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https://www.readbyqxmd.com/read/29785295/uniportal-video-assisted-thoracoscopic-segmentectomy
#1
Luis Angel Hernandez-Arenas, Rushmi D Purmessur, Diego Gonzalez-Rivas
Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is a technically more complex procedure than uniportal VATS lobectomy, since a detailed comprehension of the segmental anatomy is required. Anatomic sublobar resection can achieve outcomes equivalent to lobectomy in selected patients with stage IA non-small cell lung carcinoma (NSCLC). In this paper we describe our clinical experiences and introduce the technical details of uniportal VATS segmentectomy, including expertise advice ("tips and tricks") in patient selection, positioning and incisions and technical highlights of the most common types of segmentectomies...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29785292/thoracoscopic-stapler-based-bidirectional-segmentectomy-for-posterior-basal-segment-s10-and-its-variants
#2
Masaaki Sato, Tomonori Murayama, Jun Nakajima
Thoracoscopic segmentectomy for the posterior basal segment (S10) and its variant (e.g., S9+10 and S10b+c combined subsegmentectomy) is one of the most challenging anatomical segmentectomies. Stapler-based segmentectomy is attractive to simplify the operation and to prevent post-operative air leakage. However, this approach makes thoracoscopic S10 segmentectomy even more tricky. The challenges are caused mostly from the following three reasons: first, similar to other basal segments, "three-dimensional" stapling is needed to fold a cuboidal segment; second, the belonging pulmonary artery is not directly facing the interlobar fissure or the hilum, making identification of target artery difficult; third, the anatomy of S10 and adjacent segments such as superior (S6) and medial basal (S7) is variable...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29785291/using-novel-technology-to-augment-complex-video-assisted-thoracoscopic-single-basilar-segmentectomy
#3
Zaid M Abdelsattar, Shanda H Blackmon
There are many novel technologies that enable complex segmentectomy to be performed. As lung cancer screening becomes more prevalent, patients are increasingly diagnosed with early stage lung cancer, multifocal disease, and second primary tumors. This shift to an earlier clinical presentation combined with advances in technology and an emphasis on minimally invasive techniques have led to the current developments we are now seeing with anatomic segmentectomy. In this paper, we describe the operative technique of an indocyanine green (ICG)-guided video-assisted thoracoscopic surgery (VATS) single basilar segmental resection, augmented with methylene blue dye marker localization via SuperDimension electromagnetic navigational bronchoscopy...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29785286/anatomical-variations-and-pitfalls-to-know-during-thoracoscopic-segmentectomies
#4
REVIEW
Dominique Gossot, Agathe Seguin-Givelet
The rate of sublobar resection (SLR) for early-stage non-small cell lung carcinoma (NSCLC) is increasing, mainly because of a growing rate of early-stage lung carcinomas and ground-glass opacities. More and more SLRs are now performed by a thoracoscopic, a video-assisted or a robotically-assisted approach. Although surgeons are performing pulmonary segmentectomies for years, they need a better understanding of anatomy when using a closed chest approach, because vision is more limited and they cannot stretch and expose the parenchyma and broncho-vascular elements...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29784474/point-of-care-ultrasound-differentiation-of-lung-consolidation-and-normal-thymus-in-pediatric-patients-an-educational-case-series
#5
Cynthia A Gravel, Richard G Bachur
BACKGROUND: There is a growing body of evidence to support the utility of lung point-of-care ultrasound (POCUS) in pediatric patients with multiple pulmonary pathologies, particularly pneumonia. As we increase our use of lung POCUS for pediatric patients with respiratory complaints, we must be mindful of the normal anatomy and sonographic findings within the pediatric chest and aware of how to distinguish normal findings (e.g., thymus) from pathologic findings (e.g., consolidation). CASE REPORTS: We report four cases of pediatric patients who presented to the Emergency Department with respiratory complaints for which POCUS was able to distinguish lung consolidation and normal thymus in the anterior chest...
May 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29780731/the-resident-s-point-of-view-in-the-learning-curve-of-thymic-mis-why-should-i-learn-it
#6
REVIEW
Anna E Frick, Hans Van Veer, Herbert Decaluwé, Willy Coosemans, Dirk Van Raemdonck
Minimally invasive surgery (MIS) in thoracic surgery became quite popular during the last years. The aim of introducing and performing more MIS is to reduce surgical trauma, pain and complications in patients. Training in MIS increases operative time and thus cost in theatre but thus improves with experience. For a resident, the cases should be well selected with experienced supervision in a suitable setting with supporting staff and optimal instruments. Understanding the anatomy of the lung, using simulators, and attending workshops makes the learning curve shorter...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#7
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29776740/development-of-a-deformable-phantom-for-experimental-verification-of-4d-monte-carlo-simulations-in-a-deforming-anatomy
#8
Sara Gholampourkashi, Joanna E Cygler, Bernie Lavigne, Emily Heath
PURPOSE: To verify the accuracy of 4D Monte Carlo (MC) simulations, using the 4DdefDOSXYZnrc user code, in a deforming anatomy. We developed a tissue-equivalent and reproducible deformable lung phantom and evaluated 4D simulations of delivered dose to the phantom by comparing calculations against measurements. METHODS: A novel deformable phantom consisting of flexible foam, emulating lung tissue, inside a Lucite external body was constructed. A removable plug, containing an elastic tumor that can hold film and other dosimeters, was inserted in the phantom...
May 15, 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29752554/secondary-hypogammaglobulinemia-after-rituximab-for-neuromyelitis-optica-a-case-report
#9
Lara Farhat, Jasmeen Dara, Susan Duberstein, Aliva De
A 17-year-old male with history of neuromyelitis optica and seizures presented to the pulmonology clinic for evaluation of recurrent pneumonias. He had received rituximab for the past 6 years. Over the past 2 years, he experienced four episodes of pneumonia. In between these episodes, he would improve briefly but continued to have daily cough that was productive with yellow phlegm. He also had recurrent rhinitis and sinusitis despite multiple antibiotic courses. Review of chest X-rays revealed localized right middle lobe and right lower lobe infiltrates...
May 11, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29750708/endometrioid-adenocarcinoma-with-solitary-metastasis-to-the-appendix-mimicking-primary-appendiceal-adenocarcinoma-a-case-report-and-literature-review
#10
Qiujie Ma, Jianshe Wu
Metastatic tumors of the appendix are rare. Endometrial cancer tends to metastasize by directly invading neighboring structures; the lung, liver, bones, and brain are common sites of distant metastasis. Herein, we present a case of a solitary endometrial metastatic tumor in the appendiceal mucosa without serosal involvement that mimicked a primary adenocarcinoma of the appendix. The patient who had undergone a radical hysterectomy for an endometrioid adenocarcinoma 3 years earlier presented to the hospital with a history of persistent right-lower abdominal pain...
May 10, 2018: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/29710762/limitations-of-an-automated-embolism-segmentation-method-in-clinical-practice
#11
Ruifeng Wang, Nan Yu, Shen Zhou, Fuwen Dong, Jun Wang, Nan Yin, Lu Bai, Cong Shen, Youmin Guo
PURPOSE: Automated pulmonary embolism (PE) segmentation is frequently used as a preprocessing step in the quantitative analysis of pulmonary embolism. Objective of this study is to analyze the potential limitation in automated PE segmentation using clinical cases. METHODS: A database of 304 computer tomography pulmonary angiography (CTPA) examinations was collected and confirmed to be PE. After processing using an automated scheme, two radiologists classified these cases into four groups of A, B, C and D, which represent 4 different segmentation results namely, (1) entire pulmonary artery identified without motivation artifacts, (2) entire pulmonary artery identified with motivation artifacts, (3) part of the pulmonary artery identified, and (4) none of the pulmonary artery identified...
April 25, 2018: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/29707563/copd-time-to-improve-its-taxonomy
#12
Bartolomé R Celli, Alvar Agustí
Due to well-conducted epidemiological studies and advances in genetics, molecular biology, translational research, the advent of computed tomography of the lungs and bioinformatics, the diagnosis of chronic obstructive pulmonary disease (COPD) as a single entity caused by susceptibility to cigarette smoke is no longer tenable. Furthermore, the once-accepted concept that COPD results from a rapid and progressive loss of lung function over time is not true for a sizeable proportion of adults with the disease...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29660251/the-association-of-nasal-patency-with-small-airway-resistance-in-children-with-allergic-and-nonallergic-rhinitis
#13
Joo Young Song, Eun Kyo Ha, Yoon Ho Sheen, Mi-Ae Kim, Seung Won Lee, Jung Won Yoon, Seung Jin Lee, Young-Ho Jung, Kyung Suk Lee, Jae-Cheul Ahn, Hye Mi Jee, Man Yong Han
INTRODUCTION: Allergic rhinitis (AR) is immunologically and morphologically related to disorders in the lower airway. We investigated the relationship between the anatomy of the intranasal cavity and small airway resistance in subjects with nonallergic rhinitis (NAR). METHODS: We enrolled 226 children who were 7 years old and participated in the Seongnam Atopy Project 2016. We evaluated nasal patency using acoustic rhinometry to measure the volume of the nasal cavity at 0 to 5 cm, and measured lung function of the lower airway using an impulse oscillometry system (IOS) and spirometry...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#14
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29619059/a-comparative-assessment-of-inhomogeneity-and-finite-patient-dimension-effects-in-60-co-and-192-ir-high-dose-rate-brachytherapy
#15
Irina Fotina, Kyveli Zourari, Vasileios Lahanas, Evaggelos Pantelis, Panagiotis Papagiannis
Purpose: To perform a comparative study of heterogeneities and finite patient dimension effects in60 Co and192 Ir high-dose-rate (HDR) brachytherapy. Material and methods: Clinically equivalent plans were prepared for 19 cases (8 breast, 5 esophagus, 6 gynecologic) using the Ir2.A85-2 and the Co0.A86 HDR sources, with a TG-43 based treatment planning system (TPS). Phase space files were obtained for the two source designs using MCNP6, and validated through comparison to a single source dosimetry results in the literature...
February 2018: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29617746/thoracoabdominal-pressure-gradient-and-gastroesophageal-reflux-insights-from-lung-transplant-candidates
#16
T Masuda, S K Mittal, B Kovacs, M Smith, R Walia, J Huang, R M Bremner
Advanced lung disease is associated with gastroesophageal reflux disease (GERD). The thoracoabdominal pressure gradient (TAPG) facilitates gastroesophageal reflux, but the effects of TAPG on gastroesophageal reflux in patients with pulmonary disease have not been well defined. Patients diagnosed with end-stage lung disease are expected to have the most extreme derangement in respiratory mechanics. The aim of this study is to explore the relationship between TAPG and reflux in lung transplant (LTx) candidates...
March 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29603277/caliper-a-deformable-image-registration-algorithm-for-large-geometric-changes-during-radiotherapy-for-locally-advanced-non-small-cell-lung-cancer
#17
Christopher L Guy, Elisabeth Weiss, Gary E Christensen, Nuzhat Jan, Geoffrey D Hugo
PURPOSE: Locally-advanced non-small cell lung cancer (NSCLC) patients may experience dramatic changes in anatomy during radiotherapy and could benefit from adaptive radiotherapy (ART). Deformable image registration (DIR) is necessary to accurately accumulate dose during plan adaptation, but current algorithms perform poorly in the presence of large geometric changes, namely atelectasis resolution. The goal of this work is to develop a DIR framework, named Consistent Anatomy in Lung Parametric imagE Registration (CALIPER), to handle large geometric changes in the thorax...
March 30, 2018: Medical Physics
https://www.readbyqxmd.com/read/29594243/resolution-of-atelectasis-during-radiochemotherapy-of-lung-cancer-with-serious-implications-for-further-treatment-a-case-report
#18
Lore Helene Braun, Stefan Welz, Marén Viehrig, Frank Heinzelmann, Daniel Zips, Cihan Gani
Local failure is a major cause for low overall survival rates in advanced non small cell lung cancer (NSCLC). Among others, radioresistant tumor clones as well as geographical miss can explain these high local failure rates. One reason for geographical miss is a change of tumor related atelectasis in the course of radiotherapy. We present the case of a patient with UICC Stage IIIb NSCLC who presented with a large tumor related atelectasis. During definitive radiochemotherapy, the atelectasis resolved, which resulted in a massive tumor shift out of the planning target volume within 2 days...
February 2018: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29558041/in-memory-of-professor-czes%C3%A5-aw-ni%C3%A5-ankowski-head-of-the-department-of-anatomy-wroclaw-medical-university
#19
REVIEW
Ryszard R Kacała, Krzysztof Wronecki, Arkadiusz Kacała, Zygmunt Domagała, Michał Porwolik
Professor Czesław Niżankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wrocław School of Physical Education (since 1972 University School of Physical Education in Wrocław), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract...
March 20, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29556698/-specific-characteristics-of-chest-x%C3%A2-ray-in-childhood-basics-for-radiologists
#20
K Schneider
The radiographic technique of pediatric chest X‑rays is substantially different from that in adults. In nearly all cases ap/pa X‑rays are sufficient and lateral radiographs are rarely needed. In the first years of life the thymus may overshadow the heart, the great vessels and the lung hila. The most important anatomical structures essential for diagnosing pathological findings of the lungs and mediastinum are the trachea with the bifurcation and the main bronchi with the adjacent great vessels. For the assessment of distended lungs and intrathoracic consolidations, fundamental knowledge of the anatomy in childhood and malformations which can involve the airways, the lungs, the heart, as well as systemic and pulmonary vessels are indispensable...
March 19, 2018: Der Radiologe
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