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chest wall rigidity

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https://www.readbyqxmd.com/read/28393719/a-case-of-tracheal-leiomyoma-misdiagnosed-as-asthma
#1
Ayperi Öztürk, Zafer Aktaş, Aydın Yılmaz, Havva Yeşildağlı, Leyla Memiş
Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum...
December 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28366144/-a-case-of-tracheal-leiomyoma-misdiagnosed-as-asthma
#2
Ayperi Öztürk, Zafer Aktaş, Aydın Yılmaz, Havva Yeşildağlı, Leyla Memiş
Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum...
December 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28363371/chest-wall-reconstruction-without-prosthetic-material
#3
REVIEW
Robert E Merritt
The surgical resection of primary and secondary tumors involving the chest wall often requires reconstruction with prosthetic and soft tissues, such as muscle flaps. There are situations when a soft tissue reconstruction of the chest wall is preferable. Prosthetic material can become infected and require reoperation for removal of the infected material. Rigid prosthetic materials can result in chest wall pain and deformity. Muscle is the soft tissue of choice for coverage of full-thickness chest wall defects with or without prosthetic material...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28353119/safety-and-feasibility-of-pleural-cryobiopsy-compared-to-forceps-biopsy-during-semi-rigid-pleuroscopy
#4
Vikas Pathak, Ray W Shepherd, Ehab Hussein, Rajiv Malhotra
BACKGROUND: Pleural biopsy is often obtained in patients with undiagnosed exudative pleural effusion during pleuroscopy. Standard forceps have been traditionally used for the biopsy. Cryoprobes are being increasingly used for transbronchial lung biopsy as they obtain larger specimens and have less crush artifact. However, the safety and feasibility of cryoprobe biopsy compared to standard forceps for pleural biopsy has not been fully assessed. OBJECTIVES: The objective of this study was to demonstrate the safety and feasibility of cryoprobe biopsy in the pleural space using semi-rigid pleuroscopy...
March 28, 2017: Lung
https://www.readbyqxmd.com/read/28337407/fentanyl-induced-chest-wall-rigidity-syndrome-in-a-routine-bronchoscopy
#5
Chee Kiang Phua, Audrey Wee, Albert Lim, John Abisheganaden, Akash Verma
Combination of sedatives such as fentanyl and midazolam during bronchoscopy is recommended by American College of Chest Physician due to its favourable drug profile. It improves patient comfort and tolerance, and is commonly given unless contraindicated. We describe a rare case of fentanyl-induced chest wall rigidity syndrome during a routine bronchoscopy with endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) in a 55 year old male presenting with a lung mass and mediastinal lymphadenopathy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28333543/corrosive-induced-carcinoma-of-esophagus-esophagographic-and-ct-findings
#6
Seung Yeon Noh, Hyun Jin Kim, Hyun Joo Lee, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Hyun Kwon Ha
OBJECTIVE: The purpose of this study was to evaluate the esophagographic and CT findings of corrosive esophageal cancer. MATERIALS AND METHODS: The records of all patients who presented with corrosive esophageal strictures at one institution between June 1989 and April 2015 were retrospectively identified. The search yielded the records of 15 patients with histopathologically proven esophageal cancer. Esophagograms (13 patients) and chest CT images (14 patients) were interpreted independently by two reviewers...
March 23, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28047442/su-f-t-92-clinical-benefit-for-breast-and-chest-wall-setup-in-using-a-breast-board
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
2017: Neonatology
https://www.readbyqxmd.com/read/27747175/nuss-bar-procedure-past-present-and-future
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
November 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
#20
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
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