower lobe and invading the lower chest wall posteriorly, in a 75 years old male, via a hybrid thoracoscopic [video-assisted thoracoscopic surgery (VATS)] approach. Following conventional VATS lobectomy, a targeted 10 cm incision was performed to allow wide resection of the 7(th) to 10(th) ribs and 6(th) to 9(th) transverse processes, with the defect being subsequently reconstructed with a composite rigid prosthesis...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27645979/flat-chest-of-pleuroparenchymal-fibroelastosis-reversed-by-lung-transplantation
#9
Masahiro Yanagiya, Masaaki Sato, Shun Kawashima, Hideki Kuwano, Kazuhiro Nagayama, Jun-Ichi Nitadori, Masaki Anraku, Jun Nakajima
A patient with pleuroparenchymal fibroelastosis (PPFE) was successfully treated with living-donor lobar lung transplantation. A 27-year-old woman with a 3-month history of dyspnea received a diagnosis of PPFE. Her chest wall was extremely flattened over time, and her respiratory condition progressively deteriorated. She underwent semielective bilateral living-donor lobar lung transplantation. Her chest wall rigidity, which was secondary to PPFE, required intensive pulmonary rehabilitation postoperatively. By 6 months after transplantation, the flattening of her chest wall was reversed...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27621865/randomized-trial-of-epidural-vs-subcutaneous-catheters-for-managing-pain-after-modified-nuss-in-adults
#10
Dawn E Jaroszewski, M'hamed Temkit, MennatAllah M Ewais, Todd C Luckritz, Joshua D Stearns, Ryan C Craner, Brantley D Gaitan, Harish Ramakrishna, Christopher A Thunberg, Ricardo A Weis, Kelly M Myers, Marianne V Merritt, David M Rosenfeld
BACKGROUND: Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients' pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q)...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27559277/medium-term-effects-of-including-manual-therapy-in-a-pulmonary-rehabilitation-program-for-chronic-obstructive-pulmonary-disease-copd-a-randomized-controlled-pilot-trial
#11
Roger Mark Engel, Peter Gonski, Ken Beath, Subramanyam Vemulpad
STUDY DESIGN: Randomized clinical trial. OBJECTIVE: To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). BACKGROUND: The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function...
May 2016: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/27536488/multidisciplinary-oncoplastic-approach-reduces-infection-in-chest-wall-resection-and-reconstruction-for-malignant-chest-wall-tumors
#12
Haitham H Khalil, Marco N Malahias, Balapathiran Balasubramanian, Madava G Djearaman, Babu Naidu, Melvin F Grainger, Maninder Kalkat
BACKGROUND: Management of complex thoracic defects post tumor extipiration is challenging because of the nature of pathology, the radical approach, and the insertion of prosthetic material required for biomechanical stability. Wound complications pose a significant problem that can have detrimental effect on patient outcome. The authors outline an institutional experience of a multidisciplinary thoracic oncoplastic approach to improve outcomes. METHODS: Prospectively collected data from 71 consecutive patients treated with chest wall resection and reconstruction were analyzed (2009-2015)...
July 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27526650/the-influence-of-reconstructive-technique-on-perioperative-pulmonary-and-infectious-outcomes-following-chest-wall-resection
#13
Jonathan D Spicer, Jitesh B Shewale, Mara B Antonoff, Arlene M Correa, Wayne B Hofstetter, David C Rice, Ara A Vaporciyan, Reza J Mehran, Garrett L Walsh, Jack A Roth, Stephen G Swisher, Boris Sepesi
BACKGROUND: Emerging technologies for prosthetic reconstruction after chest wall resection have yielded a wide variety of reconstructive options for thoracic surgeons. The ideal chest wall reconstruction and its impact on perioperative outcomes has not been well defined. Our goal was to determine whether mesh characteristics such as rigidity or absorbability altered perioperative pulmonary and infectious outcomes. METHODS: Our institutional database was queried for patients who underwent chest wall resection and reconstruction for primary or secondary chest wall tumors between the years 1998 and 2013...
August 12, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27365062/-chest-wall-reconstruction-using-titanium-plates-sandwiched-between-sheets-after-resection-of-chest-wall-chondrosarcoma
#14
Makoto Endoh, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Ai Takahashi, Kenta Nakahashi, Masato Sugawara, Takashi Tsuchiya, Mitsuaki Sadahiro
Extensive chest wall resection carries the risk of difficult reconstruction and surgical complications. We report our experience on chest wall reconstruction using titanium plates for a wide thoracic defect after tumor resection. A 74-year-old man was diagnosed with chondrosarcoma of the 6th rib on the right. He needed extensive chest wall resection because of skip lesions on 4th rib noted on operative inspection, leaving a defect measuring 33 × 20 cm. Reconstruction using 5 transverse titanium plates sandwiched between an expanded polytetrafluoroethylene patch and a polypropylene mesh sheet stabilized the chest wall...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27343793/anesthetic-management-of-a-patient-with-multiple-sclerosis-case-report
#15
Eduardo Barbin Zuccolotto, Guilherme Coelho Machado Nunes, Rafael Soares Lopes Nogueira, Eugenio Pagnussatt Neto, José Roberto Nociti
BACKGROUND AND OBJECTIVES: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. CASE REPORT: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy...
July 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27293863/dynamic-3d-printed-titanium-copy-prosthesis-a-novel-design-for-large-chest-wall-resection-and-reconstruction
#16
Javier Aragón, Itzell Pérez Méndez
Due to high rates of complications, chest wall resection and reconstruction is a high risk procedure when large size of resection is required. Many different prosthetic materials have been used with similar results. Recently, thanks to the new advances in technology, personalized reconstruction have been possible with specific custom-made prosthesis. Nevertheless, they all generate certain amount of stiffness in thoracic motion because of his rigidity. In this report, we present a forward step in prosthesis design based on tridimensional titanium-printed technology...
June 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27273115/biomechanical-deformable-image-registration-of-longitudinal-lung-ct-images-using-vessel-information
#17
Guillaume Cazoulat, Dawn Owen, Martha M Matuszak, James M Balter, Kristy K Brock
Spatial correlation of lung tissue across longitudinal images, as the patient responds to treatment, is a critical step in adaptive radiotherapy. The goal of this work is to expand a biomechanical model-based deformable registration algorithm (Morfeus) to achieve accurate registration in the presence of significant anatomical changes. Six lung cancer patients previously treated with conventionally fractionated radiotherapy were retrospectively evaluated. Exhale CT scans were obtained at treatment planning and following three weeks of treatment...
July 7, 2016: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/27066432/minimally-invasive-repair-of-pectus-carinatum-in-patients-unsuited-to-bracing-therapy
#18
Jee-Won Suh, Seok Joo, Geun Dong Lee, Seok Jin Haam, Sungsoo Lee
BACKGROUND: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. METHODS: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. RESULTS: The mean age of the patients was 24.35±13.20 years (range, 14-57 years), and all patients were male...
April 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27017767/-anesthetic-management-with-v-v-ecmo-in-a-patient-with-severe-tracheal-stenosis
#19
Yuko Matsuoka, Satoshi Tanaka, Takanobu Hirabayashi, Mikito Kawamata
We here report a case in which tracheal stent insertion was performed using veno-venous extracorporeal membrane oxygenation (V-V ECMO). A 78-year-old man with severe tracheal stenosis due to thyroid cancer was suffering from dyspnea at rest. Computed tomography showed that the narrowest caliber of the trachea was 1.5 mm in diameter at 5 cm below the level of the vocal cords. Femoro-femoral V-V ECMO was established without hemodynamic instability. General anesthesia was induced with propofol 70 mg and fentanyl 50 μg and was maintained with propofol 150-200 mg x hr(-1) and remifentanil 0...
February 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26999038/could-chest-wall-rigidity-be-a-factor-in-rapid-death-from-illicit-fentanyl-abuse
#20
Glenn Burns, Rebecca T DeRienz, Daniel D Baker, Marcel Casavant, Henry A Spiller
BACKGROUND: There has been a significant spike in fentanyl-related deaths from illicit fentanyl supplied via the heroin trade. Past fentanyl access was primarily oral or dermal via prescription fentanyl patch diversion. One factor potentially driving this increase in fatalities is the change in route of administration. Rapid intravenous (IV) fentanyl can produce chest wall rigidity. We evaluated post-mortem fentanyl and norfentanyl concentrations in a recent surge of lethal fentanyl intoxications...
June 2016: Clinical Toxicology
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