Airway wall thickness associated with forced expiratory volume in 1 second decline and development of airflow limitation

NARCIS (Netherlands)

Hoesein, Firdaus A. A. Mohamed; de Jong, Pim A.; Lammers, Jan-Willem J.; Mali, Willem P. T. M.; Schmidt, Michael; de Koning, Harry J.; van der Aalst, Carlijn; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Groen, Harry J. M.; van Ginneken, Bram; van Rikxoort, Eva M.; Zanen, Pieter

Airway wall thickness and emphysema contribute to airflow limitation. We examined their association with lung function decline and development of airflow limitation in 2021 male smokers with and without airflow limitation. Airway wall thickness and emphysema were quantified on chest computed

MR imaging in tumor invasion of the chest wall

International Nuclear Information System (INIS)

Bittner, R.C.; Lang, P.; Schorner, W.; Sander, B.; Weiss, T.; Loddenkemper, R.; Kaiser, D.; Felix, R.

1989-01-01

The authors have used MR imaging to study 22 patients who had intrathoracic, pleura-related malignancies and whose CT findings had suggested chest wall invasion. ECG-gated T1- and T2-weighted spin-echo sequences were used in all patients. Additionally, in 10 patients an ungated, multisection, gradient-echo sequence was used, which was repeated after intravenous administration of Gd-DTPA in five patients. Surgery confirmed chest wall invasion in 19 patients. CT showed tumor invasion only in 14 of these 19 patients. MR imaging showed high-signal-intensity lesion within chest wall and pleura in T2-weighted and Gd-DTPA-enhanced T1-weighted images as the typical pattern of chest wall invasion in all 19 patients. Two of the three patients with pleural inflammation and without chest wall invasion had high-signal-intensity pleural lesions, but none of these lesions were within the chest wall

Use of the omentum in chest-wall reconstruction

International Nuclear Information System (INIS)

Fix, R.J.; Vasconez, L.O.

1989-01-01

Increased use of the omentum in chest-wall reconstruction has paralleled the refinement of anatomic knowledge and the development of safe mobilization techniques. Important anatomic points are the omental attachments to surrounding structures, the major blood supply from the left and right gastroepiploic vessels, and the collateral circulation via the gastroepiploic arch and Barkow's marginal artery. Mobilization of the omentum to the thorax involves division of its attachments to the transverse colon and separation from the greater curvature to fabricate a bipedicled flap. Most anterior chest wounds and virtually all mediastinal wounds can be covered with the omentum based on both sets of gastroepiploic vessels. The arc of transposition is increased when the omentum is based on a single pedicle, allowing coverage of virtually all chest-wall defects. The final method of increasing flap length involves division of the gastroepiploic arch and reliance on Barkow's marginal artery as collateral circulation to maintain flap viability. With regard to chest-wall reconstruction, we have included the omentum in the armamentarium of flaps used to cover mediastinal wounds. The omentum is our flap of choice for the reconstruction of most radiation injuries of the chest wall. The omentum may also be used to provide protection to visceral anastomoses, vascular conduits, and damaged structures in the chest, as well as to cover defects secondary to tumor excision or trauma. In brief, the omentum has proved to be a most dependable and versatile flap, particularly applicable to chest-wall reconstruction

Chest wall invasion by bronchogenic carcinoma. Evaluation with Cine-MRI

International Nuclear Information System (INIS)

Nawano, Shigeru; Murakami, Kohji; Ohnuma, Hiroshi; Iwata, Ryoko; Hayashi, Takayuki; Moriyama, Noriyuki; Nishiwaki, Yutaka; Nagai, Kanji

1996-01-01

With the view of examining possible chest wall invasion of bronchogenic carcinoma, Cine-MRI was performed on 22 such cases. These cases were suspected of having above chest wall invasion by CT and their histopathological findings were obtained in surgery. The judgment of the chest wall invasion by Cine-CT was made such that non-moving up and down of the tumor with respiration involves its invasion, moving of the tumor without any up-and-down movement suspects its invasion and moving up and down of the tumor with respiration involves no invasion. The chest wall invasion was observed in 5 of 7 cases of invasion judged by Cine-MRI. For 2 false-positive cases, the histopathological findings presumed that tumor cells disappeared from the chest wall invaded region as the result of preoperative chemotherapy. The above invasion was observed in 1 of 4 cases suspected of possible invasion. Correct diagnosis was formed of 11 cases judged invasion-free by Cine-MRI. The above results suggested Cine-MRI to be useful for diagnosis of chest wall invasion of bronchogenic carcinoma. (author)

Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

International Nuclear Information System (INIS)

Kim, Tae Jung; Lee, Kyoung Ho; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon; Hahn, Seokyung; Lee, Kyung Won

2009-01-01

Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

Regional variance of visually lossless threshold in compressed chest CT images: Lung versus mediastinum and chest wall

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Kim, Tae Jung [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)], E-mail: kholee@snubhrad.snu.ac.kr; Kim, Bohyoung; Kim, Kil Joong; Chun, Eun Ju; Bajpai, Vasundhara; Kim, Young Hoon [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Hahn, Seokyung [Medical Research Collaborating Center, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Seoul National University College of Medicine (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

2009-03-15

Objective: To estimate the visually lossless threshold (VLT) for the Joint Photographic Experts Group (JPEG) 2000 compression of chest CT images and to demonstrate the variance of the VLT between the lung and mediastinum/chest wall. Subjects and methods: Eighty images were compressed reversibly (as negative control) and irreversibly to 5:1, 10:1, 15:1 and 20:1. Five radiologists determined if the compressed images were distinguishable from their originals in the lung and mediastinum/chest wall. Exact tests for paired proportions were used to compare the readers' responses between the reversible and irreversible compressions and between the lung and mediastinum/chest wall. Results: At reversible, 5:1, 10:1, 15:1, and 20:1 compressions, 0%, 0%, 3-49% (p < .004, for three readers), 69-99% (p < .001, for all readers), and 100% of the 80 image pairs were distinguishable in the lung, respectively; and 0%, 0%, 74-100% (p < .001, for all readers), 100%, and 100% were distinguishable in the mediastinum/chest wall, respectively. The image pairs were less frequently distinguishable in the lung than in the mediastinum/chest wall at 10:1 (p < .001, for all readers) and 15:1 (p < .001, for two readers). In 321 image comparisons, the image pairs were indistinguishable in the lung but distinguishable in the mediastinum/chest wall, whereas there was no instance of the opposite. Conclusion: For JPEG2000 compression of chest CT images, the VLT is between 5:1 and 10:1. The lung is more tolerant to the compression than the mediastinum/chest wall.

Neurofibromas as bilateral cystic chest wall swellings. | Ugare ...

African Journals Online (AJOL)

A 35 year old male farmer presented with soft bilateral posterior chest wall swellings. He had no similar swellings elsewhere. There were no associated symptoms, except cosmetic deformity and discomfort when he lies on his back. A clinical diagnosis of posterior chest wall lipomata was made. However at surgery, the two ...

Prediction of Chest Wall Toxicity From Lung Stereotactic Body Radiotherapy (SBRT)

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Stephans, Kevin L., E-mail: stephak@ccf.org [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States); Djemil, Toufik; Tendulkar, Rahul D. [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States); Robinson, Cliff G. [Department of Radiation Oncology, Siteman Cancer Center, Washington University, St Louis, MO (United States); Reddy, Chandana A.; Videtic, Gregory M.M. [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH (United States)

2012-02-01

Purpose: To determine patient, tumor, and treatment factors related to the development of late chest wall toxicity after lung stereotactic body radiotherapy (SBRT). Methods and Materials: We reviewed a registry of 134 patients treated with lung SBRT to 60 Gy in 3 fractions who had greater than 1 year of clinical follow-up and no history of multiple treatments to the same lobe (n = 48). Patients were treated as per Radiation Therapy Oncology Group Protocol 0236 without specific chest wall avoidance criteria. The chest wall was retrospectively contoured. Thirty-two lesions measured less than 3 cm, and sixteen measured 3 to 5 cm. The median planning target volume was 29 cm{sup 3}. Results: With a median follow-up of 18.8 months, 10 patients had late symptomatic chest wall toxicity (4 Grade 1 and 6 Grade 2) at a median of 8.8 months after SBRT. No patient characteristics (age, diabetes, hypertension, peripheral vascular disease, or body mass index) were predictive for toxicity, whereas there was a trend for continued smoking (p = 0.066; odds ratio [OR], 4.4). Greatest single tumor dimension (p = 0.047; OR, 2.63) and planning target volume (p = 0.040; OR, 1.04) were correlated with toxicity, whereas distance from tumor edge to chest wall and gross tumor volume did not reach statistical significance. Volumes of chest wall receiving 30 Gy (V30) through 70 Gy (V70) were all highly significant, although this correlation weakened for V65 and V70 and maximum chest wall point dose only trended to significance (p = 0.06). On multivariate analysis, tumor volume was no longer correlated with toxicity and only V30 through V60 remained statistically significant. Conclusions: Tumor size and chest wall dosimetry are correlated to late chest wall toxicity. Only chest wall V30 through V60 remained significant on multivariate analysis. Restricting V30 to 30 cm{sup 3} or less and V60 to 3 cm{sup 3} or less should result in a 10% to 15% risk of late chest wall toxicity or lower.

Research Status of the Skeletalre Construction of Chest Wall

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Daixing ZHONG

2018-04-01

Full Text Available Chest wall defect may be caused by many factors such as the resection of tumor and trauma, and the reconstruction of bone-defection is still the key point of thoracic surgery. With the development of material science, more and more new materials have been used in medical practice, which makes huge progress in the surgery of chest wall. However, none of these materials satisfy all the practical needs of the reconstruction. Recently, with the development of the capacity of computer, 3D-printing technology has been gradually used in clinical work, and the idea of individual treatment has been accepted by more and more people. The weakness of these materials may be solved by the new material and the application of individual treatment, which could also make great advance in chest wall surgery. This article will make a summary of the research on the reconstruction of chest wall.

Reconstruction of the chest wall after excision of a giant malignant ...

African Journals Online (AJOL)

Primary chest wall tumors are uncommon and constitute 0.2-2% of all tumors. Metastatic tumors and tumors of local extension are more common. Malignant peripheral nerve sheath tumor (MPNST) of the chest wall is even rarer and its incidence on the chest wall not stated in the literature. The incidence in the general ...

Chest wall segmentation in automated 3D breast ultrasound scans.

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Tan, Tao; Platel, Bram; Mann, Ritse M; Huisman, Henkjan; Karssemeijer, Nico

2013-12-01

In this paper, we present an automatic method to segment the chest wall in automated 3D breast ultrasound images. Determining the location of the chest wall in automated 3D breast ultrasound images is necessary in computer-aided detection systems to remove automatically detected cancer candidates beyond the chest wall and it can be of great help for inter- and intra-modal image registration. We show that the visible part of the chest wall in an automated 3D breast ultrasound image can be accurately modeled by a cylinder. We fit the surface of our cylinder model to a set of automatically detected rib-surface points. The detection of the rib-surface points is done by a classifier using features representing local image intensity patterns and presence of rib shadows. Due to attenuation of the ultrasound signal, a clear shadow is visible behind the ribs. Evaluation of our segmentation method is done by computing the distance of manually annotated rib points to the surface of the automatically detected chest wall. We examined the performance on images obtained with the two most common 3D breast ultrasound devices in the market. In a dataset of 142 images, the average mean distance of the annotated points to the segmented chest wall was 5.59 ± 3.08 mm. Copyright © 2012 Elsevier B.V. All rights reserved.

Association of aortic wall thickness on contrast-enhanced chest CT with major cerebro-cardiac events.

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Tresoldi, Silvia; Di Leo, Giovanni; Zoffoli, Elena; Munari, Alice; Primolevo, Alessandra; Cornalba, Gianpaolo; Sardanelli, Francesco

2014-11-01

There is a significant association between aortic atherosclerosis and previous major cardiovascular events. Particularly, thoracic aortic atherosclerosis is closely related to the degree of coronary and carotid artery disease. Thus, there is a rationale for screening the thoracic aorta in patients who undergo a chest computed tomography (CT) for any clinical question, in order to detect patients at increased risk of cerebro-cardiovascular (CCV) events. To estimate the association between either thoracic aortic wall thickness (AWT) or aortic total calcium score (ATCS) and CCV events. One hundred and forty-eight non-cardiac patients (78 men; 67 ± 12 years) underwent chest contrast-enhanced multidetector CT (MDCT). The AWT was measured at the level of the left atrium (AWTref) and at the maximum AWT (AWTmax). Correlation with clinical CCV patients' history was estimated. The value of AWTmax and of a semi-quantitative ATCS as a marker for CCV events was assessed using receiver-operating characteristic curve (ROC) analysis and multivariate regression analysis. Out of 148 patients, 59% reported sedentary lifestyle, 44% hypertension, 32% smoking, 23% hypercholesterolemia, 13% family history of cardiac disease, 12% diabetes, and 10% BMI ≥ 30 kg/m(2); 9% reported myocardial infarction, 8% aortic aneurism, 8% myocardial revascularization, and 2% ischemic stroke. Twenty-six percent of patients had a medium-to-high ATCS. Both AWTmax and AWTref correlated with hypertension and age (P < 0.002). At the ROC analysis, a 4.8 mm threshold was associated to a 90% specificity and an odds ratio of 6.3 (AUC = 0.735). Assuming as threshold the AWTmax median value (4.3 mm) of patients who suffered from at least one CCV event in their history, a negative predictive value of 90%, a RR of 3.6 and an OR of 6.3 were found. At the multivariate regression analysis, AWTmax was the only independent variable associated to the frequency of CCV events. Patients with increased thoracic

Chest wall – a structure underestimated in ultrasonography. Part III: Neoplastic lesions

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Andrzej Smereczyński

2017-12-01

Full Text Available Chest wall neoplasms mainly include malignancies, metastatic in particular. Differential diagnosis should include clinical data; tumor location, extent, delineation; the degree of homogeneity; the presence of calcifications; the nature of bone destruction and the degree of vascularization. The aim of the paper is to present both the benefits and limitations of ultrasound for the diagnosis of chest wall neoplasms. The neoplastic process may be limited to the chest wall; it may spread from the chest wall into the intrathoracic structures or spread from the inside of the chest towards the chest wall. Benign tumors basically originate from vessels, nerves, bones, cartilage and soft tissues. In this paper, we briefly discuss malformations of blood and lymphatic vessels, glomus tumor as well as neurogenic tumors originating in the thoracic branches of the spinal nerves and the autonomic visceral system. Metastases, particularly lung, breast, kidney cancer, melanoma and prostate cancer, are predominant tumors of the osteocartilaginous structures of the chest wall. Plasma cell myeloma is also relatively common. The vast majority of these lesions are osteolytic, which is reflected in ultrasound as irregular cortical defects. Osteoblastic foci result only in irregular outline of the bone surface. Lipomas are the most common neoplasms of the chest wall soft tissue. Elastofibroma is another tumor with characteristic echostructure. Desmoid fibromatosis, which is considered to be a benign lesion with local aggressivity and recurrences after surgical resection, represents an interesting tumor form the clinical point of view. Ultrasonography represents an optimal tool for the monitoring of different biopsies of pathological lesions located in the chest wall. Based on our experiences and literature data, this method should be considered as a preliminary diagnosis of patients with chest wall tumors.

Chest wall tuberculosis; CT findings in 14 patients

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Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Kim, Dong Woo [Daejoen Eulji Hospital, Daejon (Korea, Republic of); Juhng, Seon Kwan [Wonkwang Univ. Medical School, Iksan (Korea, Republic of)

1996-01-01

To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis.

Chest wall tuberculosis; CT findings in 14 patients

International Nuclear Information System (INIS)

Han, Young Min; Lee, Sang Yong; Lee, Dong Won; Kim, Chong Soo; Chung, Gyung Ho; Sohn, Myung Hee; Choi, Ki Chul; Kim, Dong Woo; Juhng, Seon Kwan

1996-01-01

To present CT findings of chest wall tuberculosis. CT scans were obtained in 14 patients with proven chest wall tuberculosis. Diagnosis was confirmed by means of right open thoracostomy with abscess evacuation (n=1), excision and curettage (n=11) or excision and curettage along with resection of the involved lung (n=2). The images were assessed with emphasis for the extrapleural, pleural, and pulmonary lesions. All patients showed juxtacostal soft tissue mass with central low attenuation and peripheral rim enhancement. The lesions were located in the left hemithorax in eight patients and in the right in six. Multiple lesions were found in three patients (two in one and three in two). Rib destruction was observed in four patients. Intercostal muscle involvement of thickening and enhancement were shown in all patients. Thirteen patients (93%) had evidence of pulmonary tuberculosis: active pulmonary tuberculosis in nine and stable tuberculosis in four. Pleural lesions, including empyema necessitatis in six, were observed in eleven (79%). On CT scan, chest wall tuberculosis is characterized by juxtacostal soft tissue lesion with central low attenuation and peripheral rim enhancement. Rib destruction may be associated. Additionally, enhancing intercostal muscle suggest direct inflammatory process of tuberculosis and spread channel to the chest wall involvement of pleuropulmonary tuberculosis

Electron arc irradiation of the postmastectomy chest wall: clinical results

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Gaffney, David K; Prows, Janalyn; Leavitt, Dennis; Egger, Marlene J; Morgan, John G; Stewart, J Robert

1995-07-01

Purpose/Objective: Since 1980 electron arc irradiation of the postmastectomy chest wall has been the preferred technique for patients with advanced breast cancer at the our institution. Here we report the results of this technique in 150 consecutive patients from 1980 to 1994. Materials and Methods: Thoracic computerized tomography was used to determine internal mammary lymph node depth and chest wall thickness, and for computerized dosimetry calculations in all patients. Total doses of 45-50 Gy in 5 to 5 (1(2)) weeks were delivered to the chest wall and internal mammary lymph nodes via electron arc and, in most cases, supraclavicular and axillary nodes were treated with a matching photon field. Patients were assessed for acute and late radiation changes, local and distant control of disease, and survival. The 10 most recently treated patients were censored for disease progression, survival, and late effects calculations, thus giving a mean follow up of 49 months and a median of 33 months. All patients had advanced disease: T stages 1, 2, 3, and 4 represented 21%, 39%, 21% and 19% of the study population, with a mean number of positive axillary lymph nodes of 6.5 (0-29). Analysis was performed according to adjuvant status (no residual disease, n = 90), residual disease (positive margin, n = 15, and primary radiation, n = 2), or recurrent disease (n = 33). Results: Acute radiation reactions were generally mild and self limiting. 27% of patients developed moist desquamation, and 32% had brisk erythema. Actuarial 5 year local control, freedom from distant failure and overall survival was 91%, 64%, and 67% in the adjuvant group; 84%, 50%, and 53% in the residual disease group; and 63%, 34%, and 30% in the recurrent disease group, respectively. In univariate cox regressions, the number of positive lymph nodes was predictive for local failure in the adjuvant group (p<0.037). Chronic complications were minimal with 10% of patients having arm edema, 15% hyperpigmentation

Plastic surgery in chest wall reconstruction: relevant aspects - case series

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Diogo Franco

Full Text Available Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

Anterior chest wall examination reviewed

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F. Trotta

2011-09-01

Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

Cine magnetic resonance imaging, computed tomography and ultrasonography in the evaluation of chest wall invasion of lung cancer

International Nuclear Information System (INIS)

Yokozaki, Michiya; Nawano, Shigeru; Nagai, Kanji; Moriyama, Noriyuki; Kodama, Tetsuro; Nishiwaki, Yutaka.

1997-01-01

To assess the usefulness of cine-magnetic resonance imaging (cine-MRI) in the evaluation of chest wall invasion, we compared the results of cine-MRI with those of computed tomography (CT) and ultrasonography (US). Eleven patients were examined who had no pain and who were difficult to diagnose by routine examinations. MRI was performed with a Magnetom SP/4000, 1.5T unit (Siemens, Germany). For cine imaging, continuous turbo-FLUSH (ultra fast low angle shot) images were obtained at an orthogonal section to the chest wall during slow deep breathing. A CT scan was performed using a TCT 900S or Super Helix (Toshiba, Japan) at 1 cm intervals, with section thicknesses of 1 cm throughout the entire chest. US was performed with a model SSA-270A (Toshiba, Japan) with 7.5-MHz linear array scanners (PLF-705S; Toshiba, Japan). Sensitivity, specificity and accuracy were 67%, 75% and 73% for cine MRI, 67%, 63% and 64% for CT, 33%, 75% and 64% for US, respectively. These results indicate that cine MRI is potentially useful for the diagnosis of chest wall invasion of lung cancer. (author)

Short TI inversion-recovery MR imaging of chest wall malignancies

International Nuclear Information System (INIS)

Dubinsky, T.J.; Porter, B.A.; Olson, D.O.

1987-01-01

Short-T1 inversion-recovery (STIR) sequences have greater constant, less motion sensitivity, and require shorter imaging times than conventional T2-weighted spin-echo (SE) sequences and are therefore particularly useful for staging chest wall malignancies. MR studies of 49 patients with possible chest wall malignancies were reviewed. Images were produced at 0.15 T with a variety of SE sequences. Forty-five also had STIR (repetition time, 1,400 - 2,100; echo time, 36 or 40; inversion time, 100 or 125). MR studies indicated chest wall involvement in 39 of 49 patients; 12 had obvious rib encasement, the most definitive finding. IN 13, lesions detected on STIR were either not visible or seen only in retrospect on T1 SE images. In five of five, STIR was clearly superior to T2 SE for delineation of tumor margins. The authors have discontinued using T2 SE sequences for chest neoplasms in favor of the higher contrast and sensitivity of STIR

Chest wall resection for local recurrence of breast cancer. Presented at the 99th Meeting of the Royal Belgium Society of Obstetrics and Gynecology, Brussels May 9th 1998, Belgium.

Science.gov (United States)

Tjalma, W; Van Schil, P; Verbist, A M; Buytaert, P; van Dam, P

1999-05-01

We present three cases of chest wall resection for locally recurrent breast cancer and a Medline review of the current literature. In selected cases full thickness resection of the chest wall may be used as a salvage procedure to improve the quality of life and prolong the survival at low morbidity and mortality.

Multi-Detector CT Findings of Palpable Chest Wall Masses in Children: A Pictorial Essay

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Park, Chan Ho; Kim, Young Tong [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of); Hong, Hyun Sook [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2013-03-15

A wide variety of diseases manifest as palpable chest wall masses in children. These include normal variation, congenital anomalies, trauma, infection, axillary lymphadenopathies, soft tissue tumors and bone tumors. Given that most of these diseases are associated with chest wall deformity, diagnosis is difficult by physical examination or ultrasonography alone. However, multi-detector CT with three dimensional reconstruction is useful in the characterization and differential diagnosis of palpable chest wall lesions. In this article, we review the spectrum of palpable chest wall diseases and illustrate their multi-detector CT presentation.

Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

Science.gov (United States)

Masuda, Norikazu; Yasojima, Hiroyuki; Mizutani, Makiko; Nakamori, Shoji; Kanazawa, Toru; Kuriyama, Keiko; Mano, Masayuki; Sekimoto, Mitsugu

2014-01-01

Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient's chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery. PMID:24660001

Primary Chest Wall Abscess Mimicking a Breast Tumor That Occurred after Blunt Chest Trauma: A Case Report

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Yusuke Yamaoka

2014-01-01

Full Text Available Primary chest wall abscess occurring after blunt chest trauma is rare. We present the case of a 50-year-old woman who presented with a swelling in her left breast. The patient had experienced blunt chest trauma 2 months back. Needle aspiration revealed pus formation in the patient’s chest. Computed tomography revealed a mass in the lower region of the left mammary gland, with thickening of the parietal pleura and skin and fracture of the fifth rib under the abscess. Following antibiotic administration and irrigation of the affected region, surgical debridement was performed. During surgery, we found that the pectoralis major muscle at the level of the fifth rib was markedly damaged, although the necrotic tissue did not contact the mammary gland. We diagnosed the lesion as a chest wall abscess that occurred in response to blunt chest trauma. Her postoperative course was uneventful. There has been no recurrence for six months after surgery.

Chest wall syndrome among primary care patients: a cohort study

Directory of Open Access Journals (Sweden)

Verdon François

2007-09-01

Full Text Available Abstract Background The epidemiology of chest pain differs strongly between outpatient and emergency settings. In general practice, the most frequent cause is the chest wall pain. However, there is a lack of information about the characteristics of this syndrome. The aims of the study are to describe the clinical aspects of chest wall syndrome (CWS. Methods Prospective, observational, cohort study of patients attending 58 private practices over a five-week period from March to May 2001 with undifferentiated chest pain. During a one-year follow-up, questionnaires including detailed history and physical exam, were filled out at initial consultation, 3 and 12 months. The outcomes were: clinical characteristics associated with the CWS diagnosis and clinical evolution of the syndrome. Results Among 24 620 consultations, we observed 672 cases of chest pain and 300 (44.6% patients had a diagnosis of chest wall syndrome. It affected all ages with a sex ratio of 1:1. History and sensibility to palpation were the keys for diagnosis. Pain was generally moderate, well localised, continuous or intermittent over a number of hours to days or weeks, and amplified by position or movement. The pain however, may be acute. Eighty-eight patients were affected at several painful sites, and 210 patients at a single site, most frequently in the midline or a left-sided site. Pain was a cause of anxiety and cardiac concern, especially when acute. CWS coexisted with coronary disease in 19 and neoplasm in 6. Outcome at one year was favourable even though CWS recurred in half of patients. Conclusion CWS is common and benign, but leads to anxiety and recurred frequently. Because the majority of chest wall pain is left-sided, the possibility of coexistence with coronary disease needs careful consideration.

Chest wall syndrome among primary care patients: a cohort study.

Science.gov (United States)

Verdon, François; Burnand, Bernard; Herzig, Lilli; Junod, Michel; Pécoud, Alain; Favrat, Bernard

2007-09-12

The epidemiology of chest pain differs strongly between outpatient and emergency settings. In general practice, the most frequent cause is the chest wall pain. However, there is a lack of information about the characteristics of this syndrome. The aims of the study are to describe the clinical aspects of chest wall syndrome (CWS). Prospective, observational, cohort study of patients attending 58 private practices over a five-week period from March to May 2001 with undifferentiated chest pain. During a one-year follow-up, questionnaires including detailed history and physical exam, were filled out at initial consultation, 3 and 12 months. The outcomes were: clinical characteristics associated with the CWS diagnosis and clinical evolution of the syndrome. Among 24 620 consultations, we observed 672 cases of chest pain and 300 (44.6%) patients had a diagnosis of chest wall syndrome. It affected all ages with a sex ratio of 1:1. History and sensibility to palpation were the keys for diagnosis. Pain was generally moderate, well localised, continuous or intermittent over a number of hours to days or weeks, and amplified by position or movement. The pain however, may be acute. Eighty-eight patients were affected at several painful sites, and 210 patients at a single site, most frequently in the midline or a left-sided site. Pain was a cause of anxiety and cardiac concern, especially when acute. CWS coexisted with coronary disease in 19 and neoplasm in 6. Outcome at one year was favourable even though CWS recurred in half of patients. CWS is common and benign, but leads to anxiety and recurred frequently. Because the majority of chest wall pain is left-sided, the possibility of coexistence with coronary disease needs careful consideration.

Chest wall syndrome among primary care patients: a cohort study

Science.gov (United States)

Verdon, François; Burnand, Bernard; Herzig, Lilli; Junod, Michel; Pécoud, Alain; Favrat, Bernard

2007-01-01

Background The epidemiology of chest pain differs strongly between outpatient and emergency settings. In general practice, the most frequent cause is the chest wall pain. However, there is a lack of information about the characteristics of this syndrome. The aims of the study are to describe the clinical aspects of chest wall syndrome (CWS). Methods Prospective, observational, cohort study of patients attending 58 private practices over a five-week period from March to May 2001 with undifferentiated chest pain. During a one-year follow-up, questionnaires including detailed history and physical exam, were filled out at initial consultation, 3 and 12 months. The outcomes were: clinical characteristics associated with the CWS diagnosis and clinical evolution of the syndrome. Results Among 24 620 consultations, we observed 672 cases of chest pain and 300 (44.6%) patients had a diagnosis of chest wall syndrome. It affected all ages with a sex ratio of 1:1. History and sensibility to palpation were the keys for diagnosis. Pain was generally moderate, well localised, continuous or intermittent over a number of hours to days or weeks, and amplified by position or movement. The pain however, may be acute. Eighty-eight patients were affected at several painful sites, and 210 patients at a single site, most frequently in the midline or a left-sided site. Pain was a cause of anxiety and cardiac concern, especially when acute. CWS coexisted with coronary disease in 19 and neoplasm in 6. Outcome at one year was favourable even though CWS recurred in half of patients. Conclusion CWS is common and benign, but leads to anxiety and recurred frequently. Because the majority of chest wall pain is left-sided, the possibility of coexistence with coronary disease needs careful consideration. PMID:17850647

Hemithorax irradiation for Ewing tumors of the chest wall

International Nuclear Information System (INIS)

Schuck, Andreas; Ahrens, Susanne; Konarzewska, Agnieszka; Paulussen, Michael; Froehlich, Birgit; Koenemann, Stefan; Ruebe, Christian; Ruebe, Claudia E.; Dunst, Juergen; Willich, Normann; Juergens, Heribert

2002-01-01

Purpose: In the Cooperative Ewing's Sarcoma Study 86 and the European Intergroup Cooperative Ewing's Sarcoma Study 92, hemithorax irradiation (RT) was performed in patients with Ewing tumors of the chest wall involving the pleura or contaminating the pleural cavity. In a retrospective analysis, the outcomes of these patients were evaluated and compared with those of patients with chest wall tumors who did not receive hemithorax RT. Methods and Materials: Between 1985 and 1996, 138 patients presented with nonmetastatic Ewing tumors of the chest wall. They were treated in a multimodal treatment regimen that included polychemotherapy and local therapy depending on the tumor characteristics. Hemithorax RT was performed at a dose of 15 Gy for patients <14 years old and 20 Gy for patients ≥14 years old. Forty-two patients received hemithorax RT (Group 1) and 86 patients did not (Group 2). The data were insufficient for the other 10 patients. Results: Comparing both groups, the initial pleural effusion, pleural infiltration, and intraoperative contamination of the pleural space were significantly more frequent in Group 1. The event-free survival rate after 7 years was 63% for patients in Group 1 and 46% for patients in Group 2 (not statistically significant). The 7-year local relapse rate (including combined local-systemic relapses) was 12% in Group 1 and 10% in Group 2; the corresponding systemic relapse rates were 22% and 39%. Conclusion: Patients with chest wall tumors who received hemithorax RT were negatively selected; yet the rate of event-free survival was better for patients who received hemithorax RT than for those who did not (although the difference was not statistically significant). This result was due to a reduction of metastases, mainly lung metastases. Local control was equivalent between the two groups. These favorable results have caused us to continue using hemithorax RT to treat high-risk patients with Ewing tumors of the chest wall

Herniation of unruptured tuberculous lung abscess into chest wall without pleural or bronchial spillage

Directory of Open Access Journals (Sweden)

Rahul Magazine

2011-01-01

Full Text Available A 22-year-old unmarried man presented to the chest outpatient department with a history of productive cough of two-month duration. He also complained of pain and swelling on the anterior aspect of right side of chest of one-month duration. Imaging studies of the thorax, including chest roentgenography and computerized tomography, revealed an unruptured lung abscess which had herniated into the chest wall. Culture of pus aspirated from the chest wall swelling grew Mycobacterium tuberculosis. He was diagnosed to have a tuberculous lung abscess which had extended into the chest wall, without spillage into the pleural cavity or the bronchial tree. Antituberculosis drugs were prescribed, and he responded to the treatment with complete resolution of the lesion.

Chest-wall reconstruction in case of infection of the operative site: is there any interest in titanium rib osteosynthesis?

Science.gov (United States)

Berthet, Jean-Philippe; Solovei, Laurence; Tiffet, Olivier; Gomez-Caro, Abel; Bommart, Sébastien; Canaud, Ludovic; Alric, Pierre; Marty-Ané, Charles-Henri

2013-11-01

To describe the management of thoracic reconstructions in the presence of primary chest-wall infection (PCWI) or secondary deep chest-wall infection (SCWI), focussing on local tolerance of a titanium rib osteosynthesis system. PCWI included infected chest wall tumours (CWT), infected T3 non-small-cell lung carcinoma (NSCLC) and open flail chest. SCWI was defined by deep infection of previous thoracic-wall reconstructions. Infection was identified by preoperative bacterial analysis of the tumour or surgical site. In PCWI, a one-step procedure combined extensive resection of infected tissues and rigid reconstruction of the defect; skeletal rigidity was achieved using titanium implants. In SCWI, we removed all synthetic material except titanium implants. In both groups, the surgical field was thoroughly cleaned and implants were wrapped or covered by flaps. From January 2005 to December 2011, 11 patients (54 ± 10.2 years) with either PCWI (3 CWT, 3 T3 NSCLC, 1 open flail chest) or SCWI (3 CWT, 1 funnel chest) were treated. Infection was polymicrobial in all but 1 case. Bacteria observed in PCWI patients were multidrug resistant. In PCWI, we resected 4.2 ± 0.6 ribs en bloc with the lung (n = 5), the skin and the pectoralis major and then used mesh and 2.1 ± 1.2 titanium implants for reconstruction (n = 6). The mean defect was 1154.4 ± 318 cm(3). Surgical SCWI management removed polytetrafluoroethylene-mesh and preserved the titanium implants. A Vicryl mesh (n = 3) and greater omentum flap (n = 3) were added. One of the 2 postoperative deaths in the PCWI group was related to infection recurrence. No other patient had infection at the 6-month follow-up with leucocyte-labelled scintigraphy. Titanium rib osteosynthesis is reliable in two complex and life-threatening situations: PCWIs and SCWIs. In combination with a flap, this allows rapid, reliable, rigid reconstruction of infected full-thickness chest-wall defects in a single-step procedure.

Obesity Increases the Risk of Chest Wall Pain From Thoracic Stereotactic Body Radiation Therapy

International Nuclear Information System (INIS)

Welsh, James; Thomas, Jimmy; Shah, Deep; Allen, Pamela K.; Wei, Xiong; Mitchell, Kevin; Gao, Song; Balter, Peter; Komaki, Ritsuko; Chang, Joe Y.

2011-01-01

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly being used to treat thoracic tumors. We attempted here to identify dose-volume parameters that predict chest wall toxicity (pain and skin reactions) in patients receiving thoracic SBRT. Patients and Methods: We screened a database of patients treated with SBRT between August 2004 and August 2008 to find patients with pulmonary tumors within 2.5 cm of the chest wall. All patients received a total dose of 50 Gy in four daily 12.5-Gy fractions. Toxicity was scored according to the NCI-CTCAE V3.0. Results: Of 360 patients in the database, 265 (268 tumors) had tumors within 30 , or volume of the chest wall receiving 30 Gy. Body mass index (BMI) was also strongly associated with the development of chest pain: patients with BMI ≥29 had almost twice the risk of chronic pain (p = 0.03). Among patients with BMI >29, diabetes mellitus was a significant contributing factor to the development of chest pain. Conclusion: Safe use of SBRT with 50 Gy in four fractions for lesions close to the chest wall requires consideration of the chest wall volume receiving 30 Gy and the patient's BMI and diabetic state.

The pedicled omentoplasty and split skin graft (POSSG) for reconstruction of large chest wall defects. A validity study of 34 patients

NARCIS (Netherlands)

C.M.E. Contant; A.N. van Geel (Albert); B. van der Holt (Bronno); T. Wiggers (Theo)

1996-01-01

textabstractThe aim of this study was to evaluate retrospectively the results of pedicled omentoplasty and split skin graft (POSSG) in reconstructing (full thickness) chest wall defects, and to define its role as a palliative procedure for local symptom control. Thirty-four patients with recurrent

A Community-acquired Lung Abscess Attributable to Streptococcus pneumoniae which Extended Directly into the Chest Wall.

Science.gov (United States)

Ko, Yuki; Tobino, Kazunori; Yasuda, Yuichiro; Sueyasu, Takuto; Nishizawa, Saori; Yoshimine, Kouhei; Munechika, Miyuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Miyajima, Hiroyuki; Mukasa, Yosuke; Ebi, Noriyuki

We herein report the case of 75-year-old Japanese female with a community-acquired lung abscess attributable to Streptococcus pneumoniae (S. penumoniae) which extended into the chest wall. The patient was admitted to our hospital with a painful mass on the left anterior chest wall. A contrast-enhanced chest computed tomography scan showed a lung abscess in the left upper lobe which extended into the chest wall. Surgical debridement of the chest wall abscess and percutaneous transthoracic tube drainage of the lung abscess were performed. A culture of the drainage specimen yielded S. pneumoniae. The patient showed a remarkable improvement after the initiation of intravenous antibiotic therapy.

Turbine airfoil with outer wall thickness indicators

Science.gov (United States)

Marra, John J; James, Allister W; Merrill, Gary B

2013-08-06

A turbine airfoil usable in a turbine engine and including a depth indicator for determining outer wall blade thickness. The airfoil may include an outer wall having a plurality of grooves in the outer surface of the outer wall. The grooves may have a depth that represents a desired outer surface and wall thickness of the outer wall. The material forming an outer surface of the outer wall may be removed to be flush with an innermost point in each groove, thereby reducing the wall thickness and increasing efficiency. The plurality of grooves may be positioned in a radially outer region of the airfoil proximate to the tip.

Chest wall – underappreciated structure in sonography. Part I: Examination methodology and ultrasound anatomy

Directory of Open Access Journals (Sweden)

Andrzej Smereczyński

2017-09-01

Full Text Available Chest wall ultrasound has been awarded little interest in the literature, with chest wall anatomy described only in limited extent. The objective of this study has been to discuss the methodology of chest wall ultrasound and the sonographic anatomy of the region to facilitate professional evaluation of this complex structure. The primarily used transducer is a 7–12 MHz linear one. A 3–5 MHz convex (curvilinear transducer may also be helpful, especially in obese and very muscular patients. Doppler and panoramic imaging options are essential. The indications for chest wall ultrasound include localized pain or lesions found or suspected on imaging with other modalities (conventional radiography, CT, MR or scintigraphy. The investigated pathological condition should be scanned in at least two planes. Sometimes, evaluation during deep breathing permits identification of pathological mobility (e.g. in rib or sternum fractures, slipping rib syndrome. Several structures, closely associated with each other, need to be considered in the evaluation of the chest wall. The skin, which forms a hyperechoic covering, requires a high frequency transducer (20–45 MHz. The subcutaneous fat is characterized by clusters of hypoechoic lobules. Chest muscles have a very complex structure, but their appearance on ultrasound does not differ from the images of muscles located in other anatomical regions. As far as cartilaginous and bony structures of the chest are concerned, the differences in the anatomy of the ribs, sternum, scapula and sternoclavicular joints have been discussed. The rich vascular network which is only fragmentarily accessible for ultrasound assessment has been briefly discussed. A comprehensive evaluation of the chest wall should include the axillary, supraclavicular, apical and parasternal lymph nodes. Their examination requires the use of elastography and contrast-enhanced ultrasound.

Delayed chest wall hematoma caused by progressive displacement of rib fractures after blunt trauma

Directory of Open Access Journals (Sweden)

Nobuhiro Sato

2016-06-01

Full Text Available Rib fracture is a common injury resulting from blunt thoracic trauma. Although hemothorax and pneumothorax are known delayed complications of rib fracture, delayed chest wall hematoma has rarely been reported. We discuss the case of an 81-year-old woman who was not undergoing antiplatelet or anticoagulant therapy who presented to our emergency department after a traffic injury. This patient had a nondisplaced rib fracture that went undetected on the initial computed tomography scan; the development of progressive displacement led to hemorrhagic shock due to delayed chest wall hematoma. The chest wall hematoma was effectively diagnosed and treated via contrast-enhanced computed tomography and angiographic embolization. This case highlights the possibility of this potential delayed complication from a common injury such as a rib fracture. Keywords: Angiography, Chest wall, Delayed complication, Rib fracture, Thoracic injury

Evaluation of anterior chest wall implanted port: technical aspects, results, and complications

International Nuclear Information System (INIS)

Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young

2000-01-01

To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7±47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)

Evaluation of anterior chest wall implanted port: technical aspects, results, and complications

Energy Technology Data Exchange (ETDEWEB)

Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young [Kyung Hee University Hospital, Seoul (Korea, Republic of)

2000-07-01

To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7{+-}47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)

Reverse Abdominoplasty Flap in Reconstruction of Post-Bilateral Mastectomies Anterior Chest Wall Defect

Directory of Open Access Journals (Sweden)

William HC Tiong

2014-01-01

Full Text Available Reverse abdominoplasty was originally described for epigastric lift. Since the work by Baroudi and Huger in the 1970s, it has become clear that reverse abdominoplasty application can be extended beyond just aesthetic procedure. Through the knowledge of anterior abdominal wall vascularity, its application had included reconstructive prospect in the coverage of various chest wall defects. To date, reverse abdominoplasty flap has been used to reconstruct unilateral anterior chest wall defect or for larger defect but only in combination with other reconstructive techniques. Here, we presented a case where it is used as a standalone flap to reconstruct bilateral anterior chest wall soft tissue defect post-bilateral mastectomies in oncological resection. In conclusion, reverse abdominoplasty flap provided us with a simple, faster, and satisfactory reconstructive outcome.

Severe Chest Wall Toxicity From Cryoablation in the Setting of Prior Stereotactic Ablative Radiotherapy.

Science.gov (United States)

Chaudhuri, Aadel A; Binkley, Michael S; Aggarwal, Sonya; Qian, Yushen; Carter, Justin N; Shah, Rajesh; Loo, Billy W

2016-02-02

We present the case of a 42-year-old woman with metastatic synovial sarcoma of parotid origin, treated definitively with chemoradiation, who subsequently developed oligometastatic disease limited to the lungs. She underwent multiple left and right lung wedge resections and left lower lobectomy, followed by right lower lobe stereotactic ablative radiotherapy (SABR), 54 Gy in three fractions to a right lower lobe lesion abutting the chest wall. Two years later, she was treated with cryoablation for a separate right upper lobe nodule abutting the chest wall. Two months later, she presented with acute shortness of breath, pleuritic chest pain, decreased peripheral blood O2 saturation, and productive cough. A computed tomography (CT) scan demonstrated severe chest wall necrosis in the area of recent cryoablation that, in retrospect, also received a significant radiation dose from her prior SABR. This case demonstrates that clinicians should exercise caution in using cryoablation when treating lung tumors abutting a previously irradiated chest wall. Note: Drs. Loo and Shah contributed equally as co-senior authors.

New developments in ultrasonic imaging of the chest and other body organs

International Nuclear Information System (INIS)

Campbell, G.W.; Anderson, A.L.

1978-01-01

The ultrasonic imaging system described herein was developed to measure chest-wall thickness and the percentage of fat in the chest and around other body organs. The system uses pulse-echo techniques to transmit and detect sound waves reflected from the interfaces of body organs and adjacent tissue. A computer draws these interfaces on color scans, and a code is used to exponentially average data from several points on each scan to find the average thicknesses of the chest wall and fat layers. These average thicknesses are then used to adjust x-ray calibration factors for plutonium lung counters. The correction factor for three subjects measured for fat content ranging from 12.6 to 22.2% was 18 to 41%. The ultrasonic system also defines the shape and position of the kidneys and liver so we are able to more accurately place detectors on the body during in-vivo radiation measurements. We have also developed a technique for displaying the interfaces from a series of ultrasonic chest scans to produce a topographical map that enables us to better understand the shape and contour of the lung and chest-wall interface

Neurofibromas as bilateral cystic chest wall swellings.

African Journals Online (AJOL)

secondary to an infection, usually parasitic infections. [6,7]. However, cystic tumours of the chest wall result- ing from degenerative changes in peripheral nerves of its layers are rare, and we did not see any in the pub- lished literature. We are reporting a single case of bilat- eral cystic degenerative changes in neurofibromas ...

Chest wall reconstruction with acellular dermal matrix (Strattice™) and a TRAM flap

DEFF Research Database (Denmark)

Brunbjerg, Mette Eline; Juhl, Alexander Andersen; Damsgaard, Tine Engberg

2014-01-01

Mette Eline Brunbjerg, Alexander Andersen Juhl, Tine E. Damsgaard. "Chest wall reconstruction with acellular dermal matrix (Strattice™) and a TRAM flap.” Acta Oncol. 2013 Jun;52(5):1052-4. Epub 2012 Oct 24. PMID: 23095144......Mette Eline Brunbjerg, Alexander Andersen Juhl, Tine E. Damsgaard. "Chest wall reconstruction with acellular dermal matrix (Strattice™) and a TRAM flap.” Acta Oncol. 2013 Jun;52(5):1052-4. Epub 2012 Oct 24. PMID: 23095144...

One-stage reconstruction of chest wall defects with greater omentum transplantation

Energy Technology Data Exchange (ETDEWEB)

Harashina, T [Keio Univ., Tokyo (Japan). School of Medicine; Oshiro, T; Sato, K

1976-11-01

Reconstructive operation by greater omentum transplantation in two cases of chest wall ulcer due to radiation therapy following an operation of breast cancer was introduced. The exposed dose of one case was not clarified, but that of another case was 5000 rad. This operation method is an excellent one, because operation is completed at one-stage and reconstruction of tissue is great owing to good blood circulation. It was thought that this method must be used more positively in the treatment of chest wall ulcer due to irradiation which is difficult to be treated.

Utility of CT scan for the diagnosis of chest wall tuberculosis

Energy Technology Data Exchange (ETDEWEB)

Khalil, A.; Le Breton, C.; Tassart, M.; Korzec, J.; Bigot, J.M.; Carette, M.F. [Department of Radiology, Tenon Hospital, Paris (France)

1999-10-01

The objective of this study was to determine the utility of CT scan findings for the diagnosis of chest wall tuberculosis, excluding the spine. We reviewed 15 patients (13 Africans and 2 Indians) with chest wall tuberculosis, retrospectively. The radiologic examination consisted of a plain X-ray and a CT scan of the chest for each patient. The site of disease was the rib in 13 patients or the body of the sternum in 2 patients. One rib was involved in 11 patients, 2 contiguous ribs (one site) in 2 patients, and bilateral disease (two sites) was observed in the remaining patient. The 14 rib sites involved the posterior arc or costovertebral joint in 11 cases, the anterior arc in 2 cases, and the anterior and middle arc in 1 case. The CT scan findings were an abscess (n = 14) or a soft tissue mass (n = 2), osteolytic lesions (n = 13), periosteal reaction (n = 10), and sequestrum (n = 14). Bone sclerosis was observed only in 3 cases of rib involvement. The association of a soft tissue abscess, an osteolytic lesion, and sequestrum, especially in immigrants to France, suggests chest wall tuberculosis on CT scan. (orig.) With 5 figs., 2 tabs., 11 refs.

Bioactive nanocomposite for chest-wall replacement: Cellular response in a murine model.

Science.gov (United States)

Jungraithmayr, Wolfgang; Laube, Isabelle; Hild, Nora; Stark, Wendelin J; Mihic-Probst, Daniela; Weder, Walter; Buschmann, Johanna

2014-07-01

Chest-wall invading malignancies usually necessitate the resection of the respective part of the thoracic wall. Gore-Tex® is the material of choice that is traditionally used to repair thoracic defects. This material is well accepted by the recipient; however, though not rejected, it is an inert material and behaves like a 'foreign body' within the thoracic wall. By contrast, there are materials that have the potential to physiologically integrate into the host, and these materials are currently under in vitro and also in vivo investigation. These materials offer a gradual but complete biodegradation over time, and severe adverse inflammatory responses can be avoided. Here, we present a novel material that is a biodegradable nanocomposite based on poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles in comparison to the traditionally employed Gore-Tex® being the standard for chest-wall replacement. On a mouse model of thoracic wall resection, that resembles the technique and localization applied in humans, poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles and Gore-Tex® were implanted subcutaneously and additionally tested in a separate series as a chest-wall graft. After 1, 2, 4 and 8 weeks cell infiltration into the respective materials, inflammatory reactions as well as neo-vascularization (endothelial cells) were determined in six different zones. While Gore-Tex® allowed for cell infiltration only at the outer surface, electrospun poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles were completely penetrated by infiltrating cells. These cells were composed mainly by macrophages, with only 4% of giant cells and lymphocytes. Total macrophage count increased by time while the number of IL1-β-expressing macrophages decreased, indicating a protective state towards the graft. As such, poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles seem to develop ideal

Angiosarcoma of the Chest Wall associated with Chronic Empyema and Pulmonary Metastasis: A Case Report

International Nuclear Information System (INIS)

Kim, Dong Won; Lee, Ki Nam; Lee, Sang Yun; Roh, Mee Sook

2011-01-01

Angiosarcoma of the chest wall is a very rare tumor and it is difficult to radiologically differentiate this tumor from other malignant tumors. Chronic tuberculous empyema is a predisposing factor that has been associated with angiosarcoma. We report here on a case of a 66-year-old man with angiosarcoma that arose in the chest wall. Computed tomography (CT) demonstrated a heterogeneous enhancing mass in the chest wall with calcified pleural thickening and multiple pulmonary nodules with the halo sign, which all indicated the presence of sarcoma with hypervascular metastases

Chest wall stabilization in trauma patients: why, when, and how?

Science.gov (United States)

White, Thomas W.

2018-01-01

Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient. Recent consensus statements have sought to define the indications and contraindications, as well as the when, the how, and the technical details of CWS. Repair should be considered for patients who have three or more displaced rib fractures or a flail chest, whether or not mechanical ventilation is required. Additional candidates include patients who fail non-operative management irrespective of fracture pattern and those with rib fractures who need thoracic procedures for other reasons. Traditionally, unstable spine fracture and severe traumatic brain injury are definite contraindications. Pulmonary contusion’s role in the decision to perform CWS remains controversial. A range of rib-specific plating systems are now commercially available. PMID:29744222

Chest Wall Constriction after the Nuss Procedure Identified from Chest Radiograph and Multislice Computed Tomography Shortly after Removal of the Bar.

Science.gov (United States)

Chang, Pei-Yeh; Zeng, Qi; Wong, Kin-Sun; Wang, Chao-Jan; Chang, Chee-Jen

2016-01-01

This study radiographically examined the changes in the chest walls of patients with pectus excavatum (PE) after Nuss bar removal, to define the deformation caused by the bar and stabilizer. In the first part of the study, we compared the changes in chest radiographs of patients with PE to a preoperation PE control group. In the second part, we used multislice computed tomography (CT) scans to provide three-dimensional reconstructions with which to evaluate the changes to the thoracic wall. Part 1 From June 2006 to August 2011, 1,125 patients with PE who had posteroanterior chest radiographs taken before undergoing the Nuss procedure at four hospitals were enrolled as a preoperative control group. At the same time, 203 patients who had the bar removed were enrolled as the study group. The maximum dimensions of the outer boundary of the first to ninth rib pairs (R1-R9, rib pair width), chest height, and chest width were measured. Part 2 Thirty-one consecutive patients with PE (20 males and 11 females) who underwent Nuss bar removal were evaluated 7 to 30 days after operation. During this period, a further 34 patients with PE who had undergone CT imaging before bar insertion were evaluated and compared with the postoperative group. Part 1 The width of the lower ribs (R4-R9) after bar removal was significantly less than in the age-matched controls. The ribs adjacent to the bar (R5-R7) showed the greatest restriction. The width of the upper ribs (R1-R3) 2 to 3 years after bar placement did not differ significantly from the controls. Patients who were operated on after 10 years of age had less of a restrictive effect. Three years of bar placement resulted in more restriction than a 2-year period, particularly in patients younger than 10 years old. Part 2: A significant constriction of the chest wall was observed in 13 patients after removal of the Nuss bar. Constriction at ribs 5 to 8 was found to be present adjacent to the site of bar insertion. However

Timing of Administration of Bevacizumab Chemotherapy Affects Wound Healing Following Chest Wall Port Placement

OpenAIRE

Erinjeri, Joseph P; Fong, Abigail J; Kemeny, Nancy E; Brown, Karen T; Getrajdman, George I; Solomon, Stephen B

2010-01-01

The risk of a wound dehiscence requiring chest wall port explant in patients treated with bevacizumab is inversely proportional to the interval between bevacizumab administration and port placement. There is significantly higher risk of wound dehiscence when the interval between bevacizumab administration and chest wall port placement is less than 14 days.

Anterior chest wall tuberculous abscess: a case report

Directory of Open Access Journals (Sweden)

Papavramidis Theodossis S

2007-11-01

Full Text Available Abstract The granulomatous inflammation of tuberculosis usually involves the lungs and the hilar lymph nodes. Musculoskeletal tuberculosis (TB occurs in 1–3% of patients with TB, while TB of the chest wall constitutes 1% to 5% of all cases of musculoskeletal TB. Furthermore, nowadays it is rarer to find extrapulmonary TB in immunocompetent rather that non-immunocompetent patients. The present case reports a fifty-six-year-old immunocompetent man with an anterior chest wall tuberculous abscess. The rarity of the present case relates both to the localization of the tuberculous abscess, and to the fact that the patient was immunocompetent. The diagnosis of musculoskeletal tuberculous infection remains a challenge for clinicians and requires a high index of suspicion. The combination of indolent onset of symptoms, positive tuberculin skin test, and compatible radiographic findings, strongly suggests the diagnosis. TB, however, must be confirmed by positive culture or histologic proof. Prompt diagnosis and treatment are important to prevent serious bone and joint destruction.

A Case of “en bloc” Excision of a Chest Wall Leiomyosarcoma and Closure of the Defect with Non-Cross-Linked Collagen Matrix (Egis®

Directory of Open Access Journals (Sweden)

Marco Rastrelli

2016-10-01

Full Text Available Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis® placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction.

A Case of “en bloc” Excision of a Chest Wall Leiomyosarcoma and Closure of the Defect with Non-Cross-Linked Collagen Matrix (Egis®)

Science.gov (United States)

Rastrelli, Marco; Tropea, Saveria; Spina, Romina; Costa, Alessandra; Stramare, Roberto; Mocellin, Simone; Bonavina, Maria Giuseppina; Rossi, Carlo Riccardo

2016-01-01

Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis®) placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction. PMID:27920698

Melioidosis of Chest Wall Masquerading as a Tubercular Cold ...

African Journals Online (AJOL)

chest wall abscess mimicking tuberculous cold abscess for its rarity and to review the ... was suspected to have pulmonary tuberculosis by a private practitioner and was ... Risk factors for melioidosis include diabetes mellitus, excessive alcohol ...

High-resolution magnetic resonance imaging (HR-MRI) of the pleura and chest wall: Normal findings and pathological changes

International Nuclear Information System (INIS)

Bittner, R.C.; Schnoy, N.; Schoenfeld, N.; Grassot, A.; Loddenkemper, R.; Lode, H.; Kaiser, D.; Krumhaar, D.; Felix, R.

1995-01-01

To determine the value of high-resolution MRI in pleural and chest wall diseases, the normal and pathologic costal pleura and adjacent chest wall between paravertebral and the axillar region were examined with contrast enhanced high-resolution T 1 -weighted MRI images using a surface coil. Normal anatomy was evaluated in 5 healthy volunteers and a normal specimen of the thoracic wall, and correlation was made with corresponding HR-CT and histologic sections. CT-proved focal and diffuse changes of the pleura and the chest wall in 36 patients underwent HR-MRI, and visual comparison of MRI and CT was done retrospectively. Especially sagittal T 1 -weighted HR-MRI images allowed accurate delineation of the peripleural fat layer (PFL) and the innermost intercostal muscle (IIM), which served as landmarks of the intact inner chest wall. PFL and IIM were well delineated in 3/4 patients with tuberculous pleuritis, and in all 7 patients with non-specific pleuritis, as opposed to impairment of the PFL and/or the IIM, which was detected in 15/18 malignancies as a pattern of malignant chest wall involvement. In one case of tuberculous pleural empyema with edema of the inner chest wall HR-MRI produced false positive diagnosis of malignant disease. HR-MRI images improved non-invasive evaluation of pleural and chest wall diseases, and allowed for differentiation of bengin and malignant changes. (orig./MG) [de

An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy

International Nuclear Information System (INIS)

Wong, Sharon; Kaur, Amarjit; Back, Michael; Lee, Khai Mun; Baggarley, Shaun; Lu, Jiade Jay

2011-01-01

To determine the usefulness of ultrasonography in the assessment of post radiotherapy skin changes in postmastectomy breast cancer patients. Patients treated for postmastectomy radiotherapy in National University Hospital (NUH) and Tan Tock Seng Hospital (TTSH), Singapore between January 2004- December 2005 was recruited retrospectively. Ultrasound scan was performed on these Asian patients who had been treated to a total dose of 46-50 Gy with 1 cm bolus placed on the skin. The ultrasound scans were performed blinded to the RTOG scores, and the skin thickness of the individually marked points on the irradiated chest wall was compared to the corresponding points on the non-irradiated breast. The mean total skin thickness inclusive of the epidermis and the dermis of the right irradiated chest wall was 0.1712 mm (± 0.03392 mm) compared with the contra-lateral non-irradiated breast which was 0.1845 mm (± 0.04089 mm; p = 0.007). The left irradiated chest wall had a mean skin thickness of 0.1764 mm (± 0.03184 mm) compared with the right non-irradiated breast which was 0.1835 mm (± 0.02584 mm; p = 0.025). These independent t-tests produced a significant difference of reduced skin thickness on the right irradiated chest wall, p = 0.007 (p < 0.05) and left irradiated chest wall p = 0.025 (p < 0.025) in comparison to the non-irradiated skin thickness investigating chronic skin reactions. Patients with grade 2 acute skin toxicity presented with thinner skin as compared to patients with grade 1 (p = 0.006). This study has shown that there is a statistically significant difference between the skin thicknesses of the irradiated chest wall and the contra-lateral non-irradiated breast and a predisposition to chronic reactions was found in patients with acute RTOG scoring of grade1 and grade 2

Recurrence of Ewing Sarcomas of the Chest Wall

NARCIS (Netherlands)

Meys, Karlijn M. E.; Heinen, Richard C.; van den Berg, Henk; Aronson, Daniel C.

2008-01-01

Background. Ewing sarcomas (ES) of the chest wall are rare. Local recurrences occur in approximately 20% of these patients; however literature on this topic is scarce. Our aim was to analyze the influence of the extent of surgical resection on outcome, and to find positive prognostic factors for

Effects of Air Stacking Maneuver on Cough Peak Flow and Chest Wall Compartmental Volumes of Subjects With Amyotrophic Lateral Sclerosis.

Science.gov (United States)

Sarmento, Antonio; Resqueti, Vanessa; Dourado-Júnior, Mario; Saturnino, Lailane; Aliverti, Andrea; Fregonezi, Guilherme; de Andrade, Armele Dornelas

2017-11-01

To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination. Cross-sectional study with a matched-pair design. University hospital. Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12). CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest wall tidal volume and operational volumes, breathing pattern, and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography. Compared with healthy subjects, significantly lower CPF (P=.007), chest wall compartmental inspiratory capacity (Pprotocol in the healthy subjects, mainly because of end-inspiratory (P<.001) and abdominal volumes (P=.008). No significant differences were observed in percentage of contribution of the compartments to the inspired volume and end-expiratory volume of both groups. No significant differences were found in chest wall tidal volume, operational volume, and breathing pattern in persons with ALS. Air stacking is effective in increasing CPF, chest wall compartmental inspiratory capacity, and chest wall vital capacity of persons with ALS with no hyperinflation. Differences in compartmental volume contributions are probably because of lung and chest wall physiological changes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chest wall reconstruction with autologas rib grafts in dogs and report of a clinic case.

Science.gov (United States)

Tunçözgür, B; Elbeyli, L; Güngör, A; Işik, F; Akay, H

1999-09-01

Nowadays, in chest wall reconstruction prosthetic materials are generally used. However, the rejections of prosthetic materials and infections frequently occur in chest wall reconstruction, especially after radiotherapy or resection that is performed due to infections. We used 10 mongrel dogs and performed resections of 8 cm diameter on their chest walls. In the reconstruction of these defects, in five of the subjects, we used two free rib grafts with periosteum to be resected from the contralateral side and in other five subjects, we used free rib grafts without periosteum. After this experimental study, sternal resection was performed in a 24-year-old man because of sternal osteomyelitis. First to obtain rib grafts with periosteum, partial resection was performed to 5th, 7th, and 9th ribs of the lateral left side. After, total sternal resection, end to end anastomosis was performed to the 2nd, 3rd, 4th and 5th anterior ends of the ribs. Autogeneous rib grafts were found to be enough to provide chest wall stabilization. The contralateral autogeneous free rib grafts can successfully be used in reconstruction of wide chest wall defects. This method is found to be effective and sufficient to prevent infection, rejection and to provide stabilization.

Chest wall reconstruction in a canine model using polydioxanone mesh, demineralized bone matrix and bone marrow stromal cells.

Science.gov (United States)

Tang, Hua; Xu, Zhifei; Qin, Xiong; Wu, Bin; Wu, Lihui; Zhao, XueWei; Li, Yulin

2009-07-01

Extensive chest wall defect reconstruction remains a challenging problem for surgeons. In the past several years, little progress has been made in this area. In this study, a biodegradable polydioxanone (PDO) mesh and demineralized bone matrix (DBM) seeded with osteogenically induced bone marrow stromal cells (BMSCs) were used to reconstruct a 6 cm x 5.5 cm chest wall defect. Four experimental groups were evaluated (n=6 per group): polydioxanone (PDO) mesh/DBMs/BMSCs group, polydioxanone (PDO) mesh/DBMs group, polydioxanone (PDO) mesh group, and a blank group (no materials) in a canine model. All the animals survived except those in the blank group. In all groups receiving biomaterial implants, the polydioxanone (PDO) mesh completely degraded at 24 weeks and was replaced by fibrous tissue with thickness close to that of the normal intercostal tissue (P>0.05). In the polydioxanone (PDO) mesh/DBMs/BMSCs group, new bone formation and bone-union were observed by radiographic and histological examination. More importantly, the reconstructed rib could maintain its original radian and achieve satisfactory biomechanics close to normal ribs in terms of bending stress (P>0.05). However, in the other two groups, fibrous tissue was observed in the defect and junctions, and the reconstructed ribs were easily distorted under an outer force. Based on these results, a surgical approach utilizing biodegradable polydioxanone (PDO) mesh in combination with DBMs and BMSCs could repair the chest wall defect not only in function but also in structure.

Finite element limit loads for non-idealized through-wall cracks in thick-walled pipe

International Nuclear Information System (INIS)

Shim, Do-Jun; Han, Tae-Song; Huh, Nam-Su

2013-01-01

Highlights: • The lower bound bulging factor of thin-walled pipe can be used for thick-walled pipe. • The limit loads are proposed for thick-walled, transition through-wall cracked pipe. • The correction factors are proposed for estimating limit loads of transition cracks. • The limit loads of short transition cracks are similar to those of idealized cracks. - Abstract: The present paper provides plastic limit loads for non-idealized through-wall cracks in thick-walled pipe. These solutions are based on detailed 3-dimensional finite element (FE) analyses which can be used for structural integrity assessment of nuclear piping. To cover a practical range of interest, the geometric variables and loading conditions affecting the plastic limit loads of thick-walled pipe with non-idealized through-wall cracks were systematically varied. In terms of crack orientation, both circumferential and axial through-wall cracks were considered. As for loading conditions, axial tension, global bending, and internal pressure were considered for circumferential cracks, whereas only internal pressure was considered for axial cracks. Furthermore, the values of geometric factor representing shape characteristics of non-idealized through-wall cracks were also systematically varied. In order to provide confidence in the present FE analyses results, plastic limit loads of un-cracked, thick-walled pipe resulting from the present FE analyses were compared with the theoretical solutions. Finally, correction factors to the idealized through-wall crack solutions were developed to determine the plastic limit loads of non-idealized through-wall cracks in thick-walled pipe

Place Atrium to Water Seal (PAWS): Assessing Wall Suction Versus No Suction for Chest Tubes After Open Heart Surgery.

Science.gov (United States)

Kruse, Tamara; Wahl, Sharon; Guthrie, Patricia Finch; Sendelbach, Sue

2017-08-01

Traditionally chest tubes are set to -20 cm H 2 O wall suctioning until removal to facilitate drainage of blood, fluid, and air from the pleural or mediastinal space in patients after open heart surgery. However, no clear evidence supports using wall suction in these patients. Some studies in patients after pulmonary surgery indicate that using chest tubes with a water seal is safer, because this practice decreases duration of chest tube placement and eliminates air leaks. To show that changing chest tubes to a water seal after 12 hours of wall suction (intervention) is a safe alternative to using chest tubes with wall suction until removal of the tubes (usual care) in patients after open heart surgery. A before-and-after quality improvement design was used to evaluate the differences between the 2 chest tube management approaches in chest tube complications, output, and duration of placement. A total of 48 patients received the intervention; 52 received usual care. The 2 groups (intervention vs usual care) did not differ significantly in complications (0 vs 2 events; P = .23), chest tube output (H 1 = 0.001, P = .97), or duration of placement (median, 47 hours for both groups). Changing chest tubes from wall suction to water seal after 12 hours of wall suction is a safe alternative to using wall suctioning until removal of the tubes. ©2017 American Association of Critical-Care Nurses.

Changes in sitting posture induce multiplanar changes in chest wall shape and motion with breathing.

Science.gov (United States)

Lee, Linda-Joy; Chang, Angela T; Coppieters, Michel W; Hodges, Paul W

2010-03-31

This study examined the effect of sitting posture on regional chest wall shape in three dimensions, chest wall motion (measured with electromagnetic motion analysis system), and relative contributions of the ribcage and abdomen to tidal volume (%RC/V(t)) (measured with inductance plethysmography) in 7 healthy volunteers. In seven seated postures, increased dead space breathing automatically increased V(t) (to 1.5 V(t)) to match volume between conditions and study the effects of posture independent of volume changes. %RC/V(t) (pplane changes in sitting posture alter three-dimensional ribcage configuration and chest wall kinematics during breathing, while maintaining constant respiratory function. Copyright 2010 Elsevier B.V. All rights reserved.

Thick domain wall spacetimes with and without reflection symmetry

International Nuclear Information System (INIS)

Melfo, Alejandra; Pantoja, Nelson; Skirzewski, Aureliano

2003-01-01

We show that different thick domain wall spacetimes, for which the scalar field configuration and the potential are the same, can be found as solutions to the coupled Einstein-scalar field equations, depending on whether or not reflection symmetry on the wall is imposed. Spacetimes with reflection symmetry may be dynamic or static, while the asymmetric ones are static. Asymmetric walls are asymptotically flat on one side and reduce to the Taub spacetime on the other. Examples of asymmetric thick walls in D-dimensional spacetimes are given, and previous analysis on the distributional thin-wall limit of the dynamic symmetric thick walls are extended to the asymmetric case. A new family of reflection symmetric, static thick domain wall spacetimes, including previously known Bogomol'nyi-Prasad-Sommerfield walls, is presented

Functional results after chest wall stabilization with a new screwless fixation device

OpenAIRE

Wiese, Mark Nikolaj; Kawel-Boehm, Nadine; Moreno de la Santa, Pablo; Al-Shahrabani, Feras; Toffel, Melanie; Rosenthal, Rachel; Schäfer, Juliane; Tamm, Michael; Bremerich, Jens; Lardinois, Didier

2017-01-01

OBJECTIVES This is the experience with the Stratos system in two surgical centres for the management of two types of rib fractures: flail chest and multiple dislocated rib fractures with significant chest wall deformity. METHODS From January 2009 to May 2012, 94 consecutive patients were included. Selected indications were extended anterolateral flail chest (n = 68) and dislocated painful rib fractures (n = 26). The open reduction internal fixation (ORIF) system consists of flexible titanium ...

Extended Resection of Chest Wall Tumors with Reconstruction Using Poly Methyl Methacrylate-Mesh Prosthesis

International Nuclear Information System (INIS)

Abo Sedira, M.; Nassar, O.; Al-Ariny, A.

2003-01-01

This prospective study evaluates the early result of patients with massive chest wall tumors treated by extended resection and reconstruction using Prolene or Marlex mesh-enforced with Poly Methyl Methacrylate Bone Cement (PMMC) prosthesis. Material and Methods: This surgery was performed on 40 patients with a mean age of 45±18 (12-62) at the Department of Surgery, National Cancer Institute, Cairo University between 1998-2001. Primary chest wall tumors were the indications of surgery in 42.5%, while secondary involvement extending from other sites principally breast cancer were the indications for 57.5%. In 85% of patients more than 3 ribs were involved by tumors and lesions were more than 10 cm in the greatest dimension in 50% of cases. Resection involved sternum in 15 (37.5%) cases and in 45% of cases complete extensive rib resections extended between costovertebral junctions and the costochondral junctions were performed. Additional resections of nearby organs were needed in 20 (50%) of cases including partial lung resection in 14 cases, partial vertebral resection in 3 cases and diaphragm resection for 3 cases. Immediate bony reconstruction by inserting Prolene or Marlex mesh-enforced with Poly Methyl Methacrylate Bone Cement (PMMC) prosthesis to the resulting chest wall defect was performed in 36 cases, whereas, 4 cases had delayed reconstruction. Primary simple soft tissue closure was sufficient for 37.5% of patients; whereas 35% were covered by local rotational flap and 27.5% needed myocutaneous flaps. No patient with this immediate reconstruction needed ventilatory support or tracheostomy and flail chest was not noticed ICU stay was markedly reduced; whereas 85% required less than 7 days. Immediate post operative (40 days) complications were found in 14 patients (35%) and cases with additional lung resection had more complication rate than others (64% vs 19%). Infection occurred in 3 patients and conservative treatment for 3-4 weeks using frequent

Chest wall tuberculosis simulating breast carcinoma: Imaging appearance

International Nuclear Information System (INIS)

Goyal, M.; Sharma, R.; Sharma, A.; Swahney, S.; Berry, M.; Chumber, S.

1998-01-01

Tuberculosis of the breast is a rare disease. Tubercular abscesses predominantly affecting the soft tissues are also very infrequent. A case of chest wall tuberculosis secondarily involving the breast presenting as a hard, fixed lump simulating mammary carcinoma is presented here. There was no evidence of pleural or pulmonary tuberculosis. Copyright (1998) Blackwell Science Pty Ltd

Evaluation of a Thermoplastic Immobilization System for Breast and Chest Wall Radiation Therapy

International Nuclear Information System (INIS)

Strydhorst, Jared H.; Caudrelier, Jean-Michel; Clark, Brenda G.; Montgomery, Lynn A.; Fox, Greg; MacPherson, Miller S.

2011-01-01

We report on the impact of a thermoplastic immobilization system on intra- and interfraction motion for patients undergoing breast or chest wall radiation therapy. Patients for this study were treated using helical tomotherapy. All patients were immobilized using a thermoplastic shell extending from the shoulders to the ribcage. Intrafraction motion was assessed by measuring maximum displacement of the skin, heart, and chest wall on a pretreatment 4D computed tomography, while inter-fraction motion was inferred from patient shift data arising from daily image guidance procedures on tomotherapy. Using thermoplastic immobilization, the average maximum motion of the external contour was 1.3 ± 1.6 mm, whereas the chest wall was found to be 1.6 ± 1.9 mm. The day-to-day setup variation was found to be large, with random errors of 4.0, 12.0, and 4.5 mm in the left-right, superior-inferior, and anterior-posterior directions, respectively, and the standard deviations of the systematic errors were found to be 2.7, 9.8, and 4.1 mm. These errors would be expected to dominate any respiratory motion but can be mitigated by daily online image guidance. Using thermoplastic immobilization can effectively reduce respiratory motion of the chest wall and external contour, but these gains can only be realized if daily image guidance is used.

Volume Modulated Arc Therapy (VMAT for pulmonary Stereotactic Body Radiotherapy (SBRT in patients with lesions in close approximation to the chest wall

Directory of Open Access Journals (Sweden)

Thomas J. FitzGerald

2013-02-01

Full Text Available Chest wall pain and discomfort has been recognized as a significant late effect of radiation therapy in historical and modern treatment models. Stereotactic Body Radiotherapy (SBRT is becoming an important treatment tool in oncology care for patients with intrathoracic lesions. For lesions in close approximation to the chest wall including lesions requiring motion management, SBRT techniques can deliver high dose to the chest wall. As an unintended target of consequence, there is possibility of generating significant chest wall pain and discomfort as a late effect of therapy. The purpose of this paper is to evaluate the potential role of Volume Modulated Arc Therapy (VMAT technologies in decreasing chest wall dose in SBRT treatment of pulmonary lesions in close approximation to the chest wall.Ten patients with pulmonary lesions of various sizes and topography in close approximation to the chest wall were selected for retrospective review. All volumes including target, chest wall, ribs, and lung were contoured with maximal intensity projection maps and four-dimensional computer tomography planning. Radiation therapy planning consisted of static techniques including Intensity Modulated Radiation Therapy compared to VMAT therapy to a dose of 60Gy in 12Gy fractions. Dose volume histogram to rib, chest wall, and lung were compared between plans with statistical analysis.In all patients dose and volume were improved to ribs and chest wall using VMAT technologies compared to static field techniques. On average, volume receiving 30Gy to the chest wall was improved by 72%;the ribs by 60%. In only one patient did the VMAT treatment technique increase pulmonary volume receiving 20Gy (V20.VMAT technology has potential of limiting radiation dose to sensitive chest wall regions in patients with lesions in close approximation to this structure. This would also have potential value to lesions treated with SBRT in other body regions where targets abut critical

Cardiorespiratory effects of inelastic chest wall restriction.

Science.gov (United States)

Miller, Jordan D; Beck, Kenneth C; Joyner, Michael J; Brice, A Glenn; Johnson, Bruce D

2002-06-01

We examined the effects of chest wall restriction (CWR) on cardiorespiratory function at rest and during exercise in healthy subjects in an attempt to approximate the cardiorespiratory interactions observed in clinical conditions that result in restrictive lung and/or chest wall changes and a reduced intrathoracic space. Canvas straps were applied around the thorax and abdomen so that vital capacity was reduced by >35%. Data were acquired at rest and during cycle ergometry at 25 and 45% of peak workloads. CWR elicited significant increases in the flow-resistive work performed on the lung (160%) and the gastric pressure-time integral (>400%) at the higher workload, but it resulted in a decrease in the elastic work performed on the lung (56%) compared with control conditions. With CWR, heart rate increased and stroke volume (SV) fell, resulting in >10% fall in cardiac output at rest and during exercise at matched workloads (P < 0.05). Blood pressure and catecholamines were significantly elevated during CWR exercise conditions (P < 0.05). We conclude that CWR significantly impairs SV during exercise and that a compensatory increase in heart rate does not prevent a significant reduction in cardiac output. O(2) consumption appears to be maintained via increased extraction and a redistribution of blood flow via sympathetic activation.

Masculine Chest-Wall Contouring in FtM Transgender: a Personal Approach.

Science.gov (United States)

Lo Russo, Giulia; Tanini, Sara; Innocenti, Marco

2017-04-01

Chest-wall contouring surgery is one of the first steps in sexual reassignment in female-to-male (FtM) transsexuals that contributes to strengthening of the self-image and facilitates living in the new gender role. The main goal is to masculinize the chest by removing the female contour. Chest contour, scar placement, scar shape, scar length, nipple-areola position, nipple size and the areola size are the key points. Between July 2013 and June 2016, 25 FtM transgender patients underwent surgical procedures to create a masculine chest-wall contour. In our study, we just considered 16 patients who have undergone chest surgery with the double incision method. The patients' survey revealed a high satisfaction rate with the aesthetic result. In our group, no complications occurred, and two patients have undergone supplementary surgery for axillary dog-ear revision and nipple reconstruction. The authors propose a new technical approach and indications for FtM transgender patients' surgery. A longer scar that emphasizes the pectoralis muscle, a smaller nipple and a resized and refaced areola are the key points of our technique to give a masculine appearance to the chest. The scars are permanent, but most of them will fade and the patients are enthusiastic with their new "male" chest appearance. The high level of satisfaction, the great aesthetic result and the low rate of complications suggest to us the use of this technique in medium- and large-size breasts. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Chest wall resection for multifocal osseous haemangioma.

Science.gov (United States)

Weinandt, Marthe; Legras, Antoine; Mordant, Pierre; Le Pimpec Barthes, Françoise

2016-02-01

Intraosseous haemangioma is a rare and benign primary tumour of the bone. We report the case of a 76-year old woman who presented the exceptional condition of multifocal cavernous haemangiomas involving the spine and the ribs, requiring spinal and chest wall resections to confirm the diagnosis and treat the symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Primary chest wall Hydatid cyst: Review of literature with report of a new case

Directory of Open Access Journals (Sweden)

Abdulwahid M. Salih

Full Text Available Introduction: Hydatid cyst is a parasitic disease caused by Echinococci. The most commonly affected organ is liver, followed by lungs. Hydatid disease of the chest wall is extremely rare. The aim of this study is to report a case of chest wall Hydatid cyst with literature review. A 20-year-old pregnant lady presented with left hypochondrial and lower chest painful swelling. There was 10 × 15 centimeters, tender mass with features suggestive of abscess. The patient refused every sort of radiological examination. Under general anesthesia, oblique incision was done, on opening, clear fluid came out, with deep incision pus-like fluid and many daughter cysts drained. Complete evacuation of the cyst was done with closure of the residual cavity. The patient refused chemoprophylaxis because of her pregnancy. Conclusion: primary chest wall Hydatid cyst is a very rare disease in endemic areas. Mass and pain are the most common presentation. Excision under general anesthesia is main modality of treatment. Keywords: Hydatid cyst, Pregnancy, Albendazole

Use of omental pedicle flap for radiation induced chest wall ulcer. A case report

International Nuclear Information System (INIS)

Takamori, Shinzo; Hayashi, Akihiro; Nagamatsu, Yoshinori; Tsushimi, Mutsuo; Ono, Hirofumi; Ohtsuka, Shoji

1995-01-01

A 79-year-old female with breast carcinoma undergoing a classical Halsted radical mastectomy followed by irradiation (total; 180 Gy) 20 years before developed a left anterior chest wall ulcer. The ulcer was 10.0 x 8.0 cm in size with osteolysis of 3rd, 4th and 5th ribs, exposed pericardium, and parietal pleura with a pleuro-cutaneous fistula. After thorough debridement, an omental pedicle flap was transposed onto the chest wall defect and subsequently covered using a split-skin graft. The omental pedicle flap was 90% effective in covering the pericardial defect and resulted in a complete closure of the pleuro-cutaneous fistula. This report emphasises that an omental pedicle flap is effective in the treatment of radio-necrosis of the chest wall and also stresses the importance of judging the extent of debridement of radio-necrotic tissue. (author)

Use of omental pedicle flap for radiation induced chest wall ulcer. A case report

Energy Technology Data Exchange (ETDEWEB)

Takamori, Shinzo; Hayashi, Akihiro; Nagamatsu, Yoshinori; Tsushimi, Mutsuo; Ono, Hirofumi; Ohtsuka, Shoji [Kurume Univ., Fukuoka (Japan). School of Medicine

1995-12-01

A 79-year-old female with breast carcinoma undergoing a classical Halsted radical mastectomy followed by irradiation (total; 180 Gy) 20 years before developed a left anterior chest wall ulcer. The ulcer was 10.0 x 8.0 cm in size with osteolysis of 3rd, 4th and 5th ribs, exposed pericardium, and parietal pleura with a pleuro-cutaneous fistula. After thorough debridement, an omental pedicle flap was transposed onto the chest wall defect and subsequently covered using a split-skin graft. The omental pedicle flap was 90% effective in covering the pericardial defect and resulted in a complete closure of the pleuro-cutaneous fistula. This report emphasises that an omental pedicle flap is effective in the treatment of radio-necrosis of the chest wall and also stresses the importance of judging the extent of debridement of radio-necrotic tissue. (author).

New Methods for Imaging Evaluation of Chest Wall Deformities

Directory of Open Access Journals (Sweden)

Ana Lain

2017-12-01

Full Text Available AimThe purpose of this study is to describe the development of an external 3-dimensional (3D scanner as a noninvasive method for imaging chest wall deformities. It allows objective assessment, reconstruction of the area of interest, and evaluation of the severity of the deformity by using external indexes.External 3D scanning systemThe OrtenBodyOne scanner (Orten, Lyon, France uses depth sensors to scan the entire 3D external body surface of a patient. The depth sensors combine structured light with two classic computer vision techniques: depth from focus and depth from stereo. The data acquired are processed and analyzed using the Orten-Clinic software.Materials and methodsTo investigate the performance of the device, a preliminary prospective study (January 2015–March 2016 was carried out in patients attending our hospital chest wall deformities unit. In total, 100 patients (children and young adults with pectus excavatum or pectus carinatum, treated by surgery or non-operative methods were included. In patients undergoing non-operative treatment, external 3D scanning was performed monthly until complete correction was achieved. In surgically treated patients, scanning was done before and after surgical correction. In 42 patients, computed tomography (CT was additionally performed and correlations between the Haller index calculated by CT and the external Haller index using external scanning were investigated using a Student’s test (r = 0.83.ConclusionExternal scanning is an effective, objective, radiation-free means to diagnose and follow-up patients with chest wall deformities. Externally measured indexes can be used to evaluate the severity of these conditions and the treatment outcomes.

A clue for the diagnosis of lung cancer looking lobar consolidation with emphasis on thickness and enhancement pattern of bronchial wall on CT

International Nuclear Information System (INIS)

Yoo, Ho Seok; Kwon, Woo Cheol; Cha, Seung Whan; Kim, Sang Ha; Koh, Sang Baek; Kim, Myung Soon

2007-01-01

To differentiate between lung cancer and pneumonia for cases of lobar consolidation, with an emphasis on the thickness and enhancement pattern of the bronchial wall viewed by a CT. We retrospectively analyzed 17 patients with evidence of lobar consolidation, from a simple-chest radiographs, and divided them into groups by condition (lung cancer, n = 5; pneumonia, n 12). CT scans were performed on all patients and bronchial wall thickness, which is the cranio-caudal length of the bronchial wall thickness and the enhancement pattern, were measured and analyzed at the mediastinal window setting. The thickness of the bronchial wall in the lung cancer group (2.46 ± 0.37 mm) was significantly greater than the pneumonia group (1.73 ± 0.36 mm) (ρ = 0.002). Moreover, the bronchial wall thickness was greater than 2.0 mm for all patients in the cancer group. Further, if a diagnostic criterion was set to be larger than 2.0 mm, 100% sensitivity and 66.7% specificity would be achieved for the study subjects. The cranio-caudal length of the bronchial wall thickness in the cancer group was 37.5 ± 16.4 mm, which was significantly greater than the pneumonia group (16.3 ± 6.6 mm) (ρ = 0.001). We found no significant difference for the degree of contrast enhancement between the two groups. A CT scan measurement of the bronchial wall thickness greater than 2 mm in CT scans can be an indicator for diagnosing lung cancer in patients with lobar consolidation

Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

Directory of Open Access Journals (Sweden)

Kambiz Sheikhy

2017-01-01

Full Text Available 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.

An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy

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Baggarley Shaun

2011-01-01

Full Text Available Abstract Background To determine the usefulness of ultrasonography in the assessment of post radiotherapy skin changes in postmastectomy breast cancer patients. Methods Patients treated for postmastectomy radiotherapy in National University Hospital (NUH and Tan Tock Seng Hospital (TTSH, Singapore between January 2004- December 2005 was recruited retrospectively. Ultrasound scan was performed on these Asian patients who had been treated to a total dose of 46-50 Gy with 1 cm bolus placed on the skin. The ultrasound scans were performed blinded to the RTOG scores, and the skin thickness of the individually marked points on the irradiated chest wall was compared to the corresponding points on the non-irradiated breast. Results The mean total skin thickness inclusive of the epidermis and the dermis of the right irradiated chest wall was 0.1712 mm (± 0.03392 mm compared with the contra-lateral non-irradiated breast which was 0.1845 mm (± 0.04089 mm; p = 0.007. The left irradiated chest wall had a mean skin thickness of 0.1764 mm (± 0.03184 mm compared with the right non-irradiated breast which was 0.1835 mm (± 0.02584 mm; p = 0.025. These independent t-tests produced a significant difference of reduced skin thickness on the right irradiated chest wall, p = 0.007 (p Conclusions This study has shown that there is a statistically significant difference between the skin thicknesses of the irradiated chest wall and the contra-lateral non-irradiated breast and a predisposition to chronic reactions was found in patients with acute RTOG scoring of grade1 and grade 2.

Bladder wall thickness mapping for magnetic resonance cystography

International Nuclear Information System (INIS)

Zhao Yang; Liang Zhengrong; Zhu Hongbin; Han Hao; Yan Zengmin; Duan Chaijie; Lu Hongbing; Gu Xianfeng

2013-01-01

Clinical studies have shown evidence that the bladder wall thickness is an effective biomarker for bladder abnormalities. Clinical optical cystoscopy, the current gold standard, cannot show the wall thickness. The use of ultrasound by experts may generate some local thickness information, but the information is limited in field-of-view and is user dependent. Recent advances in magnetic resonance (MR) imaging technologies lead MR-based virtual cystoscopy or MR cystography toward a potential alternative to map the wall thickness for the entire bladder. From a high-resolution structural MR volumetric image of the abdomen, a reasonable segmentation of the inner and outer borders of the bladder wall can be achievable. Starting from here, this paper reviews the limitation of a previous distance field-based approach of measuring the thickness between the two borders and then provides a solution to overcome the limitation by an electric field-based strategy. In addition, this paper further investigates a surface-fitting strategy to minimize the discretization errors on the voxel-like borders and facilitate the thickness mapping on the three-dimensional patient-specific bladder model. The presented thickness calculation and mapping were tested on both phantom and human subject datasets. The results are preliminary but very promising with a noticeable improvement over the previous distance field-based approach. (paper)

Color structured light system of chest wall motion measurement for respiratory volume evaluation

Science.gov (United States)

Chen, Huijun; Cheng, Yuan; Liu, Dongdong; Zhang, Xiaodong; Zhang, Jue; Que, Chengli; Wang, Guangfa; Fang, Jing

2010-03-01

We present a structured light system to dynamically measure human chest wall motion for respiratory volume estimation. Based on a projection of an encoded color pattern and a few active markers attached to the trunk, respiratory volumes are obtained by evaluating the 3-D topographic changes of the chest wall in an anatomically consistent measuring region during respiration. Three measuring setups are established: a single-sided illuminating-recording setup for standing posture, an inclined single-sided setup for supine posture, and a double-sided setup for standing posture. Results are compared with the pneumotachography and show good agreement in volume estimations [correlation coefficient: R>0.99 (Pvolume during the isovolume maneuver (standard deviationpulmonary functional differences between the diseased and the contralateral sides of the thorax, and subsequent improvement of this imbalance after drainage. These results demonstrate the proposed optical method is capable of not only whole respiratory volume evaluation with high accuracy, but also regional pulmonary function assessment in different chest wall behaviors, with the advantage of whole-field measurement.

Ewing's sarcoma: a neuroectodermal tumor of the chest wall

International Nuclear Information System (INIS)

Alcaraz, M. J.; Lorente, M. L.; Martin, A. M.; Gonzalez, I.

2000-01-01

Ewing's sarcoma is the second most common malignant bone tumor in children and young adults. It is most prevalent between the ages of 10 and 15 years. There are present two cases of Ewing's sarcoma of the chest wall. The clinical, radiological and pathological features are described and the therapeutic options are discussed. (Author)

Finite element modeling of single-walled carbon nanotubes with introducing a new wall thickness

International Nuclear Information System (INIS)

Jalalahmadi, B; Naghdabadi, R

2007-01-01

A three-dimensional finite element (FE) model for armchair, zigzag and chiral single-walled carbon nanotubes (SWCNTs) is proposed. By considering the covalent bonds as connecting elements between carbon atoms, a nanotube is simulated as a space frame-like structure. Here, the carbon atoms act as joints of the connecting elements. To create the FE models, nodes are placed at the locations of carbon atoms and the bonds between them are modeled using three-dimensional elastic beam elements. Using Morse atomic potential, the elastic moduli of beam elements are obtained via considering a linkage between molecular and continuum mechanics. Also, a new wall thickness ( bond diameter) equal to 0.1296 nm is introduced. In order to demonstrate the applicability of FE model and new wall thickness, the influence of tube wall thickness, diameter and chirality on the Young's modulus of SWCNTs is investigated. It is found that the choice of wall thickness significantly affects the calculation of Young's modulus. For the values of wall thickness used in the literature, the Young's moduli are estimated which agree very well with the corresponding theoretical results and experimental measurements. We also investigate the dependence of elastic moduli on diameter and chirality of the nanotube. The larger tube diameter, the higher Young's modulus of SWCNT. The Young's modulus of chiral SWCNTs is found to be generally larger than that of armchair and zigzag SWCNTs. The presented results demonstrate that the proposed FE model and wall thickness may provide a valuable tool for studying the mechanical behavior of carbon nanotubes and their application in nano-composites

Bodybuilding-induced Mondor's disease of the chest wall.

Science.gov (United States)

Tröbinger, Christian; Wiedermann, Christian J

2017-01-01

To describe the association of bodybuilding abdominal exercise with the development of superficial sclerosing thrombophlebitis of the anterolateral thoracoabdominal wall. A single case study. University-affiliated regional community hospital. A 54-year-old man presented with an otherwise unremarkable past medical history 4 weeks after the start of left-sided chest discomfort. He had undergone orthopedic surgery of the right shoulder three months earlier. Two months after surgery, he had re-started bodybuilding with thoracoabdominal training. Soon thereafter, he noted a painful induration at the left side of his trunk. Doppler and duplex sonography revealed complete venous occlusion compatible with sclerosing thrombophlebitis leading to a palpable, subcutaneous, cord-like lesion on the left side of his trunk. Physical examination and routine laboratory findings were normal. The lesion spontaneously resolved over a course of 3 months. Mondor's disease of the subcutaneous veins of the chest wall which has been associated with breast or axillary surgery, malignant and systemic diseases can also appear in subjects performing intense thoracoabdominal exercise training. Although it requires only symptomatic therapy, physicians and therapists must be aware of the existence of this disease because, although benign and self-limiting, malignant and systemic diseases need to be ruled out. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reconstruction of the chest wall after excision of a giant malignant ...

African Journals Online (AJOL)

2011-07-29

Jul 29, 2011 ... Malignant peripheral nerve sheath tumor (MPNST) of the chest wall is even rarer and its incidence on ... manubrium. There was no preceding history of trauma, fever, ... were related to pneumothorax and respiratory failures.[5].

Histology types of chest wall tumours: Fifteen year single center ...

African Journals Online (AJOL)

Materials and Methods: We performed a retrospective study of chest wall tumours at our institution(NCTCE, UNTH, Enugu, Nigeria), for a period of 15 years, spanning October, 2001 to September, 2015.The pathologic reports were retrieved from the hospital pathology archives and correlated with patients' copies in the ...

Poster – 41: External marker block placement on the breast or chest wall for left-sided deep inspiration breath-hold radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Conroy, Leigh; Guebert, Alexandra; Smith, Wendy [Tom Baker Cancer Centre (Canada)

2016-08-15

Purpose: We investigate DIBH breast radiotherapy using the Real-time Position Management (RPM) system with the marker-block placed on the target breast or chest wall. Methods: We measured surface dose for three different RPM marker-blocks using EBT3 Gafchromic film at 0° and 30° incidence. A registration study was performed to determine the breast surface position that best correlates with overall internal chest wall position. Surface and chest wall contours from MV images of the medial tangent field were extracted for 15 patients. Surface contours were divided into three potential marker-block positions on the breast: Superior, Middle, and Inferior. Translational registration was used to align the partial contours to the first-fraction contour. Each resultant transformation matrix was applied to the chest wall contour, and the minimum distance between the reference chest wall contour and the transformed chest wall contour was evaluated for each pixel. Results: The measured surface dose for the 2-dot, 6-dot, and 4-dot marker-blocks at 0° incidence were 74%, 71%, and 77% of dose to dmax respectively. At 30° beam incidence this increased to 76%, 72%, and 81%. The best external surface position was patient and fraction dependent, with no consistent best choice. Conclusions: The increase in surface dose directly under the RPM block is approximately equivalent to 3 mm of bolus. No marker-block position on the breast surface was found to be more representative of overall chest wall motion; therefore block positional stability and reproducibility can be used to determine optimal placement on the breast or chest wall.

Study of frequency of operated chest wall tumors In Al Zahra hospital from 2007 to 2009,Isfahan,Iran

Directory of Open Access Journals (Sweden)

seyed abas Tabatabai

2011-08-01

Conclusion: According to the results of this study about 59% of the chest wall tumors were malignant and in the case of being hesitant about existing a mass on the chest wall, needed measurements for treatmentand and on time removal of the mass must be done.

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report

International Nuclear Information System (INIS)

Lee, Yeon Soo; Park, Kuhn; Kim, Jong Ok; Choi, Eun Seok; Kang, Si Won

2011-01-01

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Yeon Soo; Park, Kuhn; Kim, Jong Ok; Choi, Eun Seok; Kang, Si Won [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of)

2011-02-15

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

Ultrasonographic study of gallbladder wall thickness in acute viral hepatitis

Energy Technology Data Exchange (ETDEWEB)

Lim, Jin Sook; Kim, Kyung Jung; Park, Yang Hee; Kang, Ik Won; Yoon, Jong Sup [Hanyang Sacred Heart Hospital, Hallym University Medical Center, Seoul (Korea, Republic of)

1984-09-15

Prospective study of gallbladder wall thickness by ultrasonography was performed in 38 patients of acute viral hepatitis and 50 normal subjects as a control group from June 1983 to April 1984. The results were as follows; 1. In normal population, the range of gallbladder wall thickness is from 1 mm to 3 mm with peak incidence in 2 mm (66%, 33 case). Mean thickness of gallbladder wall is about 1.9 {+-} 0.6 mm. 2. In acute viral hepatitis, the range of gallbladder wall thickness is from 2 mm to 8 mm with peak incidence in 3 mm (34%, 13 case), second peak in 4 mm (29%, 11 case). Mean thickness of gallbladder wall is about 3.6 {+-} 1.6 mm, which is thicker than normal with statistical significance. (p<0.005) 3. In acute viral hepatitis, the mean thickness of gallbladder wall is about 4.4 {+-} 1.8 mm in the group of SGOT/SGPT level above 400 IU, and 2.8 {+-} 0.8 mm in the group of SGOT/ SGPT level below 400 IU. This difference is significant statistically. (p<0.05)

Ultrasonographic study of gallbladder wall thickness in acute viral hepatitis

International Nuclear Information System (INIS)

Lim, Jin Sook; Kim, Kyung Jung; Park, Yang Hee; Kang, Ik Won; Yoon, Jong Sup

1984-01-01

Prospective study of gallbladder wall thickness by ultrasonography was performed in 38 patients of acute viral hepatitis and 50 normal subjects as a control group from June 1983 to April 1984. The results were as follows; 1. In normal population, the range of gallbladder wall thickness is from 1 mm to 3 mm with peak incidence in 2 mm (66%, 33 case). Mean thickness of gallbladder wall is about 1.9 ± 0.6 mm. 2. In acute viral hepatitis, the range of gallbladder wall thickness is from 2 mm to 8 mm with peak incidence in 3 mm (34%, 13 case), second peak in 4 mm (29%, 11 case). Mean thickness of gallbladder wall is about 3.6 ± 1.6 mm, which is thicker than normal with statistical significance. (p<0.005) 3. In acute viral hepatitis, the mean thickness of gallbladder wall is about 4.4 ± 1.8 mm in the group of SGOT/SGPT level above 400 IU, and 2.8 ± 0.8 mm in the group of SGOT/ SGPT level below 400 IU. This difference is significant statistically. (p<0.05)

A case of divided latissimus dorsi flap repair for chest wall defect after wide resection of post-irradiation angiosarcoma

International Nuclear Information System (INIS)

Matsubara, Yukiko; Sawaizumi, Masayuki; Imai, Tomohiro; Maeda, Takuma; Fujita, Kazutoshi; Matsumoto, Seiichi; Iwase, Takuji; Motoi, Noriko; Kanda, Hiroaki

2011-01-01

We report the case of a 76-year-old woman who had undergone breast-conserving surgery for left breast cancer, followed by irradiation at a total dose of 66 Gy in 2005. When 5 years 1 month had elapsed after the operation, redness of the left chest wall was observed. A biopsy was performed and the histopathological diagnosis was angiosarcoma. Extended resection of the full thickness of the skin was performed. Adequate resection left a massive defect 15 x 18 cm in size. The divided latissimus dorsi flap was designed, and the oval-shaped skin defect was closed with the skin island of this flap. Post-irradiation sarcoma involving the vessels is a rare entity and occurs in 0.07-0.48% of all cases after radiation therapy. It metastasizes to the distant organs in an early stage and has a poor prognosis. No standard therapy for the disease has been established. Early detection and extended resection are considered to contribute to improvement of the prognosis. The divided latissimus dorsi flap is very useful for reconstructing a wide chest wall defect without the need to wide skin graft the donor site. (author)

Parametric Investigation of Optimum Thermal Insulation Thickness for External Walls

Directory of Open Access Journals (Sweden)

Omer Kaynakli

2011-06-01

Full Text Available Numerous studies have estimated the optimum thickness of thermal insulation materials used in building walls for different climate conditions. The economic parameters (inflation rate, discount rate, lifetime and energy costs, the heating/cooling loads of the building, the wall structure and the properties of the insulation material all affect the optimum insulation thickness. This study focused on the investigation of these parameters that affect the optimum thermal insulation thickness for building walls. To determine the optimum thickness and payback period, an economic model based on life-cycle cost analysis was used. As a result, the optimum thermal insulation thickness increased with increasing the heating and cooling energy requirements, the lifetime of the building, the inflation rate, energy costs and thermal conductivity of insulation. However, the thickness decreased with increasing the discount rate, the insulation material cost, the total wall resistance, the coefficient of performance (COP of the cooling system and the solar radiation incident on a wall. In addition, the effects of these parameters on the total life-cycle cost, payback periods and energy savings were also investigated.

Primary infiltrating ductal carcinoma of the axillary breast with metastasis to the contralateral chest wall

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Li-Min Sun

2013-06-01

Full Text Available Primary infiltrating ductal carcinoma of the axillary breast is rare and has a high frequency of lymph node (LN involvement. We report a woman with primary infiltrating ductal carcinoma arising from the right axillary breast with metastasis to the contralateral chest wall. Excisional biopsy of the left chest wall nodule and the right axillary mass was carried out and both showed invasive ductal carcinomas histologically. The lesion of the right axillary mass arose from the breast tissue, rather than the LN. Further surgery proved the right axillary LN metastasis. After further review, a primary infiltrating ductal carcinoma of the right axillary breast with metastasis to axillary LNs and contralateral chest wall was diagnosed. The patient also received chemotherapy and radiation and there was no evidence of tumor recurrence after treatment. The present report demonstrated a rare case with uncommon manifestation. Lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma.

Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy.

Science.gov (United States)

Laan, Danuel V; Vu, Trang Diem N; Thiels, Cornelius A; Pandian, T K; Schiller, Henry J; Murad, M Hassan; Aho, Johnathon M

2016-04-01

Current Advanced Trauma Life Support guidelines recommend decompression for thoracic tension physiology using a 5-cm angiocatheter at the second intercostal space (ICS) on the midclavicular line (MCL). High failure rates occur. Through systematic review and meta-analysis, we aimed to determine the chest wall thickness (CWT) of the 2nd ICS-MCL, the 4th/5th ICS at the anterior axillary line (AAL), the 4th/5th ICS mid axillary line (MAL) and needle thoracostomy failure rates using the currently recommended 5-cm angiocatheter. A comprehensive search of several databases from their inception to July 24, 2014 was conducted. The search was limited to the English language, and all study populations were included. Studies were appraised by two independent reviewers according to a priori defined PRISMA inclusion and exclusion criteria. Continuous outcomes (CWT) were evaluated using weighted mean difference and binary outcomes (failure with 5-cm needle) were assessed using incidence rate. Outcomes were pooled using the random-effects model. The search resulted in 34,652 studies of which 15 were included for CWT analysis, 13 for NT effectiveness. Mean CWT was 42.79 mm (95% CI, 38.78-46.81) at 2nd ICS-MCL, 39.85 mm (95% CI, 28.70-51.00) at MAL, and 34.33 mm (95% CI, 28.20-40.47) at AAL (P=.08). Mean failure rate was 38% (95% CI, 24-54) at 2nd ICS-MCL, 31% (95% CI, 10-64) at MAL, and 13% (95% CI, 8-22) at AAL (P=.01). Evidence from observational studies suggests that the 4th/5th ICS-AAL has the lowest predicted failure rate of needle decompression in multiple populations. Level 3 SR/MA with up to two negative criteria. Therapeutic. Copyright © 2015 Elsevier Ltd. All rights reserved.

Load bearing capacity of welded joints between dissimilar pipelines with unequal wall thickness

Energy Technology Data Exchange (ETDEWEB)

Beak, Jonghyun; Kim, Youngpyo; Kim, Woosik [Korea Gas Corporation, Suwon (Korea, Republic of)

2012-09-15

The behavior of the load bearing capacity of a pipeline with unequal wall thickness was evaluated using finite element analyses. Pipelines with a wall thickness ratio of 1.22-1.89 were adopted to investigate plastic collapse under tensile, internal pressure, or bending stress. A parametric study showed that the tensile strength and moment of a pipeline with a wall thickness ratio less than 1.5 were not influenced by the wall thickness ratio and taper angle; however, those of a pipeline with a wall thickness ratio more than 1.5 decreased considerably at a low taper angle. The failure pressure of a pipeline with unequal wall thickness was not influenced by the wall thickness ratio and taper angle.

Chest-wall reconstruction with a customized titanium-alloy prosthesis fabricated by 3D printing and rapid prototyping.

Science.gov (United States)

Wen, Xiaopeng; Gao, Shan; Feng, Jinteng; Li, Shuo; Gao, Rui; Zhang, Guangjian

2018-01-08

As 3D printing technology emerge, there is increasing demand for a more customizable implant in the repair of chest-wall bony defects. This article aims to present a custom design and fabrication method for repairing bony defects of the chest wall following tumour resection, which utilizes three-dimensional (3D) printing and rapid-prototyping technology. A 3D model of the bony defect was generated after acquiring helical CT data. A customized prosthesis was then designed using computer-aided design (CAD) and mirroring technology, and fabricated using titanium-alloy powder. The mechanical properties of the printed prosthesis were investigated using ANSYS software. The yield strength of the titanium-alloy prosthesis was 950 ± 14 MPa (mean ± SD), and its ultimate strength was 1005 ± 26 MPa. The 3D finite element analyses revealed that the equivalent stress distribution of each prosthesis was unifrom. The symmetry and reconstruction quality contour of the repaired chest wall was satisfactory. No rejection or infection occurred during the 6-month follow-up period. Chest-wall reconstruction with a customized titanium-alloy prosthesis is a reliable technique for repairing bony defects.

Wall thickness of major coronary arteries in Pakistani population

International Nuclear Information System (INIS)

Ullah, Q.W.; Qamar, K.; Butt, S.A.; Butt, S.A.

2012-01-01

To measure the wall thickness of major coronary arteries in Pakistani population, through micrometry. Study design: An observational study. Place and duration of study: Combined Military Hospital Rawalpindi, Khyber Medical College Peshawar and District Headquarter Hospital, Rawalpindi, in collaboration with Departments of Anatomy and Pathology, Army Medical College Rawalpindi. The duration of study was six months with effect from September 2009 to March 2010. Material and methods: After incising pericardium, 1 mm long segments of major coronary arteries i.e. right coronary artery (RCA), left anterior descending artery (LAD) and left circumflex artery (LCX) were taken 1cm distal to their origin, from adult male cadavers of up to 40 years age. After processing for paraffin embedding, 5 mu m thick sections were prepared, mounted on glass slides and subsequently stained with Hematoxylin and Eosin (H and E) for routine histological study. Verhoeff's elastic stain was used to make the elastic lamina more prominent. Wall thickness for each section was measured through micrometry, circumferentially at eight different places along the planes at 45 deg. to each other and then their mean taken as a reading for the respective artery. Results: The total wall thickness of major coronary arteries and of the individual tunicae was less in Pakistani population. The mean thickness of RCA was 0.61 +- 0.05 mm; LAD had mean thickness of 0.55 +- 0.06 mm whereas that of LCX was 0.66 +- 0.13 mm. The mean thickness of tunica intima of RCA was noted to be 0.230 +- 0.044 mm; tunica media measured 0.205 +- 0.031 mm whereas tunica adventitia was 0.172 +- 0.023 mm thick. The mean thickness of tunica intima of LAD measured 0.156 +- 0.032 mm; tunica media was observed to be 0.224 +- 0.026 mm thick whereas the tunica adventitia was 0.170 +- 0.032 mm thick. The mean thickness of tunica intima of LCX was observed to be 0.203 +- 0.059 mm; tunica media to be 0.282 +- 0.097 mm whereas that of tunica

Vesicular thick-walled swollen hyphae in pulmonary zygomycosis.

Science.gov (United States)

Kimura, Masatomo; Ito, Hiroyuki

2009-03-01

An autopsy case of pulmonary zygomycosis in a patient with rheumatoid arthritis on immunosuppressive therapy is presented herein. There was a pulmonary cavitated infarct caused by mycotic thrombosis. Thin-walled narrow hyphae and vesicular thick-walled swollen hyphae were found on the pleural surface and in the necrotic tissue at the periphery of the cavity. Findings of such shaped fungal elements may cause erroneous histopathological diagnosis because pauciseptate broad thin-walled hyphae are usually the only detectable fungal elements in zygomycosis tissue. Although immunohistochemistry confirmed these unusual elements to be zygomycetous in the present case, it is important for the differential diagnosis to be aware that zygomycetes can form thin narrow hyphae and vesicular thick-walled swollen hyphae.

Mortality by Level of Emphysema and Airway Wall Thickness

DEFF Research Database (Denmark)

Johannessen, Ane; Skorge, Trude Duelien; Bottai, Matteo

2013-01-01

There is limited knowledge of the prognostic value of quantitative computed tomography (CT) measures of emphysema and airway wall thickness (AWT) on mortality.......There is limited knowledge of the prognostic value of quantitative computed tomography (CT) measures of emphysema and airway wall thickness (AWT) on mortality....

Post mastectomy linac IMRT irradiation of chest wall and regional nodes: dosimetry data and acute toxicities

International Nuclear Information System (INIS)

Ma, Jinli; Li, Jiongyan; Xie, Jiang; Chen, Jian; Zhu, Chuanying; Cai, Gang; Zhang, Zhen; Guo, Xiaomao; Chen, Jiayi

2013-01-01

Conventional post-mastectomy radiation therapy is delivered with tangential fields for chest wall and separate fields for regional nodes. Although chest wall and regional nodes delineation has been discussed with RTOG contouring atlas, CT-based planning to treat chest wall and regional nodes as a whole target has not been widely accepted. We herein discuss the dosimetric characteristics of a linac IMRT technique for treating chest wall and regional nodes as a whole PTV after modified radical mastectomy, and observe acute toxicities following irradiation. Patients indicated for PMRT were eligible. Chest wall and supra/infraclavicular region +/−internal mammary nodes were contoured as a whole PTV on planning CT. A simplified linac IMRT plan was designed using either integrated full beams or two segments of half beams split at caudal edge of clavicle head. DVHs were used to evaluate plans. The acute toxicities were followed up regularly. Totally, 85 patients were enrolled. Of these, 45 had left-sided lesions, and 35 received IMN irradiation. Planning designs yielded 55 integrated and 30 segmented plans, with median number of beams of 8 (6–12). The integrated and segmented plans had similar conformity (1.41±0.14 vs. 1.47±0.15, p=0.053) and homogeneity indexes (0.13±0.01 vs. 0.14±0.02, p=0.069). The percent volume of PTV receiving >110% prescription dose was <5%. As compared to segmented plans, integrated plans typically increased V 5 of ipsilateral lung (p=0.005), and heart (p=0.001) in patients with left-sided lesions. Similarly, integrated plans had higher spinal cord D max (p=0.009), ipsilateral humeral head (p<0.001), and contralateral lung D mean (p=0.019). During follow-up, 36 (42%) were identified to have ≥ grade 2 radiation dermatitis (RD). Of these, 35 developed moist desquamation. The median time to onset of moist desquamation was 6 (4–7) weeks from start of RT. The sites of moist desquamation were most frequently occurred in anterior axillary

Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure.

Science.gov (United States)

Cherubino, Mario; Maggiulli, Francesca; Pellegatta, Igor; Valdatta, Luigi

2016-01-01

Poland's syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF). In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.

Extra-Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass

Directory of Open Access Journals (Sweden)

Junghyeon Lim

2017-08-01

Full Text Available A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST. En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

Chest wall – underappreciated structure in sonography. Part II: Non-cancerous lesions

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Andrzej Smereczyński

2017-12-01

Full Text Available The chest wall is a vast and complex structure, hence the wide range of pathological conditions that may affect it. The aim of this publication is to discuss the usefulness of ultrasound for the diagnosis of benign lesions involving the thoracic wall. The most commonly encountered conditions include sternal and costal injuries and thoracic lymphadenopathy. Ultrasound is very efficient in identifying the etiology of pain experienced in the anterior chest wall following CPR interventions. Both available literature and the authors’ own experience prompt us to propose ultrasound evaluation as the first step in the diagnostic workup of chest trauma, as it permits far superior visualization of the examined structures compared with conventional radiography. Sonographic evaluation allows correct diagnosis in the case of various costal and chondral defects suspicious for cancer. It also facilitates diagnosis of such conditions as degenerative lesions, subluxation of sternoclavicular joints (SCJs and inflammatory lesions of various etiology and location. US may be used as the diagnostic modality of choice in conditions following thoracoscopy or thoracotomy. It may also visualize the fairly common sternal wound infection, including bone inflammation. Slipping rib syndrome, relatively little known among clinicians, has also been discussed in the study. A whole gamut of benign lesions of thoracic soft tissues, such as enlarged lymph nodes, torn muscles, hematomas, abscesses, fissures, scars or foreign bodies, are all easily identified on ultrasound, just like in other superficially located organs.

Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

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Shao, Zhi Hong; Gao, Xiao Long; Yi, Xiang Hua; Wang, Pei Jun [Tongji Hospital of Tongji University, Shanghai (China)

2011-11-15

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

International Nuclear Information System (INIS)

Shao, Zhi Hong; Gao, Xiao Long; Yi, Xiang Hua; Wang, Pei Jun

2011-01-01

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

Operative fixation of chest wall fractures: an underused procedure?

Science.gov (United States)

Richardson, J David; Franklin, Glen A; Heffley, Susan; Seligson, David

2007-06-01

Chest wall fractures, including injuries to the ribs and sternum, usually heal spontaneously without specific treatment. However, a small subset of patients have fractures that produce overlying bone fragments that may produce severe pain, respiratory compromise, and, if untreated mechanically, result in nonunion. We performed open reduction and internal fixation on seven patients with multiple rib fractures-five in the initial hospitalization and two delayed--as well as 35 sternal fractures (19 immediate fixation and 16 delayed). Operative fixation was accomplished using titanium plates and screws in both groups of patients. All patients with rib fractures did well; there were no major complications or infections, and no plates required removal. Clinical results were excellent. There was one death in the sternal fracture group in a patient who was ventilator-dependent preoperatively and extubated himself in the early postoperative period. Otherwise, the results were excellent, with no complications occurring in this group. Three patients had their plates removed after boney union was achieved. No evidence of infection or nonunion occurred. The excellent results achieved in the subset of patients with severe chest wall deformities treated initially at our institution and those referred from outside suggest that operative fixation is a useful modality that is likely underused.

An unusual case of grass inflorescence aspiration presenting as a chest wall tumour

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Karagoez, Beguel; Koeksal, Yavuz; Varan, Ali; Bueyuekpamukcu, Muenevver [Hacettepe University, Department of Paediatric Oncology, Institute of Oncology, Ankara (Turkey); Haliloglu, Mithat [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Ekinci, Saniye [Hacettepe University, Department of Paediatric Surgery, Faculty of Medicine, Ankara (Turkey)

2006-05-15

A 9-year-old boy was referred to the Oncology Department because of a thoracic soft-tissue mass thought to be a chest wall tumour. He had a history of grass inflorescence (Hordeum murinum) aspiration 2 weeks prior to this admission. On physical examination a tender soft-tissue mass under the right scapula and diminished breath sounds from the right lower lobe were detected. Thoracic CT confirmed soft-tissue swelling of the right posterior chest wall. There was a hypodense area within the soft-tissue mass suggesting a foreign body and also focal consolidation of the right lower lobe adjacent to the soft-tissue swelling. We report here unique CT findings of grass inflorescence aspiration before and after its migration through the airways. (orig.)

An unusual case of grass inflorescence aspiration presenting as a chest wall tumour

International Nuclear Information System (INIS)

Karagoez, Beguel; Koeksal, Yavuz; Varan, Ali; Bueyuekpamukcu, Muenevver; Haliloglu, Mithat; Ekinci, Saniye

2006-01-01

A 9-year-old boy was referred to the Oncology Department because of a thoracic soft-tissue mass thought to be a chest wall tumour. He had a history of grass inflorescence (Hordeum murinum) aspiration 2 weeks prior to this admission. On physical examination a tender soft-tissue mass under the right scapula and diminished breath sounds from the right lower lobe were detected. Thoracic CT confirmed soft-tissue swelling of the right posterior chest wall. There was a hypodense area within the soft-tissue mass suggesting a foreign body and also focal consolidation of the right lower lobe adjacent to the soft-tissue swelling. We report here unique CT findings of grass inflorescence aspiration before and after its migration through the airways. (orig.)

Estimating adipose tissue in the chest wall using ultrasonic and alternate 40K and biometric measurements

International Nuclear Information System (INIS)

Anderson, A.L.; Campbell, G.W.

1982-01-01

The percentage of adipose (fat) tissue in the chest wall must be known to accurately measure Pu in the human lung. Correction factors of 100% or more in x-ray detection efficiency are common. Methods using simple 40 K and biometric measurement techniques were investigated to determine the adipose content in the human chest wall. These methods predict adipose content to within 15% of the absolute ultrasonic value. These new methods are discussed and compared with conventional ultrasonic measurement techniques

Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

Directory of Open Access Journals (Sweden)

Mario Cherubino

2016-01-01

Full Text Available Poland's syndrome (PS is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF. In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.

Repair of chest wall defects after irradiation for breast cancer

Energy Technology Data Exchange (ETDEWEB)

Hughes, L E

1976-03-01

A simple technique using a contralateral deltopectoral flap is described for the immediate repair of defects of the chest wall resulting from excision of radionecrosis or persistent tumour after radiotherapy. Successful use in 3 consecutive cases has shown that the deltopectoral flap may be rotated through a full 180/sup 0/ without compromise of blood supply and that primary healing may be obtained.

Hemorrhagic lesion on the chest wall after trauma.

LENUS (Irish Health Repository)

Roche, Lisa

2018-01-01

A 59-year-old woman presented with a burning, rapidly progressive mass on the midchest, occurring after a fall, 4 months prior. Examination found a large well-circumscribed mass over the lower xiphisternum (Figs 1 and 2). Results of baseline investigations were normal apart from mildly elevated liver function values. A computerized tomography scan confirmed a 6.4- x 4.9-cm lobulated soft tissue heterogeneous-density mass located in the subcutaneous fat with ill-defined borders and no obvious infiltration of the chest wall. A single focal abnormality\\r\

Pneumothorax, without chest wall fracture, following airbag deployment

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Samuel Parsons

2010-12-01

Full Text Available Air bags are an automatic crash protection system. They have been shown to reduce mortality from motor vehicle accidents by 31% following direct head-on impacts, by 19% following any frontal impact and by 11% overall. Despite obvious benefits there has been a corresponding increase in the number of injuries resulting from their deployment. We describe a case of a pneumothorax in the absence of chest wall pathology associated with airbag deployment, in a belted driver. There has been one previous description of pneumothorax associated with airbag deployment, in an unbelted driver.

Clad vent set cup open end (closure weld zone) wall-thickness study

Energy Technology Data Exchange (ETDEWEB)

Ulrich, G.B.; Sherrill, M.W.

1994-09-01

The wall thickness at the open end of Clad Vent Set (CVS) cups is a very important parameter for maintaining control of the fueled CVS closure weld process. Ideally, the wall thickness in the closure weld zone should be constant. The DOP-26 iridium alloy is very difficult to machine; therefore, key dimensional features are established during the two-draw warm-forming operation. Unfortunately, anisotropy in the forming blanks produces four ears at the open end of each cup. Formation of these ears produces axial and circumferential variations in wall thickness. The cup certification requirement is that the wall thickness in the closure weld zone, defined as the 2.5-mm band at the open end of a cup, measure from 0.63 to 0.73 mm. The wall thickness certification data for the open end of the CVS cups have been statistically evaluated. These data show that the cups recently produced for the Cassini mission have well-controlled open-end wall thicknesses.

Sonographic Measurement of AP Diameter and Wall Thickness of the Gallbladder

International Nuclear Information System (INIS)

Chung, S.K.; Lee, J. S.; Huh, S. J.; Baek, I. S.

1982-01-01

Call bladder size and wall thickness are important in the assessment of the pathologic condition. Authors have measured AP diameter of gallbladder and evaluated the change of all thickness between fasting and postprandial state. The results were as follows: 1. The mean of AP diameter was 2.18+0.49cm 2. The wall thickness was 2.7+0.6mm in fasting state and 3.3+0.8mm after meal. 3. The increase of wall thickness after fat meal was significant statistically(p<.001)

Osteosarcoma in the anterior chest wall that developed 20 years after postoperative radiotherapy for breast cancer

International Nuclear Information System (INIS)

Murata, Mariko; Shoji, Tsuyoshi; Nakayama, Ei; Bando, Toru

2008-01-01

Sarcomas are a rare complication of radiotherapy for breast cancer and such patients have a poor prognosis. We report resection of an osteosarcoma in the chest wall that developed 20 years after postoperative radiotherapy for breast cancer. A 57-year-old woman was referred to our department for examination and treatment of an anterior chest wall tumor in April 2007. In September 1986, she had undergone a radical mastectomy and postoperative irradiation and chemotherapy for right breast cancer. In December 2003, she underwent chemotherapy for recurrence of breast cancer which was pointed out on computed tomography involving the pleura and left superior clavicular lymph nodes. In March 2006, follow-up computed tomography of the chest demonstrated the destruction of the sternum, which was diagnosed as recurrence and she was followed with chemotherapy for breast cancer continuously thereafter. In April 2007, because of the developing sternal tumor, excisional biopsy was performed and histopathology indicated sarcoma. In May 2007, resection of the chest wall tumor with the sternum, bilateral clavicles, bilateral first and second ribs, and right partial lung (upper and middle lobe) were performed, and the chest wall defect was reconstructed with a rectus abdominis musculocutaneous free flap. Histopathologically, the tumor was osteosarcoma with margin free. Adjuvant radiotherapy to the breast plays a significant role in preventing local disease recurrence in women treated for breast cancer. However, radiotherapy can induce malignant sarcoma after a latency period of several years. The risk is extremely low for the individual patient, but this disease is aggressive and associated with a poor overall prognosis. Therefore, early detection is necessary for optimal treatment and incisional biopsy is necessary for accurate diagnosis. (author)

[A case of group G Streptococcus sepsis, chest wall abscess, and vertebral osteomyelitis mimicking a primary lung cancer with bone metastasis].

Science.gov (United States)

Hayashi, Yumeko; Ishii, Yoshiki; Arai, Ryo; Obara, Kazuki; Kamada, Aya; Takizawa, Hidenori; Hase, Isano; Mashio, Kazuki; Yamada, Issei; Takemasa, Akihiro; Sugiyama, Kumiya; Fukushima, Yasutsugu; Fukuda, Takeshi

2007-01-01

A 73-year-old woman who had been followed in our department of gynecology because of ovarian cancer since 2002, was admitted with liver dysfunction and complaining of back pain and light precordial chest pain. The chest radiograph on admission revealed a tumor in her left upper lung field, and chest CT revealed a tumor adjacent to the chest wall and mediastinum. FDG-positron emission tomography (PET) showed abnormal uptake in the tumor and Th6/7, and the subaortic lymph nodes. On the basis of these findings, primary lung cancer with bone metastasis was suspected. She had a high grade fever on admission, and blood cultures were positive for group G streptococcus. The treatment with intravenous penicillin was started. Percutaneous biopsy of the tumor in her left chest showed an abscess wall in the chest wall, but no evidence of malignancy. Transbronchial lung biopsy and CT-guided biopsy also showed no malignant cells. Since the tumor decreased in size and back pain improved gradually by only antibiotic treatment, a diagnosis of sepsis of group G streptococcus, chest wall abscess, and vertebral osteomyelitis was made. She was treated with intravenous penicillin for 4 weeks and oral amoxicillin for another 4 weeks. After 60 days of antibiotic treatment, the tumor vanished.

Quantitative estimation of myocardial thickness by the wall thickness map with Tl-201 myocardial SPECT and its clinical use

International Nuclear Information System (INIS)

Sekiai, Yasuhiro; Sawai, Michihiko; Murayama, Susumu

1988-01-01

To estimate the wall thickness of left ventricular myocardium objectively and quantitatively, we adopted the device of wall thickness map (WTM) with Tl-201 myocardial SPECT. For validation on measuring left ventricular wall thickness with SPECT, fundamental studies were carried out with phantom models, and clinical studies were performed in 10 cases comparing the results from SPECT with those in echocardiography. To draw the WTM, left ventricular wall thickness was measured using the cut off method from SPECT images obtained at 5.6 mm intervals from the base and middle of left ventricle: short-axis image for the base and middle of left ventricle and vertical and horizontal long-axis images for the apical region. Wall thickness was defined from the number of pixel above the cut off level. Results of fundamental studies disclosed that it is impossible to evaluate the thickness of less than 10 mm by Tl-201 myocardial SPECT but possible to discriminate wall thickness of 10 mm, 15 mm, and 20 mm by Tl-201 myocardial SPECT. Echocardiographic results supported the validity of WTM, showing a good linear correlation (r = 0.96) between two methods on measuring wall thickness of left ventricle. We conclude that the WTM applied in this report may be useful for objective and quantitative estimation of myocardial hypertrophy. (author)

Estimating adipose tissue in the chest wall using ultrasonic and alternate 40K and biometric measurements

International Nuclear Information System (INIS)

Anderson, A.L.; Campbell, G.W.; Singh, M.S.

1982-01-01

The percentage of adipose (fat) tissue in the chest wall must be known to accurately measure Pu in the human lung. Correction factors of 100% or more in X-ray detection efficiency are common in a normal population of individuals of differing body composition and have been determined in the past by means of elaborate and costly ultrasonic measurements of the subject's chest. Methods using simple 40 K and biometric measurement techniques have been investigated to determine the adipose content in the human chest wall. These methods compare favorably with ultrasonic measurements and allow laboratories not possessing ultrasonic equipment to make appropriate corrections for x-ray detection efficiency. These methods predict adipose content to within 15% of the absolute ultrasonic value. (author)

Revisited the mathematical derivation wall thickness measurement of pipe for radiography

Energy Technology Data Exchange (ETDEWEB)

Hamzah, A.R.; Amir, S.M.M. [Non Destructive Testing(NDT) Group, Industrial Technology Div., Malaysian Nuclear Agency, Selangor (Malaysia)

2007-07-01

Wall thickness measurement of pipe is very important of the structural integrity of the industrial plant. However, the radiography method has an advantage because the ability of penetrating the insulated pipe. This will have economic benefit for industry. Moreover, the era of digital radiography has more advantages because the speed of radiographic work, less exposure time and no chemical used for film development. Either the conventional radiography or digital radiology, the wall thickness measurement is using the tangential radiography technique (TRT). In case, of a large diameter, pipe (more than inches) the determination maximum penetration wall thickness must be taken into the consideration. This paper is revisited the mathematical derivation of the determination of wall thickness measurement based on tangential radiography technique (TRT). The mathematical approach used in this derivation is the Pythagoras theorem and geometrical principles. In order to derive the maximum penetration wall thickness a similar approach is used. (authors)

Increased Bladder Wall Thickness in Diabetic and Nondiabetic Women With Overactive Bladder

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Hakkı Uzun

2013-06-01

Full Text Available Purpose: Bladder wall thickness has been reported to be associated with overactive bladder (OAB in women. Diabetic women have an increased risk for OAB syndrome and may have an increased risk for bladder wall thickness. Methods: A total of 235 female patients aged 40 to 75 years were categorized into four groups. The first group consisted of women free of urgency or urge urinary incontinence. The second group included nondiabetic women with idiopathic OAB. The third group consisted of women with diabetes and clinical OAB, and women with diabetes but without OAB constituted the fourth group. Bladder wall thickness at the anterior wall was measured by ultrasound by the suprapubic approach with bladder filling over 250 mL. Results: The diabetic (third group and nondiabetic (second group women with OAB had significantly greater bladder wall thickness at the anterior bladder wall than did the controls. However, the difference was not significant between the diabetic (third group and the nondiabetic (second group women with OAB. Women with diabetes but without OAB (fourth group had greater bladder wall thickness than did the controls but this difference was not significant. Additionally, the difference in bladder wall thickness between diabetic women with (third group and without (fourth group OAB was not significant. Conclusions: This is the first study to show that bladder wall thickness is increased in diabetic women with and without OAB. Additionally, nondiabetic women with OAB had increased bladder wall thickness. Further studies may provide additional information for diabetic and nondiabetic women with OAB, in whom the etiopathogenesis of the disease may be similar.

Chemo-thermotherapy for radiation-induced squamous cell carcinoma in anterior chest wall

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Kodama, Ken; Doi, Osamu; Higashiyama, Masahiko; Yokouchi, Hideki; Noguchi, Shinzaburo; Koyama, Hiroki (Osaka Prefectural Center for Adult Diseases (Japan))

1992-09-01

A 62 years-old woman had visited our hospital with the large and deep ulcer formation on the left anterior chest wall. A biopsy of the ulcerous lesion established the diagnosis of a squamous cell carcinoma which might be induced by the irradiation after mastectomy. Although a wide resection of the chest wall including left arm was performed, it was impossible to resect completely. After then, she had operations for local recurrence three times in three years. However, cure was not obtained, and residual lesions gradually enlarged and all layers of the anterior chest wall were replaced with tumor tissues. Conventional chemotherapy using futraful and mytomycin C was not effective. Therefore, we tried combined therapy with intravenous administration of cisplatin (CDDP) and vindesine (VDS), and local hyperthermia using radiofrequency (RF) wave. A total number of 11 courses of this treatment modality was carried out at once a week intervals. The tumor-temperature was maintained at the range of 40-43degC for 40 min in each treatment session. Chemotherapeutic agents were administered simultaneously with hyperthermia. After these treatment, the recurrent tumor was markedly reduced, and epithelization of the ulcer was recognized from the surrounding normal skin. The residual tumor was then resected completely. The operative wound was successfully closed by surrounding normal tissue mobilization. She is in good postoperative condition. We concluded that the chemo-thermotherapy is safe and promising therapeutic modality for such invasive squamous cell carcinoma, and the normal tissues are not affected. Furthermore, this approach will expand the scope of radical resection for such an uncontrollable tumor. (author).

Chemo-thermotherapy for radiation-induced squamous cell carcinoma in anterior chest wall

International Nuclear Information System (INIS)

Kodama, Ken; Doi, Osamu; Higashiyama, Masahiko; Yokouchi, Hideki; Noguchi, Shinzaburo; Koyama, Hiroki

1992-01-01

A 62 years-old woman had visited our hospital with the large and deep ulcer formation on the left anterior chest wall. A biopsy of the ulcerous lesion established the diagnosis of a squamous cell carcinoma which might be induced by the irradiation after mastectomy. Although a wide resection of the chest wall including left arm was performed, it was impossible to resect completely. After then, she had operations for local recurrence three times in three years. However, cure was not obtained, and residual lesions gradually enlarged and all layers of the anterior chest wall were replaced with tumor tissues. Conventional chemotherapy using futraful and mytomycin C was not effective. Therefore, we tried combined therapy with intravenous administration of cisplatin (CDDP) and vindesine (VDS), and local hyperthermia using radiofrequency (RF) wave. A total number of 11 courses of this treatment modality was carried out at once a week intervals. The tumor-temperature was maintained at the range of 40-43degC for 40 min in each treatment session. Chemotherapeutic agents were administered simultaneously with hyperthermia. After these treatment, the recurrent tumor was markedly reduced, and epithelization of the ulcer was recognized from the surrounding normal skin. The residual tumor was then resected completely. The operative wound was successfully closed by surrounding normal tissue mobilization. She is in good postoperative condition. We concluded that the chemo-thermotherapy is safe and promising therapeutic modality for such invasive squamous cell carcinoma, and the normal tissues are not affected. Furthermore, this approach will expand the scope of radical resection for such an uncontrollable tumor. (author)

Etonogestrel implant migration to the vasculature, chest wall, and distant body sites: cases from a pharmacovigilance database.

Science.gov (United States)

Kang, Sarah; Niak, Ali; Gada, Neha; Brinker, Allen; Jones, S Christopher

2017-12-01

To describe clinical outcomes of etonogestrel implant patients with migration to the vasculature, chest wall and other distant body sites spontaneously reported to the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. We performed a standardized Medical Dictionary for Regulatory Activities (MedDRA) query in the FAERS database (through November 15, 2015), with reports coded with one or more MedDRA preferred terms that indicate complications with device placement or migration of the device from the original site of insertion to the vasculature, chest wall and other distant body sites. We excluded any cases previously described in the medical literature. We identified 38 cases of pronounced etonogestrel implant migration. Migration locations included the lung/pulmonary artery (n=9), chest wall (n=1), vasculature at locations other than the lung/pulmonary artery (n=14) and extravascular migrations (n=14) to other body sites (e.g., the axilla and clavicle/neck line/shoulder). The majority of cases were asymptomatic and detected when the patient desired implant removal; however, seven cases reported symptoms such as pain, discomfort and dyspnea in association with implant migration. Three cases also describe pulmonary fibrosis and skin reactions as a result of implant migration to the vasculature, chest wall and other distant body sites. Sixteen cases reported surgical removal in an operating room setting. Our FAERS case series demonstrates etonogestrel implant migration to the vasculature, chest wall and other body sites distant from the site of original insertion. As noted by the sponsor in current prescribing information, a key determinant in the risk for etonogestrel contraceptive implant migration appears to be improper insertion technique. Although migration of etonogestrel implants to the vasculature is rare, awareness of migration and education on proper insertion technique may reduce the risk. Published by Elsevier Inc.

The effect of pre-injury anti-platelet therapy on the development of complications in isolated blunt chest wall trauma: a retrospective study.

Directory of Open Access Journals (Sweden)

Ceri Battle

Full Text Available INTRODUCTION: The difficulties in the management of the blunt chest wall trauma patient in the Emergency Department due to the development of late complications are well recognised in the literature. Pre-injury anti-platelet therapy has been previously investigated as a risk factor for poor outcomes following traumatic head injury, but not in the blunt chest wall trauma patient cohort. The aim of this study was to investigate pre-injury anti-platelet therapy as a risk factor for the development of complications in the recovery phase following blunt chest wall trauma. METHODS: A retrospective study was completed in which the medical notes were analysed of all blunt chest wall trauma patients presenting to a large trauma centre in Wales in 2012 and 2013. Using univariate and multivariable logistic regression analysis, pre-injury platelet therapy was investigated as a risk factor for the development of complications following blunt chest wall trauma. Previously identified risk factors were included in the analysis to address the influence of confounding. RESULTS: A total of 1303 isolated blunt chest wall trauma patients presented to the ED in Morriston Hospital in 2012 and 2013 with complications recorded in 144 patients (11%. On multi-variable analysis, pre-injury anti-platelet therapy was found to be a significant risk factor for the development of complications following isolated blunt chest wall trauma (odds ratio: 16.9; 95% confidence intervals: 8.2-35.2. As in previous studies patient age, number of rib fractures, chronic lung disease and pre-injury anti-coagulant use were also found to be significant risk factors. CONCLUSIONS: Pre-injury anti-platelet therapy is being increasingly used as a first line treatment for a number of conditions and there is a concurrent increase in trauma in the elderly population. Pre-injury anti-platelet therapy should be considered as a risk factor for the development of complications by clinicians managing

Gastric wall thickness and stapling in laparoscopic sleeve gastrectomy - a literature review.

Science.gov (United States)

Barski, Krzysztof; Binda, Artur; Kudlicka, Emilia; Jaworski, Paweł; Tarnowski, Wiesław

2018-03-01

Despite the growing experience of bariatric surgeons in performing laparoscopic sleeve gastrectomy, the number of complications involving staple line leaks remains constant. Hence a solution to avoid such complications is still sought. A defect of the staple line may be the consequence of an inappropriate choice of staple size in relation to gastric wall thickness. Due to the variable nature of gastric wall thickness, the choice of proper staple height is not obvious. In the few studies in which gastric wall thickness was measured, it was observed to decrease gradually from the antrum to the fundus. However, the authors are divided on the issue of whether gender and body mass index influence gastric wall thickness. The question whether there are other perioperative factors that would allow gastric wall thickness to be predicted remains unanswered.

Evaluation of various boluses in dose distribution for electron therapy of the chest wall with an inward defect

Science.gov (United States)

Mahdavi, Hoda; Jabbari, Keyvan; Roayaei, Mahnaz

2016-01-01

Delivering radiotherapy to the postmastectomy chest wall can be achieved using matched electron fields. Surgical defects of the chest wall change the dose distribution of electrons. In this study, the improvement of dose homogeneity using simple, nonconformal techniques of thermoplastic bolus application on a defect is evaluated. The proposed phantom design improves the capability of film dosimetry for obtaining dose profiles of a patient's anatomical condition. A modeled electron field of a patient with a postmastectomy inward surgical defect was planned. High energy electrons were delivered to the phantom in various settings, including no bolus, a bolus that filled the inward defect (PB0), a uniform thickness bolus of 5 mm (PB1), and two 5 mm boluses (PB2). A reduction of mean doses at the base of the defect was observed by any bolus application. PB0 increased the dose at central parts of the defect, reduced hot areas at the base of steep edges, and reduced dose to the lung and heart. Thermoplastic boluses that compensate a defect (PB0) increased the homogeneity of dose in a fixed depth from the surface; adversely, PB2 increased the dose heterogeneity. This study shows that it is practical to investigate dose homogeneity profiles inside a target volume for various techniques of electron therapy. PMID:27051169

Contribution of CT quantified emphysema, air trapping and airway wall thickness on pulmonary function in male smokers with and without COPD.

Science.gov (United States)

Mohamed Hoesein, Firdaus A A; de Jong, Pim A; Lammers, Jan-Willem J; Mali, Willem P Th M; Mets, Onno M; Schmidt, Michael; de Koning, Harry J; Aalst, Carlijn van der; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Ginneken, Bram van; van Rikxoort, Eva M; Zanen, Pieter

2014-09-01

Emphysema, airway wall thickening and air trapping are associated with chronic obstructive pulmonary disease (COPD). All three can be quantified by computed tomography (CT) of the chest. The goal of the current study is to determine the relative contribution of CT derived parameters on spirometry, lung volume and lung diffusion testing. Emphysema, airway wall thickening and air trapping were quantified automatically on CT in 1,138 male smokers with and without COPD. Emphysema was quantified by the percentage of voxels below -950 Hounsfield Units (HU), airway wall thickness by the square root of wall area for a theoretical airway with 10 mm lumen perimeter (Pi10) and air trapping by the ratio of mean lung density at expiration and inspiration (E/I-ratio). Spirometry, residual volume to total lung capacity (RV/TLC) and diffusion capacity (Kco) were obtained. Standardized regression coefficients (β) were used to analyze the relative contribution of CT changes to pulmonary function measures. The independent contribution of the three CT measures differed per lung function parameter. For the FEV1 airway wall thickness was the most contributing structural lung change (β = -0.46), while for the FEV1/FVC this was emphysema (β = -0.55). For the residual volume (RV) air trapping was most contributing (β = -0.35). Lung diffusion capacity was most influenced by emphysema (β = -0.42). In a cohort of smokers with and without COPD the effect of different CT changes varies per lung function measure and therefore emphysema, airway wall thickness and air trapping need to be taken in account.

Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients

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Peters, S., E-mail: soeren.peters@rub.d [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany); Nicolas, V.; Heyer, C.M. [Department of Radiology and Nuclear Medicine, BG Universitaetsklinikum Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum (Germany)

2010-04-15

Accidental injuries are the leading cause of death in the 15 to 44-year-old age group. Blunt chest trauma is often encountered in these patients and is associated with a mortality of up to 25%. Although conventional radiography still plays an important role in the initial emergency room setting, for follow-up in the intensive care unit, multidetector computed tomography has established itself as the standard imaging method for the evaluation of chest trauma patients. The following review presents salient radiological findings of the chest wall and shoulder girdle, thoracic spine, pleural space, and lung in polytraumatized patients.

Influence of slice thickness on the determination of left ventricular wall thickness and dimension by magnetic resonance imaging

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Ohnishi, Shusaku; Fukui, Sugao; Atsumi, Chisato and others

1989-02-01

Wall thickness of the ventricular septum and left ventricle, and left ventricular cavity dimension were determined on magnetic resonance (MR) images with slices 5 mm and 10 mm in thickness. Subjects were 3 healthy volunteers and 7 patients with hypertension (4), hypertrophic cardiomyopathy (one) or valvular heart disease (2). In visualizing the cardiac structures such as left ventricular papillary muscle and right and left ventricles, 5 mm-thick images were better than 10 mm-thick images. Edges of ventricular septum and left ventricular wall were more clearly visualized on 5 mm-thick images than 10 mm-thick images. Two mm-thick MR images obtained from 2 patients yielded the most excellent visualization in end-systole, but failed to reveal cardiac structures in detail in end-diastole. Phantom studies revealed no significant differences in image quality of 10 mm and 5 mm in thickness in the axial view 80 degree to the long axis. In the axial view 45 degree to the long axis, 10 mm-thick images were inferior to 5 mm-thick images in detecting the edge of the septum and the left ventricular wall. These results indicate that the selection of slice thickness is one of the most important determinant factors in the measurement of left ventricular wall thickness and cavity dimension. (Namekawa, K).

Influence of slice thickness on the determination of left ventricular wall thickness and dimension by magnetic resonance imaging

International Nuclear Information System (INIS)

Ohnishi, Shusaku; Fukui, Sugao; Atsumi, Chisato

1989-01-01

Wall thickness of the ventricular septum and left ventricle, and left ventricular cavity dimension were determined on magnetic resonance (MR) images with slices 5 mm and 10 mm in thickness. Subjects were 3 healthy volunteers and 7 patients with hypertension (4), hypertrophic cardiomyopathy (one) or valvular heart disease (2). In visualizing the cardiac structures such as left ventricular papillary muscle and right and left ventricles, 5 mm-thick images were better than 10 mm-thick images. Edges of ventricular septum and left ventricular wall were more clearly visualized on 5 mm-thick images than 10 mm-thick images. Two mm-thick MR images obtained from 2 patients yielded the most excellent visualization in end-systole, but failed to reveal cardiac structures in detail in end-diastole. Phantom studies revealed no significant differences in image quality of 10 mm and 5 mm in thickness in the axial view 80 degree to the long axis. In the axial view 45 degree to the long axis, 10 mm-thick images were inferior to 5 mm-thick images in detecting the edge of the septum and the left ventricular wall. These results indicate that the selection of slice thickness is one of the most important determinant factors in the measurement of left ventricular wall thickness and cavity dimension. (Namekawa, K)

FLAIL CHEST

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Anton Crnjac

2003-12-01

Full Text Available Background. Major thoracic trauma is consistent with high mortality rate because of associated injuries of vital thoracic organs and dangerous complications. The flail chest occurs after disruption of the skeletal continuity of chest wall and demands because of its pathophysiological complexity rapid and accurate diagnosis and treatment.Conclusions. Basic pathophysiological mechanism of the flail chest is respiratory distress, which is provoked by pulmonary contusions and paradoxical chest wall motion. The treatment should be pointed to improvement and support of respiratory functions and include aggressive pain control, pulmonary physiotherapy and selective mechanical ventilation. Views about operative fixation of the flail chest are still controversial. Neither mortality rate neither long-term disability are improved after operative fixation.

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, G.M.; Fowble, B.L.; Hanlon, A.L.; Myint, M.A.; Hoffman, J.P.; Sigurdson, E.R.; Eisenberg, B.L.; Goldstein, L.J.; Fein, D.A.

1997-01-01

Purpose: Indications for postmastectomy radiation include primary tumor size > 5 cm and ≥ 4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with this pathologic feature who otherwise would be considered low risk (tumor size 25% at 8 years: Age ≤ 50 years was 28% vs. 0% for age > 50 (p=0.08). There was no correlation with chest wall failure and number of nodes, ER status, lymphovascular invasion, location of primary, grade, family history or type of tumor close to the margin. All four chest wall failures were in patients who had received adjuvant systemic chemotherapy ± Tamoxifen. Chest wall failures occurred in patients with margins within 1-2 mm in three patients and 5 mm in one patient. The cumulative chest wall recurrence at 8 years by margin proximity was 24% ≤ 2mm vs. 7% 2.1-6 mm (p=0.44), and by clinical size 24% for T2 tumors vs. 7% for T1 (p=0.55). Conclusions: A close or positive margin is uncommon (< 5%) after mastectomy in patients with tumor size < 5 cm and 0-3 positive axillary nodes, but when present it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤ 5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy, and therefore we recommend they be considered for postmastectomy radiation. This high risk of local failure was not observed in patients over age 50, suggesting this subgroup may not require adjuvant chest wall irradiation

Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

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Lee, Seunghyun; Lee, In Sook; Song, You Seon [Pusan National University Hospital, Biomedical Research Institute, Department of Radiology, Busan (Korea, Republic of); Pusan National University School of Medicine, Busan (Korea, Republic of); Mok, Jeongha [Pusan National University Hospital, Biomedical Research Institute, Department of Internal Medicine, Busan (Korea, Republic of); Choi, Kyung-Un [Pusan National University Hospital, Biomedical Research Institute, Department of Pathology, Busan (Korea, Republic of)

2018-03-15

Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

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Lee, Seunghyun; Lee, In Sook; Song, You Seon; Mok, Jeongha; Choi, Kyung-Un

2018-01-01

Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors. (orig.)

Surgical repair of right atrial wall rupture after blunt chest trauma.

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Telich-Tarriba, Jose E; Anaya-Ayala, Javier E; Reardon, Michael J

2012-01-01

Right atrial wall rupture after blunt chest trauma is a catastrophic event associated with high mortality rates. We report the case of a 24-year-old woman who was ejected 40 feet during a motor vehicle accident. Upon presentation, she was awake and alert, with a systolic blood pressure of 100 mmHg. Chest computed tomography disclosed a large pericardial effusion; transthoracic echocardiography confirmed this finding and also found right ventricular diastolic collapse. A diagnosis of cardiac tamponade with probable cardiac injury was made; the patient was taken to the operating room, where median sternotomy revealed a 1-cm laceration of the right atrial appendage. This lesion was directly repaired with 4-0 polypropylene suture. Her postoperative course was uneventful, and she continued to recover from injuries to the musculoskeletal system. This case highlights the need for a high degree of suspicion of cardiac injuries after blunt chest trauma. An algorithm is proposed for rapid recognition, diagnosis, and treatment of these lesions.

Evaluation of lung and chest wall mechanics during anaesthesia using the PEEP-step method.

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Persson, P; Stenqvist, O; Lundin, S

2018-04-01

Postoperative pulmonary complications are common. Between patients there are differences in lung and chest wall mechanics. Individualised mechanical ventilation based on measurement of transpulmonary pressures would be a step forward. A previously described method evaluates lung and chest wall mechanics from a change of ΔPEEP and calculation of change in end-expiratory lung volume (ΔEELV). The aim of the present study was to validate this PEEP-step method (PSM) during general anaesthesia by comparing it with the conventional method using oesophageal pressure (PES) measurements. In 24 lung healthy subjects (BMI 18.5-32), three different sizes of PEEP steps were performed during general anaesthesia and ΔEELVs were calculated. Transpulmonary driving pressure (ΔPL) for a tidal volume equal to each ΔEELV was measured using PES measurements and compared to ΔPEEP with limits of agreement and intraclass correlation coefficients (ICC). ΔPL calculated with both methods was compared with a Bland-Altman plot. Mean differences between ΔPEEP and ΔPL were mechanical properties among the lung healthy patients stresses the need for individualised ventilator settings based on measurements of lung and chest wall mechanics. The agreement between ΔPLs measured by the two methods during general anaesthesia suggests the use of the non-invasive PSM in this patient population. NCT 02830516. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Single-incision video-assisted thoracoscopic evaluation and emergent surgery for severe lung and chest wall injury after thoracic trauma in a water park.

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Sesma, Julio; Alvarez, Melodie; Lirio, Francisco; Galvez, Carlos; Galiana, Maria; Baschwitz, Benno; Fornes, Francisca; Bolufer, Sergio

2017-08-01

Thoracic trauma is a challenging situation with potential severe chest wall and intrathoracic organ injuries. We present a case of emergent surgery in a 23-year-old man with hemorrhagic shock due to massive lung and chest wall injury after thoracic trauma in a water slide. We performed a SI-VATS approach in order to define intrathoracic and chest wall injuries, and once checked the extension of the chest wall injury, we added a middle size thoracotomy just over the affected area in order to stabilize rib fractures with Judet plates, that had caused massive laceration in left lower lobe (LLL) and injured the pericardium causing myocardical tear. After checking bronchial and vascular viability of LLL we suggested a lung parenchyma preserving technique with PTFE protected pulmonary primary suture in order to avoid a lobectomy. Chest tubes were removed on 3 rd postoperative day and patient was discharged on 14 th postoperative day. He has already recovered his normal activity 6 months after surgery.

Observation of normal appearance and wall thickness of esophagus on CT images

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Xia Fan; Mao Jingfang; Ding Jinquan; Yang Huanjun

2009-01-01

Purpose: This study sought to observe the appearance of normal esophagus, measure and record the thickness of esophageal wall in order to offer reference for estimating esophageal wall abnormalities and delineating gross tumor target of esophageal carcinomas on CT images. Materials and methods: From September 2006 to February 2007, 110 consecutive CT films from adult patients without esophageal diseases were collected and studied. On CT images the entire esophagus was divided into cervical, thoracic, retrocardiac and intraabdominal segments. The appearance of esophagus was described when the esophagus contracted or dilated. Thickness of esophageal wall and diameters of esophageal cavities were measured by hard-copy reading with a magnifying glass. Age, sex and the thickness of subcutaneous fat of each patient were recorded. Results: It was observed that the esophagus presented both contracted and dilated status on CT images. In each segment there were certain portions of esophagus in complete contraction or dilatation. 47 images (42.7%) showed contracted esophagus in each segment available for measurement. The largest wall thickness when esophagus was in contraction and dilatation was 4.70 (95%CI: 4.44-4.95) mm and 2.11 (95%CI: 2.00-2.23) mm, respectively. When contracting, the intraabdominal esophagus was thicker than the cervical, thoracic and retrocardiac parts, and the average thickness was 5.68 (95%CI: 5.28-6.09) mm, 4.67 (95%CI: 4.36-4.86) mm, 4.56 (95%CI: 4.31-4.87) mm, and 4.05 (95%CI: 3.71-4.21) mm, respectively. When the esophagus was dilating, the average esophageal wall thickness was between 1.87 and 2.70 mm. The thickest part was cervical esophagus. Thickness of esophageal wall was larger in males than that of females (5.26 mm vs. 4.34 mm p < 0.001). Age and the thickness of subcutaneous fat had no significant impact on the thickness of esophageal wall (p-value was 0.056 and 0.173, respectively). Conclusion: The Observation of normal appearance and

The influence of fiber thickness, wall thickness and gap distance on the spiral nanofibrous scaffolds for bone tissue engineering

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Wang Junping; Shah, Ami; Yu Xiaojun

2011-01-01

We have developed a 3D nanofibrous spiral scaffold for bone tissue engineering which has shown enhanced cell attachment, proliferation and differentiation compared to traditional cylindrical scaffolds due to the spiral structures and the nanofiber incorporation. Some important parameters of these spiral scaffolds including gap distance, wall thickness and especially fiber thickness are crucial to the performance of the spiral structured scaffolds. In this study, we investigated the fiber thickness, gap distance and wall thickness of the spiral structure on the behavior of osteoblast cells. The human osteoblast cells are seeded on spiral structured scaffolds with various fiber thickness, gap distance and wall thickness and cell attachment, proliferation, differentiation and mineralized matrix deposition on the scaffolds are evaluated. It was found that increasing the thickness of nanofiber layer not only limited the cell infiltration into the scaffolds, but also restrained the osteoblastic cell phenotype development. Moreover, the geometric effect studies indicated that scaffolds with the thinner wall and gap distance 0.2 mm show the best bioactivity for osteoblasts.

A case of sarcoma of the chest wall after radiation therapy for breast cancer

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Izumi, Junko; Nishi, Tsunehiro; Fukuuchi, Atsushi; Takanashi, Riichiro

1998-01-01

A case of radiation-induced sarcoma of the chest wall after radiation therapy for breast cancer is reported. A 69-year-old woman underwent mastectomy with axillary lymph node dissection followed by linac therapy of 50 Gy delivered to the left axilla, left supraclavicular area, and parasternal area. During therapy for bone and liver metastases, a tumor was noted in the left chest wall 15 years after radiation therapy. Incisional biopsy was performed. Histological diagnosis was spindle cell sarcoma. Radiation-induced sarcoma was suspected because the tumor developed 15 years after radiation therapy within the same area. Radiation-induced sarcoma is a rare tumor, but radiation therapy following breast-conserving therapy is widely employed. It is important to be aware of the possibility of radiation-induced sarcoma. (author)

Comparison of conventional inserts and an add-on electron MLC for chest wall irradiation of left-sided breast cancer

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Vatanen, Tero; Lahtinen, Tapani; Traneus, Erik

2009-01-01

Background. Collimation of irregularly shaped clinical electron beams is currently based on electron inserts made of low melting point alloys. The present investigation compares a conventional electron applicator with insert and add-on eMLC-based dose distributions in the postoperative chest wall irradiation of left-sided breast cancer. Material and methods. Voxel Monte Carlo++ (VMC++) calculated dose distributions related to electron fields were compared with 10 left-sided breast cancer patients after radical mastectomy. The prescription dose was 50 Gy at a build-up maximum. The same dose was prescribed for the ipsilateral axillary, parasternal and supraclavicular lymph nodes that were treated with photons and calculated with a pencil beam algorithm. The insert beams were shaped with 1.5 cm thick Wood's metal electron inserts in an electron applicator of a Varian 2100 C/D linac. Doses for the eMLC-shaped beams were calculated for an eMLC prototype with 2 cm thick and 5 mm wide steel leaves. The same collimator-to-surface distance (CSD) of 5.8 cm was used for both collimators. Results. The mean PTV dose was slightly higher for the eMLC plans (50.7 vs 49.5 Gy, p<0.001, respectively). The maximum doses assessed by D5% for the eMLC and insert were 60.9 and 59.1 Gy (p<0.001). The difference was due to the slightly higher doses near the field edges for the eMLC. The left lung V20 volumes were 34.5% and 34.0% (p<0.001). There was only a marginal difference in heart doses. Discussion: Despite a slight increase of maximum dose in PTV the add-on electron MLC for chest wall irradiation results in practically no differences in dose distributions compared with the present insert-based collimation

Methods for determining the wall thickness variation of tubular heaters used in thermalhydraulic studies

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Cubizolles, G.; Garnier, J.; Groeneveld, D.; Tanase, A.

2009-01-01

Fuel bundle simulators used in thermalhydraulic studies typically consist of bundles of directly heated tubes. It is usually assumed that the heater tubes have a uniform circumferential heat flux distribution. In practice, this heat flux distribution is never exactly uniform because of wall thickness variations and bore eccentricity. Ignoring the non-uniformity in wall thickness can lead to under-estimating the local heat transfer coefficients. During nucleate boiling tests in a 5x5 PWR-type bundle subassembly at CEA-Grenoble, a sinusoidal temperature distribution was observed around the inside circumference of the heater rods. These heater rods were equipped with high-accuracy sliding thermocouple probes that permit the detailed measurement of the internal wall temperature distribution, both axially and circumferentially. The sinusoidal temperature distribution strongly suggests a variation in wall thickness. A methodology was subsequently derived to determine the circumferential wall thickness variation. The method is based on the principle that for directly heated fuel-element simulators, the nucleate boiling wall superheat at high pressures is nearly uniform around the heater rod circumference. The results show wall thickness variations of up to ±4% which was confirmed by subsequent ultrasonic wall-thickness measurements performed after bundle disassembly. Non-uniformities in circumferential temperature distributions were also observed during parallel thermalhydraulic tests at the University of Ottawa (UofO) on an electrically heated tube cooled internally by R-134a and equipped with fixed thermocouples on the outside. From the measured wall temperatures and knowledge of the inside heat transfer coefficient or wall temperature distribution, the variations in wall thickness and surface heat flux to the coolant were evaluated by solving conduction equations using three separate sets of data (1) single phase heat transfer data, (2) nucleate boiling data, and (3

Contralateral breast dose from chest wall and breast irradiation: local experience

International Nuclear Information System (INIS)

Alzoubi, A.; Kandaiya, S.; Shukri, A.; Elsherbieny, E.

2010-01-01

Full text: Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47 ± 0.22 c G y and 5.44 c G y, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1 % of the prescribed dose which is comparable to the values reported by other authors.

Von Reckling-hausen disease associated to thyroid carcinoma and malignant schwannoma of the chest wall. A case

International Nuclear Information System (INIS)

Diaz P, J.; Tantalean, E.; Guzman, R.; Pomatanta P, J.; Grados M, J.; Vilela, C.

1999-01-01

The multiple neurofibromatosis is an autosomal dominant hereditary disease associated to malignant schwannoma in about 3% of the cases and very rarely to others cancers. The study provides information on the case of a 32 year-old woman who suffers from this disease and presented two synchronous cancers: a papillary carcinoma of thyroid and a malignant schwannoma of the chest wall. The thyroid tumour was managed with hemithyroidectomy, hormonotherapy and radiotherapy, and the lesion of the thoracic wall was treated with local radical resection application of Marlex mesh and rotation of a musculocutaneous flap of the dorsal muscle. A review of the literature on the clinical aspects of this association and the surgical techniques employed to cover the defect of the chest wall is presented. (authors)

Pipe Wall Thickness Monitoring Using Dry-Coupled Ultrasonic Waveguide Technique

International Nuclear Information System (INIS)

Cheong, Yong Moo; Kim, Ha Nam; Kim, Hong Pyo

2012-01-01

In order to monitor a corrosion or FAC (Flow Accelerated Corrosion) in a pipe, there is a need to measure pipe wall thickness at high temperature. Ultrasonic thickness gauging is the most commonly used non-destructive testing technique for wall thickness measurement. However, current commonly available ultrasonic transducers cannot withstand high temperatures, such as above 200 .deg. C. It is therefore necessary to carry out manual measurements during plant shutdowns. The current method thus reveals several disadvantages: inspection have to be performed during shutdowns with the possible consequences of prolonging down time and increasing production losses, insulation has to be removed and replaced for each manual measurement, and scaffolding has to be installed to inaccessible areas, resulting in considerable cost for interventions. It has been suggested that a structural health monitoring approach with permanently installed ultrasonic thickness gauges could have substantial benefits over current practices. The main reasons why conventional piezoelectric ultrasonic transducers cannot be used at high temperatures are that the piezo-ceramic becomes depolarized at temperature above the Curie temperature and because differential thermal expansion of the substrate, couplant, and piezoelectric materials cause failure. In this paper, a shear horizontal waveguide technique for wall thickness monitoring at high temperature is investigated. Two different designs for contact to strip waveguide are shown and the quality of output signal is compared and reviewed. After a success of acquiring high quality ultrasonic signal, experiment on the wall thickness monitoring at high temperature is planned

Reliability assessment for thickness measurements of pipe wall using probability of detection

International Nuclear Information System (INIS)

Nakamoto, Hiroyuki; Kojima, Fumio; Kato, Sho

2013-01-01

This paper proposes a reliability assessment method for thickness measurements of pipe wall using probability of detection (POD). Thicknesses of pipes are measured by qualified inspectors with ultrasonic thickness gauges. The inspection results are affected by human factors of the inspectors and include some errors, because the inspectors have different experiences and frequency of inspections. In order to ensure reliability for inspection results, first, POD evaluates experimental results of pipe-wall thickness inspection. We verify that the results have differences depending on inspectors including qualified inspectors. Second, two human factors that affect POD are indicated. Finally, it is confirmed that POD can identify the human factors and ensure reliability for pipe-wall thickness inspections. (author)

Functional exercise capacity, lung function and chest wall deformity in patients with adolescent idiopathic scoliosis

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Evandro Fornias Sperandio

Full Text Available AbstractIntroduction The adolescent idiopathic scoliosis (AIS causes changes on the compliance of the chest. These changes may be associated with impaired lung function and reduced functional exercise capacity of these adolescents. We aimed to evaluate the correlation between functional exercise capacity, lung function and geometry of the chest at different stages of AIS.Materials and methods The study was carried out in a cross-sectional design which were evaluated 27 AIS patients at different stages of the disease. For chest wall evaluation, were created geometry angles/distances (A/D, which were quantified by Software Postural Assessment. The functional exercise capacity was assessed by a portable gas analyzer during the incremental shuttle walk test (ISWT. Besides that, manovacuometry and spirometry were also performed.Results Linear regressions showed that oxygen uptake (peak VO2 was correlated with distance travelled in the ISWT (R2 = 0.52, maximal respiratory pressures, cough peak flow (R2 = 0.59 and some thoracic deformity markers (D1, D2 and A6.Discussion We observed that the chest wall alterations, lung function and respiratory muscle strength are related to the functional exercise capacity and may impair the physical activity performance in AIS patients.Final considerations There is correlation between functional exercise capacity, lung function and geometry of the chest in AIS patients. Our results point to the possible impact of the AIS in the physical activities of these adolescents. Therefore, efforts to prevent the disease progression are extremely important.

Accuracy of thick-walled hollows during piercing on three-high mill

International Nuclear Information System (INIS)

Potapov, I.N.; Romantsev, B.A.; Shamanaev, V.I.; Popov, V.A.; Kharitonov, E.A.

1975-01-01

The results of investigations are presented concerning the accuracy of geometrical dimensions of thick-walled sleeves produced by piercing on a 100-ton trio screw rolling mill MISiS with three schemes of fixing and centering the rod. The use of a spherical thrust journal for the rod and of a long centering bushing makes it possible to diminish the non-uniformity of the wall thickness of the sleeves by 30-50%. It is established that thick-walled sleeves with accurate geometrical dimensions (nonuniformity of the wall thickness being less than 10%) can be produced if the system sleeve - mandrel - rod is highly rigid and the rod has a two- or three-fold stability margin over the length equal to that of the sleeve being pierced. The process of piercing is expedient to be carried out with increased angles of feed (14-16 deg). Blanks have been made from steel 12Kh1MF

Analysis of the impact of chest wall constraints on eligibility for a randomized trial of stereotactic body radiotherapy of peripheral stage 1 non-small cell lung cancer

International Nuclear Information System (INIS)

Siva, Shankar; Shaw, Mark; Gill, Suki; David, Ball; Chesson, Brent

2012-01-01

Chest wall toxicities are recognized complications of stereotactic radiotherapy (SBRT) in non-small cell lung cancer. To minimize toxicity, the Trans-Tasman Radiation Oncology Group (TROG) 09.02 ‘CHISEL’ study protocol excluded patients with tumours within 1cm of the chest wall. The purpose of this study is to evaluate the implication of chest wall proximity constraints on patient eligibility, toxicity and potential accrual. Exclusion zones of 1cm beyond the mediastinum and 2cm beyond the bifurcation of the lobar bronchi were incorporated into the CHISEL credentialing CT dataset. Volumes of lung within which tumours varying from 1cm to 5cm in diameter may occupy and remain eligible for the CHISEL study were calculated. These volumes were compared to a hypothetical model in which the 1cm chest wall proximity restriction was removed. The percentage of lung area in which a tumour mass can occupy and be suitable for CHISEL in the left and right lung were 54% and 60% respectively. Removing the constraint increased the percentage of available lung to 83% and 87% respectively. Considering a 2cm spherical tumour, only 21% and 31% of tumours in the left and right lung would be eligible with the chest wall constraint, whilst 39% and 50% respectively would be eligible without the constraint. The exclusion of tumours less than 1cm to chest wall significantly reduces the proportion of patients eligible for the CHISEL protocol. A review of the literature pertaining to chest wall toxicity after stereotactic radiotherapy supports a change in chest wall exclusion criteria for the CHISEL study.

Fluid-Structure Simulations of a Ruptured Intracranial Aneurysm: Constant versus Patient-Specific Wall Thickness

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S. Voß

2016-01-01

Full Text Available Computational Fluid Dynamics is intensively used to deepen the understanding of aneurysm growth and rupture in order to support physicians during therapy planning. However, numerous studies considering only the hemodynamics within the vessel lumen found no satisfactory criteria for rupture risk assessment. To improve available simulation models, the rigid vessel wall assumption has been discarded in this work and patient-specific wall thickness is considered within the simulation. For this purpose, a ruptured intracranial aneurysm was prepared ex vivo, followed by the acquisition of local wall thickness using μCT. The segmented inner and outer vessel surfaces served as solid domain for the fluid-structure interaction (FSI simulation. To compare wall stress distributions within the aneurysm wall and at the rupture site, FSI computations are repeated in a virtual model using a constant wall thickness approach. Although the wall stresses obtained by the two approaches—when averaged over the complete aneurysm sac—are in very good agreement, strong differences occur in their distribution. Accounting for the real wall thickness distribution, the rupture site exhibits much higher stress values compared to the configuration with constant wall thickness. The study reveals the importance of geometry reconstruction and accurate description of wall thickness in FSI simulations.

Matching Electron Beams Without Secondary Collimation for Treatment of Extensive Recurrent Chest-Wall Carcinoma

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Feygelman, Vladimir; Mandelzweig, Yuri; Baral, Ed

2015-01-01

Matching electron beams without secondary collimators (applicators) were used for treatment of extensive, recurrent chest-wall carcinoma. Due to the wide penumbra of such beams, the homogeneity of the dose distribution at and around the junction point is clinically acceptable and relatively insensitive to positional errors. Specifically, dose around the junction point is homogeneous to within ±4% as calculated from beam profiles, while the positional error of 1 cm leaves this number essentially unchanged. The experimental isodose distribution in an anthropomorphic phantom supports this conclusion. Two electron beams with wide penumbra were used to cover the desired treatment area with satisfactory dose homogeneity. The technique is relatively simple yet clinically useful and can be considered a viable alternative for treatment of extensive chest-wall disease. The steps are suggested to make this technique more universal.

Pulse wave velocity as a diagnostic index: The effect of wall thickness

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Hodis, Simona

2018-06-01

Vascular compliance is a major determinant of wave propagation within the vascular system, and hence the measurement of pulse wave velocity (PWV) is commonly used clinically as a method of detecting vascular stiffening. The accuracy of that assessment is important because vascular stiffening is a major risk factor for hypertension. PWV is usually measured by timing a pressure wave as it travels from the carotid artery to the femoral or radial artery and estimating the distance that it traveled in each case to obtain the required velocity. A major assumption on which this technique is based is that the vessel wall thickness h is negligibly small compared with the vessel radius a . The extent to which this assumption is satisfied in the cardiovascular system is not known because the ratio h /a varies widely across different regions of the vascular tree and under different pathological conditions. Using the PWV as a diagnostic test without knowing the effect of wall thickness on the measurement could lead to error when interpreting the PWV value as an index of vessel wall compliance. The aim of the present study was to extend the validity of the current practice of assessing wall stiffness by developing a method of analysis that goes beyond the assumption of a thin wall. We analyzed PWVs calculated with different wall models, depending on the ratio of wall thickness to vessel radius and the results showed that PWV is not reliable when it is estimated with the classic thin wall theory if the vessel wall is not around 25% of vessel radius. If the arterial wall is thicker than 25% of vessel radius, then the wave velocity calculated with the thin wall theory could be overestimated and in the clinical setting, this could lead to a false positive. For thicker walls, a thick wall model presented here should be considered to account for the stresses within the wall thickness that become dominant compared with the wall inertia.

Quality assurance in thick-walled weldments

International Nuclear Information System (INIS)

Straub, H.

1978-01-01

Some guidelines are given here for judging the magnitude of flaws in welded thick-walled components (such as nuclear reactor vessels). The actually critical defect sizes are analysed, taking into account the residual stresses after welding and after annealing also. Various procedures for repairing such work are then indicated. (Auth.)

SU-F-T-85: Energy Modulated Electron Postmastectomy Unreconstructed (PU) Chest Wall (CW) Irradiation Technique to Achieve Heart Sparing

Energy Technology Data Exchange (ETDEWEB)

Hong, L; Ballangrud, A; Mechalakos, J [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); McCormick, B [Memerial Sloan-Kettering Cancer Center, New York, NY (United States)

2016-06-15

Purpose: For left-sided PU patients requiring CW and nodal irradiation, sometimes partial wide tangents (PWT) are not feasible due to abnormal chest wall contour or heart position close to the anterior chest wall or unusual wide excision scar. We developed an energy modulated electron chest wall irradiation technique that will achieve heart sparing. Methods: Ten left-sided PU patients were selected for this dosimetry study. If PWT were used, the amount of the ipsilateral lung would be ranged 3.4 to 4.4 cm, and the amount of heart would be ranged 1.3 to 3.8 cm. We used electron paired fields that matched on the skin to achieve dose conformity to the chest wall. The enface electron fields were designed at extended SSD from a single isocenter and gantry angle with different energy beams using different cutout. Lower energy was used in the central chest wall part and higher energy was used in the periphery of the chest wall. Bolus was used for the electron fields to ensure adequate skin dose coverage. The electron fields were matched to the photon supra-clavicle field in the superior region. Daily field junctions were used to feather the match lines between all the fields. Target volumes and normal tissues were drawn according to institutional protocols. Prescription dose was 2Gy per fraction for a total 50Gy. Dose calculations were done with Eclipse EMC-11031 for Electron and AAA-11031 for photons. Results: Six patients were planned using 6/9MeV, three using 9/12MeV and one 6/12MeV. Target volumes achieved adequate coverage. For heart, V30Gy, V20Gy and Mean Dose were 0.6%±0.6%, 2.7%±1.7%, and 3.0Gy±0.8Gy respectively. For ipsilateral lung, V50Gy, V20Gy, V10Gy and V5Gy were 0.9%±1.1%, 34.3%±5.1%, 51.6%±6.3% and 64.1%±7.5% respectively. Conclusion: For left-sided PU patients with unusual anatomy, energy modulated electron CW irradiation technique can achieve heart sparing with acceptable lung dose.

Fully automated chest wall line segmentation in breast MRI by using context information

Science.gov (United States)

Wu, Shandong; Weinstein, Susan P.; Conant, Emily F.; Localio, A. Russell; Schnall, Mitchell D.; Kontos, Despina

2012-03-01

Breast MRI has emerged as an effective modality for the clinical management of breast cancer. Evidence suggests that computer-aided applications can further improve the diagnostic accuracy of breast MRI. A critical and challenging first step for automated breast MRI analysis, is to separate the breast as an organ from the chest wall. Manual segmentation or user-assisted interactive tools are inefficient, tedious, and error-prone, which is prohibitively impractical for processing large amounts of data from clinical trials. To address this challenge, we developed a fully automated and robust computerized segmentation method that intensively utilizes context information of breast MR imaging and the breast tissue's morphological characteristics to accurately delineate the breast and chest wall boundary. A critical component is the joint application of anisotropic diffusion and bilateral image filtering to enhance the edge that corresponds to the chest wall line (CWL) and to reduce the effect of adjacent non-CWL tissues. A CWL voting algorithm is proposed based on CWL candidates yielded from multiple sequential MRI slices, in which a CWL representative is generated and used through a dynamic time warping (DTW) algorithm to filter out inferior candidates, leaving the optimal one. Our method is validated by a representative dataset of 20 3D unilateral breast MRI scans that span the full range of the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) fibroglandular density categorization. A promising performance (average overlay percentage of 89.33%) is observed when the automated segmentation is compared to manually segmented ground truth obtained by an experienced breast imaging radiologist. The automated method runs time-efficiently at ~3 minutes for each breast MR image set (28 slices).

Clinical image: Hydatid disease of the chest wall

Energy Technology Data Exchange (ETDEWEB)

Graham, R.J.; Berlin, J.W.; Ghahremani, G.G. [Northwestern Univ., Evanston, IL (United States)

1996-05-01

Hydatid disease is rarely encountered among the population of the United States, but it affects several million people in sheep-raising regions of the world. Human infestation with Echinococcus granulosus begins following ingestion of its ova, which are excreted into the contaminated water during the usual dog-sheep cycle. Hydatid cysts will then develop most frequently in the liver (75% of cases) and lungs (15%) of the human host. Skeletal involvement has been reported to occur in only 0.5-4.0% of patients in the endemic areas. Because of the rarity and perplexing imaging features of hydatid disease involving the chest wall, we wish herein to present a case evaluated recently at our institution. 5 refs., 1 fig.

Wall thickness measurements using digital radiography - state of the art

International Nuclear Information System (INIS)

Wawrzinek, T.; Zscherpel, U.; Bellon, C.

1997-01-01

Projection radiography is a method long since used for wall thickness measurements in pipes. Another method sometimes applied is thickness determination based on measuring changes of the optical density by using radioactive isotopes, as in this case the effects of stray radiation are negligible. The two methods hitherto were to be performed manually, and wall thickness data were derived by calculations with a pocket calculator. The required measuring and calculating work can now be automated by way of computerized processing of digitised images. The paper presents the software for automated evaluation of data of a selected location after system calibration. (orig./CB) [de

A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger

International Nuclear Information System (INIS)

Freedman, Gary M.; Fowble, Barbara L.; Hanlon, Alexandra L.; Myint, Maung A.; Hoffman, John P.; Sigurdson, Elin R.; Eisenberg, Burton L.; Goldstein, Lori J.; Fein, Douglas A.

1998-01-01

Introduction: Indications for postmastectomy radiation include primary tumor size ≥5 cm and/or ≥4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with close or positive margins who otherwise would be considered low risk (tumor size 50 (p = 0.04). There was no correlation with chest wall failure and number of positive nodes, ER status, lymphovascular invasion, location of primary, grade, family history, or type of tumor close to the margin. Of 5 chest wall failures, 4 were in patients who had received adjuvant systemic chemotherapy ± tamoxifen. Chest wall failures occurred in 1 patient with a positive deep margin, 3 patients with margins within 2 mm, and 1 patient with a margin of 5 mm. The estimated cumulative incidence probability of chest wall recurrence at 8 years by margin proximity was 24% ≤ 2 mm vs. 7% 2.1-6 mm (p = 0.36), and by clinical size 24% for T2 tumors vs. 7% for T1 (p = 0.98). Conclusions: A close or positive margin is uncommon (≤5%) after mastectomy in patients with tumor size <5 cm and 0-3 positive axillary nodes but, when present, it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (≤5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy and, therefore, should be considered for postmastectomy radiation

Optimized thick-wall cylinders by virtue of Poisson's ratio selection

International Nuclear Information System (INIS)

Whitty, J.P.M.; Henderson, B.; Francis, J.; Lloyd, N.

2011-01-01

The principal stress distributions in thick-wall cylinders due to variation in the Poisson's ratio are predicted using analytical and finite element methods. Analyses of appropriate brittle and ductile failure criteria show that under the isochoric pressure conditions investigated that auextic (i.e. those possessing a negative Poisson's ratio) materials act as stress concentrators; hence they are predicted to fail before their conventional (i.e. possessing a positive Poisson's ratio) material counterparts. The key finding of the work presented shows that for constrained thick-wall cylinders the maximum tensile principal stress can vanish at a particular Poisson's ratio and aspect ratio. This phenomenon is exploited in order to present an optimized design criterion for thick-wall cylinders. Moreover, via the use of a cogent finite element model, this criterion is also shown to be applicable for the design of micro-porous materials.

Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

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Ding-Hui Dong

2015-01-01

Full Text Available Background: Magnetic anchored surgical instruments (MASI, relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI. Methods: For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT. Results: Abdominal wall at C point in the middle third lumbar vertebra plane (L3 is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056, P2 = 1.098 (0.03197, 2.164, P3 = −18.52 (−31.64, −5.412, R-square: 0.99. Conclusions: Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

Bilateral Multifocal Hamartoma of the Chest Wall in an Infant

Science.gov (United States)

Yilmaz, Erdem; Erol, Oguz Bulent; Pekcan, Melih; Gundogdu, Gokcen; Bilgic, Bilge; Gun, Feryal; Yekeler, Ensar

2015-01-01

Summary Background Hamartoma of the thoracic wall is a rare benign tumor that occurs in infancy and can be mistaken for a malignancy due to its clinical and imaging features. Hamartomas are extrapleural soft tissue lesions that cause rib expansion and destruction and appear on imaging as cystic areas with fluid levels and calcification. They can cause scoliosis, pressure on the neighboring lung parenchyma and mediastinal displacement. While conservative treatment is recommended in asymptomatic cases, growing lesions require surgical excision. Case Report In this report, we present the imaging findings in a 3-month-old infant that presented with a firm swelling in the chest wall and was histopathologically confirmed to have a bilateral multifocal hamartoma. Conclusions Radiological imaging methods are important for accurate diagnosis of this very rare condition that can be confused with a malignancy. PMID:26082822

Semiautomatic vessel wall detection and quantification of wall thickness in computed tomography images of human abdominal aortic aneurysms

International Nuclear Information System (INIS)

Shum, Judy; DiMartino, Elena S.; Goldhammer, Adam; Goldman, Daniel H.; Acker, Leah C.; Patel, Gopal; Ng, Julie H.; Martufi, Giampaolo; Finol, Ender A.

2010-01-01

Purpose: Quantitative measurements of wall thickness in human abdominal aortic aneurysms (AAAs) may lead to more accurate methods for the evaluation of their biomechanical environment. Methods: The authors describe an algorithm for estimating wall thickness in AAAs based on intensity histograms and neural networks involving segmentation of contrast enhanced abdominal computed tomography images. The algorithm was applied to ten ruptured and ten unruptured AAA image data sets. Two vascular surgeons manually segmented the lumen, inner wall, and outer wall of each data set and a reference standard was defined as the average of their segmentations. Reproducibility was determined by comparing the reference standard to lumen contours generated automatically by the algorithm and a commercially available software package. Repeatability was assessed by comparing the lumen, outer wall, and inner wall contours, as well as wall thickness, made by the two surgeons using the algorithm. Results: There was high correspondence between automatic and manual measurements for the lumen area (r=0.978 and r=0.996 for ruptured and unruptured aneurysms, respectively) and between vascular surgeons (r=0.987 and r=0.992 for ruptured and unruptured aneurysms, respectively). The authors' automatic algorithm showed better results when compared to the reference with an average lumen error of 3.69%, which is less than half the error between the commercially available application Simpleware and the reference (7.53%). Wall thickness measurements also showed good agreement between vascular surgeons with average coefficients of variation of 10.59% (ruptured aneurysms) and 13.02% (unruptured aneurysms). Ruptured aneurysms exhibit significantly thicker walls (1.78±0.39 mm) than unruptured ones (1.48±0.22 mm), p=0.044. Conclusions: While further refinement is needed to fully automate the outer wall segmentation algorithm, these preliminary results demonstrate the method's adequate reproducibility and

Low-grade extraskeletal osteosarcoma of the chest wall: case report and review of literature

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Chetaille Bruno

2010-11-01

Full Text Available Abstract Background Low-grade extraskeletal osteosarcomas (ESOS are extremely rare. Case presentation We present the first case of low-grade ESOS of the chest wall, which occurred in a 30-year-old man. Because of initial misdiagnosis and patient's refusal of surgery, the diagnosis was done after a 4-year history of a slowly growing mass in soft tissues, leading to a huge (30-cm diameter calcified mass locally extended over the left chest wall. Final diagnosis was helped by molecular analysis of MDM2 and CDK4 oncogenes. Unfortunately, at this time, no surgical treatment was possible due to loco-regional extension, and despite chemotherapy, the patient died one year after diagnosis, five years after the first symptoms. Conclusion We describe the clinical, radiological and bio-pathological features of this unique case, and review the literature concerning low-grade ESOS. Our case highlights the diagnostic difficulties for such very rare tumours and the interest of molecular analysis in ambiguous cases.

Low-grade extraskeletal osteosarcoma of the chest wall: case report and review of literature.

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Sabatier, Renaud; Bouvier, Corinne; de Pinieux, Gonzague; Sarran, Anthony; Brenot-Rossi, Isabelle; Pedeutour, Florence; Chetaille, Bruno; Viens, Patrice; Weiller, Pierre-Jean; Bertucci, François

2010-11-24

Low-grade extraskeletal osteosarcomas (ESOS) are extremely rare. We present the first case of low-grade ESOS of the chest wall, which occurred in a 30-year-old man. Because of initial misdiagnosis and patient's refusal of surgery, the diagnosis was done after a 4-year history of a slowly growing mass in soft tissues, leading to a huge (30-cm diameter) calcified mass locally extended over the left chest wall. Final diagnosis was helped by molecular analysis of MDM2 and CDK4 oncogenes. Unfortunately, at this time, no surgical treatment was possible due to loco-regional extension, and despite chemotherapy, the patient died one year after diagnosis, five years after the first symptoms. We describe the clinical, radiological and bio-pathological features of this unique case, and review the literature concerning low-grade ESOS. Our case highlights the diagnostic difficulties for such very rare tumours and the interest of molecular analysis in ambiguous cases.

Rib cage deformities alter respiratory muscle action and chest wall function in patients with severe osteogenesis imperfecta.

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Antonella LoMauro

Full Text Available BACKGROUND: Osteogenesis imperfecta (OI is an inherited connective tissue disorder characterized by bone fragility, multiple fractures and significant chest wall deformities. Cardiopulmonary insufficiency is the leading cause of death in these patients. METHODS: Seven patients with severe OI type III, 15 with moderate OI type IV and 26 healthy subjects were studied. In addition to standard spirometry, rib cage geometry, breathing pattern and regional chest wall volume changes at rest in seated and supine position were assessed by opto-electronic plethysmography to investigate if structural modifications of the rib cage in OI have consequences on ventilatory pattern. One-way or two-way analysis of variance was performed to compare the results between the three groups and the two postures. RESULTS: Both OI type III and IV patients showed reduced FVC and FEV(1 compared to predicted values, on condition that updated reference equations are considered. In both positions, ventilation was lower in OI patients than control because of lower tidal volume (p<0.01. In contrast to OI type IV patients, whose chest wall geometry and function was normal, OI type III patients were characterized by reduced (p<0.01 angle at the sternum (pectus carinatum, paradoxical inspiratory inward motion of the pulmonary rib cage, significant thoraco-abdominal asynchronies and rib cage distortions in supine position (p<0.001. CONCLUSIONS: In conclusion, the restrictive respiratory pattern of Osteogenesis Imperfecta is closely related to the severity of the disease and to the sternal deformities. Pectus carinatum characterizes OI type III patients and alters respiratory muscles coordination, leading to chest wall and rib cage distortions and an inefficient ventilator pattern. OI type IV is characterized by lower alterations in the respiratory function. These findings suggest that functional assessment and treatment of OI should be differentiated in these two forms of the

Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly.

Science.gov (United States)

Lunardi, Adriana C; Porras, Desiderio C; Barbosa, Renata Cc; Paisani, Denise M; Marques da Silva, Cibele C B; Tanaka, Clarice; Carvalho, Celso R F

2014-03-01

Aging causes physiological and functional changes that impair pulmonary function. Incentive spirometry is widely used for lung expansion, but the effects of volume-oriented incentive spirometry (VIS) versus flow-oriented incentive spirometry (FIS) on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly are poorly understood. We compared VIS and FIS in elderly subjects and healthy adult subjects. Sixteen elderly subjects (9 women, mean ± SD age 70.6 ± 3.9 y, mean ± SD body mass index 23.8 ± 2.5 kg/m(2)) and 16 healthy adults (8 women, mean ± age 25.9 ± 4.3 y, mean ± body mass index 23.6 ± 2.4 kg/m(2)) performed quiet breathing, VIS, and FIS in randomized sequence. Chest wall kinematics (via optoelectronic plethysmography) and inspiratory muscle activity (via surface electromyography) were assessed simultaneously. Synchrony between the superior thorax and abdominal motion was calculated (phase angle). In the elderly subjects both types of incentive spirometry increased chest wall volumes similarly, whereas in the healthy adult subjects VIS increased the chest wall volume more than did FIS. FIS and VIS triggered similar lower thoracoabdominal synchrony in the elderly subjects, whereas in the healthy adults FIS induced lower synchrony than did VIS. FIS required more muscle activity in the elderly subjects to create an increase in chest wall volume. Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.

Computed simulation of radiographies of pipes - validation of techniques for wall thickness measurements

International Nuclear Information System (INIS)

Bellon, C.; Tillack, G.R.; Nockemann, C.; Wenzel, L.

1995-01-01

A macroscopic model of radiographic NDE methods and applications is given. A computer-aided approach for determination of wall thickness from radiographs is presented, guaranteeing high accuracy and reproducibility of wall thickness determination by means of projection radiography. The algorithm was applied to computed simulations of radiographies. The simulation thus offers an effective means for testing such automated wall thickness determination as a function of imaging conditions, pipe geometries, coatings, and media tracking, and likewise is a tool for validation and optimization of the method. (orig.) [de

Lung and chest wall impedances in the dog: effects of frequency and tidal volume.

Science.gov (United States)

Barnas, G M; Stamenović, D; Lutchen, K R; Mackenzie, C F

1992-01-01

Dependences of the mechanical properties of the respiratory system on frequency (f) and tidal volume (VT) in the normal ranges of breathing are not clear. We measured, simultaneously and in vivo, resistance and elastance of the total respiratory system (Rrs and Ers), lungs (RL and EL), and chest wall (Rcw and Ecw) of five healthy anesthetized paralyzed dogs during sinusoidal volume oscillations at the trachea (50-300 ml, 0.2-2 Hz) delivered at a constant mean lung volume. Each dog showed the same f and VT dependences. The Ers and Ecw increased with increasing f to 1 Hz and decreased with increasing VT up to 200 ml. Although EL increased slightly with increasing f, it was independent of VT. The Rcw decreased from 0.2 to 2 Hz at all VT and decreased with increasing VT. Although the RL decreased from 0.2 to 0.6 Hz and was independent of VT, at higher f RL tended to increase with increasing f and VT (i.e., as peak flow increased). Finally, the f and VT dependences of Rrs were similar to those of Rcw below 0.6 Hz but mirrored RL at higher f. These data capture the competing influences of airflow nonlinearities vs. tissue nonlinearities on f and VT dependence of the lung, chest wall, and total respiratory system. More specifically, we conclude that 1) VT dependences in Ers and Rrs below 0.6 Hz are due to nonlinearities in chest wall properties, 2) above 0.6 Hz, the flow dependence of airways resistance dominates RL and Rrs, and 3) lung tissue behavior is linear in the normal range of breathing.

Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis.

Science.gov (United States)

Battle, Ceri E; Hutchings, Hayley; Evans, Phillip A

2012-01-01

The risk factors for mortality following blunt chest wall trauma have neither been well established or summarised. To summarise the risk factors for mortality in blunt chest wall trauma patients based on available evidence in the literature. A systematic review of English and non-English articles using MEDLINE, EMBASE and the Cochrane Library from their introduction until May 2010. Additional studies were identified by hand-searching bibliographies and contacting relevant clinical experts. Grey literature was sought by searching abstracts from all Emergency Medicine conferences. Broad search terms and inclusion criteria were used to reduce the number of missed studies. A two step study selection process was used. All published and unpublished observational studies were included if they investigated estimates of association between a risk factor and mortality for blunt chest wall trauma patients. A two step data extraction process using pre-defined data fields, including study quality indicators. Each study was appraised using a previously designed quality assessment tool and the STROBE checklist. Where sufficient data were available, odds ratios with 95% confidence intervals were calculated using Mantel-Haenszel method for the risk factors investigated. The I(2) statistic was calculated for combined studies in order to assess heterogeneity. Age, number of rib fractures, presence of pre-existing disease and pneumonia were found to be related to mortality in 29 identified studies. Combined odds ratio of 1.98 (1.86-2.11, 95% CI), 2.02 (1.89-2.15, 95% CI), 2.43 (1.03-5.72, 95% CI) and 5.24 (3.51-7.82) for mortality were calculated for blunt chest wall trauma patients aged 65 years or more, with three or more rib fractures, pre-existing conditions and pneumonia respectively. The risk factors for mortality in patients sustaining blunt chest wall trauma were a patient age of 65 years or more, three or more rib fractures and the presence of pre-existing disease especially

Postmastectomy Electron Beam Chest Wall Irradiation in Women With Breast Cancer: A Clinical Step Toward Conformal Electron Therapy

International Nuclear Information System (INIS)

Kirova, Youlia M.; Campana, Francois; Fournier-Bidoz, Nathalie; Stilhart, Anne; Dendale, Remi; Bollet, Marc A.; Fourquet, Alain

2007-01-01

Purpose: Electron beam radiotherapy of the chest wall with or without lymph node irradiation has been used at the Institut Curie for >20 years. The purpose of this report was to show the latest improvements of our technique developed to avoid hot spots and improve the homogeneity. Methods and Materials: The study was split into two parts. A new electron irradiation technique was designed and compared with the standard one (dosimetric study). The dose distributions were calculated using our treatment planning software ISIS (Technologie Diffusion). The dose calculation was performed using the same calculation parameters for the new and standard techniques. Next, the early skin toxicity of our new technique was evaluated prospectively in the first 25 patients using Radiation Therapy Oncology Group criteria (clinical study). Results: The maximal dose found on the five slices was 53.4 ± 1.1 Gy for the new technique and 59.1 ± 2.3 Gy for the standard technique. The hot spots of the standard technique plans were situated at the overlap between the internal mammary chain and chest wall fields. The use of one unique field that included both chest wall and internal mammary chain volumes solved the problem of junction. To date, 25 patients have been treated with the new technique. Of these patients, 12% developed Grade 0, 48% Grade 1, 32% Grade 2, and 8% Grade 3 toxicity. Conclusions: This report describes an improvement in the standard postmastectomy electron beam technique of the chest wall. This new technique provides improved target homogeneity and conformality compared with the standard technique. This treatment was well tolerated, with a low rate of early toxicity events

On thick domain walls in general relativity

Science.gov (United States)

Goetz, Guenter; Noetzold, Dirk

1989-01-01

Planar scalar field configurations in general relativity differ considerably from those in flat space. It is shown that static domain walls of finite thickness in curved space-time do not possess a reflection symmetry. At infinity, the space-time tends to the Taub vacuum on one side of the wall and to the Minkowski vacuum (Rindler space-time) on the other. Massive test particles are always accelerated towards the Minkowski side, i.e., domain walls are attractive on the Taub side, but repulsive on the Minkowski side (Taub-vacuum cleaner). It is also proved that the pressure in all directions is always negative. Finally, a brief comment is made concerning the possibility of infinite, i.e., bigger than horizon size, domain walls in our universe. All of the results are independent of the form of the potential V(phi) greater than or equal to 0 of the scalar field phi.

Comparison of Simulated PEC Probe Performance for Detecting Wall Thickness Reduction

International Nuclear Information System (INIS)

Shin, Young Kil; Choi, Dong Myung; Jung, Hee Sung

2009-01-01

In this paper, four different types of pulsed eddy current(PEC) probe are designed and their performance of detecting wall thickness reduction is compared. By using the backward difference method in time and the finite element method in space, PEC signals from various thickness and materials are numerically calculated and three features of the signal are selected. Since PEC signals and features are obtained by various types and sizes of probe, the comparison is made through the normalized features which reflect the sensitivity of the feature to thickness reduction. The normalized features indicate that the shielded reflection probe provides the best sensitivity to wall thickness reduction for all three signal features. Results show that the best sensitivity to thickness reduction can be achieved by the peak value, but also suggest that the time to peak can be a good candidate because of its linear relationship with the thickness variation.

MRI of the Chest

Medline Plus

Full Text Available ... gives detailed pictures of structures within the chest cavity, including the mediastinum , chest wall, pleura, heart and ... helpful to assess the vessels of the chest cavity (arteries and veins). MRA can also demonstrate an ...

MRI of the Chest

Medline Plus

Full Text Available ... to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI ... of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft ...

Effects of non-invasive ventilation and posture on chest wall volumes and motion in patients with amyotrophic lateral sclerosis: a case series.

Science.gov (United States)

Magalhães, Cristiana M; Fregonezi, Guilherme A; Vidigal-Lopes, Mauro; Vieira, Bruna S P P; Vieira, Danielle S R; Parreira, Verônica F

2016-01-01

The effects of non-invasive ventilation (NIV) on the breathing pattern and thoracoabdominal motion of patients with amyotrophic lateral sclerosis (ALS) are unknown. 1) To analyze the influence of NIV on chest wall volumes and motion assessed by optoelectronic plethysmography in ALS patients and 2) to compare these parameters in the supine and sitting positions to those of healthy individuals (without NIV). Nine ALS patients were evaluated in the supine position using NIV. In addition, the ALS patients and nine healthy individuals were evaluated in both sitting and supine positions. Statistical analysis was performed using the paired Student t-test or Wilcoxon test and the Student t-test for independent samples or Mann-Whitney U test. Chest wall volume increased significantly with NIV, mean volume=0.43 (SD=0.16)L versus 0.57 (SD=0.19)L (p=0.04). No significant changes were observed for the pulmonary rib cage, abdominal rib cage, or abdominal contribution. The index of the shortening velocity of the diaphragmatic muscle, mean=0.15 (SD=0.05)L/s versus 0.21 (SD=0.05)L/s (pNIV. Comparisons between the supine and sitting positions showed similar changes in chest wall motion in both groups. However, the ALS patients presented a significantly lower contribution of the abdomen in the supine position compared with the controls, mean=56 (SD=13) versus 69 (SD=10) (p=0.02). NIV improved chest wall volumes without changing the contribution of the chest wall compartment in ALS patients. In the supine position, ALS patients had a lower contribution of the abdomen, which may indicate early diaphragmatic dysfunction.

A hybrid method for airway segmentation and automated measurement of bronchial wall thickness on CT.

Science.gov (United States)

Xu, Ziyue; Bagci, Ulas; Foster, Brent; Mansoor, Awais; Udupa, Jayaram K; Mollura, Daniel J

2015-08-01

Inflammatory and infectious lung diseases commonly involve bronchial airway structures and morphology, and these abnormalities are often analyzed non-invasively through high resolution computed tomography (CT) scans. Assessing airway wall surfaces and the lumen are of great importance for diagnosing pulmonary diseases. However, obtaining high accuracy from a complete 3-D airway tree structure can be quite challenging. The airway tree structure has spiculated shapes with multiple branches and bifurcation points as opposed to solid single organ or tumor segmentation tasks in other applications, hence, it is complex for manual segmentation as compared with other tasks. For computerized methods, a fundamental challenge in airway tree segmentation is the highly variable intensity levels in the lumen area, which often causes a segmentation method to leak into adjacent lung parenchyma through blurred airway walls or soft boundaries. Moreover, outer wall definition can be difficult due to similar intensities of the airway walls and nearby structures such as vessels. In this paper, we propose a computational framework to accurately quantify airways through (i) a novel hybrid approach for precise segmentation of the lumen, and (ii) two novel methods (a spatially constrained Markov random walk method (pseudo 3-D) and a relative fuzzy connectedness method (3-D)) to estimate the airway wall thickness. We evaluate the performance of our proposed methods in comparison with mostly used algorithms using human chest CT images. Our results demonstrate that, on publicly available data sets and using standard evaluation criteria, the proposed airway segmentation method is accurate and efficient as compared with the state-of-the-art methods, and the airway wall estimation algorithms identified the inner and outer airway surfaces more accurately than the most widely applied methods, namely full width at half maximum and phase congruency. Copyright © 2015. Published by Elsevier B.V.

Study on fluidity of squeeze cast AZ91D magnesium alloy with different wall thicknesses

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Chen Yun

2014-03-01

Full Text Available Rectangular cross-section specimens with different section thicknesses were prepared to study the influences of pouring temperature, mould temperature and squeeze velocity on the fluidity of squeeze cast AZ91D magnesium alloy by means of orthogonal test design method. The results show that pouring temperature, mould temperature and squeeze velocity can significantly affect the fluidity of magnesium alloy specimens with wall thickness no more than 4 mm, and the pouring temperature is the most influential factor on the fluidity of specimens with wall thickness of 1, 2 and 3 mm, while mould temperature is the one for specimens with wall thickness of 4 mm. Increasing pouring temperature between 700 °C and 750 °C is beneficial to the fluidity of AZ91D magnesium alloy, and increasing mould temperature significantly enhances the filling ability of thick (3 and 4 mm section castings. The fluidity of squeeze cast magnesium alloy increases with the increase of wall thickness. It is not recommended to produce magnesium alloy casting with wall thickness of smaller than 3 mm by squeeze cast process due to the poor fluidity. The software DPS was used to generate the regression model, and linear regression equations of the fluidity of squeeze cast AZ91D with different wall thicknesses are obtained using the test results.

Post-cast EDM method for reducing the thickness of a turbine nozzle wall

Science.gov (United States)

Jones, Raymond Joseph; Bojappa, Parvangada Ganapathy; Kirkpatrick, Francis Lawrence; Schotsch, Margaret Jones; Rajan, Rajiv; Wei, Bin

2002-01-01

A post-cast EDM process is used to remove material from the interior surface of a nozzle vane cavity of a turbine. A thin electrode is passed through the cavity between opposite ends of the nozzle vane and displaced along the interior nozzle wall to remove the material along a predetermined path, thus reducing the thickness of the wall between the cavity and the external surface of the nozzle. In another form, an EDM process employing a profile as an electrode is disposed in the cavity and advanced against the wall to remove material from the wall until the final wall thickness is achieved, with the interior wall surface being complementary to the profile surface.

Impact of plasma tube wall thickness on power coupling in ICP sources

International Nuclear Information System (INIS)

Nawaz, Anuscheh; Herdrich, Georg

2009-01-01

The inductively heated plasma source at the Institute of Space Systems was investigated with respect to the wall thickness of the plasma tube using an air plasma. For this, the wall thickness of the quartz tube was reduced in steps from 2.5 to 1.25 mm. The significance of reducing the wall thickness was analyzed with respect to both the maximum allowable tube cooling power and the coupling efficiency. While the former results from thermal stresses in the tube's wall, the latter results from a minimization of magnetic field losses near the coil turns of the inductively coupled plasma (ICP) source. Analysis of the thermal stress could be validated by experimental data, i.e. the measurement of the tube cooling power when the respective tube structure failed. The coupling efficiency could be assessed qualitatively by simplified models, and the experimental data recorded show that coupling was improved far more than predicted.

A semi-empirical method for measuring thickness of pipe-wall using gamma scattering technique

International Nuclear Information System (INIS)

Vo Hoang Nguyen; Hua Tuyet Le; Le Dinh Minh Quan; Hoang Duc Tam; Le Bao Tran; Tran Thien Thanh; Tran Nguyen Thuy Ngan; Chau Van Tao; VNUHCM-University of Science, Ho Chi Minh City; Huynh Dinh Chuong

2016-01-01

In this work, we propose a semi-empirical method for determining the thickness of pipe-wall, of which the determination is performed by combining the experimental and Monte Carlo simulation data. The testing measurements show that this is an efficient method to measure the thickness of pipe-wall. In addition, this work also shows that it could use a NaI(Tl) scintillation detector and a low activity source to measure the thickness of pipe-wall, which is simple, quick and high accuracy method. (author)

Chest Wall Ewing Sarcoma Family of Tumors: Long-Term Outcomes

International Nuclear Information System (INIS)

Indelicato, Daniel J.; Keole, Sameer R.; Lagmay, Joanne P.; Morris, Christopher G.; Gibbs, C. Parker; Scarborough, Mark T.; Islam, Saleem; Marcus, Robert B.

2011-01-01

Purpose: To review the 40-year University of Florida experience treating Ewing sarcoma family of tumors of the chest wall. Methods and Materials: Thirty-nine patients were treated from 1966 to 2006. Of the patients, 22 were treated with radiotherapy (RT) alone, and 17 patients were treated with surgery with or without RT. Of 9 patients with metastatic disease, 8 were treated with RT alone. The risk profiles of each group were otherwise similar. The median age was 16.6 years, and the most frequent primary site was the rib (n = 17). The median potential follow-up was 19.2 years. Results: The 5-year actuarial overall survival (OS), cause-specific survival (CSS), and local control (LC) rates were 34%, 34%, and 72%, respectively. For the nonmetastatic subset (n = 30), the 5-year OS, CSS, and LC rates were 44%, 44%, and 79%, respectively. LC was not statistically significantly different between patients treated with RT alone (61%) vs. surgery + RT (75%). None of the 4 patients treated with surgery alone experienced local failure. No patient or treatment variable was significantly associated with local failure. Of the patients, 26% experienced Common Toxicity Criteria (CTC) Grade 3+ toxicity, including 2 pulmonary deaths. Modern intensive systemic therapy helped increase the 5-year CSS from 7% to 49% in patients treated after 1984 (p = 0.03). Conclusions: This is the largest single-institution series describing the treatment of chest wall Ewing tumors. Despite improvements in survival, obtaining local control is challenging and often accompanied by morbidity. Effort should be focused on identifying tumors amenable to combined-modality local therapy and to improving RT techniques.

Quantification of esophageal wall thickness in CT using atlas-based segmentation technique

Science.gov (United States)

Wang, Jiahui; Kang, Min Kyu; Kligerman, Seth; Lu, Wei

2015-03-01

Esophageal wall thickness is an important predictor of esophageal cancer response to therapy. In this study, we developed a computerized pipeline for quantification of esophageal wall thickness using computerized tomography (CT). We first segmented the esophagus using a multi-atlas-based segmentation scheme. The esophagus in each atlas CT was manually segmented to create a label map. Using image registration, all of the atlases were aligned to the imaging space of the target CT. The deformation field from the registration was applied to the label maps to warp them to the target space. A weighted majority-voting label fusion was employed to create the segmentation of esophagus. Finally, we excluded the lumen from the esophagus using a threshold of -600 HU and measured the esophageal wall thickness. The developed method was tested on a dataset of 30 CT scans, including 15 esophageal cancer patients and 15 normal controls. The mean Dice similarity coefficient (DSC) and mean absolute distance (MAD) between the segmented esophagus and the reference standard were employed to evaluate the segmentation results. Our method achieved a mean Dice coefficient of 65.55 ± 10.48% and mean MAD of 1.40 ± 1.31 mm for all the cases. The mean esophageal wall thickness of cancer patients and normal controls was 6.35 ± 1.19 mm and 6.03 ± 0.51 mm, respectively. We conclude that the proposed method can perform quantitative analysis of esophageal wall thickness and would be useful for tumor detection and tumor response evaluation of esophageal cancer.

Chest X-Ray

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Full Text Available ... and chest wall and may be used to help evaluate shortness of breath, persistent cough, fever, chest ... or injury. It may also be useful to help diagnose and monitor treatment for a variety of ...

Extrinsic tracheal compression caused by scoliosis of the thoracic spine and chest wall degormity: A case report

Energy Technology Data Exchange (ETDEWEB)

Baek, Kyong min Sarah; Lee, Bae Young; Kim, Hyeon Sook; Song, Kyung Sup; Kang, Hyeon Hul; Lee, Sang Haak; Moon, Hwa Sik [St. Paul' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2014-05-15

Extrinsic airway compression due to chest wall deformity is not commonly observed. Although this condition can be diagnosed more easily with the help of multidetector CT, the standard treatment method has not yet been definitely established. We report a case of an eighteen-year-old male who suffered from severe extrinsic tracheal compression due to scoliosis and straightening of the thoracic spine, confirmed on CT and bronchoscopy. The patient underwent successful placement of tracheal stent but later died of bleeding from the tracheostomy site probably due to tracheo-brachiocephalic artery fistula. We describe the CT and bronchoscopic findings of extrinsic airway compression due to chest wall deformity as well as the optimal treatment method, and discuss the possible explanation for bleeding in the patient along with review of the literature.

Extrinsic tracheal compression caused by scoliosis of the thoracic spine and chest wall degormity: A case report

International Nuclear Information System (INIS)

Baek, Kyong min Sarah; Lee, Bae Young; Kim, Hyeon Sook; Song, Kyung Sup; Kang, Hyeon Hul; Lee, Sang Haak; Moon, Hwa Sik

2014-01-01

Extrinsic airway compression due to chest wall deformity is not commonly observed. Although this condition can be diagnosed more easily with the help of multidetector CT, the standard treatment method has not yet been definitely established. We report a case of an eighteen-year-old male who suffered from severe extrinsic tracheal compression due to scoliosis and straightening of the thoracic spine, confirmed on CT and bronchoscopy. The patient underwent successful placement of tracheal stent but later died of bleeding from the tracheostomy site probably due to tracheo-brachiocephalic artery fistula. We describe the CT and bronchoscopic findings of extrinsic airway compression due to chest wall deformity as well as the optimal treatment method, and discuss the possible explanation for bleeding in the patient along with review of the literature.

Effects of non-invasive ventilation and posture on chest wall volumes and motion in patients with amyotrophic lateral sclerosis: a case series

Directory of Open Access Journals (Sweden)

Cristiana M. Magalhães

2016-01-01

Full Text Available ABSTRACT Background The effects of non-invasive ventilation (NIV on the breathing pattern and thoracoabdominal motion of patients with amyotrophic lateral sclerosis (ALS are unknown. Objectives 1 To analyze the influence of NIV on chest wall volumes and motion assessed by optoelectronic plethysmography in ALS patients and 2 to compare these parameters in the supine and sitting positions to those of healthy individuals (without NIV. Method Nine ALS patients were evaluated in the supine position using NIV. In addition, the ALS patients and nine healthy individuals were evaluated in both sitting and supine positions. Statistical analysis was performed using the paired Student t-test or Wilcoxon test and the Student t-test for independent samples or Mann-Whitney U test. Results Chest wall volume increased significantly with NIV, mean volume=0.43 (SD=0.16L versus 0.57 (SD=0.19L (p=0.04. No significant changes were observed for the pulmonary rib cage, abdominal rib cage, or abdominal contribution. The index of the shortening velocity of the diaphragmatic muscle, mean=0.15 (SD=0.05L/s versus 0.21 (SD=0.05L/s (p<0.01, and abdominal muscles, mean=0.09 (SD=0.02L/s versus 0.14 (SD=0.06L/s (p<0.01, increased during NIV. Comparisons between the supine and sitting positions showed similar changes in chest wall motion in both groups. However, the ALS patients presented a significantly lower contribution of the abdomen in the supine position compared with the controls, mean=56 (SD=13 versus 69 (SD=10 (p=0.02. Conclusions NIV improved chest wall volumes without changing the contribution of the chest wall compartment in ALS patients. In the supine position, ALS patients had a lower contribution of the abdomen, which may indicate early diaphragmatic dysfunction.

Prevalence and histopathological finding of thin-walled and thick-walled Sarcocysts in slaughtered cattle of Karaj abattoir, Iran.

Science.gov (United States)

Nourollahi-Fard, Saeid R; Kheirandish, Reza; Sattari, Saeid

2015-06-01

Sarcocystosis is a zoonotic disease caused by Sarcocystis spp. with obligatory two host life cycle generally alternating between an herbivorous intermediate host and a carnivorous definitive host. Some species of this coccidian parasite can cause considerable morbidity and mortality in cattle. The present study was set to investigate the prevalence of Sarcocystis spp. and type of cyst wall in slaughtered cattle of Karaj abattoir, Iran. For this purpose 125 cattle (88 males and 37 females) were investigated for the presence of macroscopic and microscopic Sarcocystis cysts in muscular tissues. No macroscopic Sarcocystis cysts were found in any of the samples. In light microscopy, 121 out of 125 cattle (96.8 %) had thin-walled cysts of Sarcocystis cruzi, while 43 out of them (34.4 %) had thick-walled Sarcocystis cyst. In this survey, the most infected tissue was esophagus and heart and the less was diaphragm. Thin-walled cysts (S. cruzi) mostly found in heart and skeletal muscle showed the less. However, thick-walled cyst (S. hominis or S. hirsuta) mostly were detected in diaphragm, heart muscle showed no thick-walled cyst. No significant relation was observed between age and sex and the rate of infection. The results showed that Sarcocystis cyst is prevalent in cattle in the North part of Iran and the evaluation of infection potential can be useful when considering control programs.

Wall Thickness Measurement Of Insulated Pipe By Tangential Radiography Technique Using Ir 192

International Nuclear Information System (INIS)

Soedarjo

2000-01-01

Insulation pipe wall thickness by tangential radiography technique has been carried out using 41 Curie Iridium 192 source has activity for two carbon steel pipes. The outer diameter of the first pipe is 90 mm, wall thickness is 75.0 mm, source film film distance is 609.5 mm, source tangential point of insulation is 489.5 mm and exposure time 3 minute and 25 second. From the calculation, the first pipe thickness is found to be 12.54 mm and for the second pipe is 8.42 mm. The thickness is due to inaccuracy in reading the pipe thickness on radiography film and the geometry distortion radiation path

Reproducibility of The Abdominal and Chest Wall Position by Voluntary Breath-Hold Technique Using a Laser-Based Monitoring and Visual Feedback System

International Nuclear Information System (INIS)

Nakamura, Katsumasa; Shioyama, Yoshiyuki; Nomoto, Satoru; Ohga, Saiji; Toba, Takashi; Yoshitake, Tadamasa; Anai, Shigeo; Terashima, Hiromi; Honda, Hiroshi

2007-01-01

Purpose: The voluntary breath-hold (BH) technique is a simple method to control the respiration-related motion of a tumor during irradiation. However, the abdominal and chest wall position may not be accurately reproduced using the BH technique. The purpose of this study was to examine whether visual feedback can reduce the fluctuation in wall motion during BH using a new respiratory monitoring device. Methods and Materials: We developed a laser-based BH monitoring and visual feedback system. For this study, five healthy volunteers were enrolled. The volunteers, practicing abdominal breathing, performed shallow end-expiration BH (SEBH), shallow end-inspiration BH (SIBH), and deep end-inspiration BH (DIBH) with or without visual feedback. The abdominal and chest wall positions were measured at 80-ms intervals during BHs. Results: The fluctuation in the chest wall position was smaller than that of the abdominal wall position. The reproducibility of the wall position was improved by visual feedback. With a monitoring device, visual feedback reduced the mean deviation of the abdominal wall from 2.1 ± 1.3 mm to 1.5 ± 0.5 mm, 2.5 ± 1.9 mm to 1.1 ± 0.4 mm, and 6.6 ± 2.4 mm to 2.6 ± 1.4 mm in SEBH, SIBH, and DIBH, respectively. Conclusions: Volunteers can perform the BH maneuver in a highly reproducible fashion when informed about the position of the wall, although in the case of DIBH, the deviation in the wall position remained substantial

Characteristics Of Congenital Chest Wall Deformities In Referred Patients To Tehran Imam Khomeini And Kashan Shahid Beheshti Hospital During 1991-2001

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Davoodabadi A

2004-08-01

Full Text Available Background: Infants and children present with a wide range of congenital chest wall deformities which have both physiologic psychologic consequences and are often associated with other abnormalities. Surgical intervention offers excellent cosmetic results with minimal morbidity and mortality. In order to investigation of chest wall deformities, and surgical results, this study was performed. Materials and Methods: A descriptive study on existing data on 60 consecutive patients with chest wall deformity during 10 years carried out. Patient's characteristics such as age, gender, signs and symptoms type of operation, associated disorder, syndrome, and surgical complications were considered. Results: Pectus excavatum 60% and pectus carinatum 30% Poland syn 6.7% 9 sternal cleft 3.2. Inpectus, M/F: Was 3/1 and others were 1:1. Age of admission 4 to 27 years 13.4±6.82 and association syndromes were, turner, Morgue and marfan, most patients were operated in delayed time (75 and hence, scoliosis was common than others. Conclusion: Pectus excavatum was the most common deformity and if scoliosis was prominent and most operation was done in old age but surgical result was excellent no anyone expired and complication was a little. So we recommended that all of the chest deformities must be operated in anytime.

Wall thickness dependence of the scaling law for ferroic stripe domains

International Nuclear Information System (INIS)

Catalan, G; Scott, J F; Schilling, A; Gregg, J M

2007-01-01

The periodicity of 180 0 stripe domains as a function of crystal thickness scales with the width of the domain walls, both for ferroelectric and for ferromagnetic materials. Here we derive an analytical expression for the generalized ferroic scaling factor and use this to calculate the domain wall thickness and gradient coefficients (exchange constants) in some ferroelectric and ferromagnetic materials. We then use these to discuss some of the wider implications for the physics of ferroelectric nanodevices and periodically poled photonic crystals. (fast track communication)

Acute effects of volume-oriented incentive spirometry on chest wall volumes in patients after a stroke.

Science.gov (United States)

Lima, Illia Ndf; Fregonezi, Guilherme Af; Melo, Rodrigo; Cabral, Elis Ea; Aliverti, Andrea; Campos, Tânia F; Ferreira, Gardênia Mh

2014-07-01

The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P = .001) and under 3 conditions (P spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to VT was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P = .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P = .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P = .14). Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation. Copyright © 2014 by Daedalus Enterprises.

Radiation therapy for chest wall recurrence of breast cancer after mastectomy in a favorable subgroup of patients

International Nuclear Information System (INIS)

Hsi, R. Alex; Antell, Andrew; Schultz, Delray J.; Solin, Lawrence J.

1998-01-01

Purpose: Long-term outcome after radiation therapy for local-regional recurrence of breast cancer after mastectomy is generally poor. This study was performed to evaluate the long-term outcome for a potentially favorable subgroup of patients with chest wall recurrence. Methods and Materials: Of 71 patients with an isolated local-regional recurrence of breast cancer after mastectomy, 18 were identified who met the following favorable selection criteria: 1) a disease-free interval after mastectomy of 2 years or more, 2) an isolated chest wall recurrence, and 3) tumor size < 3 cm or complete excision of the recurrent disease. All 18 patients were treated with local-regional irradiation between 1967 and 1988. Radiotherapy (RT) was delivered to the chest wall to a median total dose of 60 Gy (range 30-66 Gy). Four patients received adjuvant chemotherapy and six patients received adjuvant hormonal therapy. Results: With a median follow-up of 8.4 years, nine of 18 patients were alive and free of disease. The 10-year actuarial overall and cause-specific survivals were 72% and 77%, respectively. The 10-year actuarial relapse-free survival and local control were 42% and 86%, respectively. Conclusion: Treatment for a local-regional recurrence of breast cancer after mastectomy in a favorable subgroup of patients results in a high rate of long-term survival as well as excellent local control. Aggressive treatment is warranted in this favorable subgroup of patients. 1998 Elsevier Science Inc

Surgical management of the radiated chest wall

International Nuclear Information System (INIS)

Arnold, P.G.; Pairolero, P.C.

1986-01-01

Fifty consecutive patients with radiation-related problems of the chest wall were treated between 1976 and 1984. There were 40 women and 10 men with an average age of 54 years (range 26 to 78 years). Twenty-three patients had radiation ulcers alone, 20 had recurrent cancer, and 7 had infected median sternotomy wounds. Thirty-six had skeletal resections and 44 had soft-tissue resections. The skeleton was reconstructed with Prolene mesh in 12 patients and with autogenous rib in 3. Sixty-three muscles were transposed in 43 patients. Twelve omental transpositions were performed (8 for primary treatment and 4 for salvage of a failed muscle flap). Hospitalization averaged 20.2 days. There was one operative death (at 29 days). Partial flap necrosis occurred in 10 patients. Mesh was removed in three patients. There were 14 late deaths, most from recurrent tumor. The remaining patients had well-healed wounds and a generally improved quality of life. We conclude that aggressive resection and reliable reconstruction are critical considerations in the surgical management of this perplexing clinical problem

Influence of MR imaging in radiation therapy of chest lymphoma

International Nuclear Information System (INIS)

Carlsen, S.E.; Hoppe, R.; Bergin, C.J.

1991-01-01

This paper evaluates the influence of MR detection of additional sites of chest lymphoma on radiation therapy. Chest MR images and CT scans of 56 patients with new or recurrent mediastinal lymphoma obtained within 1 month of each other were retrospectively reviewed. MR images included T1- and T2-weighted SE and STIR sequences. Images were assessed for pleural and extrapleural disease. Radiation portals of patients with pleural or chest wall disease were reevaluated and compared with portals originally designed with CT. MR imaging demonstrated chest wall disease in 15 patients (21 sites). Ten patients also had pleural disease (13 sites). CT identified chest wall disease in four of these patients (five sites) and pleural disease in three patients (five sites). Seven of the 15 patients with chest wall disease were treated with radiation therapy alone. Two of the seven patients had significant modification of radiation portals based on MR findings. Retrospectively, therapy would have been altered in an additional two patients in whom pleural disease was identified at MR. The increased sensitivity of MR in detecting chest wall or pleural disease has important implications for treatment planning in chest wall lymphoma

Comparison of Maximal Wall Thickness in Hypertrophic Cardiomyopathy Differs Between Magnetic Resonance Imaging and Transthoracic Echocardiography.

Science.gov (United States)

Bois, John P; Geske, Jeffrey B; Foley, Thomas A; Ommen, Steve R; Pellikka, Patricia A

2017-02-15

Left ventricular (LV) wall thickness is a prognostic marker in hypertrophic cardiomyopathy (HC). LV wall thickness ≥30 mm (massive hypertrophy) is independently associated with sudden cardiac death. Presence of massive hypertrophy is used to guide decision making for cardiac defibrillator implantation. We sought to determine whether measurements of maximal LV wall thickness differ between cardiac magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Consecutive patients were studied who had HC without previous septal ablation or myectomy and underwent both cardiac MRI and TTE at a single tertiary referral center. Reported maximal LV wall thickness was compared between the imaging techniques. Patients with ≥1 technique reporting massive hypertrophy received subset analysis. In total, 618 patients were evaluated from January 1, 2003, to December 21, 2012 (mean [SD] age, 53 [15] years; 381 men [62%]). In 75 patients (12%), reported maximal LV wall thickness was identical between MRI and TTE. Median difference in reported maximal LV wall thickness between the techniques was 3 mm (maximum difference, 17 mm). Of the 63 patients with ≥1 technique measuring maximal LV wall thickness ≥30 mm, 44 patients (70%) had discrepant classification regarding massive hypertrophy. MRI identified 52 patients (83%) with massive hypertrophy; TTE, 30 patients (48%). Although guidelines recommend MRI or TTE imaging to assess cardiac anatomy in HC, this study shows discrepancy between the techniques for maximal reported LV wall thickness assessment. In conclusion, because this measure clinically affects prognosis and therapeutic decision making, efforts to resolve these discrepancies are critical. Copyright © 2016 Elsevier Inc. All rights reserved.

Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video).

Science.gov (United States)

von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

2008-04-01

The endoscopic full-thickness Plicator device was initially developed to provide an endoscopic treatment option for patients with GERD. Because the endoscopic full-thickness Plicator enables rapid and easy placement of transmural sutures, comparable with surgical sutures, we used the Plicator device for endoscopic treatment or prevention of GI-wall defects. To describe the outcomes and complications of endoscopic full-thickness suturing during EMR and for the treatment of gastric-wall defects. A report of 4 cases treated with the endoscopic full-thickness suturing between June 2006 and April 2007. A large tertiary-referral center. Four subjects received endoscopic full-thickness suturing. The subjects were women, with a mean age of 67 years. Of the 4 subjects, 3 received endoscopic full-thickness suturing during or after an EMR. One subject received endoscopic full-thickness suturing for treatment of a fistula. Primary outcome measurements were clinical procedural success and procedure-related adverse events. The mean time for endoscopic full-thickness suturing was 15 minutes. In all cases, GI-wall patency was restored or ensured, and no procedure-related complications occurred. All subjects responded well to endoscopic full-thickness suturing. The resection of one GI stromal tumor was incomplete. Because of the Plicator's 60F distal-end diameter, endoscopic full-thickness suturing could only be performed with the patient under midazolam and propofol sedation. The durable Plicator suture might compromise the endoscopic follow-up after EMR. The endoscopic full-thickness Plicator permits rapid and easy placement of transmural sutures and seems to be a safe and effective alternative to surgical intervention to restore GI-wall defects or to ensure GI-wall patency during EMR procedures.

The role of imaging for the surgeon in primary malignant bone tumors of the chest wall

Energy Technology Data Exchange (ETDEWEB)

Rocca, M., E-mail: michele.rocca@ior.it [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Salone, M. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Galletti, S. [Ultrasound Unit, The Rizzoli Orthopaedic Institute, Bologna (Italy); Balladelli, A. [Laboratory of Experimental Oncology, The Rizzoli Orthopaedic Institute, Bologna (Italy); Vanel, D. [Research in Imaging Musculo Skeletal Tumors, The Rizzoli Orthopaedic Institute, Bologna (Italy); Briccoli, A. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy)

2013-12-01

Primary malignant chest wall tumors are rare. The most frequent primary malignant tumor of the chest wall is chondrosarcoma, less common are primary bone tumors belonging to the Ewing Family Bone Tumors (EFBT), or even rarer are osteosarcomas. They represent a challenging clinical entities for surgeons as the treatment of choice for these neoplasms is surgical resection, excluding EFBT which are normally treated by a multidisciplinary approach. Positive margins after surgical procedure are the principal risk factor of local recurrence, therefore to perform adequate surgery a correct preoperative staging is mandatory. Imaging techniques are used for diagnosis, to determine anatomic site and extension, to perform a guided biopsy, for local and general staging, to evaluate chemotherapy response, to detect the presence of a recurrence. This article will focus on the role of imaging in guiding this often difficult surgery and the different technical possibilities adopted in our department to restore the mechanics of the thoracic cage after wide resections.

Inhibitory effect of cervical trachea and chest wall vibrations on cough reflex sensitivity and perception of urge-to-cough in healthy male never-smokers

OpenAIRE

Kashiwazaki, Naohiro; Ebihara, Satoru; Gui, Peijun; Katayama, Norihiro; Ito, Kumiko; Sato, Ryuhei; Oyama, Chika; Ebihara, Takae; Kohzuki, Masahiro

2013-01-01

Background Non-pharmacological options for symptomatic management of cough are desired. Although chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. Therefore, we investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea. Methods Twenty-four healthy male never...

Development of thick wall welding and cutting tools for ITER

International Nuclear Information System (INIS)

Nakahira, Masataka; Takahashi, Hiroyuki; Akou, Kentaro; Koizumi, Koichi

1998-01-01

The Vacuum Vessel, which is a core component of International Thermonuclear Experimental Reactor (ITER), is required to be exchanged remotely in a case of accident such as superconducting coil failure. The in-vessel components such as blanket and divertor are planned to be exchanged or fixed. In these exchange or maintenance operations, the thick wall welding and cutting are inevitable and remote handling tools are necessary. The thick wall welding and cutting tools for blanket are under developing in the ITER R and D program. The design requirement is to weld or cut the stainless steel of 70 mm thickness in the narrow space. Tungsten inert gas (TIG) arc welding, plasma cutting and iodine laser welding/cutting are selected as primary option. Element welding and cutting tests, design of small tools to satisfy space requirement, test fabrication and performance tests were performed. This paper reports the tool design and overview of welding and cutting tests. (author)

Development of thick wall welding and cutting tools for ITER

Energy Technology Data Exchange (ETDEWEB)

Nakahira, Masataka; Takahashi, Hiroyuki; Akou, Kentaro; Koizumi, Koichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

1998-04-01

The Vacuum Vessel, which is a core component of International Thermonuclear Experimental Reactor (ITER), is required to be exchanged remotely in a case of accident such as superconducting coil failure. The in-vessel components such as blanket and divertor are planned to be exchanged or fixed. In these exchange or maintenance operations, the thick wall welding and cutting are inevitable and remote handling tools are necessary. The thick wall welding and cutting tools for blanket are under developing in the ITER R and D program. The design requirement is to weld or cut the stainless steel of 70 mm thickness in the narrow space. Tungsten inert gas (TIG) arc welding, plasma cutting and iodine laser welding/cutting are selected as primary option. Element welding and cutting tests, design of small tools to satisfy space requirement, test fabrication and performance tests were performed. This paper reports the tool design and overview of welding and cutting tests. (author)

MRI of the Chest

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Full Text Available ... to assess the anatomy and function of the heart and its blood flow. Tell your doctor about ... chest cavity, including the mediastinum , chest wall, pleura, heart and vessels, from almost any angle. MRI also ...

Three-dimensional atrial wall thickness maps to inform catheter ablation procedures for atrial fibrillation.

Science.gov (United States)

Bishop, Martin; Rajani, Ronak; Plank, Gernot; Gaddum, Nicholas; Carr-White, Gerry; Wright, Matt; O'Neill, Mark; Niederer, Steven

2016-03-01

Transmural lesion formation is critical to success in atrial fibrillation ablation and is dependent on left atrial wall thickness (LAWT). Pre- and peri-procedural planning may benefit from LAWT measurements. To calculate the LAWT, the Laplace equation was solved over a finite element mesh of the left atrium derived from the segmented computed tomographic angiography (CTA) dataset. Local LAWT was then calculated from the length of field lines derived from the Laplace solution that spanned the wall from the endocardium or epicardium. The method was validated on an atrium phantom and retrospectively applied to 10 patients who underwent routine coronary CTA for standard clinical indications at our institute. The Laplace wall thickness algorithm was validated on the left atrium phantom. Wall thickness measurements had errors of atrial wall thickness measurements were performed on 10 patients. Successful comprehensive LAWT maps were generated in all patients from the coronary CTA images. Mean LAWT measurements ranged from 0.6 to 1.0 mm and showed significant inter and intra patient variability. Left atrial wall thickness can be measured robustly and efficiently across the whole left atrium using a solution of the Laplace equation over a finite element mesh of the left atrium. Further studies are indicated to determine whether the integration of LAWT maps into pre-existing 3D anatomical mapping systems may provide important anatomical information for guiding radiofrequency ablation. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Simultaneous measurement of instantaneous heart rate and chest wall plethysmography in short-term, metronome guided heart rate variability studies: suitability for assessment of autonomic dysfunction.

Science.gov (United States)

Perring, S; Jones, E

2003-08-01

Instantaneous heart rate and chest wall motion were measured using a 3-lead ECG and an air pressure chest wall plethysmography system. Chest wall plethysmography traces were found to accurately represent the breathing pattern as measured by spirometry (average correlation coefficient 0.944); though no attempt was made to calibrate plethysmography voltage output to tidal volume. Simultaneous measurements of heart rate and chest wall motion were made for short periods under metronome guided breathing at 6 breaths per minute. The average peak to trough heart rate change per breath cycle (AVEMAX) and maximum correlation between heart rate and breathing cycle (HRBRCORR) were measured. Studies of 44 normal volunteers indicated clear inverse correlation of heart rate variability parameters with age (AVEMAX R = -0.502, P < 0.001) but no significant change in HRBRCORR with age (R = -0.115). Comparison of normal volunteers with diabetics with no history of symptoms associated with autonomic failure indicated significant lower heart rate variability in diabetics (P = 0.005 for AVEMAX) and significantly worse correlation between heart rate and breathing (P < 0.001 for HRBRCORR). Simultaneous measurement of heart rate and breathing offers the possibility of more sensitive diagnosis of autonomic failure in a simple bedside test and gives further insight into the nature of cardio-ventilatory coupling.

Tumors on chest wall, breast cancer in men. A case

International Nuclear Information System (INIS)

Najera, Carlos; Guerra, Diego; Sotomayor, Sonia; Poveda, Sergio; Bucheli, Carlos

2004-01-01

A 75 years old man went to the Carlos Andrade Marin Hospital due to the appearance of a mass on his chest wall, initially diagnosed as a lypoma. During his preoperative preparation we had a suspicion of a malignant process. Finally and after a surgical procedure the diagnose was made, breast cancer. Considered this way the practice of medicine is as simple as having a suspicion. In fact it is, actually what determines the final diagnose of a pathology is the suspicion that we as physicians have about a problem. However, to generate an hypothesis we required knowledge, study and curiosity. The present work is a bibliographic review about a non so frequent problem as the thoracic mass is. The author)

Quantitative CT: Associations between Emphysema, Airway Wall Thickness and Body Composition in COPD

DEFF Research Database (Denmark)

Rutten, Erica P A; Grydeland, Thomas B; Pillai, Sreekumar G

2011-01-01

, CT scans were performed to determine emphysema (%LAA), airway wall thickness (AWT-Pi10), and lung mass. Muscle wasting based on FFMI was assessed by bioelectrical impedance. In both the men and women with COPD, FFMI was negatively associated with %LAA. FMI was positively associated with AWT-Pi10......The objective of the present study was to determine the association between CT phenotypes-emphysema by low attenuation area and bronchitis by airway wall thickness-and body composition parameters in a large cohort of subjects with and without COPD. In 452 COPD subjects and 459 subjects without COPD...... in both subjects with and without COPD. Among the subjects with muscle wasting, the percentage emphysema was high, but the predictive value was moderate. In conclusion, the present study strengthens the hypothesis that the subgroup of COPD cases with muscle wasting have emphysema. Airway wall thickness...

Quantitative CT: Associations between Emphysema, Airway Wall Thickness and Body Composition in COPD

DEFF Research Database (Denmark)

Rutten, Erica P A; Grydeland, Thomas B; Pillai, Sreekumar G

2011-01-01

The objective of the present study was to determine the association between CT phenotypes-emphysema by low attenuation area and bronchitis by airway wall thickness-and body composition parameters in a large cohort of subjects with and without COPD. In 452 COPD subjects and 459 subjects without COPD......, CT scans were performed to determine emphysema (%LAA), airway wall thickness (AWT-Pi10), and lung mass. Muscle wasting based on FFMI was assessed by bioelectrical impedance. In both the men and women with COPD, FFMI was negatively associated with %LAA. FMI was positively associated with AWT-Pi10...... in both subjects with and without COPD. Among the subjects with muscle wasting, the percentage emphysema was high, but the predictive value was moderate. In conclusion, the present study strengthens the hypothesis that the subgroup of COPD cases with muscle wasting have emphysema. Airway wall thickness...

Hot isostatically pressed (HIPed) thick-walled component for a pressurised water reactor (PWR) application

International Nuclear Information System (INIS)

Hookham, I.; Burdett, B.; Bridger, K.; Sulley, J.L.

2009-01-01

This paper presents the work conducted to justify and provide a quality assured HIPed thick-walled component for a PWR application; the component being designed and manufactured by Rolls-Royce. Rolls-Royce has previously published (ICAPP 08) its overall, staged approach to the introduction of powder HIPed components; starting with thin-walled, leak limited pressure boundaries, and culminating in the use of the powder HIPed process for thick walled components. This paper presents details specific to a thick walled pressure vessel component. Results are presented of non-destructive and destructive examinations of one of a batch of components. Mechanical testing and metallurgical examination results of sample material taken from different sections of the component are presented. A full range of test results is provided covering, as examples: tensile, Charpy impact and sensitization susceptibility. Differences in weldability between the HIPed and the previous forged form are also documented. (author)

Quantitative computed tomography measures of emphysema and airway wall thickness are related to respiratory symptoms

DEFF Research Database (Denmark)

Grydeland, Thomas B; Dirksen, Asger; Coxson, Harvey O

2010-01-01

There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness.......There is limited knowledge about the relationship between respiratory symptoms and quantitative high-resolution computed tomography measures of emphysema and airway wall thickness....

Effect of subcooling and wall thickness on pool boiling from downward-facing curved surfaces in water

Energy Technology Data Exchange (ETDEWEB)

El-Genk, M.S.; Glebov, A.G. [Univ. of New Mexico, Albuquerque, NM (United States)

1995-09-01

Quenching experiments were performed to investigate the effects of water subcooling and wall thickness on pool boiling from a downward-facing curved surface. Experiments used three copper sections of the same diameter (50.8 mm) and surface radius (148 mm), but different thickness (12.8, 20 and 30 mm). Local and average pool boiling curves were obtained at saturation and 5 K, 10 K, and 14 K subcooling. Water subcooling increased the maximum heat flux, but decreased the corresponding wall superheat. The minimum film boiling heat flux and the corresponding wall superheat, however, increased with increased subcooling. The maximum and minimum film boiling heat fluxes were independent of wall thickness above 20 mm and Biot Number > 0.8, indicating that boiling curves for the 20 and 30 thick sections were representative of quasi steady-state, but not those for the 12.8 mm thick section. When compared with that for a flat surface section of the same thickness, the data for the 12.8 mm thick section showed significant increases in both the maximum heat flux (from 0.21 to 0.41 MW/m{sup 2}) and the minimum film boiling heat flux (from 2 to 13 kW/m{sup 2}) and about 11.5 K and 60 K increase in the corresponding wall superheats, respectively.

Detrusor wall thickness compared to other non-invasivemethods in ...

African Journals Online (AJOL)

Introduction: The current study aims to compare the diagnostic accuracy of detrusor wall thickness to othernoninvasive, tools, using pressure flow studies as a reference, in the assessment of bladder outlet, obstructionamong men presenting with lower urinary tract symptoms. Patients and Methods: Men aged 50 or older ...

Relaxation of Thick-Walled Cylinders and Spheres

DEFF Research Database (Denmark)

Saabye Ottosen, N.

1982-01-01

Using the nonlinear creep law proposed by Soderberg, (1936) closed-form solutions are derived for the relaxation of incompressible thick-walled spheres and cylinders in plane strain. These solutions involve series expressions which, however, converge very quickly. By simply ignoring these series...... expressions, extremely simple approximate solutions are obtained. Despite their simplicity these approximations possess an accuracy that is superior to approximations currently in use. Finally, several physical aspects related to the relaxation of cylinders and spheres are discussed...

Necrotizing fasciitis involving the chest and abdominal wall caused by Raoultella planticola

Directory of Open Access Journals (Sweden)

Kim Si-Hyun

2012-03-01

Full Text Available Abstract Background Raoultella planticola was originally considered to be a member of environmental Klebsiella. The clinical significance of R. planticola is still not well known. Case presentation We describe the first case of necrotizing fasciitis involving the chest and abdominal wall caused by R. planticola. The identity of the organism was confirmed using 16S rRNA sequencing. The patient was successfully treated with the appropriate antibiotics combined with operative drainage and debridement. Conclusions R. planticola had been described as environmental species, but should be suspected in extensive necrotizing fasciitis after minor trauma in mild to moderate immunocompromised patients.

A case of radiation ulcer of chest wall with osteomyelitis

International Nuclear Information System (INIS)

Baba, Kyoko; Shibata, Hirotatsu; Mouri, Mari; Uchinuma, Eiju

2005-01-01

We report a case of anterior chest skin ulcer with rib and sternum osteomyelitis following radiation therapy for post operative mammary carcinoma. Operation was performed six times including debridement with sternum and rib resection reconstruction and skin grafting. It took about one and a half years after first operation to heal the ulcer with osteomyelitis. Principle of treatment for radiation ulcer accompanied by osteomyelitis is complete resection of the damaged lesion. However, it is difficult to evaluate the exact area of the damaged lesion. Therefore it is not rare to repeat its recurrence and have trouble with its treatment. In this case, it was considered that the resected area was insufficient on the initial operation. In order to treat for radiation ulcers accompanied by osteomyelitis, enough resection of the damaged lesion in the initial operation is necessary. Ultimately, in our case, the resection of all sternum, part of the right second to fifth rib and part of left second to seventh rib was necessary. It is generally said that reconstructing bone structure is required in the case of wide defect of chest wall. Though, we did not perform reconstruction of the bone structures, there is no problem in the condition of respiratory system. The surrounding soft tissues changed to hard enough to avoid paradoxical breathing. (author)

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system.

Science.gov (United States)

De Palma, Angela; Sollitto, Francesco; Loizzi, Domenico; Di Gennaro, Francesco; Scarascia, Daniele; Carlucci, Annalisa; Giudice, Giuseppe; Armenio, Andrea; Ludovico, Rossana; Loizzi, Michele

2016-03-01

We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16-83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. An optimal chest wall stabilization and reconstruction was achieved with the Synthes(®) titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long

Dose distribution of chest wall electron beam radiotherapy for patients with breast cancer after radical mastectomy

International Nuclear Information System (INIS)

Cong Yetong; Chen Dawei; Bai Lan; Zhou Yinhang; Piao Yongfeng; Wang Xi; Qu Yaqin

2006-01-01

Objective: To study the dose distribution of different bolus after different energy electron beam irradiation to different chest wall radiotherapy for the patients with breast cancer. Methods: The paper simulated the dose distribution of women's left breast cancer after radical mastectomy by 6 and 9 MeV electron beam irradiation, and TLD was used to measure. Results: The dose of skin became higher and the dose of lung was less when 0.5 and 1.0 cm bolus were used on the body; with the increasing of the energy of electron beam, the high dose field became larger; and with the same energy of electron beam, the high dose field moved to surface of the body when the bolus was thicker. Conclusion: When different energy electron ray irradiates different thickness bolus, the dosage of skin surface increases and the dosage of anterior margin of lung reduces. With electron ray energy increasing, the high dosage field is widen, when the electron ray energy is identity, the high dosage field migrates to the surface after adding bolus. Using certain depth bolus may attain the therapeutical dose of target area. (authors)

Association Between the Lateral Wall Thickness of the Maxillary Sinus and the Dental Status: Cone Beam Computed Tomography Evaluation

International Nuclear Information System (INIS)

Khajehahmadi, Saeedeh; Rahpeyma, Amin; Hoseini Zarch, Seyed Hosein

2014-01-01

Assessment of the lateral wall thickness of the maxillary sinus is very important in decision making for many surgical interventions. The association between the thickness of the lateral wall of the maxillary sinus and the dental status is not well identified. To compare the thickness of the lateral wall of the maxillary sinus in individuals with and without teeth to determine if extraction of the teeth can lead to a significant reduction in the thickness of the maxillary sinus lateral wall or not. In a retrospective study on fifty patients with an edentulous space, the thickness of the lateral wall of the maxillary sinus,one centimeter above the sinus floor in the second premolar (P2), first molar (M1) and second molar (M2) areas was determined by cone beam computed tomography scans(CBCTs) and a digital ruler in Romexis F software (Planmeca Romexis 2.4.2.R) and it was compared with values measured in fifty dentated individuals. Three way analysis of variance was applied for comparison after confirmation of the normal distribution of data. The mean of the wall thickness in each of these points was lower in patients with edentulous spaces; however it was not significant. There was no association between gender and the thickness of the lateral wall of the maxillary sinus, but location was associated with different thicknesses. The differences in the thickness based on the location and dental status necessitates assessment of the wall thickness of the maxillary sinus in addition to the current evaluation of bone thickness between the sinus floor and the edentulous crest before maxillary sinus surgery

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 11: Quantification of chest wall motion during deep inspiration breast hold treatments using cine EPID images and a physics based algorithm

Energy Technology Data Exchange (ETDEWEB)

Alpuche Aviles, Jorge E.; VanBeek, Timothy [CancerCare Manitoba, Winnipeg (Canada); Sasaki, David; Rivest, Ryan; Akra, Mohamed [CancerCare Manitoba, Winnipeg (Canada); University of Manitoba, Winnipeg (Canada)

2016-08-15

Purpose: This work presents an algorithm used to quantify intra-fraction motion for patients treated using deep inspiration breath hold (DIBH). The algorithm quantifies the position of the chest wall in breast tangent fields using electronic portal images. Methods: The algorithm assumes that image profiles, taken along a direction perpendicular to the medial border of the field, follow a monotonically and smooth decreasing function. This assumption is invalid in the presence of lung and can be used to calculate chest wall position. The algorithm was validated by determining the position of the chest wall for varying field edge positions in portal images of a thoracic phantom. The algorithm was used to quantify intra-fraction motion in cine images for 7 patients treated with DIBH. Results: Phantom results show that changes in the distance between chest wall and field edge were accurate within 0.1 mm on average. For a fixed field edge, the algorithm calculates the position of the chest wall with a 0.2 mm standard deviation. Intra-fraction motion for DIBH patients was within 1 mm 91.4% of the time and within 1.5 mm 97.9% of the time. The maximum intra-fraction motion was 3.0 mm. Conclusions: A physics based algorithm was developed and can be used to quantify the position of chest wall irradiated in tangent portal images with an accuracy of 0.1 mm and precision of 0.6 mm. Intra-fraction motion for patients treated with DIBH at our clinic is less than 3 mm.

Normal wall thickness and tumorous changes in the gastrointestinal tract demonstrated by CT

International Nuclear Information System (INIS)

Zwaan, M.; Gmelin, E.; Borgis, K.J.; Neubauer, B.

1991-01-01

55 patients with tumours of the gastroinstinal tract were ecamined by CT, using a paraffin emulsion as a negative oral contrast medium. These were compared with 119 normal patients. The appearance of normal and tumour bearing portions of the gut wall against the contrast medium was studied. Under hypotonic conditions the gut wall could regularly be distinguished from surrounding organs and gut content. Mural thickness of the oesophagus > 7 mm and of the stomach and colon > 8 mm must be regarded as abnormal. Benign diseases cannot be distinguished from malignant conditions on the basis of wall thickness. Artifacts, such as are caused by positive oral contrast, were of less significance when using paraffin emulsion. (orig.) [de

The Effect of Selected Conditions in a Thermoforming Process on Wall Thickness Variations

Directory of Open Access Journals (Sweden)

Emil Sasimowski

2017-12-01

Full Text Available The paper reports the results of a study on the effect of selected conditions in a thermoforming process for thin polystyrene sheet by vacuum assisted drape forming on the wall thickness non-uniformity of finished parts. The investigation was performed using Statistica’s DOE module for three variables: temperatures in the external and internal zones of the heater as well as heating time of the plastic sheet. The results demonstrate that the wall thickness in the finished parts at the measuring points is primarily affected by the heating time and the temperature in the internal zone of the heater, while the temperature in the external zone only affects some regions of the finished part. The results demonstrate that a short heating time and hence a lower temperature of the plastic sheet lead to a more uniform deformation of both the bottom and the side walls of the finished part, and as a consequence, to smaller variations in the wall thickness. The shortening of the heating time is however limited by the necessity of accurate reproduction of the shape of the finished part.

MDCT assessment of airway wall thickness in COPD patients using a new method: correlations with pulmonary function tests

International Nuclear Information System (INIS)

Achenbach, Tobias; Weinheimer, Oliver; Schmitt, Sabine; Freudenstein, Daniela; Kunz, Richard Peter; Dueber, Christoph; Biedermann, Alexander; Buhl, Roland; Goutham, Edula; Heussel, Claus Peter

2008-01-01

Quantitative assessment of airway-wall dimensions by computed tomography (CT) has proven to be a marker of airway-wall remodelling in chronic obstructive pulmonary disease (COPD) patients. The objective was to correlate the wall thickness of large and small airways with functional parameters of airflow obstruction in COPD patients on multi-detector (MD) CT images using a new quantification procedure from a three-dimensional (3D) approach of the bronchial tree. In 31 patients (smokers/COPD, non-smokers/controls), we quantitatively assessed contiguous MDCT cross-sections reconstructed orthogonally along the airway axis, taking the point-spread function into account to circumvent over-estimation. Wall thickness and wall percentage were measured and the per-patient mean/median correlated with FEV1 and FEV1%. A median of 619 orthogonal airway locations was assessed per patient. Mean wall percentage/mean wall thickness/median wall thickness in non-smokers (29.6%/0.69 mm/0.37 mm) was significantly different from the COPD group (38.9%/0.83 mm/0.54 mm). Correlation coefficients (r) between FEV1 or FEV1% predicted and intra-individual means of the wall percentage were -0.569 and -0.560, respectively, with p<0.001. Depending on the parameter, they were increased for airways of 4 mm and smaller in total diameter, being -0.621 (FEV1) and -0.537 (FEV1%) with p < 0.002. The wall thickness was significantly higher in smokers than in non-smokers. In COPD patients, the wall thickness measured as a mean for a given patient correlated with the values of FEV1 and FEV1% predicted. Correlation with FEV1 was higher when only small airways were considered. (orig.)

Radiation induced skin cancer the chest wall 30 years later from breast cancer operation

Energy Technology Data Exchange (ETDEWEB)

Miyamoto, Kouji; Togawa, Tamotsu; Hasegawa, Takeshi; Matsunami, Hidetoshi; Ikeda, Tsuneko [Matsunami General Hospital, Kasamatsu, Gifu (Japan); Matsuo, Youichi

1998-10-01

This paper describes the skin cancer on the frontal chest wall induced by postoperative irradiation 30 years later from mastectomy. The patients was a 62-year-old woman, who received mastectomy of the right breast cancer (invasive ductal carcinoma, comedo type) at 31 years old, and received the postoperative radiotherapy of total 11,628 rad over 38 times. On the first medical examination in author`s hospital, the patient had an ulcer of about 10 cm diameter and was diagnosed the radiation induced skin cancer (well differentiated squamous cell carcinoma) in the biopsy. Because of the general condition of the patient was extremely bad and the skin cancer had highly developed, the excision was thought to be impossible. The radiotherapy (16 Gy) and combined local chemotherapy by OK 432 and Bleomycin were performed. In spite of the short term treatment, these therapies were effective on the reduction of the tumor size and the hemostasis, and brought the patient the improvement of QOL. The general condition of the patient improved to be stable and she recovered enough to go out from the hospital for 6 months. After 10 months, she showed anorexia and dyspnea and died after about 1 year from the admission. The present case is extremely rare, and it is required the radical therapy like the excision of chest wall at early stage. (K.H.)

Effect of wall thickness and helium cooling channels on duct magnetohydrodynamic flows

International Nuclear Information System (INIS)

He, Qingyun; Feng, Jingchao; Chen, Hongli

2016-01-01

Highlights: • MHD flows in ducts of different wall thickness compared with wall uniform. • Study of velocity, pressure distribution in ducts MHD flows with single pass of helium cooling channels. • Comparison of three types of dual helium cooling channels and acquisition of an option for minimum pressure drop. • A single short duct MHD flow in blanket without FCI has been simulated for pressure gradient analysis. - Abstract: The concept of dual coolant liquid metal (LM) blanket has been proposed in different countries to demonstrate the technical feasibility of DEMO reactor. In the system, helium gas and PbLi eutectic, separated by structure grid, are used to cool main structure materials and to be self-cooled, respectively. The non-uniform wall thickness of structure materials gives rise to wall non-homogeneous conductance ratio. It will lead to electric current distribution changes, resulting in significant changes in the velocity distribution and pressure drop of magnetohydrodynamic (MHD) flows. In order to investigate the effect of helium channels on MHD flows, different methods of numerical simulations cases are carried out including the cases of different wall thicknesses, single pass of helium cooling channels, and three types of dual helium cooling channels. The results showed that helium tubes are able to affect the velocity distribution in the boundary layer by forming wave sharp which transfers from Hartmann boundary layer to the core area. In addition, the potential profile and pressure drop in the cases have been compared to these in the case of walls without cooling channel, and the pressure gradient of a simplified single short duct MHD flow in blanket shows small waver along the central axis in the helium channel position.

Effect of wall thickness and helium cooling channels on duct magnetohydrodynamic flows

Energy Technology Data Exchange (ETDEWEB)

He, Qingyun; Feng, Jingchao; Chen, Hongli, E-mail: hlchen1@ustc.edu.cn

2016-02-15

Highlights: • MHD flows in ducts of different wall thickness compared with wall uniform. • Study of velocity, pressure distribution in ducts MHD flows with single pass of helium cooling channels. • Comparison of three types of dual helium cooling channels and acquisition of an option for minimum pressure drop. • A single short duct MHD flow in blanket without FCI has been simulated for pressure gradient analysis. - Abstract: The concept of dual coolant liquid metal (LM) blanket has been proposed in different countries to demonstrate the technical feasibility of DEMO reactor. In the system, helium gas and PbLi eutectic, separated by structure grid, are used to cool main structure materials and to be self-cooled, respectively. The non-uniform wall thickness of structure materials gives rise to wall non-homogeneous conductance ratio. It will lead to electric current distribution changes, resulting in significant changes in the velocity distribution and pressure drop of magnetohydrodynamic (MHD) flows. In order to investigate the effect of helium channels on MHD flows, different methods of numerical simulations cases are carried out including the cases of different wall thicknesses, single pass of helium cooling channels, and three types of dual helium cooling channels. The results showed that helium tubes are able to affect the velocity distribution in the boundary layer by forming wave sharp which transfers from Hartmann boundary layer to the core area. In addition, the potential profile and pressure drop in the cases have been compared to these in the case of walls without cooling channel, and the pressure gradient of a simplified single short duct MHD flow in blanket shows small waver along the central axis in the helium channel position.

Automated quantification of bronchiectasis, airway wall thickening and lumen tapering in chest CT

DEFF Research Database (Denmark)

Perez-Rovira, Adria; Kuo, Wieying; Petersen, Jens

thickness and accompanying artery radius), and inter-branch Lumen-Ratio (LR, ratio between a branch's lumen and its parent branch lumen radius, a tapering measurement) were computed. Because CF-related structural abnormalities only affect a portion of branches, the 75th percentile was used as summarising......Purpose: To automatically quantify airway structural properties visualised on CT in children with cystic fibrosis (CF) and controls, including: bronchiectasis, airway wall thickening, and lumen tapering. Methods and materials: The 3D surface of the airway lumen, outer wall, and bronchial arteries...... were obtained using a fully automatic, in-house developed, segmentation method. Subsequently, for each detected airway branch, the Airway-Artery Ratio (AAR, ratio between airway outer wall and accompanying artery radius, a bronchiectasis measurement), Wall-Artery Ratio (WAR, ratio between airway wall...

Quantitative CT measures of emphysema and airway wall thickness are related to D(L)CO

DEFF Research Database (Denmark)

Grydeland, Thomas B; Thorsen, Einar; Dirksen, Asger

2011-01-01

There is limited knowledge on the relationship between diffusing capacity of the lung for carbon monoxide (D(L)CO) and quantitative computed tomography (CT) measures of emphysema and airway wall thickness.......There is limited knowledge on the relationship between diffusing capacity of the lung for carbon monoxide (D(L)CO) and quantitative computed tomography (CT) measures of emphysema and airway wall thickness....

Wall thickness tests by means of rotating electrodynamic transducers

International Nuclear Information System (INIS)

Hueschelrath, G.

1986-01-01

For about three years, the EROT system has been employed for measuring wall thicknesses on pipes of ferritic steels. The experience gathered and the degree of reliability reached up to now are definitely encouraging, so that an increased use of electrodynamic transducers can be expected for measuring pipes with outside diameters of up to 22 inches. (orig.) [de

Water hammer with fluid-structure interaction in thick-walled pipes

NARCIS (Netherlands)

Tijsseling, A.S.

2007-01-01

A one-dimensional mathematical model is presented which describes the acoustic behaviour of thick-walled liquid-filled pipes. The model is based on conventional water-hammer and beam theories. Fluid–structure interaction (FSI) is taken into account. The equations governing straight pipes are derived

Rib fixation for severe chest deformity due to multiple rib fractures.

Science.gov (United States)

Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

2012-01-01

The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

Advanced sclerosis of the chest wall skin secondary to chronic graft-versus-host disease: a case with severe restrictive lung defect.

Science.gov (United States)

Ödek, Çağlar; Kendirli, Tanil; İleri, Talia; Yaman, Ayhan; Fatih Çakmakli, Hasan; Ince, Elif; İnce, Erdal; Ertem, Mehmet

2014-10-01

Pulmonary chronic graft-versus-host disease (cGvHD) is one of the most common causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (aHSCT). Herein, we describe a patient with severe restrictive lung defect secondary to cGvHD. A 21-year-old male patient was admitted to our pediatric intensive care unit (PICU) with pneumonia and respiratory distress. He had a history of aHSCT for chronic myelogeneous leukemia at the age of 17 years. Six months after undergoing aHSCT, he had developed cGvHD involving skin, mouth, eye, lung, liver, and gastrointestinal tract. At the time of PICU admission he had respiratory distress and required ventilation support. Thorax high-resolution computed tomography was consistent with bronchiolitis obliterans. Although bronchiolitis obliterans is an obstructive lung defect, a restrictive pattern became prominent in the clinical course because of the sclerotic chest wall skin. The activity of cGvHD kept increasing despite the therapy and we lost the patient because of severe respiratory distress and massive hemoptysis secondary to bronchiectasis. In conclusion, pulmonary cGvHD can present with restrictive changes related with the advanced sclerosis of the chest wall skin. Performing a fasciotomy or a scar revision for the rigid chest wall in selected patients may improve the patients ventilation.

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

OpenAIRE

Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

2011-01-01

Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a tru...

[Use and versatility of titanium for the reconstruction of the thoracic wall].

Science.gov (United States)

Córcoles Padilla, Juan Manuel; Bolufer Nadal, Sergio; Kurowski, Krzysztof; Gálvez Muñoz, Carlos; Rodriguez Paniagua, José Manuel

2014-02-01

Chest wall deformities/defects and chest wall resections, as well as complex rib fractures require reconstruction with various prosthetic materials to ensure the basic functions of the chest wall. Titanium provides many features that make it an ideal material for this surgery. The aim is to present our initial results with this material in several diseases. From 2008 to 2012, 14 patients were operated on and titanium was used for reconstruction of the chest wall. A total of 7 patients had chest wall tumors, 2 with sternal resection, 4 patients with chest wall deformities/defects and 3 patients with severe rib injury due to traffic accident. The reconstruction was successful in all cases, with early extubation without detecting problems in the functionality of the chest wall at a respiratory level. Patients with chest wall tumors including sternal resections were extubated in the operating room as well as the chest wall deformities. Chest trauma cases were extubated within 24h from internal rib fixation. There were no complications related to the material used and the method of implementation. Titanium is an ideal material for reconstruction of the chest wall in several clinical situations allowing for great versatility and adaptability in different chest wall reconstructions. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Usefulness of left ventricular wall thickness-to-diameter ratio in thallium-201 scintigraphy

International Nuclear Information System (INIS)

Manno, B.; Hakki, A.H.; Kane, S.A.; Iskandrian, A.S.

1983-01-01

The ratio of left ventricular wall thickness to the cavity dimension, as seen on thallium-201 images, was used in this study to predict left ventricular ejection fraction and volume. We obtained rest thallium-201 images in 50 patients with symptomatic coronary artery disease. The thickness of a normal-appearing segment of the left ventricular wall and the transverse diameter of the cavity were measured in the left anterior oblique projection. The left ventricular ejection fraction and volume in these patients were determined by radionuclide ventriculography. There was a good correlation between thickness-to-diameter ratio and ejection fraction and end-systolic volume. In 18 patients with a thickness-to-diameter ratio less than 0.70, the ejection fraction was lower than in the 16 patients with thickness-to-diameter ratio greater than or equal to 1.0. Similarly, in patients with a thickness-to-diameter ratio less than 0.70, the end-diastolic and end-systolic volume were higher than in the remaining patients with higher thickness-to-diameter ratios. All 18 patients with a thickness-to-diameter ratio less than 0.70 had ejection fractions less than 40%; 14 of 15 patients with a thickness-to-diameter ratio greater than or equal to 1.0 had an ejection fraction greater than 40%. The remaining 16 patients with a thickness-to-diameter ratio of 0.7-0.99 had intermediate ejection fractions and volumes.(ABSTRACT TRUNCATED AT 250 WORDS)

Fine-Tuning the Wall Thickness of Ordered Mesoporous Graphene by Exploiting Ligand Exchange of Colloidal Nanocrystals

Directory of Open Access Journals (Sweden)

Dandan Han

2017-12-01

Full Text Available Because of their unique physical properties, three-dimensional (3D graphene has attracted enormous attention over the past years. However, it is still a challenge to precisely control the layer thickness of 3D graphene. Here, we report a novel strategy to rationally adjust the wall thickness of ordered mesoporous graphene (OMG. By taking advantage of ligand exchange capability of colloidal Fe3O4 nanocrystals, we are able to fine-tune the wall thickness of OMG from 2 to 6 layers of graphene. When evaluated as electrocatalyst for oxygen reduction reaction upon S and N doping, the 4-layer OMG is found to show better catalytic performance compared with their 2- and 6-layer counterparts, which we attribute to the enhanced exposure of active sites arising from the thin wall thickness and high surface area.

Anatomical Variation in the Wall Thickness of Wood Fibres of ...

African Journals Online (AJOL)

The wall thickness of wood fibres of rubber (Hevea brasiliensis) grown and tapped for latex in south eastern Nigeria were investigated to determine anatomical variation. The rubber trees which were overmature for tapping and keeping were sampled in hierarchical order of plantations, bud classes, trees, discs, cardinal ...

Inverse Transient Analysis for Classification of Wall Thickness Variations in Pipelines

Directory of Open Access Journals (Sweden)

Jeffrey Tuck

2013-12-01

Full Text Available Analysis of transient fluid pressure signals has been investigated as an alternative method of fault detection in pipeline systems and has shown promise in both laboratory and field trials. The advantage of the method is that it can potentially provide a fast and cost effective means of locating faults such as leaks, blockages and pipeline wall degradation within a pipeline while the system remains fully operational. The only requirement is that high speed pressure sensors are placed in contact with the fluid. Further development of the method requires detailed numerical models and enhanced understanding of transient flow within a pipeline where variations in pipeline condition and geometry occur. One such variation commonly encountered is the degradation or thinning of pipe walls, which can increase the susceptible of a pipeline to leak development. This paper aims to improve transient-based fault detection methods by investigating how changes in pipe wall thickness will affect the transient behaviour of a system; this is done through the analysis of laboratory experiments. The laboratory experiments are carried out on a stainless steel pipeline of constant outside diameter, into which a pipe section of variable wall thickness is inserted. In order to detect the location and severity of these changes in wall conditions within the laboratory system an inverse transient analysis procedure is employed which considers independent variations in wavespeed and diameter. Inverse transient analyses are carried out using a genetic algorithm optimisation routine to match the response from a one-dimensional method of characteristics transient model to the experimental time domain pressure responses. The accuracy of the detection technique is evaluated and benefits associated with various simplifying assumptions and simulation run times are investigated. It is found that for the case investigated, changes in the wavespeed and nominal diameter of the

Inverse Transient Analysis for Classification of Wall Thickness Variations in Pipelines

Science.gov (United States)

Tuck, Jeffrey; Lee, Pedro

2013-01-01

Analysis of transient fluid pressure signals has been investigated as an alternative method of fault detection in pipeline systems and has shown promise in both laboratory and field trials. The advantage of the method is that it can potentially provide a fast and cost effective means of locating faults such as leaks, blockages and pipeline wall degradation within a pipeline while the system remains fully operational. The only requirement is that high speed pressure sensors are placed in contact with the fluid. Further development of the method requires detailed numerical models and enhanced understanding of transient flow within a pipeline where variations in pipeline condition and geometry occur. One such variation commonly encountered is the degradation or thinning of pipe walls, which can increase the susceptible of a pipeline to leak development. This paper aims to improve transient-based fault detection methods by investigating how changes in pipe wall thickness will affect the transient behaviour of a system; this is done through the analysis of laboratory experiments. The laboratory experiments are carried out on a stainless steel pipeline of constant outside diameter, into which a pipe section of variable wall thickness is inserted. In order to detect the location and severity of these changes in wall conditions within the laboratory system an inverse transient analysis procedure is employed which considers independent variations in wavespeed and diameter. Inverse transient analyses are carried out using a genetic algorithm optimisation routine to match the response from a one-dimensional method of characteristics transient model to the experimental time domain pressure responses. The accuracy of the detection technique is evaluated and benefits associated with various simplifying assumptions and simulation run times are investigated. It is found that for the case investigated, changes in the wavespeed and nominal diameter of the pipeline are both important

Local wall thickness reductions in operative high-pressure gas pipelines; Lokale Wanddickenminderungen an in Betrieb befindlichen Gashochdruckleitungen

Energy Technology Data Exchange (ETDEWEB)

Hass, Georg [Netzdienste Rhein-Main GmbH, Frankfurt am Main (Germany); Hoffmann, Ulrich [Verbundnetz Gas AG (VNG), Leipzig (Germany); Konarske, Juergen [RWE Westfalen-Weser-Ems Netzservice GmbH, Recklinghausen (Germany); Soppa, Thorsten [NG Netz Gas+Wasser (Germany); Steiner, Michael [Open Grid Europe GmbH, Essen (Germany)

2011-04-15

TUeV Nord, Salzgitter Mannesmann Forschung and DVGW investigated methods to assess local wall thickness reductions in operative high-pressure gas pipelines. Methods described in the relevant literature were reviewed with regard to the limiting criteria defined for maximum permissible wall thickness reductions. (orig./GL)

Discrimination of Cylinders with Different Wall Thicknesses using Neural Networks and Simulated Dolphin Sonar Signals

DEFF Research Database (Denmark)

Andersen, Lars Nonboe; Au, Whitlow; Larsen, Jan

1999-01-01

This paper describes a method integrating neural networks into a system for recognizing underwater objects. The system is based on a combination of simulated dolphin sonar signals, simulated auditory filters and artificial neural networks. The system is tested on a cylinder wall thickness...... difference experiment and demonstrates high accuracy for small wall thickness differences. Results from the experiment are compared with results obtained by a false killer whale (pseudorca crassidens)....

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter-defibrillator in swine

Science.gov (United States)

KILLINGSWORTH, CHERYL R.; MELNICK, SHARON B.; LITOVSKY, SILVIO H.; IDEKER, RAYMOND E.; WALCOTT, GREGORY P.

2013-01-01

Background A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. Methods During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Results Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Conclusion Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. PMID:23713608

Helium ion microscopy based wall thickness and surface roughness analysis of polymer foams obtained from high internal phase emulsion

International Nuclear Information System (INIS)

Rodenburg, C.; Viswanathan, P.; Jepson, M.A.E.; Liu, X.; Battaglia, G.

2014-01-01

Due to their wide range of applications, porous polymers obtained from high internal phase emulsions have been widely studied using scanning electron microscopy. However, due to their lack of electrical conductivity, quantitative information of wall thicknesses and surface roughness, which are of particular interest to tissue engineering, has not been obtained. Here, Helium Ion Microscopy is used to examine uncoated polymer foams and some very strong but unexpected contrast is observed, the origin of which is established here. Based on this analysis, a method for the measurement of wall thickness variations and wall roughness measurements has been developed, based on the modeling of Helium ion transmission. The results presented here indicate that within the walls of the void structure there exist small features with height variations of ∼30 nm and wall thickness variations from ∼100 nm to larger 340 nm in regions surrounding interconnecting windows within the structure. The suggested imaging method is applicable to other porous carbon based structures with wall thicknesses in the range of 40–340 nm. - Highlights: • The first helium ion microscopy image of uncoated structures formed from HIPEs is presented. • Unusually high contrast features that change with accelerating voltage are observed. • The origin of the observed contrast is determined to be mass thickness contrast. • A new method for quantitative wall thickness variation/roughness measurements is demonstrated

Helium ion microscopy based wall thickness and surface roughness analysis of polymer foams obtained from high internal phase emulsion

Energy Technology Data Exchange (ETDEWEB)

Rodenburg, C., E-mail: c.rodenburg@sheffield.ac.uk [Department of Materials Science and Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom); Viswanathan, P. [Department of Biomedical Sciences, University of Sheffield, Firth Court, Western Bank Sheffield, Sheffield S10 2 TN (United Kingdom); Jepson, M.A.E. [Department of Materials, Loughborough University, Loughborough, Leicestershire LE11 3TU (United Kingdom); Liu, X. [Carl Zeiss Microscopy GmbH, Carl-Zeiss-Strasse 22, 73447 Oberkochen (Germany); Battaglia, G. [Department of Chemistry University College London, 20 Gordon Street, London WC1H 0AJ (United Kingdom); The MRC/UCL Centre for Medical Molecular Virology, University College London, 20 Gordon Street, London WC1H 0AJ (United Kingdom)

2014-04-01

Due to their wide range of applications, porous polymers obtained from high internal phase emulsions have been widely studied using scanning electron microscopy. However, due to their lack of electrical conductivity, quantitative information of wall thicknesses and surface roughness, which are of particular interest to tissue engineering, has not been obtained. Here, Helium Ion Microscopy is used to examine uncoated polymer foams and some very strong but unexpected contrast is observed, the origin of which is established here. Based on this analysis, a method for the measurement of wall thickness variations and wall roughness measurements has been developed, based on the modeling of Helium ion transmission. The results presented here indicate that within the walls of the void structure there exist small features with height variations of ∼30 nm and wall thickness variations from ∼100 nm to larger 340 nm in regions surrounding interconnecting windows within the structure. The suggested imaging method is applicable to other porous carbon based structures with wall thicknesses in the range of 40–340 nm. - Highlights: • The first helium ion microscopy image of uncoated structures formed from HIPEs is presented. • Unusually high contrast features that change with accelerating voltage are observed. • The origin of the observed contrast is determined to be mass thickness contrast. • A new method for quantitative wall thickness variation/roughness measurements is demonstrated.

Manual versus automatic bladder wall thickness measurements: a method comparison study

NARCIS (Netherlands)

Oelke, M.; Mamoulakis, C.; Ubbink, D.T.; de la Rosette, J.J.; Wijkstra, H.

2009-01-01

Purpose To compare repeatability and agreement of conventional ultrasound bladder wall thickness (BWT) measurements with automatically obtained BWT measurements by the BVM 6500 device. Methods Adult patients with lower urinary tract symptoms, urinary incontinence, or postvoid residual urine were

A comparison of skin and chest wall dose delivered with multicatheter, Contura multilumen balloon, and MammoSite breast brachytherapy.

Science.gov (United States)

Cuttino, Laurie W; Todor, Dorin; Rosu, Mihaela; Arthur, Douglas W

2011-01-01

Skin and chest wall doses have been correlated with toxicity in patients treated with breast brachytherapy . This investigation compared the ability to control skin and chest wall doses between patients treated with multicatheter (MC), Contura multilumen balloon (CMLB), and MammoSite (MS) brachytherapy. 43 patients treated with the MC technique, 45 patients treated with the CMLB, and 83 patients treated with the MS were reviewed. The maximum doses delivered to the skin and chest wall were calculated for all patients. The mean maximum skin doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.2 Gy per fraction (94% of prescription dose), respectively. Although the skin distances were similar (p = 0.23) for the two balloon techniques, the mean skin dose with the CMLB was significantly lower than with the MS (p = 0.05). The mean maximum rib doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.6 Gy per fraction (105% of prescription dose), respectively. Again, the mean rib dose with the CMLB was significantly lower than with the MS (p = 0.002). The MC and CMLB techniques are associated with significantly lower mean skin and rib doses than is the MS. Treatment with the MS was associated with significantly more patients receiving doses to the skin or rib in excess of 125% of the prescription. Treatment with the CMLB may prove to yield less normal tissue toxicity than treatment with the MS. Copyright © 2011 Elsevier Inc. All rights reserved.

A Comparison of Skin and Chest Wall Dose Delivered With Multicatheter, Contura Multilumen Balloon, and MammoSite Breast Brachytherapy

International Nuclear Information System (INIS)

Cuttino, Laurie W.; Todor, Dorin; Rosu, Mihaela; Arthur, Douglas W.

2011-01-01

Purpose: Skin and chest wall doses have been correlated with toxicity in patients treated with breast brachytherapy . This investigation compared the ability to control skin and chest wall doses between patients treated with multicatheter (MC), Contura multilumen balloon (CMLB), and MammoSite (MS) brachytherapy. Methods and Materials: 43 patients treated with the MC technique, 45 patients treated with the CMLB, and 83 patients treated with the MS were reviewed. The maximum doses delivered to the skin and chest wall were calculated for all patients. Results: The mean maximum skin doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.2 Gy per fraction (94% of prescription dose), respectively. Although the skin distances were similar (p = 0.23) for the two balloon techniques, the mean skin dose with the CMLB was significantly lower than with the MS (p = 0.05). The mean maximum rib doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.6 Gy per fraction (105% of prescription dose), respectively. Again, the mean rib dose with the CMLB was significantly lower than with the MS (p = 0.002). Conclusion: The MC and CMLB techniques are associated with significantly lower mean skin and rib doses than is the MS. Treatment with the MS was associated with significantly more patients receiving doses to the skin or rib in excess of 125% of the prescription. Treatment with the CMLB may prove to yield less normal tissue toxicity than treatment with the MS.

Fine-tuning the Wall Thickness of Ordered Mesoporous Graphene by Exploiting Ligand Exchange of Colloidal Nanocrystals

Science.gov (United States)

Han, Dandan; Yan, Yancui; Wei, Jishi; Wang, Biwei; Li, Tongtao; Guo, Guannan; Yang, Dong; Xie, Songhai; Dong, Angang

2017-12-01

Because of their unique physical properties, three-dimensional (3D) graphene has attracted enormous attention over the past years. However, it is still a challenge to precisely control the layer thickness of 3D graphene. Here, we report a novel strategy to rationally adjust the wall thickness of ordered mesoporous graphene (OMG). By taking advantage of ligand exchange capability of colloidal Fe3O4 nanocrystals, we are able to fine-tune the wall thickness of OMG from 2 to 6 layers of graphene by tailoring the hydrocarbon ligands attached to the nanocrystal surface. When evaluated as electrocatalyst for oxygen reduction reaction upon S and N doping, the 4-layer OMG is found to show better catalytic performance compared with its 2- and 6-layer counterparts, which we attribute to the enhanced exposure of active sites resulting from its ultrathin wall thickness and high surface area.

Nitrate Diffusional Releases from the Saltstone Facility, Vault 2, with Respect to Different Concrete Wall Thicknesses

International Nuclear Information System (INIS)

ROBERT, HIERGESELL

2005-01-01

To assist the Saltstone Vault 2 Design Team, an investigation was conducted to evaluate the effectiveness of alternative concrete wall thicknesses in limiting nitrate diffusion away from the planned facility. While the current design calls for 18-inch concrete walls, alternative thicknesses of 12-in, 8-in, and 6-in were evaluated using a simplified 1-D numerical model. To serve as a guide for Saltstone Vault 2 conceptual design, the results of this investigation were applied to Saltstone Vault 4 to determine what the hypothetical limits would be for concrete wall thicknesses thinner than the planned 18-inches. This was accomplished by adjusting the Vault 4 Limits, based on the increased nitrate diffusion rates through the thinner concrete walls, such that the 100-m well limit of 44 mg/L of nitrate as nitrate was not exceeded. The implication of these preliminary results is that as thinner vault walls are implemented there is a larger release of nitrate, thus necessitating optimal vault placement to minimize the number of vaults placed along a single groundwater flow path leading to the discharge zone

Conjugate heat transfer for turbulent flow in a thick walled plain pipe

Directory of Open Access Journals (Sweden)

Canli Eyub

2018-01-01

Full Text Available Laminar and turbulent flow have their own characteristics in respect of heat transfer in pipes. While conjugate heat transfer is a major concern for a thick walled pipe with laminar flow inside it, there are limited studies about a turbulent flow in a thick walled plain pipe considering the conjugate heat transfer. In order to conduct such a work by means of in-house developed code, it was desired to make a preliminary investigation with commercially available CFD codes. ANSYS CFD was selected as the tool since it has a positive reputation in the literature for reliability. Defined heat transfer problem was solved with SIMPLE and Coupled Schemes for pressure velocity coupling and results are presented accordingly.

Nonlinear seismic analysis of a thick-walled concrete canyon structure

International Nuclear Information System (INIS)

Winkel, B.V.; Wagenblast, G.R.

1989-01-01

Conventional linear seismic analyses of a thick-walled lightly reinforced concrete structure were found to grossly underestimate its seismic capacity. Reasonable estimates of the seismic capacity were obtained by performing approximate nonlinear spectrum analyses along with static collapse evaluations. A nonlinear time history analyses is planned as the final verification of seismic adequacy

Terahertz inline wall thickness monitoring system for plastic pipe extrusion

Energy Technology Data Exchange (ETDEWEB)

Hauck, J., E-mail: j.hauck@skz.de, E-mail: d.stich@skz.de, E-mail: p.heidemeyer@skz.de, E-mail: m.bastian@skz.de, E-mail: t.hochrein@skz.de; Stich, D., E-mail: j.hauck@skz.de, E-mail: d.stich@skz.de, E-mail: p.heidemeyer@skz.de, E-mail: m.bastian@skz.de, E-mail: t.hochrein@skz.de; Heidemeyer, P., E-mail: j.hauck@skz.de, E-mail: d.stich@skz.de, E-mail: p.heidemeyer@skz.de, E-mail: m.bastian@skz.de, E-mail: t.hochrein@skz.de; Bastian, M., E-mail: j.hauck@skz.de, E-mail: d.stich@skz.de, E-mail: p.heidemeyer@skz.de, E-mail: m.bastian@skz.de, E-mail: t.hochrein@skz.de; Hochrein, T., E-mail: j.hauck@skz.de, E-mail: d.stich@skz.de, E-mail: p.heidemeyer@skz.de, E-mail: m.bastian@skz.de, E-mail: t.hochrein@skz.de [SKZ - German Plastics Center, Wuerzburg (Germany)

2014-05-15

Conventional and commercially available inline wall thickness monitoring systems for pipe extrusion are usually based on ultrasonic or x-ray technology. Disadvantages of ultrasonic systems are the usual need of water as a coupling media and the high damping in thick walled or foamed pipes. For x-ray systems special safety requirements have to be taken into account because of the ionizing radiation. The terahertz (THz) technology offers a novel approach to solve these problems. THz waves have many properties which are suitable for the non-destructive testing of plastics. The absorption of electrical isolators is typically very low and the radiation is non-ionizing in comparison to x-rays. Through the electromagnetic origin of the THz waves they can be used for contact free measurements. Foams show a much lower absorption in contrast to acoustic waves. The developed system uses THz pulses which are generated by stimulating photoconductive switches with femtosecond laser pulses. The time of flight of THz pulses can be determined with a resolution in the magnitude of several ten femtoseconds. Hence the thickness of an object like plastic pipes can be determined with a high accuracy by measuring the time delay between two reflections on materials interfaces e.g. at the pipe's inner and outer surface, similar to the ultrasonic technique. Knowing the refractive index of the sample the absolute layer thickness from the transit time difference can be calculated easily. This method in principle also allows the measurement of multilayer systems and the characterization of foamed pipes.

SU-C-BRA-04: Use of Esophageal Wall Thickness in Evaluation of the Response to Chemoradiation Therapy for Esophageal Cancer

International Nuclear Information System (INIS)

Wang, J; Kligerman, S; Lu, W; Kang, M

2015-01-01

Purpose: To quantitatively evaluate the esophageal cancer response to chemoradiation therapy (CRT) by measuring the esophageal wall thickness in CT. Method: Two datasets were used in this study. The first dataset is composed of CT scans of 15 esophageal cancer patients and 15 normal controls. The second dataset is composed of 20 esophageal cancer patients who underwent PET/CT scans before (Pre-CRT) and after CRT (Post-CRT). We first segmented the esophagus using a multi-atlas-based algorithm. The esophageal wall thickness was then computed, on each slice, as the equivalent circle radius of the segmented esophagus excluding the lumen. To evaluate the changes of wall thickness, we computed the standard deviation (SD), coefficient of variation (COV, SD/Mean), and flatness [(Max–Min)/Mean] of wall thickness along the entire esophagus. Results: For the first dataset, the mean wall thickness of cancer patients and normal controls were 6.35 mm and 6.03 mm, respectively. The mean SD, COV, and flatness of the wall thickness were 2.59, 0.21, and 1.27 for the cancer patients and 1.99, 0.16, and 1.13 for normal controls. Statistically significant differences (p < 0.05) were identified in SD and flatness. For the second dataset, the mean wall thickness of pre-CRT and post-CRT patients was 7.13 mm and 6.84 mm, respectively. The mean SD, COV, and flatness were 1.81, 0.26, and 1.06 for pre-CRT and 1.69, 0.26, and 1.06 for post-CRT. Statistically significant difference was not identified for these measurements. Current results are based on the entire esophagus. We believe significant differences between pre- and post-CRT scans could be obtained, if we conduct the measurements at tumor sites. Conclusion: Results show thicker wall thickness in pre-CRT scans and differences in wall thickness changes between normal and abnormal esophagus. This demonstrated the potential of esophageal wall thickness as a marker in the tumor CRT response evaluation. This work was supported in part by

Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall: case report and review of the literature

Directory of Open Access Journals (Sweden)

Lourdes Alanis, MD, MPH

2017-09-01

Full Text Available Fibromatosis of the breast is a rare benign disease compromising <0.2% of all primary breast tumors. Although the chest wall is a common location, occurrences of implant-associated fibromatosis of the breast are extremely rare; only 33 cases have been reported. We present a case of a 42-year-old female who underwent breast augmentation with silicone breast implants, and 2 years later developed an aggressive implant-associated fibromatosis of the breast and chest wall. On imaging studies, the tumor mimicked breast carcinoma, and despite chemotherapy, the fibromatosis rapidly enlarged and was locally invasive requiring wide surgical excision. Unlike previously reported imaging findings, magnetic resonance imaging revealed an oval circumscribed mass with fringe-like internal architecture. We provide a review of the literature and discuss the imaging features of implant-associated fibromatosis of the breast.

Quantification of common carotid artery and descending aorta vessel wall thickness from MR vessel wall imaging using a fully automated processing pipeline.

Science.gov (United States)

Gao, Shan; van 't Klooster, Ronald; Brandts, Anne; Roes, Stijntje D; Alizadeh Dehnavi, Reza; de Roos, Albert; Westenberg, Jos J M; van der Geest, Rob J

2017-01-01

To develop and evaluate a method that can fully automatically identify the vessel wall boundaries and quantify the wall thickness for both common carotid artery (CCA) and descending aorta (DAO) from axial magnetic resonance (MR) images. 3T MRI data acquired with T 1 -weighted gradient-echo black-blood imaging sequence from carotid (39 subjects) and aorta (39 subjects) were used to develop and test the algorithm. The vessel wall segmentation was achieved by respectively fitting a 3D cylindrical B-spline surface to the boundaries of lumen and outer wall. The tube-fitting was based on the edge detection performed on the signal intensity (SI) profile along the surface normal. To achieve a fully automated process, Hough Transform (HT) was developed to estimate the lumen centerline and radii for the target vessel. Using the outputs of HT, a tube model for lumen segmentation was initialized and deformed to fit the image data. Finally, lumen segmentation was dilated to initiate the adaptation procedure of outer wall tube. The algorithm was validated by determining: 1) its performance against manual tracing; 2) its interscan reproducibility in quantifying vessel wall thickness (VWT); 3) its capability of detecting VWT difference in hypertensive patients compared with healthy controls. Statistical analysis including Bland-Altman analysis, t-test, and sample size calculation were performed for the purpose of algorithm evaluation. The mean distance between the manual and automatically detected lumen/outer wall contours was 0.00 ± 0.23/0.09 ± 0.21 mm for CCA and 0.12 ± 0.24/0.14 ± 0.35 mm for DAO. No significant difference was observed between the interscan VWT assessment using automated segmentation for both CCA (P = 0.19) and DAO (P = 0.94). Both manual and automated segmentation detected significantly higher carotid (P = 0.016 and P = 0.005) and aortic (P < 0.001 and P = 0.021) wall thickness in the hypertensive patients. A reliable and reproducible pipeline for fully

Exercise-mediated changes in conduit artery wall thickness in humans: role of shear stress

NARCIS (Netherlands)

Thijssen, D.H.J.; Dawson, E.A.; Munckhof, I.C. van den; Tinken, T.M.; Drijver, E. den; Hopkins, N.; Cable, N.T.; Green, D.J.

2011-01-01

Episodic increases in shear stress have been proposed as a mechanism that induces training-induced adaptation in arterial wall remodeling in humans. To address this hypothesis in humans, we examined bilateral brachial artery wall thickness using high-resolution ultrasound in healthy men across an

Reconstrucción de defectos torácicos de espesor total: Presentación de 8 casos de especial complejidad Reconstruction of full thickness defects on the chest wall: Presentation of 8 complex cases

Directory of Open Access Journals (Sweden)

J.M. Lasso

2009-12-01

Full Text Available Las lesiones de gran tamaño en el tórax, requieren casi siempre para su reparación plastias complejas, que en algunos casos han de combinar el uso de tejidos autólogos y/o materiales sintéticos. Por tanto, la reconstrucción de la pared torácica supone un desafío desde el punto de vista reconstructivo en el que es fundamental el papel de los cirujanos plásticos. Los grandes defectos torácicos suelen ser secundarios a exéresis tumoral (tumores parietales de origen primario o secundario, infecciones, radionecrosis, traumatismos y malformaciones congénitas. Si bien los principios de la reconstrucción del tórax exigen una escisión amplia de la lesión, desbridamiento de los tejidos desvitalizados o irradiados y control de la infección local, dichas actuaciones no podrían abordarse con seguridad si no dispusiéramos de un amplio arsenal de técnicas reconstructivas, capaces de aportar tejidos sanos y bien vascularizados o voluminosos y amplios en superficie, junto con soportes rígidos mediante materiales aloplásticos. Gracias a estos avances, en la mayoría de los casos conseguimos el objetivo con sólo una intervención, cuando hace unos años necesitábamos varios procedimientos quirúrgicos. Presentamos una muestra variada de la experiencia de nuestro Servicio en el tratamiento de grandes defectos del tórax, en el que resumimos las distintas posibilidades que podemos encontrar en la práctica clínica diaria, y las soluciones que mejor se adaptan a las mismas.Reconstruction of full thickness defects on the chest wall is controversial and require the use of complex techniques that combine autologous tissue and/or alloplastic materials. Thus it is a challenge for plastic surgeons since it needs a suitable and functional reconstruction. The aethiology for these defects include tumoral surgery (primary wall tumors, or recurrences or metastasis, infections, radiation injury, trauma and congenital defects. Otherwise, first surgical

Surgical treatment of chest instability

International Nuclear Information System (INIS)

Kitka, M.; Masek, M.

2015-01-01

Fractures of the ribs is the most common thoracic injury after blunt trauma. Chest wall instability (flail chest) is a common occurrence in the presence of multiple ribs fracture. Unilateral or bilateral fractures more ribs anteriorly or posteriorly will produce enough instability that paradoxical respiratory motion results in hypoventilation of an unacceptable degree. Open approach and surgical stabilisation of the chest preserved pulmonary function, improved pain control, minimized posttraumatic deformities and shorter back to work time. (author)

Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

OpenAIRE

Cherubino, Mario; Maggiulli, Francesca; Pellegatta, Igor; Valdatta, Luigi

2016-01-01

Poland's syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gr...

Radiotherapy of the chest wall following mastectomy for early-stage breast cancer: impact on local recurrence and overall survival

International Nuclear Information System (INIS)

Janni, Wolfgang; Dimpfl, Thomas; Braun, Stephan; Knobbe, Angelika; Peschers, Ursula; Rjosk, Dorothea; Lampe, Bjoern; Genz, Thomas

2000-01-01

Introduction: Recent studies have renewed an old controversy about the efficacy of adjuvant radiotherapy following mastectomy for breast cancer. Radiotherapy is usually recommended for advanced disease, but whether or not to use it in pT1-T2 pN0 situations is still being debated. This study was designed to clarify whether or not routine radiotherapy of the chest wall following mastectomy reduces the risk of local recurrence and if it influences the overall survival rate. Methods: Retrospective analysis of patients treated with mastectomy for pT1-T2 pN0 tumors and no systemic treatment. Patients treated with radiotherapy of the chest wall following mastectomy (Group A) are compared with those treated with mastectomy alone (Group B). Results: A total of 918 patients underwent mastectomy. Patients who received adjuvant radiotherapy after mastectomy (n = 114) had a significantly lower risk for local recurrence. Ten years after the primary diagnosis, 98.1% of the patients with radiotherapy were disease free compared to 86.4% of the patients without radiotherapy. The average time interval from primary diagnosis until local recurrence was 8.9 years in Group A and 2.8 years in Group B. The Cox regression analysis including radiotherapy, tumor size and tumor grading found the highest risk for local recurrence for patients without radiotherapy (p < 0.0004). In terms of overall survival however, the Kaplan-Meier analysis showed no difference between the two groups (p = 0.8787) and the Cox regression analysis failed to show any impact on overall survival. Conclusion: With observation spanning over 35 years, this study shows that adjuvant radiotherapy of the chest wall following mastectomy reduces the risk for local recurrence in node-negative patients with pT1-T2 tumors but has no impact on the overall survival rate

Optimization of Surface Roughness and Wall Thickness in Dieless Incremental Forming Of Aluminum Sheet Using Taguchi

Science.gov (United States)

Hamedon, Zamzuri; Kuang, Shea Cheng; Jaafar, Hasnulhadi; Azhari, Azmir

2018-03-01

Incremental sheet forming is a versatile sheet metal forming process where a sheet metal is formed into its final shape by a series of localized deformation without a specialised die. However, it still has many shortcomings that need to be overcome such as geometric accuracy, surface roughness, formability, forming speed, and so on. This project focus on minimising the surface roughness of aluminium sheet and improving its thickness uniformity in incremental sheet forming via optimisation of wall angle, feed rate, and step size. Besides, the effect of wall angle, feed rate, and step size to the surface roughness and thickness uniformity of aluminium sheet was investigated in this project. From the results, it was observed that surface roughness and thickness uniformity were inversely varied due to the formation of surface waviness. Increase in feed rate and decrease in step size will produce a lower surface roughness, while uniform thickness reduction was obtained by reducing the wall angle and step size. By using Taguchi analysis, the optimum parameters for minimum surface roughness and uniform thickness reduction of aluminium sheet were determined. The finding of this project helps to reduce the time in optimising the surface roughness and thickness uniformity in incremental sheet forming.

Pediatric chest imaging. Chest imaging in infants and children. 2. rev. ed.

Energy Technology Data Exchange (ETDEWEB)

Lucaya, Javier [Vall d' Hebron Hospitals, Barcelona (Spain). Dept. of Pediatric Radiology and Inst. of Diagnostic Imaging; Hospital Quiron, Barcelona (Spain). Dept. of Radiology; Strife, Janet L. (eds.) [Cincinnati Univ. Coll. of Medicine, Cincinnati, OH (United States). Dept. of Radiology Cincinnati Children' s Hospital Medical Center

2008-07-01

Imaging of the pediatric chest continues to evolve rapidly. All chapters in this 2nd edition of Pediatric Chest Imaging have been extensively updated, with additional disease-specific information and numerous new illustrations. The book thus presents the state of the art in the diagnosis of pediatric chest disorders, highlighting the role played by advanced technology. As the conventional features of most of these disorders are extremely well known, special attention is devoted to the technical aspects of the modern imaging modalities, their indications, and the diagnostic information that they supply. Individual chapters focus on chest ultrasound, nuclear medicine imaging, high-resolution chest CT, helical CT, and pediatric cardiac CT and pediatric cardiacMRI. Others are directed towards specific disorders, including congenital malformations of the chest, chest tumors, pulmonary infection, trauma, the lung in systemic diseases, the pediatric airway, foreign bodies, the thymus, and the chest wall. Without exception, the authors of this book are internationally known specialists with great expertise in the field. This book will serve as a handy, superbly illustrated reference for all who routinely image children, as well as for those who need access to information on how best to image them. (orig.)

Image-guided intensity-modulated radiotherapy for refractory bilateral breast cancer in a patient with extensive cutaneous metastasis in the chest and abdominal walls

Directory of Open Access Journals (Sweden)

Lu YF

2016-05-01

Full Text Available Yueh-Feng Lu,1 Yu-Chin Lin,2 Kuo-Hsin Chen,3,4 Pei-Wei Shueng,1 Hsin-Pei Yeh,1 Chen-Hsi Hsieh1,5,6 1Division of Radiation Oncology, Department of Radiology, 2Division of Oncology and Hematology, Department of Medicine, 3Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, 4Department of Electrical Engineering, Yuan-Ze University, Taoyuan, 5Department of Medicine, 6Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Abstract: Treatment for bilateral breast cancer with chest wall and abdominal skin invasion normally involves conventional radiotherapy (RT; however, conventional RT provides inadequate target volume coverage and excessive treatment of large volumes of normal tissue. Helical tomotherapy (HT has the ability to deliver continuous craniocaudal irradiation that suppresses junction problems and provides good conformity of dose distribution. A 47-year-old female with stage IV bilateral breast cancer with chest wall and pectoralis major muscle invasion, lymphadenopathy, bilateral pleural effusion, and multiple bone metastases received chemotherapy and target therapy beginning in January 2014; 4 months after the initiation of chemotherapy, computed tomography revealed progression of chest and abdominal wall invasion. A total dose of 70.2 Gy was delivered to both breasts, the chest wall, the abdominal wall, and the bilateral supraclavicular nodal areas in 39 fractions via HT. The total planning target volume was 4,533.29 cm3. The percent of lung volume receiving at least 20 Gy (V20 was 28%, 22%, and 25% for the right lung, left lung, and whole lung, respectively. The mean dose to the heart was 8.6 Gy. Follow-up computed tomography revealed complete response after the RT course. Grade 1 dysphagia, weight loss, grade 2 neutropenia, and grade 3 dermatitis were noted during the RT course. Pain score decreased from 6 to 1. No cardiac, pulmonary, liver, or intestinal toxicity

Penetrating cardiac injuries in blunt chest wall trauma.

Science.gov (United States)

Kanchan, Tanuj; Menezes, Ritesh G; Sirohi, Parmendra

2012-08-01

The present photocase illustrates the possible mechanism of direct cardiac injuries from broken sharp jagged fractured ends of ribs in blunt force trauma to the chest in run over traffic mishaps. We propose that the projecting fractured ends of the ribs penetrate the underlying thoracic organs due to the transient phenomenon of deformation of chest cavity under pressure in run over traffic mishaps. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.

Science.gov (United States)

Killingsworth, Cheryl R; Melnick, Sharon B; Litovsky, Silvio H; Ideker, Raymond E; Walcott, Gregory P

2013-10-01

A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. During sinus rhythm, anesthetized pigs (38 ± 6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24 hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semiquantitative scoring. Troponin I was significantly elevated at 4 hours and 24 hours (22.6 ± 16.3 ng/mL and 3.1 ± 1.3 ng/mL; baseline 0.07 ± 0.09 ng/mL) in control pigs but not in S-ICD pigs (0.12 ± 0.11 ng/mL and 0.13 ± 0.13 ng/mL; baseline 0.06 ± 0.03 ng/mL). CK-MM was significantly elevated in S-ICD pigs after shocks (6,544 ± 1,496 U/L and 9,705 ± 6,240 U/L; baseline 704 ± 398 U/L) but not in controls. Electrocardiogram changes occurred postshock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

Chest X-Ray

Medline Plus

Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... x-ray is used to evaluate the lungs, heart and chest wall and may be used to ...

Simulation on the Effect of Bottle Wall Thickness Distribution using Blow Moulding Technique

International Nuclear Information System (INIS)

Suraya, S; Azman, M D; Fatchurrohman, N; Jaafar, A A; Yusoff, A R

2016-01-01

The aims of this study are to assess the deformation behavior of a polymeric material during a blow moulding process. Transient computations of two dimensional model of a PP bottle were performed using ANSYS Polyflow computer code to predict the wall thickness distribution at four different parison's diameter; 8mm, 10mm, 18mm, and 20mm. Effects on the final wall thickness diameter and time step are studied. The simulated data shows that the inflation performance degrades with increasing parison diameter. It is concluded that the blow moulding process using 10mm parison successfully meet the product processing requirements. Factors that contribute to the variation in deformation behaviour of the plastic during the manufacturing process are discussed. (paper)

Selective chest imaging for blunt trauma patients: The national emergency X-ray utilization studies (NEXUS-chest algorithm).

Science.gov (United States)

Rodriguez, Robert M; Hendey, Gregory W; Mower, William R

2017-01-01

Chest imaging plays a prominent role in blunt trauma patient evaluation, but indiscriminate imaging is expensive, may delay care, and unnecessarily exposes patients to potentially harmful ionizing radiation. To improve diagnostic chest imaging utilization, we conducted 3 prospective multicenter studies over 12years to derive and validate decision instruments (DIs) to guide the use of chest x-ray (CXR) and chest computed tomography (CT). The first DI, NEXUS Chest x-ray, consists of seven criteria (Age >60years; rapid deceleration mechanism; chest pain; intoxication; altered mental status; distracting painful injury; and chest wall tenderness) and exhibits a sensitivity of 99.0% (95% confidence interval [CI] 98.2-99.4%) and a specificity of 13.3% (95% CI, 12.6%-14.0%) for detecting clinically significant injuries. We developed two NEXUS Chest CT DIs, which are both highly reliable in detecting clinically major injuries (sensitivity of 99.2%; 95% CI 95.4-100%). Designed primarily to focus on detecting major injuries, the NEXUS Chest CT-Major DI consists of six criteria (abnormal CXR; distracting injury; chest wall tenderness; sternal tenderness; thoracic spine tenderness; and scapular tenderness) and exhibits higher specificity (37.9%; 95% CI 35.8-40.1%). Designed to reliability detect both major and minor injuries (sensitivity 95.4%; 95% CI 93.6-96.9%) with resulting lower specificity (25.5%; 95% CI 23.5-27.5%), the NEXUS CT-All rule consists of seven elements (the six NEXUS CT-Major criteria plus rapid deceleration mechanism). The purpose of this review is to synthesize the three DIs into a novel, cohesive summary algorithm with practical implementation recommendations to guide selective chest imaging in adult blunt trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

The development and structure of thick-walled, multicellular, aerial spores in Diheterospora chlamydosporia (=Verticillium chlamydosporium).

Science.gov (United States)

Cambell, W P; Griffiths, D A

1975-07-01

The aerial, thick-walled spores in Diheterospara chlamydosporia arose as terminal swellings on erect hyphae. Repeated septation of the continuously swelling spore resulted in a multicellular structure. Immediately after the onset of septation secondary wall material was laid down between the two-layered primary wall and the plasmalemma. The presence of secondary wall material indicates that the multicellular spore is a dictyochlamydospore and not an aleuriospore. The relationship between chlamydospores and aleuriospores in other fungi is discussed.

Multislice helical CT analysis of small-sized airway wall thickness in smokers and patients with bronchial asthma

International Nuclear Information System (INIS)

Sekimura, Kenshi; Ito, Harumasa; Nakamura, Yutaka; Kobayashi, Hitoshi; Oikawa, Hirobumi; Inoue, Hiroshi; Ehara, Shigeru; Yamauchi, Kohei

2010-01-01

There is accumulating evidence that airway remodeling, which contributes to airway narrowing, plays a role in the pathogenesis of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Development of the multislice helical CT (MSCT) with improved spatial resolution has made it possible to obtain more precise imaging of small-sized airways. Small-sized airway wall-thickness was measured using the MSCT scan to analyze small-sized airways of smokers and BA patients, and examine the effects of a β 2 agonists on small-sized airway wall-thickness of BA patients. Thirty-six non-asthmatics who participated in the Health Check Program of Iwate Medical University and 25 patients with asthma were recruited. Amongst the 36 non-asthmatics were 20 healthy never-smokers and 15 smokers. The other 25 asthmatics were recruited from the outpatient clinic at Iwate Medical University. MSCT was performed and the right B10 bronchus was chosen for dimensional analysis. Airway wall thickness was expressed as a percentage of wall area (WA%). WA% of the 7 asthmatics before and 30 mim after procaterol (20μg) inspiration were compared. Small-sized airway wall thickness was significantly increased in smokers and patients with asthma compared to healthy never-smokers, when determined by MSCT. Both %V 50 and %V 25 had significant negative correlations with WA% among the healthy never-smokers and smoker population. Procaterol inspiration reduced WA% in the small airway of patients with asthma. Increase of small-sized airway thickness measured by MSCT scan may reflect peripheral obstructive lesions of smokers and BA patients. (author)

A tale of two neglected systems - structure and function of the thin- and thick-walled sieve tubes in monocotyledonous leaves.

Directory of Open Access Journals (Sweden)

Ted eBotha

2013-08-01

Full Text Available There is a large body of information relating to the ontogeny, development and the vasculature of eudicotyledonous leaves. However there is less information available concerning the vascular anatomy of monocotyledonous leaves. This is surprising, given that there are two uniquely different phloem systems present in large groups such as grasses and sedges. Monocotyledonous leaves contain marginal, large, intermediate and small longitudinal veins that are interconnected by numerous transverse veins. The longitudinal veins contain two metaphloem sieve tube types, which, based upon their ontogeny and position within the phloem, are termed early (thin-walled and late (thick-walled sieve tubes. Early metaphloem comprises sieve tubes, companion cells and vascular parenchyma cells, whilst the late metaphloem, contains thick-walled sieve tubes that lack companion cells. Thick-walled sieve tubes are generally adjacent to, or no more than one cell removed from the metaxylem. Unlike thin-walled sieve tube-companion cell complexes, thick-walled sieve tubes are connected to parenchyma by pore-plasmodesma units and are generally symplasmically isolated from the thin walled sieve tubes. This paper addresses key structural and functional differences between thin- and thick-walled sieve tubes and explores the unique advantages of alternate transport strategies that this 5 to 7 million year old dual system may offer. It would seem that these two systems may enhance, add to, or play a significant role in increasing the efficiency of solute retrieval as well as of assimilate transfer.

Time course for arm and chest muscle thickness changes following bench press training

Science.gov (United States)

Ogasawara, Riki; Thiebaud, Robert S.; Loenneke, Jeremy P.; Loftin, Mark

2012-01-01

The purpose of this study was to investigate the time course of hypertrophic adaptations in both the upper arm and trunk muscles following high-intensity bench press training. Seven previously untrained young men (aged 25 ± 3 years) performed free-weight bench press training 3 days (Monday, Wednesday and Friday) per week for 24 weeks. Training intensity and volume were set at 75% of one repetition maximum (1-RM) and 30 repetitions (3 sets of 10 repetitions, with 2−3 min of rest between sets), respectively. Muscle thickness (MTH) was measured using B-mode ultrasound at three sites: the biceps and triceps brachii and the pectoralis major. Measurements were taken a week prior to the start of training, before the training session on every Monday and 3 days after the final training session. Pairwise comparisons from baseline revealed that pectoralis major MTH significantly increased after week-1 (p = 0.002), triceps MTH increased after week-5 (p = 0.001) and 1-RM strength increased after week-3 (p = 0.001) while no changes were observed in the biceps MTH from baseline. Significant muscle hypertrophy was observed earlier in the chest compared to that of the triceps. Our results indicate that the time course of the muscle hypertrophic response differs between the upper arm and chest. PMID:24265879

Radiography of large-volume thick-walled structures using transportable high-energy sources

International Nuclear Information System (INIS)

Vanek, J.; Gross, E.

1994-01-01

Carried by a Renault Saviem truck, the ORION 4 MeV linear accelerator manufactured by the French company CGR MeV proved to be well suited for quality control of welded joints of heavy thick-walled facilities performed directly in the manufacturing plant halls or at the construction sites, as well as for radiographic testing of steel and concrete structures. The operating principles and parameters of the accelerator are given. Steel up to 200 mm thick and concrete up to 550 mm thick can be inspected. Dosimetric data show that the use of the accelerator is radiologically safe. (Z.S.). 2 figs., 5 refs

Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome?

International Nuclear Information System (INIS)

Kornaat, Peter R.; Sharma, Ruby; Geest, Rob J. van der; Lamb, Hildo J.; Bloem, Johan L.; Watt, Iain; Kloppenburg, Margreet; Hellio le Graverand, Marie-Pierre

2009-01-01

The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome. The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of α = 0.05 was used. Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p ≤ α), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population. The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome. (orig.)

Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome?

Energy Technology Data Exchange (ETDEWEB)

Kornaat, Peter R.; Sharma, Ruby; Geest, Rob J. van der; Lamb, Hildo J.; Bloem, Johan L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Hellio le Graverand, Marie-Pierre [Pfizer Global Research and Development, New London, CT (United States)

2009-12-15

The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome. The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of {alpha} = 0.05 was used. Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p {<=} {alpha}), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population. The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome. (orig.)

Development of Wall-Thinning Evaluation Procedure for Nuclear Power Plant Piping—Part 1: Quantification of Thickness Measurement Deviation

Directory of Open Access Journals (Sweden)

Hun Yun

2016-06-01

Full Text Available Pipe wall thinning by flow-accelerated corrosion and various types of erosion is a significant and costly damage phenomenon in secondary piping systems of nuclear power plants (NPPs. Most NPPs have management programs to ensure pipe integrity due to wall thinning that includes periodic measurements for pipe wall thicknesses using nondestructive evaluation techniques. Numerous measurements using ultrasonic tests (UTs; one of the nondestructive evaluation technologies have been performed during scheduled outages in NPPs. Using the thickness measurement data, wall thinning rates of each component are determined conservatively according to several evaluation methods developed by the United States Electric Power Research Institute. However, little is known about the conservativeness or reliability of the evaluation methods because of a lack of understanding of the measurement error. In this study, quantitative models for UT thickness measurement deviations of nuclear pipes and fittings were developed as the first step for establishing an optimized thinning evaluation procedure considering measurement error. In order to understand the characteristics of UT thickness measurement errors of nuclear pipes and fittings, round robin test results, which were obtained by previous researchers under laboratory conditions, were analyzed. Then, based on a large dataset of actual plant data from four NPPs, a quantitative model for UT thickness measurement deviation is proposed for plant conditions.

Chest pain in daily practice: occurrence, causes and management.

Science.gov (United States)

Verdon, François; Herzig, Lilli; Burnand, Bernard; Bischoff, Thomas; Pécoud, Alain; Junod, Michel; Mühlemann, Nicole; Favrat, Bernard

2008-06-14

We assessed the occurrence and aetiology of chest pain in primary care practice. These features differ between primary and emergency care settings, where most previous studies have been performed. 59 GPs in western Switzerland recorded all consecutive cases presenting with chest pain. Clinical characteristics, laboratory tests and other investigations as well as the diagnoses remaining after 12 months of follow-up were systematically registered. Among 24,620 patients examined during a total duration of 300 weeks of observation, 672 (2.7%) presented with chest pain (52% female, mean age 55 +/- 19(SD)). Most cases, 442 (1.8%), presented new symptoms and in 356 (1.4%) it was the reason for consulting. Over 40 ailments were diagnosed: musculoskeletal chest pain (including chest wall syndrome) (49%), cardiovascular (16%), psychogenic (11%), respiratory (10%), digestive (8%), miscellaneous (2%) and without diagnosis (3%). The three most prevalent diseases were: chest wall syndrome (43%), coronary artery disease (12%) and anxiety (7%). Unstable angina (6), myocardial infarction (4) and pulmonary embolism (2) were uncommon (1.8%). Potentially serious conditions including cardiac, respiratory and neoplasic diseases accounted for 20% of cases. A large number of laboratory tests (42%), referral to a specialist (16%) or hospitalisation (5%) were performed. Twentyfive patients died during follow-up, of which twelve were for a reason directly associated with thoracic pain [cancer (7) and cardiac causes (5)]. Thoracic pain was present in 2.7% of primary care consultations. Chest wall syndrome pain was the main aetiology. Cardio - vascular emergencies were uncommon. However chest pain deserves full consideration because of the occurrence of potentially serious conditions.

Photoelastic Analysis of Cracked Thick Walled Cylinders

Science.gov (United States)

Pastramă, Ştefan Dan

2017-12-01

In this paper, the experimental determination of the stress intensity factor in thick walled cylinders subject to uniform internal pressure and having longitudinal non-penetrating cracks is presented. Photoelastic measurements were used together with the expressions of the stress field near the crack tip for Mode I crack extension and a specific methodology for stress intensity factor determination. Two types of longitudinal cracks - internal and external - were considered. Four plane models were manufactured and analyzed in a plane polariscope at different values of the applied internal pressure. The values of the normalized stress intensity factor were calculated and the results were compared to those reported by other authors. A good accuracy was noticed, showing the reliability of the experimental procedure.

Leukoaraiosis is associated with arterial wall thickness: a quantitative analysis.

Science.gov (United States)

Auriel, Eitan; Csiba, Laszlo; Berenyi, Ervin; Varkonyi, Ildiko; Mehes, Gabor; Kardos, Laszlo; Karni, Arnon; Bornstein, Natan M

2012-06-01

Leukoaraiosis refers to an age-related, abnormal appearance of the brain white matter on neuroimaging. The association between leukoaraiosis and cerebrovascular disease suggests that ischemia may be an important contributing factor; however, the pathogenesis of the condition remains controversial. We hypothesized that physical abnormalities of blood vessels might be culpable and compared the external and internal measurements of blood vessel walls between brains that demonstrated leukoaraiosis on imaging and normal control brains. Fourteen brains of individuals who had been diagnosed as having severe leukoaraiosis and five non-leukoaraiosis control brains were studied. Arterial cross-sections were evaluated by length measurements with an image analysis device. Arterial wall thickness and the ratio of the outer and inner diameters of the vessel were measured. We measured a total of 108 vessels in the leukoaraiosis group and 95 vessels in the control group. The vessel walls of the leukoaraiosis patients were an average of 5.5 µm thicker than the walls of control vessels of the same inside diameter (P = 0.0000, 95% CI 3.01-8.08) and an average of 2.3 µm thicker than walls of control vessels of the same outside diameter (P = 0.016, 95% CI 0.48-4.17). Our data provide evidence that leukoaraiosis is associated with vessel wall thickening in an additive fashion and indicate that structural vascular abnormalities are associated with leukoaraiosis. © 2011 Japanese Society of Neuropathology.

Lung and chest wall impedances in the dog in normal range of breathing: effects of pulmonary edema.

Science.gov (United States)

Barnas, G M; Stamenović, D; Lutchen, K R

1992-09-01

We evaluated the effect of pulmonary edema on the frequency (f) and tidal volume (VT) dependences of respiratory system mechanical properties in the normal ranges of breathing. We measured resistance and elastance of the lungs (RL and EL) and chest wall of four anesthetized-paralyzed dogs during sinusoidal volume oscillations at the trachea (50-300 ml, 0.2-2 Hz), delivered at a constant mean airway pressure. Measurements were made before and after severe pulmonary edema was produced by injection of 0.06 ml/kg oleic acid into the right atrium. Chest wall properties were not changed by the injection. Before oleic acid, EL increased slightly with increasing f in each dog but was independent of VT. RL decreased slightly and was independent of VT from 0.2 to 0.4 Hz, but above 0.4 Hz it tended to increase with increasing flow, presumably due to the airway contribution. After oleic acid injection, EL and RL increased greatly. Large negative dependences of EL on VT and of RL on f were also evident, so that EL and RL after oleic acid changed two- and fivefold, respectively, within the ranges of f and VT studied. We conclude that severe pulmonary edema changes lung properties so as to make behavior VT dependent (i.e., nonlinear) and very frequency dependent in the normal range of breathing.

Conceptus radiation dose and risk from chest screen-film radiography

International Nuclear Information System (INIS)

Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia; Prassopoulos, Panos; Gourtsoyiannis, Nicholas; Varveris, Haralambos

2003-01-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d a ) was estimated for 51 women of childbearing age from chest CT examinations. The value of d a was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10 -3 mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d a estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

Conceptus radiation dose and risk from chest screen-film radiography.

Science.gov (United States)

Damilakis, John; Perisinakis, Kostas; Prassopoulos, Panos; Dimovasili, Evangelia; Varveris, Haralambos; Gourtsoyiannis, Nicholas

2003-02-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d(a)) was estimated for 51 women of childbearing age from chest CT examinations. The value of d(a) was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10(-3) mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d(a) estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is no need for

Conceptus radiation dose and risk from chest screen-film radiography

Energy Technology Data Exchange (ETDEWEB)

Damilakis, John; Perisinakis, Kostas; Dimovasili, Evangelia [Department of Medical Physics, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Prassopoulos, Panos; Gourtsoyiannis, Nicholas [Department of Radiology, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece); Varveris, Haralambos [Department of Radiotherapy, University of Crete, Faculty of Medicine, P.O. Box 1393, 714 09 Iraklion, Crete (Greece)

2003-02-01

The objectives of the present study were to (a) estimate the conceptus radiation dose and risks for pregnant women undergoing posteroanterior and anteroposterior (AP) chest radiographs, (b) study the conceptus dose as a function of chest thickness of the patient undergoing chest radiograph, and (c) investigate the possibility of a conceptus to receive a dose of more than 10 mGy, the level above which specific measurements of conceptus doses may be necessary. Thermoluminescent dosimeters were used for dose measurements in anthropomorphic phantoms simulating pregnancy at the three trimesters of gestation. The effect of chest thickness on conceptus dose and risk was studied by adding slabs of lucite on the anterior and posterior surface of the phantom chest. The conceptus risk for radiation-induced childhood fatal cancer and hereditary effects was calculated based on appropriate risk factors. The average AP chest dimension (d{sub a}) was estimated for 51 women of childbearing age from chest CT examinations. The value of d{sub a} was estimated to be 22.3 cm (17.4-27.2 cm). The calculated maximum conceptus dose was 107 x 10{sup -3} mGy for AP chest radiographs performed during the third trimester of pregnancy with maternal chest thickness of 27.2 cm. This calculation was based on dose data obtained from measurements in the phantoms and d{sub a} estimated from the patient group. The corresponding average excess of childhood cancer was 10.7 per million patients. The risk for hereditary effects was 1.1 per million births. Radiation dose for a conceptus increases exponentially as chest thickness increases. The conceptus dose at the third trimester is higher than that of the second and first trimesters. The results of the current study suggest that chest radiographs carried out in women at any time during gestation will result in a negligible increase in risk of radiation-induced harmful effects to the unborn child. After a properly performed maternal chest X-ray, there is

Outcomes of Complete Versus Partial Surgical Stabilization of Flail Chest.

Science.gov (United States)

Nickerson, Terry P; Thiels, Cornelius A; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J

2016-01-01

Rib fractures are common after chest wall trauma. For patients with flail chest, surgical stabilization is a promising technique for reducing morbidity. Anatomical difficulties often lead to an inability to completely repair the flail chest; thus, the result is partial flail chest stabilization (PFS). We hypothesized that patients with PFS have outcomes similar to those undergoing complete flail chest stabilization (CFS). A prospectively collected database of all patients who underwent rib fracture stabilization procedures from August 2009 until February 2013 was reviewed. Abstracted data included procedural and complication data, extent of stabilization, and pulmonary function test results. Of 43 patients who underwent operative stabilization of flail chest, 23 (53%) had CFS and 20 (47%) underwent PFS. Anterior location of the fracture was the most common reason for PFS (45%). Age, sex, operative time, pneumonia, intensive care unit and hospital length of stay, and narcotic use were the same in both groups. Total lung capacity was significantly improved in the CFS group at 3 months. No chest wall deformity was appreciated on follow-up, and no patients underwent additional stabilization procedures following PFS. Despite advances in surgical technique, not all fractures are amenable to repair. There was no difference in chest wall deformity, narcotic use, or clinically significant impairment in pulmonary function tests among patients who underwent PFS compared with CFS. Our data suggest that PFS is an acceptable strategy and that extending or creating additional incisions for CFS is unnecessary.

Development of a Flexible Broadband Rayleigh Waves Comb Transducer with Nonequidistant Comb Interval for Defect Detection of Thick-Walled Pipelines.

Science.gov (United States)

Zhao, Huamin; He, Cunfu; Yan, Lyu; Zhang, Haijun

2018-03-02

It is necessary to develop a transducer that can quickly detect the inner and outer wall defects of thick-walled pipes, in order to ensure the safety of such pipes. In this paper, a flexible broadband Rayleigh-waves comb transducer based on PZT (lead zirconate titanate) for defect detection of thick-walled pipes is studied. The multiple resonant coupling theory is used to expand the transducer broadband and the FEA (Finite Element Analysis) method is used to optimize transducer array element parameters. Optimization results show that the best array element parameters of the transducer are when the transducer array element length is 30 mm, the thickness is 1.2 mm, the width of one end of is 1.5 mm, and the other end is 3 mm. Based on the optimization results, such a transducer was fabricated and its performance was tested. The test results were consistent with the finite-element simulation results, and the -3 dB bandwidth of the transducer reached 417 kHz. Transducer directivity test results show that the Θ -3dB beam width was equal to 10 °, to meet the defect detection requirements. Finally, defects of thick-walled pipes were detected using the transducer. The results showed that the transducer could detect the inner and outer wall defects of thick-walled pipes within the bandwidth.

Potential of ultrasound in the pediatric chest

Energy Technology Data Exchange (ETDEWEB)

Trinavarat, Panruethai, E-mail: pantrinavarat@hotmail.com [Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330 (Thailand); Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at [Department of Radiology, Division of Pediatric Radiology, University Hospital Graz (Austria)

2014-09-15

Ultrasound (US) of chest, even with inherent limitations of the US beam and air, has been useful in many pediatric chest conditions. It has extended its role and is now widely used by many subspecialists in medicine. This review article will cover techniques, indications, and applications of chest US in neonates, infants and children, including also different common as well as some rare and modern aspects and applications, such as pleural effusion, pneumothorax, pulmonary lesions, mediastinum, diaphragm, and chest wall. Other related imaging modalities are also briefly discussed.

Risk Assessment of Abdominal Wall Thickness Measured on Pre-Operative Computerized Tomography for Incisional Surgical Site Infection after Abdominal Surgery.

Science.gov (United States)

Tongyoo, Assanee; Chatthamrak, Putipan; Sriussadaporn, Ekkapak; Limpavitayaporn, Palin; Mingmalairak, Chatchai

2015-07-01

The surgical site infection (SSI) is a common complication of abdominal operation. It relates to increased hospital stay, increased healthcare cost, and decreased patient's quality of life. Obesity, usually defined by BMI, is known as one of the risks of SSI. However, the thickness of subcutaneous layers of abdominal wall might be an important local factor affecting the rate of SSI after the abdominal operations. The objective of this study is to assess the importance of the abdominal wall thickness on incisional SSI rate. The subjects of the present study were patients who had undergone major abdominal operations at Thammasat University Hospital between June 2013 and May 2014, and had been investigated with CT scans before their operations. The demographic data and clinical information of these patients were recorded. The thickness ofsubcutaneous fatty tissue from skin down to the most superficial layer of abdominal wall muscle at the surgical site was measured on CT images. The wound infectious complication was reviewed and categorized as superficial and deep incisional SSIfollowing the definition from Centersfor Disease Control and Prevention (CDC) guidelines. The significance ofeach potentialfactors on SSI rates was determined separately with student t-test for quantitative data and χ2-test for categorical data. Then all factors, which had p operative CTscans. Post-operative SSI was 25.2% (35/139), superficial and deep types in 27 and 8 patients, respectively. The comparison of abdominal wall thickness between patients with and without infection was significantly different (20.0 ± 8.4 mm and 16.0 ± 7.2 mm, respectively). When the thickness at 20 mm was used as the cut-off value, 43 of 139 patients had abdominal wall thickness ≥ 20 mm. The incidence of SSI of the thickness ±20 mm group was 37.2% (16/43) and of the less thickness group was 19.8% (19/96), with p operation. However, only abdominal wall thickness and wound classification were still significant

AUTOMATIC THICKNESS AND VOLUME ESTIMATION OF SPRAYED CONCRETE ON ANCHORED RETAINING WALLS FROM TERRESTRIAL LIDAR DATA

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J. Martínez-Sánchez

2016-06-01

Full Text Available When ground conditions are weak, particularly in free formed tunnel linings or retaining walls, sprayed concrete can be applied on the exposed surfaces immediately after excavation for shotcreting rock outcrops. In these situations, shotcrete is normally applied conjointly with rock bolts and mesh, thereby supporting the loose material that causes many of the small ground falls. On the other hand, contractors want to determine the thickness and volume of sprayed concrete for both technical and economic reasons: to guarantee their structural strength but also, to not deliver excess material that they will not be paid for. In this paper, we first introduce a terrestrial LiDAR-based method for the automatic detection of rock bolts, as typically used in anchored retaining walls. These ground support elements are segmented based on their geometry and they will serve as control points for the co-registration of two successive scans, before and after shotcreting. Then we compare both point clouds to estimate the sprayed concrete thickness and the expending volume on the wall. This novel methodology is demonstrated on repeated scan data from a retaining wall in the city of Vigo (Spain, resulting in a rock bolts detection rate of 91%, that permits to obtain a detailed information of the thickness and calculate a total volume of 3597 litres of concrete. These results have verified the effectiveness of the developed approach by increasing productivity and improving previous empirical proposals for real time thickness estimation.

Automatic Thickness and Volume Estimation of Sprayed Concrete on Anchored Retaining Walls from Terrestrial LIDAR Data

Science.gov (United States)

Martínez-Sánchez, J.; Puente, I.; GonzálezJorge, H.; Riveiro, B.; Arias, P.

2016-06-01

When ground conditions are weak, particularly in free formed tunnel linings or retaining walls, sprayed concrete can be applied on the exposed surfaces immediately after excavation for shotcreting rock outcrops. In these situations, shotcrete is normally applied conjointly with rock bolts and mesh, thereby supporting the loose material that causes many of the small ground falls. On the other hand, contractors want to determine the thickness and volume of sprayed concrete for both technical and economic reasons: to guarantee their structural strength but also, to not deliver excess material that they will not be paid for. In this paper, we first introduce a terrestrial LiDAR-based method for the automatic detection of rock bolts, as typically used in anchored retaining walls. These ground support elements are segmented based on their geometry and they will serve as control points for the co-registration of two successive scans, before and after shotcreting. Then we compare both point clouds to estimate the sprayed concrete thickness and the expending volume on the wall. This novel methodology is demonstrated on repeated scan data from a retaining wall in the city of Vigo (Spain), resulting in a rock bolts detection rate of 91%, that permits to obtain a detailed information of the thickness and calculate a total volume of 3597 litres of concrete. These results have verified the effectiveness of the developed approach by increasing productivity and improving previous empirical proposals for real time thickness estimation.

Creep collapse of thick-walled heat transfer tube subjected to external pressure at high temperature

International Nuclear Information System (INIS)

Ioka, Ikuo; Kaji, Yoshiyuki; Terunuma, Isao; Nekoya, Shin-ichi; Miyamoto, Yoshiaki

1994-09-01

A series of creep collapse tests of thick-walled heat transfer tube were examined experimentally and analytically to confirm an analytical method for creep deformation behavior of a heat transfer tube of an intermediate heat exchanger (IHX) at a depressurization accident of secondary cooling system of HTTR (High Temperature Engineering Test Reactor). The tests were carried out using thick-walled heat transfer tubes made of Hastelloy XR at 950degC in helium gas environment. The predictions of creep collapse time obtained by a general purpose FEM-code ABAQUS were in good agreement with the experimental results. A lot of cracks were observed on the outer surface of the test tubes after the creep collapse. However, the cracks did not pass through the tube wall and, therefore, the leak tightness was maintained regardless of a collapse deformation for all tubes tested. (author)

Sternal Cleft and Pectus Excavatum: A Combined Approach for the Correction of a Complex Anterior Chest Wall Malformation in a Teenager.

Science.gov (United States)

Tocchioni, Francesca; Ghionzoli, Marco; Lo Piccolo, Roberto; Deaconu, Diana E; Facchini, Flavio; Milanez De Campos, Jose R; Messineo, Antonio

2015-06-01

Congenital sternal cleft is a rare chest wall malformation. Because of the flexibility of the chest in infants, surgical repair should be performed by primary closure in the neonatal period. In adolescents and adults, different techniques have been suggested to overcome the lack of sternal bone tissue. We describe a very rare case of an 18-year-old woman with a complete bifid sternum associated with pectus excavatum for whom a satisfactory cosmetic and functional result was obtained by adequate surgical planning, which entailed a combination of two standardized surgical techniques. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Prototype gauge for measuring contour and wall thicknesses of hemispherical parts

International Nuclear Information System (INIS)

Aarts, H.J.; Robertson, J.H.

1976-01-01

A prototype gauge (gage) was designed and fabricated using air bearings in a new configuration to provide less error and distortion during inspection of hemispherical parts. No wear occurs on the moving parts during operations and accuracy of alignment is maintained. The gauge will check outside radial distance, inside radial, and outside radial and wall, and inner radial and wall thicknesses of parts. The gauge contains only four moving parts, which increases the measuring accuracy. A horizontal table rotates. A table mounted on the horizontal table at 45 0 rotates through two transducers. All moving parts are mounted on hydrostatic gas bearings. Laser interferometric, air-bearing gauge heads are used to obtain the required data. Investigation of a hemispherical part is in any desired spiral path from equator to pole. Measurement information is obtained from two laser interferometric transducers using linear air bearings. The transducers use a Spectra Physics Model-120 helium and neon laser. Working range of each transducer is 1.5 inches. The fringe voltage signals are amplified and converted to inches to be displayed on a digital readout. A punched paper tape contains the nominal inside diameter (ID) and outside diameter (OD) information in Binary Coded Decimal form. The tape is fed into a digital computer which calculates error information on ID, OD, and wall thickness. This information is converted to analog form and displayed simultaneously on a strip-chart recorder

Incidence of non-pulmonary cancer and lung cancer by amount of emphysema and airway wall thickness: a community-based cohort.

Science.gov (United States)

Aamli Gagnat, Ane; Gjerdevik, Miriam; Gallefoss, Frode; Coxson, Harvey O; Gulsvik, Amund; Bakke, Per

2017-05-01

There is limited knowledge about the prognostic value of quantitative computed tomography (CT) measures of emphysema and airway wall thickness in cancer.The aim of this study was to investigate if using CT to quantitatively assess the amount of emphysema and airway wall thickness independently predicts the subsequent incidence of non-pulmonary cancer and lung cancer.In the GenKOLS study of 2003-2005, 947 ever-smokers performed spirometry and underwent CT examination. The main predictors were the amount of emphysema measured by the percentage of low attenuation areas (%LAA) on CT and standardised measures of airway wall thickness (AWT-PI10). Cancer data from 2003-2013 were obtained from the Norwegian Cancer Register. The hazard ratio associated with emphysema and airway wall thickness was assessed using Cox proportional hazards regression for cancer diagnoses.During 10 years of follow-up, non-pulmonary cancer was diagnosed in 11% of the subjects with LAA emphysema remained a significant predictor of the incidence of non-pulmonary cancer and lung cancer. Airway wall thickness did not predict cancer independently.This study offers a strong argument that emphysema is an independent risk factor for both non-pulmonary cancer and lung cancer. Copyright ©ERS 2017.

Ultrasonographic wall thickness measurement of the upper and lower uterine segments in the prediction of the progress of preterm labour.

Science.gov (United States)

Sayed Ahmed, W A; Madny, E H; Habash, Y H; Ibrahim, Z M; Morsy, A G K; Said, M E

2015-01-01

To assess the role of ultrasonographic measurement of the upper and lower uterine segments wall thickness in predicting the progress of preterm labour in patients presenting with preterm labour pains. Fifty pregnant women presenting at Obstetrics Department - Suez Canal University, Egypt with regular lower abdominal pains and diagnosed as having preterm labour were enrolled in the study. Measurements of the upper and lower uterine segments wall thickness by transabdominal ultrasonography in-between contractions and with full bladder were taken. The upper/lower uterine wall thickness ratio was calculated and correlated to the progress of the preterm labour and to the response to tocolytics. The ultrasonographic upper/lower uterine wall thickness ratio was directly related to the progress of preterm delivery (PTD). The change in this ratio is correlated inversely with the response to tocolysis. Using the ROC curve, when the upper/lower uterine wall thickness ratio was ≤ 1.26 the sensitivity was 94.74 and the specificity was 100.00, and when the ratio was ≤ 1.52 the sensitivity was 100.00 and the specificity was 83.33. These data may serve as a baseline ultrasonographic reference values for further studies in prediction the progress of preterm labour in patients presenting with preterm labour pains.

MRI of the Chest

Medline Plus

Full Text Available ... sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around the heart) ... prior to your scheduled examination. Infants and young children usually require sedation or anesthesia to complete an ...

MRI of the Chest

Medline Plus

Full Text Available ... sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around the heart) ... on the child's age, intellectual development and the type of exam. Moderate and conscious sedation can be ...

MRI of the Chest

Medline Plus

Full Text Available ... heart) and myocardial infarct (scar in the heart muscle due to prior obstruction of blood flow). determine ... ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac around ...

Relationship between Pipeline Wall Thickness (Gr. X60) and Water Depth towards Avoiding Failure during Installation

Science.gov (United States)

Razak, K. Abdul; Othman, M. I. H.; Mat Yusuf, S.; Fuad, M. F. I. Ahmad; yahaya, Effah

2018-05-01

Oil and gas today being developed at different water depth characterized as shallow, deep and ultra-deep waters. Among the major components involved during the offshore installation is pipelines. Pipelines are a transportation method of material through a pipe. In oil and gas industry, pipeline come from a bunch of line pipe that welded together to become a long pipeline and can be divided into two which is gas pipeline and oil pipeline. In order to perform pipeline installation, we need pipe laying barge or pipe laying vessel. However, pipe laying vessel can be divided into two types: S-lay vessel and J-lay vessel. The function of pipe lay vessel is not only to perform pipeline installation. It also performed installation of umbilical or electrical cables. In the simple words, pipe lay vessel is performing the installation of subsea in all the connecting infrastructures. Besides that, the installation processes of pipelines require special focus to make the installation succeed. For instance, the heavy pipelines may exceed the lay vessel’s tension capacities in certain kind of water depth. Pipeline have their own characteristic and we can group it or differentiate it by certain parameters such as grade of material, type of material, size of diameter, size of wall thickness and the strength. For instances, wall thickness parameter studies indicate that if use the higher steel grade of the pipelines will have a significant contribution in pipeline wall thickness reduction. When running the process of pipe lay, water depth is the most critical thing that we need to monitor and concern about because of course we cannot control the water depth but we can control the characteristic of the pipe like apply line pipe that have wall thickness suitable with current water depth in order to avoid failure during the installation. This research will analyse whether the pipeline parameter meet the requirements limit and minimum yield stress. It will overlook to simulate pipe

Optimum Insulation Thickness for Walls and Roofs for Reducing Peak Cooling Loads in Residential Buildings in Lahore

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SIBGHA SIDDIQUE SIDDIQUE

2016-10-01

Full Text Available Thermal insulation is the most effective energy saving measure for cooling in buildings. Therefore, the main subject of many engineering investigations is the selection and determination of the optimum insulation thickness. In the present study, the optimum insulation thickness on external walls and roofs is determined based on the peak cooling loads for an existing residential building in Lahore, Pakistan. Autodesk® Revit 2013 is used for the analysis of the building and determination of the peak cooling loads. The analysis shows that the optimum insulation thickness to reduce peak cooling loads up to 40.1% is 1 inch for external walls and roof respectively.

Optimum Insulation Thickness for Walls and Roofs for Reducing Peak Cooling Loads in Residential Buildings in Lahore

International Nuclear Information System (INIS)

Siddique, S.; Arif, S.; Khan, A.; Alam, A.T.

2016-01-01

Thermal insulation is the most effective energy saving measure for cooling in buildings. Therefore, the main subject of many engineering investigations is the selection and determination of the optimum insulation thickness. In the present study, the optimum insulation thickness on external walls and roofs is determined based on the peak cooling loads for an existing residential building in Lahore, Pakistan. Autodesk at the rate Revit 2013 is used for the analysis of the building and determination of the peak cooling loads. The analysis shows that the optimum insulation thickness to reduce peak cooling loads up to 40.1 percent is 1 inch for external walls and roof respectively. (author)

Plane symmetric cosmological model with thick domain walls in Brans-Dicke theory of gravitation

International Nuclear Information System (INIS)

Pawar, D.; Bayaskar, S.; Patil, V.

2009-01-01

We have investigated plane symmetric cosmological model in presence of thick domain walls in Brans-Dicke theory of gravitation, some geometrical and physical behavior of the model are discussed. (authors)

Dynamic film thickness between bubbles and wall in a narrow channel

Science.gov (United States)

Ito, Daisuke; Damsohn, Manuel; Prasser, Horst-Michael; Aritomi, Masanori

2011-09-01

The present paper describes a novel technique to characterize the behavior of the liquid film between gas bubbles and the wall in a narrow channel. The method is based on the electrical conductance. Two liquid film sensors are installed on both opposite walls in a narrow rectangular channel. The liquid film thickness underneath the gas bubbles is recorded by the first sensor, while the void fraction information is obtained by measuring the conductance between the pair of opposite sensors. Both measurements are taken on a large two-dimensional domain and with a high speed. This makes it possible to obtain the two-dimensional distribution of the dynamic liquid film between the bubbles and the wall. In this study, this method was applied to an air-water flow ranging from bubbly to churn regimes in the narrow channel with a gap width of 1.5 mm.

Factors Associated with ICU Admission following Blunt Chest Trauma

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Andrea Bellone

2016-01-01

Full Text Available Background. Blunt chest wall trauma accounts for over 10% of all trauma patients presenting to emergency departments worldwide. When the injury is not as severe, deciding which blunt chest wall trauma patients require a higher level of clinical input can be difficult. We hypothesized that patient factors, injury patterns, analgesia, postural condition, and positive airway pressure influence outcomes. Methods. The study population consisted of patients hospitalized with at least 3 rib fractures (RF and at least one pulmonary contusion and/or at least one pneumothorax lower than 2 cm. Results. A total of 140 patients were retrospectively analyzed. Ten patients (7.1% were admitted to intensive care unit (ICU within the first 72 hours, because of deterioration of the clinical conditions and gas exchange with worsening of chest X-ray/thoracic ultrasound/chest computed tomography. On univariable analysis and multivariable analysis, obliged orthopnea (p=0.0018 and the severity of trauma score (p<0.0002 were associated with admission to ICU. Conclusions. Obliged orthopnea was an independent predictor of ICU admission among patients incurring non-life-threatening blunt chest wall trauma. The main therapeutic approach associated with improved outcome is the prevention of pulmonary infections due to reduced tidal volume, namely, upright postural condition and positive airway pressure.

Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes.

NARCIS (Netherlands)

Schreuder, T.H.A.; Munckhof, I.C.L. van den; Poelkens, F.; Hopman, M.T.; Thijssen, D.H.

2015-01-01

OBJECTIVE: Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and

Treatment of necrotic infection on the anterior chest wall secondary to mastectomy and postoperative radiotherapy by the application of omentum and mesh skin grafting. Report of a case

International Nuclear Information System (INIS)

Sato, Masaaki; Tanaka, Fumihiro; Wada, Hiromi

2002-01-01

We report herein the case of a patient who initially underwent right radical mastectomy for breast carcinoma in 1988, followed by left breast-conserving surgery in 1997. On both occasions she was given postoperative radiation therapy of 50 Gy. Repeated dressings and the administration of antibiotics failed to heal ulcerative infected lesions that had formed on the anterior chest wall in early 1998. In 1999, the sternum and surrounding tissue were debrided and the anterior chest wall was reconstructed by omentum transposition and mesh skin grafting. The patient is currently well and alive without any evidence of recurrence of either infection or breast cancer. (author)

Failure rate of prehospital chest decompression after severe thoracic trauma.

Science.gov (United States)

Kaserer, Alexander; Stein, Philipp; Simmen, Hans-Peter; Spahn, Donat R; Neuhaus, Valentin

2017-03-01

Chest decompression can be performed by different techniques, like needle thoracocentesis (NT), lateral thoracostomy (LT), or tube thoracostomy (TT). The aim of this study was to report the incidence of prehospital chest decompression and to analyse the effectiveness of these techniques. In this retrospective case series study, all medical records of adult trauma patients undergoing prehospital chest decompression and admitted to the resuscitation area of a level-1 trauma center between 2009 and 2015 were reviewed and analysed. Only descriptive statistics were applied. In a 6-year period 24 of 2261 (1.1%) trauma patients had prehospital chest decompression. Seventeen patients had NT, six patients TT, one patient NT as well as TT, and no patients had LT. Prehospital successful release of a tension pneumothorax was reported by the paramedics in 83% (5/6) with TT, whereas NT was effective in 18% only (3/17). In five CT scans all thoracocentesis needles were either removed or extrapleural, one patient had a tension pneumothorax, and two patients had no pneumothorax. No NT or TT related complications were reported during hospitalization. Prehospital NT or TT is infrequently attempted in trauma patients. Especially NT is associated with a high failure rate of more than 80%, potentially due to an inadequate ratio between chest wall thickness and catheter length as previously published as well as a possible different pathophysiological cause of respiratory distress. Therefore, TT may be considered already in the prehospital setting to retain sufficient pleural decompression upon admission. Copyright © 2016. Published by Elsevier Inc.

Complex regional pain syndrome with associated chest wall dystonia: a case report

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Schwartzman Robert J

2011-09-01

Full Text Available Abstract Patients with complex regional pain syndrome (CRPS often suffer from an array of associated movement disorders, including dystonia of an affected limb. We present a case of a patient with long standing CRPS after a brachial plexus injury, who after displaying several features of the movement disorder previously, developed painful dystonia of chest wall musculature. Detailed neurologic examination found palpable sustained contractions of the pectoral and intercostal muscles in addition to surface allodynia. Needle electromyography of the intercostal and paraspinal muscles supported the diagnosis of dystonia. In addition, pulmonary function testing showed both restrictive and obstructive features in the absence of a clear cardiopulmonary etiology. Treatment was initiated with intrathecal baclofen and the patient had symptomatic relief and improvement of dystonia. This case illustrates a novel form of the movement disorder associated with CRPS with response to intrathecal baclofen treatment.

Challenges in management of pediatric life-threatening neck and chest trauma

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Shilpa Sharma

2018-01-01

Full Text Available Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2–10 years were managed. Mechanism of injury was road traffic accident, fall from height and other accidental injury in 2, 3 and 1 patient respectively. The presentation was respiratory distress and quadriplegia, exposed heart, penetrating injury in neck, dysphagia and dyspnea, and swelling over the chest wall in 1, 1, 1, 2 and 1 cases respectively. Injuries included lung laceration, open chest wall, vascular injury of the neck, tracheoesophageal fistula (2, and chest wall posttraumatic pyomyositis. One patient had a flare of miliary tuberculosis. Immediate management included chest wall repair; neck exploration and repair, esophagostomy, gastroesophageal stapling, and feeding jejunostomy (followed by gastric pull-up 8 months later. Chest tube insertion and total parenteral nutrition was required in one each. 2 and 4 patients required tracheostomy and mechanical ventilation. The patient with gastric pull-up developed a stricture of the esophagogastric anastomosis that was revised at 26-month follow-up. At follow-up of 40–61 months, five patients are well. One patient with penetrating neck injury suffered from blindness due to massive hemorrhage from the vascular injury in the neck and brain ischemia with only peripheral vision recovery. Conclusion: Successful management of neck and chest wall trauma requires timely appropriate decisions with a team effort.

Behavior of deep flaws in a thick-wall cylinder under thermal shock loading

International Nuclear Information System (INIS)

Cheverton, R.D.

1979-01-01

Behavior of inner-surface flaws in thick-walled vessels was studied in a 991-mm OD x 152 mm wall x 1220 mm length cylinder with toughness properties similar to those for HSST Plate. The initial temperature of 93 0 C and a thermal shock medium of liquid nitrogen (-197 0 C) were employed. The initial flaw selected was a sharp, 16 mm deep, long (1220 mm) axial crack. Crack arrest methodology was shown to be valid for deep flaws under severe thermal shock

Radiation testing of thick-wall objects using a linear accelerator or Co-60

International Nuclear Information System (INIS)

Depending on the energy required, a 60 Co source or various types of betatrons and linear accelerators may be used for radiation testing of thick-walled metal parts. While 60 Co sources are easily transported, accelerators are not, but a transportable linear accelerator is described

Coronary artery bypass grafting and concomitant excision of chest wall chondrosarcoma

Directory of Open Access Journals (Sweden)

Ganti Somsekhar

2009-02-01

Full Text Available Abstract Coexistence of coronary artery disease and cancer with both requiring surgical treatment at the same time is rare. A 52 year male undergoing elective coronary artery bypass grafting was incidentally discovered to have a large soft tissue mass of variable consistency with cartilaginous elements arising from the right costal margin and adjoining ribs by a broad attachment and protruding into right pleural cavity. Frozen section suggested it to be either a chondrosarcoma or a teratoma. A wide excision of the mass with the adjoining muscle and periosteum along with quadruple coronary artery bypass grafting was done. This report is unusual on account of a being the first reported case in world literature of concomitant excision of chondrosarcoma and coronary artery bypass grafting and b the conservative management of the incidentally discovered chondrosarcoma by wide excision rather than chest wall resection with no local recurrence to date. Pathology of chondrosarcoma, in particular, and various management strategies when coronary artery disease and cancer coexist, in general, is discussed.

Contribution of CT Quantified Emphysema, Air Trapping and Airway Wall Thickness on Pulmonary Function in Male Smokers With and Without COPD

NARCIS (Netherlands)

Hoesein, F.A.A.M.; Jong, P.A. de; Lammers, J.-W.J.; Mali, W.P.Th.; Mets, O.M.; Schmidt, M.; Koning, H.J. de; Aalst, C. van der; Oudkerk, M.; Vliegenthart, R.; Ginneken, B. van; Rikxoort, E.M. van; Zanen, P.

2014-01-01

Abstract Emphysema, airway wall thickening and air trapping are associated with chronic obstructive pulmonary disease (COPD). All three can be quantified by computed tomography (CT) of the chest. The goal of the current study is to determine the relative contribution of CT derived parameters on

Contribution of CT Quantified Emphysema, Air Trapping and Airway Wall Thickness on Pulmonary Function in Male Smokers With and Without COPD

NARCIS (Netherlands)

Hoesein, Firdaus A. A. Mohamed; de Jong, Pim A.; Lammers, Jan-Willem J.; Mali, Willem P. Th. M.; Mets, Onno M.; Schmidt, Michael; de Koning, Harry J.; van der Aalst, Carlijn; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; van Ginneken, Bram; van Rikxoort, Eva M.; Zanen, Pieter

Emphysema, airway wall thickening and air trapping are associated with chronic obstructive pulmonary disease (COPD). All three can be quantified by computed tomography (CT) of the chest. The goal of the current study is to determine the relative contribution of CT derived parameters on spirometry,

Development of an imaging-planning program for screen/film and computed radiography mammography for breasts with short chest wall to nipple distance.

Science.gov (United States)

Dong, S L; Su, J L; Yeh, Y H; Chu, T C; Lin, Y C; Chuang, K S

2011-04-01

Imaging breasts with a short chest wall to nipple distance (CWND) using a traditional mammographic X-ray unit is a technical challenge for mammographers. The purpose of this study is the development of an imaging-planning program to assist in determination of imaging parameters of screen/film (SF) and computed radiography (CR) mammography for short CWND breasts. A traditional mammographic X-ray unit (Mammomat 3000, Siemens, Munich, Germany) was employed. The imaging-planning program was developed by combining the compressed breast thickness correction, the equivalent polymethylmethacrylate thickness assessment for breasts and the tube loading (mAs) measurement. Both phantom exposures and a total of 597 exposures were used for examining the imaging-planning program. Results of the phantom study show that the tube loading rapidly decreased with the CWND when the automatic exposure control (AEC) detector was not fully covered by the phantom. For patient exposures with the AEC fully covered by breast tissue, the average fractional tube loadings, defined as the ratio of the predicted mAs using the imaging-planning program and mAs of the mammogram, were 1.10 and 1.07 for SF and CR mammograms, respectively. The predicted mAs values were comparable to the mAs values, as determined by the AEC. By applying the imaging-planning program in clinical practice, the experiential dependence of the mammographer for determination of the imaging parameters for short CWND breasts is minimised.

Room temperature synthesis of indium tin oxide nanotubes with high precision wall thickness by electroless deposition

Directory of Open Access Journals (Sweden)

Mario Boehme

2011-02-01

Full Text Available Conductive nanotubes consisting of indium tin oxide (ITO were fabricated by electroless deposition using ion track etched polycarbonate templates. To produce nanotubes (NTs with thin walls and small surface roughness, the tubes were generated by a multi-step procedure under aqueous conditions. The approach reported below yields open end nanotubes with well defined outer diameter and wall thickness. In the past, zinc oxide films were mostly preferred and were synthesized using electroless deposition based on aqueous solutions. All these methods previously developed, are not adaptable in the case of ITO nanotubes, even with modifications. In the present work, therefore, we investigated the necessary conditions for the growth of ITO-NTs to achieve a wall thickness of around 10 nm. In addition, the effects of pH and reductive concentrations for the formation of ITO-NTs are also discussed.

Computed tomography of active pulmonary tuberculosis with nonvisualized cavitary lesion on plain chest film

International Nuclear Information System (INIS)

Ahn, Woo Hyun; Cho, Seoung Hwan; Lee, Jun Bae; Kim, Byung Soo

1989-01-01

The detection of cavity in pulmonary tuberculosis has important roles in its diagnosis, therapy planning and follow-up of healing process, and also means at least moderate advanced tuberculosis. The plain chest film has some limitation of detection of cavity in pulmonary tuberculosis owing to several factors. CT is superior to plain chest film and conventional tomography, in detection of cavitary lesion. Authors retrospectively analyzed CT findings of 20 cases of minimal pulmonary tuberculosis, of which the plain chest films showed no cavitary lesion from Sept. 1986 to July 1988 in Pusan National University Hospital. All cases were proven by culture or AFB test of sputum and clinical evidence. The results were as follows: 1. Sex distribution showed 10 cases (50%) in male, 10 case (50%) in female and the highest incidence in the second decade (40%). 2. All 20 cases showed no cavity on the plain chest films, but all cases showed variable sized cavities on CT. 3. The size of cavities ranged from 4 mm to 30 mm, averaged as 9.9 mm, the thickness of cavitary wall from 3 mm to 8 mm, averaged as 5.8 mm. 4. It is concluded that cavitary lesions which are not visualized on the plain chest films can be demonstrated by CT scan in minimal pulmonary tuberculosis

Clinical efficiency of Piezo-ICSI using micropipettes with a wall thickness of 0.625 μm.

Science.gov (United States)

Hiraoka, Kenichiro; Kitamura, Seiji

2015-12-01

The purposes of the present study are to assess the clinical efficiency of Piezo-intracytoplasmic sperm injection (ICSI) and to improve the Piezo-ICSI method for human oocytes. We examined three ICSI methods to determine their clinical efficiency by comparing the survival, fertilization, good-quality day-3 embryo, pregnancy, and live birth rates. The three ICSI methods tested were conventional ICSI (CI) (using beveled spiked micropipettes with a wall thickness of 1 μm), conventional Piezo-ICSI (CPI) (using flat-tipped micropipettes with a wall thickness of 0.925 μm), and improved Piezo-ICSI (IPI) (using flat-tipped micropipettes with a wall thickness of 0.625 μm). We collectively investigated 2020 mature oocytes retrieved from 437 patients between October 2010 and January 2014. The survival rates after CI, CPI, and IPI were 90, 95, and 99 %, respectively. The fertilization rates after CI, CPI, and IPI were 68, 75, and 89 %, respectively. The good-quality day-3 embryo rates after CI, CPI, and IPI were 37, 43, and 55 %, respectively. The pregnancy rates after the transfer of good-quality day-3 embryo of CI, CPI, and IPI were 19, 21, and 31 %, respectively. The live birth rates of CI, CPI, and IPI were 15, 16, and 25 %, respectively. Significantly higher survival, fertilization, good-quality day-3 embryo, pregnancy, and live birth rates were obtained using IPI. When comparing the IPI to the CI and CPI, the results revealed that the Piezo-ICSI using flat-tipped micropipettes with a wall thickness of 0.625 μm significantly improves survival, fertilization, good-quality day-3 embryo, pregnancy, and live birth rates.

Sarcocystis sinensis is the most prevalent thick-walled Sarcocystis species in beef on sale for consumers in Germany.

Science.gov (United States)

Moré, G; Pantchev, A; Skuballa, J; Langenmayer, M C; Maksimov, P; Conraths, F J; Venturini, M C; Schares, G

2014-06-01

Bovines are intermediate hosts of Sarcocystis cruzi, Sarcocystis hirsuta, and Sarcocystis hominis, which use canids, felids, or primates as definitive hosts, respectively. Cattle represent also intermediate hosts of Sarcocystis sinensis, but the definitive hosts of this parasite are not yet known. Sarcocystosis in cattle is frequently asymptomatic. The infection is characterized by the presence of thin-walled (S. cruzi) or thick-walled muscle cysts or sarcocysts (S. hominis, S. sinensis, and S. hirsuta). Recent reports suggest high prevalence of the zoonotic S. hominis in beef in Europe. We therefore aimed at differentiating Sarcocystis spp. in beef offered to consumers in Germany using molecular and microscopical methods, focusing on those species producing thick-walled sarcocysts. A total of 257 beef samples were obtained from different butcheries and supermarkets in Germany and processed by conventional and multiplex real-time PCR. In addition, 130 of these samples were processed by light microscopy and in 24.6% thick-walled cysts were detected. Transmission electron microscopical analysis of six of these samples revealed an ultrastructural cyst wall pattern compatible with S. sinensis in five samples and with S. hominis in one sample. PCR-amplified 18S ribosomal DNA (rDNA) fragments of 28 individual thick-walled cysts were sequenced, and sequence identities of ≥98% with S. sinensis (n = 22), S. hominis (n = 5) and S. hirsuta (n = 1) were observed. Moreover, nine Sarcocystis sp. 18S rDNA full length gene sequences were obtained, five of S. sinensis, three of S. hominis, and one of S. hirsuta. Out of all samples (n = 257), 174 (67.7%) tested positive by conventional PCR and 179 (69.6%) by multiplex real-time PCR for Sarcocystis spp. Regarding individual species, 134 (52%), 95 (37%), 17 (6.6%), and 16 (6.2%) were positive for S. cruzi, S. sinensis, S. hirsuta, and S. hominis, respectively. In conclusion, S. sinensis is the most prevalent thick-walled

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients

Directory of Open Access Journals (Sweden)

Omar Hesham R

2011-09-01

Full Text Available Abstract Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

Science.gov (United States)

Omar, Hesham R; Mangar, Devanand; Khetarpal, Suneel; Shapiro, David H; Kolla, Jaya; Rashad, Rania; Helal, Engy; Camporesi, Enrico M

2011-09-27

Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax. The first case is an example of a true occult pneumothorax where an initial AP chest X-ray revealed no evidence of pneumothorax and a CT chest immediately performed revealed evidence of pneumothorax. The second case represents an example of a missed rather than a truly occult pneumothorax where the initial chest radiograph revealed clues suggesting the presence of pneumothorax which were missed by the reading radiologist. The third case emphasizes the fact that "occult pneumothorax is predictable". The presence of subcutaneous emphesema and pulmonary contusion should call for further imaging with CT chest to rule out pneumothorax. Thoracic CT scan is therefore the "gold standard" for early detection of a pneumothorax in trauma patients. This report aims to sensitize readers to the entity of occult pneumothorax and create awareness among intensivists and ER physicians regarding the proper diagnosis and management.

Chest pain in focal musculoskeletal disorders

DEFF Research Database (Denmark)

Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

2010-01-01

overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence......The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several...... arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice....

Shear flow over a plane wall with an axisymmetric cavity or a circular orifice of finite thickness

International Nuclear Information System (INIS)

Pozrikidis, C.

1994-01-01

Shear flow over a plane wall that contains an axisymmetric depression or pore is studied using a new boundary integral method which is suitable for computing three-dimensional Stokes flow within axisymmetric domains. Numerical results are presented for cavities in the shape of a section of a sphere or a circular cylinder of finite length, and for a family of pores or orifices with finite thickness. The results illustrate the distribution of shear stresses over the plane wall and inside the cavities or pores. It is found that in most cases, the distribution of shear stresses over the plane wall, around the depressions, is well approximated with that for flow over an orifice of infinitesimal thickness for which an exact solution is available. The kinematic structure of the flow is discussed with reference to eddy formation and three-dimensional flow reversal. It is shown that the thickness of a circular orifice or depth of a pore play an important role in determining the kinematical structure of the flow underneath the orifice in the lower half-space

Effect of bladder wall thickness on miniature pneumatic artificial muscle performance.

Science.gov (United States)

Pillsbury, Thomas E; Kothera, Curt S; Wereley, Norman M

2015-09-28

Pneumatic artificial muscles (PAMs) are actuators known for their high power to weight ratio, natural compliance and light weight. Due to these advantages, PAMs have been used for orthotic devices and robotic limbs. Small scale PAMs have the same advantages, as well as requiring greatly reduced volumes with potential application to prostheses and small scale robotics. The bladder of a PAM affects common actuator performance metrics, specifically: blocked force, free contraction, hysteresis, and dead-band pressure. This paper investigates the effect that bladder thickness has on static actuation performance of small scale PAMs. Miniature PAMs were fabricated with a range of bladder thicknesses to quantify the change in common actuator performance metrics specifically: blocked force, free contraction, and dead-band pressure. These PAMs were then experimentally characterized in quasi-static conditions, where results showed that increasing bladder wall thickness decreases blocked force and free contraction, while dead-band pressure increases. A nonlinear model was then applied to determine the structure of the stress-strain relationship that enables accurate modeling and the minimum number of terms. Two nonlinear models are compared and the identified parameters are analyzed to study the effect of the bladder thickness on the model.

Determination of optimum insulation thicknesses of the external walls and roof (ceiling) for Turkey's different degree-day regions

International Nuclear Information System (INIS)

Sisman, Nuri; Kahya, Emin; Aras, Nil; Aras, Haydar

2007-01-01

The external walls and roof of a building are the interface between its interior and the outdoor environment. Insulation of the external walls and roof is the most cost-effective way of controlling the outside elements to make homes more comfortable. Although insulation is generally accepted as a factor increasing the building costs, with the calculations we have shown that this is not the case. Fuel consumption and operational costs are reduced by increasing the thickness of the external walls and roof (ceiling), despite an increase in the investment costs. According to Turkish Standard Number 825 (TS 825), there are four different degree-day (DD) regions, and the required heat loads for the buildings in these regions exhibit large differences. Therefore, a method based on costs is needed for the determination of optimum insulation thicknesses of different DD regions. In this study, optimum insulation thicknesses for different DD regions of Turkey, namely, Izmir (DD: 1450), Bursa (DD: 2203), Eskisehir (DD: 3215) and Erzurum (DD: 4856), have been determined for a lifetime of N years, maximizing the present worth value of annual energy savings for insulated external walls

1024 matrix image reconstruction: usefulness in high resolution chest CT

International Nuclear Information System (INIS)

Jeong, Sun Young; Chung, Myung Jin; Chong, Se Min; Sung, Yon Mi; Lee, Kyung Soo

2006-01-01

We tried to evaluate whether high resolution chest CT with a 1,024 matrix has a significant advantage in image quality compared to a 512 matrix. Each set of 512 and 1024 matrix high resolution chest CT scans with both 0.625 mm and 1.25 mm slice thickness were obtained from 26 patients. Seventy locations that contained twenty-four low density lesions without sharp boundary such as emphysema, and forty-six sharp linear densities such as linear fibrosis were selected; these were randomly displayed on a five mega pixel LCD monitor. All the images were masked for information concerning the matrix size and slice thickness. Two chest radiologists scored the image quality of each ar rowed lesion as follows: (1) undistinguishable, (2) poorly distinguishable, (3) fairly distinguishable, (4) well visible and (5) excellently visible. The scores were compared from the aspects of matrix size, slice thickness and the different observers by using ANOVA tests. The average and standard deviation of image quality were 3.09 (± .92) for the 0.625 mm x 512 matrix, 3.16 (± .84) for the 0.625 mm x 1024 matrix, 2.49 (± 1.02) for the 1.25 mm x 512 matrix, and 2.35 (± 1.02) for the 1.25 mm x 1024 matrix, respectively. The image quality on both matrices of the high resolution chest CT scans with a 0.625 mm slice thickness was significantly better than that on the 1.25 mm slice thickness (ρ < 0.001). However, the image quality on the 1024 matrix high resolution chest CT scans was not significantly different from that on the 512 matrix high resolution chest CT scans (ρ = 0.678). The interobserver variation between the two observers was not significant (ρ = 0.691). We think that 1024 matrix image reconstruction for high resolution chest CT may not be clinical useful

Elastic-plastic behaviour of thick-walled containers considering plastic compressibility

International Nuclear Information System (INIS)

Betten, J.; Frosch, H.G.

1983-01-01

In this paper the elastic-plastic behaviour of thick-walled pressure vessels with internal and external pressure is studied. To describe the mechanical behaviour of isotropic, plastic compressible materials we use a plastic potential which is a single-valued function of the principle stresses. For cylinders and spheres an analytic expression for the computation of stresses and residual stresses is specified. Afterwards the strains are calculated by using the finite difference method. Some examples will high-light the influence of the plastic compressibility on the behaviour of pressure vessels. (orig.) [de

New portable pipe wall thickness measuring technique

Science.gov (United States)

Pascente, Joseph E.

1998-03-01

One of the biggest inspection challenges facing many of the process industries; namely the petrochemical, refining, fossil power, and pulp and paper industries is: How to effectively examine their insulated piping? While there are a number of failure mechanisms involved in various process piping systems, piping degradation through corrosion and erosion are by far the most prevalent. This degradation can be in the form of external corrosion under insulation, internal corrosion through a variety of mechanisms, and internal erosion caused by the flow of the product through the pipe. Refineries, chemical plants and electrical power plants have MANY thousands of miles of pipe that are insulated to prevent heat loss or heat absorption. This insulation is often made up of several materials, with calcium based material being the most dense. The insulating material is usually wrapped with an aluminum or stainless steel outer wrap. Verification of wall thickness of these pipes can be accomplished by removing the insulation and doing an ultrasound inspection or by taking x- rays at a tangent to the edge of the pipe through the insulation. Both of these processes are slow and expensive. The time required to obtain data is measured in hours per meter. The ultrasound method requires that the insulation be plugged after the inspection. The surface needs to be cleaned or the resulting data will not be accurate. The tangent x-ray only shows two thicknesses and requires that the area be roped off because of radiation safety.

Ceramic inlays and partial ceramic crowns: influence of remaining cusp wall thickness on the marginal integrity and enamel crack formation in vitro.

Science.gov (United States)

Krifka, Stephanie; Anthofer, Thomas; Fritzsch, Marcus; Hiller, Karl-Anton; Schmalz, Gottfried; Federlin, Marianne

2009-01-01

No information is currently available about what the critical cavity wall thickness is and its influence upon 1) the marginal integrity of ceramic inlays (CI) and partial ceramic crowns (PCC) and 2) the crack formation of dental tissues. This in vitro study of CI and PCC tested the effects of different remaining cusp wall thicknesses on marginal integrity and enamel crack formation. CI (n = 25) and PCC (n = 26) preparations were performed in extracted human molars. Functional cusps of CI and PCC were adjusted to a 2.5 mm thickness; for PCC, the functional cusps were reduced to a thickness of 2.0 mm. Non-functional cusps were adjusted to wall thicknesses of 1) 1.0 mm and 2) 2.0 mm. Ceramic restorations (Vita Mark II, Cerec3 System) were fabricated and adhesively luted to the cavities with Excite/Variolink II. The specimens were exposed to thermocycling and central mechanical loading (TCML: 5000 x 5 degrees C-55 degrees C; 30 seconds/cycle; 500000 x 72.5N, 1.6Hz). Marginal integrity was assessed by evaluating a) dye penetration (fuchsin) on multiple sections after TCML and by using b) quantitative margin analysis in the scanning electron microscope (SEM) before and after TCML. Ceramic- and tooth-luting agent interfaces (LA) were evaluated separately. Enamel cracks were documented under a reflective light microscope. The data were statistically analyzed with the Mann Whitney U-test (alpha = 0.05) and the Error Rates Method (ERM). Crack formation was analyzed with the Chi-Square-test (alpha = 0.05) and ERM. In general, the remaining cusp wall thickness, interface, cavity design and TCML had no statistically significant influence on marginal integrity for both CI and PCC (ERM). Single pairwise comparisons showed that the CI and PCC of Group 2 had a tendency towards less microleakage along the dentin/LA interface than Group 1. Cavity design and location had no statistically significant influence on crack formation, but the specimens with 1.0 mm of remaining wall

Male gender and sonographic gall bladder wall thickness: important predictable factors for empyema and gangrene in acute cholecystitis

International Nuclear Information System (INIS)

Khan, M.L.U.; Jawed, M.; Shaikh, U.; Abbassi, M.R.

2014-01-01

Objective: To underline the status of male gender and gall bladder wall thickness as significant risk factors for acute cholecystitis complications. Methods: The retrospective study, with purposive sampling of the patients of acute cholecystits in age above 18 years, who were operated within 10 days of onset of symptoms, was conducted at the Department of Surgery, Dow University Hospital, Karachi, by reviewing the patients' medical record from March 2010 to August 2012. Correlation of incidence of acute cholecystitis complications (empyema and gangrene) to male gender and to the sonographic gall bladder wall thickness more than 4.5mm was analysed using SPSS 16. Result: Out of 62 patients, 8 (13%) patients had gangrene while 10 (16.12%) had empyema. Overall, there were 21 (33.87%) males in the study. Ten (47.6%) of the male patients developed empyema or gangrene of the gall bladder as a complication of acute cholecystitis. Of the 41 (66.12%) female patients, only 8 (19.5%) developed these complications. There were 22 (35.48%) cases of gall bladders with sonographic wall thickness more than 4.5mm who were operated for acute cholecystitis. Of them, 16 (72.7%) had empyema or gangrene. Conclusion: Male gender and sonographic gall bladder wall thickness more than 4.5mm were statistically significant risk factors for suspicion of complicated acute cholecystitis (empyema/gangrene) and by using these risk factors, we can prioritise patients for surgery in the emergency room. (author)

Development of on-line wall thickness gauge for small size seamless tube. Shokei seamless netsukan nikuatsukei no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Okumura, T; Konya, N; Oka, H; Kasuya, T [Kawasaki Steel Corp., Tokyo (Japan)

1991-03-01

In order to heighten the accuracy of small size seamless tube wall thickness, hot wall thickness gauge was developed to be installed, immediately behind the finishing/rolling mill, for the on-line measurement, of which the method was by the parallel-beam transmissivity of gamma-ray. The measurement unit, aiming at flexible manufacturing system (FMS), is completely automated in correcting the accuracy, changing the sizes, etc. The damping characteristics of gamma-ray beam can be expressed by a characteristic function, taking the outside diameter and wall thickness of subject tube as parameters. The functional calculation, as based on measurement of transmitted quantity of gamma-ray through the three-dimensional steel material, changes, depending upon the outside diameter, wall thickness and material specification of subject tube. System was so applied as to calculate it therefore on a case-by-case basis. Though in the vicinity of tube end, the transmitted quantity of gamma-ray is largely influenced by the horizontal dislocation, that influence is slack in the middle part of tube. Therefore, the cross sectional division was made dense and sparse in the end part and middle part, respectively of tube, which division could diminish the error from several percent to less than 0.1%. The static noise was compressed by the optimized digital filter. That gauge is presently applied for the operational administration of small size seamless tube rolling. 2 refs., 11 figs., 2 tabs.

Minimization of thermal insulation thickness taking into account condensation on external walls

Directory of Open Access Journals (Sweden)

Nurettin Yamankaradeniz

2015-09-01

Full Text Available Condensation occurs in the inner layers of construction materials at whatever point the partial pressure of water vapor diffuses and reaches its saturation pressure. Condensation, also called sweating, damages materials, reduces thermal resistance, and by increasing the total heat transfer coefficient, results in unwanted events such as increased heat loss. This study applied minimization of thermal insulation thickness with consideration given to condensation in the external walls. The calculations of heat and mass transfers in the structure elements are expressed in a graphical form. While there was an increase in the required thermal insulation thickness subsequent to an increase in the internal environment’s temperature, relative humidity, and the external environment’s relative humidity, the required thickness decreased with an increase in the external environment’s temperature. The amount of water vapor transferred varied with internal or external conditions and the thickness of the insulation. A change in the vapor diffusion resistance of the insulation material can increase the risk of condensation on the internal or external surfaces of the insulation.

Measurement of wall thickness with electrodynamic test heads

International Nuclear Information System (INIS)

Koch, R.; Maurer, A.

1993-01-01

Starting from the boundary conditions fixed by the physical properties of the electromagnetic/acoustic conversion and the operating limits which result from these for the sensors used, the use of electro-dynamic ultrasonic transducers for measuring wall thickness and double checks in plants for automatic production inspection and production control is shown. The sensor itself is the heart of a test system, but only the equipment and plant concepts surrounding the sensor make economic solution of the test problem possible. The quality of the signals which are supplied by a sensor, determines the quality of a test system. This can only be achieved by optimising all parts of a complex automatic test rig, such as the test head, mechanics, electronics and evaluation for the test problem concerned. (orig./HP) [de

Imaging of blunt chest trauma

International Nuclear Information System (INIS)

Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A.

2000-01-01

In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

Chest Trauma in Athletic Medicine.

Science.gov (United States)

Phillips, Nicholas R; Kunz, Derek E

2018-03-01

While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax. Basic field-side management should be rapid and focused, using the standardized approach of Advanced Traumatic Life Support protocol. Early and appropriate diagnosis and management can help allow safe and enjoyable sports participation.

Tissue factor levels and the fibrinolytic system in thin and thick intraluminal thrombus and underlying walls of abdominal aortic aneurysms.

Science.gov (United States)

Siennicka, Aldona; Zuchowski, Marta; Kaczmarczyk, Mariusz; Cnotliwy, Miłosław; Clark, Jeremy Simon; Jastrzębska, Maria

2018-03-20

The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair. Factor levels were measured using enzyme-linked immunosorbent assay of protein extract. Tissue factor (TF) activities were significantly higher in thinner segments of AAA (B1 vs A1, P = .003; B vs A, P thick thrombus-covered wall segments (A) than in B, A1, and B1 (P = .015, P thick ILT (P = .021) and thick ILT (A1; P thick ILT (A1). However, no correlations were found at B sites, except for a correlation between plasmin and TF activities (r = 0.55; P = .004). These results suggest that higher TF activities are present in thinner AAA regions. These parameters and local fibrinolysis may be part of the processes leading to destruction of the aneurysm wall. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Development of automated welding process for field fabrication of thick walled pressure vessels

Energy Technology Data Exchange (ETDEWEB)

Schneider, U A

1981-01-01

Research on automatic welding processes for the fabrication of thick-walled pressure vessels continued. A literature review on the subject was completed. A laboratory study of criteria for judging acceptable root parameters continued. Equipment for a demonstration facility to test the components and processes of the automated welding system has been specified and is being obtained. (LCL)

Development of automated welding process for field fabrication of thick walled pressure vessels

International Nuclear Information System (INIS)

Schneider, U.A.

Research on automatic welding processes for the fabrication of thick-walled pressure vessels continued. A literature review on the subject was completed. A laboratory study of criteria for judging acceptable root parameters continued. Equipment for a demonstration facility to test the components and processes of the automated welding system has been specified and is being obtained

Standard guide for mutual inductance bridge applications for wall thickness determinations in boiler tubing

CERN Document Server

American Society for Testing and Materials. Philadelphia

2010-01-01

1.1 This guide describes a procedure for obtaining relative wall thickness indications in ferromagnetic and non-ferromagnetic steels using the mutual inductance bridge method. The procedure is intended for use with instruments capable of inducing two substantially identical magnetic fields and noting the change in inductance resulting from differing amounts of steel. It is used to distinguish acceptable wall thickness conditions from those which could place tubular vessels or piping at risk of bursting under high temperature and pressure conditions. 1.2 This guide is intended to satisfy two general needs for users of industrial Mutual Inductance Bridge (MIB) equipment: (1) the need for a tutorial guide addressing the general principles of Mutual Inductance Bridges as they apply to industrial piping; and (2) the need for a consistent set of MIB performance parameter definitions, including how these performance parameters relate to MIB system specifications. Potential users and buyers, as well as experienced M...

K-wire assisted split-thickness skin graft harvesting from the anterior trunk.

Science.gov (United States)

Yontar, Yalcin; Coruh, Atilla; Severcan, Mehmet

2016-02-01

Split thickness skin graft (STSG) harvesting from the anterior chest and abdominal wall skin is quite a difficult process. The main reason for the difficulty to perform this process is the unsuitable anatomic characteristics of the anterior trunk, such as irregular wavy-like surface over the ribs and lax abdominal wall skin resulting in collapse due to lack of adequate underneath supporting structures when a downward force is applied by the skin graft dermatome. Lower extremity and especially the thigh are generally chosen as the donor site where the STSGs are easily harvested from. However, extensive lower extremity burns, with or without other region burns, preclude harvesting auto STSGs from this invaluable anatomic site. We harvested K-wire assisted STSGs from the anterior chest and abdominal wall skin of 7 patients with lower extremity burns and also a patient that sustained motor vehicle collision. We encountered no problems in any of our patients both intra and postoperatively by using K-wire assisted STSG harvesting. All of the STSGs donor sites healed uneventfully without complications. In our opinion, K-wire assisted STSG harvesting must always be in the tool-box of any surgeon who deals with extensive burns with or without lower extremity burns and extensive traumas of lower extremities. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Minimization of thermal insulation thickness taking into account condensation on external walls

OpenAIRE

Nurettin Yamankaradeniz

2015-01-01

Condensation occurs in the inner layers of construction materials at whatever point the partial pressure of water vapor diffuses and reaches its saturation pressure. Condensation, also called sweating, damages materials, reduces thermal resistance, and by increasing the total heat transfer coefficient, results in unwanted events such as increased heat loss. This study applied minimization of thermal insulation thickness with consideration given to condensation in the external walls. The calcu...

Surgical Stabilization of Costoclavicular Injuries - A Combination of Flail Chest Injuries and a Clavicula Fracture.

Science.gov (United States)

Langenbach, Andreas; Pinther, Melina; Krinner, Sebastian; Grupp, Sina; Ekkernkamp, Axel; Hennig, Friedrich F; Schulz-Drost, Stefan

2017-01-01

Background: Flail chest injuries (FCI) are associated with a high morbidity and mortality rate. As a concomitant clavicle fracture in FCI even worsens the outcome, the question is how can those costoclavicular injuries (CCI) be managed surgically. Methods: 11 patients with CCI were surgically treated by a locked plate osteosynthesis of the Clavicle and the underlying ribs through limited surgical approaches under general anesthesia. Patients were followed up after 2, 6, 12, 26 and 52 weeks. Results: All patients showed severe chest wall deformity due to severely displaced fractures of the ribs and the clavicle. They were suffering from pain and restriction of respiratory movements. The chest wall could be restored to normal shape in all cases with uneventful bone healing and a high patient convenience. Fractures of the clavicle and the second rib were managed through an innovative clavipectoral approach, the others through standard approaches to the anterolateral and the posterolateral chest wall. Two patients complained about numbness around the lateral approach and lasting periscapular pain. Conclusions: Surgical stabilization might be the appropriate therapy in CCI with dislocated fractures since they would cause severe deformity and loss of function of the chest wall and the shoulder. Celsius.

Thick-Walled Cylinder Theory Applied on a Conical Wedge Anchorage

DEFF Research Database (Denmark)

Bennitz, Anders; Grip, Niklas; Schmidt, Jacob Wittrup

2011-01-01

for further development of the anchorage.In this paper, we derive and examine an analytical model for the internal stresses and strains within the anchorage for a prescribed presetting distance. This model is derived from the theory of thick walled cylinders under the assumptions regarding plane stress...... and axial symmetry. We simplify the resulting system of ten nonlinear equations and derive a method for solving them numerically. A comparison of plotted results for three different angles on the wedge’s outer surface and six different presetting distances follows.These results are also compared to both axi...

An Analysis of the Quality of the Thick-Walled S355J2+N Steel Joint Welded by the Mag Method

Directory of Open Access Journals (Sweden)

Krawczyk R.

2017-06-01

Full Text Available An analysis of the quality of the thick-walled S355J2+N steel welded joint used most frequently in the general-building, power and other contemporary steel constructions is presented in the following article. A process of examining welding technologies was made on the tick-walled butt joints of plates by using the MAG – 135 welding method. The aim of the discussed topic was to optimize the process of welding thick-walled welded joints due to their mechanical strength properties and efficiency.

Acoustic scattering from a contrast agent microbubble near an elastic wall of finite thickness

International Nuclear Information System (INIS)

Doinikov, Alexander A; Aired, Leila; Bouakaz, Ayache

2011-01-01

Interest in the problem under consideration in this study is motivated by targeted ultrasound imaging where one has to deal with microbubble contrast agents pulsating near blood vessel walls. A modified Rayleigh–Plesset equation is derived that describes the oscillation of a contrast agent microbubble near an elastic wall of finite thickness. It is assumed that the medium behind the wall is a fluid but it is shown that the equation obtained is easily transformable to the case that the medium behind the wall is an elastic solid. In contrast to the model of a rigid wall, which predicts decreasing natural frequency of a bubble near the wall, the elastic wall model reveals that the bubble natural frequency can both decrease and increase, and in cases of interest for medical applications, the bubble natural frequency usually increases. It is found that the influence of an elastic wall on the acoustic response of a bubble is determined by the ratio between a cumulative parameter, which integrally characterizes the mechanical properties of the wall and has the dimension of density, and the density of the liquid surrounding the bubble. It is shown that the acoustic influence of the arterial wall on the bubble is weak and apparently cannot be used to recognize the moment when the bubble approaches the wall. However, in experiments where the behavior of bubbles near various plastic walls is observed, changes in the bubble response, such as increasing natural frequency and decreasing oscillation amplitude, are detectable.

Effectiveness of chest physiotherapy in the management of bronchiectasis

International Nuclear Information System (INIS)

Arif, M.; Bashir, M.S.

2014-01-01

Bronchiectasis is a chronic disease in which clearance of sputum is disturbed because bronchi dilated permanently. So for the clearance of sputum we have to use physiotherapy techniques such as postural drainage percussion and vibration (PDPY), active cycle of breathing technique (ACBT), autogenic drainage, positive expiratory pressure, high frequency chest wall oscillation. Objective: To determine the role of Chest Physical therapy intervention in the management of Bronchi ectasis. To compare the prognosis of bronchiectasis with and without chest physiotherapy. Methodology: Data was collected from Gulab Devi Chest Hospital, Lahore. A Randomized Control Trial (RCT) study method was used and 60 patients are studied. In this study, they were divided into 03 groups 1- Antibiotics Therapy 2-Chest Physical therapy 3-Antibiotics and Chest Physical therapy. Each group consistant. (author)

Does the quality of chest compressions deteriorate when the chest compression rate is above 120/min?

Science.gov (United States)

Lee, Soo Hoon; Kim, Kyuseok; Lee, Jae Hyuk; Kim, Taeyun; Kang, Changwoo; Park, Chanjong; Kim, Joonghee; Jo, You Hwan; Rhee, Joong Eui; Kim, Dong Hoon

2014-08-01

The quality of chest compressions along with defibrillation is the cornerstone of cardiopulmonary resuscitation (CPR), which is known to improve the outcome of cardiac arrest. We aimed to investigate the relationship between the compression rate and other CPR quality parameters including compression depth and recoil. A conventional CPR training for lay rescuers was performed 2 weeks before the 'CPR contest'. CPR anytime training kits were distributed to respective participants for self-training on their own in their own time. The participants were tested for two-person CPR in pairs. The quantitative and qualitative data regarding the quality of CPR were collected from a standardised check list and SkillReporter, and compared by the compression rate. A total of 161 teams consisting of 322 students, which includes 116 men and 206 women, participated in the CPR contest. The mean depth and rate for chest compression were 49.0±8.2 mm and 110.2±10.2/min. Significantly deeper chest compression depths were noted at rates over 120/min than those at any other rates (47.0±7.4, 48.8±8.4, 52.3±6.7, p=0.008). Chest compression depth was proportional to chest compression rate (r=0.206, pcompression including chest compression depth and chest recoil by chest compression rate. Further evaluation regarding the upper limit of the chest compression rate is needed to ensure complete full chest wall recoil while maintaining an adequate chest compression depth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impact of Age and Aerobic Exercise Training on Conduit Artery Wall Thickness: Role of the Shear Pattern.

Science.gov (United States)

Tanahashi, Koichiro; Kosaki, Keisei; Sawano, Yuriko; Yoshikawa, Toru; Tagawa, Kaname; Kumagai, Hiroshi; Akazawa, Nobuhiko; Maeda, Seiji

2017-01-01

Hemodynamic shear stress is the frictional force of blood on the arterial wall. The shear pattern in the conduit artery affects the endothelium and may participate in the development and progression of atherosclerosis. We investigated the role of the shear pattern in age- and aerobic exercise-induced changes in conduit artery wall thickness via cross-sectional and interventional studies. In a cross-sectional study, we found that brachial shear rate patterns and brachial artery intima-media thickness (IMT) correlated with age. Additionally, brachial artery shear rate patterns were associated with brachial artery IMT in 102 middle-aged and older individuals. In an interventional study, 39 middle-aged and older subjects were divided into 2 groups: control and exercise. The exercise group completed 12 weeks of aerobic exercise training. Aerobic exercise training significantly increased the antegrade shear rate and decreased the retrograde shear rate and brachial artery IMT. Moreover, changes in the brachial artery antegrade shear rate and the retrograde shear rate correlated with the change in brachial artery IMT. The results of the present study indicate that changes in brachial artery shear rate patterns may contribute to age- and aerobic exercise training-induced changes in brachial artery wall thickness. © 2017 S. Karger AG, Basel.

An Approach for Patient-Specific Multi-domain Vascular Mesh Generation Featuring Spatially Varying Wall Thickness Modeling

OpenAIRE

Raut, Samarth S.; Liu, Peng; Finol, Ender A.

2015-01-01

In this work, we present a computationally efficient image-derived volume mesh generation approach for vasculatures that implements spatially varying patient-specific wall thickness with a novel inward extrusion of the wall surface mesh. Multi-domain vascular meshes with arbitrary numbers, locations, and patterns of both iliac bifurcations and thrombi can be obtained without the need to specify features or landmark points as input. In addition, the mesh output is coordinate-frame independent ...

Numerical investigation on residual stress distribution and evolution during multipass narrow gap welding of thick-walled stainless steel pipes

International Nuclear Information System (INIS)

Liu, C.; Zhang, J.X.; Xue, C.B.

2011-01-01

Research highlights: → We performed pass-by-pass simulation of stresses for welding of thick-walled pipes. → The distributions and evolution of the residual stresses are demonstrated. → After the groove is filled to a height, the through-wall stress is almost unchanged. - Abstracts: The detailed pass-by-pass finite element (FE) simulation is presented to investigate the residual stresses in narrow gap multipass welding of pipes with a wall thickness of 70 mm and 73 weld passes. The simulated residual stress on the outer surface is validated with the experimental one. The distribution and evolution of the through-wall residual stresses are demonstrated. The investigated results show that the residual stresses on the outer and inner surfaces are tensile in the weld zone and its vicinity. The through-wall axial residual stresses at the weld center line and the HAZ line demonstrate a distribution of bending type. The through-wall hoop residual stress within the weld is mostly tensile. After the groove is filled to a certain height, the peak tensile stresses and the stress distribution patterns for both axial and hoop stresses remain almost unchanged.

Rare cause of multiple nodular opacities at chest x-ray: pulmonary hydatid cyst

International Nuclear Information System (INIS)

Inan, K.; Hamcan, S.; Gumus, S.; Turhan, U.; Karaman, B.

2012-01-01

Full text: Introduction: Hydatid disease is incidentally common in our country. Objectives and tasks: In this study, unlike the classical radiological appearance of hydatid disease of the lung, MDCT appearance of multiple nodules were demonstrated. Materials and methods: The patient who comes our hospital's Pulmonary Clinic with shortness of breath and with membranes that come from his mouth, referred to our clinic for chest radiography and chest HRCT. Results: In the conventional chest x-ray, multiple nodular opacities in both lungs were common. HRCT was performed with 5 mm and 1 mm thick sections of our patient. In both hemithorax, multiple nodular lesions were found in various sizes and configurations, some of them opened to the bronchus which is the largest one is 2 cm in diameter. Nodule in the left hemithorax inferior lingular segment has calcified wall. Patient's Echinococcus granulosus test was evaluated positive for IgG. Conclusion: Hydatid disease is a parasitic infestation created by Echinococcus granulosus. Although seen most frequently in the liver, often seen in the lungs 10-30%.. 30 to 50% of cases are asymptomatic and incidentally diagnosed radiologically. Although we know that the classic radiologic findings of hydatid cyst, different radiographic views (eg nodular mass) should be considered in rare circumstances

Measurement of thickness of film deposited on the plasma-facing wall in the QUEST tokamak by colorimetry.

Science.gov (United States)

Wang, Z; Hanada, K; Yoshida, N; Shimoji, T; Miyamoto, M; Oya, Y; Zushi, H; Idei, H; Nakamura, K; Fujisawa, A; Nagashima, Y; Hasegawa, M; Kawasaki, S; Higashijima, A; Nakashima, H; Nagata, T; Kawaguchi, A; Fujiwara, T; Araki, K; Mitarai, O; Fukuyama, A; Takase, Y; Matsumoto, K

2017-09-01

After several experimental campaigns in the Kyushu University Experiment with Steady-state Spherical Tokamak (QUEST), the originally stainless steel plasma-facing wall (PFW) becomes completely covered with a deposited film composed of mixture materials, such as iron, chromium, carbon, and tungsten. In this work, an innovative colorimetry-based method was developed to measure the thickness of the deposited film on the actual QUEST wall. Because the optical constants of the deposited film on the PFW were position-dependent and the extinction coefficient k 1 was about 1.0-2.0, which made the probing light not penetrate through some thick deposited films, the colorimetry method developed can only provide a rough value range of thickness of the metal-containing film deposited on the actual PFW in QUEST. However, the use of colorimetry is of great benefit to large-area inspections and to radioactive materials in future fusion devices that will be strictly prohibited from being taken out of the limited area.

The thick left ventricular wall of the giraffe heart normalises wall tension, but limits stroke volume and cardiac output

DEFF Research Database (Denmark)

Smerup, Morten Holdgaard; Damkjær, Mads; Brøndum, Emil

2016-01-01

Giraffes - the tallest extant animals on Earth - are renowned for their high central arterial blood pressure, which is necessary to secure brain perfusion. The pressure which may exceed 300 mmHg has historically been attributed to an exceptionally large heart. Recently, this has been refuted...... by several studies demonstrating that the mass of giraffe heart is similar to that of other mammals when expressed relative to body mass. It remains enigmatic, however, how the normal-sized giraffe heart generates such massive arterial pressures.We hypothesized that giraffe hearts have a small...... intraventricular cavity and a relatively thick ventricular wall, allowing for generation of high arterial pressures at normal left ventricular wall tension. In nine anaesthetized giraffes (495±38 kg), we determined in vivo ventricular dimensions using echocardiography along with intraventricular and aortic...

An analytical method for calculating stresses and strains of ATF cladding based on thick walled theory

Energy Technology Data Exchange (ETDEWEB)

Kim, Dong Hyun; Kim, Hak Sung [Hanyang University, Seoul (Korea, Republic of); Kim, Hyo Chan; Yang, Yong Sik; In, Wang kee [KAERI, Daejeon (Korea, Republic of)

2016-05-15

In this paper, an analytical method based on thick walled theory has been studied to calculate stress and strain of ATF cladding. In order to prescribe boundary conditions of the analytical method, two algorithms were employed which are called subroutine 'Cladf' and 'Couple' of FRACAS, respectively. To evaluate the developed method, equivalent model using finite element method was established and stress components of the method were compared with those of equivalent FE model. One of promising ATF concepts is the coated cladding, which take advantages such as high melting point, a high neutron economy, and low tritium permeation rate. To evaluate the mechanical behavior and performance of the coated cladding, we need to develop the specified model to simulate the ATF behaviors in the reactor. In particular, the model for simulation of stress and strain for the coated cladding should be developed because the previous model, which is 'FRACAS', is for one body model. The FRACAS module employs the analytical method based on thin walled theory. According to thin-walled theory, radial stress is defined as zero but this assumption is not suitable for ATF cladding because value of the radial stress is not negligible in the case of ATF cladding. Recently, a structural model for multi-layered ceramic cylinders based on thick-walled theory was developed. Also, FE-based numerical simulation such as BISON has been developed to evaluate fuel performance. An analytical method that calculates stress components of ATF cladding was developed in this study. Thick-walled theory was used to derive equations for calculating stress and strain. To solve for these equations, boundary and loading conditions were obtained by subroutine 'Cladf' and 'Couple' and applied to the analytical method. To evaluate the developed method, equivalent FE model was established and its results were compared to those of analytical model. Based on the

Thoracic Wall Necrotizing Fasccitiss in a Neonate: a Case Report

Directory of Open Access Journals (Sweden)

Serdar Onat

2010-09-01

Full Text Available Necrotizing fasciitis (NF is a rapidly progressive and potentially life-threatening infection of superficial fascia and subcutaneous tissue. Thoracic wall is one of the rarest locations for NF. Broadspectrum antibiotics receiving, early surgical debridement, and skin grafting are life saving in NF. We report a 7-day-old female neonate who had left sided thoracic wall NF. She had undergone extensive surgical debridement within 4 hours of hospital admission, and reconstruction of skin defect by split-thickness skin grafting later. Early diagnosis is important, as prompt surgical debridement offers the best chance for survival. Early and extensive surgical debridement is a widely accepted clinical approach and the mainstay of effective treatment. The goals of surgical intervention are to remove all necrotic tissues, and to help control the progression of NF. Reconstruction of skin defects should be performed by early split-thickness skin grafting like our patient or primary closure. Because early wound resurfacing prevents fluid, electrolyte, and protein loss from the wound site, and decreases secondary infection. Although chest wall NF is rare in neonates, it is a rapidly spreading, highly lethal infection. A high index of suspicion, early diagnosis, and aggressive approach are essential to its successful treatment.

Ultrasonic guided wave tomography for wall thickness mapping in pipes

Science.gov (United States)

Willey, Carson L.

Corrosion and erosion damage pose fundamental challenges to operation of oil and gas infrastructure. In order to manage the life of critical assets, plant operators must implement inspection programs aimed at assessing the severity of wall thickness loss (WTL) in pipelines, vessels, and other structures. Maximum defect depth determines the residual life of these structures and therefore represents one of the key parameters for robust damage mitigation strategies. In this context, continuous monitoring with permanently installed sensors has attracted significant interest and currently is the subject of extensive research worldwide. Among the different monitoring approaches being considered, significant promise is offered by the combination of guided ultrasonic wave technology with the principles of model based inversion under the paradigm of what is now referred to as guided wave tomography (GWT). Guided waves are attractive because they propagate inside the wall of a structure over a large distance. This can yield significant advantages over conventional pulse-echo thickness gage sensors that provide insufficient area coverage -- typically limited to the sensor footprint. While significant progress has been made in the application of GWT to plate-like structures, extension of these methods to pipes poses a number of fundamental challenges that have prevented the development of sensitive GWT methods. This thesis focuses on these challenges to address the complex guided wave propagation in pipes and to account for parametric uncertainties that are known to affect model based inversion and which are unavoidable in real field applications. The main contribution of this work is the first demonstration of a sensitive GWT method for accurately mapping the depth of defects in pipes. This is achieved by introducing a novel forward model that can extract information related to damage from the complex waveforms measured by pairs of guided wave transducers mounted on the pipe

Enhanced washout of 99mTc-tetrofosmin in hypertrophic cardiomyopathy: quantitative comparisons with regional 123I-BMIPP uptake and wall thickness determined by MRI

International Nuclear Information System (INIS)

Thet-Thet-Lwin, Tohoru; Takeda, Jin; Wu, Yuko; Fumikura, Keiji; Iida, Satoru; Kawano, Iwao; Yamaguchi, Yuji; Itai

2003-01-01

The diagnostic value of technetium-99m tetrofosmin (TF) washout in hypertrophic cardiomyopathy (HCM) was examined by investigating its relation to the metabolic abnormality depicted by iodine-123 β-methyl-p-iodophenylpentadecanoic acid (BMIPP) uptake and the left ventricular (LV) myocardial wall thickness as measured by magnetic resonance imaging (MRI). TF washout was evaluated in 31 patients with HCM and 23 normal control subjects using 30-min (early) and 3-h (delayed) TF single-photon emission tomography images. The LV myocardial wall was divided into 19 segments and the percentage TF washout, regional BMIPP uptake and LV wall thickness were measured in each segment. Mean TF washout in the patients with HCM was significantly faster than that in normal control subjects (23.7±5.7 vs 13.4±4.1, P<0.0001). In the patients with HCM, TF washout showed an excellent correlation with MRI wall thickness (r=0.82, P<0.0001) and a good inverse correlation with regional BMIPP uptake (r=-0.72, P<0.0001). In addition, a good linear correlation was observed between TF uptake and MRI wall thickness in the 19 regional segments. In conclusion, the degree of TF washout corresponds well with the severity of myocardial wall thickness and the degree of metabolic abnormality in patients with HCM. These results suggest that enhanced TF washout might provide additional clinical information regarding metabolic alterations in HCM. (orig.)

Enhanced washout of 99mTc-tetrofosmin in hypertrophic cardiomyopathy: quantitative comparisons with regional 123I-BMIPP uptake and wall thickness determined by MRI.

Science.gov (United States)

Thet-Thet-Lwin; Takeda, Tohoru; Wu, Jin; Fumikura, Yuko; Iida, Keiji; Kawano, Satoru; Yamaguchi, Iwao; Itai, Yuji

2003-07-01

The diagnostic value of technetium-99m tetrofosmin (TF) washout in hypertrophic cardiomyopathy (HCM) was examined by investigating its relation to the metabolic abnormality depicted by iodine-123 beta-methyl- p-iodophenylpentadecanoic acid (BMIPP) uptake and the left ventricular (LV) myocardial wall thickness as measured by magnetic resonance imaging (MRI). TF washout was evaluated in 31 patients with HCM and 23 normal control subjects using 30-min (early) and 3-h (delayed) TF single-photon emission tomography images. The LV myocardial wall was divided into 19 segments and the percentage TF washout, regional BMIPP uptake and LV wall thickness were measured in each segment. Mean TF washout in the patients with HCM was significantly faster than that in normal control subjects (23.7+/-5.7 vs 13.4+/-4.1, P<0.0001). In the patients with HCM, TF washout showed an excellent correlation with MRI wall thickness ( r=0.82, P<0.0001) and a good inverse correlation with regional BMIPP uptake ( r=-0.72, P<0.0001). In addition, a good linear correlation was observed between TF uptake and MRI wall thickness in the 19 regional segments. In conclusion, the degree of TF washout corresponds well with the severity of myocardial wall thickness and the degree of metabolic abnormality in patients with HCM. These results suggest that enhanced TF washout might provide additional clinical information regarding metabolic alterations in HCM.

Role of computed tomography in blunt chest trauma

International Nuclear Information System (INIS)

Cho, Jae Hyun; Kim, Sang Jin; Lee, Chan Wha; Kim, Hae Kyoon

1994-01-01

In patient with blunt trauma of chest, supine AP x-ray cannot differentiate the lung contusion, laceration, atelectasis, and hemothorax definitely. Therefore, computed tomographic evaluation is needed for accurate evaluation of the injuries. In our knowledge, there are few reports about CT findings of blunt chest trauma, in our country, therefore we tried to fluid the characteristic CT findings in patients with blunt trauma. We analyzed the plain x-ray and CT image of 4 patients with blunt chest trauma. Location and morphology of lung parenchymal contusion and laceration, hemopneumothorax, chest wall injuries and location of chest tube. Lung parenchymal contusion was noted in 53 segments., of 16 patients infiltration(n=27 segment), and multiple nodular pattern was noted in 15 segment, pattern of consolidation along the lung periphery was seen in 11 segment. Laceration was noted in 18 lesion and most commonly located in paravertebral area(b=8). CT scan of chest in patient with blunt chest trauma, provides accurate information of the pattern of injuries, and localization, therefore, should be performed as possible

Paediatric chest wall trauma causing delayed presentation of ventricular arrhythmia.

Science.gov (United States)

Tegethoff, Angela M; Raney, Emerald; Mendelson, Jenny; Minckler, Michael R

2017-07-24

This report describes a paediatric patient presenting with haemodynamically stable non-sustained ventricular tachycardia 1 day after minor blunt chest trauma. Initial laboratory studies, chest X-ray and echocardiography were normal; however, cardiac MRI revealed precordial haematoma, myocardial contusion and small pericardial effusion. Throughout her hospital course, she remained asymptomatic aside from frequent couplets and triplets of premature ventricular contractions. Ectopy was controlled with oral verapamil. This case highlights how significant cardiac injury may be missed with standard diagnostic algorithms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Creep properties in similar weld joint of a thick-walled P92 steel pipe

Czech Academy of Sciences Publication Activity Database

Sklenička, Václav; Kuchařová, Květa; Svobodová, M.; Kvapilová, Marie; Král, Petr; Horváth, P.

2016-01-01

Roč. 119, č. 1 (2016), s. 1-12 ISSN 1044-5803 R&D Projects: GA ČR(CZ) GA16-09518S; GA MPO FR-TI4/406 Institutional support: RVO:68081723 Keywords : 9–12%Cr steels * Creep testing * High temperature creep * Thick-walled pipe * Welding Subject RIV: JG - Metallurgy Impact factor: 2.714, year: 2016

The effect of wall thickness distribution on mechanical reliability and strength in unidirectional porous ceramics

Science.gov (United States)

Seuba, Jordi; Deville, Sylvain; Guizard, Christian; Stevenson, Adam J.

2016-01-01

Macroporous ceramics exhibit an intrinsic strength variability caused by the random distribution of defects in their structure. However, the precise role of microstructural features, other than pore volume, on reliability is still unknown. Here, we analyze the applicability of the Weibull analysis to unidirectional macroporous yttria-stabilized-zirconia (YSZ) prepared by ice-templating. First, we performed crush tests on samples with controlled microstructural features with the loading direction parallel to the porosity. The compressive strength data were fitted using two different fitting techniques, ordinary least squares and Bayesian Markov Chain Monte Carlo, to evaluate whether Weibull statistics are an adequate descriptor of the strength distribution. The statistical descriptors indicated that the strength data are well described by the Weibull statistical approach, for both fitting methods used. Furthermore, we assess the effect of different microstructural features (volume, size, densification of the walls, and morphology) on Weibull modulus and strength. We found that the key microstructural parameter controlling reliability is wall thickness. In contrast, pore volume is the main parameter controlling the strength. The highest Weibull modulus (?) and mean strength (198.2 MPa) were obtained for the samples with the smallest and narrowest wall thickness distribution (3.1 ?m) and lower pore volume (54.5%).

Effects of non-invasive ventilation and posture on chest wall volumes and motion in patients with amyotrophic lateral sclerosis: a case series

OpenAIRE

Magalh?es, Cristiana M.; Fregonezi, Guilherme A.; Vidigal-Lopes, Mauro; Vieira, Bruna S. P. P.; Vieira, Danielle S. R.; Parreira, Ver?nica F.

2016-01-01

ABSTRACT Background The effects of non-invasive ventilation (NIV) on the breathing pattern and thoracoabdominal motion of patients with amyotrophic lateral sclerosis (ALS) are unknown. Objectives 1) To analyze the influence of NIV on chest wall volumes and motion assessed by optoelectronic plethysmography in ALS patients and 2) to compare these parameters in the supine and sitting positions to those of healthy individuals (without NIV). Method Nine ALS patients were evaluated in the supine...

Airway wall thickness of allergic asthma caused by weed pollen or house dust mite assessed by computed tomography.

Science.gov (United States)

Liu, Liping; Li, Guangrun; Sun, Yuemei; Li, Jian; Tang, Ningbo; Dong, Liang

2015-03-01

Little was known about Airway wall thickness of asthma patients with different allergen allergy. So we explored the possible difference of Airway wall thickness of asthma patients mono-sensitized to weed pollen or HDM using high-resolution computed tomography. 85 severe asthma patients were divided into weed pollen group and HDM group according to relevant allergen. 20 healthy donors served as controls. Airway wall area, percentage wall area and luminal area at the trunk of the apical bronchus of the right upper lobe were quantified using HRCT and compared. The values of pulmonary function were assessed as well. There were differences between HDM group and weed pollen group in WA/BSA,WA% and FEF25-75% pred, and no significant difference in FEV1%pred, FEV1/FVC and LA/BSA. In weed pollen group, WA/BSA was observed to correlate with the duration of rhinitis, whereas in HDM group, WA/BSA and LA/BSA was observed to correlate with the duration of asthma. In weed pollen group, FEV1/FVC showed a weak but significant negative correlation with WA%, but in HDM group FEV1/FVC showed a significant positive correlation with WA% and a statistical negative correlation with LA/BSA. FEV1/FVC and FEF25-75% pred were higher and WA/BSA and LA/BSA were lower in healthy control group than asthma group. FEV1%pred and WA% was no significant difference between asthma patients and healthy subjects. There are differences between HDM mono-sensitized subjects and weed pollen mono-sensitized subjects, not only in airway wall thickness, but also small airway obstruction. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quantitative analysis of dynamic airway changes after methacholine and salbutamol inhalation on xenon-enhanced chest CT

Energy Technology Data Exchange (ETDEWEB)

Park, Sang Joon; Goo, Jin Mo; Kim, Jong Hyo; Park, Eun-Ah [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of); Lee, Chang Hyun [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of); Seoul National University Hospital, Healthcare Gangnam Center, Seoul (Korea, Republic of); Jung, Jae-Woo; Park, Heung-Woo [Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Institute of Allergy and Clinical Immunology, Seoul (Korea, Republic of); Cho, Sang-Heon [Seoul National University Hospital, Healthcare Gangnam Center, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Internal Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Institute of Allergy and Clinical Immunology, Seoul (Korea, Republic of)

2012-11-15

To investigate the dynamic changes in airways in response to methacholine and salbutamol inhalation and to correlate the xenon ventilation index on xenon-enhanced chest CTs in asthmatics. Thirty-one non-smokers (6 normal, 25 asthmatics) underwent xenon-enhanced chest CT and pulmonary function tests. Images were obtained at three stages (basal state, after methacholine inhalation and after salbutamol inhalation), and the total xenon ventilation index (TXVI) as well as airway values were measured and calculated. The repeated measures ANOVA and Spearman's correlation coefficient were used for statistical analysis. TXVI in the normal group did not significantly change (P > 0.05) with methacholine and salbutamol. For asthmatics, however, the TXVI significantly decreased after methacholine inhalation and increased after salbutamol inhalation (P < 0.05). Of the airway parameters, the airway inner area (IA) significantly increased after salbutamol inhalation in all airways (P < 0.01) in asthmatics. Airway IA, wall thickness and wall area percentage did not significantly decrease after methacholine inhalation (P > 0.05). IA of the large airways was well correlated with basal TXVI, FEV{sub 1} and FVC (P < 0.05). Airway IA is the most reliable parameter for reflecting the dynamic changes after methacholine and salbutamol inhalation, and correlates well with TXVI in asthmatics on xenon-enhanced CT. (orig.)

Limit load analysis of thick-walled concrete structures

International Nuclear Information System (INIS)

Argyris, J.H.; Faust, G.; Willam, K.J.

1975-01-01

The paper illustrates the interaction of constitutive modeling and finite element solution techniques for limit load prediction of concrete structures. On the constitutive side, an engineering model of concrete fracture is developed in which the Mohr-Coulomb criterion is augmented by tension cut-off to describe incipient failure. Upon intersection with the stress path the failure surface collapses for brittle behaviour according to one of three softening rules, no-tension, no-cohesion, and no-friction. The stress transfer accompanying the energy dissipation during local failure is modelled by several fracture rules which are examined with regard to ultimate load prediction. On the numerical side the effect of finite element idealization is studied first as far as ultimate load convergence is concerned. Subsequently, incremental tangential and initial load techniques are compared together with the effect of step size. Limit load analyses of a thick-walled concrete ring and a lined concrete reactor closure conclude the paper with examples from practical engineering. (orig.) [de

Identification of sex-different specimens of costicartilage pairs 2 - 6: post mortem study by radiograms of the anterior chest wall

International Nuclear Information System (INIS)

Markert, K.; Reinwarth, E.M.; Wirth, I.; Brautzsch, G.

1983-01-01

On the basis of widely laterally resected anterior chest walls, ossification specimens of female (n=95) and male (n=112) individuals of different age have been examined. An unexpected high significance of the already described sex dimorphism could be secured between the 20th and 50th year of age. The estimated epiphenomenological changes impress as a female calcification type with centrally in the costal cartilage situated ossifications and as a male calcification type with sheath-like calcifications situated at the cranial and caudal edges of the costicartilage. (author)

NDE of stresses in thick-walled components by ultrasonic methods

International Nuclear Information System (INIS)

Goebbels, K.; Pitsch, H.; Schneider, E.; Nowack, H.

1985-01-01

The possibilty of measuring stresses - especially residual stresses - by ultrasonic methods has been presented at the 4th and 5th International Conference on NDE in Nuclear Industry. This contribution now presents results of several applications to thick walled components such as turbines and generators for power plants. The measurement technique using linearly polarized shear waves allows one to characterize the homogeneitry of the residual stress situation along and around cylindrically shaped components. Some important results show that the stress distribution integrated over the cross section of the component has not followed in any case the simple relations derived by stress analysts. Conclusions referring to the stress situation inside the components are discussed

Simultaneous measurements of thickness and temperature profile in a wavy liquid film falling freely on a heating wall

International Nuclear Information System (INIS)

Lyu, T.; Mudawar, I.

1990-01-01

This paper reports on a technique for measuring the thickness of liquid films that was developed and tested. The feasibility of this technique was demonstrated in stagnant liquid films as well as in liquid jets. A procedure for in-situ calibration of the thickness probe was developed, allowing the adaptation of the probe to measurements of wavy liquid films. The thickness probe was constructed from a platinum-rhodium wire that was stretched across the film. A constant DC current was supplied through the probe wire, and film thickness was determined from variations in the probe voltage drop resulting from the large differences in the electrical resistances of the wetted and unwetted segments of the wire. Unlike electrical admittance thickness probes, the new probe did not require dissolving an electrolyte in the liquid, making the new probe well suited to studies involving sensible heating of a film of pure dielectric liquid that is in direct contact with a current- carrying wall. Also presented is a composite probe that facilitated simultaneous measurements of temperature profile across a wavy liquid film and film thickness. Experimental results demonstrate a strong influence of waviness on liquid temperature in a film of deionized water falling freely on the outside wall of a vertical, electrically heated tube for film Reynolds numbers smaller than 10,000

Criteria of assessment for local wall thickness reductions in operative high-pressure gas pipelines; Beurteilungskriterien fuer lokale Wanddickenminderungen an in Betrieb befindlichen Gashochdruckleitungen

Energy Technology Data Exchange (ETDEWEB)

Hass, Georg [NetzDienste Rhein/Main GmbH, Frankfurt am Main (Germany); Hoffman, Ulrich [VNG - Verbundnetz Gas AG, Leipzig (Germany); Konarske, Juergen [RWE Westfalen-Weser-Ems Netzservice GmbH, Recklinghausen (Germany); Soppa, Thorsten [NG Netz Gas+Wasser (Germany). Bau/Betrieb Hochdrucknetz; Steiner, Michael [Open Grid Europe GmbH, Essen (Germany). Integritaet/Werkstofftechnik

2011-07-01

TUeV Nord, Salzgitter Mannesmann Forschung and DVGW investigated methods to assess local wall thickness reductions in operative high-pressure gas pipelines. Methods described in the relevant literature were reviewed with regard to the limiting criteria defined for maximum permissible wall thickness reductions. On the basis of this literature study and additional calculations, a comparative evaluation of the available methods was made. Several methods were identified that are compatible with the existing safety concept and general availability. It was found that - nearly independent of the method - burst safeties of 1.8 to 2.0 were used. The ultimate goal is the development of a German standard evaluation concept for local wall thickness reductions in high-pressure gas pipelines in order to avoid uncertainties and/or misinterpretations.

Simulation of Stress Distribution in a Thick- Walled Bushing Produced by Die-Casting

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Pisarek B.P.

2017-12-01

Full Text Available Metallographic investigations and a computer simulation of stresses in a gravity die-casting bushing were performed. Simulation of the casting process, solidification of the thick-walled bushing and calculations of the stress was performed using MAGMA5.3 software. The size variability of phases κII affecting the formation of phase stresses σf, depending on the location of the metallographic test area, was identified. The distribution of thermal σt and shrinkage stresses σs, depending on the location of the control point SC in the bushing's volume, was estimated. Probably the nature of these stresses will change slightly even after machining. This can cause variations in operating characteristics (friction coefficient, wear. Due to the strong inhomogeneity of the stress distribution in the bushing's casting, it is necessary to perform further tests of the possibility to conduct thermal treatment guaranteeing homogenization of the internal stresses in the casting, as well as to introduce changes in the bushing' s construction and the casting technology. The paper presents the continuation of the results of research aimed at identifying the causes of defects in the thick-walled bushing, die-casting made of CuAl10Fe5Ni5Cr aluminium bronze.

Follow-up of CT-derived airway wall thickness : Correcting for changes in inspiration level improves reliability

NARCIS (Netherlands)

Pompe, Esther; van Rikxoort, Eva M; Mets, Onno M; Charbonnier, Jean-Paul; Kuhnigk, Jan-Martin; de Koning, Harry J; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Zanen, Pieter; Lammers, Jan-Willem J; van Ginneken, Bram; de Jong, Pim A; Mohamed Hoesein, Firdaus A A

2016-01-01

OBJECTIVES: Airway wall thickness (AWT) is affected by changes in lung volume. This study evaluated whether correcting AWT on computed tomography (CT) for differences in inspiration level improves measurement agreement, reliability, and power to detect changes over time. METHODS: Participants of the

Follow-up of CT-derived airway wall thickness : Correcting for changes in inspiration level improves reliability

NARCIS (Netherlands)

Pompe, Esther; van Rikxoort, Eva M.; Mets, Onno M.; Charbonnier, Jean-Paul; Kuhnigk, Jan-Martin; de Koning, Harry J.; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Zanen, Pieter; Lammers, Jan-Willem J.; van Ginneken, Bram; de Jong, Pim A.; Hoesein, Firdaus A. A. Mohamed

2016-01-01

Objectives: Airway wall thickness (AWT) is affected by changes in lung volume. This study evaluated whether correcting AWT on computed tomography (CT) for differences in inspiration level improves measurement agreement, reliability, and power to detect changes over time. Methods: Participants of the

Heat deposition, damage, and tritium breeding characteristics in thick liquid wall blanket concepts

International Nuclear Information System (INIS)

Youssef, M.Z.; Abdou, M.A.

2000-01-01

The advanced power extraction (APEX) study aims at exploring new and innovative blanket concepts that can efficiently extract power from fusion devices with high neutron wall load. Among the concepts under investigation is the free liquid FW/liquid blanket concept in which a fast flowing liquid FW (∼2-3 cm) is followed by thick flowing blanket (B) of ∼40-50 cm thickness with minimal amount of structure. The liquid FW/B are contained inside the vacuum vessel (VV) with a shielding zone (S) located either behind the VV and outside the vacuum boundary (case A) or placed after the FW/B and inside the VV (case B). In this paper we investigate the nuclear characteristics of this concept in terms of: (1) attenuation capability of the liquid FW/B/S and protection of the VV and magnet against radiation damage; (2) profiles of tritium production rate and tritium breeding ratio (TBR) for several liquid candidates; and (3) profiles of heat deposition rate and power multiplication. The candidate liquid breeders considered are Li, Flibe, Li-Sn, and Li-Pb. Parameters varied are (1) FW/B thickness, L, (2) Li-6 enrichment and (3) thickness of the shield

Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD

Directory of Open Access Journals (Sweden)

Nicolini A

2018-02-01

Full Text Available Antonello Nicolini,1 Bruna Grecchi,2 Maura Ferrari-Bravo,3 Cornelius Barlascini4 1Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante, Italy; 2Rehabilitation Unit, ASL4 Chiavarese, Chiavari, Italy; 3Statistics Unit, ASL4 Chiavarese, Chiavari, Italy; 4Health Medicine Unit, Hospital of Sestri Levante, Sestri Levante, Italy Purpose: Chest physiotherapy is an important tool in the treatment of COPD. Intrapulmonary percussive ventilation (IPV and high-frequency chest wall oscillation (HFCWO are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We tested the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT may provide additional clinical benefit over chest physiotherapy in patients with severe COPD. Methods: Sixty patients were randomized into three groups (20 patients in each group: IPV group (treated with PT and IPV, PT group with (treated with PT and HFCWO, and control group (treated with PT alone. Primary outcome measures included results on the dyspnea scale (modified Medical Research Council and Breathlessness, Cough, and Sputum scale (BCSS, as well as an evaluation of daily life activity (COPD Assessment Test [CAT]. Secondary outcome measures were pulmonary function testing, arterial blood gas analysis, and hematological examinations. Moreover, sputum cell counts were performed at the beginning and at the end of the study. Results: Patients in both the IPV group and the HFCWO group showed a significant improvement in the tests of dyspnea and daily life activity evaluations (modified Medical Research Council scale, BCSS, and CAT compared to the control group, as well as in pulmonary function tests (forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity%, total lung capacity, residual volume, diffusing lung capacity monoxide, maximal inspiratory

Conjugate heat transfer in a porous cavity filled with nano-fluids and heated by a triangular thick wall

International Nuclear Information System (INIS)

Chamkha, Ali J.; Ismael, Muneer A.

2013-01-01

The conjugate natural convection-conduction heat transfer in a square domain composed of nano-fluids filled porous cavity heated by a triangular solid wall is studied under steady-state conditions. The vertical and horizontal walls of the triangular solid wall are kept isothermal and at the same hot temperature Th. The other boundaries surrounding the porous cavity are kept adiabatic except the right vertical wall where it is kept isothermally at the lower temperature T c . Equations governing the heat transfer in the triangular wall and heat and nano-fluid flow, based on the Darcy model, in the nano-fluid-saturated porous medium together with the derived relation of the interface temperature are solved numerically using the over-successive relaxation finite-difference method. A temperature independent nano-fluids properties model is adopted. Three nano-particle types dispersed in one base fluid (water) are investigated. The investigated parameters are the nano-particles volume fraction φ (0-0.2), Rayleigh number Ra (10-1000), solid wall to base-fluid saturated porous medium thermal conductivity ratio K ro (0.44, 1, 23.8), and the triangular wall thickness D (0.1-1). The results are presented in the conventional form; contours of streamlines and isotherms and the local and average Nusselt numbers. At a very low Rayleigh number Ra = 10, a significant enhancement in heat transfer within the porous cavity with φ is observed. Otherwise, the heat transfer may be enhanced or deteriorated with φ depending on the wall thickness D and the Rayleigh number Ra. At high Rayleigh numbers and low conductivity ratios, critical values of D, regardless of 4, are observed and accounted. (authors)