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Sample records for reinnervated chest skin

  1. Cutaneous collateral axonal sprouting re-innervates the skin component and restores sensation of denervated Swine osteomyocutaneous alloflaps.

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    Zuhaib Ibrahim

    Full Text Available Reconstructive transplantation such as extremity and face transplantation is a viable treatment option for select patients with devastating tissue loss. Sensorimotor recovery is a critical determinant of overall success of such transplants. Although motor function recovery has been extensively studied, mechanisms of sensory re-innervation are not well established. Recent clinical reports of face transplants confirm progressive sensory improvement even in cases where optimal repair of sensory nerves was not achieved. Two forms of sensory nerve regeneration are known. In regenerative sprouting, axonal outgrowth occurs from the transected nerve stump while in collateral sprouting, reinnervation of denervated tissue occurs through growth of uninjured axons into the denervated tissue. The latter mechanism may be more important in settings where transected sensory nerves cannot be re-apposed. In this study, denervated osteomyocutaneous alloflaps (hind- limb transplants from Major Histocompatibility Complex (MHC-defined MGH miniature swine were performed to specifically evaluate collateral axonal sprouting for cutaneous sensory re-innervation. The skin component of the flap was externalized and serial skin sections extending from native skin to the grafted flap were biopsied. In order to visualize regenerating axonal structures in the dermis and epidermis, 50 um frozen sections were immunostained against axonal and Schwann cell markers. In all alloflaps, collateral axonal sprouts from adjacent recipient skin extended into the denervated skin component along the dermal-epidermal junction from the periphery towards the center. On day 100 post-transplant, regenerating sprouts reached 0.5 cm into the flap centripetally. Eight months following transplant, epidermal fibers were visualized 1.5 cm from the margin (rate of regeneration 0.06 mm per day. All animals had pinprick sensation in the periphery of the transplanted skin within 3 months post

  2. Adherence evaluation of vented chest seals in a swine skin model.

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    Arnaud, Françoise; Maudlin-Jeronimo, Eric; Higgins, Adam; Kheirabadi, Bijan; McCarron, Richard; Kennedy, Daniel; Housler, Greggory

    2016-10-01

    Perforation of the chest (open pneumothorax) with and without lung injury can cause air accumulation in the chest, positive intrapleural pressure and lead to tension pneumothorax if untreated. The performance of chest seals to prevent tension physiology depends partially on their ability to adhere to the skin and seal the chest wound. Novel non-occlusive vented chest seals were assessed for their adhesiveness on skin of live swine under normal and extreme environmental conditions to simulate austere battlefield conditions. Chest seals were applied on the back of the swine on skin that was soiled by various environmental contaminants to represent battlefield situations. A peeling (horizontal rim peeling) and detachment and breaching (vertical pulling) techniques were used to quantify the adhesive performance of vented chest seals. Among eight initially selected vented seals, five (Bolin, Russell, Fast breathe, Hyfin and SAM) were further down-selected based on their superior adherence scores at ambient temperatures. The adherence of these seals was then assessed after approximately 17h storage at extreme cold (-19.5°C) and hot (71.5°C) temperatures. Adherence scores for peeling (above 90%) and detachment scores (less than 25%) were comparable for four vented chest seals when tested at ambient temperature, except for the Bolin seal which had higher breaching. Under extreme storage temperatures, adherence peeling scores were comparable to those at ambient temperatures for four chest seals. Scores were significantly lower for the Bolin seal at extreme temperatures. This seal also had the highest detachment and breaching scores. In contrast, the Russell, Fast breathe, Hyfin and SAM seals showed similar ability to stay air tight without breaching after hot storage. No significant difference was found in skin adherence of the five vented chest seals at ambient temperature and the four seals (Russell, Fast breathe, Hyfin and SAM) maintained superior adherence even after

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

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    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.)

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

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    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.

  5. 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.

  6. Functional reinnervation of vocal folds after selective laryngeal adductor denervation-reinnervation surgery for spasmodic dysphonia.

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    DeConde, Adam S; Long, Jennifer L; Armin, Bob B; Berke, Gerald S

    2012-09-01

    Selective laryngeal adductor denervation-reinnervation surgery (SLAD-R) offers a viable surgical alternative for patients with adductor spasmodic dysphonia refractory to botulinum toxin injections. SLAD-R selectively denervates the symptomatic thyroarytenoid muscle by dividing the distal adductor branch of the recurrent laryngeal nerve (RLN), and preventing reinnervation, by the proximal RLN and maintaining vocal fold bulk and tone by reinnervating the distal RLN with the ansa cervicalis. We present a patient who had previously undergone successful SLAD-R but presented 10 years postoperatively with a new regional dystonia involving his strap muscles translocated to his reinnervated larynx by his previous ansa-RLN neurorraphy. The patient's symptomatic vocal fold adduction resolved completely on division of the ansa-RLN neurorraphy confirming successful selective functional reinnervation of vocal fold adductors by the ansa cervicalis. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  7. How accurate are measurements of skin-lesion depths on prebiopsy supine chest computed tomography for transthoracic needle biopsies?

    International Nuclear Information System (INIS)

    Cheung, Joo Yeon; Kim, Yookyung; Shim, Sung Shine; Lee, Jin Hwa; Chang, Jung Hyun; Ryu, Yon Ju; Lee, Rena J.

    2012-01-01

    Aim: To evaluate the accuracy of depth measurements on supine chest computed tomography (CT) for transthoracic needle biopsy (TNB). Materials and methods: We measured skin-lesion depths from the skin surface to nodules on both prebiopsy supine CT scans and CT scans obtained during cone beam CT-guided TNB in the supine (n = 29) or prone (n = 40) position in 69 patients, and analyzed the differences between the two measurements, based on patient position for the biopsy and lesion location. Results: Skin-lesion depths measured on prebiopsy supine CT scans were significantly larger than those measured on CT scans obtained during TNB in the prone position (p < 0.001; mean difference ± standard deviation (SD), 6.2 ± 5.7 mm; range, 0–18 mm), but the differences showed marginal significance in the supine position (p = 0.051; 3.5 ± 3.9 mm; 0–13 mm). Additionally, the differences were significantly larger for the upper (mean ± SD, 7.8 ± 5.7 mm) and middle (10.1 ± 6.5 mm) lung zones than for the lower lung zones (3.1 ± 3.3 mm) in the prone position (p = 0.011), and were larger for the upper lung zone (4.6 ± 5.0 mm) than for the middle (2.4 ± 2.0 mm) and lower (2.3 ± 2.3 mm) lung zones in the supine position (p = 0.004). Conclusions: Skin-lesion depths measured on prebiopsy supine chest CT scans were inaccurate for TNB in the prone position, particularly for nodules in the upper and middle lung zones.

  8. L-acetylcarnitine enhances functional muscle re-innervation.

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    Pettorossi, V E; Brunetti, O; Carobi, C; Della Torre, G; Grassi, S

    1991-01-01

    The efficacy of L-acetylcarnitine and L-carnitine treatment on motor re-innervation was analyzed by evaluating different muscular parameters describing functional muscle recovery after denervation and re-innervation. The results show that L-acetylcarnitine markedly enhances functional muscle re-innervation, which on the contrary is unaffected by L-carnitine. The medial gastrocnemius muscle was denervated by cutting the nerve at the muscle entry point. After 20 days the sectioned nerve was resutured into the medial gastrocnemius muscle, and the extent of re-innervation was monitored 45 days later. L-acetylcarnitine-treated animals show significantly higher twitch and tetanic tensions of re-innervated muscle. Furthermore the results, obtained by analysing the twitch time to peak and tetanic contraction-relaxation times, suggest that L-acetylcarnitine mostly affects the functional re-innervation of slow motor units. The possible mechanisms by which L-acetylcarnitine facilitates such motor and nerve recovery are discussed.

  9. Skin Entrance dose to patients from routine P-A chest X-ray ...

    African Journals Online (AJOL)

    Background: Radiation of any amount is potentially hazardous and it should be minimized as much as possible during health care delivery. Objective: To determine and assess the variation of the dose received by patients undergoing chest x-ray examination, and to provide a useful baseline data to evaluate the dose to the ...

  10. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients.

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    Singleton, J Robinson; Marcus, Robin L; Lessard, Margaret K; Jackson, Justin E; Smith, A Gordon

    2015-01-01

    Unmyelinated cutaneous axons are vulnerable to physical and metabolic injury, but also capable of rapid regeneration. This balance may help determine risk for peripheral neuropathy associated with diabetes or metabolic syndrome. Capsaicin application for 48 hours induces cutaneous fibers to die back into the dermis. Regrowth can be monitored by serial skin biopsies to determine intraepidermal nerve fiber density (IENFD). We used this capsaicin axotomy technique to examine the effects of exercise on cutaneous regenerative capacity in the setting of metabolic syndrome. Baseline ankle IENFD and 30-day cutaneous regeneration after thigh capsaicin axotomy were compared for participants with type 2 diabetes (n = 35) or metabolic syndrome (n = 32) without symptoms or examination evidence of neuropathy. Thirty-six participants (17 with metabolic syndrome) then joined twice weekly observed exercise and lifestyle counseling. Axotomy regeneration was repeated in month 4 during this intervention. Baseline distal leg IENFD was significantly reduced for both metabolic syndrome and diabetic groups. With exercise, participants significantly improved exercise capacity and lower extremity power. Following exercise, 30-day reinnervation rate improved (0.051 ± 0.027 fibers/mm/day before vs 0.072 ± 0.030 after exercise, p = 0.002). Those who achieved improvement in more metabolic syndrome features experienced a greater degree of 30-day reinnervation (p Metabolic syndrome was associated with reduced baseline IENFD and cutaneous regeneration capacity comparable to that seen in diabetes. Exercise-induced improvement in metabolic syndrome features increased cutaneous regenerative capacity. The results underscore the potential benefit to peripheral nerve function of a behavioral modification approach to metabolic improvement. © 2014 American Neurological Association.

  11. Contralateral reinnervation of midline muscles in nonidiopathic facial palsy.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Beurskens, C.H.G.; Vries, J. de; Marres, H.A.M.; Hartman, E.H.M.; Zwarts, M.J.

    2003-01-01

    The purpose of this study was to analyze contralateral reinnervation of the facial nerve in eight patients with complete facial palsy after surgery or trauma and seven healthy volunteers. All patients had contralateral reinnervation of facial muscles as demonstrated by electrical nerve stimulation

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

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    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

  13. Evaluation of entrance skin air kerma in digital and conventional pediatric chest examinations performed in Parana-Brazil

    International Nuclear Information System (INIS)

    Oliveira, Ana L.R.; Schelin, Hugo R.; Lunelli, Neuri; Paschuk, Sergei; Tilly Jr, Joao G.; Rogacheski, Enio; Khoury, Helen J.; Ferreira, Jose R.L.

    2008-01-01

    Full text: In pediatric radiology it is important to evaluate patient exposure due to the high sensitivity of his/her tissue and his/her relatively longer life expectancy, which may increase the chance of radiogenic cancer development. Special attention is necessary when digital systems are used since a high dosage level for the patient may go unnoticed because the resulting image is not overexposed. The purpose of this work is to evaluate the Entrance Skin Air Kerma (ESAK) in pediatric patients submitted to digital and conventional chest examinations performed in the State of Parana, located in the Southern region of Brazil. The survey was performed in two hospitals, one located in Curitiba, the Capital of the State (A) and the other in the city of Cascavel (B). Hospital A uses a conventional image system and Hospital B uses a CR digital system. The study group consisted of 50 patients (from 2 days to six years of age) undergoing chest PA/AP examinations. At the time of the examination, the exposure parameters (kV, mAs, focal-film distance, etc) and the gender, height, weight and age of the patient were recorded. To evaluate the Entrance Skin Air Kerma (ESAK), two TLD-100 dosimeters were packaged in a polyethylene case, heat sealed and placed on the surface of each patient. The TLDs were calibrated the Metrology Laboratory of Ionizing Radiation of the Federal University of Pernambuco. The TLDs were processed on a Victoreen readout system model 2800M. The results showed that the kilovoltage values used in Hospital A are in the range of 46 to 65 kV with the average value of 51,7 kV, while the ones in Hospital B are in the range of 65 to 80 kV. On the other hand, even though hospital B uses the CR system, the mAs used for the chest exams are 4 times higher than the ones used in Hospital A. For Hospital A, the mean ESAK value was 0.044 mGy (min: 0.08 and max 0.146 mGy), and for Hospital B the mean ESAK value was 0.368 mGy (min: 0.021 and max 1.21mGy). The results made

  14. 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)

  15. Evaluation of skin entrance radiation dose in pediatric patients undergoing chest X-rays exams

    International Nuclear Information System (INIS)

    Gabardo, Farly Piantini

    2016-01-01

    The aim of this work was to estimate the incident air kerma of lateral (LAT) and anterior-posterior (AP) together with posterior-anterior (PA) projection chest X-ray exams in one of the largest pediatric hospitals in Brazil. Dosimetric results are accompanied with the detailed analysis of patient characteristics and radiographer strategy. The exams of 225 (119 male and 106 female) patients were studied and 389 X-ray exams (200 AP/PA projections and 189 LAT projections) of pediatric patients were acquired. Patient thickness can be restored from age, height or weight with the uncertainty of ∼20-30%. Very slight correlation between the patient dose and thickness was observed with the difference in dose for patients of the same thickness reaching 4 times. By standardization of radiological protocols, it should be possible to keep dose within the intervals 50-100 μGy for LAT projection and 40-80 μGy for AP/PA projection. The dose values are lower than those recommended by major European guidelines to good practice. (author)

  16. Functional significance of cardiac reinnervation in heart transplant recipients.

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    Schwaiblmair, M; von Scheidt, W; Uberfuhr, P; Ziegler, S; Schwaiger, M; Reichart, B; Vogelmeier, C

    1999-09-01

    There is accumulating evidence of structural sympathetic reinnervation after human cardiac transplantation. However, the functional significance of reinnervation in terms of exercise capacity has not been established as yet; we therefore investigated the influence of reinnervation on cardiopulmonary exercise testing. After orthotopic heart transplantation 35 patients (mean age, 49.1 +/- 8.4 years) underwent positron emission tomography with scintigraphically measured uptake of C11-hydroxyephedrine (HED), lung function testing, and cardiopulmonary exercise testing. Two groups were defined based on scintigraphic findings, indicating a denervated group (n = 15) with a HED uptake of 5.45%/min and a reinnervated group (n = 20) with a HED uptake of 10.59%/min. The two study groups did not show significant differences with regard to anthropometric data, number of rejection episodes, preoperative hemodynamics, and postoperative lung function data. The reinnervated group had a significant longer time interval from transplantation (1625 +/- 1069 versus 800 +/- 1316 days, p exercise (137 +/- 15 versus 120 +/- 20 beats/min, p = .012), peak oxygen uptake (21.0 +/- 4 versus 16.1 +/- 5 mL/min/kg, p = .006), peak oxygen pulse (12.4 +/- 2.9 versus 10.2 +/- 2.7 mL/min/beat, p = .031), and anaerobic threshold (11.2 +/- 1.8 versus 9.5 +/- 2.1 mL/min, p = .046) were significantly increased in comparison to denervated transplant recipients. Additionally, a decreased functional dead space ventilation (0.24 +/- 0.05 versus 0.30 +/- 0.05, p = .004) was observed in the reinnervated group. Our study results support the hypothesis that partial sympathetic reinnervation after cardiac transplantation is of functional significance. Sympathetic reinnervation enables an increased peak oxygen uptake. This is most probably due to partial restoration of the chronotropic and inotropic competence of the heart as well as an improved oxygen delivery to the exercising muscles and a reduced ventilation

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

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    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.

  18. Electromyographic permutation entropy quantifies diaphragmatic denervation and reinnervation.

    Directory of Open Access Journals (Sweden)

    Christopher Kramer

    Full Text Available Spontaneous reinnervation after diaphragmatic paralysis due to trauma, surgery, tumors and spinal cord injuries is frequently observed. A possible explanation could be collateral reinnervation, since the diaphragm is commonly double-innervated by the (accessory phrenic nerve. Permutation entropy (PeEn, a complexity measure for time series, may reflect a functional state of neuromuscular transmission by quantifying the complexity of interactions across neural and muscular networks. In an established rat model, electromyographic signals of the diaphragm after phrenicotomy were analyzed using PeEn quantifying denervation and reinnervation. Thirty-three anesthetized rats were unilaterally phrenicotomized. After 1, 3, 9, 27 and 81 days, diaphragmatic electromyographic PeEn was analyzed in vivo from sternal, mid-costal and crural areas of both hemidiaphragms. After euthanasia of the animals, both hemidiaphragms were dissected for fiber type evaluation. The electromyographic incidence of an accessory phrenic nerve was 76%. At day 1 after phrenicotomy, PeEn (normalized values was significantly diminished in the sternal (median: 0.69; interquartile range: 0.66-0.75 and mid-costal area (0.68; 0.66-0.72 compared to the non-denervated side (0.84; 0.78-0.90 at threshold p<0.05. In the crural area, innervated by the accessory phrenic nerve, PeEn remained unchanged (0.79; 0.72-0.86. During reinnervation over 81 days, PeEn normalized in the mid-costal area (0.84; 0.77-0.86, whereas it remained reduced in the sternal area (0.77; 0.70-0.81. Fiber type grouping, a histological sign for reinnervation, was found in the mid-costal area in 20% after 27 days and in 80% after 81 days. Collateral reinnervation can restore diaphragm activity after phrenicotomy. Electromyographic PeEn represents a new, distinctive assessment characterizing intramuscular function following denervation and reinnervation.

  19. Evaluation of the entrance skin dose due to paediatric chest X-rays examinations carried out at a great hospital in Rio de Janeiro city

    International Nuclear Information System (INIS)

    Mohamadain, K.E.M.; Azevedo, A.C.P.; Rosa, L.A.R. da; Mota, H.C.; Goncalves, O.D.; Guebel, M.R.N.

    2001-01-01

    A dosimetric survey in paediatric radiology is currently being carried out at the paediatric unit of a great hospital in Rio de Janeiro city, aiming the assessment of patient doses and image quality. The aim of this work was to estimate the entrance skin dose for frontal and lateral chest X-rays exposure to paediatric patients. Three examination techniques were investigated, namely PA, AP and lateral positions. For entrance skin dose evaluation, two different TL dosimeters were used, namely LiF:Mg,Ti and CaSO4:Dy. The age intervals considered were 0-1 year, 1-5 years, 5-10 years and 10-15 years. The results obtained with both dosimeters are similar and the entrance skin dose values evaluated for the different age intervals considered are compared with previous values found in Brazil and also in Europe. (author)

  20. SELECTIVE LARYNGEAL ABDUCTOR REINNERVATION IN CATS USING A PHRENIC-NERVE TRANSFER AND ORG-2766

    NARCIS (Netherlands)

    MAHIEU, HF; VANLITHBIJL, JT; GROENHOUT, C; TONNAER, JADM; DEWILDE, P

    Reinnervation of the recurrent laryngeal nerve following nerve injury often leads to laryngeal synkinesis. Selective reinnervation of adductor and abductor muscles might be able to avoid synkinesis. This study presents the results of selective abductor reinnervation in cats, using a phrenic nerve

  1. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report

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    Jun Yao

    2015-01-01

    Full Text Available This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR. As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1 before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.

  2. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report.

    Science.gov (United States)

    Yao, Jun; Chen, Albert; Kuiken, Todd; Carmona, Carolina; Dewald, Julius

    2015-01-01

    This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.

  3. Type grouping in skeletal muscles after experimental reinnervation: another explanation

    NARCIS (Netherlands)

    Vleggeert-lankamp, C.L.A.M.; de Ruiter, G.C.W.; Wolfs, J.F.C.; Pêgo, A.P.; Feirabend, H.K.P.; Lakke, E.A.J.F.; Malessy, M.J.A.

    2005-01-01

    Type grouping signifies clustering of muscle fibres of the same metabolic type, and is a frequent finding in reinnervated muscles. To elucidate the mechanism behind it, the rat sciatic nerve was either autografted or grafted with hollow synthetic nerve grafts. Twelve weeks later the number and fibre

  4. Reinnervation following catheter-based radio-frequency renal denervation.

    Science.gov (United States)

    Booth, Lindsea C; Nishi, Erika E; Yao, Song T; Ramchandra, Rohit; Lambert, Gavin W; Schlaich, Markus P; May, Clive N

    2015-04-20

    What is the topic of this review? Does catheter-based renal denervation effectively denervate the afferent and efferent renal nerves and does reinnervation occur? What advances does it highlight? Following catheter-based renal denervation, the afferent and efferent responses to electrical stimulation were abolished, renal sympathetic nerve activity was absent, and levels of renal noradrenaline and immunohistochemistry for tyrosine hydroxylase and calcitonin gene-related peptide were significantly reduced. By 11 months after renal denervation, both the functional responses and anatomical markers of afferent and efferent renal nerves had returned to normal, indicating reinnervation. Renal denervation reduces blood pressure in animals with experimental hypertension and, recently, catheter-based renal denervation was shown to cause a prolonged decrease in blood pressure in patients with resistant hypertension. The randomized, sham-controlled Symplicity HTN-3 trial failed to meet its primary efficacy end-point, but there is evidence that renal denervation was incomplete in many patients. Currently, there is little information regarding the effectiveness of catheter-based renal denervation and the extent of reinnervation. We assessed the effectiveness of renal nerve denervation with the Symplicity Flex catheter and the functional and anatomical reinnervation at 5.5 and 11 months postdenervation. In anaesthetized, non-denervated sheep, there was a high level of renal sympathetic nerve activity, and electrical stimulation of the renal nerve increased blood pressure and reduced heart rate (afferent response) and caused renal vasoconstriction and reduced renal blood flow (efferent response). Immediately after renal denervation, renal sympathetic nerve activity and the responses to electrical stimulation were absent, indicating effective denervation. By 11 months after denervation, renal sympathetic nerve activity was present and the responses to electrical stimulation

  5. People with dyslexia and heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders were more dissatisfied with neighbourhoods: Scottish Household Survey, 2007-2008.

    Science.gov (United States)

    Shiue, Ivy

    2016-12-01

    Rarely do we know the perception toward neighbourhoods in people specifically with health conditions. Therefore, the aim of the present study was to understand the perception toward neighbourhoods among adults with a series of the existing health conditions in a country-wide and population-based setting. Data were retrieved from and analysed in Scottish Household Survey, 2007-2008. Information on demographics, self-reported health conditions and perception toward neighbourhoods and the surrounding facilities was obtained by household interview. Analysis including chi-square test, t test and logistic regression modelling were performed. Of 19,150 Scottish adults (aged 16-80) included in the study cohort, 1079 (7.7 %) people were dissatisfied with their living areas; particularly for those who experienced harassment (15.4 %), did not recycle or with dyslexia, chest, digestive, mental and musculoskeletal problems. Twenty to forty per cent reported common neighbourhood problems including noise, rubbish, disputes, graffiti, harassment and drug misuse. People with heart or digestive problems were more dissatisfied with the existing parks and open space. People with arthritis, chest or hearing problems were more dissatisfied with the waste management condition. People with dyslexia were more dissatisfied with the existing public transportation. People with heart problems were more dissatisfied with the current street cleaning condition. People with hearing, vision, speech, learning problems or dyslexia were also more dissatisfied with sports and recreational facilities. People with heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders and dyslexia were more dissatisfied with their current neighbourhood environments. Upgrading neighbourhood planning to tackle social environment injustice and put pleasant life experience as priorty would be suggested. Graphical abstract interrelations of individual health and neighbourhood

  6. Chest MRI

    Science.gov (United States)

    ... resonance imaging - chest; NMR - chest; MRI of the thorax; Thoracic MRI Patient Instructions ... Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  7. Effect of chest wall radiotherapy in different manners using tissue equivalent bolus on skin and lung of cavia cobayas

    International Nuclear Information System (INIS)

    Huang Wei; Qu Yaqin; Song Xiangfu; Liu Shixin; Jia Xiaojing; Guo He; Yang Lei

    2009-01-01

    Objective: To probe the influence of electron beam radiotherapy in different manners using different tissue equivalent boluses on skin and lung. Methods: Adult female cavia cobayas were randomly divided into four groups as control group, half-time with bolus group, half-time with bolus group and without bolus group. Acute-irradiation animal models were established using electron beam in different manners with or without 0.5 cm tissue equivalent bolus. Pathological changes in lung, hair vesicle and fibroblast cell count were analyzed 40 clays after irradiation. Results: The radiation dermatitis in the group with bolus was slighter than that of the group without bolus, but the radiation pneumonia was reverse. With bolus, the radiation dermatitis of haft-time group was slighter than that of full-time group. The injury repair of half-time group was more active than full-time group. Conclusions: The treatment of haft-time bolus could protect lung without serious skin complications. (authors)

  8. Impact of Nonselective Laryngeal Reinnervation on Main Voice Characteristics

    Directory of Open Access Journals (Sweden)

    V.A. Palamarchuck

    2014-02-01

    Results. The anastomosis of the RLN was performed in 95 patients, who were in the main group (53 patients with anastomosis ansa cervicalis — RLN, 34 patients with anastomosis RLN — RLN and 8 with anastomosis RLN — nerve-donor — RLN.The postoperative average follow-up was 12.0 ± 1.8 months and the median time to the first indirect evidence of reinnervation —4.5 ± 2.9 months, which were observed in all patients of the main group: the emergence of vocal fold tone, reducing the size of the glottis during phonation (especially at the anastomosis ansa cervicalis — RLN from 2.25 ± 0.86 mm to 0.35 ± 0.17 mm. Acoustic analysis showed the most effective reinnervation by the anastomosis ansa cervicalis — RLN, with change of HNR from 12.0 ± 3.7 dB to 24.0 ± 2.4 dB, MPT — from 7.00 ± 1.22 s to 16.00 ± 3.52 s (p < 0.01. The analysis of subjective psychosocial self-assessment of phonation showed the improvement in all subgroups of the main group.

  9. FLAIL CHEST

    Directory of Open Access Journals (Sweden)

    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.

  10. Chest radiology

    International Nuclear Information System (INIS)

    Reed, J.C.

    1990-01-01

    This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case

  11. Skin

    International Nuclear Information System (INIS)

    Hunter, R.D.

    1985-01-01

    Malignant disease involving the skin represents a significant work load to the general radiotherapist and can involve interesting diagnostic and therapeutic decisions. Primary skin cancer is also relatively common and there is a need to provide an efficient service in which the first treatment is successful in the majority of patients. The reward for careful attention to technique is very considerable both in terms of clinical cancer control and functional results. Squamous cell carcinoma, basal cell carcinoma, and intra-epidermal carcinoma constitute the majority of the lesions dealt with clinically, but metastatic disease, lymphomas, and malignant melanomas are also referred regularly for opinions and may require radiotherapy. The general principle of the techniques of assessment and radiotherapeutic management to be described are equally applicable to any malignant skin tumour once the decision has been made to accept it for radiotherapy. Dosage and fractionation may have to be adjusted to allow for the nature of the disease process and the intent of the treatment

  12. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  13. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

  14. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very small dose ... Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the most commonly performed diagnostic ...

  15. Chest pain

    International Nuclear Information System (INIS)

    Martinez A, Juan Carlos; Saenz M, Oscar; Martinez M, Camilo; Gonzales A Francisco; Nicolas R, Jose; Vergara V, Erika P; Pereira G, Alberto M

    2010-01-01

    In emergency departments, chest pain is one of the leading motives of consultation. We thus consider it important to review aspects such as its classification, causes, and clinical profiles. Initial assessment should include a full clinical history comprising thorough anamnesis and physical examination. Adequate interpretation of auxiliary tests, ordered in accordance with suspected clinical conditions, should lead to accurate diagnosis. We highlight certain symptoms and clinical signs, ECG and X-ray findings, cardiac bio markers, arterial blood gases, and CT-scanning. Scores of severity and prognosis such as TIMI are assessed. Optimal treatment of the clinical conditions leading to chest pain depends on adequate initial approach and assessment.

  16. Chest X-Ray

    Medline Plus

    Full Text Available ... talk with you about chest radiography also known as chest x-rays. Chest x-rays are the ... treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray ...

  17. Functional evaluation of peripheral nerve regeneration and target reinnervation in animal models: a critical overview.

    Science.gov (United States)

    Navarro, Xavier

    2016-02-01

    Peripheral nerve injuries usually lead to severe loss of motor, sensory and autonomic functions in the patients. Due to the complex requirements for adequate axonal regeneration, functional recovery is often poorly achieved. Experimental models are useful to investigate the mechanisms related to axonal regeneration and tissue reinnervation, and to test new therapeutic strategies to improve functional recovery. Therefore, objective and reliable evaluation methods should be applied for the assessment of regeneration and function restitution after nerve injury in animal models. This review gives an overview of the most useful methods to assess nerve regeneration, target reinnervation and recovery of complex sensory and motor functions, their values and limitations. The selection of methods has to be adequate to the main objective of the research study, either enhancement of axonal regeneration, improving regeneration and reinnervation of target organs by different types of nerve fibres, or increasing recovery of complex sensory and motor functions. It is generally recommended to use more than one functional method for each purpose, and also to perform morphological studies of the injured nerve and the reinnervated targets. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  18. Interval training by normobaric hypoxia accelerates the reinnervation of musculus extensor digitorum longus in mice

    DEFF Research Database (Denmark)

    Vardya, Irina; (Vard'ya); Mospanova, Svetlana V.

    2000-01-01

    Dokl Biol Sci. 2000 Mar-Apr;371:112-4. Interval training by normobaric hypoxia accelerates the reinnervation of musculus extensor digitorum longus in mice. Vard'ya IV , Mospanova SV , Portnov VV , Balezina OP , Koshelev VB . Department of Human and Animal Physiology, Faculty of Biology, Moscow St...... State University, Russia. PMID: 10833635 [PubMed - indexed for MEDLINE] Udgivelsesdato: 2000...

  19. Chest radiography after minor chest trauma

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    Rossen, B.; Laursen, N.O.; Just, S.

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

  20. Chest X-Ray

    Medline Plus

    Full Text Available ... about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed x-ray exams and use a very small dose of ... of the inside of the chest. A chest x-ray is used to evaluate the lungs, heart and ...

  1. Thin chest wall is an independent risk factor for the development of pneumothorax after chest tube removal.

    Science.gov (United States)

    Anand, Rahul J; Whelan, James F; Ferrada, Paula; Duane, Therese M; Malhotra, Ajai K; Aboutanos, Michel B; Ivatury, Rao R

    2012-04-01

    The factors contributing to the development of pneumothorax after removal of chest tube thoracostomy are not fully understood. We hypothesized that development of post pull pneumothorax (PPP) after chest tube removal would be significantly lower in those patients with thicker chest walls, due to the "protective" layer of adipose tissue. All patients on our trauma service who underwent chest tube thoracostomy from July 2010 to February 2011 were retrospectively reviewed. Patient age, mechanism of trauma, and chest Abbreviated Injury Scale score were analyzed. Thoracic CTs were reviewed to ascertain chest wall thickness (CW). Thickness was measured at the level of the nipple at the midaxillary line, as perpendicular distance between skin and pleural cavity. Chest X-ray reports from immediately prior and after chest tube removal were reviewed for interval development of PPP. Data are presented as average ± standard deviation. Ninety-one chest tubes were inserted into 81 patients. Patients who died before chest tube removal (n = 11), or those without thoracic CT scans (n = 13) were excluded. PPP occurred in 29.9 per cent of chest tube removals (20/67). When PPP was encountered, repeat chest tube was necessary in 20 per cent of cases (4/20). After univariate analysis, younger age, penetrating mechanism, and thin chest wall were found to be significant risk factors for development of PPP. Chest Abbreviated Injury Scale score was similar in both groups. Logistic regression showed only chest wall thickness to be an independent risk factor for development of PPP.

  2. 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 ...

  3. 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 ...

  4. The influence of L-acetylcarnitine on reinnervation of the oculomotor nerve.

    Science.gov (United States)

    Pettorossi, V E; Draicchio, F; Fernandez, E; Pallini, R

    1993-01-01

    In guinea-pigs the oral administration of L-acetylcarnitine (L-AC) markedly favours the process of reinnervation of the oculomotor nerve sectioned at intracranial level. The gains of the horizontal and vertical vestibulo-ocular reflexes (HVOR, VVOR) were taken into consideration in testing the functional recovery of the nerve. As a consequence of the drug administration, 24 weeks after the operation the gains of the treated animals were higher than those of the controls. Reduction of misalignments of the stimulus-response orientation was also observed in treated animals as compared to the controls. This suggests that L-AC potentiates motor reinnervation by enhancing the nerve-growing processes and favouring a better consolidation of the appropriate neuromuscular synapses. The increased gain, and the improvement of the alignment in ocular responses, due to L-AC would allow for an increase of visual function during head movement by optimizing gaze stability.

  5. Sensory Feedback for Lower Extremity Prostheses Incorporating Targeted Muscle Reinnervation (TMR)

    Science.gov (United States)

    2017-10-01

    hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...map and characterize the sensory capabilities of lower extremity Targeted Reinnervation (TR) sites under tactile stimulation , and (2) Measure the...descent machine; developed new tactile stimulators that we expect to use in later stages of this project; and completed baseline studies to calibrate

  6. Innervation status in chronic vocal fold paralysis and implications for laryngeal reinnervation.

    Science.gov (United States)

    Lin, R Jun; Smith, Libby J; Munin, Michael C; Sridharan, Shaum; Rosen, Clark A

    2018-01-22

    Treatment options for symptomatic unilateral vocal fold paralysis (VFP) include vocal fold augmentation, laryngeal framework surgery, and laryngeal reinnervation. Laryngeal reinnervation (LR) has been suggested to provide "tone" to the paralyzed VF. This implies a loss of tone as a result of denervation without reinnervation. We performed laryngeal electromyography (LEMG) in patients with chronic VFP to understand the innervation status associated with a chronically paralyzed vocal fold. Retrospective review of LEMG data in adult patients with chronic VFP from January 2009 to December 2014. LEMG was performed at least 6 months after-onset of VFP. Qualitative LEMG, quantitative LEMG, and adductory synkinesis testing were performed, and the parameters were collected. Twenty-seven vocal folds were studied (23 unilateral VFP and 2 bilateral VFP). Average age was 59 ± 17 years. The median duration from recurrent laryngeal nerve injury to LEMG was 8.5 months (range 6-90 months). The majority of patients, 24 of 27 (89%), had motor unit potentials during phonation tasks on LEMG, and only 3 of 27 (11%) patients were electrically silent. Quantitative LEMG showed 287.8 mean turns per second (normal ≥ 400). Motor unit configuration was normal in 12 of 27 (44%), polyphasic in 12 of 27 (44%), and absent in the electrically silent patients. Adductory synkinesis was found in 6 of 20 (30%) patients. Chronic vocal fold paralysis is infrequently associated with absent motor-unit recruitment, indicating some degree of preserved innervation and/or reinnervation in these patients. LEMG should be part of the routine workup for chronic VFP prior to consideration of LR. 4. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Reinnervation of Paralyzed Muscle by Nerve-Muscle-Endplate Band Grafting

    Science.gov (United States)

    2015-10-01

    Antoniadis G, Braun V, Rath SA, Richter HP. Evaluation of iatrogenic lesions in 722 surgically treated cases of peripheral nerve trauma. J Neurosurg...achieved by end-to-end approximation: review of 2,181 nerve lesions . Microsurgery. 1993;14(4):244- 246. 18 25. McAllister RM, Gilbert SE, Calder JS...innervation through irreparable damage to its nerve . DNI has been used for selective reinnervation of paralyzed laryngeal and facial muscles [15,16] as well

  8. Product estimate of air kerma-area and the air kerma in the input surface of the skin of pediatric patients undergoing chest X-ray

    International Nuclear Information System (INIS)

    Villa-Chan, Beatriz; Carvalho, Aline; Andrade, Marcos Ely A.; Barros, Vinicius S.M. de; Khoury, Helen J.

    2014-01-01

    The aim of this paper is to evaluate the entrance air kerma (Ka,e) and the product air kerma-area (Pka) for chest examinations performed with pediatric patients in a large public hospital of Recife. For this study 89 examinations of patient with ages from zero to 10 years old were evaluated. The results showed that the mean Ka,e values, for patients of 0-1 years old, 1-5 years old and 5-10 years old, were, respectively, 100 mGy, 120 mGy and 100 mGy. The Pka values for newborn patients range from 11,9 to 58,4 mGy.cm 2 , for patients with 1 to 5 years old range from 17 to 192 mGy.cm 2 , and from 30,4 to 136,2 mGy.cm 2 for patients with ages from 5 to 10 years old. The differences in the Pka values are due the different dimensions of the radiation field. For the results its possible to conclude that the Pka values are high, in special for patients with ages from 1 to 5 years old, indicating that the collimation of the radiation field is not adequate. (author)

  9. Chest radiography after minor chest trauma

    International Nuclear Information System (INIS)

    Rossen, B.; Laursen, N.O.; Just, S.

    1987-01-01

    The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6(30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma. (orig.)

  10. Chest X-Ray

    Medline Plus

    Full Text Available ... I’d like to talk with you about chest radiography also known as chest x-rays. Chest x-rays are the most ... far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot org. Thank you for your time! ...

  11. Chest Pain: First Aid

    Science.gov (United States)

    First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

  12. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... d like to talk with you about chest radiography also known as chest x-rays. Chest x- ...

  13. Chest X-Ray

    Medline Plus

    Full Text Available ... by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, ... you about chest radiography also known as chest x-rays. Chest x-rays are the most commonly performed ...

  14. The chest

    International Nuclear Information System (INIS)

    Berdon, W.E.

    1985-01-01

    Radiographic interpretation of chest films of newborns in respiratory distress remains one of the most difficult aspects of pediatric radiology. Complex pulmonary and cardiac adjustments to extrauterine life are rapidly taking place. The small, fluid-filled fetal lung must rid itself of fluid and fill with air. The high vascular resistance of the fetal pulmonary bed and the open ductus arteriosus allow shunting of blood in both directions. Films taken in this period of time may show lungs that resemble those seen in congestive heart failure or fluid overload. When these findings are observed in infants who may appear dusky or even cyanotic, the result may be the diagnosis of disease in normal infants passing through a stormy transition period. To make things worse, the films are taken as portable surpine films, usually in an isolette in the intensive care unit (ICU). The phase of respiration is difficult, if not impossible, to control, and lateral films are usually not obtained. Many of the infants are on assisted ventilation either by tube or nasal prongs-nasal continuous positive airway pressure (CPAP)-and lungs can appear over-inflated or whited out, depending on the pressures used and the phase of the respiratory cycle. Prolonged crying itself can make lungs appear semiopaque; the next breath may show such a dramatic reinflation that it is hard to believe the two films are of the same infant, made only seconds apart. Is the heart large? Or is it the thymus? Are the lungs ''wet''? Is there infection? Is there pulmonary vascular engorgement? Why are these films so hard to interpret? They have no easy answers. The radiologist must realize that the neonatal intensive care personnel, armed though they may be with blood gas values, are no better at interpreting films. If anything, they read into them what they wish to see

  15. Reinnervation of bilateral posterior cricoarytenoid muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis.

    Directory of Open Access Journals (Sweden)

    Meng Li

    Full Text Available OBJECTIVE: To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. METHODS: Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. RESULTS: Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05. No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. CONCLUSIONS: Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity.

  16. Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

    Science.gov (United States)

    Zheng, Hongliang; Chen, Donghui; Zhu, Minhui; Wang, Wei; Liu, Fei; Zhang, Caiyun

    2013-01-01

    Objective To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA) muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. Methods Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. Results Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05). No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. Conclusions Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity. PMID:24098581

  17. Effect of rib-cage structure on acoustic chest impedance

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hansen, John

    2011-01-01

    When a stethoscope is placed on the surface of the chest, the coupler picks up sound from heart and lungs transmitted through the tissues of the ribcage and from the surface of the skin. If the acoustic impedance of the chest surface is known, it is possible to optimize the coupler for picking up...

  18. Selective reinnervation: a comparison of recovery following microsuture and conduit nerve repair.

    Science.gov (United States)

    Evans, P J; Bain, J R; Mackinnon, S E; Makino, A P; Hunter, D A

    1991-09-20

    Selective reinnervation was studied by comparing the regeneration across a conventional neurorraphy versus a conduit nerve repair. Lewis rats underwent right sciatic nerve transection followed by one of four different nerve repairs (n = 8/group). In groups I and II a conventional neurorraphy was performed and in groups III and IV the proximal and distal stumps were coapted by use of a silicone conduit with an interstump gap of 5 mm. The proximal and distal stumps in groups I and III were aligned anatomically correct and the proximal stump was rotated 180 degrees in groups II and IV (i.e. proximal peroneal nerve opposite the distal tibial nerve and the proximal tibial nerve opposite the distal peroneal nerve). By 14 weeks, there was an equivalent, but incomplete return in sciatic function index (SFI) in groups I, III, and IV as measured by walking track analysis. However, the SFI became unmeasurable by 6 weeks in all group II animals. At 14 weeks, the percent innervation of the tibialis anterior and medial gastronemius muscles by the peroneal and tibial nerves respectively was estimated by selective compound muscle action potential amplitude recordings. When fascicular alignment was reversed, there was greater tibial (P = 0.02) and lesser peroneal (P = 0.005) innervation of the gastrocnemius muscle in the conduit (group IV) versus the neurorraphy (group II) group. This suggests that the gastrocnemius muscle may be selectively reinnervated by the tibial nerve. However, there was no evidence of selective reinnervation of the tibialis anterior muscle. Despite these differences, the functional recovery in both conduit repair groups (III and IV) was equivalent to a correctly aligned microsuture repair (group I) and superior to that in the incorrectly aligned microsuture repair (group II).

  19. Chest X-Ray

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    Full Text Available ... some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a ... posted: How to Obtain and Share ...

  20. 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 ...

  1. MRI of the Chest

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    Full Text Available ... are the limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging ( ... heart, valves, great vessels, etc.). top of page What are some common uses of the procedure? MR ...

  2. Chest X-Ray

    Medline Plus

    Full Text Available ... breath, persistent cough, fever, chest pain or injury. It may also be useful to help diagnose and ... have some concerns about chest x-rays. However, it’s important to consider the likelihood of benefit to ...

  3. 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 ...

  4. Chest tube insertion

    Science.gov (United States)

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

  5. Chest computed tomography

    DEFF Research Database (Denmark)

    Loeve, Martine; Krestin, Gabriel P.; Rosenfeld, Margaret

    2013-01-01

    are not suitable to study CF lung disease in young children. Chest computed tomography (CT) holds great promise for use as a sensitive surrogate endpoint in CF. A large body of evidence has been produced to validate the use of chest CT as primary endpoint to study CF lung disease. However, before chest CT can...

  6. Patient dosimetry during chest radiography

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, O.; Kosutic, D.; Markovic, S.

    2004-01-01

    Reasons for the variation in patient doses from chest radiography procedure were investigated by assessing entrance skin doses from kerma-area product measurements. Data were collected from seven x-ray tubes in five hospitals involving 259 adult patients. The third quartile value was 0.81 mGy compared to general reference level of 0.30 mGy. The applied tube potential was main contributor to patient dose variation. If department use at least 90 k Vp, the mean entrance surface dose would be reduced ut to factor six. Modification of departmental procedure is correct approach for dose reduction in diagnostic radiology. (author) [sr

  7. American College of Chest Physicians

    Science.gov (United States)

    ... Foundation Participate in the e-Community Get Social Career Connection Publications CHEST Journal CHEST SEEK Guidelines & Consensus Statements CHEST Physician CHEST NewsBrief Coding for Chest Medicine Tobacco Dependence Toolkit (3rd Ed.) Mobile Websites and Apps CHEST Journal ...

  8. Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults.

    Science.gov (United States)

    Smith, Marshall E; Roy, Nelson; Stoddard, Kelly

    2008-09-01

    To assess the outcomes of management of unilateral vocal fold paralysis by ansa-RLN reinnervation in a series of patients ages 12-21. Clinical outcomes study. Six consecutive adolescents and young adults (ages 12-21 years) seeking treatment for unilateral vocal fold paralysis and glottal incompetence underwent ansa-RLN neurorraphy. Pre- and post-operative voice recordings acquired at least 1 year following surgery were submitted to acoustic and perceptual analysis. Patient-based measures were also taken. Mean perceptual visual analogue scale rating of dysphonia severity (0mm=profoundly abnormal voice, 100mm=completely normal voice) improved from 50mm pre-operatively to 82mm post-operatively. Mean maximum phonation time improved from 6.5s to 13.2s. Pitch and dynamic range were also observed to improve. Global self-ratings of voice function (0-100%) increased from 31.2% to 81.6% of normal. Ansa-RLN reinnervation is an effective treatment option for adolescents and young adults with unilateral vocal fold paralysis. The procedure has the potential to improve vocal function substantially, especially in those with isolated paralysis of the recurrent laryngeal nerve. The procedure alleviates the disadvantages associated with other surgical options for this age group.

  9. Long-term high-level exercise promotes muscle reinnervation with age.

    Science.gov (United States)

    Mosole, Simone; Carraro, Ugo; Kern, Helmut; Loefler, Stefan; Fruhmann, Hannah; Vogelauer, Michael; Burggraf, Samantha; Mayr, Winfried; Krenn, Matthias; Paternostro-Sluga, Tatjana; Hamar, Dusan; Cvecka, Jan; Sedliak, Milan; Tirpakova, Veronika; Sarabon, Nejc; Musarò, Antonio; Sandri, Marco; Protasi, Feliciano; Nori, Alessandra; Pond, Amber; Zampieri, Sandra

    2014-04-01

    The histologic features of aging muscle suggest that denervation contributes to atrophy, that immobility accelerates the process, and that routine exercise may protect against loss of motor units and muscle tissue. Here, we compared muscle biopsies from sedentary and physically active seniors and found that seniors with a long history of high-level recreational activity up to the time of muscle biopsy had 1) lower loss of muscle strength versus young men (32% loss in physically active vs 51% loss in sedentary seniors); 2) fewer small angulated (denervated) myofibers; 3) a higher percentage of fiber-type groups (reinnervated muscle fibers) that were almost exclusive of the slow type; and 4) sparse normal-size muscle fibers coexpressing fast and slow myosin heavy chains, which is not compatible with exercise-driven muscle-type transformation. The biopsies from the old physically active seniors varied from sparse fiber-type groupings to almost fully transformed muscle, suggesting that coexpressing fibers appear to fill gaps. Altogether, the data show that long-term physical activity promotes reinnervation of muscle fibers and suggest that decades of high-level exercise allow the body to adapt to age-related denervation by saving otherwise lost muscle fibers through selective recruitment to slow motor units. These effects on size and structure of myofibers may delay functional decline in late aging.

  10. Differential regulation of axon outgrowth and reinnervation by neurotrophin-3 and neurotrophin-4 in the hippocampal formation.

    Science.gov (United States)

    Hechler, Daniel; Boato, Francesco; Nitsch, Robert; Hendrix, Sven

    2010-08-01

    In this study, we investigated the hypothesis whether neurotrophins have a differential influence on neurite growth from the entorhinal cortex depending on the presence or absence of hippocampal target tissue. We investigated organotypic brain slices derived from the entorhinal-hippocampal system to analyze the effects of endogenous and recombinant neurotrophin-3 (NT-3) and neurotrophin-4 (NT-4) on neurite outgrowth and reinnervation. In the reinnervation assay, entorhinal cortex explants of transgenic mice expressing enhanced green fluorescent protein (EGFP) were co-cultured with wild-type hippocampi under the influence of recombinant NT-3 and NT-4 (500 ng/ml). Both recombinant NT-3 and NT-4 significantly increased the growth of EGFP+ nerve fibers into the target tissue. Consistently, reinnervation of the hippocampi of NT-4(-/-) and NT-3(+/-)NT-4(-/-) mice was substantially reduced. In contrast, the outgrowth assay did not exhibit reduction in axon outgrowth of NT-4(-/-) or NT-3(+/-)NT-4(-/-) cortex explants, while the application of recombinant NT-3 (500 ng/ml) induced a significant increase in the neurite extension of cortex explants. Recombinant NT-4 had no effect. In summary, only recombinant NT-3 stimulates axon outgrowth from cortex explants, while both endogenous and recombinant NT-3 and NT-4 synergistically promote reinnervation of the denervated hippocampus. These results suggest that endogenous and exogenous NT-3 and NT-4 differentially influence neurite growth depending on the presence or absence of target tissue.

  11. The fate of neurotization techniques on reinnervation after denervation of the gastrocnemius muscle: an experimental study.

    Science.gov (United States)

    Askar, I; Sabuncuoglu, B T; Yormuk, E; Saray, A

    2001-07-01

    In nerve injuries, if it is not possible to reinnervate muscle by using neurorrhaphy and nerve grafting technique, reinnervation should be provided by the use of neuroization-directly implanting motor nerve into muscle. A comparative study of three techniques of neurotization is presented in rabbits. In this experimental study, a total of 40 white New Zealand rabbits were used and divided into four groups, each including 10 rabbits. In the first group (control--Group 1), only surgical exposure of the gastrocnemius muscle, main muscle nerve (tibial nerve), and peroneal nerve was done, without any injury to the nerves. In the second group (direct neurotization group--Group 2), the tibial nerve was transected, and the peroneal nerve, which had already been divided into fascicles, was implanted into the lateral head of the gastrocnemius muscle aneural zone. In the third group (dual neurotization group--Group 3), the tibial nerve which had been transected and re-anastomosed, and the peroneal nerve were implanted into the lateral head of the gastrocnemius muscle. In the last experimental group (hyperneurotization group--Group 4), fascicles of the peroneal nerve were implanted into the lateral head of the gastrocnemius, preserving the tibial nerve. Six months later, changes in the histologic pattern and the functional recovery of the gastrocnemius muscle were investigated. It was found that functional recovery was achieved in all neurotization groups. Groups with the tibial nerve transected had less muscular weights than those of groups with the tibial nerve intact. EMG recordings showed that polyphasic and late potentials were frequently seen in groups with the tibial nerve transected. Degeneration and regeneration of myofibrils was observed in such groups as well. New motor end-plates, including vesicles, were formed in a scattered manner in all neurotization groups. As a result, the authors conclude that direct and dual neurotization techniques are useful in peripheral

  12. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Blunt chest trauma.

    Science.gov (United States)

    Stewart, Daphne J

    2014-01-01

    Blunt chest trauma is associated with a wide range of injuries, many of which are life threatening. This article is a case study demonstrating a variety of traumatic chest injuries, including pathophysiology, diagnosis, and treatment. Literature on the diagnosis and treatment was reviewed, including both theoretical and research literature, from a variety of disciplines. The role of the advance practice nurse in trauma is also discussed as it relates to assessment, diagnosis, and treatment of patients with traumatic chest injuries.

  15. CT of chest trauma

    International Nuclear Information System (INIS)

    Goodman, P.C.

    1986-01-01

    There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

  16. MRI of the Chest

    Medline Plus

    Full Text Available ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed ... in diagnosing a broad range of conditions, including cancer, heart and ... tissues, except for lung abnormalities where Chest CT is a preferred imaging ...

  17. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Johnsen, Karen Kirstine; Thomsen, Henrik

    on collimation and dose reduction in digital chest radiography Methods and Materials A retrospective study of digital chest radiography is performed to evaluate the primary x-ray tube collimation of the PA and lateral radiographs. Data from one hundred fifty self-reliant female patients between 15 and 55 years...

  18. Restoration of quinine-stimulated Fos-immunoreactive neurons in the central nucleus of the amygdala and gustatory cortex following reinnervation or cross-reinnervation of the lingual taste nerves in rats.

    Science.gov (United States)

    King, Camille Tessitore; Garcea, Mircea; Spector, Alan C

    2014-08-01

    Remarkably, when lingual gustatory nerves are surgically rerouted to inappropriate taste fields in the tongue, some taste functions recover. We previously demonstrated that quinine-stimulated oromotor rejection reflexes and neural activity (assessed by Fos immunoreactivity) in subregions of hindbrain gustatory nuclei were restored if the posterior tongue, which contains receptor cells that respond strongly to bitter compounds, was cross-reinnervated by the chorda tympani nerve. Such functional recovery was not seen if instead, the anterior tongue, where receptor cells are less responsive to bitter compounds, was cross-reinnervated by the glossopharyngeal nerve, even though this nerve typically responds robustly to bitter substances. Thus, recovery depended more on the taste field being reinnervated than on the nerve itself. Here, the distribution of quinine-stimulated Fos-immunoreactive neurons in two taste-associated forebrain areas was examined in these same rats. In the central nucleus of the amygdala (CeA), a rostrocaudal gradient characterized the normal quinine-stimulated Fos response, with the greatest number of labeled cells situated rostrally. Quinine-stimulated neurons were found throughout the gustatory cortex, but a "hot spot" was observed in its anterior-posterior center in subregions approximating the dysgranular/agranular layers. Fos neurons here and in the rostral CeA were highly correlated with quinine-elicited gapes. Denervation of the posterior tongue eliminated, and its reinnervation by either nerve restored, numbers of quinine-stimulated labeled cells in the rostralmost CeA and in the subregion approximating the dysgranular gustatory cortex. These results underscore the remarkable plasticity of the gustatory system and also help clarify the functional anatomy of neural circuits activated by bitter taste stimulation. © 2014 Wiley Periodicals, Inc.

  19. Usefulness of Ga-67 citrate whole body imaging, chest spot imaging, and chest SPECT in sarcoidosis

    International Nuclear Information System (INIS)

    Ueno, Kyoichi; Nishi, Koichi; Namura, Masanobu; Kawashima, Yoshio; Kurumaya, Hiroshi

    1999-01-01

    To assess the sensitivity, and the relative role of Ga-67 whole body, chest spot imaging, and chest SPECT, we retrospectively studied 34 cases of sarcoidosis (24 biopsy proven, 10 clinically diagnosed) with Ga-67 (111 MBq), and compared the results of lung (25 cases), muscle (25 cases), skin (3 cases), and myocardial (2 cases) biopsies. Ga-67 chest SPECT (single photon emission CT) were done in 17 cases with Siemens MultiSPECT3. Ga-67 planar imaging visualized only 2 of 12 (16.7%) lung biopsy-positive cases, 5 of 12 (41.6%) muscle biopsy-positive cases, 2 of 3 (66.7%) skin biopsy-positive cases. However, Ga-67 imaging revealed the lesions in 1 of 9 (11.1%) of muscle biopsy-negative cases, in 2 of 3 (66.7%) of skin biopsy-negative cases, and in 1 of 2 myocardial biopsy-negative cases. Ga-67 chest SPECT visualized 14 hilar lymphadenopathy (LN), 3 supraclavicular LN, and 1 myocardial sarcoidosis. Although both SPECT, and planar spot imaging detected the lesions equally, the former showed them more clearly. Compared with various biopsies, the sensitivity of Ga-67 imaging was not so high. However, Ga-67 imaging is non-invasive, easy to perform the whole body imaging, and can detect the activity of the lesions. Ga-67 SPECT showed clear imaging of the hilar, mediastinal LN, and potentially fatal myocardial sarcoidosis. (author)

  20. Simulated Cholinergic Reinnervation of β (INS-1 Cells: Antidiabetic Utility of Heterotypic Pseudoislets Containing β Cell and Cholinergic Cell

    Directory of Open Access Journals (Sweden)

    Ao Jiao

    2018-01-01

    Full Text Available Cholinergic neurons can functionally support pancreatic islets in controlling blood sugar levels. However, in islet transplantation, the level of cholinergic reinnervation is significantly lower compared to orthotopic pancreatic islets. This abnormal reinnervation affects the survival and function of islet grafts. In this study, the cholinergic reinnervation of beta cells was simulated by 2D and 3D coculture of INS-1 and NG108-15 cells. In 2D culture conditions, 20 mM glucose induced a 1.24-fold increase (p<0.0001 in insulin secretion from the coculture group, while in the 3D culture condition, a 1.78-fold increase (p<0.0001 in insulin secretion from heterotypic pseudoislet group was observed. Glucose-stimulated insulin secretion (GSIS from 2D INS-1 cells showed minimal changes when compared to 3D structures. E-cadherin expressed in INS-1 and NG108-15 cells was the key adhesion molecule for the formation of heterotypic pseudoislets. NG108-15 cells hardly affected the proliferation of INS-1 cells in vitro. Heterotypic pseudoislet transplantation recipient mice reverted to normoglycemic levels faster and had a greater blood glucose clearance compared to INS-1 pseudoislet recipient mice. In conclusion, cholinergic cells can promote insulin-secreting cells to function better in vitro and in vivo and E-cadherin plays an important role in the formation of heterotypic pseudoislets.

  1. Radiological diagnosis of chest wall tuberculosis: CT versus chest radiograph

    International Nuclear Information System (INIS)

    Liu Fugeng; Pan Jishu; Chen Qihang; Zhou Cheng; Yu Jingying; Tang Dairong

    2006-01-01

    Objective: To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis. Methods: The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all eases, while enhanced CT in 9 cases, and all images were reviewed by 2 radiologists. Results: Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(χ 2 =42.000, P 2 =4.421, P<0.05). Conclusion: CT, especially enhanced CT scan is the first choice in the diagnosis of chest wall tuberculosis. (authors)

  2. Assessment of chest impedance in relation to phonocardiography

    DEFF Research Database (Denmark)

    Zimmermann, Niels Henrik; Møller, Henrik; Hammershøi, Dorte

    2010-01-01

    the surface of the skin to the transducer. If the impedance of the skin is known, it may be possible to optimize the transducer to achieve an improved signal for a certain frequency range, while attenuating disturbing noise. Further, from a classical stethoscope it is known, that the sound picked up...... by the stethoscope can be influenced by changing the pressure on the chest piece of the stethoscope. A high pressure will stretch the skin similar to a drum skin, and attenuate lower frequencies, while lighter pressure will broaden the frequency range. By using an impedance tube (also known as standing wave tube......), it is possible to measure the impedance of the surface of the skin and at the same time investigate the influence of different pressures and diameters of a transducer. The impedance tube is made specifically with the purpose of measuring chest impedances in the frequency range from 50 Hz to 5 kHz. An MLS...

  3. MRI of the Chest

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    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... abnormalities where Chest CT is a preferred imaging test. MR imaging can assess blood flow without risking ...

  4. Chest X-Ray

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    Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  5. Learning chest imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pedrozo Pupo, John C. (ed.) [Magdalena Univ., Santa Maria (Colombia). Respire - Inst. for Respiratory Care

    2013-03-01

    Useful learning tool for practitioners and students. Overview of the imaging techniques used in chest radiology. Aid to the correct interpretation of chest X-ray images. Radiology of the thorax forms an indispensable element of the basic diagnostic process for many conditions and is of key importance in a variety of medical disciplines. This user-friendly book provides an overview of the imaging techniques used in chest radiology and presents numerous instructive case-based images with accompanying explanatory text. A wide range of clinical conditions and circumstances are covered with the aim of enabling the reader to confidently interpret chest images by correctly identifying structures of interest and the causes of abnormalities. This book, which will be an invaluable learning tool, forms part of the Learning Imaging series for medical students, residents, less experienced radiologists, and other medical staff. Learning Imaging is a unique case-based series for those in professional education in general and for physicians in prarticular.

  6. MRI of the Chest

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    Full Text Available ... to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures ... over time. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  7. Chest x-ray

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    ... pain from a chest injury (with a possible rib fracture or lung complication) or from heart problems Coughing ... arteries Evidence of heart failure In the bones: Fractures or other problems of the ribs and spine Osteoporosis

  8. Chest X-Ray

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    Full Text Available ... evaluate shortness of breath, persistent cough, fever, chest pain or injury. It may also be useful to ... of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. For more information about ...

  9. MRI of the Chest

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    Full Text Available ... to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  10. Chest X-Ray

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    Full Text Available ... also be useful to help diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  11. MRI of the Chest

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    Full Text Available ... is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no ... Chest? Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. ...

  12. MRI of the Chest

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    Full Text Available ... a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures of ... understanding of the possible charges you will incur. Web page review process: This Web page is reviewed ...

  13. Chest X-Ray

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    Full Text Available ... X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey Rubin, a radiologist ... about chest x-rays, visit Radiology Info dot org. Thank you for your time! Spotlight Recently posted: ...

  14. MRI of the Chest

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    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 ...

  15. MRI of the Chest

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    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 ...

  16. MRI of the Chest

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    Full Text Available ... or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played ... the limitations of MRI of the Chest? High-quality images are assured only if you are able ...

  17. MRI of the Chest

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    Full Text Available ... detailed pictures of the structures within the chest. It is primarily used to assess abnormal masses such ... and determine the size, extent and degree of its spread to adjacent structures. It’s also used to ...

  18. MRI of the Chest

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    Full Text Available ... etc.). top of page What are some common uses of the procedure? MR imaging of the chest ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  19. Chest X-Ray

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    Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray ... posted: How to Obtain and Share Your Medical Images Movement Disorders Video: The Basketball Game: An MRI ...

  20. MRI of the Chest

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    Full Text Available ... determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted ... of the chest cavity (arteries and veins). MRA can also demonstrate an abnormal ballooning out of the ...

  1. Chest X-Ray

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    Full Text Available ... accurate diagnosis far outweighs any risk. For more information about chest x-rays, visit Radiology Info dot ... Inc. (RSNA). To help ensure current and accurate information, we do not permit copying but encourage linking ...

  2. MRI of the Chest

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    Full Text Available ... MRI) of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed ... there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some ...

  3. MRI of the Chest

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    Full Text Available ... primarily used to assess abnormal masses such as cancer and determine the size, extent and degree of ... chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either ...

  4. Chest X-Ray

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    Full Text Available ... Site Index A-Z Spotlight Recently posted: Pancreatic Cancer The Limitations of Online Dose Calculators Video: The ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  5. MRI of the Chest

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    Full Text Available ... etc.). top of page What are some common uses of the procedure? MR imaging of the chest ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  6. MRI of the Chest

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    Full Text Available ... a computer to produce detailed pictures of the structures within the chest. It is primarily used to ... extent and degree of its spread to adjacent structures. It’s also used to assess the anatomy and ...

  7. MRI of the Chest

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    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) ... clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in ...

  8. MRI of the Chest

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    Full Text Available ... copied to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed ... sedative prior to your scheduled examination. Infants and young children usually require sedation or anesthesia to complete ...

  9. Chest X-Ray

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    Full Text Available ... exams and use a very small dose of ionizing radiation to produce pictures of the inside of the ... chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs ...

  10. Chest X-Ray

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    Full Text Available ... However, it’s important to consider the likelihood of benefit to your health. While a chest x-ray use a tiny dose of ionizing radiation, the benefit of an accurate diagnosis far outweighs any risk. ...

  11. MRI of the Chest

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    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 ...

  12. MRI of the Chest

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    Full Text Available ... have a history of kidney disease or liver transplant, it will be necessary to perform a blood ... cancer, heart and vascular disease, heart valve abnormalities, bone and other soft tissue abnormalities of the chest. ...

  13. Chest X-Ray

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    Full Text Available ... June is Men's Health Month Recently posted: Pancreatic Cancer The Limitations of Online Dose Calculators Video: The ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  14. MRI of the Chest

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    Full Text Available ... around the heart) disease. characterize mediastinal or pleural lesions seen by other imaging modalities, such as chest ... ports artificial limbs or metallic joint prostheses implanted nerve stimulators metal pins, screws, plates, stents or surgical ...

  15. Digital chest radiography

    DEFF Research Database (Denmark)

    Debess, Jeanne Elisabeth; Vejle-Sørensen, Jens Kristian; Thomsen, Henrik

    ,3 mAs and SID SID of 180 centimetres using a phantom and lithium fluoride thermo luminescence dosimeter (TLD). Dose to risk organs mamma, thyroid and colon are measured at different collimations with one-centimetre steps. TLD results are used to estimate dose reduction for different collimations...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  16. Safety and efficacy of 2,790-nm laser resurfacing for chest photoaging.

    Science.gov (United States)

    Grunebaum, Lisa D; Murdock, Jennifer; Cofnas, Paul; Kaufman, Joely

    2015-01-01

    Chest photodamage is a common cosmetic complaint. Laser treatment of the chest may be higher risk than other areas. The objective of this study was to assess the safety and efficacy of 2,790-nm chest resurfacing for photodamage. Twelve patients with Fitzpatrick skin types I-III were enrolled in this university IRB-approved study. Photo documentation was obtained at baseline and each visit. A test spot with the 2,790-nm resurfacing laser was performed on the chest. Patients who did not have adverse effects from the test spot went on to have a full chest resurfacing procedure. Patients were instructed on standardized aftercare, including sunscreen. A 5-point healing and photodamage improvement scale was used to rate improvement by both investigators and the patients and was obtained at 2 weeks, 1 month, 2 months, and 3 months. One pass chest treatment with the 2,790-nm resurfacing laser at fluences greater than or equal to 3.0 mJ with 10% overlap leads to unacceptable rates of hyperpigmentation. Double pass chest treatment at fluences less than or equal to 2.5 mJ with 10% overlap leads to mild improvement in chest photodamage parameters without significant or persistent adverse effects. Laser treatment of aging/photodamaged chest skin remains a challenge due to the delicacy of chest skin. Mild improvement may be obtained with double pass resurfacing with the 2,790-nm wavelength.

  17. Progranulin promotes peripheral nerve regeneration and reinnervation: role of notch signaling.

    Science.gov (United States)

    Altmann, Christine; Vasic, Verica; Hardt, Stefanie; Heidler, Juliana; Häussler, Annett; Wittig, Ilka; Schmidt, Mirko H H; Tegeder, Irmgard

    2016-10-22

    Peripheral nerve injury is a frequent cause of lasting motor deficits and chronic pain. Although peripheral nerves are capable of regrowth they often fail to re-innervate target tissues. Using newly generated transgenic mice with inducible neuronal progranulin overexpression we show that progranulin accelerates axonal regrowth, restoration of neuromuscular synapses and recovery of sensory and motor functions after injury of the sciatic nerve. Oppositely, progranulin deficient mice have long-lasting deficits in motor function tests after nerve injury due to enhanced losses of motor neurons and stronger microglia activation in the ventral horn of the spinal cord. Deep proteome and gene ontology (GO) enrichment analysis revealed that the proteins upregulated in progranulin overexpressing mice were involved in 'regulation of transcription' and 'response to insulin' (GO terms). Transcription factor prediction pointed to activation of Notch signaling and indeed, co-immunoprecipitation studies revealed that progranulin bound to the extracellular domain of Notch receptors, and this was functionally associated with higher expression of Notch target genes in the dorsal root ganglia of transgenic mice with neuronal progranulin overexpression. Functionally, these transgenic mice recovered normal gait and running, which was not achieved by controls and was stronger impaired in progranulin deficient mice. We infer that progranulin activates Notch signaling pathways, enhancing thereby the regenerative capacity of partially injured neurons, which leads to improved motor function recovery.

  18. Modulation of the Neuregulin 1/ErbB system after skeletal muscle denervation and reinnervation.

    Science.gov (United States)

    Morano, Michela; Ronchi, Giulia; Nicolò, Valentina; Fornasari, Benedetta Elena; Crosio, Alessandro; Perroteau, Isabelle; Geuna, Stefano; Gambarotta, Giovanna; Raimondo, Stefania

    2018-03-22

    Neuregulin 1 (NRG1) is a growth factor produced by both peripheral nerves and skeletal muscle. In muscle, it regulates neuromuscular junction gene expression, acetylcholine receptor number, muscle homeostasis and satellite cell survival. NRG1 signalling is mediated by the tyrosine kinase receptors ErbB3 and ErbB4 and their co-receptors ErbB1 and ErbB2. The NRG1/ErbB system is well studied in nerve tissue after injury, but little is known about this system in skeletal muscle after denervation/reinnervation processes. Here, we performed a detailed time-course expression analysis of several NRG1 isoforms and ErbB receptors in the rat superficial digitorum flexor muscle after three types of median nerve injuries of different severities. We found that ErbB receptor expression was correlated with the innervated state of the muscle, with upregulation of ErbB2 clearly associated with the denervation state. Interestingly, the NRG1 isoforms were differently regulated depending on the nerve injury type, leading to the hypothesis that both the NRG1α and NRG1β isoforms play a key role in the muscle reaction to injury. Indeed, in vitro experiments with C2C12 atrophic myotubes revealed that both NRG1α and NRG1β treatment influences the best-known atrophic pathways, suggesting that NRG1 might play an anti-atrophic role.

  19. Spatiotemporal dynamics of re-innervation and hyperinnervation patterns by uninjured CGRP fibers in the rat foot sole epidermis after nerve injury

    Directory of Open Access Journals (Sweden)

    Duraku Liron S

    2012-08-01

    Full Text Available Abstract The epidermis is innervated by fine nerve endings that are important in mediating nociceptive stimuli. However, their precise role in neuropathic pain is still controversial. Here, we have studied the role of epidermal peptidergic nociceptive fibers that are located adjacent to injured fibers in a rat model of neuropathic pain. Using the Spared Nerve Injury (SNI model, which involves complete transections of the tibial and common peroneal nerve while sparing the sural and saphenous branches, mechanical hypersensitivity was induced of the uninjured lateral (sural and medial (saphenous area of the foot sole. At different time points, a complete foot sole biopsy was taken from the injured paw and processed for Calcitonin Gene-Related Peptide (CGRP immunohistochemistry. Subsequently, a novel 2D-reconstruction model depicting the density of CGRP fibers was made to evaluate the course of denervation and re-innervation by uninjured CGRP fibers. The results show an increased density of uninjured CGRP-IR epidermal fibers on the lateral and medial side after a SNI procedure at 5 and 10 weeks. Furthermore, although in control animals the density of epidermal CGRP-IR fibers in the footpads was lower compared to the surrounding skin of the foot, 10 weeks after the SNI procedure, the initially denervated footpads displayed a hyper-innervation. These data support the idea that uninjured fibers may play a considerable role in development and maintenance of neuropathic pain and that it is important to take larger biopsies to test the relationship between innervation of injured and uninjured nerve areas.

  20. Radiology in chest trauma

    International Nuclear Information System (INIS)

    Wenz, W.; Kloehn, I.; Wolfart, W.; Freiburg Univ.

    1979-01-01

    In chest trauma, a routine chest film, preferably in the lateral as well as the frontal projection, is the basic part of the work-up. Occasionally valuable additional methods are fluoroscopy, tomography, bronchography, contrast studies of the GI Tract and angiography and angiocardiography. In 679 chest trauma patients, traffic accidents and falls were the main reason for the trauma. There were 248 fractures; then - in order of frequency - hemopneumothorax (76), lung contusion (58), subcutaneous emphysema (33) cardiac (16) and vascular trauma (12) and damage to other organs. While 20-30% mistakes are made in diagnosing rib fractures in acute trauma, there is high accuracy in the diagnosis of the other injuries. Many cases are shown to demonstrate the value of diagnostic radiology. (orig.) [de

  1. Chest sonography. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Mathis, Gebhard (ed.)

    2008-07-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  2. Chest sonography. 2. ed.

    International Nuclear Information System (INIS)

    Mathis, Gebhard

    2008-01-01

    Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography. A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. (orig.)

  3. MRI of the Chest

    Medline Plus

    Full Text Available ... Imaging (MRI) - Chest Sponsored by Please note RadiologyInfo.org is not a medical facility. Please contact your ... links: For the convenience of our users, RadiologyInfo .org provides links to relevant websites. RadiologyInfo.org , ACR ...

  4. MRI of the Chest

    Medline Plus

    Full Text Available ... transplant, it will be necessary to perform a blood test to determine whether the kidneys are functioning adequately. ... abnormalities where Chest CT is a preferred imaging test. MR imaging can assess blood flow without risking the side effects of conventional ( ...

  5. MRI of the Chest

    Medline Plus

    Full Text Available ... internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

  6. Chest X-Ray

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    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 ...

  7. MRI of the Chest

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    Full Text Available ... of which shows a thin slice of the body. The images can then be studied from different angles by ... bear denotes child-specific content. Related Articles and Media MR ... Images related to Magnetic Resonance Imaging (MRI) - Chest Sponsored ...

  8. MRI of the Chest

    Medline Plus

    Full Text Available ... body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various ... seen by other imaging modalities, such as chest x-ray or CT. A special form of MRI called ...

  9. MRI of the Chest

    Medline Plus

    Full Text Available ... computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI ... cancer, heart and vascular disease, heart valve abnormalities, bone and other soft tissue abnormalities of the chest. MRI is also useful ...

  10. Chest X-Ray

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    Full Text Available ... change into a gown. You may have some concerns about chest x-rays. However, it’s important to ... You Sponsored by About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 ...

  11. Skin graft

    Science.gov (United States)

    Skin transplant; Skin autografting; FTSG; STSG; Split thickness skin graft; Full thickness skin graft ... donor site. Most people who are having a skin graft have a split-thickness skin graft. This takes ...

  12. Partial recovery of respiratory function and diaphragm reinnervation following unilateral vagus nerve to phrenic nerve anastomosis in rabbits.

    Directory of Open Access Journals (Sweden)

    Junxiang Wen

    Full Text Available Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI. Reinnervation of the paralyzed diaphragm via an anastomosis between phrenic nerve and a donor nerve is a potential strategy to mitigate ventilatory deficits. In this study, anastomosis of vagus nerve (VN to phrenic nerve (PN in rabbits was performed to assess the potential capacity of the VN to compensate for lost PN inputs. At first, we compared spontaneous discharge pattern, nerve thickness and number of motor fibers between these nerves. The PN exhibited a highly rhythmic discharge while the VN exhibited a variable frequency discharge pattern. The rabbit VN had fewer motor axons (105.3±12.1 vs. 268.1±15.4. Nerve conduction and respiratory function were measured 20 weeks after left PN transection with or without left VN-PN anastomosis. Compared to rabbits subjected to unilateral phrenicotomy without VN-PN anastomosis, diaphragm muscle action potential (AP amplitude was improved by 292%, distal latency by 695%, peak inspiratory flow (PIF by 22.6%, peak expiratory flow (PRF by 36.4%, and tidal volume by 21.8% in the anastomosis group. However, PIF recovery was only 28.0%, PEF 28.2%, and tidal volume 31.2% of Control. Our results suggested that VN-PN anastomosis is a promising therapeutic strategy for partial restoration of diaphragm reinnervation, but further modification and improvements are necessary to realize the full potential of this technique.

  13. Sandstorm in the chest?

    Directory of Open Access Journals (Sweden)

    Talluri MR

    2011-07-01

    Full Text Available A 32 year old female presented with dry cough and progressive breathlessness of one year duration. There was no history suggestive of collagen vascular disease, lung parenchymal infection or allergic airway disease. Clinical evaluation showed basal fine inspiratory crepitations. Radiographic examination of the chest revealed a black pleura line and lung parenchymal calcification. CT scan of the chest demonstrated nodular calcification of lung parenchyma with a “crazy pavement” pattern, which is suggestive of alveolar calcification. Pulmonary function test showed a severe restrictive defect. On transbronchial lung biopsy calcific spherules suggestive of the alveolar microlithiasis were seen. Diagnosis of pulmonary alveolar microlithiasis was made and symptomatic treatment was given, as there is no specific therapy available. The case illustrates an unusual cause of shortness of breath in a young female with striking radiographic features.

  14. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  15. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  16. Trauma of the chest

    International Nuclear Information System (INIS)

    Reuter, M.

    1996-01-01

    This paper describes the typical radiologic findings in chest trauma, and the value of conventional radiography, CT, MRI, and aortography is discussed. Conventional radiography rather than cross-sectional imaging is the mainstay in diagnosing thoracic trauma. During the critical phase with often concomitant shock, pelvic and spinal injuries tailored raiographic views or even upright chest radiographs are impractical. The severely traumatized patient is usually radiographed in the supine position and suboptimal roentgenograms may have to be accepted for several reasons. It is well documented that many abnormalities detected on CT were not apparent on conventional radiographs, but CT is reserved for hemodynamical stable patients. Nevertheless certain situations like aortic rupture require further evaluation by CT and aortography. (orig./MG)

  17. Skin Diseases: Skin Health and Skin Diseases

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Skin Health and Skin Diseases Past Issues / Fall 2008 Table of Contents ... acne to wrinkles Did you know that your skin is the largest organ of your body? It ...

  18. MRI of the Chest

    Medline Plus

    Full Text Available ... experience some bruising. There is also a very small chance of irritation of your skin at the ... a result, must be kept away from the area to be imaged. Furthermore, the examination takes longer ...

  19. MRI of the Chest

    Medline Plus

    Full Text Available ... traditional MRI unit is a large cylinder-shaped tube surrounded by a circular magnet. You will lie ... your skin at the site of the IV tube insertion. Some patients may sense a temporary metallic ...

  20. Evaluation of skin entrance radiation dose in pediatric patients undergoing chest X-rays exams; Avaliacao da dose de entrada na pele em pacientes pediatricos submetidos a exames radiograficos do torax

    Energy Technology Data Exchange (ETDEWEB)

    Gabardo, Farly Piantini

    2016-07-01

    The aim of this work was to estimate the incident air kerma of lateral (LAT) and anterior-posterior (AP) together with posterior-anterior (PA) projection chest X-ray exams in one of the largest pediatric hospitals in Brazil. Dosimetric results are accompanied with the detailed analysis of patient characteristics and radiographer strategy. The exams of 225 (119 male and 106 female) patients were studied and 389 X-ray exams (200 AP/PA projections and 189 LAT projections) of pediatric patients were acquired. Patient thickness can be restored from age, height or weight with the uncertainty of ∼20-30%. Very slight correlation between the patient dose and thickness was observed with the difference in dose for patients of the same thickness reaching 4 times. By standardization of radiological protocols, it should be possible to keep dose within the intervals 50-100 μGy for LAT projection and 40-80 μGy for AP/PA projection. The dose values are lower than those recommended by major European guidelines to good practice. (author)

  1. 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)

  2. Reinnervating the penis in spina bifida patients in the United States: ilioinguinal-to-dorsal-penile neurorrhaphy in two cases.

    Science.gov (United States)

    Jacobs, Micah A; Avellino, Anthony M; Shurtleff, David; Lendvay, Thomas S

    2013-10-01

    Penile sensation is absent in some patients with myelomeningocele owing to the dysfunction of the pudendal nerve. Here, we describe the introduction of penile sensation via ilioinguinal-to-dorsal-penile neurorrhaphy in two patients with penile anesthesia due to neural tube defects. To establish penile sensation via ilioinguinal-to-dorsal-penile-nerve neurorrhaphy. A 20-year-old and a 35-year-old male with L5/S1 myelomeningocele were both highly functioning and ambulatory, with intact ilioinguinal nerve distribution sensation but anesthesia of the penis and glans. They were sexually active and able to ejaculate antegrade. Both had high International Index of Erectile Function scores for confidence to achieve erection sufficient for intercourse. An incision was made from anterior superior iliac crest to the glans penis to expose the inguinal canal and ilioinguinal nerve. The ilioinguinal and dorsal penile nerve were transected and anastomosed. The anastomotic site was then wrapped in a hemostatic agent and a drain was left in place. For penile rehabilitation, both patients were instructed to stimulate the penis while looking at the genitalia to encourage redistribution of perceived sensation. Presence of erogenous penile sensation was tested by neurologic examination and patient feedback, and patients completed sexual health questionnaires. Both patients reported paresthesias of the groin with penile stimulation 1 month after surgery. Both patients are now 24 months postoperative and have erogenous sensation on the ipsilateral glans and shaft during intercourse. Neither patient has difficulty achieving or maintaining erections. We present two patients with dorsal penile reinnervation via the ilioinguinal nerve. Although nerve reinnervation has been used in urological procedures, this is the first description of an attempt to resupply penile sensation via the dorsal penile nerve in the United States with a minimum of 18 months follow-up. Early follow-up suggests

  3. Plasticity of the transverse tubules following denervation and subsequent reinnervation in rat slow and fast muscle fibres.

    Science.gov (United States)

    Takekura, Hiroaki; Tamaki, Hiroyuki; Nishizawa, Tomie; Kasuga, Norikatsu

    2003-01-01

    We have studied the effects of short term denervation followed by reinnervation on the ultrastructure of the membrane systems and on the content of and distribution of key proteins involved in calcium regulation of fast-twitch (FT) extensor digitorum longus (EDL) and slow-twitch (ST) soleus (SOL) muscle fibres. Ischiadic nerve freezing resulted in total lack of neuromuscular transmission for 3 days followed by a slow recovery, but no decline in twitch force elicited by direct stimulation. The latter measurements indicate no significant atrophy within this time frame. The membrane systems of skeletal muscle fibres were visualized using Ca92+)-K3Fe(CN)6-OsO4 techniques and observed using a high voltage electron microscope. [3H]nitrendipine binding was used to detect levels of dihydropyridine receptor (DHPR) expression. The Ca2+ pumping free sarcoplasmic reticulum domains were not affected by the denervation, but the Ca2+ release domains were dramatically increased, particularly in the FT-EDL muscle fibres. The increase is evidenced by a doubling up of the areas of contacts between SR and transverse (t-) tubules, so that in place of the normal triadic arrangement, pentadic and heptadic junctions, formed by multiple interacting layers of ST and t-tubules are seen. Frequency of pentads and heptads increases and declines in parallel to the denervation and reinnervation but with a delay. Immunofluorecence and electron microscopy observations show presence of DHPR and ryanodine receptor clusters at pentads and heptads junctions. A significant (P muscle fibres indicating that overexpression of DHPRs accompanies the build up extra junctional contacts. The results indicate that denervation reversibly affects the domains of the membrane systems involved in excitation-contraction coupling.

  4. Chest tube insertion - series (image)

    Science.gov (United States)

    Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed in the pleural space. The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest ...

  5. Mass chest radiography in Greece

    International Nuclear Information System (INIS)

    Papavasiliou, C.

    1987-01-01

    In Greece mass chest radiography has been performed regularly on various population groups as a measure to control tuberculosis. Routine chest radiography is performed in most Greek hospitals on admission. In this report available data-admittedly inadequate-directly or indirectly addressing the problem of benefit versus the risk or cost associated with this examination is presented

  6. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Prosch, H.; Negrin, L.

    2014-01-01

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [de

  7. Ultrasonography of chest wall lesion

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  8. Ultrasonography of chest wall lesion

    International Nuclear Information System (INIS)

    Park, Cheol Min; Kim, C. H.; Cha, I. H.; Chung, K. B.; Ser, W. H.; Choi, Y. H.

    1989-01-01

    Thirty-one patients with chest wall diseases were studied with ultrasound to evaluate its role in chest wall lesions. There were eight infectious conditions, 9 benign tumors, 11 malignant lesions and 3 miscellaneous cases. Diffuse chest wall thickening with heterogeneous echogenicity and obliteration of subcutaneous fat layer are findings of acute infection. In cases of tuberculous smpyema necessitates, pleural abnormality extended to the chest wall through intercostal space. Benign tumors were well demarcated, except in 4 cases of lipoma/lipomatosis. Malignant lesions showed irregular soft tissue masses, bone destruction, pleural effusion and subcutaneous invasion. Multiple enlarged lymph nodes were also shown. Ultrasound can demonstrate te internal structure, extent, depth and associated findings such as pleural effusion, bone destruction and peripheral lung involvement. Ultrasound is not only safe, non-invasive and an effective diagnostic imaging modality for chest wall disease, but can also guide aspiration or biopsy for pathologic diagnosis

  9. Your Skin

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Your Skin KidsHealth / For Kids / Your Skin What's in this ... body) are really dead skin cells. Bye-Bye Skin Cells These old cells are tough and strong, ...

  10. Endobronchial Tuberculosis and Chest Radiography

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Sasani

    2016-03-01

    Full Text Available Endobronchial tuberculosis and chest radiography I read, with interest, the article entitled “Clinical and Para-clinical Presentations of Endobronchial Tuberculosis” by Ahmadi Hoseini H. S. et al. (1 published in this journal. I would like to focus on some details about the chest X-ray of patients as elaborated by the authors in the results section. Accordingly, the findings of chest radiography in the available patients were as follows: pulmonary consolidation (75%, reduced pulmonary volume (20%, and hilar adenopathy (10%. This is an incomplete statement because the authors did not explain whether there was any normal chest radiography in the study population. In addition, it is not clear whether the X-ray examinations of the patients were normal, how many abnormal plain films yielded the presented data. On the other hand, the fact that the studied patients had no normal chest radiography is  controversial since in the literature, 10-20% of the patients with endobronchial tuberculosis are reported to have normal chest X-ray (2, 3. In fact, this is one of the problems in the diagnosis of the disease, as well as a potential cause of delayed diagnosis and treatment of the patients. Therefore, the absence of normal chest radiographs is in contrast to the available literature, and if not an error, it could be a subject of further investigation.

  11. Reinnervation of the diaphragm by the inferior laryngeal nerve to the phrenic nerve in ventilator-dependent tetraplegic patients with C3-5 damage.

    Science.gov (United States)

    Verin, Eric; Morelot-Panzini, Capucine; Gonzalez-Bermejo, Jesus; Veber, Benoit; Perrouin Verbe, Brigitte; Soudrie, Brigitte; Leroi, Anne Marie; Marie, Jean Paul; Similowski, Thomas

    2017-10-01

    The aim of this study was to evaluate the feasibility of unilateral diaphragmatic reinnervation in humans by the inferior laryngeal nerve. This pilot study included chronically ventilated tetraplegic patients with destruction of phrenic nerve motoneurons. Five patients were included. They all had a high level of tetraplegia, with phrenic nerve motor neuron destruction. They were highly dependent on ventilation, without any possibility of weaning. They did not have other chronic pathologies, especially laryngeal disease. They all had diaphragmatic explorations to diagnose the destruction of the motoneurons of the phrenic nerves and nasoendoscopy to be sure that they did not have laryngeal or pharyngeal disease. Then, surgical anastomosis of the right phrenic nerve was performed with the inferior laryngeal nerve, by a cervical approach. A laryngeal reinnervation was performed at the same time, using the ansa hypoglossi. One patient was excluded because of a functional phrenic nerve and one patient died 6 months after the surgery of a cardiac arrest. The remaining three patients were evaluated after the anastomosis every 6 months. They did not present any swallowing or vocal alterations. In these three patients, the diaphragmatic explorations showed that there was a recovery of the diaphragmatic electromyogram of the right and left hemidiaphragms after 1 year. Two patients had surgical diaphragmatic explorations for diaphragmatic pacing 18-24 months after the reinnervation with excellent results. At 36 months, none of the patients could restore their automatic ventilation. In conclusion, this study demonstrated that diaphragmatic reinnervation by the inferior laryngeal nerve is effective, without any vocal or swallowing complications.

  12. Comparative study of 6 MV and 15 MV treatment plans for large chest wall irradiation

    International Nuclear Information System (INIS)

    Prasana Sarathy, N.; Kothanda Raman, S.; Sen, Dibyendu; Pal, Bipasha

    2007-01-01

    Conventionally, opposed tangential fields are used for the treatment of chest wall irradiation. If the chest wall is treated in the linac, 4 or 6 MV photons will be the energy of choice. It is a welI-established rule that for chest wall separations up to 22 cm, one can use mid-energies, with acceptable volume of hot spots. For larger patient sizes (22 cm and above), mid-energy beams produce hot spots over large volumes. The purpose of this work is to compare plans made with 6 and 15 MV photons, for patients with large chest wall separations. The obvious disadvantage in using high-energy photons for chest wall irradiation is inadequate dose to the skin. But this can be compensated by using a bolus of suitable thickness

  13. Radiology illustrated. Chest radiology

    International Nuclear Information System (INIS)

    Lee, Kyung Soo; Han, Joungho; Chung, Man Pyo; Jeong, Yeon Joo

    2014-01-01

    Pattern approach to the diagnosis of lung diseases based on CT scan appearances. Guide to quick and reliable differential diagnosis. CT-pathology correlation. Emphasis on state-of-the-art MDCT. The purpose of this atlas is to illustrate how to achieve reliable diagnoses when confronted by the different abnormalities, or ''disease patterns'', that may be visualized on CT scans of the chest. The task of pattern recognition has been greatly facilitated by the advent of multidetector CT (MDCT), and the focus of the book is very much on the role of state-of-the-art MDCT. A wide range of disease patterns and distributions are covered, with emphasis on the typical imaging characteristics of the various focal and diffuse lung diseases. In addition, clinical information relevant to differential diagnosis is provided and the underlying gross and microscopic pathology is depicted, permitting CT-pathology correlation. The entire information relevant to each disease pattern is also tabulated for ease of reference. This book will be an invaluable handy tool that will enable the reader to quickly and easily reach a diagnosis appropriate to the pattern of lung abnormality identified on CT scans.

  14. The effects of denervation, reinnervation, and muscle imbalance on functional muscle length and elbow flexion contracture following neonatal brachial plexus injury.

    Science.gov (United States)

    Weekley, Holly; Nikolaou, Sia; Hu, Liangjun; Eismann, Emily; Wylie, Christopher; Cornwall, Roger

    2012-08-01

    The pathophysiology of paradoxical elbow flexion contractures following neonatal brachial plexus injury (NBPI) is incompletely understood. The current study tests the hypothesis that this contracture occurs by denervation-induced impairment of elbow flexor muscle growth. Unilateral forelimb paralysis was created in mice in four neonatal (5-day-old) BPI groups (C5-6 excision, C5-6 neurotomy, C5-6 neurotomy/repair, and C5-T1 global excision), one non-neonatal BPI group (28-day-old C5-6 excision), and two neonatal muscle imbalance groups (triceps tenotomy ± C5-6 excision). Four weeks post-operatively, motor function, elbow range of motion, and biceps/brachialis functional lengths were assessed. Musculocutaneous nerve (MCN) denervation and reinnervation were assessed immunohistochemically. Elbow flexion motor recovery and elbow flexion contractures varied inversely among the neonatal BPI groups. Contracture severity correlated with biceps/brachialis shortening and MCN denervation (relative axon loss), with no contractures occurring in mice with MCN reinnervation (presence of growth cones). No contractures or biceps/brachialis shortening occurred following non-neonatal BPI, regardless of denervation or reinnervation. Neonatal triceps tenotomy did not cause contractures or biceps/brachialis shortening, nor did it worsen those following neonatal C5-6 excision. Denervation-induced functional shortening of elbow flexor muscles leads to variable elbow flexion contractures depending on the degree, permanence, and timing of denervation, independent of muscle imbalance. Copyright © 2012 Orthopaedic Research Society.

  15. The relationship of over density to overexposure each film/screen systems in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Min; Huo Joon [Korea University, Seoul (Korea, Republic of); Taro, Hayash; Yuji, Ishida; Tatsuya, Sakurai [The Chemotherapeutic Istitute Hospital, Tokyo (Japan)

    1999-06-01

    This study is to calculate the exposed radiation dose using Bit method, NDD calculation method and monogram method without dosimeter. In addition,we can calculate the radiation dose from x-ray film density as a film badge. The authors examined the entrance skin dose from 2 {approx} 3 intercostal chest x-ray film density. We also studied the relationship between film density and equivalent dose in the each screen film system under the different radiation quality and the poor geometry condition of grid ratio. As results, we established the deductive method to define the entrance skin dose from chest x-ray film density. The error range was found in the range -13 percent {approx} +17 percent for between deductive entrance skin dose and the 2 {approx} 3 inter coastal chest x-ray film density to actual detective radiation dose with dosimeter. (author)

  16. Interpretation of neonatal chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-05-15

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

  17. Interpretation of neonatal chest radiography

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung

    2016-01-01

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice

  18. CT findings of chest trauma

    International Nuclear Information System (INIS)

    Kim, Young Tong; Kim Young Il

    1998-01-01

    Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 persons under 40 years of age. Most pleural, pulmonary, mediastinal, and diaphragmatic injuries are not seen on conventional chest radiographs, or are underestimated. In patients with chest trauma, CT scanning is an effective and sensitive method of detecting thoracic injuries and provides accurate information regarding their pattern and extent. (author). 5 refs., 17 figs

  19. Confocal comparison of corneal reinnervation after small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).

    Science.gov (United States)

    Li, Meiyan; Niu, Lingling; Qin, Bing; Zhou, Zimei; Ni, Katherine; Le, Qihua; Xiang, Jun; Wei, Anji; Ma, Weiping; Zhou, Xingtao

    2013-01-01

    To evaluate corneal reinnervation, and the corresponding corneal sensitivity and keratocyte density after small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK). In this prospective, non-randomized observational study, 18 patients (32 eyes) received SMILE surgery, and 22 patients (42 eyes) received FS-LASIK surgery to correct myopia. The corneal subbasal nerve density and microscopic morphological changes in corneal architecture were evaluated by confocal microscopy prior to surgery and at 1 week, 1 month, 3 months, and 6 months after surgery. A correlation analysis was performed between subbasal corneal nerve density and the corresponding keratocyte density and corneal sensitivity. The decrease in subbasal nerve density was less severe in SMILE-treated eyes than in FS-LASIK-treated eyes at 1 week (P = 0.0147), 1 month (P = 0.0243), and 3 months (P = 0.0498), but no difference was detected at the 6-month visit (P = 0.5277). The subbasal nerve density correlated positively with central corneal sensitivity in both groups (r = 0.416, PLASIK group, respectively). The SMILE-treated eyes have a lower risk of developing peripheral empty space with epithelial cells filling in (P = 0.0005). The decrease in subbasal nerve fiber density was less severe in the SMILE group than the FS-LASIK group in the first 3 months following the surgeries. The subbasal nerve density was correlated with central corneal sensitivity.

  20. Neo-phalloplasty with re-innervated latissimus dorsi free flap: a functional study of a novel technique.

    Science.gov (United States)

    Ranno, R; Veselý, J; Hýza, P; Stupka, I; Justan, I; Dvorák, Z; Monni, N; Novák, P; Ranno, S

    2007-01-01

    Twenty two patients with gender dysphoria underwent neo-phalloplasties using a novel technique. Latissimus dorsi musculocutaneus re-innervated free flap was used to allow voluntary rigidity of the neo-penis. From the first 22 patients, 18 have obtained motoric function of reconstructed penis; the "paradox erection" was obtained. 14 patients came for examination after a follow-up period of mean 26.4 months. We evaluated the motility and shape changes of neo-phallus measuring its different size and dimension during relax and muscle contraction. The range of neo-phallus length in relaxed position was between 7 and 17 cm (mean 12.2 cm), its circumference in the same position had a range between 13 and 20 cm (mean 13.7 cm). All patients were able to contract the muscle with an average length reduction of 3.08 cm and an average circumference enlargement of 4 cm. In this study, the dimensions and motility were quantified demonstrating the neo-phallus function and size changes during sexual intercourse.

  1. Skin Conditions

    Science.gov (United States)

    Your skin is your body's largest organ. It covers and protects your body. Your skin Holds body fluids in, preventing dehydration Keeps harmful ... it Anything that irritates, clogs, or inflames your skin can cause symptoms such as redness, swelling, burning, ...

  2. Skin abscess

    Science.gov (United States)

    Abscess - skin; Cutaneous abscess; Subcutaneous abscess; MRSA - abscess; Staph infection - abscess ... Skin abscesses are common and affect people of all ages. They occur when an infection causes pus ...

  3. Chest tube placement in thorax trauma - comparison chest X-ray and computed tomography (CT)

    International Nuclear Information System (INIS)

    Heim, P.; Maas, R.; Buecheler, E.; Tesch, C.

    1998-01-01

    Estimation of chest tube placement in patients with thoracic trauma with regard to chest tube malposition in chest radiography in the supine position compared to additional computed tomography of the thorax. Material and methods: Apart from compulsory chest radiography after one or multiple chest tube insertions, 31 severely injured patients with thoracic trauma underwent a CT scan of the thorax. These 31 patients with 40 chest tubes constituted the basis for the present analysis. Results: In chest radiography in the supine position there were no chest tube malpositions (n=40); In the CT scans 25 correct positions, 7 pseudo-malpositions, 6 intrafissural and 2 intrapulmonary malpositions were identified. Moreover 16 sufficient, 18 insufficient and 6 indifferent functions of the chest tubes were seen. Conclusion: In case of lasting clinical problems and questionable function of the chest tube, chest radiography should be supplemented by a CT scan of the thorax in order to estimate the position of the chest tube. (orig.) [de

  4. 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.)

  5. 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.

  6. Chest Wall tumor: combined management

    International Nuclear Information System (INIS)

    Rao Bhaskar, N.

    1997-01-01

    Cancer is relatively rare disease among children and adolescents. The incidence of solid tumors other than CNS is less than 2/100,000. Tumors of the chest wall can arise either from the somatic tissue or ribs. These are rare, so either institutional reviews or multi institutional studies should determine optimal therapeutic management. Of the bony chest wall, Ewing's sarcoma or the family of tumor (peripheral neuro epithelioma, Askin tumor), are the most common. These lesions are lytic and have associated large extra pleural component. This large extra pleural component often necessitates major chest wall resection (3 or more ribs), and when lower ribs are involved, this entails resection of portion of diaphragm. Despite this resection, survival in the early 1970 was 10-20%. Since 1970 multi agent chemotherapy has increased survival rates. of importance, however, is these regimens have caused significant reduction of these extra pleural components so that major chest wall resections have become a rarity. With improved survival and decreased morbidity preoperative chemotherapy followed by surgery is now the accepted modality of treatment. Another major advantage of this regimen is that potential radiation therapy may be obviated. The most common chest wall lesion is rhabdomyosarcoma. In the IRS study of 1620 RMS patients, in 141 (9%) the primary lesion was in the chest wall. these are primarily alveolar histology. when lesions were superficial, wide local excision with supplemental radiation therapy was associated with low morbidity and good overall survival. however, a majority have significant intra- thoracic components. in these circumstances the resectability rate is less than 30% and the survival poor. Other lesions include non rhabdomyosarcomas, eosinophilic granuloma, chondrosarcoma, and osteomyelitis. The management of these lesions varies according to extent, histology, and patient characteristics

  7. Revision of orthovoltage chest wall treatment using Monte Carlo simulations.

    Science.gov (United States)

    Zeinali-Rafsanjani, B; Faghihi, R; Mosleh-Shirazi, M A; Mosalaei, A; Hadad, K

    2017-01-01

    Given the high local control rates observed in breast cancer patients undergoing chest wall irradiation by kilovoltage x-rays, we aimed to revisit this treatment modality by accurate calculation of dose distributions using Monte Carlo simulation. The machine components were simulated using the MCNPX code. This model was used to assess the dose distribution of chest wall kilovoltage treatment in different chest wall thicknesses and larger contour or fat patients in standard and mid sternum treatment plans. Assessments were performed at 50 and 100 cm focus surface distance (FSD) and different irradiation angles. In order to evaluate different plans, indices like homogeneity index, conformity index, the average dose of heart, lung, left anterior descending artery (LAD) and percentage target coverage (PTC) were used. Finally, the results were compared with the indices provided by electron therapy which is a more routine treatment of chest wall. These indices in a medium chest wall thickness in standard treatment plan at 50 cm FSD and 15 degrees tube angle was as follows: homogeneity index 2.57, conformity index 7.31, average target dose 27.43 Gy, average dose of heart, lung and LAD, 1.03, 2.08 and 1.60 Gy respectively and PTC 11.19%. Assessments revealed that dose homogeneity in planning target volume (PTV) and conformity between the high dose region and PTV was poor. To improve the treatment indices, the reference point was transferred from the chest wall skin surface to the center of PTV. The indices changed as follows: conformity index 7.31, average target dose 60.19 Gy, the average dose of heart, lung and LAD, 3.57, 6.38 and 5.05 Gy respectively and PTC 55.24%. Coverage index of electron therapy was 89% while it was 22.74% in the old orthovoltage method and also the average dose of the target was about 50 Gy but in the given method it was almost 30 Gy. The results of the treatment study show that the optimized standard and mid sternum treatment for different chest

  8. Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Chardoli Mojtaba

    2013-12-01

    Full Text Available 【Abstract】 Objective: Thoracic injuries are respon- sible for 25% of deaths of blunt traumas. Chest X-ray (CXR is the first diagnostic method in patients with blunt trauma. The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy (CT in hemodynami- cally stable patients with blunt chest trauma. Methods: Study was conducted at the emergency department of Sina Hospital from March 2011 to March 2012. Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included. All patients underwent the same diagnostic protocol which consisted of physical examination, CXR and CT scan respectively. Results: Two hundreds patients (84% male and 16% female were included with a mean age of (37.9±13.7 years. Chin J Traumatol 2013;16(6:351-354 Rib fracture was the most common finding of CXR (12.5% and CT scan (25.5%. The sensitivity of CXR for hemothorax, thoracolumbar vertebra fractures and rib fractures were 20%, 49% and 49%, respectively. Pneumothorax, foreign body, emphysema, pulmonary contusion, liver hematoma and ster- num fracture were not diagnosed with CXR alone. Conclusion: Applying CT scan as the first-line diag- nostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome. Key words: Radiography; Thoracic injuries; Tomography, X-ray computed

  9. Skin Cancer.

    Science.gov (United States)

    Linares, Miguel A; Zakaria, Alan; Nizran, Parminder

    2015-12-01

    Skin cancer accounts for most malignancies across the globe. They are primarily divided into melanoma and nonmelanoma skin malignancies. Nonmelanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma. Fair skin and chronic ultraviolet B exposure are the most important risk factors. Primary prevention is achieved by avoiding sun exposure and tanning beds. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Computed tomography of chest trauma

    International Nuclear Information System (INIS)

    Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

    1987-01-01

    Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient. (orig.) [de

  11. Computed tomography of chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Dinkel, E.; Uhl, H.; Reinbold, W.D.; Wimmer, B.; Wenz, W.

    1987-09-01

    Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. CT proved to be a more sensitive method for detection of parenchymal lung lesions and occult pneumothorax than bedside radiographs. CT contributed substantially in differentiation of lung abscess and empyema, exclusion of mediastinal pathology and spinal injuries. Aortography is still indicated, even when CT findings are normal, if aortic laceration is clinically suspected. Despite all technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for selected problems in the traumatized patient.

  12. Contemporary management of flail chest.

    Science.gov (United States)

    Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A

    2014-06-01

    Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management.

  13. Nuclear imaging of the chest

    International Nuclear Information System (INIS)

    Bahk, Y.W.

    1998-01-01

    This book provides up-to-the minute information on the diagnostic nuclear imaging of chest disorders. The authors have endeavored to integrate and consolidate the many different subspecialities in order to enable a holistic understanding of chest diseases from the nuclear medicine standpoint. Highlights of the book include in addition to the cardiac scan the description of aerosol lung imaging in COPD and other important pulmonary diseases and the updates on breast and lung cancer imaging, as well as imaging of the bony thorax and esophagus. It is required reading not only for nuclear medicine practitioners and researchers but also for all interested radiologists, traumatologists, pulmonologists, oncologists and cardiologists. (orig.)

  14. Skin tightening.

    Science.gov (United States)

    Woolery-Lloyd, Heather; Kammer, Jenna N

    2011-01-01

    Skin tightening describes the treatment of skin laxity via radiofrequency (RF), ultrasound, or light-based devices. Skin laxity on the face is manifested by progressive loss of skin elasticity, loosening of the connective tissue framework, and deepening of skin folds. This results in prominence of submandibular and submental tissues. Genetic factors (chronological aging) and extrinsic factors (ultraviolet radiation) both contribute to skin laxity. There are many RF, ultrasound, and light-based devices directed at treating skin laxity. All of these devices target and heat the dermis to induce collagen contraction. Heating of the dermis causes collagen denaturation and immediate collagen contraction in addition to long-term collagen remodeling. Via RF, light, or ultrasound, these skin tightening devices deliver heat to the dermis to create new collagen and induce skin tightening. This chapter will provide an overview of the various skin tightening devices. Copyright © 2011 S. Karger AG, Basel.

  15. Confocal comparison of corneal reinnervation after small incision lenticule extraction (SMILE and femtosecond laser in situ keratomileusis (FS-LASIK.

    Directory of Open Access Journals (Sweden)

    Meiyan Li

    Full Text Available PURPOSE: To evaluate corneal reinnervation, and the corresponding corneal sensitivity and keratocyte density after small incision lenticule extraction (SMILE and femtosecond laser in situ keratomileusis (FS-LASIK. METHODS: In this prospective, non-randomized observational study, 18 patients (32 eyes received SMILE surgery, and 22 patients (42 eyes received FS-LASIK surgery to correct myopia. The corneal subbasal nerve density and microscopic morphological changes in corneal architecture were evaluated by confocal microscopy prior to surgery and at 1 week, 1 month, 3 months, and 6 months after surgery. A correlation analysis was performed between subbasal corneal nerve density and the corresponding keratocyte density and corneal sensitivity. RESULTS: The decrease in subbasal nerve density was less severe in SMILE-treated eyes than in FS-LASIK-treated eyes at 1 week (P = 0.0147, 1 month (P = 0.0243, and 3 months (P = 0.0498, but no difference was detected at the 6-month visit (P = 0.5277. The subbasal nerve density correlated positively with central corneal sensitivity in both groups (r = 0.416, P<0.0001, and r = 0.2567, P = 0.0038 for SMILE group and FS-LASIK group, respectively. The SMILE-treated eyes have a lower risk of developing peripheral empty space with epithelial cells filling in (P = 0.0005. CONCLUSIONS: The decrease in subbasal nerve fiber density was less severe in the SMILE group than the FS-LASIK group in the first 3 months following the surgeries. The subbasal nerve density was correlated with central corneal sensitivity.

  16. Reinnervation of Vastus lateralis is increased significantly in seniors (70-years old with a lifelong history of high-level exercise

    Directory of Open Access Journals (Sweden)

    Simone Mosole

    2013-12-01

    Full Text Available It has long been recognized that histological changes observed in aging muscle suggest that denervation contributes to muscle deterioration and that disuse accelerates the process while running activity, sustained for decades, protects against age-related loss of motor units. Here we show at the histological level that lifelong increased physical activity promotes reinnervation of muscle fibers. In muscle biopsies from 70-year old men with a lifelong history of high-level physical activity, we observed a considerable increase in fiber-type groupings (almost exclusively of the slow type in comparison to sedentary seniors, revealing a large population of reinnervated muscle fibers in the sportsmen. Slow-type transformation by reinnervation in senior sportsmen seems to be a clinically relevant mechanism: the muscle biopsies fluctuate from those with scarce fiber-type transformation and groupings to almost fully transformed muscle, going through a process in which isolated fibers co-expressing fast and slow MHCs seems to fill the gaps. Taken together, our results suggest that, beyond the direct effects of aging on the muscle fibers, changes occurring in skeletal muscle tissue appear to be largely, although not solely, a result of sparse denervation. Our data suggest that lifelong exercise allows the body to adapt to the consequences of the age-related denervation and to preserve muscle structure and function by saving otherwise lost muscle fibers through recruitment to different, mainly slow, motor units. These beneficial effects on motoneurons and, subsequently on muscle fibers, serve to maintain size, structure and function of muscle fibers, delaying the functional decline and loss of independence that are commonly seen in late aging.

  17. Functional activity of substantia nigra grafts reinnervating the striatum: neurotransmitter metabolism and (14C)2-deoxy-D-glucose autoradiography. [Rats

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, R H; Ingvar, M; Lindvall, O; Stenevi, U; Bjoerklund, A

    1982-03-01

    Dopaminergic innervation of the caudate nucleus in adult rats can be partially restored by the grafting of embryonic substantia nigra into the overlying parietal cortex with concomitant compensation of certain behavioral abnormalities. In this study the function of such grafts was investigated neurochemically by quantification of transmitter metabolism and glucose utilization in the reinnervated target. Rats with unilateral 6-hydroxydopamine lesions of the nigrostriatal bundle received a single graft to the dorsal caudate-putamen and were screened for rotational behavior following 5 mg/kg methamphetamine. The grafts restored dopamine concentrations in the caudate-putamen from initially less than 0.5% to an average of 13.6% of normal in rats with behavioral compensation. The ratio of 3,4-dihydroxyphenylacetic acid to dopamine, which is a measure of the rate of transmitter turnover, were equivalent in transplanted and normal control rats. Moreover, measurements of DOPA accumulation for a 30-min period after DOPA decarboxylase inhibition indicated similar fractional dopamine turnover rates in normal and transplant-reinnervated tissues. Correlations between rotational behavior and dopamine concentrations showed that reinnervation to only 3% of normal was sufficient to counterbalance the motor asymmetry. Measurements of glucose utilization by (14C)deoxyglucose autoradiography indicated equivalent metabolic rates for the grafted tissue and the intact substantia nigra. Overall the results indicate that behaviorally functional neuronal grafts spontaneously metabolize dopamine and utilize glucose at rates characteristic of the intact nigrostriatal system. This provides further evidence that ectopic intracortical nigral transplants can reinstate dopaminergic neurotransmission in regions of the host brain initially denervated by the 6-hydroxydopamine lesion.

  18. Imaging of chest wall infections

    International Nuclear Information System (INIS)

    Chelli Bouaziz, Mouna; Jelassi, Helmi; Chaabane, Skander; Ladeb, Mohamed Fethi; Ben Miled-Mrad, Khaoula

    2009-01-01

    A wide variety of infections can affect the chest wall including pyogenic, tuberculous, fungal, and some other unusual infections. These potentially life-threatening disorders are frequent especially among immunocompromised patients but often misdiagnosed by physical examination and radiographs. The purpose of this article is to describe the clinical and imaging features of these different chest wall infections according to the different imaging modalities with emphasis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The outcome of chest wall infection depends on early diagnosis, severity of the immunosuppression, offending organism, and extent of infection. Because clinical findings and laboratory tests may be not contributive in immunocompromised patients, imaging plays an important role in the early detection and precise assessment of the disease. US, CT, and MRI are all useful: bone destruction is more accurately detected with CT whereas soft tissue involvement are better visualized with US and MRI. CT and US are also used to guide percutaneous biopsy and drainage procedures. MR images are helpful in pre-operative planning of extensive chest wall infections. (orig.)

  19. Radiology of blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Shulman, H.S.; Samuels, T.H. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

    1983-09-01

    Chest injuries and related complications prove fatal in over half of the victims of multiple trauma. The radiologist's responsibility is twofold: a) to recognize key radiographic signs and b) to guide the clinician in the radiologic investigation and management of the patient. The important diagnoses to be recognized from radiographs are pneumothorax, aortic rupture, bronhcial rupture and diaphragmatic rupture.

  20. Managing a chest tube and drainage system.

    Science.gov (United States)

    Durai, Rajaraman; Hoque, Happy; Davies, Tony W

    2010-02-01

    Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport. This article provides an overview of indications, insertion techniques, and management of chest tubes. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. Skin Complications

    Science.gov (United States)

    ... Text Size: A A A Listen En Español Skin Complications Diabetes can affect every part of the ... lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis. General Skin Conditions Bacterial Infections Several kinds of bacterial infections ...

  3. Cryotherapy - skin

    Science.gov (United States)

    Cryosurgery - skin; Warts - freezing; Warts - cryotherapy; Actinic keratosis - cryotherapy; Solar keratosis - cryotherapy ... may be used to: Remove warts Destroy precancerous skin lesions (actinic keratoses or solar keratoses) In rare ...

  4. Skin Cancer

    Science.gov (United States)

    Skin cancer is the most common form of cancer in the United States. The two most common types ... face, neck, hands, and arms. Another type of skin cancer, melanoma, is more dangerous but less common. Anyone ...

  5. Sagging Skin

    Science.gov (United States)

    ... turkey neck,” this occurs as skin loses its elasticity and in cases where individuals have lost a ... technique or procedure is appropriate for my skin type? Did the doctor show me before-and-after ...

  6. Skin Biopsy

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... like these: skin rashes or conditions, such as eczema or psoriasis skin infections, such as staph diseases, ...

  7. Regionally adaptive histogram equalization of the chest

    International Nuclear Information System (INIS)

    Sherrier, R.H.; Johnson, G.A.

    1986-01-01

    Advances in digital chest radiography have resulted in the acquisition of high-quality digital images of the human chest. With these advances, there arises a genuine need for image processing algorithms, specific to chest images. The author has implemented the technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with a regionally adaptive histogram equalization method. Histograms are calculated locally and then modified according to both the mean pixel value of a given region and certain characteristics of the cumulative distribution function. The method allows certain regions of the chest radiograph to be enhanced differentially

  8. Skin Graft

    OpenAIRE

    Shimizu, Ruka; Kishi, Kazuo

    2012-01-01

    Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin grafts are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital skin deficiencies, hair restoration, vitiligo, and nipple-areola reconstruction. Skin grafts are generally avoided in the management of more complex wounds. Conditions with deep spaces and exposed bones normally require the use o...

  9. Diaphragmatic reinnervation in ventilator-dependent patients with cervical spinal cord injury and concomitant phrenic nerve lesions using simultaneous nerve transfers and implantable neurostimulators.

    Science.gov (United States)

    Kaufman, Matthew R; Elkwood, Andrew I; Aboharb, Farid; Cece, John; Brown, David; Rezzadeh, Kameron; Jarrahy, Reza

    2015-06-01

    Patients who are ventilator dependent as a result of combined cervical spinal cord injury and phrenic nerve lesions are generally considered to be unsuitable candidates for diaphragmatic pacing due to loss of phrenic nerve integrity and denervation of the diaphragm. There is limited data regarding efficacy of simultaneous nerve transfers and diaphragmatic pacemakers in the treatment of this patient population. A retrospective review was conducted of 14 consecutive patients with combined lesions of the cervical spinal cord and phrenic nerves, and with complete ventilator dependence, who were treated with simultaneous microsurgical nerve transfer and implantation of diaphragmatic pacemakers. Parameters of interest included time to recovery of diaphragm electromyographic activity, average time pacing without the ventilator, and percent reduction in ventilator dependence. Recovery of diaphragm electromyographic activity was demonstrated in 13 of 14 (93%) patients. Eight of these 13 (62%) patients achieved sustainable periods (> 1 h/d) of ventilator weaning (mean = 10 h/d [n = 8]). Two patients recovered voluntary control of diaphragmatic activity and regained the capacity for spontaneous respiration. The one patient who did not exhibit diaphragmatic reinnervation remains within 12 months of initial treatment. Surgical intervention resulted in a 25% reduction (p nerve transfers and pacemaker implantation can result in reinnervation of the diaphragm and lead to successful ventilator weaning. Our favorable outcomes support consideration of this surgical method for appropriate patients who would otherwise have no alternative therapy to achieve sustained periods of ventilator independence. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Skin Aging

    Science.gov (United States)

    Your skin changes as you age. You might notice wrinkles, age spots and dryness. Your skin also becomes thinner and loses fat, making it ... heal, too. Sunlight is a major cause of skin aging. You can protect yourself by staying out ...

  11. Digital radiography of the chest

    International Nuclear Information System (INIS)

    Sakurai, Kenji; Hachiya, Junichi; Korenaga, Tateo; Nitatori, Toshiaki; Miyasaka, Yasuo; Furuya, Yoshiro

    1984-01-01

    Initial clinical experience in digital chest radiography utilizing photostimulable phosphor and scanning laser stimulated luminescence was reported. Image quality of conventional film/screen radiography and digital radiography was compared in 30 normal cases. Reflecting wide dynamic range of the system, improved image quality was confirmed in all 30 cases, particularly in visibility of various mediastinal structures and pulmonary vessels. High sensor sensitivity of the system enabled digital radiography to reduce radiation dose requirement significantly. Diagnostically acceptable chest images were obtained with approximately 1/5 of routine dose for conventional radiography without significant image quality degradation. Some artifact created by digital processing were mostly overcome by a routine use of simultaneous display of two different types of image processing and therefore was not an actual drawback from diagnostic standpoint. Further technical advancement of the system to be seen for digital storage, retrieval and tranceference of images. (author)

  12. Gastric tumors on chest radiographs

    International Nuclear Information System (INIS)

    Tamura, Shozo; Kawanami, Takashi; Russell, W.J.

    1978-04-01

    Gastric neoplasms of three patients protruded into their gas-containing fornices and were first visualized on plain chest radiographs. Endoscopy and/or surgery confirmed these to be a polyp, a leiomyoma, and an adenocarcinoma. The polyp, 1.3 cm in diameter, was the smallest of these three, but smaller lesions may be detectable under suitable conditions. Adequate technique and positioning, sufficiently large lesions in the upper portion of the stomach, a central beam tangential to the tumor, sufficient gas in the stomach, and careful scrutiny by the observer are required. Lesions may be more readily visualized during chest radiography when oral sodium bicarbonate is used to distend the stomach. In chest radiography, exposure limited to the lung fields has been advocated for economy and dose reduction. However, too small an exposure field may result in loss of information potentially beneficial to the patient. Using the smaller of two popular film sizes (35 x 43 cm and 35 x 35 cm), the saving in surface and bone marrow doses is negligible, and the saving in gonad dose may be nil over that when shielding is used. The interest of the observer may be absorbed by a concomitant cardiac or pulmonary lesion. Careful scrutiny of the entire radiograph is therefore essential. (author)

  13. Chest tomosynthesis: technical and clinical perspectives.

    Science.gov (United States)

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Entrance skin dose on patients undergoing X-ray examinations at ...

    African Journals Online (AJOL)

    survey was conducted on the Entrance Skin Dose (ESD) in patients undergoing X-ray examinations [Skull Postero-Anterior (PA), Skull Lateral (LAT), Chest Postero-Anterior (PA), Chest Lateral (LAT), Abdomen Antero-Posterior (AP) and Pelvis Antero-Posterior (AP)] in five hospitals/Xray centres in Yaba, Lagos State, Nigeria ...

  15. 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)

  16. Imaging of fetal chest masses

    Energy Technology Data Exchange (ETDEWEB)

    Barth, Richard A. [Lucile Packard Children' s Hospital, Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2012-01-15

    Prenatal imaging with high-resolution US and rapid acquisition MRI plays a key role in the accurate diagnosis of congenital chest masses. Imaging has enhanced our understanding of the natural history of fetal lung masses, allowing for accurate prediction of outcome, parental counseling, and planning of pregnancy and newborn management. This paper will focus on congenital bronchopulmonary malformations, which account for the vast majority of primary lung masses in the fetus. In addition, anomalies that mimic masses and less common causes of lung masses will be discussed. (orig.)

  17. 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.

  18. Coronary artery dissection following chest trauma

    Directory of Open Access Journals (Sweden)

    Manoj K Agarwala

    2016-01-01

    Full Text Available Chest trauma has a high rate of mortality. Coronary dissection causing myocardial infarction (MI following blunt chest trauma is rare. We describe the case of an anterior MI following blunt chest trauma. A 39-year-old male was received in our hospital following a motorcycle accident. The patient was asymptomatic before the accident. The patient underwent craniotomy for evacuation of hematoma. He developed severe chest pain and an electrocardiogram (ECG revealed anterior ST segment elevation following surgery. Acute coronary event was medically managed; subsequently, coronary angiogram was performed that showed dissection in the left anterior coronary artery, which was stented.

  19. Improved drainage with active chest tube clearance.

    Science.gov (United States)

    Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Arakawa, Yoko; Horai, Tetsuya; Boyle, Edward M; Gillinov, A Marc; Fukamachi, Kiyotaka

    2010-05-01

    This study was performed to evaluate the efficacy of a novel chest drainage system. This system employs guide wire-based active chest tube clearance to improve drainage and maintain patency. A 32 Fr chest tube was inserted into pleural cavities of five pigs. On the left, a tube was connected to the chest canister, and on the right, the new system was inserted between the chest tube and chest canister. Acute bleeding was mimicked by periodic infusion of blood. The amount of blood drained from each chest cavity was recorded every 15 min for 2 h. After completion of the procedure, all residual blood and clots in each chest cavity were assessed. The new system remained widely patent, and the amount of drainage achieved with this system (670+/-105 ml) was significantly (P=0.01) higher than that with the standard tube (239+/-131 ml). The amount of retained pleural blood and clots with this system (150+/-107 ml) was significantly (P=0.04) lower than that with the standard tube (571+/-248 ml). In conclusion, a novel chest drainage system with active tube clearance significantly improved drainage without tube manipulations. 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. 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.

  1. Dry Skin Relief

    Science.gov (United States)

    ... on a budget Skin care products Skin care secrets Skin lighteners Skin of color Summer skin problems ... condition, such as eczema. Additional related information Dermatologists' top tips for relieving dry skin FIND A DERMATOLOGIST ...

  2. 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...

  3. Clinical Databases for Chest Physicians.

    Science.gov (United States)

    Courtwright, Andrew M; Gabriel, Peter E

    2018-04-01

    A clinical database is a repository of patient medical and sociodemographic information focused on one or more specific health condition or exposure. Although clinical databases may be used for research purposes, their primary goal is to collect and track patient data for quality improvement, quality assurance, and/or actual clinical management. This article aims to provide an introduction and practical advice on the development of small-scale clinical databases for chest physicians and practice groups. Through example projects, we discuss the pros and cons of available technical platforms, including Microsoft Excel and Access, relational database management systems such as Oracle and PostgreSQL, and Research Electronic Data Capture. We consider approaches to deciding the base unit of data collection, creating consensus around variable definitions, and structuring routine clinical care to complement database aims. We conclude with an overview of regulatory and security considerations for clinical databases. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. Ultrasonographic examination in chest disease

    Energy Technology Data Exchange (ETDEWEB)

    Choe, K.O.; Lee, J.D.; Yoo, H.S. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Ultrasonographic examination is not widely applied to chest disease, but is may give useful information when the acoustic window for a lesion exist. We did perform ultrasound examination in 68 cases of chest disease. 1. The cases of pleural diseases was predominant; pleural effusion 35 cases, pleural metastatic tumor 2 case, mesothelioma 2 cases and fibrous thickening 1 case, total 40 cases. It was useful to differentiate pleural effusion and fibrous thickening or parenchymal lesion simulating pleural disease, to localize the optimal aspiration site for a loculated empyema, to detect pleural bumorhidden by effusion such as metastatic tumor or mesothelioma. 2. 15 cases of parenchymal lesion and 2 cases of extra pleural mass was examined. The echo pattern of consolidation and atelectasis shows typical multiple tubular streaks within the echogenic area. The echogenicity of the peripheral mass due to primary bronchogenic carcinoma, parenchymal or extrapleural metastatic tumor and granuloma were compared. 3. In the cases of pleural or parenchymal cystic lesions, such as loculated empyema or lung abscess, because of strong reverberation artifact from posterior border of the lesion, the prediction of cystic and solid lesion is sometimes difficult. 4. In 7 cases of mediastinal lesion, cystic lesion show free echo and posterior enhancement. In contrast, solid or fat component show characteristic echo pattern. 5. In the cases of juxta diaphragmatic lesion, sonogram can confirm the underlying intraabdominal pathology, in this case subphrenic abscess

  5. Chest complication after abdominal surgery

    International Nuclear Information System (INIS)

    Koh, B. H.; Choi, J. Y.; Hahm, C. K.; Kang, S. R.

    1981-01-01

    In spite of many advances in medicine, anesthetic technique and surgical managements, pulmonary problems are the most frequent postoperative complications, particularly after abdominal surgery. As postoperative pulmonary complications, atelectasis, pleural effusion, pneumonia, chronic bronchitis and lung abscess can be occurred. This study include evaluation of chest films of 2006 patients (927 male, 1079 female), who had been operated abdominal surgery from Jan. 1979 to June, 1980 in the Hanyang university hospital. The results were as follows: 1. 70 cases out of total 2006 cases (3.5%) developed postoperative chest complications, 51 cases (5.5%) in male, 19 cases (1.8%) in female. 2. The complication rate was increased according to the increase of age. The incidence of the postoperative complications over 40 years of age was higher than the overall average complications rate. 3. The most common postoperative pulmonary complication was pleural effusion, next pneumonia, atelectasis and pulmonary edema respectively. 4. The complication rate of the group of upper abdominal surgery is much higher than the group of lower abdominal surgery. 5. Complication rate was increased according to increase of the duration of operation. 6. There were significant correlations between the operation site and side of the complicated hemithorax

  6. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    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.

  7. Ultrasonographic examination in chest disease

    International Nuclear Information System (INIS)

    Choe, K.O.; Lee, J.D.; Yoo, H.S.

    1983-01-01

    Ultrasonographic examination is not widely applied to chest disease, but is may give useful information when the acoustic window for a lesion exist. We did perform ultrasound examination in 68 cases of chest disease. 1. The cases of pleural diseases was predominant; pleural effusion 35 cases, pleural metastatic tumor 2 case, mesothelioma 2 cases and fibrous thickening 1 case, total 40 cases. It was useful to differentiate pleural effusion and fibrous thickening or parenchymal lesion simulating pleural disease, to localize the optimal aspiration site for a loculated empyema, to detect pleural bumorhidden by effusion such as metastatic tumor or mesothelioma. 2. 15 cases of parenchymal lesion and 2 cases of extra pleural mass was examined. The echo pattern of consolidation and atelectasis shows typical multiple tubular streaks within the echogenic area. The echogenicity of the peripheral mass due to primary bronchogenic carcinoma, parenchymal or extrapleural metastatic tumor and granuloma were compared. 3. In the cases of pleural or parenchymal cystic lesions, such as loculated empyema or lung abscess, because of strong reverberation artifact from posterior border of the lesion, the prediction of cystic and solid lesion is sometimes difficult. 4. In 7 cases of mediastinal lesion, cystic lesion show free echo and posterior enhancement. In contrast, solid or fat component show characteristic echo pattern. 5. In the cases of juxta diaphragmatic lesion, sonogram can confirm the underlying intraabdominal pathology, in this case subphrenic abscess

  8. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

    OpenAIRE

    Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

    2016-01-01

    Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective coho...

  9. 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

  10. Skin cancer

    International Nuclear Information System (INIS)

    Yamada, Michiko

    1992-01-01

    This chapter reviews the development of skin cancer associated with radiation, focusing on the knowledge of A-bomb radiation-induced skin cancer. Since the discovery of X radiation in 1895, acute and chronic radiation dermatitis has been the first matter of concern. Then, in 1902, skin cancer found among radiological personnel has posed a social problem. In earlier study determining the relationship between skin cancer and A-bomb radiation, there is no increase in the incidence of either skin cancer or precancerous condition during the first 20 years after A-bombing. More recent studies have showed that there is a significant correlation between the incidence of skin cancer and distance from the hypocenter; and the incidence of skin cancer is found to be remarkably increased since 1975 in the group exposed at ≤2,000 m. Excess relative risk is 2.2 at one Gy dose. The incidence of skin cancer is also found to be extremely increased with aging. Relative risk is high in younger A-bomb survivors at the time of exposure. Histologically, basal cell carcinoma is more senstitive to ionizing radiation than squamous cell carcinoma. (N.K.)

  11. Correlations between quality indexes of chest compression.

    Science.gov (United States)

    Zhang, Feng-Ling; Yan, Li; Huang, Su-Fang; Bai, Xiang-Jun

    2013-01-01

    Cardiopulmonary resuscitation (CPR) is a kind of emergency treatment for cardiopulmonary arrest, and chest compression is the most important and necessary part of CPR. The American Heart Association published the new Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2010 and demanded for better performance of chest compression practice, especially in compression depth and rate. The current study was to explore the relationship of quality indexes of chest compression and to identify the key points in chest compression training and practice. Totally 219 healthcare workers accepted chest compression training by using Laerdal ACLS advanced life support resuscitation model. The quality indexes of chest compression, including compression hands placement, compression rate, compression depth, and chest wall recoil as well as self-reported fatigue time were monitored by the Laerdal Computer Skills and Reporting System. The quality of chest compression was related to the gender of the compressor. The indexes in males, including self-reported fatigue time, the accuracy of compression depth and the compression rate, the accuracy of compression rate, were higher than those in females. However, the accuracy of chest recoil was higher in females than in males. The quality indexes of chest compression were correlated with each other. The self-reported fatigue time was related to all the indexes except the compression rate. It is necessary to offer CPR training courses regularly. In clinical practice, it might be better to change the practitioner before fatigue, especially for females or weak practitioners. In training projects, more attention should be paid to the control of compression rate, in order to delay the fatigue, guarantee enough compression depth and improve the quality of chest compression.

  12. Advances in plasma skin regeneration.

    Science.gov (United States)

    Foster, K Wade; Moy, Ronald L; Fincher, Edgar F

    2008-09-01

    Plasma skin regeneration (PSR) is a novel method of resurfacing that uses plasma energy to create a thermal effect on the skin. PSR is different from lasers, light sources, and ablative lasers in that it is not chromophore dependent and does not vaporize tissue, but leaves a layer of intact, desiccated epidermis that acts as a natural biologic dressing and promotes wound healing and rapid recovery. Histological studies performed on plasma resurfacing patients have confirmed continued collagen production, reduction of elastosis, and progressive skin rejuvenation beyond 1 year after treatment. PSR has received US Food and Drug Administration 510 (k) clearance for treatment of rhytides of the body, superficial skin lesions, actinic keratoses, viral papillomata, and seborrheic keratoses. PSR also has beneficial effects in the treatment of other conditions including dyschromias, photoaging, skin laxity, and acne scars. The safety profile of PSR is excellent, and there have been no reports of demarcation lines in perioral, periorbital, or jawline areas, as can sometimes be observed following CO2 resurfacing. PSR is effective in improving facial and periorbital rhytides and can be used on nonfacial sites, including the hands, neck, and chest. Numerous treatment protocols with variable energy settings allow for individualized treatments and provide the operator with fine control over the degree of injury and length of subsequent recovery time.

  13. 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)

  14. 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).

  15. Determinants of Mortality in Chest Trauma Patients

    African Journals Online (AJOL)

    10% of trauma admissions.[1,2] In the United States it is estimated at 12 out of 1 million population per day.[3] Furthermore chest injury is still directly responsible for about 25% of trauma‑related deaths and contribute to death in another 25% of trauma‑related deaths.[1,2,4] Therefore, chest injury directly and indirectly ...

  16. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  17. Chest radiographic findings in Human Immunodeficiency Virus ...

    African Journals Online (AJOL)

    This study was carried out to determine findings on chest radiographs in HIV positive/AIDS patients at the University of Benin Teaching Hospital (UBTH) Benin City. All consecutive HIV positive/AIDS patients, managed at the UBTH between 1991 and 2001 were included in the study. Patients had postero-anterior (PA) chest ...

  18. Chest Radiographic Findings in Newly Diagnosed Pulmonary ...

    African Journals Online (AJOL)

    Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...

  19. Chest radiography in supporting the diagnosis of asthma in children with persistent cough.

    Science.gov (United States)

    Halaby, Claudia; Feuerman, Martin; Barlev, Dan; Pirzada, Melodi

    2014-03-01

    To establish whether chest radiographic findings suggestive of lower airway obstruction (LAO) disease support the diagnosis of asthma in pediatric patients with persistent cough in an outpatient setting. 180 patient charts were reviewed. The patients were children aged 1 to 18 years referred over a 3-year period to a pediatric pulmonary subspecialty clinic for evaluation of cough lasting ≥ 4 weeks. Chest radiographic images obtained after the initial evaluation of 90 patients diagnosed with cough-variant asthma and 90 patients diagnosed with persistent cough from nonasthma origins were compared with radiologic findings of a control group consisting of patients with a positive tuberculin skin test and no respiratory symptoms. Increased peribronchial markings/peribronchial cuffing and hyperinflation were considered radiographically suggestive findings of LAO disease. Children diagnosed with cough-variant asthma at the initial evaluation had higher rates of chest radiographic findings suggestive of LAO disease (30.00%) than children with persistent cough from other causes (17.80%) or those with a positive tuberculin skin test and no respiratory symptoms (8.16%) (overall P value = 0.0063). They also had higher rates of spirometry abnormalities suggestive of an LAO defect. Children with chest radiographic findings suggestive of LAO disease were found to be younger than those with normal chest radiographic findings (5.0 ± 2.7 years vs 8.6 ± 4.7 years; P < 0.0001). This study suggests that chest radiographic findings indicative of an LAO in correlation with the clinical presentation can support the diagnostic suspicion of asthma, especially in younger children unable to perform spirometry.

  20. [How to do - the chest tube drainage].

    Science.gov (United States)

    Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

    2015-03-01

    A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

  1. Why x-ray chests

    International Nuclear Information System (INIS)

    Evans, D.W.S.

    1979-06-01

    In order to assess the validity of screening chest radiography at Chalk River Nuclear Laboratories, the yield of occult major disease and its significance to the afflicted employees have been examined over a ten year period. The study suggests that the incidence rate of occult disease which in retrospect proved to have been of major or life-threatening importance to the afflicted employee approximates 1 per 1000 population per annum. Major benefit accrued only to about 1 in 3 of these employees, the remainder gaining little more than that which would have followed treatment had their diseases presented symptomatically. These results are considered in relation to the health surveillance needs of a population generally and selectively exposed to diverse health hazards within the nuclear industry. (auth)

  2. Examination of musculoskeletal chest pain

    DEFF Research Database (Denmark)

    Brunse, Mads Hostrup; Stochkendahl, Mette Jensen; Vach, Werner

    2010-01-01

    using a standardized examination protocol, (2) to determine inter-observer reliability of single components of the protocol, and (3) to determine the effect of observer experience. Eighty patients were recruited from an emergency cardiology department. Patients were eligible if an obvious cardiac or non......-cardiac diagnosis could not be established at the cardiology department. Four observers (two chiropractors and two chiropractic students) performed general health and manual examination of the spine and chest wall. Percentage agreement, Cohen's Kappa and ICC were calculated for observer pairs (chiropractors.......01 to 0.59. Provided adequate training of observers, the examination protocol can be used in carefully selected patients in clinical settings and should be included in pre- and post-graduate clinical training....

  3. Chest HRCT findings in acute transformation of adult T-cell lymphoma/leukemia

    International Nuclear Information System (INIS)

    Okada, Fumito; Sato, Haruka; Omeri, Ahmad Khalid; Ono, Asami; Tokuyama, Kouhei; Ando, Yumiko; Matsumoto, Akira; Mori, Hiromu; Ogata, Masao; Kohno, Kazuhiro; Takano, Kuniko

    2015-01-01

    To assess chest high-resolution computed tomography (HRCT) findings in patients with acute transformation of adult T cell leukaemia/lymphoma (ATLL). We retrospectively identified 72 consecutive patients at our institution with ATLL between October 2000 and March 2014. The cases included acute type (n = 20), lymphoma type (n = 21), smouldering type (n = 24) and chronic type (n = 7). Sixteen (7 men, 9 women; aged 36-85 years, mean 63.3 years) of 31 patients (24 with smouldering and seven with chronic type; 51.6 %) developed acute transformation of ATLL, and had undergone chest HRCT examinations. Parenchymal abnormalities, enlarged lymph nodes, pericardial effusion, pleural effusion and skin lesions were evaluated on HRCT. Chest HRCT of 15 of the 16 patients showed abnormal findings, including ground-glass opacity (GGO) (n = 8), consolidation (n = 5), interlobular septal thickening (n = 5) and nodules (n = 5). Pleural effusion was found in five patients, lymph node enlargement in 10 patients and multiple skin thickening in two patients. Almost all patients with acute transformation of ATLL had abnormal findings on chest HRCT, which consisted mainly of lymph node enlargement, GGO, interlobular septal thickening, nodules and bilateral pleural effusions. (orig.)

  4. Chest HRCT findings in acute transformation of adult T-cell lymphoma/leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Fumito; Sato, Haruka; Omeri, Ahmad Khalid; Ono, Asami; Tokuyama, Kouhei; Ando, Yumiko; Matsumoto, Akira; Mori, Hiromu [Oita University Faculty of Medicine, Department of Radiology, Yufu, Oita (Japan); Ogata, Masao; Kohno, Kazuhiro; Takano, Kuniko [Oita University Faculty of Medicine, Department of Medical Oncology and Hematology, Yufu, Oita (Japan)

    2015-06-01

    To assess chest high-resolution computed tomography (HRCT) findings in patients with acute transformation of adult T cell leukaemia/lymphoma (ATLL). We retrospectively identified 72 consecutive patients at our institution with ATLL between October 2000 and March 2014. The cases included acute type (n = 20), lymphoma type (n = 21), smouldering type (n = 24) and chronic type (n = 7). Sixteen (7 men, 9 women; aged 36-85 years, mean 63.3 years) of 31 patients (24 with smouldering and seven with chronic type; 51.6 %) developed acute transformation of ATLL, and had undergone chest HRCT examinations. Parenchymal abnormalities, enlarged lymph nodes, pericardial effusion, pleural effusion and skin lesions were evaluated on HRCT. Chest HRCT of 15 of the 16 patients showed abnormal findings, including ground-glass opacity (GGO) (n = 8), consolidation (n = 5), interlobular septal thickening (n = 5) and nodules (n = 5). Pleural effusion was found in five patients, lymph node enlargement in 10 patients and multiple skin thickening in two patients. Almost all patients with acute transformation of ATLL had abnormal findings on chest HRCT, which consisted mainly of lymph node enlargement, GGO, interlobular septal thickening, nodules and bilateral pleural effusions. (orig.)

  5. Skin Dictionary

    Science.gov (United States)

    ... Registration General information Housing & travel Education Exhibit hall Mobile app 2019 Annual Meeting Derm Exam Prep Course ... SkinPAC State societies Scope of practice Truth in advertising NP/PA laws Action center Public and patients ...

  6. Hyperelastic skin

    Science.gov (United States)

    ... is most often seen in people who have Ehlers-Danlos syndrome. People with this disorder have very elastic skin. ... any member of your family been diagnosed with Ehlers-Danlos syndrome? What other symptoms are present? Genetic counseling may ...

  7. Skin Cancer

    Science.gov (United States)

    ... sunlamps. There are 2 types of UV rays: UVA rays (long-wave) – UVA rays penetrate clouds and glass. They penetrate the ... to cancer. But studies have shown that both UVA and UVB damage the skin and can cause ...

  8. Investigation of the dosimetry of chest tomosynthesis

    Science.gov (United States)

    Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

    2009-02-01

    Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

  9. CT of blunt chest trauma in children

    International Nuclear Information System (INIS)

    Manson, D.; Babyn, P.S.; Palder, S.; Bergmann, K.

    1993-01-01

    While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

  10. Skin Cancer Screening

    Science.gov (United States)

    ... Genetics of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? ... These are called diagnostic tests . General Information About Skin Cancer Key Points Skin cancer is a disease ...

  11. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  12. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    Newman, Beverley; Gawande, Rakhee; Krane, Elliot J.; Holmes, Tyson H.; Robinson, Terry E.

    2014-01-01

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  13. Skin protection by sucralfate cream during electron beam therapy

    International Nuclear Information System (INIS)

    Maiche, A.

    1994-01-01

    We performed a double-blind randomized study to compare the efficacy of sucralfate cream to a base cream in 50 breast cancer patients receiving postoperative electron beam therapy to their chest wall. The acute radiation reaction of the skin was statistically significantly prevented by the sucralfate cream. The recovery of the skin was also significantly faster in the sucralfate cream group. Side-effects due to the cream were rare. (orig./MG)

  14. Skin protection by sucralfate cream during electron beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Maiche, A. (Helsinki Univ. Central Hospital (Finland). Dept. of Radiotherapy and Oncology); Isokangas, O.P. (Helsinki Univ. Central Hospital (Finland). Dept. of Radiotherapy and Oncology); Groehn, P. (Deaconess Hospital, Helsinki (Finland))

    1994-01-01

    We performed a double-blind randomized study to compare the efficacy of sucralfate cream to a base cream in 50 breast cancer patients receiving postoperative electron beam therapy to their chest wall. The acute radiation reaction of the skin was statistically significantly prevented by the sucralfate cream. The recovery of the skin was also significantly faster in the sucralfate cream group. Side-effects due to the cream were rare. (orig./MG).

  15. Radiological diagnostic in acute chest pain

    International Nuclear Information System (INIS)

    Kawel, Nadine; Bremerich, Jens

    2010-01-01

    Acute chest pain is one of the main symptoms leading to a consultation of the emergency department. Main task of the initial diagnostic is the confirmation or exclusion of a potentially life threatening cause. Conventional chest X-ray and computed tomography are the most significant techniques. Due to limited availability and long examination times magnetic resonance tomography rather plays a limited role in routine clinical workup. In the following paper we will systematically review the radiological diagnostic of the acute life threatening causes of chest pain. Imaging modalities, technical aspects and image interpretation will be discussed. (orig.)

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. A Monte Carlo estimation of effective dose in chest tomosynthesis

    International Nuclear Information System (INIS)

    Sabol, John M.

    2009-01-01

    calculated to be 0.124 mSv (ICRP60) [0.134 mSv (ICRP103)]. This is less than 75% of that predicted by scaling of the PA mA s ratio. This lower dose was due to changes in the focal-spot-to-skin distance, effective changes in collimation with projection angle, rounding down of the mA s step, and variations in organ exposure to the primary x-ray beam for each view. Large errors in dose estimation can occur if these factors are not accurately modeled. Conclusions: The effective dose of a chest examination with this chest tomosynthesis system is about twice that of a two-view chest examination and less than 2% of the published average values for thoracic CT. It is shown that complete consideration of the tomosynthesis acquisition technique and geometry is required for accurate determination of the effective dose to the patient. Tomosynthesis provides three-dimensional imaging at a dose level comparable to a two-view chest x-ray examination and may provide a low dose alternative to thoracic CT for obtaining depth information in chest imaging.

  19. Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings

    Science.gov (United States)

    Harvey, H. Benjamin; Gilman, Matthew D.; Wu, Carol C.; Cushing, Matthew S.; Halpern, Elkan F.; Zhao, Jing; Pandharipande, Pari V.; Shepard, Jo-Anne O.

    2015-01-01

    Purpose To evaluate the diagnostic yield of recommended chest computed tomography (CT) prompted by abnormalities detected on outpatient chest radiographic images. Materials and Methods This HIPAA-compliant study had institutional review board approval; informed consent was waived. Reports of all outpatient chest radiographic examinations performed at a large academic center during 2008 (n = 29 138) were queried to identify studies that included a recommendation for a chest CT imaging. The radiology information system was queried for these patients to determine if a chest CT examination was obtained within 1 year of the index radiographic examination that contained the recommendation. For chest CT examinations obtained within 1 year of the index chest radiographic examination and that met inclusion criteria, chest CT images were reviewed to determine if there was an abnormality that corresponded to the chest radiographic finding that prompted the recommendation. All corresponding abnormalities were categorized as clinically relevant or not clinically relevant, based on whether further work-up or treatment was warranted. Groups were compared by using t test and Fisher exact test with a Bonferroni correction applied for multiple comparisons. Results There were 4.5% (1316 of 29138 [95% confidence interval {CI}: 4.3%, 4.8%]) of outpatient chest radiographic examinations that contained a recommendation for chest CT examination, and increasing patient age (P recommendation for chest CT examination. Of patients within this subset who met inclusion criteria, 65.4% (691 of 1057 [95% CI: 62.4%, 68.2%) underwent a chest CT examination within the year after the index chest radiographic examination. Clinically relevant corresponding abnormalities were present on chest CT images in 41.4% (286 of 691 [95% CI: 37.7%, 45.2%]) of cases, nonclinically relevant corresponding abnormalities in 20.6% (142 of 691 [95% CI: 17.6%, 23.8%]) of cases, and no corresponding abnormalities in 38

  20. Laryngotracheobronchial papillomatosis: chest CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Fortes, Helena Ribeiro; Zanetti, Glaucia; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Ranke, Felipe Mussi von [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Escuissato, Dante Luiz [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Dept. de Clinica Medica; Araujo Neto, Cesar Augusto [Universidade Federal da Bahia (UFBA), Salvador (Brazil). Dept. de Medicina e Apoio Diagnostico; Hochhegger, Bruno [Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), RS (Brazil). Diagnostico por Imagem; Irion, Klaus Loureiro [Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool (United Kingdom); Souza, Carolina Althoff [Dept. of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ontario (Canada)

    2017-07-15

    To evaluate the findings on chest CTs in 16 patients (8 men and 8 women) with laryngotracheobronchial papillomatosis. Methods: This was a retrospective study involving patients ranging from 2 to 72 years of age. The evaluation of the CT scans was independently performed by two observers, and discordant results were resolved by consensus. The inclusion criteria were presence of abnormalities on the CT scans, and the diagnosis was confirmed by anatomopathological examination of the papillomatous lesions. Results: The most common symptoms were hoarseness, cough, dyspnea, and recurrent respiratory infections. The major CT findings were nodular formations in the trachea, solid or cavitated nodules in the lung parenchyma, air trapping, masses, and consolidation. Nodular formations in the trachea were observed in 14 patients (87.5%). Only 2 patients had lesions in lung parenchyma without tracheal involvement. Only 1 patient had no pulmonary dissemination of the disease, showing airway involvement only. Solid and cavitated lung nodules were observed in 14 patients (87.5%) and 13 (81.2%), respectively. Masses were observed in 6 patients (37.5%); air trapping, in 3 (18.7%); consolidation in 3 (18.7%); and pleural effusion, in 1 (6.3%). Pulmonary involvement was bilateral in all cases. Conclusions: The most common tomography findings were nodular formations in the trachea, as well as solid or cavitated nodules and masses in the lung parenchyma. Malignant transformation of the lesions was observed in 5 cases. (author)

  1. Skin decontamination

    International Nuclear Information System (INIS)

    Moehrle, G.

    1975-01-01

    A general survey of skin decontamination is given. The success of every decontamination treatments depends mainly on the speed, but also on the care, with which the action is taken. The best way to remove the skin contaminants is thorough washing under lukewarm running water with mild soap and a soft brush. This washing is to be repeated several times for a period of several minutes. If results are not satisfactory, light duty detergents and wetting agents available commercially may also be used. Some solutions which have proved useful are mentioned. The decontamination solutions are best used in the order given. When one has no satisfactory decontamination effect, the next one is to be used. If necessary, these agents must be used several times in the stated order as long as this does not involve too much strain for the skin. All the decontamination measures mentioned refer, of course, to intact healthy skin. After decontamination has been completed, the skin should be treated with a protective cream

  2. The impact of chest compression rates on quality of chest compressions : a manikin study

    OpenAIRE

    Field, Richard A.; Soar, Jasmeet; Davies, Robin P.; Akhtar, Naheed; Perkins, Gavin D.

    2012-01-01

    Purpose\\ud Chest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables.\\ud Methods\\ud Twenty healthcare professionals performed two minutes of co...

  3. Improving screen-film chest radiography

    International Nuclear Information System (INIS)

    Shaikh, N.; Baker, R.A.

    1996-01-01

    Traditionally symmetric screens and double emulsion symmetric films with medium to wide latitutde are used for radiography of the chest. Beacuse of mismatch of transmitted exposure through the chest with limited latitude of the film, most of the dense areas of the chest are underexposed. Kodak's recent innovation of a unique asymmetry screen-film system (InSight) alleviates this problem. Our phantom measurement indicates that the InSight system offers wider recording range, and the flexible grid permits more positional latitude than conventional grids. Our five-year extensive clinical experience indicates that dense anatomic structures, such as mediastinum, retrocardiac and subdiaphragmatic, are more visible in the InSight system than in the conventional symmetric system. Similarly, a substantial improvement in image quality in portable chest imaging is realized by use of flexible grids because of scatter rejection and invisible grid lines. (author)

  4. Aspergillosis - chest x-ray (image)

    Science.gov (United States)

    ... usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung ... are usually seen as black areas on an x-ray. The cloudiness on the left side of this ...

  5. Computed tomography of chest wall abscess

    International Nuclear Information System (INIS)

    Ikezoe, Junpei; Morimoto, Shizuo; Akira, Masanori

    1986-01-01

    Inflammatory lesions of the chest wall become less common because of the improvement of antibiotics and chemotherapeutic agents. Over a 5-year period, 7 patients with chest wall inflammatory diseases underwent chest computed tomography. These were 2 tuberculous pericostal abscesses, 2 empyema necessitatis, 1 spinal caries, and 2 bacterial chest wall abscesses (unknown organisms). Computed tomography (CT) helped in demonstrating the density, border, site, and extent of the lesions. CT images also demonstrated the accompaning abnormalities which included bone changes, pleural calcification, or old tuberculous changes of the lung. CT was very effective to demonstrate the communicating portions from the inside of the bony thorax to the outside of the bony thorax in 2 empyema necessitatis. (author)

  6. THE DEADLY DOZEN OF CHEST TRAUMA

    African Journals Online (AJOL)

    Enrique

    specialised surgical intervention; probably the most common presentation is related .... failure. Operation is another treatment option for flail chest, after having been discarded in the ... physiologically unstable due to trauma in other anatomical ...

  7. Tuberculosis, advanced - chest x-rays (image)

    Science.gov (United States)

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  8. Penetrating chest injury: A miraculous life salvage

    Directory of Open Access Journals (Sweden)

    Santosh B Dalavi

    2013-01-01

    Full Text Available An unusual penetrating chest injury was caused by high velocity road traffic accident. An 18-year-old had a four wheeler accident and was brought in emergency department with a ′bamboo′ stick on the left side chest exiting through back. After the stabilization of vital parameters, an inter-costal tube drainage was done on the left side. Except the minor brochopleural fistula which healed by 10 th day, his recovery was uneventful. The outcome was consistent with current aggressive management of penetrating chest injuries. Management of penetrating chest injury involving pulmonary trauma is based on three principles. One is stabilization of hemodynamics of patient with proper clinical evaluation. Second, a mere intercostal tube drainage sufficient for majority of the cases. Third, post-operative active as well as passive physiotherapy is necessary for speedy recovery.

  9. 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....

  10. WILDE,OSCAR SKIN-DISEASE - ALLERGIC CONTACT-DERMATITIS

    NARCIS (Netherlands)

    NATER, JP

    During the last years of his life, Oscar Wilde (1856-1900) suffered from a suppurating otitis media as well as from an unidentified skin disease. The eruption was localized to his face, arms, chest and back and itched severely. A new theory is suggested, based on the fact that Wilde almost certainly

  11. Noncardiac chest pain: diagnosis and management.

    Science.gov (United States)

    Yamasaki, Takahisa; Fass, Ronnie

    2017-07-01

    Noncardiac chest pain (NCCP) has been defined as recurrent chest pain that is indistinguishable from ischemic heart pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional chest pain. The purpose of this review is to discuss the current diagnosis and treatment of NCCP. Utilization of new diagnostic techniques such as pH-impedance and high-resolution esophageal manometry, and the introduction of a new definition for functional chest pain have helped to better diagnose the underlying mechanisms of NCCP. A better therapeutic approach toward GERD-related NCCP, the introduction of new interventions for symptoms due to esophageal spastic motor disorders and the expansion of the neuromodulator armamentarium for functional chest pain have changed the treatment landscape of NCCP. GERD is the most common esophageal cause of NCCP, followed by functional chest pain and esophageal dysmotility. The proton pump inhibitor test, upper endoscopy, wireless pH capsule and pH-impedance are used to identify GERD-induced NCCP. High-resolution esophageal manometry is the main tool to identify esophageal motor disorder in non-GERD-related NCCP. Negative diagnostic assessment suggests functional chest pain. Potent antireflux treatment is offered to patients with GERD-related NCCP; medical, endoscopic or surgical interventions are considered in esophageal dysmotility; and neuromodulators are prescribed for functional chest pain. Assessment and treatment of psychological comorbidity should be considered in all NCCP patients.

  12. Digital chest radiography: collimation and dose reduction

    DEFF Research Database (Denmark)

    Debess, Jeanne; Johnsen, Karen Kirstine; Vejle-Sørensen, Jens Kristian

    ,3 mAs and SID SID of 180 centimetres using a phantom and lithium fluoride thermo luminescence dosimeter (TLD). Dose to risk organs mamma, thyroid and colon are measured at different collimations with one-centimetre steps. TLD results are used to estimate dose reduction for different collimations...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  13. Indications for chest CT. Retrospective study of cases with normal chest CT

    International Nuclear Information System (INIS)

    Obata, Shiro

    1995-01-01

    The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

  14. 46 CFR 169.743 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 169.743 Section 169.743... Vessel Control, Miscellaneous Systems, and Equipment Markings § 169.743 Portable magazine chests. Portable magazine chests must be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST...

  15. 46 CFR 196.37-47 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE — KEEP...

  16. How to remove a chest drain.

    Science.gov (United States)

    Allibone, Elizabeth

    2015-10-07

    RATIONALE AND KEY POINTS: This article aims to help nurses to undertake the removal of a chest drain in a safe, effective and patient-centred manner. This procedure requires two practitioners. The chest drain will have been inserted aseptically to remove air, blood, fluid or pus from the pleural cavity. ▶ Chest drains may be small or wide bore depending on the underlying condition and clinical setting. They may be secured with a mattress suture and/or an anchor suture. ▶ Chest drains are usually removed under medical instructions when the patient's lung has inflated, the underlying condition has resolved, there is no evidence of respiratory compromise or failure, and their anticoagulation status has been assessed as satisfactory. ▶ Chest drains secured with a mattress suture should be removed by two practitioners. One practitioner is required to remove the tube and the other to tie the mattress suture (if present) and secure the site. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. How this article could be used to educate patients with chest drains. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

  17. Squamous cell skin cancer

    Science.gov (United States)

    ... that reflect light more, such as water, sand, concrete, and areas that are painted white. The higher ... - skin - squamous cell; Skin cancer - squamous cell; Nonmelanoma skin cancer - squamous ...

  18. 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.

  19. Chest Seal Placement for Penetrating Chest Wounds by Prehospital Ground Forces in Afghanistan.

    Science.gov (United States)

    Schauer, Steven G; April, Michael D; Naylor, Jason F; Simon, Erica M; Fisher, Andrew D; Cunningham, Cord W; Morissette, Daniel M; Fernandez, Jessie Renee D; Ryan, Kathy L

    Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting. To evaluate adherence to TCCC guidelines for chest seal placement among personnel deployed to Afghanistan. We obtained data from the Prehospital Trauma Registry (PHTR). Joint Trauma System personnel linked patients to the Department of Defense Trauma Registry, when available, for outcome data upon reaching a fixed facility. In the PHTR, we identified 62 patients with documented gunshot wound (GSW) or puncture wound trauma to the chest. The majority (74.2%; n = 46) of these were due to GSW, with the remainder either explosive-based puncture wounds (22.6%; n = 14) or a combination of GSW and explosive (3.2%; n = 2). Of the 62 casualties with documented GSW or puncture wounds, 46 (74.2%) underwent chest seal placement. Higher proportions of patients with medical officers in their chain of care underwent chest seal placement than those that did not (63.0% versus 37.0%). The majority of chest seals placed were not vented. Of patients with a GSW or puncture wound to the chest, 74.2% underwent chest seal placement. Most of the chest seals placed were not vented in accordance with guidelines, despite the guideline update midway through the study period. These data suggest the need to improve predeployment training on TCCC guidelines and matching of the Army logistical supply chain to the devices recommended by the CoTCCC. 2017.

  20. Corneal Reinnervation and Sensation Recovery in Patients With Herpes Zoster Ophthalmicus: An In Vivo and Ex Vivo Study of Corneal Nerves.

    Science.gov (United States)

    Cruzat, Andrea; Hamrah, Pedram; Cavalcanti, Bernardo M; Zheng, Lixin; Colby, Kathryn; Pavan-Langston, Deborah

    2016-05-01

    To study corneal reinnervation and sensation recovery in Herpes zoster ophthalmicus (HZO). Two patients with HZO were studied over time with serial corneal esthesiometry and laser in vivo confocal microscopy (IVCM). A Boston keratoprosthesis type 1 was implanted, and the explanted corneal tissues were examined by immunofluorescence histochemistry for βIII-tubulin to stain for corneal nerves. The initial central corneal IVCM performed in each patient showed a complete lack of the subbasal nerve plexus, which was in accordance with severe loss of sensation (0 of 6 cm) measured by esthesiometry. When IVCM was repeated 2 years later before undergoing surgery, case 1 showed a persistent lack of central subbasal nerves and sensation (0 of 6). In contrast, case 2 showed regeneration of the central subbasal nerves (4786 μm/mm) with partial recovery of corneal sensation (2.5 of 6 cm). Immunostaining of the explanted corneal button in case 1 showed no corneal nerves, whereas case 2 showed central and peripheral corneal nerves. Eight months after surgery, IVCM was again repeated in the donor tissue around the Boston keratoprosthesis in both patients to study innervation of the corneal transplant. Case 1 showed no nerves, whereas case 2 showed new nerves growing from the periphery into the corneal graft. We demonstrate that regaining corneal innervation and corneal function are possible in patients with HZO as shown by corneal sensation, IVCM, and ex vivo immunostaining, indicating zoster neural damage is not always permanent and it may recover over an extended period of time.

  1. Correlation between the Appearance of Neuropeptides in the Rat Trigeminal Ganglion and Reinnervation of the Healing Root Socket after Tooth Extraction

    International Nuclear Information System (INIS)

    Gunjigake, Kaori K.; Goto, Tetsuya; Nakao, Kayoko; Konoo, Tetsuro; Kobayashi, Shigeru; Yamaguchi, Kazunori

    2006-01-01

    The neuropeptide substance P (SP) modulates bone metabolism. This study examined the temporal appearance of the neuropeptides SP and brain-derived nerve growth factor (BDNF) and their receptors (neurokinin-1 receptor (NK 1 -R) and Trk B, respectively) in the rat trigeminal ganglion to investigate the role of neuropeptides in healing after tooth extraction. Rats were anesthetized and their upper right first molars were extracted; the rats were sacrificed 3 hours and 1–21 days after extraction. Their trigeminal ganglion and maxilla were removed, and cryosections were prepared and immunostained using specific antibodies against SP, BDNF, NK 1 -R, and Trk B. In the tooth sockets after extraction, new bone and a few SP-immunoreactive nerve fibers were first seen at day 7, and bone completely filled the sockets at day 21. In the trigeminal ganglion, the proportions of NK 1 -R-, BDNF-, and Trk B-immunoreactive neurons changed similarly, i.e., they initially decreased, increased rapidly to maximum levels by day 3, and then decreased gradually to control levels until 21 days. These findings suggest that the appearance of neuropeptides in the trigeminal ganglion, the reinnervation of SP-immunoreactive nerve fibers, and bone repair in the tooth socket during healing after extraction were correlated

  2. Electrical stimulation of paralyzed vibrissal muscles reduces endplate reinnervation and does not promote motor recovery after facial nerve repair in rats.

    Science.gov (United States)

    Sinis, Nektarios; Horn, Frauke; Genchev, Borislav; Skouras, Emmanouil; Merkel, Daniel; Angelova, Srebrina K; Kaidoglou, Katerina; Michael, Joern; Pavlov, Stoyan; Igelmund, Peter; Schaller, Hans-Eberhard; Irintchev, Andrey; Dunlop, Sarah A; Angelov, Doychin N

    2009-10-01

    The outcome of peripheral nerve injuries requiring surgical repair is poor. Recent work has suggested that electrical stimulation (ES) of denervated muscles could be beneficial. Here we tested whether ES has a positive influence on functional recovery after injury and surgical repair of the facial nerve. Outcomes at 2 months were compared to animals receiving sham stimulation (SS). Starting on the first day after end-to-end suture (facial-facial anastomosis), electrical stimulation (square 0.1 ms pulses at 5 Hz at an ex tempore established threshold amplitude of between 3.0 and 5.0V) was delivered to the vibrissal muscles for 5 min a day, 3 times a week. Restoration of vibrissal motor performance following ES or SS was evaluated using the video-based motion analysis and correlated with the degree of collateral axonal branching at the lesion site, the number of motor endplates in the target musculature and the quality of their reinnervation, i.e. the degree of mono- versus poly-innervation. Neither protocol reduced collateral branching. ES did not improve functional outcome, but rather reduced the number of innervated motor endplates to approximately one-fifth of normal values and failed to reduce the proportion of poly-innervated motor endplates. We conclude that ES is not beneficial for recovery of whisker function after facial nerve repair in rats.

  3. Low Yield of Chest Radiography in a Large Tuberculosis Screening Program1

    Science.gov (United States)

    Pollock, Nira R.

    2010-01-01

    Purpose: To assess the frequency and spectrum of abnormalities on routine screening chest radiographs in the pre-employment evaluation of health care workers with positive tuberculin skin test (TST) results. Materials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the need for written informed patient consent. Chest radiographic reports of all 2586 asymptomatic individuals with positive TST results who underwent pre-employment evaluation between January 1, 2003, and December 31, 2007, were evaluated to determine the frequency of detection of evidence of active tuberculosis (TB) or latent TB infection (LTBI) and the spectrum of imaging findings. All chest radiographs interpreted as positive were reviewed by an experienced board-certified radiologist. If there was a discrepancy between the two readings, a second experienced radiologist served as an independent and final arbiter. Any follow-up chest radiographs or computed tomographic images that had been acquired by employee health services or by the employee’s private physician as a result of a suspected abnormality detected at initial screening were also evaluated. Results: Of the 159 (6.1%) chest radiographic examinations that yielded abnormal results, there were no findings that were consistent with active TB. There were 92 cases of calcified granulomas, calcified lymph nodes, or both; 25 cases of apical pleural thickening; 16 cases of fibrous scarring; and 31 cases of noncalcified nodules. All cases of fibrous scarring involved an area smaller than 2 cm2. All noncalcified nodules were 4 mm in diameter or smaller, with the exception of one primary lung malignancy and one necrotizing granuloma (negative for acid-fast bacilli) that grew Mycobacterium kansasii on culture. Conclusion: Universal chest radiography in a large pre-employment TB screening program was of low yield in the detection of active TB or increased LTBI reactivation risk, and it provided

  4. 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.)

  5. 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.

  6. 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.

  7. TRANSDERMAL PERMEABILITY OF ESTRADIOL THROUGH THE HUMAN SKIN OF DIFFERENT BODY REGIONS IN VITRO

    Institute of Scientific and Technical Information of China (English)

    CHENGuo-Shen; GONGSai-Jun; DUJie; MARun-Zhen; ZHOURong-Rong; LIULiang-Chu

    1989-01-01

    Transdermal permeability of estradiol was carried out by using Valia-Chien double compartment permeation cells for the following regions of intact skin and skin without stratum corncum: chest, abdomen, hip, upper arm, thigh and back. The estradiol permeation rates and accumulative amounts within 72h in vitro were examined by HPLC. The results showed that the permeation rates of intact skin from different regions of the body

  8. Pulmonary nodule size evaluation with chest tomosynthesis.

    Science.gov (United States)

    Johnsson, Åse A; Fagman, Erika; Vikgren, Jenny; Fisichella, Valeria A; Boijsen, Marianne; Flinck, Agneta; Kheddache, Susanne; Svalkvist, Angelica; Båth, Magnus

    2012-10-01

    To evaluate intra- and interobserver variability, as well as agreement for nodule size measurements on chest tomosynthesis and computed tomographic (CT) images. The Regional Ethical Review Board approved this study, and all participants gave written informed consent. Thirty-six segmented nodules in 20 patients were included in the study. Eight observers measured the left-to-right, inferior-to-superior, and longest nodule diameters on chest tomosynthesis and CT images. Intra- and interobserver repeatability, as well as agreement between measurements on chest tomosynthesis and CT images, were assessed as recommended by Bland and Altman. The difference between the mean manual and the segmented diameter was -2.2 and -2.3 mm for left-to-right and -2.6 and -2.2 mm for the inferior-to-superior diameter for measurements on chest tomosynthesis and CT images, respectively. Intraobserver 95% limits of agreement (LOA) for the longest diameter ranged from a lower limit of -1.1 mm and an upper limit of 1.0 mm to -1.8 and 1.8 mm for chest tomosynthesis and from -0.6 and 0.9 mm to -3.1 and 2.2 mm for axial CT. Interobserver 95% LOA ranged from -1.3 and 1.5 mm to -2.0 and 2.1 mm for chest tomosynthesis and from -1.8 and 1.1 mm to -2.2 and 3.1 mm for axial CT. The 95% LOA concerning the mean of the observers' measurements of the longest diameter at chest tomosynthesis and axial CT were ±2.1 mm (mean measurement error, 0 mm). For the different observers, the 95% LOA between the modalities ranged from -2.2 and 1.6 mm to -3.2 and 2.8 mm. Measurements on chest tomosynthesis and CT images are comparable, because there is no evident bias between the modalities and the repeatability is similar. The LOA between measurements for the two modalities raise concern if measurements from chest tomosynthesis and CT were to be used interchangeably. © RSNA, 2012.

  9. Skin Pigmentation Disorders

    Science.gov (United States)

    Pigmentation means coloring. Skin pigmentation disorders affect the color of your skin. Your skin gets its color from a pigment called melanin. Special cells in the skin make melanin. When these cells become damaged or ...

  10. Skin Cancer Foundation

    Science.gov (United States)

    ... Host a Fundraising Event | About Us | Store The Skin Cancer Foundation The Skin Cancer Foundation is the ... Handbook A "Sunscreen Gene"? Skin Cancer Facts & Statistics Skin Cancer Treatment Glossary Information on medications and procedures ...

  11. Skin Cancer Treatment

    Science.gov (United States)

    ... Unusual Cancers of Childhood Treatment Genetics of Skin Cancer Skin color and being exposed to sunlight can increase ... is based on the type of nonmelanoma skin cancer or other skin condition diagnosed: Basal cell carcinoma Enlarge Basal cell ...

  12. Stages of Skin Cancer

    Science.gov (United States)

    ... Unusual Cancers of Childhood Treatment Genetics of Skin Cancer Skin color and being exposed to sunlight can increase ... is based on the type of nonmelanoma skin cancer or other skin condition diagnosed: Basal cell carcinoma Enlarge Basal cell ...

  13. Ectodermal dysplasia-skin fragility syndrome

    Directory of Open Access Journals (Sweden)

    Vijay S Adhe

    2011-01-01

    Full Text Available Ectodermal dysplasia-skin fragility (EDSF syndrome is a rare and first described inherited disorder of desmosomes. It occurs due to loss-of-function mutations in PKP1 gene resulting in poorly formed desmosomes and loss of desmosomal and epidermal integrity. We report a case of a 2-year-old Indian male child who presented with palmoplantar hyperkeratosis with fissuring, short, sparse, and easily pluckable scalp hair, nail dystrophy, and multiple erosions over the skin. Skin biopsy showed epidermal hyperplasia with widening of intercellular spaces. His developmental milestones were delayed but intelligence was normal. Echocardiography, X-ray chest, and electrocardiogram were normal. Very few cases of this syndrome have been reported in the literature. We consider this as the first case report from India.

  14. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

    Science.gov (United States)

    Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

    2016-12-01

    Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

  15. Satisfaction of Search in Chest Radiography 2015.

    Science.gov (United States)

    Berbaum, Kevin S; Krupinski, Elizabeth A; Schartz, Kevin M; Caldwell, Robert T; Madsen, Mark T; Hur, Seung; Laroia, Archana T; Thompson, Brad H; Mullan, Brian F; Franken, Edmund A

    2015-11-01

    Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest. Sixty-four chest computed radiographs half demonstrating various "test" abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Results of previous studies were reanalyzed using similar modern techniques. In the present study, adding nodules did not influence detection accuracy for the other abnormalities (P = .93), but did induce a reluctance to report them (P chest radiography (P chest radiography has changed, but it is not clear why. SOS may be changing as a function of changes in radiology education and practice. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  16. Treatment of funnel chest in children

    Directory of Open Access Journals (Sweden)

    Viktor N. Stalmakhovich

    2017-10-01

    Full Text Available Background. Funnel chest has a relatively high prevalence in the Russian population. Given the high percentage of the unsatisfactory results of thoracoplasty, further research for the development of new treatment methods is needed. Aim. To improve the treatment results for funnel chest in children. Materials and methods. We analyzed the treatment results of 230 children with funnel chest after thoracoplasty. We used 2 surgical techniques: classic thoracoplasty by Nuss (114 children and its modified version by the authors (116 children. The modified technique included two-sided thoracoscopy, partial resection of the deformed rib cartilages, and endoscopic longitudinal transection of the sternal cortical plate, resulting in subcutaneous emphysema along the sternum. Results. The comparison of the 2 surgical techniques showed no significant difference in terms of duration and invasiveness of the procedure. Recurrent episodes of funnel chest were observed in children who had undergone thoracoplasty before 7 years of age, regardless of the technique used. Conclusion. This study revealed that the author’s modified thoracoplasty method was more effective in children > 14 years of age with rigid funnel chest because it allowed the surgeon to decrease the thoracic pressure on the plate and the plate itself on the ribs, facilitating the repositioning of the sternum and preventing the deformation and development of pressure sores on the ribs.

  17. Chest trauma in children: A local experience

    International Nuclear Information System (INIS)

    Al-Saigh, A.; Fazili, Fiaz M.; Allam, Abdulla R.

    1999-01-01

    Chest trauma in childhood is relatively uncommon in clinical practice andhas been the subject of few reports in literature. This study was undertakento examine our experience in dealing with chest trauma in children. This wasa retrospective study of 74 children who sustained chest trauma and werereferred to King Fahd Hospital in Medina over a two-year period. The age,cause of injury, severity of injury, associated extrathoracic injuries,treatment and outcome were analyzed. The median age of patients was nineyears. Fifty-nine of them (80%) sustained blunt trauma in 62% of thechildren, gun shot wounds were seen in five and stab wounds in 10 children.Head injury was the most common injury associated with thoracic trauma andwas seen in 14 patients (19%) and associated intra-abdominal injuries wereseen in nine patients. Chest x-ray of the blunt trauma patients revealedfractured ribs in 24 children, pneumothorax in six, hemothorax in four,hemoneumothorax in three, and pulmonary contusions in 22 patients. Fifty onepercent of children were managed conservatively, 37% required tubethoracostomy, 8% were mechanically ventilated and 4% underwent thoractomy.The prevalence of chest trauma in children due to road traffic accidents ishigh in Saudi Arabia. Head injury is thought to be the most common associatedextrathoracic injuries, however, most of these patients can be managedconservatively. (author)

  18. Classification and management of chest trauma

    International Nuclear Information System (INIS)

    Farooq, U.; Raza, W.; Zia, N.; Hanif, M.; Khan, M.M.

    2006-01-01

    Objective: To classify the predominant pattern of injuries following blunt and penetrating chest trauma and to assess the adequacy of treatment strategies, complications and mortality associated with such injuries. Design: Descriptive study. Place and Duration of Study: Surgical Unit I, Holy Family Hospital, Rawalpindi, from December 2000 to December 2003. Patients and Methods: One hundred consecutive patients with thoracic trauma either blunt or penetrating, admitted in the ward were evaluated. Their injuries were classified, treatment strategies outlined and complications and mortality were documented on a specially-designed proforma. Results: Out of the 100 patients presenting in emergency, 44% presented with blunt and 56% with penetrating trauma. Pneumothorax was detected in 39% of the patients, hemopneumothorax in 29%, hemothorax in 12%, flail chest in 9%. Two had involvement of the heart and major vessels, 4% had injury to the diaphragm and 5% had multiple trauma. During treatment, 3% of all the patients were managed conservatively, 83% of patients required chest intubations, 6% needed ventilatory support and 8 % required thoracotomy. Complications were experienced in 28% of the patients of which 9% had pneumonias, 14% empyema and 5% suffered from wound infections. The overall mortality was 7%. Conclusion: This series showed the pattern of injuries following blunt and penetrating chest trauma. Furthermore, it was found that chest incubation and simple resuscitation was adequate for majority of the cases. (author)

  19. 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.

  20. Computed and conventional chest radiography: a comparison of image quality and radiation dose

    International Nuclear Information System (INIS)

    Ramli, K.; Abdullah, B.J.J.; Ng, K-H.; Hussain, A.F.; Mahmud, R.

    2005-01-01

    The aim of this study was to compare the image quality and entrance skin dose (ESD) for film-screen and computed chest radiography. Analysis of the image quality and dose on chest radiography was carried out on a conventional X-ray unit using film-screen, storage phosphor plates and selenium drum direct chest radiography. For each receptor, ESD was measured in 60 patients using thermoluminescent dosemeters. Images were printed on 35 x 43 cm films. Image quality was assessed subjectively by evaluation of anatomic features and estimation of the image quality, following the guidelines established by the protocols of the Commission of the European Communities. There was no statistically significant difference noted between the computed and conventional images (Wilcoxon rank sum test, P>0.05). Imaging of the mediastinum and peripheral lung structures were better visualized with the storage phosphor and selenium drum technique than with the film-screen combination. The patients' mean ESD for chest radiography using the storage phosphor, film-screen combination and selenium drum was 0.20, 0.20 and 0.25 mGy, respectively, with no statistically significant difference with P > 0.05 (χ 2 tests) Copyright (2005) Blackwell Publishing Asia Pty Ltd

  1. Secretion of arsenic, cholesterol, vitamin E, and zinc from the site of arsenical melanosis and leucomelanosis in skin.

    Science.gov (United States)

    Yousuf, A K M; Misbahuddin, Mir; Rahman, Md Sayedur

    2011-06-01

    Melanosis and leucomelanosis with or without keratosis are the earliest symptoms of arsenicosis. Uneven distribution of arsenical melanosis and leucomelanosis in skin led us to investigate the possibility of preferential secretion of arsenic and three constituents of sweat; cholesterol, vitamin E, and zinc. Twenty-four-hour skin secretion was collected from skin lesions and unaffected sites of 20 patients. Skin secretions were collected from 20 people exposed to arsenic-contaminated drinking water and 20 healthy, unexposed individuals. The secretion of arsenic from the skin of healthy controls (mean ± SE; unit: μg/in.(2) of skin/24 h; chest: 0.6 ± 0.2; back: 0.3 ± 0.1; abdomen: 0.5 ± 0.2) was increased several folds in arsenic-exposed controls (chest: 8.4 ± 1.8; back: 8.3 ± 1.9; abdomen: 6.7 ± 1.8) and patients (chest: 9.2 ± 1.3; back: 7.8 ± 1.3; abdomen: 5.2 ± 1.0). There was no difference in the skin lesions and unaffected sites in patients. However, the secretion of cholesterol was significantly lower in the chest of patients (190 ± 36) and healthy controls (686 ± 100) (p vitamin E were low in healthy controls (chest: 8.5 ± 3.1; back: 5.2 ± 1.7; and abdomen: 8.7 ± 2.4), higher in arsenic-exposed controls (chest: 30.2 ± 8.1; back: 16.3 ± 8.9; and abdomen: 24.8 ± 9.3), and highest in patients [chest: 91.4 ± 14.9 (p skin lesions showed no alteration in secretion of arsenic, although the secretion of cholesterol, vitamin E, and zinc was changed. Potential implications are discussed.

  2. Cutaneous skin tag

    Science.gov (United States)

    Skin tag; Acrochordon; Fibroepithelial polyp ... have diabetes. They are thought to occur from skin rubbing against skin. ... The tag sticks out of the skin and may have a short, narrow stalk connecting it to the surface of the skin. Some skin tags are as long as ...

  3. Understanding chest radiographic anatomy with MDCT reformations

    Energy Technology Data Exchange (ETDEWEB)

    Sussmann, A.R. [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States); Ko, J.P., E-mail: jane.ko@nyumc.or [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States)

    2010-02-15

    Chest radiograph interpretation requires an understanding of the mediastinal reflections and anatomical structures. Computed tomography (CT) improves the learning of three-dimensional (3D) anatomy, and more recently multidetector CT (MDCT) technology has enabled the creation of high-quality reformations in varying projections. Multiplanar reformations (MPRs) of varying thickness in the coronal and sagittal projections can be created for direct correlation with findings on frontal and lateral chest radiographs, respectively. MPRs enable simultaneous visualization of the craniocaudal extent of thoracic structures while providing the anatomic detail that has been previously illustrated using cadaveric specimens. Emphasis will be placed on improving knowledge of mediastinal anatomy and reflections including edges, lines, and stripes that are visible on chest radiographs.

  4. Design of an Electronic Chest-Band

    Science.gov (United States)

    Atakan, R.; Acikgoz Tufan, H.; Baskan, H.; Eryuruk, S. H.; Akalin, N.; Kose, H.; Li, Y.; Kursun Bahadir, S.; Kalaoglu, F.

    2017-10-01

    In this study, an electronic chest strap prototype was designed for measuring fitness level, performance optimization, mobility and fall detection. Knitting technology is used for production by using highly elastic nylon yarn. In order to evaluate comfort performance of the garment, yarn strength and elongation, air permeability, moisture management and FAST tests (Fabric Assurance Fabric Testing) were carried out, respectively. After testing of textile part of the chest band, IMU sensors were integrated onto the garment by means of conductive yarns. Electrical conductivity of the circuit was also assessed at the end. Results indicated that the weight and the thickness of the product are relatively high for sports uses and it has a negative impact on comfort properties. However, it is highly stretchable and moisture management properties are still in acceptable values. From the perspective of possible application areas, developed smart chest band in this research could be used in sports facilities as well as health care applications for elderly and disabled people.

  5. Spiral CT for evaluation of chest trauma

    International Nuclear Information System (INIS)

    Roehnert, W.; Weise, R.

    1997-01-01

    After implementation of spiral CT in our department, we carried out an analysis for determining anew the value of CT as a modality of chest trauma diagnosis in the emergency department. The retrospective study covers a period of 10 months and all emergency patients with chest trauma exmined by spiral CT. The major lesions of varying seriousness covered by this study are: pneumothorax, hematothorax, pulmonary contusion or laceration, mediastinal hematoma, rupture of a vessel, injury of the heart and pericardium. The various fractures are not included in this study. In many cases, spiral CT within relatively short time yields significant diagnostic findings, frequently saving additional angiography. A rigid diagnostic procedure cannot be formulated. Plain-film chest radiography still remains a diagnostic modality of high value. (Orig.) [de

  6. Cardiogenic shock following blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Rodríguez-González Fayna

    2010-01-01

    Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

  7. Chest radiographic manifestations of scrub typhus.

    Science.gov (United States)

    Abhilash, Kpp; Mannam, P R; Rajendran, K; John, R A; Ramasami, P

    2016-01-01

    Respiratory system involvement in scrub typhus is seen in 20-72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. The study cohort contained 398 patients. Common presenting complaints included fever (100%), generalized myalgia (83%), headache (65%), dyspnea (54%), cough (24.3%), and altered sensorium (14%). Almost half of the patients (49.4%) had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%), acute respiratory distress syndrome (14%), airspace opacity (10.5%), reticulonodular opacities (10.3%), peribronchial thickening (5.8%), and pulmonary edema (2%). Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of 2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89-33.16), invasive ventilation (OR: 18.07; 95% CI: 6.42-50.88), inotropes (OR: 8.76; 95% CI: 4.35-17.62), higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; Pscrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.

  8. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  9. Inferior hilar window on lateral chest radiographs

    International Nuclear Information System (INIS)

    Park, C.K.; Webb, W.R.; Klein, J.S.

    1990-01-01

    This paper determines the accuracy of lateral chest radiography in the detection of masses in the inferior hilar window, a normally avascular hilar region anterior to the lower lobe bronchi. Fifty patients with normal thoracic CT scans and 25 with hilar masses/adenopathy were selected retrospectively. The 75 corresponding lateral chest radiographs were blindly evaluated for visibility of the anterior walls of the lower lobe bronchi and the presence and laterality of abnormal soft tissue (>1 cm) in the inferior hilar window. Only a 7 x 7-cm square of the lateral radiograph was viewed

  10. Chest pain related to crack cocaine smoking

    International Nuclear Information System (INIS)

    Eurman, D.W.; Potash, H.I.; Eyler, W.R.; Beute, G.H.; Paganussi, P.

    1988-01-01

    The chest radiographs of 80 patients coming to emergency room because of chest pain and/or shortness of breath following the smoking of highly potent crack cocaine were retrospectively reviewed. Four showed intrathoracic free air (pneumomediastinum in two, hemopneumothorax in one, and pneumothorax in one). Four other patients showed subsegmental atelectasis or parenchymal infiltrate. Radiographic detection of these abnormalities was of importance in the clinical management of the patients. This spectrum of findings is presented with a discussion of the pathophysiologic mechanisms and other potential complications of this form of drug abuse

  11. Cardiac and pericardial calcifications on chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ferguson, E.C., E-mail: ecferguson@hotmail.co [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States); Berkowitz, E.A. [University of Texas Medical School at Houston, Department of Diagnostic and Interventional Imaging, Section of Thoracic Imaging, Houston, TX 77030 (United States)

    2010-09-15

    Many types of cardiac and pericardial calcifications identified on chest radiographs can be recognized and distinguished based on characteristic locations and appearances. The purpose of this review is to emphasize the importance of detecting cardiac and pericardial calcifications on chest radiographs, and to illustrate and describe the various types of calcifications that may be encountered and how they may be differentiated from one another. Each type of cardiac and pericardial calcification is discussed, its location and appearance described, and its significance explained. Recognizing and understanding these calcifications is important as they are often encountered in daily practice and play an important role in patient care.

  12. Chest Tube Management after Surgery for Pneumothorax.

    Science.gov (United States)

    Pompili, Cecilia; Salati, Michele; Brunelli, Alessandro

    2017-02-01

    There is scant evidence on the management of chest tubes after surgery for pneumothorax. Most of the current knowledge is extrapolated from studies performed on subjects with lung cancer. This article reviews the existing literature with particular focus on the effect of suction and no suction on the duration of air leak after lung resection and surgery for pneumothorax. Moreover, the role of regulated suction, which seems to provide some benefit in reducing pneumothorax recurrence after bullectomy and pleurodesis, is discussed. Finally, a personal view on the management of chest tubes after surgery for pneumothorax is provided. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. CHEST: Home of the Clinician-Educator.

    Science.gov (United States)

    Kelly, William F; Niven, Alexander S

    2018-03-01

    Many hands can build a house; it takes trust to make that house a home. Trust has two main components: credibility (worthiness based on preparation and past performance) and empathy (the ability to understand and share another person's values). CHEST has maintained its credibility and empathy as the global leader in clinical pulmonary, critical care, and sleep medical education. It follows that the leader in chest clinical education would also be the home of the clinician-educator. You are that educator. Published by Elsevier Inc.

  14. Possibilities of CT examinations by chest trauma

    International Nuclear Information System (INIS)

    Ftacnikova, B.

    1994-01-01

    Chest trauma represents the most frequent associated injury in multiply injured patients. The success of treatment depends also on prompt and effective diagnosis and extent of the injuries, on quality interdisciplinary approach. Author presents contributions of computed tomography (CT) in the management of 77 critically injured patients. Attention is focused on the efficacy of CT examination routinely employed in the setting of thoracic trauma and its relationship to following rationalization of treatment. CT scans of thorax is modality of choice for evaluating patients with occult pneumothorax, chest wall deformity of rib fractures, early diagnosis of lung contusion and laceration. (author). 13 figs., 1 tab., 7 refs

  15. Quality of intensive care chest imaging

    International Nuclear Information System (INIS)

    Adam, G.; Wein, B.; Keulers, P.; Stargardt, A.; Guenther, R.W.

    1989-01-01

    The authors have evaluated the image quality of a stimulable phosphorous plate system in intensive care chest radiography. Four radiologists examined 308 chest radiographs (200 conventional, 108 digital) according to the following criteria: visibility of catheters, tubes (artificial objects), bronchi, central and peripheral vessels, diaphragm, trachea, and retrocardial lung parenchyma. Detectability of these structures was classified as good, poor, or impossible to see. In addition, optical density was measured in the region of liver, heart, and lung. Results were evaluated by Student and υ test

  16. Diagnosis and Treatment of Chest Injury and Emergency Diseases of Chest Organs

    Directory of Open Access Journals (Sweden)

    A. M. Khadjibaev

    2016-01-01

    Full Text Available Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1% victims. There were 477 (22,6% patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3% patients and complicated forms of lung echinococcosis were evident in 72 patients.Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1% patients, whereas the traditional methods were effective only in 905 cases (42,9%.Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

  17. Assessment of patient radiation doses in chest X-ray examinations

    International Nuclear Information System (INIS)

    Orsini, S.; Scribano, V.S.; Merluzzi, F.; Tosca, L.

    1987-01-01

    The paper reports the initial results of a radioprotection programme for diagnostic radiology carried out in a major hospital in Milan. The data cover chest X-ray examinations. The dose values were obtained using different techniques, according to the specific diagnostic requirements in each departement. A wide radiation dose range was observed between the different techniques, with a ratio between maximum and minimum dose > 30 for the skin and the spine. The doses were however lower than those capable of inducing non-stochastic effects by about 10000 and were so low that the probability of a stochastics effect is minimal. Nevertheless, because chest X-rays are performed so frequently, it is recommended that radiologists take greater account of patient dose, as far as compatible with diagnostic requirements. Radiology technicians must strictly observe the regulations for radioprotection of the patient

  18. Dose-image quality study in digital chest radiography using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Correa, S.C.A.; Souza, E.M.; Silva, A.X.; Lopes, R.T.; Yoriyaz, H.

    2008-01-01

    One of the main preoccupations of diagnostic radiology is to guarantee a good image-sparing dose to the patient. In the present study, Monte Carlo simulations, with MCNPX code, coupled with an adult voxel female model (FAX) were performed to investigate how image quality and dose in digital chest radiography vary with tube voltage (80-150 kV) using air-gap technique and a computed radiography system. Calculated quantities were normalized to a fixed value of entrance skin exposure (ESE) of 0.0136 R. The results of the present analysis show that the image quality for chest radiography with imaging plate is improved and the dose reduced at lower tube voltage

  19. Product estimate of air kerma-area and the air kerma in the input surface of the skin of pediatric patients undergoing chest X-ray; Estimativa do produto kerma ar-area e do kerma ar na superficie de entrada da pele de pacientes pediatricos submetidos a radiografia de torax

    Energy Technology Data Exchange (ETDEWEB)

    Villa-Chan, Beatriz; Carvalho, Aline; Andrade, Marcos Ely A.; Barros, Vinicius S.M. de; Khoury, Helen J., E-mail: beatrizvillachan@gmail.com, E-mail: alinecx90@gmail.com, E-mail: marcos.ely@gmail.com, E-mail: vsmdbarros@gmail.com, E-mail: hjkhoury@gmail.com [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear

    2014-07-01

    The aim of this paper is to evaluate the entrance air kerma (Ka,e) and the product air kerma-area (Pka) for chest examinations performed with pediatric patients in a large public hospital of Recife. For this study 89 examinations of patient with ages from zero to 10 years old were evaluated. The results showed that the mean Ka,e values, for patients of 0-1 years old, 1-5 years old and 5-10 years old, were, respectively, 100 mGy, 120 mGy and 100 mGy. The Pka values for newborn patients range from 11,9 to 58,4 mGy.cm{sup 2}, for patients with 1 to 5 years old range from 17 to 192 mGy.cm{sup 2}, and from 30,4 to 136,2 mGy.cm{sup 2} for patients with ages from 5 to 10 years old. The differences in the Pka values are due the different dimensions of the radiation field. For the results its possible to conclude that the Pka values are high, in special for patients with ages from 1 to 5 years old, indicating that the collimation of the radiation field is not adequate. (author)

  20. Algorithm for optimisation of paediatric chest radiography

    International Nuclear Information System (INIS)

    Kostova-Lefterova, D.

    2016-01-01

    The purpose of this work is to assess the current practice and patient doses in paediatric chest radiography in a large university hospital. The X-ray unit is used in the paediatric department for respiratory diseases. Another purpose was to recommend and apply optimized protocols to reduce patient dose while maintaining diagnostic image quality for the x-ray images. The practice of two different radiographers was studied. The results were compared with the existing practice in paediatric chest radiography and the opportunities for optimization were identified in order to reduce patient doses. A methodology was developed for optimization of the x-ray examinations by grouping children in age groups or according to other appropriate indication and creating an algorithm for proper selection of the exposure parameters for each group. The algorithm for the optimisation of paediatric chest radiography reduced patient doses (PKA, organ dose, effective dose) between 1.5 and 6 times for the different age groups, the average glandular dose up to 10 times and the dose for the lung between 2 and 5 times. The resulting X-ray images were of good diagnostic quality. The subjectivity in the choice of exposure parameters was reduced and standardization has been achieved in the work of the radiographers. The role of the radiologist, the medical physicist and radiographer in the process of optimization was shown. It was proven the effect of teamwork in reducing patient doses at keeping adequate image quality. Key words: Chest Radiography. Paediatric Radiography. Optimization. Radiation Exposure. Radiation Protection

  1. Ventricular septal necrosis after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Alireza Ahmadi

    2012-07-01

    Full Text Available Ventricular Septal Defect (VSD after blunt chest trauma is a very rare traumatic affection.We report here a case of blunt chest injury-related VSD and pseudoaneurysm.A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edemaand echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely theintracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue somehidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinicalsequelae.

  2. 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 ...

  3. The Funen Neck and Chest Pain study

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    OBJECTIVE: To describe the Funen Neck and Chest Pain (FNCP) study and carry out a comprehensive non-response analysis of the quality of the survey. METHODS: The FNCP questionnaire was sent out to 7000 randomly selected individuals aged 20-71 years living in Funen County, Denmark. A full description...

  4. Chest pain: Coronary CT in the ER

    NARCIS (Netherlands)

    E. Maffei (Erica); S. Seitun (Sara); A.I. Guaricci (Andrea); F. Cademartiri (Filippo)

    2016-01-01

    textabstractCardiac CT has developed into a robust clinical tool during the past 15 years. Of the fields in which the potential of cardiac CT has raised more interest is chest pain in acute settings. In fact, the possibility to exclude with high reliability obstructive coronary artery disease (CAD)

  5. Adenocarcinoma - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

  6. VAC for external fixation of flail chest

    DEFF Research Database (Denmark)

    Winge, Rikke; Berg, Jais O; Albret, Rikke

    2012-01-01

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure...

  7. Image processing in digital chest radiography

    International Nuclear Information System (INIS)

    Manninen, H.; Partanen, K.; Lehtovirta, J.; Matsi, P.; Soimakallio, S.

    1992-01-01

    The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512x512 image format) viewed on a 625 line monitor were processed in 3 different ways: 1.standard display; 2.digital edge enhancement for the standard display; 3.inverse intensity display. The radiographs were interpreted independently by 3 radiologists. Diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease, 17 with pneumonia /atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases respectively. Sensitivity of conventional radiography when averaged overall findings was better than that of digital techniques (P<0.001). Differences in diagnostic accuracy measured by sensitivity and specificity between the 3 digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P<0.05) but poorer specificity for pulmonary emphysema (0.85 vs 0.93; P<0.05) compared with inverse intensity display. It is concluded that when using 512x512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted. (author). 12 refs.; 4 figs.; 2 tabs

  8. Radiography of the chest and upper airway

    International Nuclear Information System (INIS)

    Sharko, G.A.; Wilmot, D.M.

    1987-01-01

    The techniques of radiography of the chest in all pediatric-age groups differ only slightly from those used in adult radiography. The technologist's principal challenge, however, relates to optimum handling of the patient with respect to positioning and radiation protection. The hints provided in this chapter should permit the conscientious radiographer to obtain high quality radiographs on all pediatric patients

  9. Chest CT findings in pediatric Wegener's granulomatosis

    International Nuclear Information System (INIS)

    Levine, Daniel; Akikusa, Jonathan; Manson, David; Silverman, Earl; Schneider, Rayfel

    2007-01-01

    Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients. To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG). The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children. The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01). In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares. (orig.)

  10. The radiology of blunt chest trauma

    International Nuclear Information System (INIS)

    Shulman, H.S.; Samuels, T.H.

    1983-01-01

    Chest injuries and related complications prove fatal in over half of the victims of multiple trauma. The radiologist's responsibility is twofold: a) to recognize key radiographic signs and b) to guide the clinician in the radiologic investigation and management of the patient. The important diagnoses to be recognized from radiographs are pneumothorax, aortic rupture, bronhcial rupture and diaphragmatic rupture

  11. Sonographic evaluation of the chest in children

    Energy Technology Data Exchange (ETDEWEB)

    Reither, M.

    1983-02-01

    Although limited by osseous structures and gas the sonographic evaluation of the chest may be useful for certain conditions. Illustrated by three cases - supradiaphragmatic and parasternal tumor, subpulmonic effusion, and pleural effusion combined with a mediastinal tumor - the indications for ultrasound studies in children are discussed. In many cases the ultrasound may be helpful considering the diagnostic procedure and therapeutic consequences.

  12. Diagnostic value of chest ultrasound after cardiac surgery: a comparison with chest X-ray and auscultation.

    Science.gov (United States)

    Vezzani, Antonella; Manca, Tullio; Brusasco, Claudia; Santori, Gregorio; Valentino, Massimo; Nicolini, Francesco; Molardi, Alberto; Gherli, Tiziano; Corradi, Francesco

    2014-12-01

    Chest auscultation and chest x-ray commonly are used to detect postoperative abnormalities and complications in patients admitted to intensive care after cardiac surgery. The aim of the study was to evaluate whether chest ultrasound represents an effective alternative to bedside chest x-ray to identify early postoperative abnormalities. Diagnostic accuracy of chest auscultation and chest ultrasound were compared in identifying individual abnormalities detected by chest x-ray, considered the reference method. Cardiac surgery intensive care unit. One hundred fifty-one consecutive adult patients undergoing cardiac surgery. All patients included were studied by chest auscultation, ultrasound, and x-ray upon admission to intensive care after cardiac surgery. Six lung pathologic changes and endotracheal tube malposition were found. There was a highly significant correlation between abnormalities detected by chest ultrasound and x-ray (k = 0.90), but a poor correlation between chest auscultation and x-ray abnormalities (k = 0.15). Chest auscultation may help identify endotracheal tube misplacement and tension pneumothorax but it may miss most major abnormalities. Chest ultrasound represents a valid alternative to chest x-ray to detect most postoperative abnormalities and misplacements. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Non-Invasive Mechanic Ventilation Using in Flail Chest, Caused By Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Serdar Onat

    2008-01-01

    Full Text Available A 75-year-old woman admitted our faculty emergency room with shortness of breath, and chest pain after traffic accident’s second hour. She was diagnosed as bilateral multipl rib fractures, left clavicula fracture, and left flail chest by phsical and radiological examinations. She was transfered to Chest Surgery Depatment’s intensive care unit. The patient was undergone non-invasive mask mechanic ventilation support, because of the decreasing of blood oxygen saturation and increasing of arteriel blood partial carbondioxide pressure. The treatment of non-invasive mechanic ventilation was succesfull for ventilation support. With this report, we would like to attentioned that non-invasive mechanic ventilation for blunt chest trauma patients could be used succesfully and could be used instead of endotracheal invasive mechanic ventilation.

  14. Skin metastases from lung cancer: a case report.

    Science.gov (United States)

    Pajaziti, Laura; Hapçiu, Syzana Rexhepi; Dobruna, Shkendije; Hoxha, Naim; Kurshumliu, Fisnik; Pajaziti, Artina

    2015-04-11

    Lung cancer is one of the most frequent malignancies, with high mortality rates. It can metastasize in almost all organs, but more often invades hilar nodes, liver, adrenal glands, bones and brain. There are various data on the incidence of lung cancer metastases in the skin. In 1-12% of patients with lung cancer are developed skin metastases. Metastases in the skin may be the first sign of lung cancer. Forty-five years old Albanian male, smoker, was admitted to our department with multiple nodules localized in the skin of the head, neck, back and chest. The nodules measuring 5-15 millimeters in greatest dimension were round and skin-colored, with telangiectasias, firm and tender. They appeared in an eruptive form about two weeks before being admitted at our hospital. In addition, the patient exhibited signs of weight loss, anorexia and fatigue. Excisional biopsy was performed to one of the lesions. Histopathology confirmed metastatic nature of the lesion namely, malignant tumor of neuroendocrine phenotype consistent with small-cell carcinoma. Chest X-ray and computed tomography revealed an expansive process in the 7(th) segment of the left lung, left hilar and mediastinal lymphadenopathy and a suspicious initial secondary deposit in the left adrenal gland. The patient was referred to the department of oncology for further treatment. After the third cycle of chemotherapy, the magnetic resonance imaging revealed brain metastases. The patient passed away four months after the diagnosis of lung cancer first presented with skin metastases. Metastases in skin may be the first sign of lung cancer. Although rare appearing, we should raise suspicion in cases of atypical lesions in the skin not only of the smokers, but also of the non-smokers. Skin metastases from small-cell lung carcinoma are a poor prognostic indicator. The appearance of multiple skin metastases with other internal metastases shorten the survival time.

  15. Diagnostic problems in chest injuries (angiography)

    International Nuclear Information System (INIS)

    Wenz, W.; Strecker, E.P.; Kloehn, I.

    1979-01-01

    Roentgenography is the simplest and most reliable means to arrive at the diagnosis of chest injury. General roentgenograms are difficult to interpret as they tend to be technically imperfect. Fractures, emphysema, pneumothorax, accumulation of fluid can usually be ascertained directly; but the traumatic origin of changes in the pulmonary parenchyma or of an enlarged heart shadow cannot be reliably deduced from the X-ray appearance. It may provide some differential-diagnostic information but the correct interpretation of the findings depends on further observation. In 6-7% of severe chest trauma with vascular injuries and rupture of the diaphragm angiography is indicated. The evidence to be obtained from chest radiography should not be overestimated: fractures of ribs are sometimes overlocked, even by the expert; parenchymatous lesions may manifest themselves as shadows but their nature remains obscure until they have been related to the clinical and subsequent radiological findings. The same applies to rupture of the diaphragm, bronchi or vessels, if only the immediate posttraumatic roentgenographs are examined. A tent-shaped heart shadow is considered characteristic of the presence of fluid in the pericardium; this is valid only for chronic hydropericardium, but not for the potentially fatal cardiac tamponade; if the pericardium has lost its elasticity a haemorrhage of not more than 150 ml may prove fatal. Nor does the roentgenogram provide information about pulmonary function. Especially in cases of pulmonary shock minor changes in the chest roentgenogram may give a false sense of security when, in fact, blood gas analyses show that a life-endangering situation has developed. The radiologist who is aware of the limitations of the method will derive maximum diagnostic benefit from a chest angiography. No other method is capable of supplying information of such great importance in such a short time. (orig.) [de

  16. Anyone Can Get Skin Cancer

    Science.gov (United States)

    ... of Skin Cancer Skin Cancer Screening Research Anyone Can Get Skin Cancer Order the free Anyone Can ... rarely, younger children can develop skin cancer. How can people with dark skin get skin cancer? Although ...

  17. 46 CFR 78.47-70 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Portable magazine chests. 78.47-70 Section 78.47-70... Fire and Emergency Equipment, Etc. § 78.47-70 Portable magazine chests. (a) Portable magazine chest shall be marked in letters of at least 3 inches high “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND...

  18. 46 CFR 108.651 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 108.651 Section 108.651... AND EQUIPMENT Equipment Markings and Instructions § 108.651 Portable magazine chests. Each portable magazine chest must be marked: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP LIGHTS AND FIRE AWAY” in letters at...

  19. 46 CFR 97.37-47 - Portable magazine chests.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Portable magazine chests. 97.37-47 Section 97.37-47... OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: “PORTABLE MAGAZINE CHEST—FLAMMABLE—KEEP...

  20. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification...-rays as described in Appendix A. (b) A chest X-ray to establish the existence of pneumoconiosis shall...

  1. Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report

    OpenAIRE

    Idris, Baig M.; Hefny, Ashraf F.

    2016-01-01

    Introduction: Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. Presentation of case: A 63- year- old man presented...

  2. Abnormally dark or light skin

    Science.gov (United States)

    Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark ... Normal skin contains cells called melanocytes. These cells produce melanin , the substance that gives skin its color. Skin with ...

  3. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Lima, F.R.A. [Centro regional de Ciencias Nucleares, CRCN/CNEN, Rua Conego Barata, 999, Tamarineira, Recife, PE (Brazil); Kramer, R.; Vieira, J.W.; Khoury, H.J. [Departamento de Energia Nuclear, DEN/UFPE, Cidade Universitaria, Recife, PE (Brazil)]. E-mail: falima@cnen.gov.br

    2004-07-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  4. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    International Nuclear Information System (INIS)

    Lima, F.R.A.; Kramer, R.; Vieira, J.W.; Khoury, H.J.

    2004-01-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  5. The single chest tube versus double chest tube application after pulmonary lobectomy: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Xuefei Zhang

    2016-01-01

    Conclusion: Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.

  6. Clinical assessment compared with chest X-Ray after removal of chest tube to diagnose pneumothorax

    International Nuclear Information System (INIS)

    Majeed, F. A.; Noor, Q. U. H.; Mehmood, U.; Imtiaz, T.; Zafar, U.

    2017-01-01

    Objective: To evaluate clinical judgment in ruling out pneumothorax during the removal of the chest tube by auscultating the chest before removal and after the extubation of the chest tube in comparison to x ray radiological results. Study Design: Descriptive cross sectional study. Place and Duration of Study: Combined Military Hospital (CMH) Lahore Pakistan, from August 2015 to March 2016. Material and Methods: A sample size of 100 was calculated. Patients were selected via non probability purposive sampling. Children under 14 years were not included. The patients with mal-positioned chest tube, surgical site infection, air leak and the patients with more than one chest tube on one side were excluded. A proforma was made and filled by one person. Chest tubes were removed by two trained senior registrars according to a protocol devised. It was ensured that there was no air leak present before removal clinically and radiologically. Another chest x-ray was done within 24 hours of extubation to detect any pathology that might have occurred during the process. Any complication in the patient clinically was observed till the x-ray film became available. Two sets of readings were obtained. Set A included auscultation findings and set B included x ray results. Results: Out of 100 patients, 60 (60 percent) were males and 40 (40 percent) females. The ages of the patients ranged between 17-77 years. Mean age of the patient was 43.27 ± 17.05 years. In set A out of 100 (100 percent) no pneumothorax developed clinically. In set B out of 100 patients 99 (99 percent) showed no pneumothorax on chest x ray, only 1 (1 percent) showed pneumothorax which was not significant (less than 15 percent on X ray). However, the patient remained asymptomatic clinically and there was no need of reinsertion of the chest tube. Conclusion: Auscultatory findings in diagnosing a significant pneumothorax are justified. Hence, if the chest tube is removed according to the protocol, clinically by

  7. Chest radiographic manifestations of scrub typhus

    Directory of Open Access Journals (Sweden)

    KPP Abhilash

    2016-01-01

    Full Text Available Background and Rationale: Respiratory system involvement in scrub typhus is seen in 20–72% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications. Materials and Methods: Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed. Results: The study cohort contained 398 patients. Common presenting complaints included fever (100%, generalized myalgia (83%, headache (65%, dyspnea (54%, cough (24.3%, and altered sensorium (14%. Almost half of the patients (49.4% had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%, acute respiratory distress syndrome (14%, airspace opacity (10.5%, reticulonodular opacities (10.3%, peribronchial thickening (5.8%, and pulmonary edema (2%. Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of 2 mg/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89–33.16, invasive ventilation (OR: 18.07; 95% CI: 6.42–50.88, inotropes (OR: 8.76; 95% CI: 4.35–17.62, higher involvement of other organ systems, longer duration of hospital stay (3.18 ± 3 vs. 7.27 ± 5.58 days; P< 0.001, and higher mortality (OR: 4.63; 95% CI: 1.54–13.85. Conclusion: Almost half of the patients with scrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.

  8. Performance of chest ultrasound in pediatric pneumonia

    International Nuclear Information System (INIS)

    Claes, Anne-Sophie; Clapuyt, Philippe; Menten, Renaud; Michoux, Nicolas; Dumitriu, Dana

    2017-01-01

    Highlights: • Prospective comparison between chest X-ray and thoracic ultrasound for the detection of pneumonia in children. • Good correlation between X-ray and ultrasound for the detection and localization of pneumonia. • Thoracic ultrasound has an excellent negative predictive value (99%) for pediatric pneumonia. • Ultrasound may be used as a non-ionizing alternative to X-ray to exclude pneumonia in children. - Abstract: Objective: The objective of this study was to evaluate the performance of ultrasound in detecting lung consolidation in children suspected of pneumonia, in comparison to the current gold standard, chest X-rays. Materials and methods: From September 2013 to June 2014, a monocentric prospective study was performed on all children between 0 and 16 years-old, referred for chest X-ray for suspected pneumonia. Each child was examined by chest ultrasound by an examiner blinded to the chest X-ray. The presence or absence of areas of consolidation, their number and location were noted for each technique. The size of the consolidations identified only on ultrasound was compared with that of consolidations visible on both techniques. Results: 143 children (mean age 3 years; limits between 8 days and 14 years) were included. Ultrasound detected at least one area of consolidation in 44 out of 45 patients with positive X-rays. Of the 59 areas of consolidation on X-ray, ultrasound identified 54. In the 8 patients with negative X-ray, ultrasound revealed 17 areas of consolidation. The mean size of consolidations visible only on ultrasound was 9.4 mm; for consolidations visible on both techniques the mean size was 26 mm (p < 0.0001). The sensitivity and specificity of ultrasound were calculated at 98% and 92%. PPV and NPV were 85% and 99%, respectively. Conclusion: Chest ultrasound is a fast, non-ionizing and feasible technique. With its high negative predictive value, it can replace X-rays in order to exclude lung consolidation in children, thus

  9. Performance of chest ultrasound in pediatric pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Claes, Anne-Sophie, E-mail: anso.claes@gmail.com [Departement of Radiology, Pediatric and Thoracic Radiology Unit, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels (Belgium); Clapuyt, Philippe, E-mail: philippe.clapuyt@uclouvain.be [Departement of Radiology, Pediatric Radiology Unit, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels (Belgium); Menten, Renaud, E-mail: renaud.menten@uclouvain.be [Departement of Radiology, Pediatric Radiology Unit, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels (Belgium); Michoux, Nicolas, E-mail: nicolas.michoux@uclouvain.be [Departement of Radiology, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels (Belgium); Dumitriu, Dana, E-mail: dana.dumitriu@uclouvain.be [Departement of Radiology, Pediatric Radiology Unit, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels (Belgium)

    2017-03-15

    Highlights: • Prospective comparison between chest X-ray and thoracic ultrasound for the detection of pneumonia in children. • Good correlation between X-ray and ultrasound for the detection and localization of pneumonia. • Thoracic ultrasound has an excellent negative predictive value (99%) for pediatric pneumonia. • Ultrasound may be used as a non-ionizing alternative to X-ray to exclude pneumonia in children. - Abstract: Objective: The objective of this study was to evaluate the performance of ultrasound in detecting lung consolidation in children suspected of pneumonia, in comparison to the current gold standard, chest X-rays. Materials and methods: From September 2013 to June 2014, a monocentric prospective study was performed on all children between 0 and 16 years-old, referred for chest X-ray for suspected pneumonia. Each child was examined by chest ultrasound by an examiner blinded to the chest X-ray. The presence or absence of areas of consolidation, their number and location were noted for each technique. The size of the consolidations identified only on ultrasound was compared with that of consolidations visible on both techniques. Results: 143 children (mean age 3 years; limits between 8 days and 14 years) were included. Ultrasound detected at least one area of consolidation in 44 out of 45 patients with positive X-rays. Of the 59 areas of consolidation on X-ray, ultrasound identified 54. In the 8 patients with negative X-ray, ultrasound revealed 17 areas of consolidation. The mean size of consolidations visible only on ultrasound was 9.4 mm; for consolidations visible on both techniques the mean size was 26 mm (p < 0.0001). The sensitivity and specificity of ultrasound were calculated at 98% and 92%. PPV and NPV were 85% and 99%, respectively. Conclusion: Chest ultrasound is a fast, non-ionizing and feasible technique. With its high negative predictive value, it can replace X-rays in order to exclude lung consolidation in children, thus

  10. Skin color - patchy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003224.htm Skin color - patchy To use the sharing features on this page, please enable JavaScript. Patchy skin color is areas where the skin color is irregular. ...

  11. Histoplasma skin test

    Science.gov (United States)

    Histoplasmosis skin test ... health care provider cleans an area of your skin, usually the forearm. An allergen is injected just below the cleaned skin surface. An allergen is a substance that causes ...

  12. Skin Condition Finder

    Science.gov (United States)

    ... SKIN CONDITIONS HEALTH TOPICS FOR PROFESSIONALS Rash and Skin Condition Finder 1 Select Age Group Infant Child ... Toe Toe Webspace Toe Nail CLOSE About the Skin Condition Finder Have a health question or concern? ...

  13. Skin Complications of IBD

    Science.gov (United States)

    ... Home > Resources > Skin Complications of IBD Go Back Skin Complications of IBD Email Print + Share After arthritis, ... about 5% of people with inflammatory bowel disease. SKIN DISORDERS COMMONLY SEEN IN IBD ERHTHEMA NODOSUM The ...

  14. Skin Peeling Syndrome

    Directory of Open Access Journals (Sweden)

    Sharma Rajeev

    2000-01-01

    Full Text Available Peeling of the skin is an uncommonly encountered disorder. Occurrence of vesicles and bullae in peeling skin syndrome is very rare. We report a case of idiopathic peeling skin syndrome with vesicular lesions.

  15. Advances in chest drain management in thoracic disease

    Science.gov (United States)

    George, Robert S.

    2016-01-01

    An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

  16. A Novel Device for Accurate Chest Tube Insertion

    DEFF Research Database (Denmark)

    Katballe, Niels; Moeller, Lars B; Olesen, Winnie H

    2016-01-01

    BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity...... can be a challenge. METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. The forgotten view: Chest X-ray - Lateral view

    Directory of Open Access Journals (Sweden)

    Abraham M. Ittyachen

    2017-01-01

    Full Text Available With CT (computed tomography chest gaining more importance as a diagnostic tool, chest X-ray especially the lateral view is taken less commonly nowadays. Besides CT chest is also proven to be superior to chest X-ray in patients with major blunt trauma. We are presenting a 68-year old male who was partially treated from outside for a left sided pneumonia. He came to our hospital because of persisting chest pain. Chest X-ray, frontal view (postero-anterior was almost normal except for a mild opacity in the left lower zone. CT scan of the chest revealed a fluid collection posteriorly enclosed within enhancing pleura. Chest X-ray, left lateral view showed a corresponding posterior pleural based opacity. We are presenting this case to highlight the importance of the lateral view of the chest X-ray. In selected cases there is still a role for the lateral view. With the three dimensional visualization provided by the CT, the lateral view of the chest may be easier to understand. Consequent to the initial diagnosis by CT further follow up can be done with the chest X-ray. In a limited way this mitigates unnecessary expenditure and more importantly prevents the patient from exposure to harmful radiation in the form of repeated CT.

  19. Calculation of the Cardiothoracic Ratio from Portable Anteroposterior Chest Radiography

    Science.gov (United States)

    Chon, Sung Bin; Oh, Won Sup; Cho, Jun Hwi; Kim, Sam Soo

    2011-01-01

    Cardiothoracic ratio (CTR), the ratio of cardiac diameter (CD) to thoracic diameter (TD), is a useful screening method to detect cardiomegaly, but is reliable only on posteroanterior chest radiography (chest PA). We performed this cross-sectional 3-phase study to establish reliable CTR from anteroposterior chest radiography (chest AP). First, CDChest PA/CDChest AP ratios were determined at different radiation distances by manipulating chest computed tomography to simulate chest PA and AP. CDChest PA was inferred from multiplying CDChest AP by this ratio. Incorporating this CD and substituting the most recent TDChest PA, we calculated the 'corrected' CTR and compared it with the conventional one in patients who took both the chest radiographies. Finally, its validity was investigated among the critically ill patients who performed portable chest AP. CDChest PA/CDChest AP ratio was {0.00099 × (radiation distance [cm])} + 0.79 (n = 61, r = 1.00, P chest AP with an available previous chest PA. This might help physicians detect congestive cardiomegaly for patients undergoing portable chest AP. PMID:22065900

  20. Percutaneous drainage of chest abscesses in children

    International Nuclear Information System (INIS)

    Ball, W.S. Jr.; Towbin, R.B.; Bisset, G.S. III.

    1987-01-01

    Similar techniques for draining abdominal abscesses are now being applied to abscesses within the chest. This report describes the authors' experience in percutaneous drainage of seven chest abscesses in six children aged 3-13 years (mean, 7.3 years). Four pleural/extrapleural loculations were drained in three patients. Abscess location included right apex (one), right minor fissure (one), and left supradiaphragmatic (two). Collections resulted from esophageal perforation (two) or esophageal anastomotic leak (two). Three lung abscesses were drained in three patients. Abscess location included right lower, left lower, and right middle lobes. All lay adjacent to a pleural surface and were localized by CT or US before drainage. There were no complications. Complete resolution occurred in all six patients without the need for surgical intervention

  1. Chest X-ray of the neonate

    International Nuclear Information System (INIS)

    Puig, S.; Hoermann, M.; Rand, T.; Schaefer-Prokop, C.; Ponhold, W.; Kuhle, S.; Rebhandl, W.

    2000-01-01

    In diagnostic imaging of thoracic pathologies in mature and especially immature neonates, chest X-ray has a leading position. Profound knowledge of the normal chest X-ray and the potential physiological perinatal changes is the basic requirement for interpretation of the X-ray of a neonate. Childhood pathologie: Many congenital and acquired diseases that the radiologist is faced with in neonatology are unknown in the imaging of adults. Many of these changes are life-threatening or may have an impact on the patient's future quality of life. Therefore, early diagnosis in close cooperation with the paediatrician is essential. We give here an overview of the most important pathologic changes that the radiologist may be confronted with in daily routine. (orig.) [de

  2. Transmission dynamic range in chest radiology

    International Nuclear Information System (INIS)

    Lemmers, H.E.A.S.J.; Schultze Kool, L.J.; van Elburg, H.J.; Boelens, F.

    1989-01-01

    Due to the large difference in transmission between the lung area and the mediastinum, the human chest is a challenging object for radiographic imaging. This study is performed in order to define the dynamic range needed for a chest imaging chain. Eight hundred seventy-five consecutive outpatients were imaged with a prototype AMBER (advanced multiple beam equalization radiography) unit at 141 kVp. The equalization facility was disabled, allowing for the simultaneous capture of a film image and a digital dataset representing the local patient transmission in fields of approximately 2x2 cm. The datasets were analyzed to obtain the relation between the average transmission distribution in a subset of the population and physical parameters characterizing this subset, such as body weight or length

  3. Myocardial contusion following nonfatal blunt chest trauma

    International Nuclear Information System (INIS)

    Kumar, S.A.; Puri, V.K.; Mittal, V.K.; Cortez, J.

    1983-01-01

    Currently available diagnostic techniques for myocardial contusion following blunt chest trauma were evaluated. We investigated 30 patients prospectively over a period of 1 year for the presence of myocardial contusion. Among the 30 patients, eight were found to have myocardial contusion on the basis of abnormal electrocardiograms, elevated creatine phosphokinase MB fraction (CPK-MB), and positive myocardial scan. Myocardial scan was positive in seven of eight patients (87.5%). CPK-MB fraction was elevated in four of eight patients (50%). Definitive electrocardiographic changes were seen in only two of eight patients (25%). It appears that myocardial scan using technetium pyrophosphate and CPK-MB fraction determinations are the most reliable aids in diagnosis of myocardial contusion following blunt chest trauma

  4. Chest radiographic findings in acute paraquat poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Na, Gyeong Gyun; Lee, Mi Sook; Kim, Hee Jun; Sun, In O [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2016-01-15

    To describe the chest radiographic findings of acute paraquat poisoning. 691 patients visited the emergency department of our hospital between January 2006 and October 2012 for paraquat poisoning. Of these 691, we identified 56 patients whose initial chest radiographs were normal but who developed radiographic abnormalities within one week. We evaluated their radiographic findings and the differences in imaging features based on mortality. The most common finding was diffuse consolidation (29/56, 52%), followed by consolidation with linear and nodular opacities (18/56, 32%), and combined consolidation and pneumomediastinum (7/56, 13%). Pleural effusion was noted in 17 patients (30%). The two survivors (4%) showed peripheral consolidations, while the 54 patients (96%) who died demonstrated bilateral (42/54, 78%) or unilateral (12/54, 22%) diffuse consolidations. Rapidly progressing diffuse pulmonary consolidation was observed within one week on follow-up radiographs after paraquat ingestion in the deceased, but the survivors demonstrated peripheral consolidation.

  5. Chest radiographs of near-drowned children

    International Nuclear Information System (INIS)

    Wunderlich, P.; Rupprecht, E.; Burkhardt, J.; Trefftz, F.; Thomsen, H.

    1985-01-01

    From 1972 through 1983 there were 10 near-drowned children (7 boys and 3 girls) aged 1 to 4 years, treated as inpatients at the Children's Hospital of the Medical Academy Dresden. Three of them showed a severe aspiration pneumonia which in one case was complicated by bilateral pneumothoraces. In a further five children there were radiological signs of pulmonary oedema. Only in two children were the X-ray pictures of the chest normal. (orig.)

  6. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. Injuries of the chestFNx01

    Directory of Open Access Journals (Sweden)

    Deodhar S

    1979-01-01

    Full Text Available Thirty cases of chest injuries were admitted in the Department of Surgery, K.E.M. Hospital, Bombay. These injuries seem to be fairly common. Detailed examination at the time of admission is necessary to assess the clinical presentation and the presence of major complications. Institution of intra-peritoneal drainage, restoration of negative intra-pleural pressure and active respiratory physiotherapy constitute an important part of the treatment. The literature on this subject is briefly reviewed

  8. Revisit image control for pediatric chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko [Toho Univ., School of Medicine, Tokyo (Japan); Tsutsumi, Yoshiyuki; Masaki, Hidekazu [National Center for Child Health and Development, Tokyo (Japan); Shiraga, Nobuyuki [Kyousai Tachikawa Hospital, Tachikawa, Tokyo (Japan)

    2007-02-15

    The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

  9. Revisit image control for pediatric chest radiography

    International Nuclear Information System (INIS)

    Kohda, Ehiichi; Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Kawawa, Yohko; Tsutsumi, Yoshiyuki; Masaki, Hidekazu; Shiraga, Nobuyuki

    2007-01-01

    The aim of this study was to analyze the fraction defectiveness and efficacy of the patient immobilization device (PID) for pediatric chest radiography. We examined 840 plain chest radiographs in six hospitals, including four children's hospitals and two general hospitals. The mean age of the patients was 1.9 years (range 0-5 years). Two boardqualified pediatric radiologists rated (into three grades, by consensus) the degree of inspiration, rotation, lordosis, scoliosis, and cutoff or coning as well as the quality of the chest radiographs. The incidence of ''poor'' and ''very poor'' quality examinations was 2/140 and 3/140 in each of two children's hospitals using PID. The corresponding figures were 9/139 and 17/140 in the two children's hospitals that did not use PID. The general hospital using PID had 14/140 ''poor'' and ''very poor'' examinations. The general hospital that did not use PID had 28/140 ''poor'' and ''very poor'' examinations. Thus, statistically better quality chest radiography was obtained with the use of PID (P<0.001). Likewise, rotation, lordosis, and scoliosis were less frequently diagnosed as present when PID was used (P<0.001, 0.001, 0.05). Cutoff or coning had no relation to the use of PID (P=0.13). No significant difference was found between the degree of inspiration and the use of PID (P=0.56). Fraction defectiveness in the general hospital that did not use PID was as much as 14 times higher than that of the children's hospitals that used PID. The patient immobilization device is recommended for hospitals with technologists not specifically trained for pediatric examination. (author)

  10. Chest radiograph interpretation by medical students

    International Nuclear Information System (INIS)

    Jeffrey, D.R.; Goddard, P.R.; Callaway, M.P.; Greenwood, R.

    2003-01-01

    AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK

  11. 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.

  12. Chest Tomosynthesis: Technical Principles and Clinical Update

    Science.gov (United States)

    Dobbins, James T.; McAdams, H. Page

    2009-01-01

    Digital tomosynthesis is a radiographic technique that can produce an arbitrary number of section images of a patient from a single pass of the x-ray tube. It utilizes a conventional x-ray tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. While it does not have the depth resolution of computed tomography (CT), tomosynthesis provides some of the tomographic benefits of CT but at lower cost and radiation dose than CT. Compared to conventional chest radiography, chest tomosynthesis results in improved visibility of normal structures such as vessels, airway and spine. By reducing visual clutter from overlying normal anatomy, it also enhances detection of small lung nodules. This review article outlines the components of a tomosynthesis system, discusses results regarding improved lung nodule detection from the recent literature, and presents examples of nodule detection from a clinical trial in human subjects. Possible implementation strategies for use in clinical chest imaging are discussed. PMID:19616909

  13. Determinants of rib motion in flail chest.

    Science.gov (United States)

    Cappello, M; Legrand, A; De Troyer, A

    1999-03-01

    We have previously developed a canine model of isolated flail chest to assess the effects of this condition on the mechanics of breathing, and these studies have led to the conclusion that the respiratory displacement of the fractured ribs is primarily determined by the fall in pleural pressure (Delta Ppl) and the action of the parasternal intercostal muscles. The present studies were designed to test the validity of this conclusion. A flail was induced in six supine anesthetized animals by fracturing both dorsally and ventrally the second to fifth ribs on the right side of the chest, after which the phrenic nerve roots were bilaterally sectioned in the neck. Sectioning the phrenic nerves caused a 34% decrease in Delta Ppl, associated with a 39% increase in parasternal intercostal inspiratory EMG activity (p Delta Ppl during the subsequent inspiration, all animals again showed a clear-cut inward rib displacement. These observations therefore confirm that in dogs with flail chest, the inspiratory displacement of the fractured ribs is set by the balance between the force related to pleural pressure and that generated by the parasternal intercostals. These observations also point to the critical importance of the pattern of inspiratory muscle activation in determining the magnitude of rib cage paradox in such patients.

  14. Lung involvement quantification in chest radiographs

    International Nuclear Information System (INIS)

    Giacomini, Guilherme; Alvarez, Matheus; Oliveira, Marcela de; Miranda, Jose Ricardo A.; Pina, Diana R.; Pereira, Paulo C.M.; Ribeiro, Sergio M.

    2014-01-01

    Tuberculosis (TB) caused by Mycobacterium tuberculosis, is an infectious disease which remains a global health problem. The chest radiography is the commonly method employed to assess the TB's evolution. The methods for quantification of abnormalities of chest are usually performed on CT scans (CT). This quantification is important to assess the TB evolution and treatment and comparing different treatments. However, precise quantification is not feasible for the amount of CT scans required. The purpose of this work is to develop a methodology for quantification of lung damage caused by TB through chest radiographs. It was developed an algorithm for computational processing of exams in Matlab, which creates a lungs' 3D representation, with compromised dilated regions inside. The quantification of lung lesions was also made for the same patients through CT scans. The measurements from the two methods were compared and resulting in strong correlation. Applying statistical Bland and Altman, all samples were within the limits of agreement, with a confidence interval of 95%. The results showed an average variation of around 13% between the two quantification methods. The results suggest the effectiveness and applicability of the method developed, providing better risk-benefit to the patient and cost-benefit ratio for the institution. (author)

  15. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung [Samsung Medical Center, Seoul (Korea, Republic of); Chung, Seung Eun [Sangkye Paek Hospital, Seoul (Korea, Republic of)

    1996-12-15

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  16. Unilateral Hemithorax Opacification on Chest Radiograph : Comparison of Diagnostic Accuracy of Chest Ultrasonography with CT

    International Nuclear Information System (INIS)

    Namkung, Sook; Lee, Kyung Soo; Kwon, O Jung; Chung, Seung Eun

    1996-01-01

    To compare the diagnostic accuracy of chest ultrasonography (US) with computed tomography (CT) inpatients with opacification more than one third of unilateral hemithorax on chest radiograph (CXR). Chest US and CT scans from 41 consecutive patients with opacification more than one third of unilateral hemithorax on CXR were prospectively evaluated by two independent radiologists. Each radiologist recorded 1) the nature of pleural effusion (transudate vs. exudate), 2) presence or absence of pulmonary lesion, 3) the characteristic of pulmonary lesion (consolidation or atelectasis and tumor), and 4) presence of solid pleural tumor. The diagnostic accuracy of chest US was compared with CT scan in patients with pleural, pulmonary or other disease. In 32 patients with pleural effusion, differentiation between transudate and exudate was feasible in 27 (84%) patients with US and 26 (81%) patients with CT. In 32 patients with pulmonary and other pleural diseases, sensitivity, specificity and accuracy of US in lesion detection were 86%, 75% and 83% respectively when CT was regarded as a diagnostic gold standard. The diagnostic accuracy of chest US is comparable to CT in patients with hemithorax opacification on CXR

  17. An investigation into the management of acute skin reactions from tangential breast irradiation

    International Nuclear Information System (INIS)

    Meegan, M.A.; Haycocks, T.R.

    1997-01-01

    This research examined the acute skin reaction of two consecutive groups receiving tangetial breast irradiation for carcinoma of the breast. The first group used the traditional skin care advice of using warm water only within the treatment area, while the second group continued with their normal skin care regime. Data was collected on the physical manifestations of the acute reaction, medical history, the use of concurrent cytotoxic agents, treatment parameters and skin care products used. Statistical analysis using the T-test method showed no difference in the skin reaction between the two groups. The investigation has lead to a change of policy in the management of acute breast reactions. Patients receiving radiation therapy to the breast or chest wall can now use their routine skin care products with no adverse effect on skin reactions. (author)

  18. Early appearance of SARS on chest CT scan

    International Nuclear Information System (INIS)

    Cheng Xiaoguang; Feng Suchen; Xia Guoguang; Zhao Tao; Gu Xiang; Qu Hui

    2003-01-01

    Objective: To evaluate the early appearance of SARS on chest CT scan and its role in the early diagnosis. Methods: Forty cases of SARS in keeping with the criteria of the Ministry of Health had chest CT scans within 7 days of onset of symptoms, and CR chest X-ray films were available as well. These chest X-rays and CT images were retrospectively reviewed to determine if there were any abnormalities on the images. The lesions on the chest CT images were then further analyzed in terms of the number, location, size, and density. Results: Positive abnormalities on chest CT scans were revealed in all 40 SARS cases. Positive findings on CR chest films were showed in only 25 cases, equivocal in 6, and normal in 9 cases. The main abnormalities seen on CT and X-rays were pulmonary infiltrations varied markedly in severity. 70 % cases had 1 or 2 lesions on chest CT scan, 30 % cases had 3 or more lesions. The lesions seen on chest CT scan tended to be ground-glass opacification, sometimes with consolidation which was very faint and inhomogeneous, easily missed on chest X-rays. Typically the lesions were located in the periphery of the lung, or both central and peripheral lung, but very rare in a pure central location. They were commonly in the shape of patch or ball. Conclusions: Chest CT scan is much more sensitive in detecting the lesions of the lung in SARS. The early appearance of SARS on chest CT scan is characteristic but non-specific, indicating that chest CT scan plays a very important role in the early diagnosis and differential diagnosis of SARS

  19. Skin, Hair, and Nails

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Skin, Hair, and Nails KidsHealth / For Parents / Skin, Hair, and ... piel, el cabello y las uñas About Skin, Hair and Nails Skin is our largest organ. If ...

  20. Estrogens and aging skin

    OpenAIRE

    Thornton, M. Julie

    2013-01-01

    Estrogen deficiency following menopause results in atrophic skin changes and acceleration of skin aging. Estrogens significantly modulate skin physiology, targeting keratinocytes, fibroblasts, melanocytes, hair follicles and sebaceous glands, and improve angiogenesis, wound healing and immune responses. Estrogen insufficiency decreases defense against oxidative stress; skin becomes thinner with less collagen, decreased elasticity, increased wrinkling, increased dryness and reduced vascularity...

  1. Urostomy - stoma and skin care

    Science.gov (United States)

    ... it well before you attach the pouch. Avoid skin care products that contain alcohol. These can make your skin ... the pouch to your skin. Use fewer special skin care products. This will make problems with your skin less ...

  2. Risks of Skin Cancer Screening

    Science.gov (United States)

    ... factors increase or decrease the risk of skin cancer. Skin cancer is a disease in which malignant (cancer) ... following PDQ summaries for more information about skin cancer: Skin Cancer Prevention Skin Cancer Treatment Melanoma Treatment Genetics ...

  3. Radiation exposure to chest X-rays in the neonatal nursery

    International Nuclear Information System (INIS)

    Takeuchi, Toshio; Itabashi, Kazuo; Kawaguchi, Shigeru; Suzuka, Takahisa; Okuyama, Kazuo

    1989-01-01

    To measure how much very low birth-weight infants are exposed to chest X-rays during nursery, skin doses were calculated using phantoms under the same condition as that used in chest X-rays. Skin doses obtained were multiplied by the number of X-rays performed in 86 very low birth-weight infants (mean birth weight+-SD, 1163.0+-232.8 g; mean gestational age+-SD, 29.3+-3.0 week). Exposure doses per film ranged from 4.9 to 14.4 mR, with a mean dose of 6.1+-2.0 mR. Exposure doses per neonate ranged from 6.3 to 794.3 mR, with a mean dose of 170.4+-151.5 mR. The number of films per neonate ranged from one to 107, with a mean of 28.0+-24.9. Eighty-seven percent of X-rays were performed when the body weight was 1,500 g or less. Fourteen patients received 300 mR or more that may be the potential dose of radiation effects. (Namekawa, K)

  4. 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)

  5. Birt-Hogg-Dube syndrome prospectively detected by review of chest computed tomography scans.

    Directory of Open Access Journals (Sweden)

    Hye Jung Park

    Full Text Available Birt-Hogg-Dube syndrome (BHD is a rare disorder caused by mutations in the gene that encodes folliculin (FLCN and is inherited in an autosomal dominant manner. BHD is commonly accompanied by fibrofolliculomas, renal tumors, multiple pulmonary cysts, and spontaneous pneumothorax. The aim of this study was to detect BHD prospectively in patients undergoing chest computed tomography (CT scans and to evaluate further the characteristics of BHD in Korea.We prospectively checked and reviewed the chest CT scans obtained for 10,883 patients at Gangnam Severance Hospital, Seoul, Korea, from June 1, 2015 to May 31, 2016. Seventeen patients met the study inclusion criteria and underwent screening for FLCN mutation to confirm BHD. We analyzed the characteristics of the patients confirmed to have BHD and those for a further 6 patients who had previously been described in Korea.Six (0.06% of the 10,883 patients reviewed were diagnosed with BHD. There was no difference in demographic or clinical features between the patients with BHD (n = 6 and those without BHD (n = 11. Pneumothorax was present in 50% of the patients with BHD but typical skin and renal lesions were absent. The maximum size of the cysts in the BHD group (median 39.4 mm; interquartile range [IQR] 11.4 mm was significantly larger than that in the non-BHD group (median 15.8 mm; IQR 7.8 mm; P = 0.001. Variable morphology was seen in 100.0% of the cysts in the BHD group but in only 18.2% of the cysts in the non-BHD group (P = 0.002. Nine (95% of the total of 12 Korean patients with BHD had experienced pneumothorax. Typical skin and renal lesions were present in 20.0% of patients with BHD.Our findings suggest that BHD can be detected if chest CT scans are read in detail.

  6. Evaluation of chest tomosynthesis for the detection of pulmonary nodules: effect of clinical experience and comparison with chest radiography

    Science.gov (United States)

    Zachrisson, Sara; Vikgren, Jenny; Svalkvist, Angelica; Johnsson, Åse A.; Boijsen, Marianne; Flinck, Agneta; Månsson, Lars Gunnar; Kheddache, Susanne; Båth, Magnus

    2009-02-01

    Chest tomosynthesis refers to the technique of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest. In this study, a comparison of chest tomosynthesis and chest radiography in the detection of pulmonary nodules was performed and the effect of clinical experience of chest tomosynthesis was evaluated. Three senior thoracic radiologists, with more than ten years of experience of chest radiology and 6 months of clinical experience of chest tomosynthesis, acted as observers in a jackknife free-response receiver operating characteristics (JAFROC-1) study, performed on 42 patients with and 47 patients without pulmonary nodules examined with both chest tomosynthesis and chest radiography. MDCT was used as reference and the total number of nodules found using MDCT was 131. To investigate the effect of additional clinical experience of chest tomosynthesis, a second reading session of the tomosynthesis images was performed one year after the initial one. The JAFROC-1 figure of merit (FOM) was used as the principal measure of detectability. In comparison with chest radiography, chest tomosynthesis performed significantly better with regard to detectability. The observer-averaged JAFROC-1 FOM was 0.61 for tomosynthesis and 0.40 for radiography, giving a statistically significant difference between the techniques of 0.21 (p<0.0001). The observer-averaged JAFROC-1 FOM of the second reading of the tomosynthesis cases was not significantly higher than that of the first reading, indicating no improvement in detectability due to additional clinical experience of tomosynthesis.

  7. Lung Morphological Changes in Closed Chest Injury (an experimental study

    Directory of Open Access Journals (Sweden)

    A. M. Golubev

    2012-01-01

    Full Text Available Objective: to study lung morphological changes in a closed chest injury model in laboratory animals. Material and methods. Experiments were carried out in 30 male albino nonbred rats weighing 350—380 g. Closed chest injury was simulated, by exposing the chest of anesthetized rats to a 300-g metal cylinder falling from a height of 30 cm. The observation periods were 1, 3, 6, and 24 hours. Results. The signs of evident perivenular edema that was uncharas-teristic to acute respiratory distress syndrome induced by other causes are an important peculiarity of lung morphological changes in this experimental model of closed chest injury. Conclusion. The experimental studies clarified the pattern of lung morphological changes in the early period after closed chest injury. Key words: closed chest injury, pulmonary edema.

  8. 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

  9. Bacteriological research for the contamination of equipment in chest radiography

    International Nuclear Information System (INIS)

    Choi, Seung Gu; Song, Woon Heung; Kweon, Dae Cheol

    2015-01-01

    The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections

  10. 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)

  11. Bacteriological research for the contamination of equipment in chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Gu; Song, Woon Heung; Kweon, Dae Cheol [Shinhan University, Uijeongbu (Korea, Republic of)

    2015-12-15

    The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections.

  12. Does hemopericardium after chest trauma mandate sternotomy?

    Science.gov (United States)

    Thorson, Chad M; Namias, Nicholas; Van Haren, Robert M; Guarch, Gerardo A; Ginzburg, Enrique; Salerno, Tomas A; Schulman, Carl I; Livingstone, Alan S; Proctor, Kenneth G

    2012-06-01

    Recently, three patients with hemopericardium after severe chest trauma were successfully managed nonoperatively at our institution. This prompted the question whether these were rare or common events. Therefore, we reviewed our experience with similar injuries to test the hypothesis that trauma-induced hemopericardium mandates sternotomy. Records were retrospectively reviewed for all patients at a Level I trauma center (December 1996 to November 2011) who sustained chest trauma with pericardial window (PCW, n = 377) and/or median sternotomy (n = 110). Fifty-five (15%) patients with positive PCW proceeded to sternotomy. Penetrating injury was the dominant mechanism (n = 49, 89%). Nineteen (35%) were hypotensive on arrival or during initial resuscitation. Most received surgeon-performed focused cardiac ultrasound examinations (n = 43, 78%) with positive results (n = 25, 58%). Ventricular injuries were most common, with equivalent numbers occurring on the right (n = 16, 29%) and left (n = 15, 27%). Six (11%) with positive PCW had isolated pericardial lacerations, but 21 (38%) had no repairable cardiac or great vessel injury. Those with therapeutic versus nontherapeutic sternotomies were similar with respect to age, mechanisms of injury, injury severity scores, presenting laboratory values, resuscitation fluids, and vital signs. Multiple logistic regression revealed that penetrating trauma (odds ratio: 13.3) and hemodynamic instability (odds ratio: 7.8) were independent predictors of therapeutic sternotomy. Hemopericardium per se may be overly sensitive for diagnosing cardiac or great vessel injuries after chest trauma. Some stable blunt or penetrating trauma patients without continuing intrapericardial bleeding had nontherapeutic sternotomies, suggesting that this intervention could be avoided in selected cases. Therapeutic study, level III. Copyright © 2012 by Lippincott Williams & Wilkins.

  13. Chest trauma in children, single center experience.

    Science.gov (United States)

    Ismail, Mohamed Fouad; al-Refaie, Reda Ibrahim

    2012-10-01

    Trauma is the leading cause of mortality in children over one year of age in industrialized countries. In this retrospective study we reviewed all chest trauma in pediatric patients admitted to Mansoura University Emergency Hospital from January 1997 to January 2007. Our hospital received 472 patients under the age of 18. Male patients were 374 with a mean age of 9.2±4.9 years. Causes were penetrating trauma (2.1%) and blunt trauma (97.9%). The trauma was pedestrian injuries (38.3%), motor vehicle (28.1%), motorcycle crash (19.9%), falling from height (6.7%), animal trauma (2.9%), and sports injury (1.2%). Type of injury was pulmonary contusions (27.1%) and lacerations (6.9%), rib fractures (23.9%), flail chest (2.5%), hemothorax (18%), hemopneumothorax (11.8%), pneumothorax (23.7%), surgical emphysema (6.1%), tracheobronchial injury (5.3%), and diaphragm injury (2.1%). Associated lesions were head injuries (38.9%), bone fractures (33.5%), and abdominal injuries (16.7%). Management was conservative (29.9%), tube thoracostomy (58.1%), and thoracotomy (12.1%). Mortality rate was 7.2% and multiple trauma was the main cause of death (82.3%) (Ptrauma is the most common cause of pediatric chest trauma and often due to pedestrian injuries. Rib fractures and pulmonary contusions are the most frequent injuries. Delay in diagnosis and multiple trauma are associated with high incidence of mortality. Copyright © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved.

  14. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  15. An Unusual Cause of Precordial Chest Pain

    Directory of Open Access Journals (Sweden)

    Sevket Ozkaya

    2013-01-01

    Full Text Available Extraskeletal chondrosarcoma in anterior mediastinum is very rare. A 45-year-old male patient was admitted to the hospital with precordial chest pain. A large and well-shaped mass in the anterior mediastinum was seen radiologically, and there was a clearly compression of the heart by the mass. The lesion was totally resected, and extraskeletal mediastinal chondrosarcoma was histopathologically diagnosed. We aimed to present and discuss the radiologic, clinic, and histopathologic features of unusual presentation of extraskeletal chondrosarcoma in a case.

  16. Radiological diagnosis and therapy of chest pain

    International Nuclear Information System (INIS)

    Kutzner, J.; Ernst, H.

    1980-01-01

    The causes and localization of chest pain are numerous. They can derive from infections, traumas, or tumors. Possible sites of origin are: skeletal portions, vertebral column, ribs, and sternum, as well as mediastinum and pleura. In women, occurrence tends to be cyclic and affect the mamma region. Radiological diagnosis includes radiography, nuclear techniques as well as whole body computer-tomography. Radiation therapy is indicated in cases of mediastinal tumor formation. Radiation of painful osteolytic vertebral metastases and rib destructions proves to be an efficient palliative measure. (orig.) [de

  17. Esophageal dynamics scintigraphy in noncoronarian chest pain

    International Nuclear Information System (INIS)

    Oliveira Lemme, E.M. de.; Souto, F.J.D.; Penas, M.E.

    1990-01-01

    A group of 27 patients with noncoronarian chest pain (NCCP) was submitted to radionuclide transit as part of esophageal disorders investigation. Features were compared with radiological examinations: barium swallow (BS) and bread-barium swallow (BBS). Abnormal radionuclide transit was found in 63% of patients and incoordinating pattern was the most frequent finding. Motor disorders were detected in 18.5% and 33% of patients by BS and BBS respectively. We conclude that radionuclide transit is a sensitive method for investigation of esophageal motor disorders and we recommend it as a screening test in NCCP, since it is a simple and very well tolerated technique. (author)

  18. Atrioventricular Dissociation following Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Salim Surani

    2014-01-01

    Full Text Available Blunt chest trauma (BCT is a common clinical presentation seen in emergency departments. Few cases of cardiac conduction abnormalities due to BCT have been reported in the medical literature. This dysrhythmias may present as permanent conduction defects requiring permanent pacemaker or may have temporary conduction abnormalities requiring temporary pacemaker or supportive care. We present the case of a young woman who suffered from BCT after being kicked by a horse with the development of a significant substernal hematoma. She developed temporary atrioventricular block, which was completely resolved with the decrease in the size of the substernal hematoma suffered.

  19. Digital luminescence radiography using a chest phantom

    International Nuclear Information System (INIS)

    Lyttkens, K.; Kehler, M.; Andersson, B.; Carlsen, S.; Ebbesen, A.; Hochbergs, P.; Stroembaeck, A.

    1993-01-01

    With the introduction of picture and archiving communicating systems an alternative image display for the wards might be a personal computer (PC). The intention with this study was to evaluate the diagnostic image quality of the monitor of a PC compared to that of a workstation. Eighty-five digital radiographs of a chest phantom with simulated tumors in the mediastinum and right lung were saved on optical discs. The examinations were reviewed by 4 radiologists on a monitor at a workstation and at a PC, and receiver operating characteristic (ROC) curves were constructed. No significant difference was found between performance of the PC and the workstation. (orig.)

  20. Computer-assisted optimization of chest fluoroscopy

    International Nuclear Information System (INIS)

    Korolyuk, I.P.; Filippova, N.V.; Kirillov, L.P.; Momsenko, S.F.

    1987-01-01

    The main trends in the use of computer for the optimization of chest fluorography among employees and workers of a large industrial enterprise are considered. The following directions were determined: automatted sorting of fluorograms, formalization of X-ray signs in describing fluorograms, organization of a special system of fluorographic data management. Four levels of algorithms to solve the problems of fluorography were considered: 1) shops, personnel department, etc.; 2) an automated center for mass screening and a medical unit; 3) a computer center and 4) planning and management service. The results of computer use over a 3-year period were analyzed. The efficacy of computer was shown

  1. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain

    OpenAIRE

    Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

    2016-01-01

    Background and Objectives A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Subjects and Methods Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were ex...

  2. Pulmonary effects of synthetic marijuana: chest radiography and CT findings.

    Science.gov (United States)

    Berkowitz, Eugene A; Henry, Travis S; Veeraraghavan, Srihari; Staton, Gerald W; Gal, Anthony A

    2015-04-01

    The purpose of this article is to present the first chest radiographic and CT descriptions of organizing pneumonia in response to smoking synthetic marijuana. Chest radiographs showed a diffuse miliary-micronodular pattern. Chest CT images showed diffuse centrilobular nodules and tree-in-bud pattern and a histopathologic pattern of organizing pneumonia with or without patchy acute alveolar damage. This distinct imaging pattern should alert radiologists to include synthetic marijuana abuse in the differential diagnosis.

  3. OBLITERATION OF COSTOPHRENIC ANGTE IN A PLAIN X - RAY CHEST

    Directory of Open Access Journals (Sweden)

    Ramakrishna

    2015-08-01

    Full Text Available Obliteration of Costophrenicangle can be a pleural effusion in a majority of cases but other causes of mediastinal masses , aortic aneurysm , postpneumonectomy , lung and pleural masses and consolidation and collapse of the lung can cause shadows mimicking pleural effusion. It is always essential to take the help of later al and decubitus films , ultrasonography of chest and CT scan chest to come to a proper diagnosis. Inadvertent pleural aspiration basing on chest x - ray PA alone can have disastrous consequences

  4. Pulmonary disease in cystic fibrosis: assessment with chest CT at chest radiography dose levels.

    Science.gov (United States)

    Ernst, Caroline W; Basten, Ines A; Ilsen, Bart; Buls, Nico; Van Gompel, Gert; De Wachter, Elke; Nieboer, Koenraad H; Verhelle, Filip; Malfroot, Anne; Coomans, Danny; De Maeseneer, Michel; de Mey, Johan

    2014-11-01

    To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlation coefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (chest CT protocol can replace the two yearly follow-up chest radiographic examinations without major dose penalty and with similar diagnostic quality compared with conventional CT.

  5. Nodule detection in digital chest radiography: Summary of the radius chest trial

    International Nuclear Information System (INIS)

    Haakansson, M.; Baath, M.; Boerjesson, S.; Kheddache, S.; Grahn, A.; Ruschin, M.; Tingberg, A.; Mattson, S.; Maansson, L. G.

    2005-01-01

    As a part of the Europe-wide research project 'Unification of physical and clinical requirements for medical X-ray imaging' - governed by the Radiological Imaging Unification Strategies (RADIUS) Group - a major image quality trial was conducted by members of the group. The RADIUS chest trial aimed at thoroughly examining various aspects of nodule detection in digital chest radiography, such as the effects of nodule location, system noise, anatomical noise, and anatomical background. The main findings of the RADIUS chest trial concerning the detection of a lung nodule with a size in the order of 10 mm can be summarised as: (1) the detectability of the nodule is largely dependent on its location in the chest, (2) the system noise has a minor impact on the detectability at the dose levels used today, (3) the disturbance of the anatomical noise is larger than that of the system noise but smaller than that of the anatomical background and (4) the anatomical background acts as noise to a large extent and is the major image component affecting the detectability of the nodule. (authors)

  6. Utility of Chest Computed Tomography after a "Normal" Chest Radiograph in Patients with Thoracic Stab Wounds.

    Science.gov (United States)

    Nguyen, Brian M; Plurad, David; Abrishami, Sadaf; Neville, Angela; Putnam, Brant; Kim, Dennis Y

    2015-10-01

    Chest computed tomography (CCT) is used to screen for injuries in hemodynamically stable patients with penetrating injury. We aim to determine the incidence of missed injuries detected on CCT after a negative chest radiograph (CXR) in patients with thoracic stab wounds. A 10-year retrospective review of a Level I trauma center registry was performed on patients with thoracic stab wounds. Patients who were hemodynamically unstable or did not undergo both CXR and CCT were excluded. Patients with a negative CXR were evaluated to determine if additional findings were diagnosed on CCT. Of 386 patients with stab wounds to the chest, 154 (40%) underwent both CXR and CCT. One hundred and fifteen (75%) had a negative screening CXR. CCT identified injuries in 42 patients (37%) that were not seen on CXR. Pneumothorax and/or hemothorax occurred in 40 patients (35%), of which 14 patients underwent tube thoracostomy. Two patients had hemopericardium on CCT and both required operative intervention. Greater than one-third of patients with a normal screening CXR were found to have abnormalities on CCT. Future studies comparing repeat CXR to CCT are required to further define the optimal diagnostic strategy in patients with stab wounds to chest after normal screening CXR.

  7. Determination of entrance skin dose from diagnostic X-ray of human ...

    African Journals Online (AJOL)

    patient during x-ray examination in Federal Medical Centre, Keffi in Nasarawa state, Nigeria. Entrance skin doses (ESDs) for a common type of x-ray procedures, namely chest AP/PA (anterior/posterior) were measured. A total of 200 data were collected from patients who were exposed to diagnostic X-ray during their routine ...

  8. Staphylococcus aureus sternal osteomyelitis: a rare cause of chest pain

    Directory of Open Access Journals (Sweden)

    Kaur M

    2015-10-01

    Full Text Available Chest pain is a common presenting symptom with a broad differential. Life-threatening cardiac and pulmonary etiologies of chest pain should be evaluated first. However, it is critical to perform a thorough assessment for other sources of chest pain in order to limit morbidity and mortality from less common causes. We present a rare case of a previously healthy 45 year old man who presented with focal, substernal, reproducible chest pain and Staphylococcus aureus bacteremia who was later found to have primary Staphylococcus aureus sternal osteomyelitis.

  9. Heartburn or Chest Pain: When Is It Heart Attack?

    Science.gov (United States)

    ... of cardiovascular imaging in emergency department patients with chest pain: A joint document of the American College of Radiology Appropriateness Criteria Committee and the American College of ...

  10. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    International Nuclear Information System (INIS)

    Palas, J.; Matos, A.P.; Ramalho, M.; Mascarenhas, V.; Heredia, V.

    2014-01-01

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  11. Biometric estimation of chest wall thickness of females

    International Nuclear Information System (INIS)

    Berger, C.D.; Lane, B.H.

    1985-01-01

    Optimal use of whole-body counting data to estimate pulmonary deposition of many of the actinides is dependent upon accurate measurement of the thickness of the chest wall because of severe attenuation of low-energy x rays and photons associated with the decay of these radionuclides. An algorithm for estimation of female chest wall thicknesses, verified by real-time ultrasonic measurements, has been derived based on the correlation of measured chest wall thickness and other common biometric quantities. Use of this algorithm will reduce the error generally associated with estimation of internal actinide deposition previously resulting from assuming an average chest wall thickness for all female subjects

  12. Chest trauma in children: current imaging guidelines and techniques.

    LENUS (Irish Health Repository)

    Moore, Michael A

    2011-09-01

    Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child\\'s clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

  13. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    Directory of Open Access Journals (Sweden)

    João Palas

    2014-01-01

    Full Text Available Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  14. The impact of chest compression rates on quality of chest compressions - a manikin study.

    Science.gov (United States)

    Field, Richard A; Soar, Jasmeet; Davies, Robin P; Akhtar, Naheed; Perkins, Gavin D

    2012-03-01

    Chest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables. Twenty healthcare professionals performed 2 min of continuous compressions on an instrumented manikin at rates of 80, 100, 120, 140 and 160 min(-1) in a random order. An electronic metronome was used to guide compression rate. Compression data were analysed by repeated measures ANOVA and are presented as mean (SD). Non-parametric data was analysed by Friedman test. At faster compression rates there were significant improvements in the number of compressions delivered (160(2) at 80 min(-1) vs. 312(13) compressions at 160 min(-1), P<0.001); and compression duty-cycle (43(6)% at 80 min(-1) vs. 50(7)% at 160 min(-1), P<0.001). This was at the cost of a significant reduction in compression depth (39.5(10)mm at 80 min(-1) vs. 34.5(11)mm at 160 min(-1), P<0.001); and earlier decay in compression quality (median decay point 120 s at 80 min(-1) vs. 40s at 160 min(-1), P<0.001). Additionally not all participants achieved the target rate (100% at 80 min(-1) vs. 70% at 160 min(-1)). Rates above 120 min(-1) had the greatest impact on reducing chest compression quality. For Guidelines 2005 trained rescuers, a chest compression rate of 100-120 min(-1) for 2 min is feasible whilst maintaining adequate chest compression quality in terms of depth, duty-cycle, leaning, and decay in compression performance. Further studies are needed to assess the impact of the Guidelines 2010 recommendation for deeper and faster chest compressions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Errors in chest x-ray interpretation

    International Nuclear Information System (INIS)

    Woznitza, N.; Piper, K.

    2015-01-01

    Full text: Reporting of adult chest x-rays by appropriately trained radiographers is frequently used in the United Kingdom as one method to maintain a patient focused radiology service in times of increasing workload. With models of advanced practice being developed in Australia, New Zealand and Canada, the spotlight is on the evidence base which underpins radiographer reporting. It is essential that any radiographer who extends their scope of practice to incorporate definitive clinical reporting perform at a level comparable to a consultant radiologist. In any analysis of performance it is important to quantify levels of sensitivity and specificity and to evaluate areas of error and variation. A critical review of the errors made by reporting radiographers in the interpretation of adult chest x-rays will be performed, examining performance in structured clinical examinations, clinical audit and a diagnostic accuracy study from research undertaken by the authors, and including studies which have compared the performance of reporting radiographers and consultant radiologists. overall performance will be examined and common errors discussed using a case based approach. Methods of error reduction, including multidisciplinary team meetings and ongoing learning will be considered

  16. 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.

  17. Optical compensation device for chest film radiography

    Science.gov (United States)

    Gould, Robert G.; Hasegawa, Bruce H.; DeForest, Sherman E.; Schmidt, Gregory W.; Hier, Richard G.

    1990-07-01

    Although chest radiography is the most commonly performed radiographic examination and one of the most valuable and cost-effective studies in medicine it suffers from relatively high error rates in both missing pathology and false positive interpretations. Detectability of lung nodules and other structures in underpenetrated regions of the chest film can be improved by both exposure and optical compensation but current compensation systems require major capital cost or a significant change in normal clinical practice. A new optical compensation system called the " Intelligent X-Ray Illuminator" (IXI) automatically and virtually instantaneously generates a patient-specific optical unsharp mask that is projected directly on a radiograph. When a radiograph is placed on the IXI which looks much like a conventional viewbox it acquires a low-resolution electronic image of this film from which the film transmission is derived. The transmission information is inverted and blurred in an image processor to form an unsharp mask which is fed into a spatial light modulator (SLM) placed between a light source and the radiograph. The SLM tailors the viewbox luminance by decreasing illumination to underexposed (i. e. transmissive) areas of the radiograph presenting the observer with an optically unsharp-masked image. The IXI uses the original radiograph and will allow it to be viewed on demand with conventional (uniform illumination. Potentially the IXI could introduce the known beneficial aspects of optical unsharp masking into radiology at low capital

  18. The chest radiological manifestation in psittacosis

    International Nuclear Information System (INIS)

    Zhang Jun; Fu Jiazhen; Wang Shulan; Zhang Shuxin; Sun Guochang; Tang Guangjian

    2005-01-01

    Objective: To summarize the clinical characteristics and imaging features of psittacosis. Methods: The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed. Results: The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dissociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of neutrophils might be increased. The chest X-ray and CT scan showed air-space consolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were also present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittaci. Erythromycin was effective in all 3 patients. Conclusion: Although the appearance of psittacosis on clinical findings and chest X-ray and CT scan is not characteristic, psittacosis can be diagnosed with the combination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging features of psittacosis is helpful in differential diagnosis. (authors)

  19. Cross-chest liposuction in gynaecomastia

    Directory of Open Access Journals (Sweden)

    Biju Murali

    2011-01-01

    Full Text Available Background: Gynaecomastia is usually treated with liposuction or liposuction with excision of the glandular tissue. The type of surgery chosen depends on the grade of the condition. Objective: Because gynaecomastia is treated primarily as a cosmetic procedure, we aimed at reducing the invasiveness of the surgery. Materials and Methods: The technique complies with all recommended protocols for different grades of gynaecomastia. It uses liposuction, gland excision, or both, leaving only minimal post-operative scars. The use of cross-chest liposuction through incisions on the edge of the areola helps to get rid of all the fat under the areola without an additional scar as in the conventional method. Results: This is a short series of 20 patients, all with bilateral gynaecomastia (i.e., 40 breasts, belonging to Simon′s Stage 1 and 2, studied over a period of 2 years. The average period of follow-up was 15 months. Post-operative complications were reported in only two cases, with none showing long-term complications or issues specifically due to the procedure. Conclusions : Cross-chest liposuction for gynaecomastia is a simple yet effective surgical tool in bilateral gynaecomastia treatment to decrease the post-operative scars. The use of techniques like incision line drain placement and post-drain removal suturing of wounds aid in decreasing the scar.

  20. Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report.

    Science.gov (United States)

    Idris, Baig M; Hefny, Ashraf F

    2016-01-01

    Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. A 63- year- old man presented to the Emergency Department complaining of left lateral chest pain due to a fall on his chest at home. On examination, he was hemodynamically stable. An urgent chest X-ray showed evidence of left sided pneumothorax. CT scan of the chest showed pneumothorax of more than 30% of the left hemithorax (around 600ml of air) with multiple left ribs fracture. Patient refused tube thoracostomy and was admitted to surgical department for close observation. The patient was managed conservatively without chest tube insertion. A repeat CT scan of the chest has shown complete resolution of the pneumothorax. The clinical spectrum of pneumothorax varies from asymptomatic to life threatening tension pneumothorax. In stable patients, conservative management can be safe and effective for small pneumothorax. To the best of our knowledge, this is the second reported case in the English literature with large pneumothorax which resolved spontaneously without chest drain. Blunt traumatic large pneumothorax in a clinically stable patient can be managed conservatively. Current recommendations for tube placement may need to be reevaluated. This may reduce morbidity associated with chest tube thoracostomy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Oily skin: an overview.

    Science.gov (United States)

    Sakuma, Thais H; Maibach, Howard I

    2012-01-01

    Oily skin (seborrhea) is a common cosmetic problem that occurs when oversized sebaceous glands produce excessive amounts of sebum giving the appearance of shiny and greasy skin. This paper overviews the main concepts of sebaceous gland anatomy and physiology, including the biosynthesis, storage and release of sebum, as well as its relationship to skin hydration and water barrier function. We also address how skin oiliness may vary according to diet, age, gender, ethnicity and hot humid climates. The deeper understanding of this skin type provides the opportunity to better guide patients regarding skin care and also assist in the development of sebosuppressive agents. Copyright © 2012 S. Karger AG, Basel.

  2. Comparison of chest compression quality between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method during CPR.

    Science.gov (United States)

    Park, Sang-Sub

    2014-01-01

    The purpose of this study is to grasp difference in quality of chest compression accuracy between the modified chest compression method with the use of smartphone application and the standardized traditional chest compression method. Participants were progressed 64 people except 6 absentees among 70 people who agreed to participation with completing the CPR curriculum. In the classification of group in participants, the modified chest compression method was called as smartphone group (33 people). The standardized chest compression method was called as traditional group (31 people). The common equipments in both groups were used Manikin for practice and Manikin for evaluation. In the meantime, the smartphone group for application was utilized Android and iOS Operating System (OS) of 2 smartphone products (G, i). The measurement period was conducted from September 25th to 26th, 2012. Data analysis was used SPSS WIN 12.0 program. As a result of research, the proper compression depth (mm) was shown the proper compression depth (p< 0.01) in traditional group (53.77 mm) compared to smartphone group (48.35 mm). Even the proper chest compression (%) was formed suitably (p< 0.05) in traditional group (73.96%) more than smartphone group (60.51%). As for the awareness of chest compression accuracy, the traditional group (3.83 points) had the higher awareness of chest compression accuracy (p< 0.001) than the smartphone group (2.32 points). In the questionnaire that was additionally carried out 1 question only in smartphone group, the modified chest compression method with the use of smartphone had the high negative reason in rescuer for occurrence of hand back pain (48.5%) and unstable posture (21.2%).

  3. Ultrasonic measurements of chest wall thickness and realistic chest phantom for calibration of Pu lung counting facilities

    International Nuclear Information System (INIS)

    Shirotani, Takashi

    1990-01-01

    There are four important problems for the measurements of chest wall thickness using ultrasonic device: (1) selection of optimum position of transducer and the number of measured points on the chest covered with detector, (2) estimation of adipose-to-muscle ratio in the chest wall, especially for dispersed adipose like 'marbled beef', (3) determination of regression equations for the prediction of chest wall thickness, derived from groups of different body shape, i.e. corpulent and lean, and (4) estimation of effective chest wall thickness involved self-absorption layer of lung tissue, which changes with distribution of activity in the lungs. This quantity can not be measured with ultrasonic device. Realistic chest phantom was developed. The phantom contains removable model organs (lungs, liver, kidneys and heart), model trachea and artificial rib cage, and also includes chest plates that can be placed over the chest to simulate wide range adipose-to-muscle ratio in the chest wall. Various soft tissue substitutes were made of polyurethane with different concentrations of additive, and the rib cage were made of epoxy resin with calcium carbonate. The experimental data have shown that the phantom can be used as a standard phantom for the calibration. (author)

  4. Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts.

    Science.gov (United States)

    Olson-Kennedy, Johanna; Warus, Jonathan; Okonta, Vivian; Belzer, Marvin; Clark, Leslie F

    2018-05-01

    Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery. Using a novel measure of chest dysphoria, this cohort study at a large, urban, hospital-affiliated ambulatory clinic specializing in transgender youth care collected survey data about testosterone use and chest distress among transmasculine youth and young adults. Additional information about regret and adverse effects was collected from those who had undergone surgery. Eligible youth were 13 to 25 years old, had been assigned female at birth, and had an identified gender as something other than female. Recruitment occurred during clinical visits and via telephone between June 2016 and December 2016. Surveys were collected from participants who had undergone chest surgery at the time of survey collection and an equal number of youth who had not undergone surgery. Outcomes were chest dysphoria composite score (range 0-51, with higher scores indicating greater distress) in all participants; desire for chest surgery in patients who had not had surgery; and regret about surgery and complications of surgery in patients who were postsurgical. Of 136 completed surveys, 68 (50.0%) were from postsurgical participants, and 68 (50.0%) were from nonsurgical participants. At the time of the survey, the mean (SD) age was 19 (2.5) years for postsurgical participants and 17 (2.5) years for nonsurgical participants. Chest dysphoria composite score mean (SD) was 29.6 (10.0) for participants who had not undergone chest reconstruction, which

  5. Skin Stem Cells in Skin Cell Therapy

    Directory of Open Access Journals (Sweden)

    Mollapour Sisakht

    2015-12-01

    Full Text Available Context Preclinical and clinical research has shown that stem cell therapy is a promising therapeutic option for many diseases. This article describes skin stem cells sources and their therapeutic applications. Evidence Acquisition Compared with conventional methods, cell therapy reduces the surgical burden for patients because it is simple and less time-consuming. Skin cell therapy has been developed for variety of diseases. By isolation of the skin stem cell from the niche, in vitro expansion and transplantation of cells offers a surprising healing capacity profile. Results Stem cells located in skin cells have shown interesting properties such as plasticity, transdifferentiation, and specificity. Mesenchymal cells of the dermis, hypodermis, and other sources are currently being investigated to promote regeneration. Conclusions Because skin stem cells are highly accessible from autologous sources and their immunological profile is unique, they are ideal for therapeutic approaches. Optimization of administrative routes requires more investigation own to the lack of a standard protocol.

  6. Examine Your Skin

    Science.gov (United States)

    ... Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video below and in only two minutes, you can learn to examine your skin. A special thanks to Dr. Martin Weinstock, MD, ...

  7. Examine Your Skin

    Medline Plus

    Full Text Available ... Support Donate Share Facebook Twitter Newsletter Examine Your Skin Watch the video below and in only two minutes, you can learn to examine your skin. A special thanks to Dr. Martin Weinstock, MD, ...

  8. Bleeding into the skin

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003235.htm Bleeding into the skin To use the sharing features on this page, please enable JavaScript. Bleeding into the skin can occur from broken blood ...

  9. Mantoux Tuberculin Skin Test

    Centers for Disease Control (CDC) Podcasts

    Learn how to evaluate people for latent TB infection with the Mantoux tuberculin skin test. This podcast includes sections on administering and reading the Mantoux tuberculin skin test, the standard method for detecting latent TB infection since the 1930s.

  10. Skin graft - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100100.htm Skin graft - series—Normal anatomy To use the sharing features ... entire body, and acts as a protective barrier. Skin grafts may be recommended for: Extensive wounds Burns Specific ...

  11. Laser surgery - skin

    Science.gov (United States)

    ... Bleeding Problem not going away Infection Pain Scarring Skin color changes Some laser surgery is done when you are asleep and ... TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical ... lasers, lights, and tissue interactions. In: Hruza GJ, Avram ...

  12. Examine Your Skin

    Medline Plus

    Full Text Available ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ... Suggestions Examine Your Skin Newly Diagnosed? Understanding Your Pathology Biopsy: The First Step Sentinel Node Biopsy Melanoma ...

  13. Paediatric dose measurements for chest X-ray examinations at Maternity and Children Hospital in Najran - Saudi Arabia

    International Nuclear Information System (INIS)

    Saeed, M.K.; Al-Qahtani, J.M.

    2012-01-01

    The entrance skin dose (ESD) of chest X-ray examinations for AP and PA projections of paediatric patients at Maternity and Children Hospital in Najran, Saudi Arabia have been obtained using DoseCal software. The majority of the results obtained show low measured ESD for chest X-ray examinations. The mean of ESD for the AP projection was found to be 37.5, 40.5, 41.3, and 52.3μGy for age groups 0−1, >1−5, >5−10, and >10−15 years respectively. However, the ESD for PA projection was found to be 50.7 and 56.7μGy for age groups >5−10, and >10−15 years respectively.

  14. Should the lateral chest radiograph be routinely performed?

    International Nuclear Information System (INIS)

    Osman, Fatuma; Williams, Imelda

    2014-01-01

    Background: The chest x-ray is one of the most common plain film radiographic examinations performed. Inclusion of the lateral chest radiograph varies internationally and nationally across radiology departments and states in Australia. Search strategy: A search strategy of the databases Cochrane Library, Ovid Medline/Medline, PubMed, Scopus and Science Direct was conducted. The results were restricted to those published between 1985 and 2013 and those published in English. The following search terms were used: ‘lateral chest’, ‘radiograph’, ‘digital radiography’, ‘chest x-ray’, ‘plain film radiography’, ‘ionising radiation’. The results were restricted to publications with these terms in the title, abstract and/or keywords. Main findings: There are few national or international guidelines pertaining to the inclusion of the lateral chest x-ray as routine. Primary concerns are the increased radiation dose associated with the additional chest view and reduction of medical imaging services cost. Modern digital imaging systems result in a lower radiation dose. The diagnostic yield of the lateral chest x-ray is highly dependent on the clinical indications of the patient. Further research into the routine inclusion of the lateral chest x-ray is recommended. Conclusion: Review of the literature suggests that the lateral chest radiograph should not be performed routinely unless clinically indicated

  15. The Courtrai chest from New College, Oxford, re-examined

    International Nuclear Information System (INIS)

    Hall, E.T.

    1987-01-01

    The paper concerns the age estimation of the Courtrai chest from New College Oxford, using the accelerator mass spectrometer method. Radiocarbon dating of the wood in the chest revealed a date around 1280, which is in agreement with dates determined using the dendrochronological technique. (UK)

  16. Predictors of Adverse Outcomes of Patients with Chest Pain and ...

    African Journals Online (AJOL)

    Background: Chest pain is a common symptom for referring patients to emergency departments (ED). Among those referred, some are admitted to hospitals with a definite or tentative diagnosis of acute coronary syndrome and some are discharged with primary diagnosis of non-cardiac chest pain. This study aimed at ...

  17. Experience With The Management Of unusual Penetrating Chest ...

    African Journals Online (AJOL)

    The presentation shows how a victim of fall from height in the bush can sustain a penetrating chest injury on a dry stick of a shrub. Applications on the principles of management of penetrating chest injury is needed despite the grotesque clinical appearance. [Jnl College of Medicine Vol.7(1) 2002: 40-42] ...

  18. 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

  19. Use of chest sonography in acute-care radiology☆

    Science.gov (United States)

    De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

    2008-01-01

    Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

  20. Management of chest drainage tubes after lung surgery.

    Science.gov (United States)

    Satoh, Yukitoshi

    2016-06-01

    Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.

  1. Chest Injuries Associated with Head Injury | Mezue | Nigerian ...

    African Journals Online (AJOL)

    Conclusion: Associated chest injuries result in higher mortality from head injuries. This association is more likely in the young and more productive. All patients presenting with head and spinal cord injury should be specifically and carefully evaluated for associated chest injuries. Computerized tomographic has not replaced ...

  2. 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 ...

  3. An audit of 3859 preadmission chest radiographs of apparently ...

    African Journals Online (AJOL)

    Background: Chest radiographs are routinely requested as part of the medical screening process prior to admission to institutions. Literature on the yield of such an exercise is sparse especially in the Nigerian setting. This study was therefore carried out to assess the usefulness of routine chest radiography for students at ...

  4. A method to detect occult pneumothorax with chest radiography.

    Science.gov (United States)

    Matsumoto, Shokei; Kishikawa, Masanobu; Hayakawa, Koichi; Narumi, Atsushi; Matsunami, Katsutoshi; Kitano, Mitsuhide

    2011-04-01

    Small pneumothoraces are often not visible on supine screening chest radiographs because they develop anteriorly to the lung. These pneumothoraces are termed occult. Occult pneumothoraces account for an astonishingly high 52% to 63% of all traumatic pneumothoraces. A 19-year-old obese woman was involved in a head-on car accident. The admission anteroposterior chest radiographs were unremarkable. Because of the presence of right chest tenderness and an abrasion, we suspected the presence of a pneumothorax. Thus, we decided to take a supine oblique chest radiograph of the right side of the thorax, which clearly revealed a visceral pleural line, consistent with a diagnosis of traumatic pneumothorax. A pneumothorax may be present when a supine chest radiograph reveals either an apparent deepening of the costophrenic angle (the "deep sulcus sign") or the presence of 2 diaphragm-lung interfaces (the "double diaphragm sign"). However, in practice, supine chest radiographs have poor sensitivity for occult pneumothoraces. Oblique chest radiograph is a useful and fast screening tool that should be considered for cases of blunt chest trauma, especially when transport of critically ill patients to the computed tomographic suite is dangerous or when imminent transfer to another hospital is being arranged and early diagnosis of an occult pneumothorax is essential. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  5. 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.

  6. Chest tube care in critically ill patient: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Hanan Mohammed Mohammed

    2015-10-01

    Full Text Available Breathing is automatic. We don’t usually think too much about it unless we develop a problem. Lack of adequate ventilation and impairment of our respiratory system can quickly become life-threatening. There are many clinical conditions that may necessitate the use of chest tubes. When there is an accumulation of positive pressure in the chest cavity (where it should normally be negative pressure between pleurae, a patient will require chest drainage. Chest tubes may be inserted to drain body fluids or to facilitate the re-expansion of a lung. It is important for the clinician to determine the most appropriate tube size to use prior to intubation. The position of the chest tube is related to the function that the chest tube performs. When managing the care of patients who have chest tubes it is important to fully understand what to do in case problems arise. It is also important to be able to assess when the chest tube is ready to be discontinued. Nurses and other healthcare professionals who are responsible for the safe delivery of care should be knowledgeable about respiratory pathophysiology, signs of respiratory compromise, and the care and management of interventions that may be utilized to ensure adequate respiration.

  7. 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.

  8. Skin self-exam

    Science.gov (United States)

    Skin cancer - self-exam; Melanoma - self-exam; Basal cell cancer - self-exam; Squamous cell - self-exam; Skin mole - self-exam ... Checking your skin regularly can help you notice any unusual changes. Follow your health care provider's recommendations on how often to ...

  9. Skin Conditions during Pregnancy

    Science.gov (United States)

    ... during pregnancy. For most skin changes, however, health care providers are not sure of the exact cause. Why do dark spots and patches appear on the skin during pregnancy? Dark spots and patches are caused by an increase in the body’s melanin—a natural substance that gives color to the skin and ...

  10. Psychoneuroimmunology and the Skin.

    Science.gov (United States)

    Honeyman, Juan F

    2016-08-23

    The nervous, immune, endocrine and integumentary systems are closely related and interact in a number of normal and pathological conditions. Nervous system mediators may bring about direct changes to the skin or may induce the release of immunological or hormonal mediators that cause pathological changes to the skin. This article reviews the psychological mechanisms involved in the development of skin diseases.

  11. Skin layer mechanics

    NARCIS (Netherlands)

    Geerligs, M.

    2010-01-01

    The human skin is composed of several layers, each with an unique structure and function. Knowledge about the mechanical behavior of these skin layers is important for clinical and cosmetic research, such as the development of personal care products and the understanding of skin diseases. Until

  12. Nonspecific motility disorders, irritable esophagus, and chest pain.

    Science.gov (United States)

    Krarup, Anne Lund; Liao, Donghua; Gregersen, Hans; Drewes, Asbjørn Mohr; Hejazi, Reza A; McCallum, Richard W; Vega, Kenneth J; Frazzoni, Marzio; Frazzoni, Leonardo; Clarke, John O; Achem, Sami R

    2013-10-01

    This paper presents commentaries on whether Starling's law applies to the esophagus; whether erythromycin affects esophageal motility; the relationship between hypertensive lower esophageal sphincter and vigorous achalasia; whether ethnic- and gender-based norms affect diagnosis and treatment of esophageal motor disorders; health care and epidemiology of chest pain; whether normal pH excludes esophageal pain; the role of high-resolution manometry in noncardiac chest pain; whether pH-impedance should be included in the evaluation of noncardiac chest pain; whether there are there alternative therapeutic options to PPI for treating noncardiac chest pain; and the usefulness of psychological treatment and alternative medicine in noncardiac chest pain. © 2013 New York Academy of Sciences.

  13. Electronic versus traditional chest tube drainage following lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Licht, Peter B; Neckelmann, Kirsten

    2015-01-01

    thoracic surgery, we conducted a randomized controlled trial (RCT) investigating chest tube duration and length of hospitalization. METHODS: Patients undergoing lobectomy were included in a prospective open label RCT. A strict algorithm was designed for early chest tube removal, and this decision...... was delegated to staff nurses. Data were analysed by Cox proportional hazard regression model adjusting for lung function, gender, age, BMI, video-assisted thoracic surgery (VATS) or open surgery and presence of incomplete fissure or pleural adhesions. Time was distinguished as possible (optimal) and actual.......014). CONCLUSIONS: Electronic drainage systems did not reduce chest tube duration or length of hospitalization significantly compared with traditional water seal drainage when a strict algorithm for chest tube removal was used. This algorithm allowed delegation of chest tube removal to staff nurses, and in some...

  14. Radiodiagnosis of pulmonary lesions in a severe closed chest trauma

    International Nuclear Information System (INIS)

    Kishkovskij, A.N.; Tyutin, L.A.; Savchenko, B.K.

    1986-01-01

    The results of X-ray examination of 548 persons with a severe closed chest trauma were summed up. Urgent chest X-ray examination included panoramic roentgenography or electroroentgenography of the chest in two projections performed mostly in a special wheelchair without resetting and turning the patients. Dynamic X-ray control was used afterwards. Pulmonary lesions developed most frequently in a closed chest trauma. Roentgenosemiotics of lung contusion was characterized by a variety of symptoms and determined by the nature of a contusion syndrome. Infiltrate like, cavitary, miliary and peribronchial forms of lung contusion should be distinguished by an X-ray picture. In lung rupture, pneumothorax was detected in 33%, pneumohemothorax in 56%, emphysema of the chest soft tissues in 28%, mediastinal emphysema in 4% of the cases

  15. Chest magnetic resonance imaging: a protocol suggestion

    Directory of Open Access Journals (Sweden)

    Bruno Hochhegger

    2015-12-01

    Full Text Available Abstract In the recent years, with the development of ultrafast sequences, magnetic resonance imaging (MRI has been established as a valuable diagnostic modality in body imaging. Because of improvements in speed and image quality, MRI is now ready for routine clinical use also in the study of pulmonary diseases. The main advantage of MRI of the lungs is its unique combination of morphological and functional assessment in a single imaging session. In this article, the authors review most technical aspects and suggest a protocol for performing chest MRI. The authors also describe the three major clinical indications for MRI of the lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.

  16. Chest tuberculosis: Radiological review and imaging recommendations

    International Nuclear Information System (INIS)

    Bhalla, Ashu Seith; Goyal, Ankur; Guleria, Randeep; Gupta, Arun Kumar

    2015-01-01

    Chest tuberculosis (CTB) is a widespread problem, especially in our country where it is one of the leading causes of mortality. The article reviews the imaging findings in CTB on various modalities. We also attempt to categorize the findings into those definitive for active TB, indeterminate for disease activity, and those indicating healed TB. Though various radiological modalities are widely used in evaluation of such patients, no imaging guidelines exist for the use of these modalities in diagnosis and follow-up. Consequently, imaging is not optimally utilized and patients are often unnecessarily subjected to repeated CT examinations, which is undesirable. Based on the available literature and our experience, we propose certain recommendations delineating the role of imaging in the diagnosis and follow-up of such patients. The authors recognize that this is an evolving field and there may be future revisions depending on emergence of new evidence

  17. An unusual cause for recurrent chest infections.

    LENUS (Irish Health Repository)

    Lobo, Ronstan

    2012-10-01

    We present a case of an elderly non-smoking gentleman who, since 2005, had been admitted multiple times for recurrent episodes of shortness of breath, wheeze, cough and sputum. The patient was treated as exacerbations of chronic obstructive pulmonary disease (COPD) and\\/or lower respiratory tract infections. Bronchoscopy was done which revealed multiple hard nodules in the trachea and bronchi with posterior tracheal wall sparing. Biopsies confirmed this as tracheopathia osteochondroplastica (TO). He had increasing frequency of admission due to methicillin-resistant Staphylococcus aureus and pseudomonas infections, which failed to clear despite intravenous, prolonged oral and nebulised antibiotics. The patient developed increasing respiratory distress and respiratory failure. The patient died peacefully in 2012. This case report highlights the typical pathological and radiological findings of TO and the pitfalls of misdiagnosing patients with recurrent chest infections as COPD.

  18. Chest radiographic findings of tuberculous pneumonia

    International Nuclear Information System (INIS)

    Jung, Seung Hye; Sung, Dong Wook; Yoon, Yup; Lim, Jae Hoon

    1991-01-01

    When tuberculous pneumonia appears as a segmental or loabr consolidation, its is difficult to differentiate tuberculous pneumonia from nontuberculous bacterial pneumonia radiologically. The object of this study was to define the typical radiographic findings of tuberculous pneumonia through comparative analysis of tuberculous and nontuberculous pneumonia. A review of chest radiolograph in 29 patients with tuberculous pneumonia and in 23 patients with nontuberculous bacterial pneumonia was made with regard to homogeneity, volume loss, air-fluid level within the cavities, air-bronchogram, pleural disease, and predilection sites. The characteristic findings of tuberculous pneumonia are a heterogeneous density of infiltration (66%), evidence of volume loss of infiltrative lesion (52%), and cavity formation (48%) without air - fluid level. An associated parameter of analysis is the relative absence of leukocytosis (76%)

  19. Hepatic hydrothorax after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Shang-Chiung Wang

    2012-08-01

    Full Text Available We report a successful treatment result in a rare case of hepatitis C virus-related cirrhosis, who had sustained hydrothorax after blunt thoracoabdominal trauma. This was a female patient with liver cirrhosis, Child–Turcotte–Pugh class A, without ascites before injury. She sustained blunt thoracoabdominal trauma with a left clavicle fracture dislocation and right rib fractures. There was no hemopneumothorax at initial presentation. However, dyspnea and right pleural effusion developed gradually. We inserted a chest tube to relieve the patient's symptoms, and the daily drainage amount remained consistent. Hepatic hydrothorax was confirmed by the intraperitoneal injection of radioisotope 99mTc-sulfur colloid that demonstrated one-way transdiaphragmatic flow of fluid from the peritoneal cavity to pleural cavities. Finally, the hydrothorax was treated successfully by minocycline-induced pleural symphysis. To the best of our knowledge, this is the first case of hepatic hydrothorax developed after thoracoabdominal trauma.

  20. Digital luminescence radiography of the chest

    International Nuclear Information System (INIS)

    Kehler, M.

    1991-10-01

    The aim of the present study was to evaluate the efficacy of a digital system in chest radiology compared to the conventional film-screen system. The first studies (1-3) were purely clinical, had two parts, one clinical and one using phantoms, and the 5:th used solely phantoms. Except for the first - pilot - study, the studies were performed as receiver operating characteristic (ROC) analysis. From one exposure, two digital radiographs were obtained, one simulating the film-screen radiograph and one enhanced, using an unsharp mask. The conventional radiograph was compared to this double-image, but in addition to this, even to the simulated normal and enhanced separately (1-3). To evaluate the value of inverted (positive) radiographs, the original digital (negative) radiographs were inverted, and then compared to the originals (4). As digitzation means easy storing and transfer of data and possibility of electronic display, the diagnostic performance of an interactive workstation was assessed (5). In the clinical studies, a variety of chest affections were used: atelectasis, tumor, pneumothorax, fibrosis, mediastinal and bony changes, tuberculosis, incompensations and enlargement of the heart (1), pneumothorax (2), fibrosis (3), and tumor (4). In the phantom studies, test objects simulating tumors (4) and pneumothorax (5) were used. In no study was statistical significant difference seen between the digital and conventional system (p>0.05). Neither in the clinical nor the phantom study did inversion of the radiographs improve diagnostic performance. The workstation performed almost equally well as the radiographs even with a resolution of 1.25 1p/mm compared to the digital radiographs 2.5 and film-screen radiographs 5 1p/mm. (au) (50 refs.)

  1. Taking Care of Your Skin

    Science.gov (United States)

    ... Educators Search English Español Taking Care of Your Skin KidsHealth / For Kids / Taking Care of Your Skin ... you're in. Why Be Nice to Your Skin? Like the heart, stomach, and brain, your skin ...

  2. Treatment of chest burn contracture causing respiratory compromise with island release and grafting using cross-link collagen and Integra™ bilayer dressing

    Directory of Open Access Journals (Sweden)

    Neil Doctor

    2014-04-01

    Full Text Available Post-burn skin contractures of the anterior and lateral abdomen and chest may result in respiratory compromise due to limitation of rib excursion. This case report describes a young man with respiratory compromise limiting his daily activity and function, as a result of a 90% burn sustained 6 years previously. Release of his chest and upper abdomen was achieved using “island” scar releases and a cross-linked bovine tendon collagen and glycosaminoglycan and a semi-permeable polysiloxane bilayer matrix dressing (Integra™ followed by subsequent split thickness skin graft. An immediate increase in maximal inspiratory volume was obtained intra-operatively and in the im­mediate post-operative period, and this improvement was sustained after healing of all wounds with subjective relief of the patient’s symptoms.

  3. 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.

  4. 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.

  5. SKIN CARE IN INFANTS

    Directory of Open Access Journals (Sweden)

    I. N. Zakharova

    2014-01-01

    Full Text Available Human skin is a complex organ in its structure. Numerous functions of the skin may be impaired in its pathology. Anatomical and physiological characteristics of the skin in children predispose to common diseases of the skin. Diaper dermatitis is one of the most common skin diseases during infancy and childhood. Diapered skin is exposed to friction and excessive hydration, has a higher pH than nondiapered skin, and is repeatedly soiled with feces that contains enzymes with high irritation potential for the skin. Diaper dermatitis may vary in clinical severity and course. Therapeutically, frequent diaper changes and adequate skin care are most important. Appropriate skin care can help to prevent the occurrence of diaper dermatitis and to speed up the healing of affected skin. This includes frequent diaper changes and aeration, gentle cleansing, and the use of a barrier cream. For the treatment of diaper dermatitis agents selected depending on the presence and severity of complications. For prevention and treatment of uncomplicated diaper dermatitis effective means of containing dexpantenol.

  6. Nutrition and skin.

    Science.gov (United States)

    Pappas, Apostolos; Liakou, Aikaterini; Zouboulis, Christos C

    2016-09-01

    Nutrition has long been associated with skin health, including all of its possible aspects from beauty to its integrity and even the aging process. Multiple pathways within skin biology are associated with the onset and clinical course of various common skin diseases, such as acne, atopic dermatitis, aging, or even photoprotection. These conditions have been shown to be critically affected by nutritional patterns and dietary interventions where well-documented studies have demonstrated beneficial effects of essential nutrients on impaired skin structural and functional integrity and have restored skin appearance and health. Although the subject could be vast, the intention of this review is to provide the most relevant and the most well-documented information on the role of nutrition in common skin conditions and its impact on skin biology.

  7. Skin absorption through atopic dermatitis skin

    DEFF Research Database (Denmark)

    Halling-Overgaard, A-S; Kezic, S; Jakasa, I

    2017-01-01

    Patients with atopic dermatitis have skin barrier impairment in both lesional and non-lesional skin. They are typically exposed to emollients daily and topical anti-inflammatory medicaments intermittently, hereby increasing the risk of developing contact allergy and systemic exposed to chemicals...... ingredients found in these topical preparations. We systematically searched for studies that investigated skin absorption of various penetrants, including medicaments, in atopic dermatitis patients, but also animals with experimentally induced dermatitis. We identified 40 articles, i.e. 11 human studies...... examining model penetrants, 26 human studies examining atopic dermatitis drugs and 3 animal studies. We conclude that atopic dermatitis patients have nearly two-fold increased skin absorption when compared to healthy controls. There is a need for well-designed epidemiological and dermato...

  8. 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

  9. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.

    Science.gov (United States)

    Reamy, Brian V; Williams, Pamela M; Odom, Michael Ryan

    2017-09-01

    Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. Validated clinical decision rules are available to help exclude coronary artery disease. Viruses are common causative agents of pleuritic chest pain. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Treatment is guided by the underlying diagnosis. Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.

  10. Diagnostic Evaluation of Nontraumatic Chest Pain in Athletes.

    Science.gov (United States)

    Moran, Byron; Bryan, Sean; Farrar, Ted; Salud, Chris; Visser, Gary; Decuba, Raymond; Renelus, Deborah; Buckley, Tyler; Dressing, Michael; Peterkin, Nicholas; Coris, Eric

    This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes. Cross-referencing published articles from the databases searched discovered additional articles. No dissertations, theses, or meeting proceedings were reviewed. The authors discuss the scope of this complex problem and the diagnostic dilemma chest pain in athletes can provide. Next, the authors delve into the vast differential and attempt to simplify this process for the sports medicine physician by dividing potential etiologies into cardiac and noncardiac conditions. Life-threatening causes of chest pain in athletes may be cardiac or noncardiac in origin, which highlights the need for the sports medicine physician to consider pathology in multiple organ systems simultaneously. This article emphasizes the importance of ruling out immediately life threatening diagnoses, while acknowledging the most common causes of noncardiac chest pain in young athletes are benign. The authors propose a practical algorithm the sports medicine physician can use as a guide for the assessment and diagnostic work-up of the athlete with chest pain designed to help the physician arrive at the correct diagnosis in a clinically efficient and cost-effective manner.

  11. 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

  12. Digital tomosynthesis of the chest: A literature review

    International Nuclear Information System (INIS)

    Molk, N.; Seeram, E.

    2015-01-01

    Digital tomosynthesis is a relatively novel imaging modality using limited angle tomography to provide 3D imaging. The purpose of this review is to compare the sensitivity of digital tomosynthesis of the chest and plain film chest imaging in accurately identifying pulmonary nodules and to compare the effective dose between standard chest examinations using digital tomosynthesis and CT. A review of current literature has shown that small scale studies found digital tomosynthesis to be three times more effective in identifying pulmonary nodules compared to conventional radiography and at lower doses compared with routine chest CT examinations. This indicates that tomosynthesis could potentially be a beneficial imaging modality and could be used in a number of ways to detect and monitor pulmonary nodules for cancer. However with limited research, large-scale studies would need to be performed to confirm its benefits and identify where it is best used in the clinical setting. - Highlights: • The detection of pulmonary nodules is compared between tomosynthesis and plain film. • The effective dose of digital chest tomosynthesis and chest CT are compared. • The place of digital tomosynthesis of the chest in the clinical setting is explored. • Three times more pulmonary nodules are seen with tomosynthesis. • The effective dose of tomosynthesis is significantly lower than CT

  13. Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Merve Tarhan

    2016-12-01

    Full Text Available Objective: The physician is responsible for inserting one or more chest tubes into the pleural space or the mediastinal space and connecting them to an appropriate drainage system. When the general principles about care of patients with chest drains were implemented correctly and effectively by nurses, nurse will contribute to accelerate the healing process of patients. In this context, the aim of this study was to determine the nurses’ level of knowledge regarding the care of patients with chest drains. Methods: The study was conducted with 153 nurses who worked in a chest diseases and thoracic surgery hospital in July 2014. Questionnaire form of 35 questions prepared by investigators was used to collect data. For the analysis of results, frequency tests, independent sample t-test and oneway ANOVA test were used. Results: 69.3% of nurses stated that they had obtained information from colleguages. 35.3% considered their knowledge about chest drain management to be inadequate. 55.6% scored 13 points and above from knowledge questionnaire about chest drain management. There were statistically significant difference between knowledge level and educational background, clinic work type, working unit, years of professional experience and institutional experience, frequency of contact patients with chest drain and perception of knowledge level (p<0.05. Conclusion: Results of this study indicate that lack of evidence-based nursing care and insufficient training has resulted in uncertainty and knowledge deficit in important aspects of chest drain care. It can be concluded that nurses receive training needs and training protocols are about chest drain management.

  14. Chest pain control with kinesiology taping after lobectomy for lung cancer: initial results of a randomized placebo-controlled study.

    Science.gov (United States)

    Imperatori, Andrea; Grande, Annamaria; Castiglioni, Massimo; Gasperini, Laura; Faini, Agnese; Spampatti, Sebastiano; Nardecchia, Elisa; Terzaghi, Lorena; Dominioni, Lorenzo; Rotolo, Nicola

    2016-08-01

    Kinesiology taping (KT) is a rehabilitative technique performed by the cutaneous application of a special elastic tape. We tested the safety and efficacy of KT in reducing postoperative chest pain after lung lobectomy. One-hundred and seventeen consecutive patients, both genders, age 18-85, undergoing lobectomy for lung cancer between January 2013 and July 2015 were initially considered. Lobectomies were performed by the same surgical team, with thoracotomy or video-assisted thoracoscopic surgery (VATS) access. Exclusion criteria (n = 25 patients) were: previous KT exposure, recent trauma, pre-existing chest pain, lack of informed consent, >24-h postoperative intensive care unit treatment. After surgery, the 92 eligible patients were randomized to KT experimental group (n = 46) or placebo control group (n = 46). Standard postoperative analgesia was administered in both groups (paracetamol/non-steroidal anti-inflammatory drugs, epidural analgesia including opioids), with supplemental analgesia boluses at patient request. On postoperative day 1 in addition, in experimental group patients a specialized physiotherapist applied KT, with standardized tape length, tension and shape, over three defined skin areas: at the chest access site pain trigger point; over the ipsilateral deltoid/trapezius; lower anterior chest. In control group, usual dressing tape mimicking KT was applied over the same areas, as placebo. Thoracic pain severity score [visual analogue scale (VAS) ranging 0-10] was self-assessed by all patients on postoperative days 1, 2, 5, 8, 9 and 30. The KT group and the control group had similar demographics, lung cancer clinico-pathological features and thoracotomy/VATS ratio. Postoperatively, the two groups also resulted similar in supplemental analgesia, complication rate, mean duration of chest drainage and length of stay. There were no adverse events with KT application. After tape application, KT patients reported overall less thoracic pain than the

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

  17. 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)

  18. Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.

    LENUS (Irish Health Repository)

    Kiely, J L

    2012-02-03

    The question of whether a chest radiographic severity staging system could be correlated with standard blood\\/serum diagnostic indices in allergic bronchopulmonary aspergillosis (ABPA) was addressed in 41 patients. Asthma and positive Aspergillus fumigatus (AF) serology were considered essential diagnostic inclusion criteria. Eosinophil count, serum immunoglobulin (Ig)E and immediate skin hypersensitivity were also tested to grade patients as "definite" or "likely" ABPA. Definite cases had all five of these factors present, whereas likely cases had three or more. Chest radiographs were examined by experienced radiologists blinded to the clinical data. The six-stage radiographic score (0-5) was based on the severity and duration of changes seen: stage 0: normal; stage 1: transient hyperinflation; stage 2: transient minor changes; stage 3: transient major changes; stage 4: permanent minor changes; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.

  19. Non-traumatic thoracic emergencies: acute chest pain: diagnostic strategies

    International Nuclear Information System (INIS)

    Bonomo, Lorenzo; Di Fabio, Francesca; Rita Larici, Anna; Merlino, Biagio; Luigia Storto, Maria

    2002-01-01

    Acute chest pain may represent the initial and/or accompanying symptom in a variety of disease processes that may occur in the cardiovascular system, respiratory system, gastrointestinal tract, or musculoskeletal system. Although clinical history, risk factors, and physical examination are important factors in establishing the etiology of symptoms in patients presenting with acute chest pain, imaging modalities are frequently utilized. Noncardiac causes of acute chest pain are reviewed in this paper with special reference to the most recently published literature and emphasis on acute aortic diseases. Imaging modalities with indication of appropriateness, optimal technique and practical keys for interpretation are discussed. (orig.)

  20. Diagnosis of Grave's disease with pulmonary hypertension on chest CT.

    Science.gov (United States)

    Lee, Hwa Yeon; Yoo, Seung Min; Kim, Hye Rin; Chun, Eun Ju; White, Charles S

    To evaluate the diagnostic accuracy of chest CT findings to diagnose Grave's disease in pulmonary hypertension. We retrospectively evaluated chest CT and the medical records of 13 patients with Grave's disease with (n=6) or without pulmonary hypertension (n=7) and in 17 control patients. Presence of iso-attenuation of diffusely enlarged thyroid glands compared with adjacent neck muscle on non-enhanced CT as a diagnostic clue of Grave's disease, and assessment of pulmonary hypertension on CT has high diagnostic accuracy. Chest CT has the potential to diagnose Grave's disease with pulmonary hypertension in the absence of other information. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Bacterial contamination of stethoscope chest pieces and the effect of daily cleaning.

    Science.gov (United States)

    Fujita, H; Hansen, B; Hanel, R

    2013-01-01

    Stethoscopes are a potential source of nosocomial infection for hospitalized humans, a phenomenon not previously studied in companion animals. To determine if daily cleaning of stethoscope chest pieces reduces bacterial contamination between cleanings. Client-owned dogs and cats. Prospective observational study. In phase 1, bacterial cultures were obtained from the chest pieces of 10 participant stethoscopes once weekly for 3 weeks. In phase 2, stethoscopes were cleaned daily and 2 culture samples were obtained once weekly, immediately before and after cleaning with 70% isopropyl alcohol, for 3 weeks. Daily cleaning eliminated bacteria immediately after each cleaning (P = .004), but did not reduce the rate of positive cultures obtained before cleaning in phase 2. Cultures were positive for 20/30 (67%) samples during phase 1 and 18/30 (60%) obtained before daily cleaning during phase 2. Recovered organisms included normal skin flora, agents of opportunistic infections, and potential pathogens. The only genus that was repeatedly recovered from the same stethoscope for 2 or more consecutive weeks was Bacillus sp. Daily cleaning was highly effective at removing bacteria, but provided no reduction in precleaning contamination. Cleaning stethoscopes after use on dogs or cats infected with pathogenic bacteria and before use on immunocompromised animals should be considered. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  2. Construction of pediatric homogeneous phantoms for optimization of chest and skull radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Allan Felipe Fattori, E-mail: allan@ibb.unesp.br [Instituto de Biociências de Botucatu, P.O. BOX 510, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Miranda, José Ricardo de Arruda, E-mail: jmiranda@ibb.unesp.br [Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Bacchim Neto, Fernando Antonio, E-mail: fernando.bacchim@gmail.com [Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil); Duarte, Sérgio Barbosa, E-mail: sbd@cbpf.br [Centro Brasileiro de Pesquisas Físicas, Laboratório de Altas Energias, Dr. Xavier Sigaud, 150, Rio de Janeiro, 22290-180 Rio de Janeiro (Brazil); Pina, Diana Rodrigues de, E-mail: drpina@fmb.unesp.br [Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP—Universidade Estadual Paulista, Distrito de Rubião Junior S/N, Botucatu, 18618-000 São Paulo (Brazil)

    2015-08-15

    Highlights: • We developed two pediatric patient-equivalent phantoms. • Our phantoms were used in the optimization process of computed radiography systems. • We evaluated physical quantities such as effective detective quantum efficiency and contrast-to-noise ratio. • We determined optimized techniques for pediatric protocols. - Abstract: Objectives: To develop two pediatric patient-equivalent phantoms, the Pediatric Chest Equivalent Patient (PCEP) and the Pediatric Skull Equivalent Patient (PSEP) for children aged 1 to 5 years. We also used both phantoms for image quality evaluations in computed radiography systems to determine Gold Standard (GS) techniques for pediatric patients. Methods: To determine the simulator materials thickness (Lucite and aluminum), we quantified biological tissues (lung, soft, and bone) using an automatic computational algorithm. To objectively establish image quality levels, two physical quantities were used: effective detective quantum efficiency and contrast-to-noise ratio. These quantities were associated to values obtained for standard patients from previous studies. Results: For chest radiographies, the GS technique applied was 81 kVp, associated to 2.0 mAs and 83.6 μGy of entrance skin dose (ESD), while for skull radiographies, the GS technique was 70 kVp, associated to 5 mAs and 339 μGy of ESD. Conclusion: This procedure allowed us to choose optimized techniques for pediatric protocols, thus improving quality of diagnosis for pediatric population and reducing diagnostic costs to our institution. These results could also be easily applied to other services with different equipment technologies.

  3. Effectiveness of muscle coverage to manage osteomyelitis of very late onset in the irradiated chest wall

    International Nuclear Information System (INIS)

    Funayama, Emi; Minakawa, Hidehiko; Otani, Hidekazu; Saito, Noriko; Oyama, Akihiko; Furukawa, Hiroshi; Hayashi, Toshihiko; Saito, Akira; Yamamoto, Yuhei

    2012-01-01

    Radiation therapy for breast cancer has improved survival rates; however, a consequence of this is treatment-induced complications in longer-living patients. Decades after chest wall irradiation, very late onset radiation-induced osteomyelitis can develop, caused by osteoradionecrosis. This may lead to the development of small, but very refractory, skin ulcers. Many reports recommend well-vascularized tissue coverage after appropriate debridement for irradiation ulcers; however, when the ulcers are of very late onset, this sometimes causes recurrence of ulceration in non-muscle-covered areas after flap transfer. Thus, for very late onset cases, we propose treatment with an absolute muscle flap to cover both the obviously infected focus and the surrounding irradiated area. A muscle flap consisting of the entire latissimus dorsi, the shape of which is very large in the horizontal direction, satisfies this requirement. Latissimus dorsi muscle coverage for the treatment of very late onset osteomyelitis should be reappraised. (author)

  4. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. 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

  7. Computer-aided diagnosis in chest radiology.

    Science.gov (United States)

    MacMahon, H; Doi, K; Chan, H P; Giger, M L; Katsuragawa, S; Nakamori, N

    1990-01-01

    Digital radiography offers several important advantages over conventional systems, including abilities for image manipulation, transmission, and storage. In the long term, however, the unique ability to apply artificial intelligence techniques for automated detection and quantitation of disease may have an even greater impact on radiologic practice. Although CAD is still in its infancy, the results of several recent studies clearly indicate a major potential for the future. The concept of using computers to analyze medical images is not new, but recent advances in computer technology together with progress in implementing practical digital radiography systems have stimulated research efforts in this exciting field. Several facets of CAD are presently being developed at the University of Chicago and elsewhere for application in chest radiology as well as in mammography and vascular imaging. To date, investigators have focused on a limited number of subjects that have been, by their nature, particularly suitable for computer analysis. There is no aspect of radiologic diagnosis that could not potentially benefit from this approach, however. The ultimate goal of these endeavors is to provide a system for comprehensive automated image analysis, the results of which could be accepted or modified at the discretion of the radiologist.

  8. Penetrating chest wound of the foetus

    Directory of Open Access Journals (Sweden)

    Albert Wandaogo

    2016-01-01

    Full Text Available Traumas of the foetus caused by stabbings are rare but actually life-threatening for both the foetus and the mother. We report a case of penetrating chest wound on a baby taken from the obstetrics unit to the paediatric surgical department. His mother was assaulted by his father, a mentally sick person with no appropriate follow-up. The foetus did not show any sign of vital distress. Surgical exploration of the wound has revealed a section of the 10 th rib, a laceration of the pleura and a tearing of the diaphragm. A phrenorraphy and a pleural drainage were performed. The new-born and its mother were released from hospital after 5 days and the clinical control and X-ray checks 6 months later showed nothing abnormal. We insisted a medical, psychiatric follow-up be initiated for the father. As regards pregnant women with penetrating wounds, the mortality rate of the foetus is 80%. The odds are good for our newborn due to the mild injuries and good professional collaboration of the medical staff. Penetrating transuterine wounds of the foetus can be very serious. The health care needed should include many fields due to the mother and the foetus′ lesions extreme polymorphism. In our case, it could have prevented by a good psychiatric followed up of the offender.

  9. Radiation doses measured by TLD (thermoluminescent dosimeter) in x-ray examination, especially on the skin area beneath of which female gonads situate

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, S; Hiraki, M; Murakami, S; Nishikawa, N; Yagi, T [Nissei Hospital, Osaka (Japan)

    1977-03-01

    By means of TLD, we measured the radiation doses to the skin in the central area of the field of radiation and doses scattered outside of the radiation field, utilizing a phantom to define a suitable radiation field. Clinically, when radiography of the gall bladder and the chest was done, we measured both the radiation doses of the central skin area where radiation was done and the skin above the area of the female gonads. In radiography of the chest, the radiation doses to the skin area above the female gonads situate was under 0.1 mR. When female gonads are less than 15 cm from the margin of the radiation field of the radiation dose can be decreased by 30% if gum sheets containing lead are used to cover the skin area outside the radiation field.

  10. Skin barrier function

    DEFF Research Database (Denmark)

    2016-01-01

    Renowned experts present the latest knowledge Although a very fragile structure, the skin barrier is probably one of the most important organs of the body. Inward/out it is responsible for body integrity and outward/in for keeping microbes, chemicals, and allergens from penetrating the skin. Since...... the role of barrier integrity in atopic dermatitis and the relationship to filaggrin mutations was discovered a decade ago, research focus has been on the skin barrier, and numerous new publications have become available. This book is an interdisciplinary update offering a wide range of information...... on the subject. It covers new basic research on skin markers, including results on filaggrin and on methods for the assessment of the barrier function. Biological variation and aspects of skin barrier function restoration are discussed as well. Further sections are dedicated to clinical implications of skin...

  11. Recommendations for skin decontamination

    International Nuclear Information System (INIS)

    1989-01-01

    Further to the reecommendations for determining the surface contamination of the skin and estimating the radiation exposure of the skin after contamination (SAAS-Mitt--89-16), measures for skin decontamination are recommended. They are necessary if (1) after simple decontamination by means of water, soap and brush without damaging the skin the surface contamination limits are exceeded and the radiation exposure to be expected for the undamaged healthy skin is estimated as to high, and if (2) a wound is contaminated. To remove skin contaminations, in general universally applicable, non-aggressive decontamination means and methods are sufficient. In special cases, nuclide-specific decontamination is required taking into account the properties of the radioactive substance

  12. Routine chest X-ray in the allergy clinic

    International Nuclear Information System (INIS)

    Garcia-Barredo, M.R.; Usamentiaga, E.; Fidalgo, I.

    1997-01-01

    To determine whether routine chest X-ray is indicated in allergy patients when there is no evidence of cardiopulmonary involvement. A retrospective study to analyze the indications and radiologic findings in 515 consecutive patients who underwent chest X-ray: Positive findings were considered to be any radiological sing that led to the performance of additional diagnostic measures or a change in the therapeutic management of the patient. Positive radiologic findings were observed in 39 cases (7.59%). Only two patients (0.38%) were diagnosed as having diseases that were susceptible to proper treatment. In one of them (0.19%), the failure to perform chest X-ray would have impeded the introduction of proper treatment. We do not recommend carrying out routine chest X-ray in this patient population. (Author) 7 refs

  13. Chest X ray examination of workers exposed to pneumoconiosis risk

    International Nuclear Information System (INIS)

    Indovina, P.L.; Reggiani, A.; Calicchia, A.; Nicolosi, A.

    1986-01-01

    Chest X-ray examination of workers exposed to pneumoconiosis risk: critical analysis of legal and radiation protection aspects. Chest X-ray examination is one of the most common radiological examinations practised in Italy. According to Presidential Decree 1124/65, workers exposed to risk of asbestosis and silicosis must undergo a chest radiography once a year, on occasion of the periodic medical examination. Basic requirements aimed at the radiation protection of the patient must therefore be complied with, and optimization of the chest radiography execution procedures is required. This paper illustrates the results obtained with the implementation of the NEXT programme in Italy for this kind of X-ray examination. The main objective of the NEXT programme is the optimization of radiological techniques. On the basis of the most recent publications in the field of radiation protection, a critical analysis is made of the laws in force in Italy

  14. Mitral valve plasty for mitral regurgitation after blunt chest trauma.

    Science.gov (United States)

    Kumagai, H; Hamanaka, Y; Hirai, S; Mitsui, N; Kobayashi, T

    2001-06-01

    A 21 year-old woman was admitted to our hospital because of chest and back pain after blunt chest trauma. On admission, consciousness was clear and a physical examination showed labored breathing. Her vital signs were stable, but her breathing gradually worsened, and artificial respiration was started. The chest roentgenogram and a subsequent chest computed tomographic scans revealed contusions, hemothorax of the left lung and multiple rib fractures. A transthoracic echocardiography (TTE) revealed normal left ventricular wall motion and mild mitral regurgitation (MR). TTE was carried out repeatedly, and revealed gradually progressive MR and prolapse of the posterior medial leaflet, although there was no congestive heart failure. After her general condition had recovered, surgery was performed. Intraoperative transesophageal echocardiography (TEE) revealed torn chordae at the posterior medial leaflet. The leaflet where the chorda was torn was cut and plicated, and posterior mitral annuloplasty was performed using a prosthetic ring. One month later following discharge, the MR had disappeared on TTE.

  15. [Clinico-roentgenological semiotics of the chest damage in polytrauma].

    Science.gov (United States)

    Zamiatin, P N; Panchenko, E V; Grigor'ian, G O; Goloshchapova, E V

    2006-10-01

    There are presented the main clinico-roentgenological signs of the chest damage in the injured persons, suffering polytrauma, according to the data from the specialized department of traumatic shock and polytrauma.

  16. 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 ...

  17. Preoperative chest x-ray findings in peptic ulcer perforation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J. [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

    1981-12-15

    This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings.

  18. Preoperative chest x-ray findings in peptic ulcer perforation

    International Nuclear Information System (INIS)

    Kim, T. H.; Kim, S. W.; Lim, J. S.; Kim, Y. J.

    1981-01-01

    This study was carried out to analyze the distribution of age, sex, chief complaint, physical examination and findings of chest x-ray films before operation in 59 cases of peptic ulcer perforation. The ratio of male to female was 1.7 : 1 and incidence of the ulcer perforation was most common in 5th decades. Thirty five among 59 cases showed pleural effusion, segmental atelectasis and pneumonic infiltration on chest x-ray film. Twenty nine among 50 cases of duodenal ulcer perforation and 6 of 9 cases of stomach ulcer perforation showed positive chest x-ray findings. No relationship was found between fever and preoperative chest x-ray findings

  19. Approach to chest pain and acute myocardial infarction | Pandie ...

    African Journals Online (AJOL)

    Approach to chest pain and acute myocardial infarction. ... Patient history, physical examination, 12-lead electrocardiogram (ECG) and cardiac biomarkers ... Essential adjunctive therapies include antiplatelet therapy (aspirin, P2Y12 inhibitors), ...

  20. Multi-detector row computed tomography and blunt chest trauma

    International Nuclear Information System (INIS)

    Scaglione, Mariano; Pinto, Antonio; Pedrosa, Ivan; Sparano, Amelia; Romano, Luigia

    2008-01-01

    Blunt chest trauma is a significant source of morbidity and mortality in industrialized countries. The clinical presentation of trauma patients varies widely from one individual to another and ranges from minor reports of pain to shock. Knowledge of the mechanism of injury, the time of injury, estimates of motor vehicle accident velocity and deceleration, and evidence of associated injury to other systems are all salient features to provide for an adequate assessment of chest trauma. Multi-detector row computed tomography (MDCT) scanning and MDCT-angiography are being used more frequently in the diagnosis of patients with chest trauma. The high sensitivity of MDCT has increased the recognized spectrum of injuries. This new technology can be regarded as an extremely valuable adjunct to physical examination to recognize suspected and unsuspected blunt chest trauma

  1. Prehospital chest tube thoracostomy: effective treatment or additional trauma?

    NARCIS (Netherlands)

    Spanjersberg, W.R.; Bergs, B.; Krijen, P.; Schipper, I.; Ringburg, A.; Steyerberg, E.W.; Edwards, M.J.R.; Schipper, I.B.; Vugt, A.B. van

    2005-01-01

    BACKGROUND: The use of prehospital chest tube thoracostomy (TT) remains controversial because of presumed increased complication risks. This study analyzed infectious complication rates for physician-performed prehospital and emergency department (ED) TT. METHODS: Over a 40-month period, all

  2. Blunt chest trauma: bony injury in the thorax.

    Science.gov (United States)

    Zreik, Nasri H; Francis, Irene; Ray, Arun; Rogers, Benedict A; Ricketts, David M

    2016-02-01

    The management of blunt chest trauma is an evolving concept with no clear current guidelines. This article explores the bony injuries associated with this, focusing on rib fractures and flail segments and the themes around investigation and best management.

  3. Research Status of the Skeletalre Construction of Chest Wall

    Directory of Open Access Journals (Sweden)

    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.

  4. Intrathoracic tuberculous lymphadenopathy in children: a guide to chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    George, Anthony; Andronikou, Savvas [Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); Pillay, Tanyia; Zar, Heather J. [University of Cape Town and Medical Research Council Unit on Child and Adolescent Health, Department of Paediatrics and Child Health, Red Cross War Memorial Children' s Hospital, Cape Town (South Africa); Goussard, Pierre [Tygerberg Hospital and the University of Stellenbosch, Department of Paediatrics and Child Health, Cape Town (South Africa)

    2017-09-15

    Making the diagnosis of pulmonary tuberculosis in children can be difficult because microbiological confirmation is not often achieved. Diagnosis is therefore often based on clinical features in combination with chest radiograph findings. Chest radiographs can demonstrate lymphadenopathy of the hilar and para-tracheal regions on the anteroposterior view, and subcarinal lymphadenopathy on the lateral view. However poor interobserver agreement has been reported for radiologist and clinician assessment of lymphadenopathy. This might reflect the lack of standardised imaging criteria for diagnosis as well as radiologists' objectives for achieving sensitivity rather than specificity. In this paper the authors provide a pictorial aid of chest radiographs in children with culture-confirmed tuberculosis to help clinicians identify lymph node enlargement in primary pulmonary tuberculosis. This collection of images comprises chest radiographs accompanied by schematics and either CT or MRI scan confirmation of pathological lymph node enlargement at the positions commonly affected in tuberculosis. (orig.)

  5. Pneumothorax and subcutaneous emphysema secondary to blunt chest injury

    OpenAIRE

    Porhomayon, Jahan; Doerr, Ralph

    2011-01-01

    This is the case of a patient with a history of blunt chest trauma associated with subcutaneous emphysema and pneumothorax. The patient complained of inspiratory stridor on presentation. Anatomical relationships can explain the pathophysiological process.

  6. Thoracic Trauma: Which Chest Tube When and Where?

    Science.gov (United States)

    Molnar, Tamas F

    2017-02-01

    Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Roentgenologic findings of non-penetrating extracardiac chest injuries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Duck; Ra, Woo Youn [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1975-06-15

    Of the conventional P-A and A-P chest films which have been studied, many roentgenologic signs suggested for chest trauma. In the present study, an effort was designated to further clarify the x-ray findings of the nonpenetrating extracardiac chest injuries and to observe the x-ray findings being a leading maneuver of surgical procedure. Fat embolism and shock lung must be kept in mind on follow up films. The results thus obtained are summarized as follows; 1. Most of cases are visualized between the age of 10 and 50 and more common in male. 2. The denoting rib fracture, hemopneumothorax, and lung contusion are direct roentgenologic signs. 3. In case of serious result which showed pulmonary edema pattern on conventional chest films, we thought fat embolism or shock lung to be the cause of death.

  8. Evaluation of radiation doses delivered in different chest CT protocols

    International Nuclear Information System (INIS)

    Gorycki, Tomasz; Lasek, Iwona; Kamiński, Kamil; Studniarek, Michał

    2014-01-01

    There are differences in the reference diagnostic levels for the computed tomography (CT) of the chest as cited in different literature sources. The doses are expressed either in weighted CT dose index (CTDI VOL ) used to express the dose per slice, dose-length product (DLP), and effective dose (E). The purpose of this study was to assess the radiation dose used in Low Dose Computer Tomography (LDCT) of the chest in comparison with routine chest CT examinations as well as to compare doses delivered in low dose chest CT with chest X-ray doses. CTDI VOL and DLP doses were taken to analysis from routine CT chest examinations (64 MDCT TK LIGHT SPEED GE Medical System) performed in 202 adult patients with FBP reconstruction: 51 low dose, 106 helical, 20 angio CT, and 25 high resolution CT protocols, as well as 19 helical protocols with iterative ASIR reconstruction. The analysis of chest X-ray doses was made on the basis of reports from 44 examinations. Mean values of CTDI VOL and DLP were, respectively: 2.1 mGy and 85.1 mGy·cm, for low dose, 9.7 mGy and 392.3 mGy·cm for helical, 18.2 mGy and 813.9 mGy·cm for angio CT, 2.3 mGy and 64.4 mGy·cm for high resolution CT, 8.9 mGy. and 317.6 mGy·cm for helical ASIR protocols. Significantly lower CTDI VOL and DLP values were observed for low dose and high resolution CT versus the remaining CT protocols; doses delivered in CT ASIR protocols were also lower (80–81%). The ratio between medial doses in low dose CT and chest X-ray was 11.56. Radiation dose in extended chest LDCT with parameters allowing for identification of mediastinal structures and adrenal glands is still much lower than that in standard CT protocols. Effective doses predicted for LDCT may exceed those used in chest X-ray examinations by a factor of 4 to 12, depending on LDCT scan parameters. Our results, as well as results from other authors, suggest a possibility of reducing the dose by means of iterative reconstruction. Efforts towards further dose

  9. Relationship between chest compression rates and outcomes from cardiac arrest.

    Science.gov (United States)

    Idris, Ahamed H; Guffey, Danielle; Aufderheide, Tom P; Brown, Siobhan; Morrison, Laurie J; Nichols, Patrick; Powell, Judy; Daya, Mohamud; Bigham, Blair L; Atkins, Dianne L; Berg, Robert; Davis, Dan; Stiell, Ian; Sopko, George; Nichol, Graham

    2012-06-19

    Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Included were patients aged ≥ 20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67 ± 16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112 ± 19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.

  10. The role of CT in assessing chest pain

    International Nuclear Information System (INIS)

    Capsa, R.

    2012-01-01

    Full text: Objective: Thoracic pain represents the common feature of a wide range of diseases of different causes. Usually, chest pain requires a fast workup, in order to eliminate potentially hazardous underlying conditions. The objective of the paper consists of presenting the role of computerized tomography (CT) in assessing the different causes and conditions related to chest pain. Materials and methods: The educational presentation relies on current literature data and mostly on images obtained from patients admitted in the various clinics and departments of our hospital, suffering from chest pain as admittance condition or as a symptom appeared during the hospital stay. Results: There are various radiological and imaging options for assessing a patient with chest pain, with reference to the underlying condition, type of pain onset (acute or chronic), specific indications and contraindications. From all these, CT is considered one of the most useful imaging options, in terms of diagnosis accuracy, fast workup, cost and availability. This paper focuses on the role of CT, presenting the most important diseases and conditions related to potential occurrence of chest pain and the most specific CT signs and findings usually reported in this setting. Furthermore, the presentation separates acute and chronic conditions, presenting the actual imaging protocols employed in this circumstances. Finally, there are considerations regarding CT rule-out protocols used in patients with acute chest pain in emergency conditions. Conclusions: Fast and accurate diagnosis is crucial for patient outcome, often life-saving, but currently there is no single algorithm in the imaging assessment of chest pain, while choosing the best imaging option relies mainly on history, clinical and laboratory data. CT is one of the most important imaging options available in patients with both acute and chronic chest pain. CT rule-out techniques have still to establish their clear role in a

  11. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain.

    Science.gov (United States)

    Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

    2016-03-01

    A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram. Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R(2)=0.092, p=0.004; β= -0.525, R(2)=0.290, p=0.010). No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.

  12. 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.

  13. 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.

  14. Metastases skin of a mesothelioma. Report case

    International Nuclear Information System (INIS)

    Aguero, M.; Gauna, C.; Plans, J.; Pereira, R.; Caballero, C.

    2010-01-01

    Introduction: Malignant mesothelioma derived from mesothelium cells. On his pleural location is frequently associated with stroke and that is the first manifestation, presenting low rates performing diagnostic cytology of the spill, with only a third positivity, and even conducting blind pleural biopsy. In early stages of thoracoscopy disease expands the diagnostic possibilities. The age of neoplasia presentation is between 50 and 70 years, with a predominance in men than matters women, probably because the most common occupational exposure to asbestos in it, main risk factor. The main sites of metastases occurring in a patient with malignant mesothelioma in lung, liver and central nervous system. The incidence of skin metastases (visceral primary) are between 1.2% and 4.4% and the ranks occurs in all types of tumours. There is one report of cutaneous metastasis of mesothelioma as a diagnostic event. Case report: Patient 63, who consulted for chest pain of one month evolution by which it prompted Chest X-ray being verified the left pleural effusion which is drained and analyzed to meet the biochemical criteria of an exudate, with crops negative. pleural biopsy, and thoracentesis was performed which resulted in negative cells neoplastic. It was decided to perform VATS where multiple pleural nodules notes occupying the entire pleural cavity which biopsy; the pathology report Undifferentiated Malignant Tumour reported. IHC: Cytokeratin AE1 / AE3 weak positive, cytokeratin 8/18 Vimentin Positive Positive and thus favors the diagnosis of Mesothelioma. It was made 6 cycles of cisplatin + pemetrexed completed in February / 2010 with good response. Six months have chest pain again so PET-CT is performed where finds local relapse, and likely adrenal marrow MTS MTS and contralateral lung. Eight Study days after skin nodules are detected in respecting scalp and face neck which supports 1rio biopsy is taken. known. Conclusion: The Mesothelioma is a rare entity in our

  15. Chest X ray effective doses estimation in computed radiography

    International Nuclear Information System (INIS)

    Abdalla, Esra Abdalrhman Dfaalla

    2013-06-01

    Conventional chest radiography is technically difficult because of wide in tissue attenuations in the chest and limitations of screen-film systems. Computed radiography (CR) offers a different approach utilizing a photostimulable phosphor. photostimulable phosphors overcome some image quality limitations of chest imaging. The objective of this study was to estimate the effective dose in computed radiography at three hospitals in Khartoum. This study has been conducted in radiography departments in three centres Advanced Diagnostic Center, Nilain Diagnostic Center, Modern Diagnostic Center. The entrance surface dose (ESD) measurement was conducted for quality control of x-ray machines and survey of operators experimental techniques. The ESDs were measured by UNFORS dosimeter and mathematical equations to estimate patient doses during chest X rays. A total of 120 patients were examined in three centres, among them 62 were males and 58 were females. The overall mean and range of patient dosed was 0.073±0.037 (0.014-0.16) mGy per procedure while the effective dose was 3.4±01.7 (0.6-7.0) mSv per procedure. This study compared radiation doses to patients radiographic examinations of chest using computed radiology. The radiation dose was measured in three centres in Khartoum- Sudan. The results of the measured effective dose showed that the dose in chest radiography was lower in computed radiography compared to previous studies.(Author)

  16. Chest wall segmentation in automated 3D breast ultrasound scans.

    Science.gov (United States)

    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.

  17. Dual-source CT in chest pain diagnosis

    International Nuclear Information System (INIS)

    Johnson, Thorsten R.C.; Nikolaou, K.; Fink, C.; Rist, C.; Reiser, M.F.; Becker, C.R.; Becker, A.; Knez, A.

    2007-01-01

    With the depiction of pulmonary arteries, coronary arteries, and the aorta, CT angiography of the chest offers a comprehensive diagnostic work-up of unclear chest pain. The aim of this study was to assess the diagnostic accuracy of dual-source CT in this patient group. A total of 47 patients suffering from unclear chest pain were examined with a Siemens Somatom Definition. Volume and flow of contrast media (Ultravist, Schering) were adapted to the body weight. The examinations were evaluated with regard to image quality and contrast opacification and to the diagnostic accuracy with reference to the final clinical diagnosis. Adequate contrast opacification was achieved in all examinations. The depiction of the coronary arteries was diagnostic in all cases. The cause of chest pain could be identified in 41 cases. Among the diagnoses were coronary and myocardial pathologies, valvular disease, aortic aneurysms and dissections, pulmonary embolism, and pneumonic consolidation. DSCT angiography of the chest offers a very good image quality even at high heart rates so that a high diagnostic accuracy is achieved in patients with acute chest pain. (orig.) [de

  18. Evaluation of a Noise Reduction Procedure for Chest Radiography

    Science.gov (United States)

    Fukui, Ryohei; Ishii, Rie; Kodani, Kazuhiko; Kanasaki, Yoshiko; Suyama, Hisashi; Watanabe, Masanari; Nakamoto, Masaki; Fukuoka, Yasushi

    2013-01-01

    Background The aim of this study was to evaluate the usefulness of noise reduction procedure (NRP), a function in the new image processing for chest radiography. Methods A CXDI-50G Portable Digital Radiography System (Canon) was used for X-ray detection. Image noise was analyzed with a noise power spectrum (NPS) and a burger phantom was used for evaluation of density resolution. The usefulness of NRP was evaluated by chest phantom images and clinical chest radiography. We employed the Bureau of Radiological Health Method for scoring chest images while carrying out our observations. Results NPS through the use of NRP was improved compared with conventional image processing (CIP). The results in image quality showed high-density resolution through the use of NRP, so that chest radiography examination can be performed with a low dose of radiation. Scores were significantly higher than for CIP. Conclusion In this study, use of NRP led to a high evaluation in these so we are able to confirm the usefulness of NRP for clinical chest radiography. PMID:24574577

  19. Diagnosing pulmonary edema: lung ultrasound versus chest radiography.

    Science.gov (United States)

    Martindale, Jennifer L; Noble, Vicki E; Liteplo, Andrew

    2013-10-01

    Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. To evaluate the ability of residents to recognize pulmonary edema on lung ultrasound using chest radiographs as a comparison standard. This is a prospective, blinded, observational study of a convenience sample of resident physicians in the Departments of Emergency Medicine (EM), Internal Medicine (IM), and Radiology. Residents were given a tutorial on interpreting pulmonary edema on both chest radiograph and lung ultrasound. They were then shown both ultrasounds and chest radiographs from 20 patients who had presented to the emergency department with dyspnea, 10 with a primary diagnosis of pulmonary edema, and 10 with alternative diagnoses. Cohen's κ values were calculated to describe the strength of the correlation between resident and gold standard interpretations. Participants included 20 EM, 20 IM, and 20 Radiology residents. The overall agreement with gold standard interpretation of pulmonary edema on lung ultrasound (74%, κ = 0.51, 95% confidence interval 0.46-0.55) was superior to chest radiographs (58%, κ = 0.25, 95% confidence interval 0.20-0.30) (P Radiology residents interpreted chest radiographs more accurately than did EM and IM residents. Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.

  20. Impacted thoracic foreign bodies after penetrating chest trauma.

    Science.gov (United States)

    Sersar, Sameh I; Albohiri, Khalid A; Abdelmohty, Hysam

    2016-10-01

    Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest. We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4. Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs. Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration. © The Author(s) 2016.