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Brachial plexus

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https://www.readbyqxmd.com/read/28077110/the-first-rib-hypoplasia-and-the-aberrant-pulmonary-artery-branch-detected-by-three-dimensional-computed-tomography-in-a-surgical-case-with-apical-lung-cancer-a-case-report
#1
Yasoo Sugiura, Hiroyuki Fujimoto, Masao Naruke, Toshinori Hashizume, Shizuka Kaseda, Etsuo Nemoto
BACKGROUND: The complete resection is one of the most crucial requirements to achieve favorable outcomes in oncologic surgery. The apex of the lung is surrounded complicatedly by the clavicle, the first rib, the subclavian artery and vein, and the brachial plexus. Therefore, the image information especially about the infiltration of adjacent anatomic structures, facilitates the surgery in the apical lung cancer. CASE PRESENTATION: A 70-year-old man presented at our hospital with a computed tomography (CT) scan showing a tumor at the left lung apex that infiltrated the chest wall...
January 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28068408/pharmacokinetics-of-lidocaine-hydrochloride-administered-with-or-without-adrenaline-for-the-paravertebral-brachial-plexus-block-in-dogs
#2
Amélie Choquette, Eric Troncy, Martin Guillot, France Varin, Jérôme R E Del Castillo
Adrenaline is known to prolong the duration of local anesthesia but its effects on the pharmacokinetic processes of local anesthetic drugs are not fully understood. Our objective was to develop a compartmental model for quantification of adrenaline's impact on the pharmacokinetics of perineurally-injected lidocaine in the dog. Dogs were subjected to paravertebral brachial plexus block using lidocaine alone or adrenalinated lidocaine. Data was collected through a prospective, randomised, blinded crossover protocol performed over three periods...
2017: PloS One
https://www.readbyqxmd.com/read/28054138/-ultrasound-guided-interventions-on-the-peripheral-nervous-system
#3
A Loizides, L Gruber, S Peer, M Plaikner, H Gruber
CLINICAL/METHODICAL ISSUE: Up to the advent of high-resolution ultrasound, interventions on the peripheral nervous system, including local anesthesia and pain treatment were performed without visual guidance, which in some cases led to treatment failure or local tissue and nerve damage. METHODICAL INNOVATIONS: Progress in the field of ultrasound has enabled the functional visualization, anesthesia and anti-inflammatory or neurolytic treatment of many peripheral nerves, such as the brachial plexus, nerves of the upper and lower extremities and various nerves of the trunk...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28052417/c8-cross-transfer-for-the-treatment-of-caudal-brachial-plexus-avulsion-in-three-dogs
#4
Pierre Moissonnier, Claude Carozzo, Jean-Laurent Thibaut, Catherine Escriou, Antoine Hidalgo, Stéphane Blot
OBJECTIVE: To evaluate the cervical nerve 8 cross-transfer technique (C8CT) as a part of surgical treatment of caudal brachial plexus avulsion (BPA) in the dog. STUDY DESIGN: Case series. ANIMALS: Client-owned dogs suspected to have caudal BPA based on neurological examination and electrophysiological testing (n = 3). METHODS: The distal stump of the surgically transected contralateral C8 ventral branch (donor) was bridged to the proximal stump of the avulsed C8 ventral branch (recipient) and secured with 9-0 polypropylene suture under an operating microscope...
January 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28050801/low-dose-intravenous-dexamethasone-4-mg-and-10-mg-significantly-prolongs-the-analgesic-duration-of-single-shot-interscalene-block-after-arthroscopic-shoulder-surgery-a-prospective-randomized-placebo-controlled-study
#5
Frédéric Chalifoux, François Colin, Patrick St-Pierre, Nadia Godin, Véronique Brulotte
BACKGROUND: Although intravenous dexamethasone prolongs the analgesic duration of interscalene brachial plexus block, it is uncertain whether this effect can be observed using lower doses of dexamethasone. This study evaluated the impact of intravenous dexamethasone (4 mg and 10 mg) on the analgesic duration of single-shot interscalene block after arthroscopic shoulder surgery. We hypothesized that both doses would prolong the analgesic duration compared with placebo. METHODS: This was a prospective double-blind randomized placebo-controlled study in patients undergoing elective arthroscopic shoulder surgery under regional anesthesia with a single-shot interscalene block (0...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#6
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28048472/tu-h-campus-jep3-04-factors-predicting-a-need-for-treatment-replanning-with-proton-radiotherapy-for-lung-cancer
#7
C Teng, G Janssens, C Ainsley, B Teo, G Valdes, B Burgdorf, A Berman, W Levin, Y Xiao, L Lin, P Gabriel, C Simone, T Solberg
PURPOSE: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. METHODS: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047711/su-f-r-06-traumatic-brachial-plexus-injury-imaging-developing-a-coherent-clinical-protocol-from-literature-review-through-practice
#8
D Wu, E France, J Lambert, J Hinkle
PURPOSE: Medical Physics teams can now play a critical role to help plan and provide studied approaches for traumatic brachial plexus MR imaging (tbpMRI). This is especially important for coordination with uncommon applications, since it is challenging to select the right modality, parameters, and train technologists on the essential components. For this work, we started with a review of the medical literature, performed crossover/volunteer studies to bring tbpMRI to practice with greater image QC and protocol management...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047669/we-h-brc-07-validation-of-a-commercial-atlas-based-auto-segmentation-package-for-automated-contour-quality-control
#9
S Berry, K Jedruszczuk, H Veeraraghavan, A Apte, Z Saleh, M Hunt
PURPOSE: To investigate whether a commercial atlas based auto-segmentation (ABAS) package can be used for automated review and quality control (QC) of physician segmentations, and if so, to determine action levels for future clinical implementation. METHODS: 42 head and neck cancer (HNC) patient plan CT scans with manually defined expert physician organ at risk (OAR) segmentations were retrospectively identified. Five representative patients were selected as ABAS models and were subsequently applied to each of the remaining 37 studies, resulting in 5 auto-segmentations (AS) per patient...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047372/su-f-t-128-dose-volume-constraints-for-particle-therapy-treatment-planning
#10
R Stewart, W Smith, K Hendrickson, J Meyer, N Cao, E Lee, O Gopan, G Sandison, U Parvathaneni, G Laramore
PURPOSE: Determine equivalent Organ at Risk (OAR) tolerance dose (TD) constraints for MV x-rays and particle therapy. METHODS: Equivalent TD estimates for MV x-rays are determined from an isoeffect, regression-analysis of published and in-house constraints for various fractionation schedules (n fractions). The analysis yields an estimate of (α/β) for an OAR. To determine equivalent particle therapy constraints, the MV x-ray TD(n) values are divided by the RBE for DSB induction (RBEDSB ) or cell survival (RBES )...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047366/su-f-j-64-comparison-of-dosimetric-robustness-between-proton-therapy-and-imrt-plans-following-tumor-regression-for-locally-advanced-non-small-cell-lung-cancer-nsclc
#11
C Teng, C Ainsley, B Teo, B Burgdorf, G Janssens, A Berman, W Levin, Y Xiao, L Lin, C Simone, T Solberg
PURPOSE: In the light of tumor regression and normal tissue changes, dose distributions can deviate undesirably from what was planned. As a consequence, replanning is sometimes necessary during treatment to ensure continued tumor coverage or to avoid overdosing organs at risk (OARs). Proton plans are generally thought to be less robust than photon plans because of the proton beam's higher sensitivity to changes in tissue composition, suggesting also a higher likely replanning rate due to tumor regression...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046503/su-f-t-377-monte-carlo-re-evaluation-of-volumetric-modulated-arc-plans-of-advanced-stage-nasopharygeal-cancers-optimized-with-convolution-superposition-algorithm
#12
K Lee, R Leung, G Law, M Wong, V Lee, S Tung, S Cheung, M Chan
BACKGROUND: Commercial treatment planning system Pinnacle3 (Philips, Fitchburg, WI, USA) employs a convolution-superposition algorithm for volumetric-modulated arc radiotherapy (VMAT) optimization and dose calculation. Study of Monte Carlo (MC) dose recalculation of VMAT plans for advanced-stage nasopharyngeal cancers (NPC) is currently limited. METHODS: Twenty-nine VMAT prescribed 70Gy, 60Gy, and 54Gy to the planning target volumes (PTVs) were included. These clinical plans achieved with a CS dose engine on Pinnacle3 v9...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041767/-nerve-transfer-between-the-intercostal-nerves-and-the-motor-component-of-the-musculocutaneous-nerve-anatomical-study-of-feasibility
#13
M Fleury, D Lepage, I Pluvy, J Pauchot
INTRODUCTION: The intercostal nerves (ICN) transfer to the musculocutaneous nerve (MCN) can restore elbow flexion in complete brachial plexus palsy. The last cases our service dealt with, allowed our staff to observe two different situations. In the 2 first patients, we were able to proceed with an intraneurodissection of the MCN motor component up to the axillary cavity level, while on the third case such dissection could not be performed as high. The aim of this work is to assess the feasibility of a transfer on the MCN's motor component...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#14
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28033509/atlas-based-segmentation-in-breast-cancer-radiotherapy-evaluation-of-specific-and-generic-purpose-atlases
#15
Delia Ciardo, Marianna Alessandra Gerardi, Sabrina Vigorito, Anna Morra, Veronica Dell'acqua, Federico Javier Diaz, Federica Cattani, Paolo Zaffino, Rosalinda Ricotti, Maria Francesca Spadea, Marco Riboldi, Roberto Orecchia, Guido Baroni, Maria Cristina Leonardi, Barbara Alicja Jereczek-Fossa
OBJECTIVES: Atlas-based automatic segmentation (ABAS) addresses the challenges of accuracy and reliability in manual segmentation. We aim to evaluate the contribution of specific-purpose in ABAS of breast cancer (BC) patients with respect to generic-purpose libraries. MATERIALS AND METHODS: One generic-purpose and 9 specific-purpose libraries, stratified according to type of surgery and size of thorax circumference, were obtained from the computed tomography of 200 BC patients...
December 26, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28033242/brachial-plexus-palsy-in-young-infants-harboring-osteomyelitis-of-the-humerus-case-report-and-review-of-the-literature
#16
Petra Zimmermann, Nigel Curtis
We present an infant with brachial plexus palsy who had osteomyelitis of the humerus, and summarize previously reported cases. Although Staphylococcus aureus is the most common pathogen in osteomyelitis in infants, group B streptococcus is responsible for 40% of humeral osteomyelitis. Early diagnosis is critical to prevent long-term sequalae, but is hampered by infants frequently being well and afebrile at presentation.
December 28, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28033192/variations-of-cords-of-brachial-plexus-and-branching-pattern-of-nerves-emanating-from-them
#17
Rajani Singh
Brachial plexus is complex network of nerves, formed by joining and splitting of ventral rami of spinal nerves C5, C6, C7, C8, and T1 forming trunks, divisions, and cords. The nerves emerging from trunks and cords innervate the upper limb and to some extent pectoral region. Scanty literature describes the variations in the formation of cords and nerves emanating from them. Moreover, the variations of cords of brachial plexus and nerves emanating from them have iatrogenic implications in the upper limb and pectoral region...
December 28, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027238/free-functioning-gracilis-muscle-transfer-for-elbow-flexion-reconstruction-after-traumatic-adult-brachial-pan-plexus-injury-where-is-the-optimal-distal-tendon-attachment-for-elbow-flexion
#18
Andrés A Maldonado, Santiago Romero-Brufau, Michelle F Kircher, Robert J Spinner, Allen T Bishop, Alexander Y Shin
BACKGROUND: Reconstruction after pan-plexus root avulsions often includes gracilis free functioning muscle transfer. For elbow flexion reconstruction, the free functioning muscle transfer distal tendon is inserted into the biceps tendon or more distally (i.e., flexor digitorum profundus/flexor pollicis longus tendons) for combined elbow and finger flexion; the theoretical drawback of the latter approach is weaker elbow flexion. The authors compared elbow flexion strength with a biceps tendon versus a flexor digitorum profundus/flexor pollicis longus tendon attachment to determine which insertion point resulted in better elbow flexion...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28025374/effect-of-local-anesthetic-concentration-0-2-vs-0-1-ropivacaine-on-pulmonary-function-and-analgesia-after-ultrasound-guided-interscalene-brachial-plexus-block-a-randomized-controlled-study
#19
Andrew K Wong, Lauren Georgiades Keeney, Liting Chen, Rebekah Williams, Jiabin Liu, Nabil M Elkassabany
OBJECTIVE: This study aims to assess diaphragmatic excursion and measure pulmonary functions as measures of the degree to which the phrenic nerve is blocked after ISB with two different concentrations of ropivacaine: 0.2% and 0.1%. DESIGN: Randomized, double-blinded study. SETTING AND PATIENTS: Ambulatory surgical facility. SUBJECTS: Fifty patients undergoing shoulder arthroscopy for rotator cuff repair. METHODS: Patients were randomized to receive ultrasound-guided ISB with 20 mL of either 0...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28018833/aneurysmal-bone-cyst-arising-from-the-first-rib-a-rare-cause-of-thoracic-outlet-syndrome
#20
Manuel Medina, Subroto Paul
Aneurysmal bone cyst is a rare benign cystic bone lesion with an incidence of only 0.14 per 100,000 individuals and most commonly affects the metaphyses of long bones, spine, and pelvis. We present a very rare case of a 17-year-old boy with a rapidly expanding aneurysmal bone cyst arising from the first rib, resulting in neurogenic thoracic outlet syndrome secondary to its compression of the brachial plexus. The patient's symptoms resolved after en bloc resection. To our knowledge there have been no other reports in the literature of thoracic outlet syndrome due to aneurysmal bone cyst arising from the first rib...
December 2016: Thoracic and Cardiovascular Surgeon Reports
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