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Sample records for underwent chest hrct

  1. HRCT findings of chest complications in patients with leukemia

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    Tanaka, Nobuyuki; Matsumoto, Tsuneo; Miura, Gouji; Emoto, Takuya; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University School of Medicine (Japan)

    2002-06-01

    High-resolution CT (HRCT) findings of several chest complications occurring in leukemic patients were reviewed. Although most entities show non-specific HRCT findings including ground-glass opacity and air-space consolidation, characteristic findings are observed in several pulmonary complications including Pneumocystis carinii pneumonia, fungal infections, miliary tuberculosis, leukemic infiltration, pulmonary edema, bronchiolitis obliterans, and bronchiolitis obliterans organizing pneumonia. A combination of these characteristic HRCT findings and the information obtained from the clinical setting may help in achieving a correct diagnosis of chest complications occurring in leukemic patients. (orig.)

  2. Chronic complications of inhalation injury: chest HRCT findings and a correlation with the pulmonary function test in reactive airway dysfunction syndrome

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    Song, Ki Hyeok; Lee, In Sun; Jung, Eun Hee; Ji, Young Gu; Lee, Young Seok [Dankook University Hospital, Cheonan (Korea, Republic of)

    2007-09-15

    To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PET. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PET. Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PET were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis.

  3. Diagnostic accuracy for X-ray chest in interstitial lung disease as confirmed by high resolution computed tomography (HRCT) chest

    International Nuclear Information System (INIS)

    Afzal, F.; Raza, S.; Shafique, M.

    2017-01-01

    Objective: To determine the diagnostic accuracy of x-ray chest in interstitial lung disease as confirmed by high resolution computed tomography (HRCT) chest. Study Design: A cross-sectional validational study. Place and Duration of Study: Department of Diagnostic Radiology, Combined Military Hospital Rawalpindi, from Oct 2013 to Apr 2014. Material and Method: A total of 137 patients with clinical suspicion of interstitial lung disease (ILD) aged 20-50 years of both genders were included in the study. Patients with h/o previous histopathological diagnosis, already taking treatment and pregnant females were excluded. All the patients had chest x-ray and then HRCT. The x-ray and HRCT findings were recorded as presence or absence of the ILD. Results: Mean age was 40.21 ± 4.29 years. Out of 137 patients, 79 (57.66 percent) were males and 58 (42.34 percent) were females with male to female ratio of 1.36:1. Chest x-ray detected ILD in 80 (58.39 percent) patients, out of which, 72 (true positive) had ILD and 8 (false positive) had no ILD on HRCT. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of chest x-ray in diagnosing ILD was 80.0 percent, 82.98 percent, 90.0 percent, 68.42 percent and 81.02 percent respectively. Conclusion: This study concluded that chest x-ray is simple, non-invasive, economical and readily available alternative to HRCT with an acceptable diagnostic accuracy of 81 percent in the diagnosis of ILD. (author)

  4. Chest HRCT signs predict deaths in long-term follow-up among asbestos exposed workers

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    Vehmas, Tapio, E-mail: tapio.vehmas@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki (Finland); Oksa, Panu, E-mail: panu.oksa@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Uimalankatu 1, FI-33101 Tampere (Finland)

    2014-10-15

    Highlights: • Much lung and pleural pathology is found in chest CT studies. • HRCT signs were screened and subsequent mortality followed up. • Several signs were related to all-cause and disease specific deaths. • The HRCT classification system used was able to predict mortality. • Secondary preventive strategies should be developed for patients with such signs. - Abstract: Objectives: To study associations between chest HRCT signs and subsequent deaths in long-term follow-up. Methods: Lung and pleural signs of 633 asbestos exposed workers (age 45–86, mean 65) screened with HRCT were recorded by using the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) system, which contains detailed instructions for use and reference images. Subsequent mortality was checked from the national register. Cox regression adjusted for covariates (age, sex, BMI, asbestos exposure, pack-years) was used to explore the relations between HRCT signs and all-cause deaths, cardiovascular and benign respiratory deaths, and deaths from neoplasms – all according to the ICD-10 diagnostic system. Results: The follow-up totalled 5271.9 person-years (mean 8.3 y/person, range .04–10.3). 119 deaths were reported. Irregular/linear opacities, honeycombing, emphysema, large opacities, visceral pleural abnormalities and bronchial wall thickening were all significantly related to all-cause deaths. Most of these signs were associated also with deaths from neoplasms and benign respiratory disease. Deaths from cardiovascular disease were predicted by emphysema and visceral pleural abnormalities. Conclusions: Several HRCT signs predicted deaths. Careful attention should be paid on subjects with radiological signs predictive of deaths and new secondary preventive strategies developed. This calls for further focused studies among different populations.

  5. Sarcoidosis: assessment of disease severity using HRCT

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    Drent, Marjolein [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Sarcoidosis Management Center, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Vries, Jolanda De [Department of Clinical Health Psychology, Tilburg University, P.O. Box 90153, 5000, LE Tilburg (Netherlands); Lenters, Merinke; Wouters, Emiel F.M. [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Lamers, Rob J.S. [Department of Radiology, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Rothkranz-Kos, Snjezana; Dieijen-Visser, Marja P. van [Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Department of Clinical Chemistry, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Verschakelen, Johny A. [Department of Radiology, Catholic University, 3000, Leuven (Belgium)

    2003-11-01

    The value of high-resolution computed tomography (HRCT) in diagnosing and assessing inflammatory activity in sarcoidosis is well established. The aim of the present study was to address the intra- and inter-observer agreements of the HRCT score by Oberstein et al. [8], and to evaluate the relationship between HRCT findings and disease severity expressed in respiratory functional impairment in sarcoidosis. The clinical records of 80 known sarcoidosis patients visiting the outpatient clinic between January 2000 and August 2001, who underwent a HRCT as well as lung function tests (including exercise testing), were reviewed. Two readers scored the first 60 HRCT images twice. Weighted kappa and intra-class correlation coefficient were used to assess the reliability of the HRCT scoring system. Spearman's rank correlation coefficients and multiple regression analyses were performed to evaluate the relationship between HRCT findings (first reading, reader A) and respiratory functional impairment. Intra- and inter-reader reliability demonstrated good agreement. All HRCT subscores, except enlargement of lymph nodes, were correlated to the FEV{sub 1}, FVC, DLco, Pao{sub 2}max (all p<0.05) and A-aPo{sub 2}max (p <0.001). Furthermore, HRCT abnormalities, but not the chest radiographic stage, were strongly associated with functional parameters. Abnormal changes of lung parenchyma, established by HRCT features, were associated with respiratory functional impairment in sarcoidosis. Moreover, compared with the radiographic stages, HRCT findings appeared to be much more sensitive in depicting respiratory disability, especially abnormal gas exchange. (orig.)

  6. Influence of timing of chest tube removal on early outcome of patients underwent lung resection

    Directory of Open Access Journals (Sweden)

    Ahmed Labib Dokhan

    2016-05-01

    Conclusion: Early removal of chest tube may have beneficial effect on control of post-thoracotomy pain, improvement of pulmonary functions and decreasing the risk of complications after lung resection.

  7. Late lung parenchymal changes on HRCT in children with mycoplasma pneumonia

    International Nuclear Information System (INIS)

    Lee, Soo Hyeon; Kim, Joung Sook; Yoon, Jung Hee; Hur, Gham; Kim, Chang Gun

    1999-01-01

    To evaluate late lung parenchymal change, as seen on high-resolution CT(HRCT) in children with mycoplasma pneumonia. Twenty-three patients [15 boys and 8 girls aged two to 13 (mean, 6) years] with mycoplasma pneumonia underwent HRCT four to 39 (mean, 10) months after initial infection. Using increased mycoplasma antibody titer( > 1;640) mycoplasma pneumonia was diagnosed, and patients were divided into two groups : high titer group (antibody titer > 1:5120), and lower titer group ( < 1:5120). CT scans were performed using 2mm collimation and 5-10mm interval from apex to diaphragm. In seven patients who were cooperative, both inspiratory scans were obtained at a window width of 1600 HU and level of 700. HRCT findings of mosaic low attenuations and changes in bronchioles and bronchial walls were assessed by three radiologists and correlated with initial chest radiographic findings. On HRCT, 17 of 23 patients (74%) demonstrated abnormal findings. These included mosaic attenuation of lung density alone in 11 of 17 patients (65%), mosaic attenuation associated with bronchiectasis in five(29%), and bronchiectasis only in one(6%). Mosaic attenuation was more accentuated on expiratory scans than on inspiratory. These findings were obtained in 10 of 12 high titer group and in 7 of 11 in the lower titer group. In 15 of 23 patients(65%), involved areas seen on HRCT exactly corresponded with initially involved areas seen on chest radiographs (CXR). Two patients in whom findings on initial CXR were normal showed mosaic attenuation on HRCT. Six patients in whom such findings were abnormal showed normal findings on HRCT, a fact which reflected their complete recovery. The most common late parenchymal change in mycoplasma pneumonia, as seen on HRCT, was mosaic attenuation of lung density followed by bronchiectasis. The latter is presumably due to bronchiolitis obliterans, a well-known complication. We believe that HRCT is very useful for the evaluation of long-term sequelae of

  8. HRCT of diffuse interstitial pneumonia during treatment

    International Nuclear Information System (INIS)

    Takahashi, Masashi; Sano, Akira; Imanaka, Kazufumi

    1989-01-01

    HRCT was carried out in twenty patients with diffuse interstitial pneumonia: 13 cases of IIP, 3 of BOOP, 2 of drug-induced pneumonia, 1 of rheumatoid lung and acute interstitial pneumonia of unknown origin. With special attention to inflammatory activity, the patients underwent HRCT periodically during the treatment. Correlative investigation between HRCT image and grade of accumulation in 67 Ga scintigraphy was also performed. Response to steroid therapy was clearly reflected on HRCT image, that was shown as decreasing pulmonary density or thinning of honeycomb wall. HRCT is considered to be useful in assessing the activity of diffuse interstitial pneumonia. (author)

  9. Idiopathic pulmonary fibrosis complicated by acute thromboembolic disease: chest X-ray, HRCT and multi-detector row CT angiographic findings.

    Science.gov (United States)

    Camera, Luigi; Campanile, Francesco; Imbriaco, Massimo; Ippolito, Renato; Sirignano, Cesare; Santoro, Ciro; Galderisi, Maurizio; Salvatore, Marco

    2013-02-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial disease characterized by a predominant reticular pattern of involvement of the lung parenchyma which can be well documented by High Resolution Computed Tomography (HRCT). While almost half of the patients with IPF may develop pulmonary arterial hypertension, the occurrence of superimposed acute thrombo-embolic disease is rare.We describe a case of an 87 yrs old female who was found to have IPF complicated by acute pulmonary thrombo-embolism during the clinical and radiological investigation of a rapidly worsening dyspnea. While chest x-ray findings were initially considered consistent with a congestive heart failure, a bed side echocardiography revealed findings suggestive of pulmonary arterial hypertension and right ventricular failure with enlargement of both right cavities and associated valvular regurgitations. An acute thrombo-embolic disease was initially ruled out by a perfusion lung scintigraphy and subsequently confirmed by contrast-enhanced multi-detector CT which showed an embolus at the emergency of the right inter-lobar artery with associated signs of chronic pulmonary hypertension. However, unenhanced scans performed with both conventional and high resolution techniques also depicted a reticular pattern of involvement of lung parenchyma considered suggestive of IPF despite a atypical upper lobe predominance. IPF was later confirmed by further clinical, serological and instrumental follow-up.

  10. Miliary tuberculosis: HRCT findings in 14 patients

    International Nuclear Information System (INIS)

    Son, Hyun Ju; Kim, Kun II; Juhng, Dong Hi; Lee, Suk Hong; Kim, Byung Su; Park, Soon Kew

    1994-01-01

    To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significance. We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 - 2 mm in 6 cases, and 3 mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). HRCT findings of miliary tuberculosis are diffusely distributed micro nodules of variable size, less than 5 mm in diameter. The ground-glass opacity can be combined

  11. Mixed Herbal Medicine Induced Diffuse Infiltrative Lung Disease: The HRCT and Histopathologic Findings

    International Nuclear Information System (INIS)

    Kim, Tae Gyu; Shin, Eun A; Kim, Joung Sook

    2010-01-01

    The purpose of this study was to evaluate the high-resolution CT (HRCT) and pathologic findings of mixed herbal medicine-induced diffuse interstitial lung disease. Eight patients (6 women and 2 men, age range: 31 to 81 years, mean age: 51.4 years) who presented with cough or dyspnea after taking mixed herbal medicine were included in this study. All the patients underwent plain chest radiography and HRCT. We obtained pathologic specimens from 7 patients via fluoroscopy guided large bore cutting needle biopsy and transbronchial lung biopsy. All the patients were treated with steroid therapy. The most common HRCT finding was bilateral diffuse ground glass opacity (n=7), followed by peribronchial consolidation (n=5) and inter- or intralobular septal thickening (n=2). For the disease distribution, the lower lung zone was dominantly involved. The pathologic results of 7 patients were nonspecific interstitial pneumonia (n=3), bronchiolitis obliterans organizing pneumonia (n=2), hypersensitivity pneumonitis (n=1) and eosinophilic pneumonia (n=1). Irrespective of the pathologic results, all 8 patients improved clinically and radiologically after steroid treatment. The HRCT findings of mixed herbal medicine-induced diffuse infiltrative lung disease were mainly bilateral diffuse ground glass opacity, peribronchial consolidation and dominant involvement of the lower lung zone. Those pathologic findings were nonspecific and the differential diagnosis could include interstitial pneumonia, bronchiolitis obliterans organizing pneumonia, hypersensitivity pneumonitis and eosinophilic pneumonia

  12. Mixed Herbal Medicine Induced Diffuse Infiltrative Lung Disease: The HRCT and Histopathologic Findings

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    Kim, Tae Gyu; Shin, Eun A [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kim, Joung Sook [Mokdong Hospital, Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2010-12-15

    The purpose of this study was to evaluate the high-resolution CT (HRCT) and pathologic findings of mixed herbal medicine-induced diffuse interstitial lung disease. Eight patients (6 women and 2 men, age range: 31 to 81 years, mean age: 51.4 years) who presented with cough or dyspnea after taking mixed herbal medicine were included in this study. All the patients underwent plain chest radiography and HRCT. We obtained pathologic specimens from 7 patients via fluoroscopy guided large bore cutting needle biopsy and transbronchial lung biopsy. All the patients were treated with steroid therapy. The most common HRCT finding was bilateral diffuse ground glass opacity (n=7), followed by peribronchial consolidation (n=5) and inter- or intralobular septal thickening (n=2). For the disease distribution, the lower lung zone was dominantly involved. The pathologic results of 7 patients were nonspecific interstitial pneumonia (n=3), bronchiolitis obliterans organizing pneumonia (n=2), hypersensitivity pneumonitis (n=1) and eosinophilic pneumonia (n=1). Irrespective of the pathologic results, all 8 patients improved clinically and radiologically after steroid treatment. The HRCT findings of mixed herbal medicine-induced diffuse infiltrative lung disease were mainly bilateral diffuse ground glass opacity, peribronchial consolidation and dominant involvement of the lower lung zone. Those pathologic findings were nonspecific and the differential diagnosis could include interstitial pneumonia, bronchiolitis obliterans organizing pneumonia, hypersensitivity pneumonitis and eosinophilic pneumonia

  13. Cytomegalovirus pneumonia in immunocompromised patients : HRCT findings

    International Nuclear Information System (INIS)

    Kim, Hyung Soo; Lee, Jin Seong

    1999-01-01

    The purpose of this study was to describe the HRCT findings of cytomegalovirus (CMV) pneumonia in immunocompromised patients. Eleven immunocompromised patients with proven CMV pneumonia underwent HRCT scanning. Three had undergone a transplant, three had a malignant tumor, two had undergone steroid therapy, one had pancytopenia and two had AIDS. In all patients, CMV was diagnosed by bronchoalveolar lavage culture. HRCT scans were retrospectively reviewed by two radiologists for disease distribution and patterns. HRCT findings included ground-glass opacity(n=11), consolidation (n=7), reticular opacity (n=10), multiple small nodules or mass (n=6), and bronchiectasis or bronchial wall thickening (n=5). Ground-glass opacity was usually distributed bilaterally and diffusely. Consolidation was most marked in the lower lobes, and reticular opacity and nodules or mass showed a variable, nonsegmental distribution. The HRCT findings of CMV pneumonia in immunocompromised patients were variable and nonspecific. The most common patterns included diffuse ground-glass opacity and consolidation, combined with variable reticulation

  14. Cocaine-induced pulmonary changes: HRCT findings

    International Nuclear Information System (INIS)

    Almeida, Renata Rocha de; Zanetti, Glaucia; Marchiori, Edson; Souza, Luciana Soares de; Silva, Jorge Luiz Pereira e; Mancano, Alexandre Dias; Nobre, Luiz Felipe; Hochhegger, Bruno; Marchiori, Edson

    2015-01-01

    Objective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease. Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors. Results: In 8 patients (36.4%), the clinical and tomographic findings were consistent with 'crack lung', those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each. Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings. (author)

  15. Cocaine-induced pulmonary changes: HRCT findings

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    Renata Rocha de Almeida

    2015-08-01

    Full Text Available AbstractObjective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.Results:In 8 patients (36.4%, the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%, barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.

  16. Cocaine-induced pulmonary changes: HRCT findings

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    Almeida, Renata Rocha de; Zanetti, Glaucia; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Programa de Pos-Graduacao em Radiologia; Souza Junior, Arthur Soares [Faculdade de Medicina de Petropolis, Petropolis, RJ (Brazil); Souza, Luciana Soares de [Ultra-X, Sao Jose do Rio Preto, SP (Brazil); Silva, Jorge Luiz Pereira e [Universidade Federal da Bahia (UFBA), Salvador (Brazil). Dep. de Medicina e Apoio Diagnostico; Escuissato, Dante Luiz [Universidade Federal do Parana (UFPR), Curitiba (Brazil). Dept. de Clinica Medica; Irion, Klaus Loureiro [Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool (United Kingdom); Mancano, Alexandre Dias [Hospital Anchieta, Taguatinga, DF (Brazil); Nobre, Luiz Felipe [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil); Hochhegger, Bruno [Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS (Brazil); Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2015-07-15

    Objective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease. Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors. Results: In 8 patients (36.4%), the clinical and tomographic findings were consistent with 'crack lung', those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each. Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings. (author)

  17. Pneumoconiosis and emphysema in construction workers : results of HRCT and lung function findings

    NARCIS (Netherlands)

    Meijer, E.; Nij, E. Tjoe; Kraus, T.; van der Zee, J. S.; van Delden, O.; van Leeuwen, M.; Lammers, J. W.; Heederik, D.

    Objectives To evaluate the prevalence of HRCT findings in construction workers previously surveyed by chest radiographs classified according to ILO guidelines. To examine the association between HRCT findings and exposure to quartz containing dust, and lung function. Methods The study comprised a

  18. Pneumoconiosis and emphysema in construction workers: results of HRCT and lung function findings

    NARCIS (Netherlands)

    Meijer, E.; Tjoe Nij, E.; Kraus, T.; van der Zee, J. S.; van Delden, O.; van Leeuwen, M.; Lammers, J. W.; Heederik, D.

    2011-01-01

    To evaluate the prevalence of HRCT findings in construction workers previously surveyed by chest radiographs classified according to ILO guidelines. To examine the association between HRCT findings and exposure to quartz containing dust, and lung function. The study comprised a questionnaire,

  19. High-resolution CT (HRCT) of the lung in Wegener's granulomatosis. High-Resolution CT (HRCT) der Lunge bei Wegenerscher Granulomatose

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    Schubert, F. (Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)); Muhle, C. (Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)); Schnabel, A. (Medizinische Abt., Rheumaklinik Bad Bramstedt (Germany) Abt. fuer Klinische Rheumatologie, Luebeck Univ. (Germany)); Handrock, K. (Medizinische Abt., Rheumaklinik Bad Bramstedt (Germany) Abt. fuer Klinische Rheumatologie, Luebeck Univ. (Germany)); Reuter, M. (Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)); Spielmann, R.P. (Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany)); Gross, W.L. (Medizinische Abt., Rheumaklinik Bad Bramstedt (Germany) Abt. fuer Klinische Rheumatologie, Luebeck Univ. (Germany)); Heller, M. (Klinik fuer Radiologische Diagnostik, Kiel Univ. (Germany))

    1994-07-01

    HRCT of the lung and plain chest X-ray were performed to reveal pulmonary manifestation in primary diagnostics or reevaluation of 35 patients with Wegener's granulomatosis. Pleural and parenchymal pathology was detected in chest X-ray of 20 (57%) and in HRCT of 30 (85,7%) patients. Granulomas with and without cavitations and with smooth or spiculated margins were deemed pathognomonic. Nonspecific findings were infiltrates, thickened interlobular septae and fibrotic changes of parenchyma and pleura. Ground glass opacities, traction bronchiectasis and small cysts were only visible on HRCT. As expected HRCT proved to be more sensitive in detecting subtle lung alterations than plain film chest X-ray. It helps to differentiate acute inflammatory and thus potentially curable processes from chronic fibrotic changes in Wegener's granulomatosis. (orig.)

  20. High resolution computed tomography of the chest in cystic fibrosis (CF): is simplification of scoring systems feasible?

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    Oikonomou, Anastasia; Prassopoulos, Panos [University Hospital of Alexandroupolis, Democritus University of Thrace, Department of Radiology, Dragana, Alexandroupolis (Greece); Tsanakas, John; Hatziagorou, Elpis; Kirvassilis, Fotios [Ippokratio Hospital of Thessaloniki, Aristotle University of Thessaloniki, 3d Department of Pediatrics, Thessaloniki (Greece); Efremidis, Stavros [University Hospital of Ioannina, University of Ioannina, Department of Radiology, Ioannina (Greece)

    2008-03-15

    The purpose of this study was to simplify HRCT scoring systems (SS) for CF by selecting representative HRCT parameters. Forty-two consecutive patients with CF underwent baseline and follow-up chest HRCT. Three radiologists evaluated 84 HRCTs employing five SS. ''Simplified'' HRCT SS were formed by selection of parameters exhibiting statistically significant relations with FEV1. Pulmonary function tests (PFTs) and nutrition (IBW%) were recorded. Regression analysis, Pearson correlation and T-test were used for statistical analysis. Three HRCT parameters were selected for the formation of ''simplified'' HRCT SS (severity of bronchiectasis, bronchial wall thickening, atelectasis-consolidation) using regression analysis. There was excellent correlation between each ''simplified'' and corresponding complete score (0.892 < r < 0.0967, p < 0.0001) or the remaining four complete scores (0.786 < r < 0.961, p < 0.0001). Strong correlation was found among the five ''simplified'' scores (0.803 < r < 0.997, p < 0.0001). Comparing baseline complete and ''simplified'' scores with corresponding follow-up ones, significant worsening was observed (p < 0.0001). PFTs and IBW% did not change significantly. HRCT scores correlated moderately with FVC and FEV1, but there was no correlation with FEF25-75 and IBW%. ''Simplified'' HRCT SS are as reliable as the complete ones and detect progression of lung disease earlier than clinical parameters. They are easy to use and could be adopted in clinical practice. (orig.)

  1. Influenza A (H1N1) pneumonia: HRCT findings

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    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Zanetti, Glaucia [Escola de Medicina de Petropolis, RJ (Brazil); Hochhegger, Bruno [Santa Casa de Misericordia de Porto Alegre, RS (Brazil)

    2013-11-01

    Objective: to describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. Methods: we retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. Results: the most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. Conclusions: the most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or cranio caudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms. (author)

  2. Influenza A (H1N1 pneumonia: HRCT findings

    Directory of Open Access Journals (Sweden)

    Viviane Brandao Amorim

    2013-06-01

    Full Text Available OBJECTIVE: To describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1 virus. METHODS: We retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. RESULTS: The most common HRCT findings were ground-glass opacities (85%, consolidation (64%, or a combination of ground-glass opacities and consolidation (58%. Other findings were airspace nodules (25%, bronchial wall thickening (25%, interlobular septal thickening (21%, crazy-paving pattern (15%, perilobular pattern (3%, and air trapping (3%. The findings were frequently bilateral (89%, with a random distribution (68%. Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. CONCLUSIONS: The most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or craniocaudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms.

  3. Influenza A (H1N1) pneumonia: HRCT findings

    International Nuclear Information System (INIS)

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson; Zanetti, Glaucia; Hochhegger, Bruno

    2013-01-01

    Objective: to describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. Methods: we retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. Results: the most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. Conclusions: the most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or cranio caudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms. (author)

  4. Acute and subacute non-infectious lung diseases. Usefulness of HRCT for evaluation of activity especially in follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Johkoh, Takeshi; Tomiyama, Noriyuki; Honda, Osamu [Osaka Univ., Suita (Japan). Medical School] (and others)

    2000-08-01

    The purpose of this study was to survey the usefulness of high-resolution CT (HRCT) for the evaluation of activity in acute and subacute non-infectious diffuse infiltrative lung diseases before and after corticosteroid treatment. Sequential HRCT images and chest radiographs obtained before and after treatment were retrospectively evaluated in 33 patients with acute or subacute non-infectious diffuse infiltrative lung diseases. All these patients were histologically confirmed to have pulmonary Inflammation and to have responded to treatment with corticosteroid. Radiographic and CT scores were correlated with the degree of dyspnea and the results of arterial blood gas analysis using Spearman's rank-correlation coefficient. On follow-up HRCT, the profusion score of areas with increased attenuation was significantly correlated with arterial oxygen tension (PaO{sub 2}) (p=.003, r=-.53) and the alveolar-arterial oxygen tension difference (AaDO{sub 2}) (p=.001, r=.57). No other correlation was found after treatment. Nodular and linear opacities were more commonly seen on follow-up chest radiographs and HRCT images than on initial ones. HRCT is useful for the evaluation of disease activity in acute and subacute non-infectious infiltrative lung diseases before and after treatment if paying special attention to the profusion of ground-glass attenuation. Even if pretreatment HRCT has not been performed, posttreatment HRCT should be examined. (author)

  5. Serial HRCT lung changes after 3-field radiation treatment of breast cancer

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    Ooi, G.C.; Kwong, D.L.W.; Chan, K.N.; Ngan, H.; Lock, D.T.W.; Lam, W.K.; Chan, F.L.; Au, G.; Tsang, K.W.T

    2000-11-01

    AIMS: To document serial high resolution computed tomography (HRCT) features of lung injury after 3-field radiotherapy for breast cancer. MATERIALS AND METHODS: Thirty women who received opposing tangential chest wall and supraclavicular field (SCF) irradiation after breast surgery were recruited. Thoracic HRCT was performed before and at 1, 3, 6 and 12 months after radiotherapy (RT). Lung injury at 3 months was quantified by applying a scoring system to each HRCT section. Findings were correlated with spirometric lung function tests. RESULTS: There was HRCT evidence of lung injury in 27 (90%) women at 1 month and in all 30 patients at 3 months. Spirometric lung function declined post-RT (P < 0.05), correlating with an increased SCF acute lung injury score at 3 months [r = -0.54 and -0.46, P 0.01 and 0.03 for forced expiratory volume in 1st (FEV{sub 1}) and forced vital capacity (FVC), respectively]. Lung injury on HRCT progressed from ground glass opacification at 1 month to nodular consolidation (3 months), increasing linear densities (6 months), and finally to residual subpleural linear and dense opacities (12 months). CONCLUSION: There is a high incidence of lung injury associated with 3-field radiotherapy for breast cancer, with concurrent SCF irradiation increasing the risk of lung damage and functional impairment. A characteristic sequence of HRCT changes is seen in most patients receiving this type of radiotherapy. Ooi, G.C. (2000)

  6. Acute respiratory distress syndrome (ARDS): HRCT findings in survivors

    International Nuclear Information System (INIS)

    Jung, Jung Im; Park, Seog Hee; Lee, Jae Mun; Song, Jeong Sup; Lee, Kyo Young

    1999-01-01

    The purpose of this report is to describe the high-resolution computed tomography (HRCT) findings of the lung in survivors of acute respiratory distress syndrome (ARDS). Among eleven patients who survived ARDS for one year, chest radiography and HRCT revealed pulmonary fibrosis in four. Causes of ARDS included pneumonia during pregnancy, near drowning, pneumonia during liver cirrhosis, and postoperative sepsis. Thoracoscopic biopsy and histopathologic correlation were available in one patient. HRCT showed diffuse interlobular septal thickening, ground glass opacity, parenchymal distortion, and traction bronchiectasis. Fuzzy centrilobular nodules were seen in two patients and one patient had multiple, large bullae in the left hemithorax. In all patients, lesions affected the upper and anterior zones of the lung more prominently. The distribution of pulmonary fibrosis was characteristic and reflected the pathogenesis of lung injury; fibrosis was largely due to hyperoxia caused by ventilator care. In one patient, histopathologic correlation showed that imaging findings were accounted for by thickening of the alveolar septum along with infiltration of chronic inflammatory cells and fibrosis. Fuzzy centrilobular nodules corresponded with bronchiolitis

  7. Acute respiratory distress syndrome (ARDS): HRCT findings in survivors

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    Jung, Jung Im; Park, Seog Hee; Lee, Jae Mun; Song, Jeong Sup; Lee, Kyo Young [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    The purpose of this report is to describe the high-resolution computed tomography (HRCT) findings of the lung in survivors of acute respiratory distress syndrome (ARDS). Among eleven patients who survived ARDS for one year, chest radiography and HRCT revealed pulmonary fibrosis in four. Causes of ARDS included pneumonia during pregnancy, near drowning, pneumonia during liver cirrhosis, and postoperative sepsis. Thoracoscopic biopsy and histopathologic correlation were available in one patient. HRCT showed diffuse interlobular septal thickening, ground glass opacity, parenchymal distortion, and traction bronchiectasis. Fuzzy centrilobular nodules were seen in two patients and one patient had multiple, large bullae in the left hemithorax. In all patients, lesions affected the upper and anterior zones of the lung more prominently. The distribution of pulmonary fibrosis was characteristic and reflected the pathogenesis of lung injury; fibrosis was largely due to hyperoxia caused by ventilator care. In one patient, histopathologic correlation showed that imaging findings were accounted for by thickening of the alveolar septum along with infiltration of chronic inflammatory cells and fibrosis. Fuzzy centrilobular nodules corresponded with bronchiolitis.

  8. Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

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    Laurent, F.; Philippe, J.C. [Department of Medical Imaging, Diagnostic and Interventional Radiology, University of Bordeaux (France); Vergier, B. [Department of Pathology, University of Bordeaux, Bordeaux (France); Granger-Veron, B.; Darpeix, B.; Vergeret, J.; Blanc, P. [Department of Pneumology, University of Bordeaux, F-33000 Bordeaux (France); Velly, J.F. [Department of Thoracic Surgery, University of Bordeaux, F-33000 Bordeaux (France)

    1999-08-01

    The objective of this study was to describe high-resolution CT (HRCT) and MR findings of exogenous lipoid pneumonia and to correlate them with pathologic findings. A retrospective review of the medical records of our institution revealed seven patients with a diagnosis of lipoid pneumonia based on clinical data, chest films, bronchoalveolar lavage, and follow-up. Both HRCT and MR imaging were reviewed by two readers. Pathologic examination of the resected specimen or surgical biopsies were also reviewed in the four available cases. The HRCT findings were pulmonary consolidations (n = 6) with fatty (n = 3) or unspecific but low attenuation values (n = 3), areas of ground-glass opacities (n = 5), septal lines, and centrilobular interstitial thickening (n = 5). In five of the seven cases, a crazy-paving pattern of various spread was also present, either isolated (n = 1) or surrounding a pulmonary consolidation. In two cases traction bronchiectasis and cystic changes consistent with fibrosis were seen. At MR imaging (n = 2) a pulmonary consolidation of high signal intensity on T1-weighted image consistent with lipid content was present in one case. Pathologic examination (n = 4) showed the coexistence of lobules with lesions of various ages, sometimes in contiguous lobules, within the same patient. Recent lesions were those with alveolar fill-in by spumous macrophages and almost normal alveolar walls and septae. In more advanced lesions, lobules were filled in with larger vacuoles often surrounded by inflammatory infiltrates of alveolar walls, bronchiolar walls, and septa. The oldest lesions were characterized by fibrosis and parenchymal distortion around large lipid-containing vacuoles. The HRCT findings reflect pathologic findings in exogenous lipoid pneumonia. Although non-specific, consolidation areas of low attenuation values and crazy-paving pattern are frequently associated in exogenous lipoid pneumonia and are indicative of the diagnosis. (orig.) With 3 figs

  9. Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

    International Nuclear Information System (INIS)

    Laurent, F.; Philippe, J.C.; Vergier, B.; Granger-Veron, B.; Darpeix, B.; Vergeret, J.; Blanc, P.; Velly, J.F.

    1999-01-01

    The objective of this study was to describe high-resolution CT (HRCT) and MR findings of exogenous lipoid pneumonia and to correlate them with pathologic findings. A retrospective review of the medical records of our institution revealed seven patients with a diagnosis of lipoid pneumonia based on clinical data, chest films, bronchoalveolar lavage, and follow-up. Both HRCT and MR imaging were reviewed by two readers. Pathologic examination of the resected specimen or surgical biopsies were also reviewed in the four available cases. The HRCT findings were pulmonary consolidations (n = 6) with fatty (n = 3) or unspecific but low attenuation values (n = 3), areas of ground-glass opacities (n = 5), septal lines, and centrilobular interstitial thickening (n = 5). In five of the seven cases, a crazy-paving pattern of various spread was also present, either isolated (n = 1) or surrounding a pulmonary consolidation. In two cases traction bronchiectasis and cystic changes consistent with fibrosis were seen. At MR imaging (n = 2) a pulmonary consolidation of high signal intensity on T1-weighted image consistent with lipid content was present in one case. Pathologic examination (n = 4) showed the coexistence of lobules with lesions of various ages, sometimes in contiguous lobules, within the same patient. Recent lesions were those with alveolar fill-in by spumous macrophages and almost normal alveolar walls and septae. In more advanced lesions, lobules were filled in with larger vacuoles often surrounded by inflammatory infiltrates of alveolar walls, bronchiolar walls, and septa. The oldest lesions were characterized by fibrosis and parenchymal distortion around large lipid-containing vacuoles. The HRCT findings reflect pathologic findings in exogenous lipoid pneumonia. Although non-specific, consolidation areas of low attenuation values and crazy-paving pattern are frequently associated in exogenous lipoid pneumonia and are indicative of the diagnosis. (orig.)

  10. HRCT findings of childhood follicular bronchiolitis

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    Weinman, Jason P.; Browne, Lorna P. [Children' s Hospital Colorado, Department of Radiology, Aurora, CO (United States); Manning, David A. [Children' s Hospital of New Orleans, Department of Radiology, New Orleans, LA (United States); Liptzin, Deborah R. [Children' s Hospital Colorado, Department of Pediatrics, Section of Pediatric Pulmonology, Aurora, CO (United States); Krausert, Amanda J. [New Orleans Forensic Center, New Orleans, LA (United States)

    2017-12-15

    Follicular bronchiolitis is a lymphoproliferative form of interstitial lung disease (ILD) defined by the presence of peribronchial lymphoid follicles. Follicular bronchiolitis has been associated with viral infection, autoimmune disease and immunodeficiency. The most common clinical manifestation is respiratory distress in infancy followed by a prolonged course with gradual improvement. We found no reports of systematic review of high-resolution computed tomography (HRCT) findings in pediatric follicular bronchiolitis. The purpose of this study was to describe the HRCT findings of follicular bronchiolitis in children and correlate these imaging findings with histopathology. A 5-year retrospective review of all pathology-proven cases of follicular bronchiolitis was performed. Inclusion criteria were age <18 years and an HRCT within 6 months of lung biopsy. HRCTs were reviewed by three observers and scored using the system previously described by Brody et al. Six patients met the inclusion criteria with age range at HRCT of 7-82 months (median: 39.5 months). Pulmonary nodules (n=6) were the most common HRCT finding followed by focal consolidation (n=5), bronchiectasis (n=4) and lymphadenopathy (n=3). Tree and bud opacities and nodules on CT correlated with interstitial lymphocytic infiltrates and discrete lymphoid follicles on pathology. The salient HRCT findings of childhood follicular bronchiolitis are bilateral, lower lung zone predominant pulmonary nodules and bronchiectasis with infantile onset of symptoms. These characteristic HRCT findings help differentiate follicular bronchiolitis from other forms of infantile onset ILD. (orig.)

  11. Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Biederer, J.; Muhle, C.; Heller, M.; Reuter, M.; Schnabel, A.; Gross, W.L.

    2004-01-01

    A prospective study correlating high-resolution computed tomography (HRCT), lung function tests (PFT) and bronchoalveolar lavage (BAL) cytology in patients with interstitial lung disease (ILD) associated with rheumatoid arthritis (RA). Fifty-three RA patients with suspected ILD (19 men, 34 women) underwent 71 HRCT (14 of 53 with sequential HRCT, mean follow-up 24.3 months). The HRCT evaluation by two observers on consensus included a semi-quantitative characterisation of lesion pattern and profusion on representative anatomical levels. Fifty-two HRCT were followed by PFT and BAL. Agreement or discordance of HRCT-, PFT- and BAL findings were analysed with Pearson's correlation, κ score and McNemar's test. Tobacco-fume exposure was estimated in pack years. Smoking/non-smoking groups were compared with Student's t test. In 49 of 53 patients, HRCT was suggestive of ILD associated with RA (66 of 71 HRCT). Reticular lesions were found in 40 of 53 patients, in 15 of 40 presenting as mixed pattern with ground-glass opacities (GGO). Pure reticular patterns predominated in patients with long duration of ILD (p>0.01). Pure GGO were not observed. Lesion profusion was highly variable and correlated moderately negative with diffusion capacity (mean 88.2% (SD±20.9%); r=-0.54; p 0.2), but not towards lymphocytosis (κ=0.10; p=0.23; McNemar test p>0.2). Differences in smoking history were not significant (p>0.1). The HRCT appears most appropriate for the detection and follow-up of ILD associated with RA. The PFT and BAL correlate only partially with lesion profusion or grading on HRCT, but they contribute valuable information about dynamic lung function and differential diagnoses (pneumonia, medication side effects). (orig.)

  12. Radiographic and HRCT findings of pneumocystis carinii pneumonia

    International Nuclear Information System (INIS)

    Heo, Jin Sam; Kim, Kun Il; Kim, Chang Won; Park, Soon Kew; Cho, Goon Jae

    1999-01-01

    To analyze the radiographic and HRCT findings of Pneumocystic carinii pneumonia. We reviewed the medical records and retrospectively analysed the chest radiographs(n=31) and HRCT scans(n=17) of 31 patients with Pneumocystis carinii pneumonia who had been followed up at our institute between, 1993 and March 1998. Pneumocystis carinii pneumonia was confirmed by cytologic evaluation of sputum stained with methenamine silver(n=25) or on the basis of clinical history(n=6). The study group included 17 men and 14 women aged 28-78(average, 53.6) years. Twenty-eight patients had underlying conditions such as hematologic diseases(n=13), AIDS(n=8), malignancy(n=2), DM(n=2) and malnutrition(n=1), and three were free from underlying diseases. Twenty patients had pure Pneumocystis carinii pneumonia and 11 had combined lung diseases, namely pulmonary tuberculosis(n=4), pulmonary metastasis(n=2), bacterial pneumonia(n=2), atypical mycobacterial infection(n=1), pulmonary edema(n=1), and Kaposi' s sarcoma(n=1). Chest radiographic findings of 20 cases of pure Pneumocystis carinii pneumonia included consolidation(n=12), linear-reticular opacity(n=8), ill defined haziness(n=7), and nodules(n=6), with bilaterality in is cases and zonal predominance in ten [central(n=5), lower(n=5)]. Ancillary findings included pleural effusion(n=10), cysts(n=5), lymphadenopathy(n=4) and pneumothorax(n=1). In two patients, findings were entirely normal. HRCT findings in ten cases of pure Pneumocystis carinii pneumonia included ground-glass opacity(n=6), consolidation(n=6), linear-reticular opacity(n=8), and nodules(n=5), with bilaterallity in seven cases and zonal predominance in five [central(n=5), lower(n=2)]. Ancillary findings among these cases included pleural effusion(n=4), lymphadenopathy(n=2), cysts(n=1), and pneumothorax(n=1). HRCT findings in seven cases of Pneumocystis carinii pneumonia combined with other lung diseases included nodules(n=6), ground-glass opacity(n=5), linear-reticular opacity

  13. Radiographic and HRCT findings of pneumocystis carinii pneumonia

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    Heo, Jin Sam; Kim, Kun Il; Kim, Chang Won; Park, Soon Kew; Cho, Goon Jae [Pusan National Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    To analyze the radiographic and HRCT findings of Pneumocystic carinii pneumonia. We reviewed the medical records and retrospectively analysed the chest radiographs(n=31) and HRCT scans(n=17) of 31 patients with Pneumocystis carinii pneumonia who had been followed up at our institute between, 1993 and March 1998. Pneumocystis carinii pneumonia was confirmed by cytologic evaluation of sputum stained with methenamine silver(n=25) or on the basis of clinical history(n=6). The study group included 17 men and 14 women aged 28-78(average, 53.6) years. Twenty-eight patients had underlying conditions such as hematologic diseases(n=13), AIDS(n=8), malignancy(n=2), DM(n=2) and malnutrition(n=1), and three were free from underlying diseases. Twenty patients had pure Pneumocystis carinii pneumonia and 11 had combined lung diseases, namely pulmonary tuberculosis(n=4), pulmonary metastasis(n=2), bacterial pneumonia(n=2), atypical mycobacterial infection(n=1), pulmonary edema(n=1), and Kaposi' s sarcoma(n=1). Chest radiographic findings of 20 cases of pure Pneumocystis carinii pneumonia included consolidation(n=12), linear-reticular opacity(n=8), ill defined haziness(n=7), and nodules(n=6), with bilaterality in is cases and zonal predominance in ten [central(n=5), lower(n=5)]. Ancillary findings included pleural effusion(n=10), cysts(n=5), lymphadenopathy(n=4) and pneumothorax(n=1). In two patients, findings were entirely normal. HRCT findings in ten cases of pure Pneumocystis carinii pneumonia included ground-glass opacity(n=6), consolidation(n=6), linear-reticular opacity(n=8), and nodules(n=5), with bilaterallity in seven cases and zonal predominance in five [central(n=5), lower(n=2)]. Ancillary findings among these cases included pleural effusion(n=4), lymphadenopathy(n=2), cysts(n=1), and pneumothorax(n=1). HRCT findings in seven cases of Pneumocystis carinii pneumonia combined with other lung diseases included nodules(n=6), ground-glass opacity(n=5), linear

  14. Superstructure of stapes. An analysis by HRCT

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    Horiuchi, Yasuharu; Hunai, Hiroaki; Ichimura; Keiiti; Iinuma, Toshitaka; Oyama, Kazuyuki

    1989-03-01

    High-resolution Computed Tomography (HRCT) of the temporal bone has now become a routine test for the diagnosis of various temporal bone lesions. Correct assessment of such minute structures as ossicles, especially stapes, is important in the pre-operative HRCT evaluation. On the other hand, analysis for the reliability of HRCT findings has not been done, including the superstructure of the stapes. A retrospectively study was done in order to assess the availability of HRCT findings in axial overlapping scans in 226 ears, with respect to the superstructures of stapes. The study was concerned with the analysis of HRCTs of 148 normal ears, 71 ears of chronic otitis media and 7 ears of ossicular abnormalities. HRCT findings were compared to those of surgeries in pathological cases. The present study revealed that the superstructures of stapes are noted in 70% when the stapes is surrounded by air. The major limitations in the proper analysis of stapes by HRCT are partial volume averaging and effects of soft tissue silhouetting, this is especially so when the stapes is surrounded by soft tissue density.

  15. Multiple, thin-walled cysts are one of the HRCT features of airspace enlargement with fibrosis

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    Watanabe, Yasutaka, E-mail: yasuyasu@omiya.jichi.ac.jp [Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama 360-0105 (Japan); Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University, Saitama Medical Center, Amanuma-cho, Omiya City, Saitama 330-8503 (Japan); Kawabata, Yoshinori [Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama 360-0105 (Japan); Kanauchi, Tetsu [Department of Radiology, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama 360-0105 (Japan); Hoshi, Eishin [Department of Thoracic Surgery, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama 360-0105 (Japan); Kurashima, Kazuyoshi [Department of Pulmonary Medicine, Saitama Prefectural Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama 360-0105 (Japan); Koyama, Shinichiro [Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University, Saitama Medical Center, Amanuma-cho, Omiya City, Saitama 330-8503 (Japan); Colby, Thomas V. [Department of Laboratory Medicine and Pathology, Mayo Clinic Scottsdale, Scottsdale, AZ 85259 (United States)

    2015-05-15

    Highlights: • High resolution computed tomography (HRCT) findings of airspace enlargement with fibrosis (AEF), recently identified as a smoking related change. • Investigation was in 35 smokers. • They underwent lobectomy for lung cancer with pathological confirmation of AEF. • Multiple, thin-walled cysts are one of the HRCT features of AEF. - Abstract: Purpose: Airspace enlargement with fibrosis (AEF) has been identified pathologically as a smoking related change. We sought to identify the HRCT findings of AEF and search for distinguishing features from honeycombing. Materials and methods: 50 patients (47 males; mean age 69) were evaluated. All had undergone lobectomy for lung cancer and had confirmed AEF and/or usual interstitial pneumonia (UIP) by pathological evaluation. HRCT findings were first evaluated preresection for resected lobes, and then correlated with the subsequent pathological findings in the resection specimens. Three groups were devised: one with AEF alone to determine the HRCT findings of AEF, a second with AEF and UIP and third with UIP alone. HRCT features of AEF and honeycombing were compared. Results: There were 11 patients (10 male; mean age 69) with AEF alone, 24 patients (22 male; mean age 69) with AEF and UIP, and 15 patients (15 male; mean age 68) with UIP alone. The HRCT on the AEF alone showed subpleural (but not abutting the pleura) multiple thin-walled cysts (MTWCs) in 7 and reticular opacities in 3. The HRCT in AEF and UIP showed MTWCs in 10, reticular opacities in 17; and honeycombing in 5. Among these 35 patients with the pathological finding of AEF (with or without UIP), 17 showed MTWCs. The maximum cyst wall thickness of MTWCs (mean 0.81 mm) was significantly thinner than that of honeycombing (mean 1.56 mm). MTWCs did not locate in lung base and was distant from the pleura. HRCT findings correlated with gross findings on both cysts and honeycombing. No MTWCs were seen in the 15 patients with UIP, 8 of 15 had

  16. Therapeutic relevance of HRCT findings from a pneumological viewpoint; Therapeutische Relevanz des HRCT-Befundes aus pneumologischer Sicht

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    Suchy, R. [Klinik Donaustauf, Zentrum fuer Pneumologie, Donaustauf (Germany); Pfeifer, M. [Klinik Donaustauf, Universitaetsklinikum Regensburg, Krankenhaus Barmherzige Brueder Regensburg, Donaustauf (Germany)

    2014-12-15

    The high-resolution computed tomography (HRCT) technique is an essential component in diagnosing interstitial lung disease (ILD) as it provides important and specialized information and a much greater accuracy than chest X-rays. It contributes to a narrowing down of the differential diagnoses and is also important for planning further invasive investigations, e.g. bronchoscopy, bronchoalveolar lavage, transbronchial lung biopsy and surgical lung biopsy, if needed. An accurate diagnosis of ILD is based on a multidisciplinary discussion involving pulmonologists, radiologists and pathologists experienced in the diagnosis of ILD. The therapy approaches of five different entities of ILD are shown as examples. In hypersensitivity pneumonitis the mainstay of treatment is complete avoidance of exposure to the provoking antigen. In cryptogenic organizing pneumonia most patients recover with corticosteroid therapy with prednisolone over a period of 6 months to 1 year. In cases of sarcoidosis therapy depends on organ involvement and functional impairment but there is no durable benefit to routine treatment of patients with acute pulmonary sarcoidosis, even among those with stage II or III chest radiographs. In general, patients with severe or progressive disease will require treatment. In idiopathic pulmonary fibrosis (IPF) a confident radiological diagnosis of definitive usual interstitial pneumonia (UIP) obviates the need for surgical lung biopsy. Other etiologies of a HRCT pattern of UIP, such as domestic and occupational environmental exposure, connective tissue disease and drug toxicity must be ruled out. In IPF antifibrotic therapy with pirfenidone (approval since 2011) or the triple tyrosine kinase inhibitor nintendanib (pending approval in 2015) can reduce disease progression but therapy with acetylcysteine alone or in combination with prednisolone and azathioprine failed to meet efficacy endpoints. In the management of scleroderma associated ILD rapid

  17. Presence and HRCT quantification of bronchiectasis in coal workers

    Energy Technology Data Exchange (ETDEWEB)

    Altin, R.; Savranlar, A.; Kart, L.; Mahmutyazicioglu, K.; Ozdemir, H.; Akdag, B.; Gundogdu, S. [Zonguldak Karalmas University, Zonguldak (Turkey). Dept. of Pulmonary Medicine

    2004-11-01

    The purpose of this study was to evaluate the presence of bronchiectasis in coal workers with or without coal worker pneumoconiosis (CWT) and to assess the extent of bronchiectasis, severity of bronchial wall dilatation and thickening by high resolution computed tomography (HRCT). The patient group consisted of 78 patients (43 CWP; 35 non-CWP). Pneumoconiosis profusions of CWP workers were between p0/1 and p2/2 according to ILO 1980 chest X-ray classification. HRCT examinations of all subjects were evaluated for the presence, extent, dilatation and thickness of bronchiectasis. The diagnosis of bronchiectasis was put on 19 of 43 CWP (44.1 %) and 7 of 35 non-CWP workers (20.0 %). There were statistically significant differences between bronchiectasis positive and negative coal workers with CWP concerning age and exposure duration (P = 0.012 and 0.009, respectively). Then, multiple logistic regression analysis was performed to define exact risk factors. Exposure duration was only found to be related with presence of bronchiectasis ((odds ratio) OR = 1.494, 95 % confidence interval 1.168-1.912). The data from the present study shows that bronchiectasis is frequent and severe in CWP workers than without. Bronchiectasis is influenced by coal dust exposure. Thus, coal dust protection measures must be controlled efficiently to prevent bronchiectasis in coal workers.

  18. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    Energy Technology Data Exchange (ETDEWEB)

    Win, Thida [Lister Hospital, Respiratory Medicine, Stevenage (United Kingdom); Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M. [University College London, Institute of Nuclear Medicine, University College Hospital, London (United Kingdom); Screaton, Nicholas J. [Papworth Hospital, Radiology Department, Papworth Everard (United Kingdom); Porter, Joanna C. [University College London, Centre for Respiratory Diseases, University College Hospital, London (United Kingdom); Maher, Toby M. [Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom); Lukey, Pauline [GSK, Fibrosis DPU, Research and Development, Stevenage (United Kingdom)

    2014-02-15

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent {sup 18}F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of {sup 18}F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). IPF patients have increased pulmonary uptake of {sup 18}F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  19. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients

    International Nuclear Information System (INIS)

    Win, Thida; Thomas, Benjamin A.; Lambrou, Tryphon; Hutton, Brian F.; Endozo, Raymondo; Shortman, Robert I.; Afaq, Asim; Ell, Peter J.; Groves, Ashley M.; Screaton, Nicholas J.; Porter, Joanna C.; Maher, Toby M.; Lukey, Pauline

    2014-01-01

    Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent 18 F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of 18 F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p 18 F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring. (orig.)

  20. HRCT of the lung in collagen vascular diseases

    International Nuclear Information System (INIS)

    Diederich, S.; Roos, N.; Schmitz-Linneweber, B.; Gaubitz, M.; Peters, P.E.

    1996-01-01

    Collagen vascular diseases, representing systemic soft tissue disorders, may cause a broad spectrum of pathologic changes of the respiratory tract. The type and extent of manifestations can vary considerably among individuals and entities. This survey describes the chest radiographic and, in particular, high-resolution computed tomographic and, in particular, high-resolution computed tomographic (HRCT) findings of individual lesions of the respiratory tract. It includes fibrosing alveolitis (alveolitis, interstitial pneumonia, pulmonary fibrosis) and bronchial (bronchitis/bronchiolitis, bronchiectasis), pleural and vascular manifestations, as well as lymphadenopathy and abnormalities related to therapy. We present typical patterns of changes in progressive systemic sclerosis (PSS, scleroderma), systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD, Sharp syndrome), Sjoegren syndrome, overlap syndrome and rheumatoid arthritis (RA). Furthermore, we describe findings which are specific for individual entities such as esophageal involvement in PSS, acute pneumonitis and pulmonary hemorrhage in SLE, lymphoproliferative disease in Sjoegren syndrome and necrobiotic nodules in RA. (orig.) [de

  1. Positional shifting of HRCT findings in patients with pulmonary edema

    International Nuclear Information System (INIS)

    Kim, Young Sun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Seo, Heung Suk; Lee, Seung Rho; Hahm, Chang Kok

    2001-01-01

    To assess the value of positional shifting to a gravity-dependent area, as revealed by HRCT, in differentiating pulmonary edema (PE) from other conditions. Sixteen consecutive patients in whom plain radiographs suggested the presence of pulmonary edema but the clinical findings were indefinite underwent HRCT of the lung. For initial scanning they were in the supine position, and then in the prone position. Findings of ground-glass opacity, interlobular septal thickening and peribronchovascular interistitial thickening were analyzed in terms of the presence and degree of shifting to a gravity-dependent area, a grade of high, intermediate or low being assigned. PE was diagnosed in 8 of 16 cases, the remainder being designated as non-pulmonary edema (NPE). Ground-glass opacity was observed in all 16, while the degree of positional shifting was found to be high in ten (PE:NPE=6:4), intermediate in four (PE:NPE=2:2), and low in two (PE:NPE=0:2). There was no significant difference between the two groups (ρ > 0.05). Interlobular septal thickening was observed in all but two NPE cases; the degree of shifting was high in six (PE:NPE=6:0), intermediate in one (PE), and low in seven (PE:NPE=1:6). Shifting was significantly more prominent in PE than in NPE case (ρ <0.05). Peribronchovascular interstitial thickening was positive in all PE cases and one NPE case, with no positional shifting. Positional shifting of interlobular septal thickening to a gravity-dependent area, as demonstrated by HRCT, is the most specific indicator of pulmonary edema

  2. Evaluation of the temporal bone malformations by HRCT in 17 patients with Treacher Collins Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chihara, Yasuhiro [Kanto Medical Center NTT EC, Tokyo (Japan); Takegoshi, Hideki [Saitama Medical School, Moroyama (Japan); Kaga, Kimitaka [Tokyo Univ. (Japan). Faculty of Medicine

    2003-05-01

    Patients with Treacher Collins Syndrome have severe middle ear malformations. We have studied high-resolution computed tomography (HRCT) of seventeen patients with Treacher Collins Syndrome by using Jahrsdoerfer's grading system. Four patients underwent canalplasty. The appearance of the auricle (which we evaluated by using Marx's grading system) was correlated with the development of the middle ear in patients with Treacher Collins Syndrome. The four cases who underwent canalplasty were using a canal type hearing aid. (author)

  3. HRCT findings of bleomycin-related lung toxicity: a report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Jeong Geun; Jang, Won Ho; Yoon, Dae Young; Bae, Sang Hoon [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-01-01

    Many drugs can result in a variety of pathologic reactions in the lung, especially the cytotoxic drugs. Among cytotoxic drugs bleomycin is a prototype. Bleomycin-related pulmonary toxicity is usually known as dose-dependent and can be enhanced with concurrent oxygen therapy, irradiation, or other chemotherapeutic agents. The incidence of bleomycin-induced pulmonary toxicity has been reported as varying from 2 to 46%, and 1% of fatal lung disease. We describe the radiographic and HRCT findings of bleomycin-related pulmonary toxicity developed in two patients: one in ovarian teratocarcinoma, the other malignant lymphoma patient. Chest radiographs and HRCT of these patients showed ground-glass opacities, consolidation, linear and reticular opacities, and interlobular septal thickening. These abnormalities were bilateral, and symmetrical and were found predominantly in the area of mid- and lower-lung zone.

  4. Acute and subacute chemical-induced lung injuries: HRCT findings

    Energy Technology Data Exchange (ETDEWEB)

    Akira, Masanori, E-mail: Akira@kch.hosp.go.jp [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai City, Osaka 591-8555 (Japan); Suganuma, Narufumi [Department of Environmental Medicine, Kochi Medical School (Japan)

    2014-08-15

    Lung injury caused by chemicals includes bronchitis, bronchiolitis, chemical pneumonitis, pulmonary edema, acute respiratory distress syndrome, organizing pneumonia, hypersensitivity pneumonitis, acute eosinophilic pneumonia, and sarcoid-like granulomatous lung disease. Each chemical induces variable pathophysiology and the situation resembles to the drug induced lung disease. The HRCT features are variable and nonspecific, however HRCT may be useful in the evaluation of the lung injuries and so we should know about HRCT features of lung parenchymal abnormalities caused by chemicals.

  5. The effects of secondhand smoke exposure on HRCT findings among asbestos-exposed workers.

    Science.gov (United States)

    Vierikko, Tuula; Järvenpää, Ritva; Uitti, Jukka; Virtema, Pauliina; Oksa, Panu; Jaakkola, Maritta S; Autti, Taina; Vehmas, Tapio

    2008-05-01

    There is evidence suggesting that secondhand smoke (SHS) exposure is causally linked to adverse respiratory effects. We examined the relations between the exposure to SHS and radiological signs in chest high-resolution computed tomography (HRCT). Asbestos-exposed workers (n=633) were imaged with HRCT, primarily to investigate potential occupational lung disease. After excluding current smokers, the study population included 361 ex- and 141 never-smokers. They answered a questionnaire on occupational exposures, smoking habits and SHS exposure. HRCT images were assessed for emphysema, ground-glass, irregular/linear and rounded opacities, honeycombing and several other signs. Regression analyses were adjusted for asbestos exposure, ex-smoking, age, body mass index and potential reader effect. Due to missing data the multivariate analyses were restricted to 310 participants aged 47.5-87.0 years. Their lifetime SHS exposure ranged between 0 and 193.5 pack-years (mean 23.5), and exposure in the past 12 months 0-30 packs (0.43). Total (B=0.005, 95% confidence intervals (95% CI) 0.002-0.008, p=0.000) and workplace (B=0.006, 95% CI 0.003-0.009, p=0.001) cumulative SHS exposures were significantly related to ground-glass opacities. Total SHS exposure in the last 12 months (B=0.027, 95% CI 0.000-0.054, p=0.048) and workplace exposure (B=0.027, 95% CI 0.000-0.054, p=0.048) were also significantly related to ground-glass opacities. Positive effects of SHS were also detected on irregular/linear opacities. SHS exposure in the last 12 months and over lifetime significantly increases ground-glass opacity in HRCT, suggesting an early or subclinical desquamative interstitial pneumonia/respiratory bronchiolitis. This study further supports that SHS has adverse effects on the lungs that can be detected by X-ray methods.

  6. Comparative study of clinical, pathological and HRCT findings of primary alveolar proteinosis and silicoproteinosis

    International Nuclear Information System (INIS)

    Souza, Carolina Althoff; Marchiori, Edson; Gonçalves, Letícia Pereira; Meirelles, Gustavo de Souza P.; Zanetti, Gláucia; Escuissato, Dante L.; Capobianco, Julia; Souza, Arthur Soares

    2012-01-01

    Objective: To compare the clinical, high-resolution computed tomography (HRCT) and pathological findings of primary alveolar proteinosis (PAP) and silicoproteinosis. Material and methods: The study included 15 patients with PAP (6 women, 9 men, mean age 31 years) and 13 with silicoproteinosis (13 men, mean age 29.5 years). PAP was diagnosed by lung biopsy in 13 and bronchoalveolar lavage in two patients and silicoproteinosis by bronchoalveolar lavage in 10 and autopsy in three cases. HRCT images were reviewed by two chest radiologists with consensus for the presence, extent and distribution of ground-glass opacities, septal thickening, consolidation and nodules. Radiological–pathological correlation was performed by one radiologist and one chest pathologist. Results: Seven (46%) patients with PAP were asymptomatic; the remainder presented slowly progressive dyspnea and dry cough. All silicoproteinosis patients had dry cough and rapidly progressive dyspnea. The most common HRCT finding on PAP was the crazy-paving pattern (93%). All cases had areas of geographic sparing in the affected lung. The most common finding in silicoproteinosis (92%) was dependent consolidation with calcification in 83%. Centrilobular nodules were common (85%). On pathology, both diseases demonstrated intra-alveolar accumulation of PAS material, thickening of interlobular septae and alveolar walls and no evidence of fibrosis. A few silica particles were seen in silicoproteinosis. Conclusion: Despite the pathological similarities, PAP and silicoproteinosis have distinct clinical and imaging features and prognosis. Bilateral crazy-paving pattern with areas of geographic sparing is characteristic for PAP. Silicoproteinosis presents with bilateral dependent consolidation often with areas of calcification. The crazy-paving pattern is not seen in silicoproteinosis.

  7. High-resolution computed tomography versus chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis

    International Nuclear Information System (INIS)

    Azevedo, Ana Beatriz Cordeiro de; Calderaro, Debora; Moreira, Caio; Guimaraes, Silvana Mangeon Meirelles; Tavares Junior, Wilson Campos; Leao Filho, Hilton Muniz; Andrade, Diego Correa de; Ferreira, Cid Sergio; Vieira, Jose Nelson Mendes

    2005-01-01

    Objective: To compare the accuracy of high-resolution computed tomography (HRCT) with chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis (SSc). Materials And Methods: HRCT scans and chest radiographs in postero-anterior and lateral views were performed in 34 patients with systemic sclerosis, according to the American College of Rheumatology preliminary criteria for the diagnosis of SSc. The prevalence of radiological findings suggestive of interstitial lung disease in SSc seen on both imaging methods was compared. Results: Interstitial disease was observed on HRCT images of 31 patients (91%) and in the chest radiographs of 16 patients (47%). The most frequent findings observed on HRCT were septal lines (74%), honeycombing (56%) and parenchymal bands (26%). Chest radiographs showed reticular areas of attenuation in 11 patients (32%) and parenchymal distortion in 12% of the patients. In 18 patients (53%) with normal chest radiographs HRCT showed septal lines in 55%, ground glass in 44%, honeycombing in 38.5% and cysts in 33%. Conclusion: HRCT is more sensitive than chest radiography in the evaluation of incipient interstitial lung involvement in patients with SSc and can provide a justification for immunosuppressive therapy in patients with early disease. (author)

  8. HRCT and bronchial asthma: visualization of the pathophysiologic changes of the pulmonary parenchyma after inhalation provocation; HRCT und Asthma bronchiale: Visualisierung pathophysiologischer Veraenderungen des Lungenparenchyms nach inhalativer Provokation

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, G.; Neumann, K.; Helbich, T.; Herold, C.J. [Univ. Klinik fuer Radiodiagnostik, Abt. fuer konservative Faecher, Vienna (Austria); Riemer, H. [Univ. Klinik fuer Innere Medizin IV, Abt. fuer Pulmologie, Vienna (Austria); Backfrieder, W. [Allgemeines Krankenhaus, Vienna (Austria). Inst. fuer Biomedizinische Technik und Physik; Sertl, K. [Krankenhaus der Stadt Wien-Floridsdorf (Austria). Abt. fuer Innere Medizin; Pittner, B. [Vienna Univ. (Austria). Inst. fuer Medizinische Statistik

    2004-03-01

    Purpose: To characterize parenchymal lung affections morphologically in patients with asthma and healthy subjects by high resolution computed tomography (HRCT) subsequent to histamine-triggered inhalation bronchoprovocation and salbutamolinduced broncholysis, and to compare the results with pulmonary function tests. Materials and Methods: Fifteen asthmatics with bronchial hyperreactivity, with a>20% decrease in FEV1 and a>10 mmHg decrease in PaO{sub 2} after bronchoprovocation (PC20%+), twelve asthmatics with a<20% decrease in FEV1 and a>10 mmHg decrease in PaO{sub 2} after bronchoprovocation (PC20%-), and eight healthy persons without bronchial hyperreactivity underwent inhalation bronchoprovocation and broncholysis. Spirometer-triggered HRCT at high lung volumes was performed, and total and peripheral lung densities and the amount of solid lung structures, representing predominantly vessels, were measured. Results: After bronchoprovocation, we observed significant decreases in total and peripheral lung densities in all groups (p<0.0005), and a significant increase in lung densities subsequent to bronchodilation (p<0.0002). The morphological alterations in solid lung structure were not significantly different after bronchoprovocation or broncholysis (p>0.05), as compared to the baseline measurements. In hyperreactive patients, PaO{sub 2} significantly decreased after provocation and significantly increased after lysis (p<0.05). In PC20%+ asthmatics, a mean reduction of 27.8% in FEV1 was observed, which was <20% in the other groups. No significant correlations were observed between radiological data and the results of pulmonary function tests. In healthy persons, we demonstrated highly significant parenchymal response to bronchoprovocation and broncholysis, which was not otherwise documented by pulmonary function tests. Conclusion: In both PC20%+ and PC20%- patients as well as in healthy individuals, HRCT was efficient in the evaluation of pathoanatomical

  9. Correlation between HRCT and pulmonary functional tests in cystic fibrosis

    International Nuclear Information System (INIS)

    Mastellari, Paola; Biggi, Simona; Lombardi, Alfonsa; Zompatori, Maurizio; Grzincich, Gianluigi; Pisi, Giovanna; Spaggiari, Cinzia

    2005-01-01

    Purpose. To compare the HRCT score by Oikonottlou and air trapping in expiratory scans with pulmonary functional tests and evaluate which radiological criteria are more useful to predict clinical impairment. Materials and methods. From January to September 2003, pulmonary HRCT study was performed in 37 patients (23 males), aged between 7 and 41 years, with cystic fibrosis. In the same day of CT examination they also received a complete functional evaluation. HRCT studies were evaluated by three radiologists blinded to the clinical data and were correlated with the lung function tests. Results. We obtained a high correlation (p=0.01) for two of the HRCT signs: extent of mucus plugging and mosaic perfusion pattern and all function tests. Discussion. Previous studies have demonstrated good correlation between lung function tests, in particular with FEV1 and HRCT signs. Our study differed from previous ones in that we analysed the correlation between lung function tests and with both single and combined CT criteria. Conclusion. Our results suggest that a simplified HRCT store could be useful to evaluate patients with cystic fibrosis [it

  10. Bronchiolitis obliterans following exposure to sulfur mustard: chest high resolution computed tomography

    International Nuclear Information System (INIS)

    Ghanei, Mostafa; Mokhtari, Majid; Mohammad, Mehdi Mir; Aslani, Jafar

    2004-01-01

    Background: Pulmonary complications are known to occur in over half of the patients exposed to sulfur mustard (SM). Chemical weapons of mass destruction (WMD) including SM were used by Iraq during Iran-Iraq war between 1983 and 1989. We undertook this study to evaluate the chest high resolution computerized tomography (HRCT) as a diagnostic tool in patients with documented exposure to SM and chronic respiratory symptoms. Method: The medical records of 155 patients exposed to SM during Iran-Iraq war and suffered respiratory complications were reviewed. Chest HRCTs of these patients were examined. Ten healthy controls with no history of exposure to HD were matched for age, gender, and chest HRCT protocol applied. Results: Fifty chest HRCTs of these patients were randomly selected for this study. The most frequent findings were; air trapping 38 (76%), bronchiectasis 37 (74%), mosaic parenchymal attenuation (MPA) 36 (72%), irregular and dilated major airways 33 (66%) bronchial wall thickening (BWT) 45 (90%), and interlobular septal wall thickening (SWT) 13 (26%), respectively. Air trapping in one patient (10%) was the only positive finding in the control group. Conclusions: Chest HRCT findings of bronchiectasis, air trapping, MPA, SWT, and BWT were seen in our patients 15 years after exposure to HD. These findings suggest the diagnosis of bronchiolitis obliterans (BO). We did not encounter chest HRCT features consistent with pulmonary fibrosis

  11. Bronchiolitis obliterans following exposure to sulfur mustard: chest high resolution computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ghanei, Mostafa E-mail: m.ghanei@bmsu.ac.ir; Mokhtari, Majid; Mohammad, Mehdi Mir; Aslani, Jafar

    2004-11-01

    Background: Pulmonary complications are known to occur in over half of the patients exposed to sulfur mustard (SM). Chemical weapons of mass destruction (WMD) including SM were used by Iraq during Iran-Iraq war between 1983 and 1989. We undertook this study to evaluate the chest high resolution computerized tomography (HRCT) as a diagnostic tool in patients with documented exposure to SM and chronic respiratory symptoms. Method: The medical records of 155 patients exposed to SM during Iran-Iraq war and suffered respiratory complications were reviewed. Chest HRCTs of these patients were examined. Ten healthy controls with no history of exposure to HD were matched for age, gender, and chest HRCT protocol applied. Results: Fifty chest HRCTs of these patients were randomly selected for this study. The most frequent findings were; air trapping 38 (76%), bronchiectasis 37 (74%), mosaic parenchymal attenuation (MPA) 36 (72%), irregular and dilated major airways 33 (66%) bronchial wall thickening (BWT) 45 (90%), and interlobular septal wall thickening (SWT) 13 (26%), respectively. Air trapping in one patient (10%) was the only positive finding in the control group. Conclusions: Chest HRCT findings of bronchiectasis, air trapping, MPA, SWT, and BWT were seen in our patients 15 years after exposure to HD. These findings suggest the diagnosis of bronchiolitis obliterans (BO). We did not encounter chest HRCT features consistent with pulmonary fibrosis.

  12. Soft tissue attenuation in middle ear on HRCT: Pictorial review

    International Nuclear Information System (INIS)

    Anbarasu, Arangasamy; Chandrasekaran, Kiruthika; Balakrishnan, Sivasubramanian

    2012-01-01

    Middle ear disease is a common clinical entity; imaging, especially High resolution Computed Tomography (HRCT), plays a crucial role in diagnosis and assessing the disease extent, helping to decide appropriate management. Temporal bone imaging is challenging and involves thorough understanding of the anatomy, especially in relation to HRCT imaging. Most of the middle ear pathologies appear as “soft tissue” on imaging. Careful analysis of the soft tissue on the HRCT is crucial in achieving the right diagnosis; clinical information is essential and the imaging findings need correlation with clinical presentation and otoscopic findings. The purpose of this pictorial essay is to enlist the pathologies that present as soft tissue in middle ear and to provide a structured and practical imaging approach that will serve as a guide for confident reporting in daily practice

  13. Pulmonary complications of crack cocaine use: high-resolution computed tomography of the chest

    International Nuclear Information System (INIS)

    Mancano, Alexandre

    2008-01-01

    Here, we report high-resolution computed tomography (HRCT) findings in a patient who developed sudden hemoptysis, dyspnea and chest pain after smoking crack cocaine. Chest X-rays showed consolidations, primarily in the upper lobes, and HRCT scans showed ground glass attenuation opacities, consolidations and air-space nodules. A follow-up CT, after drug use discontinuation and administration of corticosteroids, showed partial resolution of pulmonary lesions and the appearance of cavitations. Clinical, imaging and laboratory findings led to a diagnosis of 'crack lung'. (author)

  14. Pulmonary complications of crack cocaine use: high-resolution computed tomography of the chest

    Energy Technology Data Exchange (ETDEWEB)

    Mancano, Alexandre [Taguatinga Regional Hospital, Taguatinga, DF (Brazil). Medical Residency in Radiology and Diagnostic Imaging; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Dept. of Radiology]. E-mail: edmarchiori@bol.com.br; Zanetti, Glaucia [Faculdade de Medicina de Petropolis (FMP), RJ (Brazil). School of Medicine; Escuissato, Dante Luiz [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Radiology; Duarte, Beatriz Cunha; Apolinario, Lourenco de Araujo [Radiologia Anchieta, Taguatinga, DF (Brazil)

    2008-05-15

    Here, we report high-resolution computed tomography (HRCT) findings in a patient who developed sudden hemoptysis, dyspnea and chest pain after smoking crack cocaine. Chest X-rays showed consolidations, primarily in the upper lobes, and HRCT scans showed ground glass attenuation opacities, consolidations and air-space nodules. A follow-up CT, after drug use discontinuation and administration of corticosteroids, showed partial resolution of pulmonary lesions and the appearance of cavitations. Clinical, imaging and laboratory findings led to a diagnosis of 'crack lung'. (author)

  15. The value of coronal image reconstructions of HRCT using MDCT for the assessment of bronchiectasis: experiment with 64 MDCTs

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jin; Kim, Hyung Sik; Jeong, Sung Hwan; Jin, Wook; Yang, Dal Mo [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

    2006-09-15

    The aim of our study was to evaluate the value of coronal image reconstructions of HRCT with using 64 MDCT scans for the assessment of bronchiectasis. Chest CT scans (0.6-mm collimation, table speed of 14 mm/sec and a rotation time of 0.5 sec) that employed 64 MDCT images (Somatom Sensation 64, Siemens) without contrast media were performed in 56 patients (21 males and 35 females, mean age: 55 years) who displayed hemoptysis. The images were reconstructed with a 1 mm slice thickness in the axial (10 mm apart) and coronal (10 mm apart) planes with using a high frequency algorithm, and they were sent to PACS monitors. The axial images were assessed with and without the coronal images by two radiologists at two separate occasions. The presence of bronchiectasis was decided upon by consensus diagnosis of the two radiologists. The detection rates of bronchiectasis were compared between the readings with using the axial images alone and the readings with using both the axial and coronal images. The detection rate of bronchiectasis was significantly higher with using both the axial and coronal images than with using with axial images alone (82.1%, 46/56 patients Vs 64.3%, 36/56 patients, respectively, {rho} = 0.001). The detection rates for all the lobes, except for the superior division of the left upper lobe, were significantly improved with using both the axial and coronal images (RUL; {rho} = 0.013, RML; {rho} = 0.002, RLL; 0.024, Lt lingular segment; {rho} = 0.004, LLL; {rho} = 0.018). The coronal images of HRCT with using 64 MDCT improved the detection rate of bronchiectasis in the patients with hemoptysis when they were used in conjunction with the standard axial images. We suggest that HRCT with the coronal images should be obtained for the patients with hemoptysis, despite that the simple chest radiographs are often normal or they have non-specific findings.

  16. 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

  17. High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Agnaldo Jose [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Pedro Ernesto Univ. Hospital. Dept. of Respiratory Function]. E-mail: phel.lop@uol.com.br; Mogami, Roberto; Capone, Domenico; Jansen, Jose Manoel [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). School of Medical Sciences; Tessarollo, Bernardo [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Dept. of Radiology and Diagnostic Image; Melo, Pedro Lopes de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. of Biology

    2008-05-15

    Objective: To correlate tomographic findings with pulmonary function findings, as well as to compare chest X-ray findings with high-resolution computed tomography (HRCT) findings, in patients with silicosis. Methods: A cross-sectional study was conducted in 44 non-smoking patients without a history of tuberculosis. Chest X-ray findings were classified according to the International Labour Organization recommendations. Using a semiquantitative system, the following HRCT findings were measured: the full extent of pulmonary involvement; parenchymal opacities; and emphysema. Spirometry and forced oscillation were performed. Pulmonary volumes were evaluated using the helium dilution method, and diffusing capacity of the lung for carbon monoxide was assessed. Results: Of the 44 patients studied, 41 were male. The mean age was 48.4 years. There were 4 patients who were classified as category 0 based on X-ray findings and as category 1 based on HRCT findings. Using HRCT scans, we identified progressive massive fibrosis in 33 patients, compared with only 23 patients when X-rays were used. Opacity score was found to correlate most closely with airflow, DLCO and compliance. Emphysema score correlated inversely with volume, DLCO and airflow. In this sample of patients presenting a predominance of large opacities (75% of the individuals), the deterioration of pulmonary function was associated with the extent of structural changes. Conclusions: In the early detection of silicosis and the identification of progressive massive fibrosis, HRCT scans are superior to X-rays. (author)

  18. High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests

    International Nuclear Information System (INIS)

    Lopes, Agnaldo Jose; Mogami, Roberto; Capone, Domenico; Jansen, Jose Manoel; Tessarollo, Bernardo; Melo, Pedro Lopes de

    2008-01-01

    Objective: To correlate tomographic findings with pulmonary function findings, as well as to compare chest X-ray findings with high-resolution computed tomography (HRCT) findings, in patients with silicosis. Methods: A cross-sectional study was conducted in 44 non-smoking patients without a history of tuberculosis. Chest X-ray findings were classified according to the International Labour Organization recommendations. Using a semiquantitative system, the following HRCT findings were measured: the full extent of pulmonary involvement; parenchymal opacities; and emphysema. Spirometry and forced oscillation were performed. Pulmonary volumes were evaluated using the helium dilution method, and diffusing capacity of the lung for carbon monoxide was assessed. Results: Of the 44 patients studied, 41 were male. The mean age was 48.4 years. There were 4 patients who were classified as category 0 based on X-ray findings and as category 1 based on HRCT findings. Using HRCT scans, we identified progressive massive fibrosis in 33 patients, compared with only 23 patients when X-rays were used. Opacity score was found to correlate most closely with airflow, DLCO and compliance. Emphysema score correlated inversely with volume, DLCO and airflow. In this sample of patients presenting a predominance of large opacities (75% of the individuals), the deterioration of pulmonary function was associated with the extent of structural changes. Conclusions: In the early detection of silicosis and the identification of progressive massive fibrosis, HRCT scans are superior to X-rays. (author)

  19. HRCT findings of pulmonary complications in non-AIDS immunocompromised patients. Are they useful in differential diagnosis?

    International Nuclear Information System (INIS)

    Emoto, Takuya; Matsumoto, Tsuneo; Tanaka, Nobuyuki; Miura, Gouji; Kawamura, Takeo; Matsunaga, Naofumi

    2003-01-01

    This study was designed to evaluate the diagnostic value of characteristic high-resolution CT (HRCT) findings in the differential diagnosis of acute pulmonary complications (APCs) in immunocompromised patients and to investigate how to improve diagnostic accuracy. We reviewed the chest CT images of 103 consecutive immunocompromised non-acquired immunodeficiency syndrome (AIDS) patients with APCs. The presence, extent, and anatomical distribution of the CT findings were assessed by two radiologists. The sensitivity and positive predictive value (PPV) of each criterion determined by the combination of CT findings that were characteristic in previous studies were calculated. The average sensitivity of each criterion was 0.50 in the total cases. There were many false positives, and the PPVs of some criteria were low. Among the significantly less frequent CT findings, the frequency of bronchovascular bundle thickening was 0% in cytomegaloviral pneumonia (CMV P). The absence of this finding improved the diagnostic accuracy of CMV P. Because the combination of only characteristic HRCT findings in each disease was of relatively limited value in making a diagnosis, infrequent findings should be also added to the CT criteria to improve accuracy. (author)

  20. HRCT findings of pulmonary complications in non-AIDS immunocompromised patients. Are they useful in differential diagnosis?

    Energy Technology Data Exchange (ETDEWEB)

    Emoto, Takuya; Matsumoto, Tsuneo; Tanaka, Nobuyuki; Miura, Gouji; Kawamura, Takeo; Matsunaga, Naofumi [Yamaguchi Univ., Ube (Japan). School of Medicine

    2003-02-01

    This study was designed to evaluate the diagnostic value of characteristic high-resolution CT (HRCT) findings in the differential diagnosis of acute pulmonary complications (APCs) in immunocompromised patients and to investigate how to improve diagnostic accuracy. We reviewed the chest CT images of 103 consecutive immunocompromised non-acquired immunodeficiency syndrome (AIDS) patients with APCs. The presence, extent, and anatomical distribution of the CT findings were assessed by two radiologists. The sensitivity and positive predictive value (PPV) of each criterion determined by the combination of CT findings that were characteristic in previous studies were calculated. The average sensitivity of each criterion was 0.50 in the total cases. There were many false positives, and the PPVs of some criteria were low. Among the significantly less frequent CT findings, the frequency of bronchovascular bundle thickening was 0% in cytomegaloviral pneumonia (CMV P). The absence of this finding improved the diagnostic accuracy of CMV P. Because the combination of only characteristic HRCT findings in each disease was of relatively limited value in making a diagnosis, infrequent findings should be also added to the CT criteria to improve accuracy. (author)

  1. HRCT findings of asthmatic children under maintenance therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Park, Jai Soung; Goo, Dong Erk; Lee, Hae Kyung; Kwon, Kui Hyang; Choi, Deuk Lin; Pyun, Bok Yang [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2000-05-01

    The purpose of this study was to evaluate the HRCT findings of bronchial asthma during maintenance bronchodilator therapy and to determine whether there were irreversible bronchial changes occurred in pediatric patients with this condition. HRCT findings of the lung in 21 asthmatic children (14 boys and 7 girls aged between 3.5 and 13.8 (mean: 7.7) years) who were receiving maintenance bronchodilator therapy were retrospectively studied. At the time of CT examination, 16 were receiving nonsteroid bronchodilator therapy only, and five were receiving both bronchodilator and steroid therapy. Thirteen patients were defined as allergic and eight were nonallergic. The clinical severity of chronic asthma was graded as severe in seven cases, and moderate in 14. The duration of the disease ranged from 4 months to 6 years (mean 3.2 years). HRCT was performed in 19 cases for evaluation of the atelectasis, hyperinflation, and prominent bronchovascular bundles seen on plain radiographs, and in two cases for evaluation following acute exacerbation. A CT W-2000 scanner (Hitachi Medical Co. Tokyo, Japan) was used during the end inspiratory phase, and in addition, ten patients were scanned during the expiratory phase. Scans were reviewed for evidence of bronchial thickening, bronchiectasis, emphysema, abnormal density, mucus plugs, and other morphological abnormalities. The presence of bronchial wall thickening or air trapping was evaluated according to the duration, severity and type of asthma. Among the 21 patients, 7 (33.3%) had normal HRCT findings, while in 14 (66.7%), bronchial wall thickening was demonstrated. Eleven of the 14 patients with bronchial wall thickening(78.6%) also had air trapping. No patient was suffering from bronchiectasis or emphysema. There were no statistically significant correlations between the presence of bronchial wall thickening or air trapping and the duration of the disease, its severity, or type of asthma. There was, however, a statistically

  2. 3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: initial results in comparison to HRCT.

    Science.gov (United States)

    Attenberger, U I; Morelli, J N; Henzler, T; Buchheidt, D; Fink, C; Schoenberg, S O; Reichert, M

    2014-01-01

    To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia. In a prospective study, 3 Tesla MRI was performed in 19 febrile neutropenic patients (5 women, 14 men; mean age 61 years ± 14.2; range 23-77 years). All patients underwent high-resolution CT less than 24h prior to MRI. The MRI protocol (Magnetom Tim Trio, Siemens) included a T2-weighted HASTE sequence (TE/TR: 49 ms/∞, slice thickness 6mm) and a high-resolution 3D VIBE sequence with an ultra-short TETesla MRI with a sensitivity of 82.3% and a specificity of 78.6%, resulting in an overall accuracy of 88% (NPV/PPV 66.7%/89.5%). In 51 lobes (19 of 19 patients), pulmonary abnormalities visualized by MR were judged to be concordant in their location and in the lesion type identified by both readers. In 22 lobes (11 of 19 patients), no abnormalities were present on either MR or HRCT (true negative). In 6 lobes (5 of 19 patients), ground glass opacity areas were detected on MRI but were not visible on HRCT (false positives). In 11 lobes (7 of 19 patients), MRI failed to detect ground glass opacity areas identified by HRCT. However, since the abnormalities were disseminated in these patients, accurate treatment decisions were possible in every case based on MRI. In one case MRI showed a central area of cavitation, which was not visualized by HRCT. Infectious nodules and consolidations can be detected in neutropenic patients with acute myeloid leukemia with a sufficient diagnostic accuracy by 3 Tesla MRI. Detection of ground glass opacity areas is the main limitation of 3-Tesla MRI when compared to HRCT. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Pulmonary involvement in rheumatoid arthritis. HRCT findings as their correlation with the clinical data, with function tests and with bronchoalveolar lavage

    International Nuclear Information System (INIS)

    Dosda, R.; Domingo, M. L.; Marti-Bonmati, L.; Rodrigo, C.; Torregrosa, A.

    1999-01-01

    To assess the high-resolution computed tomography (HRCT) findings in rheumatoid arthritis and their correlation with clinical data, respiratory function tests (RFT) and bronchoalveolar lavage (BAL). Nineteen patients were studied by inspiratory and expiratory HRCT scan and clinical examination: 17 also underwent RFT and 12 were also subjected to BAL. The χ''2 test was used to analyze the correlation among the clinical data, RAFT, BAL and the HRCT images. Six patients had no respiratory symptoms and seven were smokers. The most common findings was bronchiectasis (37%), followed by nodules (26%), ground glass (26%), non septal lines (21%), septal lines (16%), emphysema (21%), lymph nodes (21%), pleural changes (16%), pericardial changes (11%) and enlarged pulmonary artery (5%). All the patients presented a mosaic pattern on expiration. The RFT disclosed obstructive lung disease in 74% of cases, normal in 41% and restrictive disease in 12%. BAL was normal in 50% of the patients, containing a high neutrophil count in 42% and high lymphocyte count in 8%. Only the correlations between smoking and emphysema and between the results of RFT and bronchiectasis, septal and non septal lines, ground glass and honey combing were found to be statistically significant. HRCT detects pulmonary involvement in rheumatoid arthritis even in the absence of respiratory symptoms. The most common finding is bronchiectasis. Air trapping is always present in expiration, obstructive lung disease being the most common finding in RFT. The only significant associations were those between smoking and emphysema and between the results of RFT and the HRCT findings, as indicated by the high incidence of restrictive lung disease in these patients. (Author) 10 refs

  4. Chest Pain

    Science.gov (United States)

    ... or tightness in your chest Crushing or searing pain that radiates to your back, neck, jaw, shoulders, and one or both arms Pain that lasts ... com. Accessed Sept. 6, 2017. Yelland MJ. Outpatient evaluation of the adult with chest pain. https://www.uptodate.com/contents/search. Accessed Sept. ...

  5. HRCT features in a 5-year-old child with follicular bronchiolitis

    Energy Technology Data Exchange (ETDEWEB)

    Reittner, P.; Fotter, R.; Lindbichler, F.; Tillich, M. [Department of Radiology, Karl-Franzens University and University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz (Austria); Varga, E.M.; Zach, M. [Department of Pediatrics, Karl-Franzens University and University Hospital Graz, Graz (Austria); Popper, H. [Department of Pathology, Karl-Franzens University and University Hospital Graz, Graz (Austria)

    1997-11-01

    High-resolution CT (HRCT) is the most sensitive radiographic method to image small airways disease. We discuss the HRCT features of follicular bronchiolitis in a 5-year-old boy and correlate them with the histopathological findings. The changes described include centrilobular nodules, bronchiectasis and bronchiolectasis, branching opacities and areas of reduced lung attenuation. (orig.) With 2 figs., 5 refs.

  6. 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.

  7. Online Feature Selection for Classifying Emphysema in HRCT Images

    Directory of Open Access Journals (Sweden)

    M. Prasad

    2008-06-01

    Full Text Available Feature subset selection, applied as a pre- processing step to machine learning, is valuable in dimensionality reduction, eliminating irrelevant data and improving classifier performance. In the classic formulation of the feature selection problem, it is assumed that all the features are available at the beginning. However, in many real world problems, there are scenarios where not all features are present initially and must be integrated as they become available. In such scenarios, online feature selection provides an efficient way to sort through a large space of features. It is in this context that we introduce online feature selection for the classification of emphysema, a smoking related disease that appears as low attenuation regions in High Resolution Computer Tomography (HRCT images. The technique was successfully evaluated on 61 HRCT scans and compared with different online feature selection approaches, including hill climbing, best first search, grafting, and correlation-based feature selection. The results were also compared against ldensity maskr, a standard approach used for emphysema detection in medical image analysis.

  8. Chest X-Ray (Chest Radiography)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z X-ray (Radiography) - Chest Chest x-ray uses a very ... limitations of Chest Radiography? What is a Chest X-ray (Chest Radiography)? The chest x-ray is the ...

  9. 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

  10. The chest features of patients with the novel influenza type A H1N1 on high resolution CT

    International Nuclear Information System (INIS)

    Shi Yuxin; Li Shujuan; Zhou Su; Shi Suodi; Zhang Zhiyong

    2010-01-01

    Objective: To explore the chest features of patients with the novel influenza type A H1N1 on HRCT. Methods: One hundred and seventy-two chest HRCT examinations on 163 cases with Influenza type A H1N1 (9 cases were reexamed) were retrospectively analyzed using standard pulmonary window and mediastinal window, respectively. HRCT imaging appearances were summarized. Results: Ninety-seven cases showed normal on chest HRCT, while the others showed abnormalities of parenchymal and interstitial. Among them, HRCT identified ground-glass opacity in 35 cases (53.0%), centrilobular nodules in 30 cases (45.5%), thickening of intralobular septa in 31 cases (47.0%), intralobular thin reticulation and micro-nodule in 8 cases (12.1%), single-lobular inflammation in 19 cases (28.8%), consolidation of lung (the large consolidation and multiple small consolidations) in 15 cases (22.7%), pulmonary atelectasis in 3 cases (4.5%), and irregular lines in 2 cases (3.0%). Pleurisy was also revealed including 8 cases with right pleurisy, 5 cases with left pleurisy, 5 cases with left pleurisy, and 19 cases with bilateral pleurisy. Mediastinal and axillary lymphadenopathy were found in 7 cases, who were spared of pleural effusion. All above abnormalities resolved quickly after anti-virus treatment. Conclusion: Parenchymal and interstitial abnormalities, mediastinum and axillary fossa lymphadenopathy, and pleural effusion were the common findings on HRCT in patients with Influenza type A H1N1, which were similar to those of other viral pneumonia. (authors)

  11. HRCT appearances of pulmonary interstitial diseases. The pathologic basis and clinical diagnostic significance

    International Nuclear Information System (INIS)

    Ma Daqing; Li Tieyi; Guan Yansheng; He Wen; Nie Yongkang

    1999-01-01

    Objective: To evaluate the CT appearances, the pathologic basis and diagnostic significance of pulmonary interstitial diseases. methods: 14 isolated lungs with interstitial diseases were obtained at autopsy and surgery. The lungs were inflated and fixed. HRCT and 1 cm thin slice soft X-ray radiograph were performed and then histologic examination was done. HRCT images of 72 cases with interstitial diseases were analysed. The HRCT appearances of 10 cases were followed up for 1.5-7.0 years. Results: According to HRCT-pathologic correlation, pulmonary interstitial diseases had the following HRCT findings: (1) Intralobular interstitial thickening (33 cases, 46%), including fine linear, reticular and radiating appearances and the interface sign. (2) Interlobular septal thickening (24 cases, 33%). (3) Thickening of bronchovesicular bundles (35 cases, 49%), with coarse, blurred or smooth bundle, and nodular shape. (4) Subpleural lines (31 cases, 43%). (5) Ground-glass opacity (22 cases, 31%) with peripheral, diffuse or locular distribution. (6) Honeycombing (27 cases, 38%), having sizes: 5 mm. Of the 10 cases with follow-up, 2 cases became normal on CT and 8 cases progressing to honeycombed lung. Conclusions: The HRCT findings of pulmonary interstitial diseases represent abnormalities of axial, peripheral and septal interstitium. Interstitial fibrosis of the lung can be differentiated from that without fibrosis by HRCT. Ground-glass opacity, intralobular interstitial thickening and subpleural lines are preliminary findings of pulmonary interstitial fibrosis

  12. Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis.

    Science.gov (United States)

    Gargani, Luna; Doveri, Marica; D'Errico, Luigia; Frassi, Francesca; Bazzichi, Maria L; Delle Sedie, Andrea; Scali, Maria C; Monti, Simonetta; Mondillo, Sergio; Bombardieri, Stefano; Caramella, Davide; Picano, Eugenio

    2009-11-01

    To assess the correlation between ultrasound lung comets (ULCs, a recently described echographic sign of interstitial lung fibrosis) and the current undisputed gold-standard high-resolution CT (HRCT) to detect pulmonary fibrosis in patients with SSc. We enrolled 33 consecutive SSc patients (mean age 54 +/- 13 years, 30 females) in the Rheumatology Clinic of the University of Pisa. We assessed ULCs and chest HRCT within 1 week independently in all the patients. ULC score was obtained by summing the number of lung comets on the anterior and posterior chest. Pulmonary fibrosis was quantified by HRCT with a previously described 30-point Warrick score. Presence of ULCs (defined as a total number more than 10) was observed in 17 (51%) SSc patients. Mean ULC score was 37 +/- 50, higher in the diffuse than in the limited form (73 +/- 66 vs 21 +/- 35; P < 0.05). A significant positive linear correlation was found between ULCs and Warrick scores (r = 0.72; P < 0.001). ULCs are often found in SSc, are more frequent in the diffuse than the limited form and are reasonably well correlated with HRCT-derived assessment of lung fibrosis. They represent a simple, bedside, radiation-free hallmark of pulmonary fibrosis of potential diagnostic and prognostic value.

  13. Desmoid fibromatosis of the chest wall.

    Science.gov (United States)

    Ong, QiHao; Wong, Janice; Sinha, Sanjay; Kejriwal, Nand

    2018-05-01

    We report a case of desmoid fibromatosis of the chest wall. A 70-year-old woman was referred to our hospital with right shoulder blade pain and paresthesia over the right upper breast. Chest X-ray and computed tomography demonstrated a 5 cm right apical mass in the chest. Biopsy of the mass demonstrated features of desmoid fibromatosis. The patient subsequently underwent surgical resection of the mass and received adjuvant radiation therapy for microscopic positive margins. In conclusion, although desmoid tumour of the chest is rare, it is worth considering in the differential diagnoses of chest wall tumours.

  14. Paraquat induced lung injury: long-term follow-up of HRCT

    International Nuclear Information System (INIS)

    Kim, Young Tong; Kim, Hyun Cheol; Bae, Won Kyung; Kim, Il Young; Im, Han Hyek

    2004-01-01

    To determine the long-term follow-up CT findings of paraquat-induced lung injury. Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years and more than above 7 years after poisoning were analyzed. We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed

  15. Paraquat induced lung injury: long-term follow-up of HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong; Kim, Hyun Cheol; Bae, Won Kyung; Kim, Il Young; Im, Han Hyek [Soonchunhyang Univ., Chunan (Korea, Republic of)

    2004-03-01

    To determine the long-term follow-up CT findings of paraquat-induced lung injury. Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years and more than above 7 years after poisoning were analyzed. We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed.

  16. 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.

  17. [HRCT imaging characterized of congenital abnormalities of the inner ear in 45 cases].

    Science.gov (United States)

    Wang, Jinling; Meng, Meijuan; Huan, Yi; Zhang, Jinsong

    2003-10-01

    To explore the high resolution CT (HRCT) image characterized of congenital abnormalities of the inner ear(CAIE), and its value in the diagnosis and treatment of CAIE. The clinic data and axial HRCT scans of CAIE in 45 cases were analyzed. In 45 CAIE patients, most of them were frequently associated with slowly progressive sensorineural hearing loss in childhood, 15 ears were fluctuating hearing loss. Seventeen ears were unilateral semicircular canal paralysis. HRCT showed that Michel type 3 cases(4 ears), Mondini type 25 cases(39 ears). Large vestibular aqueduct malformation not associated with anomalies of inner ears 13 cases(23 ears), anomalies of internal auditory canal 4 cases (5 ears). Thirteen ears were associated with outer and middle ear malformation. HRCT image has the important value in the diagnosis and treatment of CAIE, especially for the excerpt of indication of cochlear implantation.

  18. Air trapping on HRCT in asthmatics: correlation with pulmonary function test

    International Nuclear Information System (INIS)

    Hwang, Jung Hwa; Cha, Chull Hee; Park, Jai Soung; Kim, Young Beom; Lee, Hae Kyung; Choi, Deuk Lin; Kim, Kyung Ho; Park, Choon Sik

    1997-01-01

    To evaluate on the basis of the pulmonary function test the correlation between the extent of air trapping on HRCT with the severity of airway obstruction and also to identify the prognostic effect of the extent of air trapping after treatment of asthma. Thirty five patients with clinically diagnosed bronchial asthma and air trapping, as seen on HRCT, were included in this study. We quantitatively analysed on HRCT the extent of air trapping and then statistically compared this with the clinical parameters of the pulmonary function test. We classified the patients into two groups on the basis of the pulmonary function test and clinical status : Group 1 (N=35), the total number of asthmatic patients; Group 2 (N=18), relatively stable asthmatics without acute asthmatic attack who showed FEV1 of more than 80% of the predicted value. Using the functional paramenters of PEFR, one of the obijective indicators of improvement in airway obstruction, we also classified the patients into three groups on the basis of interval between treatment and clinical improvement. The result of this was as follows : group 1, asymptomatic group (initial PEFR within normal limit, N=7); group 2, early responder (improvement of PEFR within three hospital days, N=18); group 3, late responder (improvement of PEFR within fourteen hospital days should there be a number here). Using HRCT, we then statistically analysed the differences between the three groups in the extent of air trapping. Among the total of 35 asthmatics, the extent of air trapping on HRCT showed significant correlation with FEV1 (r= -0.6161, p < 0.001) and MEFR (r= -0.6012, p < 0.001). Among the relatively stable asthmatics who showed FEV1 more than 80% of the predicted value, MEFR (r= -0.7553, p < 0.001) and FEF75 (r= -0.7529, p=0.012) showed statistically significant correlation with the extent of air trapping on HRCT, but there was no significant correlation between air trapping on HRCT and FEV1. In the three groups of

  19. Fibrotic idiopathic interstitial pneumonias: HRCT findings that predict mortality

    Energy Technology Data Exchange (ETDEWEB)

    Edey, Anthony J.; Hansell, David M. [The Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Devaraj, Anand A. [St. George' s NHS Foundation Trust, Department of Radiology, Tooting (United Kingdom); Barker, Robert P. [Frimley Park Hosptal, Department of Radiology, Frimley, Surrey (United Kingdom); Nicholson, Andrew G. [The Royal Brompton Hospital, Department of Histopathology, London (United Kingdom); Wells, Athol U. [The Royal Brompton Hospital, Interstitial Lung Disease Unit, London (United Kingdom)

    2011-08-15

    The study aims were to identify CT features that predict outcome of fibrotic idiopathic interstitial pneumonia (IIP) when information from lung biopsy data is unavailable. HRCTs of 146 consecutive patients presenting with fibrotic IIP were studied. Visual estimates were made of the extent of abnormal lung and proportional contribution of fine and coarse reticulation, microcystic (cysts {<=}4 mm) and macrocystic honeycombing. A score for severity of traction bronchiectasis was also assigned. Using death as our primary outcome measure, variables were analysed using the Cox proportional hazards model. CT features predictive of a worse outcome were coarse reticulation, microcystic and macrocystic honeycombing, as well as overall extent of lung abnormality (p < 0.001). Importantly, increased severity of traction bronchiectasis, corrected for extent of parenchymal abnormality, was predictive of poor prognosis regardless of the background pattern of abnormal lung (HR = 1.04, CI = 1.03-1.06, p < 0.001). On bivariate Cox analysis microcystic honeycombing was a more powerful determinant of a poor prognosis than macrocystic honeycombing. In fibrotic IIPs we have shown that increasingly severe traction bronchiectasis is indicative of higher mortality irrespective of the HRCT pattern and extent of disease. Extent of microcystic honeycombing is a more powerful determinant of outcome than macrocystic honeycombing. (orig.)

  20. Fibrotic idiopathic interstitial pneumonias: HRCT findings that predict mortality

    International Nuclear Information System (INIS)

    Edey, Anthony J.; Hansell, David M.; Devaraj, Anand A.; Barker, Robert P.; Nicholson, Andrew G.; Wells, Athol U.

    2011-01-01

    The study aims were to identify CT features that predict outcome of fibrotic idiopathic interstitial pneumonia (IIP) when information from lung biopsy data is unavailable. HRCTs of 146 consecutive patients presenting with fibrotic IIP were studied. Visual estimates were made of the extent of abnormal lung and proportional contribution of fine and coarse reticulation, microcystic (cysts ≤4 mm) and macrocystic honeycombing. A score for severity of traction bronchiectasis was also assigned. Using death as our primary outcome measure, variables were analysed using the Cox proportional hazards model. CT features predictive of a worse outcome were coarse reticulation, microcystic and macrocystic honeycombing, as well as overall extent of lung abnormality (p < 0.001). Importantly, increased severity of traction bronchiectasis, corrected for extent of parenchymal abnormality, was predictive of poor prognosis regardless of the background pattern of abnormal lung (HR = 1.04, CI = 1.03-1.06, p < 0.001). On bivariate Cox analysis microcystic honeycombing was a more powerful determinant of a poor prognosis than macrocystic honeycombing. In fibrotic IIPs we have shown that increasingly severe traction bronchiectasis is indicative of higher mortality irrespective of the HRCT pattern and extent of disease. Extent of microcystic honeycombing is a more powerful determinant of outcome than macrocystic honeycombing. (orig.)

  1. 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.

  2. Lateral decubitus HRCT: a simple technique to replace expiratory CT in children with air trapping

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo-Jung; Choi, Byeong-Kyoo; Kim, Hyeon Joo; Lee, Soo Hyun; Choi, Seong Hoon; Park, Sang Joon; Goo, Hyun Woo; Lee, Jin Seong; Yoon, Chong Hyun [Department of Diagnostic Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul (Korea)

    2002-03-01

    Objective: To evaluate the effectiveness of lateral decubitus high-resolution CT (HRCT) in detecting air trapping in children. Materials and methods: HRCT scans of 21 children with heterogeneous lung attenuation caused by air trapping (n=10) or with infiltrative lung disease (n=11) were reviewed retrospectively. The air-trapping disease included bronchiolitis obliterans (n=7), bronchial obstruction due to mediastinal lymphoma (n=1), endobronchial haemangioma (n=1) and foreign body aspiration (n=1). HRCT was performed in both lateral decubitus positions as well as the supine position. The attenuation (Hounsfield units; HU) was measured in both the hypo- and adjacent hyper-attenuating areas of the heterogeneous lung portion, and the difference of attenuation between these two areas was calculated in the supine and both lateral decubitus scans, respectively. The attenuation differences of the three scans were compared in each group. Results: The attenuation difference was larger in the ipsilateral decubitus (207.95{+-}105.24 HU) scans than in the contralateral (121.25{+-}90.05 HU) or supine (162{+-}94.01 HU) scans in the air-trapping group (P<0.05). There were no significant differences among the three scans in the infiltrative lung disease group (P>0.05). Conclusions: Lateral decubitus HRCT is an effective adjunct to standard HRCT in the evaluation of air trapping as a cause of mosaic lung attenuation in uncooperative paediatric patients. (orig.)

  3. Niemann-Pick disease type B: HRCT assessment of pulmonary involvement

    Directory of Open Access Journals (Sweden)

    Heloisa Maria Pereira Freitas

    Full Text Available ABSTRACT Objective: To analyze HRCT findings in patients with Niemann-Pick disease (NPD type B, in order to determine the frequency of HRCT patterns and their distribution in the lung parenchyma, as well as the most common clinical characteristics. Methods: We studied 13 patients (3 males and 10 females aged 5 to 56 years. HRCT images were independently evaluated by two observers, and disagreements were resolved by consensus. The inclusion criteria were presence of abnormal HRCT findings and diagnosis of NPD type B confirmed by histopathological examination of a bone marrow, lung, or liver biopsy specimen. Results: The most common clinical findings were hepatosplenomegaly and mild to moderate dyspnea. The most common HRCT patterns were smooth interlobular septal thickening and ground-glass opacities, which were both present in all patients. Intralobular lines were present in 12 patients (92.3%. A crazy-paving pattern was observed in 5 patients (38.4%, and areas of air trapping were identified in only 1 case (7.6%. Pulmonary involvement was bilateral in all cases, with the most affected area being the lower lung zone. Conclusions: Smooth interlobular septal thickening, with or without associated ground-glass opacities, in patients with hepatosplenomegaly is the most common finding in NPD type B.

  4. Lung fibrosis quantified by HRCT in scleroderma patients with different disease forms and ANA specificities

    Directory of Open Access Journals (Sweden)

    S. Mancin

    2011-09-01

    Full Text Available Objective: to define the prevalence of interstitial lung fibrosis in systemic sclerosis (SSc and its relationship with the different clinical forms of disease and ANA specificities. Methods: fifty patients with SSc were submitted to pulmonary high resolution computed tomography (HRCT. Lung abnormalities were evaluated according to Warrick’s score that considers both the severity and the extent of fibrotic lesions. Results: pulmonary HRCT abnormalities were observed in 84% of SSc patients. Ground glass aspects (60%, irregular pleural margins (56% and septal/subpleural lines (68% were the most common lesions. The distribution of these abnormalities favoured the posterior basilar segments of both lungs. HRCT findings were significantly more frequent in males and in patients with the cutaneous diffuse form of SSc and with the specific antibody anti-Scl70. Conclusions: HRCT is a very useful method for the diagnosis of interstitial lung fibrosis in SSc. Warrick’s score permits to quantify the HRCT findings and to evaluate their relationship with the disease clinical forms and ANA specificities.

  5. CHEST SONOGRAPHY IN COMMON PAEDIATRIC CHEST DISEASES

    Directory of Open Access Journals (Sweden)

    Pradeep Raghavendra Kulkarni

    2017-03-01

    Full Text Available BACKGROUND The aim of the study is to determine the utility of chest sonography in common paediatric diseases and to present chest sonography images with possible explanation for the same. MATERIALS AND METHODS This retrospective study was conducted in Department of Paediatric Medicine, Bharati Medical College, Sangli. The patients admitted in paediatric ward, NICU, PICU with respiratory complaints and findings were subjected to chest sonography after chest x-ray. The chest sonography images were interpreted and an attempt was made to correlate with findings of chest xray. The information given by chest sonography was analysed and possible cause of image was evaluated. RESULTS The chest sonography appearances were found to be specific and in certain instances more informative than chest x-ray. It can differentiate between collapse and consolidation easily. The limitation of chest sonography was- it can assess only peripheral lung regions with inability to assess deeper lesions, especially with aerated peripheral lung. CONCLUSION The chest sonography is superior to chest x-ray in diagnosing minimal effusion and minimal pneumothorax. Also, when there is difficulty in differentiating pulmonary from pleural pathology. Though, chest sonography cannot replace chest x-ray, it is very useful additional investigation and often times very helpful with additional diagnostic information.

  6. Chest X-Ray

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    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 ...

  7. Chest x-ray

    Science.gov (United States)

    Chest radiography; Serial chest x-ray; X-ray - chest ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  8. MRI of the Chest

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    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 ...

  9. Chest radiation - discharge

    Science.gov (United States)

    Radiation - chest - discharge; Cancer - chest radiation; Lymphoma - chest radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after your first treatment: It may be hard ...

  10. MRI of the Chest

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    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 ...

  11. MRI of the Chest

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    Full Text Available ... MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the chest is performed ...

  12. Pretransplant HRCT Characteristics Are Associated with Worse Outcome of Lung Transplantation for Cystic Fibrosis Patients.

    Directory of Open Access Journals (Sweden)

    Gerdien Belle-van Meerkerk

    Full Text Available Peri- and postoperative complications diminish the outcome of lung transplantation (LTx in patients with cystic fibrosis (CF. We hypothesized that the degree of pathological findings on pre-LTx high resolution computed tomography (HRCT is associated with higher morbidity and mortality in CF.All our CF patients undergoing LTx between 2001 and 2011 were included. HRCT examinations were evaluated according to a scoring system for pulmonary disease in CF patients, the Severe Advanced Lung Disease (SALD score and for pleural involvement.Fifty-three patients were included. Dominant infectious/inflammatory disease according to the SALD score was observed in 10 patients (19%. Five (50% of those patients died within one week after LTx, compared to 2 (5% patients without dominant infectious/inflammatory disease (p<0.001. This difference in survival percentage remained also significant in multivariate analysis. Patients with infectious/inflammatory disease received more packed red blood cells; 26 versus 8 in the first week (p<0.001. Pleural thickening was associated with higher requirement (10 units for blood transfusion during LTx, compared to patients with normal pleura (4 units.The analysis of HRCT in CF patients according to the SALD score showed that dominant infectious/inflammatory disease is associated with a higher mortality after LTx. If confirmed in other studies, HRCT might aid estimation of surgical risk in some adult CF patients.

  13. 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

  14. 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.

  15. HRCT Correlation with Round Window Identification during Cochlear Implantation in Children.

    Science.gov (United States)

    Pendem, Sai Kiran; Rangasami, Rajeswaran; Arunachalam, Ravi Kumar; Mohanarangam, Venkata Sai Pulivadulu; Natarajan, Paarthipan

    2014-01-01

    To determine the accuracy of High Resolution Computer Tomography (HRCT) temporal bone measurements in predicting the actual visualization of round window niche as viewed through posterior tympanotomy (i.e. facial recess). This is a prospective study of 37 cochlear implant candidates, aged between 1and 6 years, who were referred for HRCT temporal bone during the period December 2013 to July 2014. Cochlear implantation was done in 37 children (25 in the right ear and 12 in the left ear). The distance between the short process of incus and the round window niche and the distance between the oval window and the round window niche were measured preoperatively on sub-millimeter (0.7 mm) HRCT images. We classified the visibility of round window niche based on the surgical view (i.e. through posterior tympanotomy) during surgery into three types: 1) Type 1- fully visible, 2) Type 2- partially visible, and 3) Type 3- difficult to visualize. The preoperative HRCT measurements were used to predict the type of visualization of round window niche before surgery and correlated with the findings during surgery. The mean and standard deviation for the distance between the short process of incus and the round window niche and for the distance between the oval window and the round window niche for Types 1, 2, and 3 were 8.5 ± 0.2 mm and 3.2 ± 0.2 mm, 8.0 ± 0.4 mm and 3.8 ± 0.2 mm, 7.5 ± 0.2 mm and 4.4 ± 0.2 mm respectively, and showed statistically significant difference (P window niche. This study shows preoperative HRCT temporal bone measurements are useful in predicting the actual visualization of round window niche as viewed through posterior tympanotomy.

  16. MRI of the Chest

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    Full Text Available ... Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic resonance imaging (MRI) of the chest uses a powerful ... Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  17. 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) of the chest ... limitations of MRI of the Chest? What is MRI of the Chest? Magnetic resonance imaging (MRI) is ...

  18. Chest X-Ray

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    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 ...

  19. Chest X-Ray

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    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- ...

  20. 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

  1. HRCT findings and the response to the treatment for interstitial pneumonia in patients with polymyositis and dermatomyositis

    Energy Technology Data Exchange (ETDEWEB)

    Abo, Hitoshi [Toyama Prefectural Central Hospital (Japan); Kobayashi, Takeshi; Shibata, Yoshihiro; Matsui, Osamu

    2002-01-01

    HRCT findings and the response to the treatment for interstitial pneumonia were evaluated retrospectively in 9 patients with polymyositis and dermatomyositis. Ground-glass attenuation and consolidation were observed most frequently on HRCT images. The response to the treatment for cases with ground-glass attenuation and consolidation were initially tend to improve, but considerable different in the long run. Therefore we considered the response to the treatment would be difficult to expect on each case. (author)

  2. Visual classification of emphysema heterogeneity compared with objective measurements: HRCT vs spiral CT in candidates for lung volume reduction surgery

    International Nuclear Information System (INIS)

    Cederlund, K.; Hoegberg, S.; Rasmussen, E.; Svane, B.; Bergstrand, L.; Tylen, U.; Aspelin, P.

    2002-01-01

    The aim of this study was to investigate whether spiral CT is superior to high-resolution computed tomography (HRCT) in evaluating the radiological morphology of emphysema, and whether the combination of both CT techniques improves the evaluation in patients undergoing lung volume reduction surgery (LVRS). The material consisted of HRCT (with 2-mm slice thickness) and spiral CT (with 10-mm slice thickness) of 94 candidates for LVRS. Selected image pairs from these examinations were evaluated. Each image pair consisted of one image from the cranial part of the lung and one image from the caudal part. The degree of emphysema in the two images was calculated by computer. The difference between the images determined the degree of heterogeneity. Five classes of heterogeneity were defined. The study was performed by visual classification of 95 image pairs (spiral CT) and 95 image pairs (HRCT) into one of five different classes of emphysema heterogeneity. This visual classification was compared with the computer-based classification. Spiral CT was superior to HRCT with 47% correct classifications of emphysema heterogeneity compared with 40% for HRCT-based classification (p<0.05). The combination of the techniques did not improve the evaluation (42%). Spiral CT is superior to HRCT in determining heterogeneity of emphysema visually, and should be included in the pre-operative CT evaluation of LVRS candidates. (orig.)

  3. Visual classification of emphysema heterogeneity compared with objective measurements: HRCT vs spiral CT in candidates for lung volume reduction surgery

    Energy Technology Data Exchange (ETDEWEB)

    Cederlund, K.; Hoegberg, S.; Rasmussen, E.; Svane, B. [Department of Thoracic Radiology, Karolinska Hospital, Stockholm (Sweden); Bergstrand, L. [Department of Radiology, Danderyds Hospital, Danderyd (Sweden); Tylen, U. [Deparment of Radiology, Sahlgrenska University Hospital, Gothenberg (Sweden); Aspelin, P. [Department of Radiology, Huddinge University Hospital, Huddinge (Sweden)

    2002-05-01

    The aim of this study was to investigate whether spiral CT is superior to high-resolution computed tomography (HRCT) in evaluating the radiological morphology of emphysema, and whether the combination of both CT techniques improves the evaluation in patients undergoing lung volume reduction surgery (LVRS). The material consisted of HRCT (with 2-mm slice thickness) and spiral CT (with 10-mm slice thickness) of 94 candidates for LVRS. Selected image pairs from these examinations were evaluated. Each image pair consisted of one image from the cranial part of the lung and one image from the caudal part. The degree of emphysema in the two images was calculated by computer. The difference between the images determined the degree of heterogeneity. Five classes of heterogeneity were defined. The study was performed by visual classification of 95 image pairs (spiral CT) and 95 image pairs (HRCT) into one of five different classes of emphysema heterogeneity. This visual classification was compared with the computer-based classification. Spiral CT was superior to HRCT with 47% correct classifications of emphysema heterogeneity compared with 40% for HRCT-based classification (p<0.05). The combination of the techniques did not improve the evaluation (42%). Spiral CT is superior to HRCT in determining heterogeneity of emphysema visually, and should be included in the pre-operative CT evaluation of LVRS candidates. (orig.)

  4. The halo sign: HRCT findings in 85 patients.

    Science.gov (United States)

    Alves, Giordano Rafael Tronco; Marchiori, Edson; Irion, Klaus; Nin, Carlos Schuler; Watte, Guilherme; Pasqualotto, Alessandro Comarú; Severo, Luiz Carlos; Hochhegger, Bruno

    2016-01-01

    The halo sign consists of an area of ground-glass opacity surrounding pulmonary lesions on chest CT scans. We compared immunocompetent and immunosuppressed patients in terms of halo sign features and sought to identify those of greatest diagnostic value. This was a retrospective study of CT scans performed at any of seven centers between January of 2011 and May of 2015. Patients were classified according to their immune status. Two thoracic radiologists reviewed the scans in order to determine the number of lesions, as well as their distribution, size, and contour, together with halo thickness and any other associated findings. Of the 85 patients evaluated, 53 were immunocompetent and 32 were immunosuppressed. Of the 53 immunocompetent patients, 34 (64%) were diagnosed with primary neoplasm. Of the 32 immunosuppressed patients, 25 (78%) were diagnosed with aspergillosis. Multiple and randomly distributed lesions were more common in the immunosuppressed patients than in the immunocompetent patients (p estado imunológico. Dois radiologistas torácicos analisaram os exames a fim de determinar o número de lesões e sua distribuição, tamanho e contorno, bem como a espessura do halo e quaisquer outros achados associados. Dos 85 pacientes avaliados, 53 eram imunocompetentes e 32 eram imunodeprimidos. Dos 53 pacientes imunocompetentes, 34 (64%) receberam diagnóstico de neoplasia primária. Dos 32 pacientes imunodeprimidos, 25 (78%) receberam diagnóstico de aspergilose. Lesões múltiplas e distribuídas aleatoriamente foram mais comuns nos imunodeprimidos do que nos imunocompetentes (p que apresentem o sinal do halo.

  5. 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 ...

  6. MRI of the Chest

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    Full Text Available ... vascular and lymphatic malformations of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and ... for an MRI. If you have a history of kidney disease or liver transplant, it will be necessary to ...

  7. 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 ...

  8. 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 ...

  9. 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) of the chest uses a powerful magnetic field, radio waves and a computer to produce ...

  10. Chest X-Ray

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    Full Text Available ... chest x-ray is used to evaluate the lungs, heart and chest wall and may be used ... diagnose and monitor treatment for a variety of lung conditions such as pneumonia, emphysema and cancer. A ...

  11. Chest X-Ray

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    Full Text Available ... evaluate the lungs, heart and chest wall and may be used to help evaluate shortness of breath, persistent cough, fever, chest pain or injury. It may also be useful to help diagnose and monitor ...

  12. MRI of the Chest

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    Full Text Available ... the chest cavity, including the mediastinum , chest wall, pleura, heart and vessels, from almost any angle. MRI ... sac around the heart) disease. characterize mediastinal or pleural lesions seen by other imaging modalities, such as ...

  13. Assessment of HRCT findings of small bronchioloalveolar carcinoma by radiologic-pathologic correlation

    International Nuclear Information System (INIS)

    Kobayashi, Takuya; Satoh, Katashi; Takahashi, Kazue

    2001-01-01

    The purpose of this study is to assess the appearance of early stage bronchioloalveolar carcinoma (BAC) on HRCT in correlation with pathological findings. Fourteen cases of BAC were examined. Diameter of the lesion in all cases was less than 1.5 cm. Two cases of BAC appeared as inhomogeneous ground-glass opacity (GGO) in correlation with foci of BAC. Two cases of BAC appeared as homogeneous GGO on HRCT in correlation with hyperplasia of alveolar cells on mildly hyperplastic alveolar septa. One case of BAC had microscopical small alveolar collapse area, however the foci were too small to be recognized as elevated density area on HRCT. Eight cases of BAC appeared as elevated density areas in GGO. These elevated density areas were correlated with areas of diminishing intraalveolar air caused by fibrotic foci due to collapse of alveolar structure, high grade atypia of tumor cells with severe hyperplasia of alveolar septa, lymphoproliferation scattered in the lesion and cellular infiltration in alveoli. One case of BAC appeared as consolidative small nodule in correlation with mucinous BAC. (author)

  14. Paraquat Poisoning of the Lung: HRCT Findings According to the Amount of Ingestion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo Lim; Song, Sun Wha; Park, Mi Jung; Lee, Su Lim; Ahn, Myeong Im; Park, Seog Hee [Catholic University, Seoul (Korea, Republic of)

    2009-02-15

    This study was designed to investigate the pattern, distribution and extent of pulmonary abnormalities in relation to the amount of ingested paraquat as determined with the use of high resolution computed tomography (HRCT). The study included 15 patients exposed to paraquat based on a positive urine assay and the presence of pulmonary abnormalities as detected on HRCT scans. The pattern, distribution and extent of pulmonary abnormalities in relation to the amount of ingested paraquat was evaluated. Patients were classified into five groups based on the amount of paraquat that was ingested. The groups were designated as indirect exposure, minimum exposure (the patient spat out the agent after swallowing), low exposure (<= 30 cc), medium exposure (31-60 cc) and high exposure (61-100 cc). Abnormal lung parenchymal patterns as depicted on HRCT images consisted of ground glass opacity (n = 9), consolidation (n = 9), irregular lines (n = 9) and the presence of nodules (n = 2). The most common distribution was in the lower and subpleural lung zone with no relation to the amount of ingestion. The most common patterns were the presence of irregular lines in the indirect exposure group and ground glass opacity in the high exposure group. The mean number of involved lobes increased in relation to the amount of ingestion. For paraquat poisoning, the pattern and extent of pulmonary abnormalities were related to the amount of ingestion, but the distribution of pulmonary abnormalities was not related to the amount of ingestion

  15. Paraquat Poisoning of the Lung: HRCT Findings According to the Amount of Ingestion

    International Nuclear Information System (INIS)

    Kim, Hyo Lim; Song, Sun Wha; Park, Mi Jung; Lee, Su Lim; Ahn, Myeong Im; Park, Seog Hee

    2009-01-01

    This study was designed to investigate the pattern, distribution and extent of pulmonary abnormalities in relation to the amount of ingested paraquat as determined with the use of high resolution computed tomography (HRCT). The study included 15 patients exposed to paraquat based on a positive urine assay and the presence of pulmonary abnormalities as detected on HRCT scans. The pattern, distribution and extent of pulmonary abnormalities in relation to the amount of ingested paraquat was evaluated. Patients were classified into five groups based on the amount of paraquat that was ingested. The groups were designated as indirect exposure, minimum exposure (the patient spat out the agent after swallowing), low exposure (≤ 30 cc), medium exposure (31-60 cc) and high exposure (61-100 cc). Abnormal lung parenchymal patterns as depicted on HRCT images consisted of ground glass opacity (n = 9), consolidation (n = 9), irregular lines (n = 9) and the presence of nodules (n = 2). The most common distribution was in the lower and subpleural lung zone with no relation to the amount of ingestion. The most common patterns were the presence of irregular lines in the indirect exposure group and ground glass opacity in the high exposure group. The mean number of involved lobes increased in relation to the amount of ingestion. For paraquat poisoning, the pattern and extent of pulmonary abnormalities were related to the amount of ingestion, but the distribution of pulmonary abnormalities was not related to the amount of ingestion

  16. Chest wall reconstruction using Gore-Tex® dual mesh.

    Science.gov (United States)

    Akiba, Tadashi; Marushima, Hideki; Nogi, Hiroko; Kamiya, Noriki; Kinoshita, Satoki; Takeyama, Hiroshi; Morikawa, Toshiaki

    2012-01-01

    This study aimed to evaluate the clinical outcomes of chest wall reconstruction using a relatively new expanded polytetrafluoroethylene prosthesis Gore-Tex(®) dual mesh. We reviewed charts of 11 patients who underwent bony chest wall resection from April 2006 to January 2011. Six patients underwent three ribs resection, three patients underwent two ribs resection, and the other two patients underwent sternal resection. Of six patients after three ribs resection, three underwent reconstruction using 2 mm Gore-Tex(®) dual mesh, one using Gore-Tex(®), one using Bard composite E/X, and the remaining one used no prosthesis. Three patients who underwent two ribs resection underwent no chest wall reconstruction using prosthesis. Two patients who underwent sternal resection underwent chest wall reconstruction using dual mesh with or without a vascularized musculocutaneous pedicle flap. Immediate postoperative extubation was performed in all patients, except one who was extubated the following day. No postoperative deaths or cases with paradoxical respiration occurred. Chest wall reconstruction using Gore-Tex(®) dual mesh demonstrated acceptable durability.

  17. MRI of the Chest

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    Full Text Available ... vessels and heart chambers. display lymph nodes and blood vessels, including vascular and lymphatic malformations of the chest. assess disorders of the chest bones (vertebrae, ribs and sternum) and chest wall soft tissue (muscles and fat). assess for pericardial (thin sac ...

  18. Chest Tube Thoracostomy

    Science.gov (United States)

    ... in the space around the lungs (called a pleural effusion) . A chest tube may also be needed when a patient has ... or chest CT are also done to evaluate pleural fluid. If the X-ray shows a need for a chest tube to drain fluid or air, the procedure is ...

  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 history (P = .001) were associated with increased likelihood of a 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

  20. 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)

  1. Sarcoma Arising from the Chest Wall : A Case Report.

    Science.gov (United States)

    Akhtar, Aisha; Shah, Sana; Sheikh, Abu Baker; Nasrullah, Adeel; Haq, Shujaul; Ghazanfar, Haider; Rizwan, Muneeba

    2017-08-24

    Chest wall contains a wide array of tissues ranging from soft tissues like skin and muscle to bone. A variety of sarcomas can present with a painful or painless mass, which often requires histological testing for diagnosis. Chest wall sarcomas are very rare entities which are often growing slow . A multidisciplinary team is necessary for the management of chest wall sarcomas. We present a case of a 30-year-old male with spindle cell sarcoma of the chest wall and he underwent wide local excision along with surgical reconstruction.

  2. Sarcoma Arising from the Chest Wall : A Case Report

    OpenAIRE

    Akhtar, Aisha; Shah, Sana; Sheikh, Abu Baker; Nasrullah, Adeel; Haq, Shujaul; Ghazanfar, Haider; Rizwan, Muneeba

    2017-01-01

    Chest wall contains a wide array of tissues ranging from soft tissues like skin and muscle to bone. A variety of sarcomas can present with a painful or painless mass, which often requires histological testing for diagnosis. Chest wall sarcomas are very rare entities which are often growing slow . A multidisciplinary team is necessary for the management of chest wall sarcomas. We present a case of a 30-year-old male with spindle cell sarcoma of the chest wall and he underwent wide local excisi...

  3. Observer agreement in the diagnosis of interstitial lung diseases based on HRCT scans

    International Nuclear Information System (INIS)

    Antunes, Viviane Baptista; Meirelles, Gustavo de Souza Portes; Jasinowodolinski, Dany; Verrastro, Carlos Gustavo Yuji; Torlai, Fabiola Goda

    2010-01-01

    Objective: to determine the interobserver and intraobserver agreement in the diagnosis of interstitial lung diseases (ILDs) based on HRCT scans and the impact of observer expertise, clinical data and confidence level on such agreement. Methods: two thoracic radiologists and two general radiologists independently reviewed the HRCT images of 58 patients with ILDs on two distinct occasions: prior to and after the clinical anamnesis. The radiologists selected up to three diagnostic hypotheses for each patient and defined the confidence level for these hypotheses. One of the thoracic and one of the general radiologists re-evaluated the same images up to three months after the first readings. In the coefficient analyses, the kappa statistic was used. Results: the thoracic and general radiologists, respectively, agreed on at least one diagnosis for each patient in 91.4% and 82.8% of the patients. The thoracic radiologists agreed on the most likely diagnosis in 48.3% (κ = 0.42) and 62.1% (κ = 0.58) of the cases, respectively, prior to and after the clinical anamnesis; likewise, the general radiologists agreed on the most likely diagnosis in 37.9% (κ 0.32) and 36.2% (κ = 0.30) of the cases. For the thoracic radiologist, the intraobserver agreement on the most likely diagnosis was 0.73 and 0.63 prior to and after the clinical anamnesis, respectively. That for the general radiologist was 0.38 and 0.42.The thoracic radiologists presented almost perfect agreement for the diagnostic hypotheses defined with the high confidence level. Conclusions: Interobserver and intraobserver agreement in the diagnosis of ILDs based on HRCT scans ranged from fair to almost perfect and was influenced by radiologist expertise, clinical history and confidence level. (author)

  4. MRI of the Chest

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    Full Text Available ... Angiography (MRA) Magnetic Resonance Imaging (MRI) Safety Contrast Materials MRI Safety During Pregnancy Images related to Magnetic Resonance Imaging (MRI) - Chest Sponsored by Please note ...

  5. Thoracoscopic pulmonary wedge resection without post-operative chest drain

    DEFF Research Database (Denmark)

    Holbek, Bo Laksafoss; Hansen, Henrik Jessen; Kehlet, Henrik

    2016-01-01

    OBJECTIVE: Chest drains are used routinely after wedge resection by video-assisted thoracoscopic surgery (VATS), although this practice is based largely on tradition rather than evidence. Chest drains may furthermore cause pain, infections, and prolonged length of stay. The aim of this prospective...... observational study was to assess the feasibility of avoiding chest drains following VATS wedge resection for pulmonary nodules. METHODS: Between 1 February and 25 August 2015 166 consecutive patients planned for VATS wedge resection of pulmonary nodules were screened for inclusion using the following criteria...... effusion and coagulopathy. Chest X-rays were done twice on the day of surgery. 30-day complications were compiled from patient records. RESULTS: 49 patients underwent 51 unilateral VATS wedge resections without using a post-operative chest drain. No patient required reinsertion of a chest drain. 30 (59...

  6. Chest X-Ray

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    Full Text Available ... loose, comfortable clothing. You may be asked to change into a gown. You may have 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 tiny ...

  7. MRI of the Chest

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    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 ...

  8. Chest tube insertion

    Science.gov (United States)

    ... of your chest cavity. This is called the pleural space. It is done to allow your lungs to fully expand. ... pneumothorax ) Fluid buildup in the chest (called a pleural ... in the esophagus (the tube that allows food to go from the mouth ...

  9. 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%.

  10. Serial chest CT findings in interstitial lung disease associated with polymyositis-dermatomyositis

    Energy Technology Data Exchange (ETDEWEB)

    Bonnefoy, Olivier; Ferretti, Gilbert; Calaque, Olivier; Coulomb, Max; Begueret, Hugues; Beylot-Barry, Marie; Laurent, Francois E-mail: francois.laurent@chu-bordeaux.fr

    2004-03-01

    Objective: A retrospective study was carried out in two institutions to determine serial changes in the pattern, distribution, and extent of interstitial lung disease (ILD) associated with polymyositis (PM)-dermatomyositis (DM) using HRCT. Subjects and methods: Twenty patients with PM-DM and clinical suspicion of ILD who underwent at least two serial HRCT examinations were retrospectively evaluated by two readers. Patients were classified according to the dominant CT pattern which was correlated with clinical evolution and underlying histology when available (n=6). Results: Patients were classified into four groups according to the dominant pattern: ground-glass attenuation and reticulation (group 1, n=9); honeycombing (group 2, n=4); airspace consolidation (group 3, n=4), and normal or almost normal lung (group 4, n=3). Under medical treatment, serial HRCT showed that the extent of areas of ground-glass opacities (group 1) decreased in five patients, stabilized in two, and increased in two. Pathologic findings demonstrated usual interstitial pneumonia (UIP) in two cases and unspecified interstitial pneumonia in one. In group 2, extent of honeycombing increased in three cases and stabilized in one. In group 3, dramatic resolution of airspace consolidation occurred in three cases. Clinical deterioration with extensive consolidation at CT and diffuse alveolar damage (DAD) at histology occurred in one patient of each of the three previous groups. Lesions stayed invisible or progressed slightly in the fourth group. Conclusion: In ILD associated with PM-DM, clinical deterioration and DAD in the follow-up can be observed whatever the HRCT pattern. However, unfavorable evolution is constant when honeycombing is present at the initial CT.

  11. Bacterial pneumonia following bone marrow transplantation: HRCT findings Achados de TCAR nas pneumonias bacterianas após transplante de medula óssea

    Directory of Open Access Journals (Sweden)

    Luiz Otávio de Mattos Coelho

    2009-05-01

    Full Text Available OBJECTIVE: To describe HRCT findings in patients with bacterial pneumonia following bone marrow transplantation (BMT. METHODS: This was a retrospective study involving 30 patients diagnosed with bacterial pneumonia in whom HRCT of the chest was performed within 24 h after the onset of symptoms and the diagnosis was confirmed, based on a positive culture of sputum or bronchial aspirate, together with a positive pleural fluid or blood culture, within one week after symptom onset. There were 20 male patients and 10 female patients. The median age was 21 years (range, 1-41 years. The BMT had been performed for the treatment of the following: chronic myeloid leukemia, in 14 cases; severe aplastic anemia, in 6; acute myeloid leukemia, in 4; Fanconi's anemia, in 3; and acute lymphocytic leukemia, in 3. Two radiologists analyzed the HRCT scans and reached their final decisions by consensus. RESULTS: The most common HRCT findings were air-space consolidation (in 60%, small centrilobular nodules (in 50%, ground-glass opacities (in 40%, bronchial wall thickening (in 20%, large nodules (in 20%, pleural lesions (in 16.7% and tree-in-bud opacities (in 10%. The pulmonary lesions were distributed in the central and peripheral areas in 15 patients, whereas they were exclusively peripheral in 11. Lesions were located in the lower and middle lobes of the lung in 22 and 20 patients, respectively. CONCLUSIONS: The most common HRCT findings in our patient sample were air-space consolidation, small centrilobular nodules and ground-glass opacities, most often in the central and peripheral regions of the middle and lower lung zones.OBJETIVO: Descrever os achados de TCAR em pacientes com pneumonia bacteriana após transplante de medula óssea (TMO. MÉTODOS: Estudo retrospectivo com 30 pacientes diagnosticados com pneumonia bacteriana, documentada com TCAR do tórax realizada em até 24 h do início dos sintomas, e com diagnóstico comprovado com base em cultura positiva

  12. The application of 18F-FDG PET and HRCT in the diagnosis of bronchial alveolar carcinoma

    International Nuclear Information System (INIS)

    Zhou Min; Lin Meifu; Chen Wenxin

    2011-01-01

    Objective: To investigate the features and diagnostic values of 18 F-FDG PET and high resolution CT (HRCT) in patients with bronchial alveolar carcinoma(BAC). Methods: Seventeen cases with pathologically confirmed BAC and 1 case confirmed inflammation were studied retrospectively. The standardized uptake value (SUV) of the lesions were detected and 18 F-FDG uptake characteristics were studied. The diagnostic values of 18 F-FDG PET, HRCT and 18 F-FDG PET combined with HRCT were analyzed. Results: (1) In the group of solitary nodule (n =5), SUV of lesions were 1.5-3.5. HRCT (4/5) demonstrated spiculated(4/4), lobulated (3/4), pleural indentation (3/4), vascular convergence (3/4), vacuole sign (2/4) and ground-glass sign (1/4). (2) In the group of lobar consolidation (n=6), SUV of lesions were 1.6-2.3. HRCT (5/6) demonstrated ground-glass (5/5), pleural indentation (3/5), vacuole sign (2/5), air bronchogram sign (2/5) and blood vessel convergency (1/5). (3) In the group of mixed shadow(n=4), SUV of lesions were 4.5-10.0. Ground-glass sign, vacuole sign, pleural tag and air bronchogram sign were seen in 2, 1, 2 and 3 cases respectively. (4) There was 1 case in the group of mass lesion. The SUV of lesion was 5.6, and HRCT demonstrated lobulated, cavity, pleural indentation and blood vessel convergency. (5) There was 1 case in the multi-nodular group, SUV was 4.6, lobulation and spiculation sign were found. (6) SUV was 1.2 in the false positive case, with the lesion size of 2.1 cm x 2.3 cm. Conclusions: Low uptake of 18 F-FDG in solitary nodule and lobar consolidation groups might cause false negative in the diagnosis of BAC. To improve the diagnosis accuracy and to decrease misdiagnosis rate of BAC, combination of HRCT with 18 F-FDG PET should be carried out. (authors)

  13. Change of pulmonary arterial and bronchial diameter during respiration : HRCT findings

    International Nuclear Information System (INIS)

    Yang, Sang Kyu; Kwak, Byung Kook; Kim, Young Min; Jung, Gul Ho; Lee, Shin Hyung; Lee, Chang Joon; Song, Chi Ho

    1997-01-01

    To evaluate the changes and normal ranges of the artery-bronchus ratio(ABR) during respiration We analyzed HRCT of 10 healthy adults. The HRCT findings of ten healthy adults were analysed. CT scanning was performed with 1mm collimation at 3mm intervals during full inspiration and full expiration, with a range during inspiration from 2cm to 4cm above the carina and from 4cm above to 2cm below the right hemidiaphragm. The range during expiration was from 1cm to 3cm above the carina and from 4cm above to 2cm below the right hemidiaphragm. ABiR (defined as the diameter of pulmonary artery divided by the inner diameter of the bronchus), ABoR (defined as the diameter of pulmonary artery divided by the outer diameter of the bronchus) and BLR (defined as the inner diameter of the bronchus divided by the outer diameter of the bronchus) were measured on the display console. The mean inner diameter of the bronchi was 2.04±0.73mm during inspiration and 1.68±0.51mm during expiration, while the mean diameter of the arteries was 3.95±1.03mm during inspiration and 4.37±1.09mm during expiration. The diameters of the bronchi were thus seen to increase during inspiration, and the diameters of the pulmonary arteries, to decrease. The mean thickness of the bronchial wall was 1.07±0.19mm during inspiration and 1.06±0.24mm during expiration;thus, no change in thickness was seen during respiration (p<0.05). Mean ABiR was 2.01±0.60 (range 1.15-4.58) during inspiration and 2.59±0.74(range 1.16-4.9) during expiration, and in all cases the inner diameter of the bronchus was less than that of the accompanying pulmonary artery. Mean ABoR was 0.91±0.19 during inspiration and 1.09±0.22 during expiration. While for BLR, the corresponding fingures were 0.46±0.06, and 0.44±0.09. HRCT is a useful tool for evaluating changes in the pulmonary arteries and bronchi during respiration

  14. The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas

    International Nuclear Information System (INIS)

    Krestan, C.; Czerny, C.; Gstoettner, W.; Franz, P.

    2003-01-01

    The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [de

  15. 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 ... at these links. About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 ...

  16. 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......Background: Chest radiography is one of the most common examinations in radiology departments. In 2013 approximately 80,000 chest x-rays were performed on women in the fertile age. Even low dose for the examinationCorrect collimation Purpose: Quality improvement of basic radiography focusing...... of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance of clinical supervisors. Optimal collimation is determined by European...

  17. Digital chest radiography

    DEFF Research Database (Denmark)

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

    Purpose: Quality improvement of basic radiography focusing 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 of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  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 ... gadolinium contrast, it may still be possible to use it after appropriate pre-medication. Patient consent will ...

  19. MRI of the Chest

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    Full Text Available ... of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of ... of the body being imaged, send and receive radio waves, producing signals that are detected by the coils. ...

  20. 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 ...

  1. MRI of the Chest

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    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Chest Magnetic ... determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted ...

  2. Chest X-Ray

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    Full Text Available ... Radiology and You Take our survey 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 ...

  3. MRI of the Chest

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    Full Text Available ... nearby harm. These items include: jewelry, watches, credit cards and hearing aids, all of which can be ... Imaging (MRI) Safety Contrast Materials MRI Safety During Pregnancy Images related to Magnetic Resonance Imaging (MRI) - Chest ...

  4. Mechanical chest compressions.

    Science.gov (United States)

    Pomeroy, Matthew

    2012-09-13

    The authors of this study state that there is a lack of evidence about the efficiency of mechanical devices in producing chest compressions as an adjunct to resuscitation during cardiorespiratory arrest.

  5. Chest X-Ray

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    Full Text Available ... Site Index A-Z Spotlight February is American Heart Month Recently posted: Carotid Intima-Media Thickness Test ... x-ray is used to evaluate the lungs, heart and chest wall and may be used to ...

  6. Chest X-Ray

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    Full Text Available ... Abdominal Ultrasound Video: Pelvic Ultrasound Medical Imaging Costs Radiology and You Take our survey Sponsored by Image/ ... Radiologist Explains Chest X-ray Transcript Welcome to Radiology Info dot org! Hello, I’m Dr. Geoffrey ...

  7. 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 ... physicians with expertise in several radiologic areas. Outside links: For the convenience of our users, RadiologyInfo .org ...

  8. 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 ... Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding ...

  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. 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 ... their usual alignment, they emit different amounts of energy that vary according to the type of body ...

  11. MRI of the Chest

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    Full Text Available ... to assess the vessels of the chest cavity (arteries and veins). MRA can also demonstrate an abnormal ballooning out of the wall of an artery ( aneurysm ) or a torn inner lining of an ...

  12. 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 ...

  13. Chest X-Ray

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    Full Text Available ... and You Take our survey Sponsored by Image/Video Gallery Your Radiologist Explains Chest X-ray Transcript ... Carotid Intima-Media Thickness Test Medical Imaging Costs Video: Abdominal Ultrasound Video: Pelvic Ultrasound Radiology and You ...

  14. 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. ...

  15. MRI of the Chest

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    Full Text Available ... body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, ... doctor for a mild sedative prior to the exam. What is MRI of the Chest? What are ...

  16. MRI of the Chest

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  17. 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. ...

  18. MRI of the Chest

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    Full Text Available ... to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed ... for differentiating and characterizing soft tissues, except for lung abnormalities where Chest CT is a preferred imaging ...

  19. 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. ...

  20. Chest X-Ray

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  1. MRI of the Chest

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    Full Text Available ... of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures ... medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed ...

  2. 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.

  3. 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 ...

  4. 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 ...

  5. Chest X-Ray

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    Full Text Available ... Index A-Z Spotlight March is National Colorectal Cancer Awareness Month Recently posted: Carotid Intima-Media Thickness ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  6. 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 ... metal called gadolinium . Gadolinium can be used in patients with iodine contrast allergy. It is far less ...

  7. 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 ... their usual alignment, they emit different amounts of energy that vary according to the type of body ...

  8. 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 ...

  9. 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 ...

  10. Chest X-Ray

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    Full Text Available ... Index A-Z Spotlight March is National Colorectal Cancer Awareness Month Recently posted: How to Obtain and ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  11. Chest X-Ray

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    Full Text Available ... Index A-Z Spotlight March is National Colorectal Cancer Awareness Month Recently posted: Video: The Basketball Game: ... of lung conditions such as pneumonia, emphysema and cancer. A chest x-ray requires no special preparation. ...

  12. MRI of the Chest

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    Full Text Available ... be examined on a computer monitor, transmitted electronically, printed or copied to a CD or uploaded to a digital cloud server. MRI of the chest gives detailed pictures of structures within ...

  13. Chylothorax after Blunt Chest Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Pawit Sriprasit

    2017-10-01

    Full Text Available Traumatic chylothorax after blunt chest trauma alone is considered rare. Our patient was a 27-year-old female who was in a motorcycle accident and sustained blunt thoracic and traumatic thoracic aortic injuries with T1–T2 vertebral subluxation. She underwent thoracic endovascular aortic repair from T4 to T9 without any thoracic or spinal surgery. On postoperative day 7, the drainage from her left chest turned into a milky- white fluid indicative of chyle leakage. The patient was treated conservatively for 2 weeks and then the chest drain was safely removed. The results show that traumatic chylothorax can be successfully managed with conservative treatment.

  14. Quiescent Volcano-Chest Wall Hemangioma.

    Science.gov (United States)

    Saldanha, Elroy; Martis, John J S; Kumar, B Vinod; D'Cunha, Rithesh J; Vijin, V

    2017-08-01

    Chest wall hemangiomas are rare tumors that may originate within the soft tissue or from the ribs. Intramuscular hemangioma is infrequent, representing less than 1 % of all hemangiomas, and the localization in the chest wall is even less frequent. They are typically cutaneous in location, large, and poorly circumscribed and can be locally destructive. We present a case of a 34-year-old lady presented with firm lump 3 × 3 cm in left upper and inner quadrant of left breast well defined borders, non-pulsatile and restricted mobility. Sono-mammogram was suggestive of ill-defined lesion at 10 o'clock position. CT chest was conclusive of chest wall hemangioma. The patient underwent excision of the lump. HPE was suggestive of cavernous hemangioma. Cavernous hemangioma typically manifest at birth or before the age of 30 years. CT is more sensitive than plain radiography in detecting phleboliths, which are present in approximately 30 % of cavernous hemangiomas. Surgical excision would be treatment of choice. In this case, the site of the lesion was in the breast clinically mimicking that of a fibroadenoma which warrants hemangioma as a differential diagnosis.

  15. Plain chest radiographic findings of smoke inhalation

    International Nuclear Information System (INIS)

    Lee, Shin Ho; Lee, Eil Weong; Kim, Hyun Suk; Park, Ju Youn; Kim, Soo Hyun; Hong, Sung Hwan; Park, Hong Suk; Lee, Kwan Seop; Kang Ik Won

    2000-01-01

    To evaluate the plain chest radiographic findings of smoke inhalation. Our study included 72 burn patients who had suffered smoke inhalation. On admission, all underwent serial portable chest AP radiography. We retrospectively reviewed the plain chest radiographs taken between admission and pootburn day five, evaluating the pattern, distribution, and time onset of direct injury to the respiratory system by smoke inhalation. The lesions were also assessed for change. In 16 of 72 patients (22%), abnormal findings of direct injury to the respiratory system by smoke inhalation were revealed by the radiographs. Abnormal findings were 15 pulmonary lesions and one subglottic tracheal narrowing. Findings of pulmonary lesions were multiple small patchy consolidations (10/15), peribronchial cuffing (8/15), and perivascular fuzziness (6/15). Patterns of pulmonary lesions were mixed alveolar and interstitial lesion (n=3D9), interstitial lesion (n=3D5), and alveolar lesion (n=3D1). No interlobular septal thickening was observed. Pulmonary edema was distributed predominantly in the upper lung zone and perihilar region, with asymmetricity. Its time of onset was within 24 hours in 13 cases, 24-48 hours in two cases, and 48-72 hours in one. Five of 16 patients progressed to ARDS. Chest radiographs showed that pulmonary lesions caused by inhalation injury were due to pulmonary edema, which the pattern of which was commonly mixed alveolar and interstitial. (author)

  16. High-resolution CT of the lung (HRCT) in collagen diseases: A prospective study of 73 patients. Hochaufloesende Computertomographie der Lunge (HRCT) bei Kollagenosen: eine prospektive Untersuchung an 73 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Leisse, C. (Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)); Bussmann, A.; Mayer, O. (Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)); Genth, E.; Guenther, R.W. (Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany))

    1994-07-01

    To determine pulmonary features of collagenous vascular diseases as assessed by high resolution computed tomography (HRCT) we performed a prospective study of 73 consecutive patients, 44 with rheumatoid arthritis (ra), 11 with progressive systemic sclerosis (pss), 8 with systemic lupus erythematosus (sle), 5 with sjoegren's syndrome, 3 with dermato-/polymyositis and 2 with mixed connective-tissue disease. Pathological lung changes were demonstrated in 70% of patients with ra, 91% with pss, 63% with sle and 60% with the rest. HRCT features included: Intralobular thickening (48%) with a predominance in posterior lower and middle lung areas, pleural thickening (48%) with a predominance in upper lung areas, prominent interlobular septa (37%), subpleural lines (33%), parenchymal bands (33%) with a predominance in lower and anterior lung areas, honeycombing (33%), groundglass pattern (29%) with a predominance in upper and middle, micronodules (18%) with a predominance in upper lung areas and bronchiectasis (14%). HRCT is an important means for the assessment of lung changes associated with collagenous vascular diseases and a definite diagnosis is possible in most cases. (orig.)

  17. Chest wall stabilization in ventilator-dependent traumatic flail chest patients: who benefits?

    Science.gov (United States)

    Kocher, Gregor J; Sharafi, Siamak; Azenha, Luis Filipe; Schmid, Ralph A

    2017-04-01

    Traumatic flail chest is a potentially life threatening injury, often associated with prolonged invasive mechanical ventilation and intensive care unit stay. This study evaluates the usefulness and cost-effectiveness of surgical rib stabilization in patients with flail chest resulting in ventilator dependent respiratory insufficiency. A retrospective study on a consecutive series of patients with flail chest with the need for mechanical ventilation was performed. Effectiveness of rib fixation was evaluated in terms of predictors for prolonged ventilation, cost-effectiveness and outcome. A total of 61 patients underwent flail chest stabilization using a locked titanium plate fixation system between July 2010 and December 2015 at our institution. 62% ( n  = 38) of patients could be weaned from the ventilator within the first 72 h after surgery. Multiple linear regression analysis revealed that closed head injury, bilateral flail chest, number of stabilized ribs and severity of lung contusion were the main independent predictors for prolonged mechanical ventilation (Odds ratio (OR) 6.88; 3.25; 1.52 and 1.42) and tracheostomy (OR 9.17; 2.2; 1.76 and 0.84 ), respectively. Furthermore cost analysis showed that already a two day reduction in ICU stay could outweigh the cost of surgical rib fixation. Operative rib fixation has the potential to reduce ventilator days and ICU stay and subsequently hospital costs in selected patients with severe traumatic flail chest requiring mechanical ventilation. Especially associated closed head injury can adversely affect mechanical ventilation time. Furthermore the subgroups of patients sustaining a fall from a height and those with flail chest after cardiopulmonary re-animation seem to profit only marginally from surgical rib fixation. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Paraquat-induced pulmonary lesions : HRCT findings in long-term follow-up : a case report

    International Nuclear Information System (INIS)

    Kim, Young Tong; Hong, Sae Yong; Kim, Il Young

    1997-01-01

    We illustrate serial HRCT findings over a 16-month period in a 35-year-old woman who had ingested paraquat. Initial areas of ground-glass opacity changed into areas of multiple air cysts on follow up scan obtained five months after ingestion. A further follow-up scan obtained 16 months after ingestion showed improvement, with increased lung volume and normalized lung architecture

  19. MRI of the Chest

    Medline Plus

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

  20. Chest X-Ray

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... to consider the likelihood of benefit to your health. While a chest x-ray use a tiny ...

  1. 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 ...

  2. 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 ...

  3. MRI of the Chest

    Medline Plus

    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 ...

  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 ... heart, valves, great vessels, etc.). top of page What are some common uses of the procedure? MR imaging of the chest is performed to: assess abnormal masses, including cancer of the lungs or other tissues, which either cannot be assessed adequately with other ...

  6. Synovial sarcoma of the chest wall.

    Science.gov (United States)

    Kawano, Daigo; Yoshino, Ichiro; Shoji, Fumihiro; Morodomi, Yosuke; Yano, Tokujiro; Maehara, Yoshihiko

    2010-02-01

    We here report a rare case of synovial sarcoma of the chest wall. A 71-year-old Japanese woman noticed a left anterior chest wall mass after twice having had surgery for lung cancer. An aspiration biopsy diagnosed synovial sarcoma. She then underwent a surgical resection. Pathology examination revealed a biphasic-type synovial sarcoma. When the prepared RNA from the tumor was subjected to a polymerase chain reaction, SYT-SSX1 fusion gene transcripts were demonstrated. Patients with the SYT-SSX1 fusion gene have a worse clinical outcome than patients with SYT-SSX2-positive tumors. After a second surgery, performed in 1 year later, there was no evidence of recurrence for 30 months; however, careful observation may be required.

  7. Clinical experience with titanium mesh in reconstruction of massive chest wall defects following oncological resection

    Science.gov (United States)

    Yang, Haitang; Tantai, Jicheng

    2015-01-01

    Objectives To present our experience of reconstructing wide defects with porously titanium mesh after radical resection of malignant chest wall tumors. Methods A retrospective review of surgical reconstruction for large chest wall resections with titanium mesh was conducted from January 2009 to August 2014 in Shanghai Chest Hospital. Results A total of 27 patients underwent major chest wall reconstructions with titanium mesh, following oncological resections. Chest wall sarcomas were the most frequent (63.0%). The mean tumor size was 72.4 (range, 36-140) cm2. The average size of the applied porously titanium mesh was 140.9 (range, 80-225) cm2. Mean postoperative length of stay was 7.1 (range, 4-14) days. There were no perioperative mortalities. Four (14.8%) patients experienced treatable complications. All had a resection of at least 3 ribs (median 3, mean 3.5 ribs). A total of 22 patients underwent ribs without sternal resections, and five patients underwent partial sternal resections with adjacent costal cartilage. Anterior chest wall resections were performed in 13 patients while lateral chest wall resections were performed in 9 patients. Three patients had extended resections beyond the chest wall in patients with primary chest wall malignancies, including two with wedge resections of lung and one with partial resection of pericardium. No patient was lost to follow-up. Mean follow-up was 30.7 months. Neither chest wall instability nor wound infection/necrosis was observed. Of these, 23 patients (85.2%) were alive at the last follow-up. Local recurrence was detected in three cases. The 5-year disease-free and overall survivals of primary chest tumors were 72.1% and 80.8%, respectively. Conclusions Our results showed that chest wall reconstruction utilizing synthetic titanium meshes following extensive resections of the chest wall malignant tumors allowed adequate resection size, with acceptable complications and survival benefits. PMID:26380739

  8. A suitable system of reconstruction with titanium rib prosthesis after chest wall resection for Ewing sarcoma.

    Science.gov (United States)

    Billè, Andrea; Gisabella, Mara; Errico, Luca; Borasio, Piero

    2011-02-01

    The recent improvements in chemotherapy and surgical resection in Ewing sarcoma (ES) increased the overall survival as well as the importance of chest wall reconstruction. These improvements are in order to avoid asymmetrical growth, functional and cosmetic compromise after surgery. Chest wall reconstruction still remains a big issue in young patients with ES. We present a case of ES of the left chest wall, arising from a rib, in a 14-year-old patient. He was admitted after neoadjuvant chemotherapy and radiotherapy. The patient underwent a chest wall resection of three ribs and a wedge lung resection of the upper lobe followed by chest wall reconstruction with Stratos™ rib titanium prostheses. This new device is suitable for reconstruction after major chest wall resection with good cosmetic and functional results. During the follow-up, there was no evidence of local and distant recurrence, the pain was under control and there were no functional alterations in the chest wall.

  9. The HRCT appearances of granulomatous pulmonary disease in common variable immune deficiency

    Energy Technology Data Exchange (ETDEWEB)

    Park, J.E.S. [Royal Free and Hampstead NHS Trust, Pond Street, London NW3 2QG (United Kingdom); Beal, I. [Royal Free and Hampstead NHS Trust, Pond Street, London NW3 2QG (United Kingdom); Dilworth, J.P. [Royal Free and Hampstead NHS Trust, Pond Street, London NW3 2QG (United Kingdom); Tormey, V. [Royal Free and Hampstead NHS Trust, Pond Street, London NW3 2QG (United Kingdom); Haddock, J. [Royal Free and Hampstead NHS Trust, Pond Street, London NW3 2QG (United Kingdom)]. E-mail: jamandahaddock@royalfree.nhs.uk

    2005-06-01

    Approximately 10% of patients with common variable immune deficiency have systemic granulomatous disease with associated interstitial lung disease. From a population of patients with CVID attending a large tertiary referral clinic for primary immunodeficiency diseases we selected a cohort who had a restrictive defect or impaired gas transfer on pulmonary function testing and/or histologically proven granulomatous disease. HRCT scans of the thorax were reviewed retrospectively in 18 patients by two radiologists. Thirteen patients had diffuse reticulation, which varied from fine to coarse with features of fibrosis. Nodules were found in eight patients. In seven, these were associated with reticulation and in one they were an isolated finding. Bronchiectasis was found as the only abnormality in three and in addition to diffuse reticulation or nodules in another three patients. Greater appreciation of the spectrum of the radiological abnormalities in CVID patients with interstitial lung disease is important. Deteriorating lung function in patients with granulomatous CVID may be secondary to interstitial lung disease rather than bronchiectasis, and treatment should be tailored accordingly.

  10. 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

  11. The role of HRCT and three-dimensional VR CT findings in patients of congenital atresia combined with microtia.

    Science.gov (United States)

    Gao, Ruzhen; Wang, Yun; Fan, Yue; Ai, Xing; Zhang, Xiaona; Xue, Huadan; Chen, Xiaowei; Jin, Zhengyu

    2012-12-01

    To determine the anatomic differences in patients of atresia by using high-resolution computed tomography (HRCT) and 3D volume rendered (VR) CT. High-resolution computed tomography (HRCT) was performed in 43 atresia patients including 34 unilateral atresia patients (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 9 bilateral atresia patients (6 males, 3 females, mean age 13.2 years, range 9-19 years). HRCT and 3D VR findings were compared with those in 43 normal ears of the unilateral atresia patients with normal PTA results (n=34, 26 males, 8 females, mean age 13.82 years, range 8-19 years) and 11 patients with sensorineural hearing loss but with no associated aplasia of the middle and inner ear (n=22, 7 males and 4 females, range 8-20.8 years, median age of 13.4 years) by using the independent one sample T test. On the HRCT images, the angle between the basic line and the tympanic segment of the facial nerve is more acute. And the area of the malleus-incus-joint or the malleus-incus-complex in the diseased ears is smaller than that in the control subjects (Patresia group, while the diameter of the oval window is also smaller in atresia group than that in the control group (P<0.05). The morphologic differences of the small ossicles and the entire length of the tympanic and mastoid segments can be depicted on a single 3D VR CT image. The facial nerve demonstrates abnormal lateral and anterior displacement in the CAA patients and the area of the Malleus-incus-joint and the tympanic cavity are significantly smaller, and the oval window is much narrower in the control group. HRCT and 3D VR CT provide valuable information about preoperative planning of patients with CAA. Measurements of all the angles and length serve as useful adjunct measurements in determining surgical candidacy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. 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.

  13. Comparison of chest-CT findings of Influenza virus-associated pneumonia in immunocompetent vs. immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany); Forler, S.; Gatidis, S. [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany); Beck, R. [Institute of Medical Virology and Epidemiology of Viral Diseases, Eberhard-Karls-University, Elfriede-Aulhorn-Straße 6, 72076 Tübingen (Germany); Spira, D.; Nikolaou, K.; Horger, M. [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen (Germany)

    2015-06-15

    Highlights: • Patterns of pulmonary infiltration caused by Influenza viruses do not significantly differ between immunocompetent and immunocompromised patients or between different types and subtypes of Influenza virus. • Patterns of pulmonary infiltration caused by Influenza viruses seem to be interchangeable which might in part explain the great overlap in CT-imaging findings that has been reported in the past. • Interestingly, pattern transition from interstitial into airway-centric pattern seems to be frequent in immunocompromised patients receiving specific antiviral therapy, whereas the conversion of the airway-centric pattern into an interstitial pattern was observed more frequent in immunocompetent patients developing ARDS. - Abstract: Purpose: To retrospectively compare CT-patterns of pulmonary infiltration caused by different Influenza virus types and subtypes in immunocompetent and immunocompromised patients for possible discrimination. Materials and methods: Retrospective database search at our institution yielded 237 patients who were tested positive for Influenza virus type A or type B by bronchoalveolar lavage between January 2009 and April 2014. Fifty-six of these patients (female 26; male 30; median age 55.8 y, range 17–86 y; SD ± 14.4 y) underwent chest-HRCT due to a more severe clinical course of pulmonary infection. We registered all CT-findings compatible with pulmonary infection classifying them as airway predominant (tree-in-bud, centrilobular nodules, bronchial wall thickening ± peribronchial ground-glass opacity and consolidation) vs. interstitial-parenchymal predominant (bilateral, symmetrical GGO, consolidation, crazy paving and/or interlobular septal thickening). Twenty-six patients (46.4%) had follow-up CT-studies (0.78 mean, SD ± 5.8 scans). Results: Thirty-six patients were immunocompromised (group I) whereas 20 patients were immunocompetent (group II). An airway-centric pattern of infection was found in 15 patients (group

  14. Application of adjusted subpixel method (ASM) in HRCT measurements of the bronchi in bronchial asthma patients and healthy individuals.

    Science.gov (United States)

    Mincewicz, Grzegorz; Rumiński, Jacek; Krzykowski, Grzegorz

    2012-02-01

    Recently, we described a model system which included corrections of high-resolution computed tomography (HRCT) bronchial measurements based on the adjusted subpixel method (ASM). To verify the clinical application of ASM by comparing bronchial measurements obtained by means of the traditional eye-driven method, subpixel method alone and ASM in a group comprised of bronchial asthma patients and healthy individuals. The study included 30 bronchial asthma patients and the control group comprised of 20 volunteers with no symptoms of asthma. The lowest internal and external diameters of the bronchial cross-sections (ID and ED) and their derivative parameters were determined in HRCT scans using: (1) traditional eye-driven method, (2) subpixel technique, and (3) ASM. In the case of the eye-driven method, lower ID values along with lower bronchial lumen area and its percentage ratio to total bronchial area were basic parameters that differed between asthma patients and healthy controls. In the case of the subpixel method and ASM, both groups were not significantly different in terms of ID. Significant differences were observed in values of ED and total bronchial area with both parameters being significantly higher in asthma patients. Compared to ASM, the eye-driven method overstated the values of ID and ED by about 30% and 10% respectively, while understating bronchial wall thickness by about 18%. Results obtained in this study suggest that the traditional eye-driven method of HRCT-based measurement of bronchial tree components probably overstates the degree of bronchial patency in asthma patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Examination of musculoskeletal chest pain

    DEFF Research Database (Denmark)

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

    2010-01-01

    Chest pain may be caused by joint and muscle dysfunction of the neck and thorax (termed musculoskeletal chest pain). The objectives of this study were (1) to determine inter-observer reliability of the diagnosis 'musculoskeletal chest pain' in patients with acute chest pain of non-cardiac origin......-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...... and students) and all. Musculoskeletal chest pain was diagnosed in 45 percent of patients. Inter-observer kappa values were substantial for the chiropractors and overall (0.73 and 0.62, respectively), and moderate for the students (0.47). For single items of the protocol, the overall kappa ranged from 0...

  16. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  17. A case that underwent bilateral video-assisted thoracoscopic ...

    African Journals Online (AJOL)

    No Abstract Available A case that underwent bilateral video-assisted thoracoscopic surgical (VATS) biopsy combined with pneumonectomy is presented. The patient developed hypoxia during the contralateral VATS biopsy. His hypoxia was treated with positive expiratory pressure (PEEP) to the dependent lung and apneic ...

  18. Pulmonary edema following intravenous injection of nonionic low-osmolar contrast medium - appearance on HRCT. A case report

    International Nuclear Information System (INIS)

    Bristedt, P.; Tylen, U.

    1998-01-01

    Pulmonary edema following i.v. contrast medium injection is a rare adverse reaction. We report on a 71-year-old woman who developed pulmonary edema following i.v. injection of iohexol during spiral CT of the thorax. She developed shortness of breath during the injection, and the first radiographic signs of pulmonary edema were visible on CT images 25 s after the onset of injection. On HRCT images 15 min later, marked edema was demonstrated in both lungs in a mosaic pattern of distribution. After appropriate therapy, the patient recovered without sequelae. A repeat CT 6 days later showed complete normalization. (orig.)

  19. Scoring CT/HRCT findings among asbestos-exposed workers: effects of patient's age, body mass index and common laboratory test results

    Energy Technology Data Exchange (ETDEWEB)

    Vehmas, T.; Huuskonen, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); Kivisaari, L. [Helsinki University Central Hospital, Department of Radiology, Helsinki (Finland); Jaakkola, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); University of Birmingham, Institute of Occupational and Environmental Medicine, Birmingham (United Kingdom)

    2005-02-01

    We studied the effects of age, body mass index (BMI) and some common laboratory test results on several pulmonary CT/HRCT signs. Five hundred twenty-eight construction workers (age 38-80, mean 63 years) were imaged with spiral and high resolution CT. Images were scored by three radiologists for solitary pulmonary nodules, signs indicative of fibrosis and emphysema, ground glass opacities, bronchial wall thickness and bronchiectasis. Multivariate statistical analyses were adjusted for smoking and asbestos exposure. Increasing age, blood haemoglobin value and erythrocyte sedimentation rate correlated positively with several HRCT signs. Increasing BMI was associated with a decrease in several signs, especially parenchymal bands, honeycombing, all kinds of emphysema and bronchiectasis. The latter finding might be due to the suboptimal image quality in obese individuals, which may cause suspicious findings to be overlooked. Background data, including patient's age and body constitution, should be considered when CT/HRCT images are interpreted. (orig.)

  20. Quantitative evaluation of interstitial pneumonia using 3D-curved high-resolution CT imaging parallel to the chest wall: A pilot study.

    Directory of Open Access Journals (Sweden)

    Hiroyasu Umakoshi

    Full Text Available To quantify the imaging findings of patients with interstitial pneumonia (IP and emphysema using three-dimensional curved high-resolution computed tomography (3D-cHRCT at a constant depth from the chest wall, and compare the results to visual assessment of IP and each patient's diffusing capacity of the lungs for carbon monoxide (DLco.We retrospectively reviewed the axial CT findings and pulmonary function test results of 95 patients with lung cancer (72 men and 23 women, aged 45-84 years with or without IP, as follows: non-IP (n = 47, mild IP (n = 31, and moderate IP (n = 17. The 3D-cHRCT images of the lung at a 1-cm depth from the chest wall were reconstructed automatically using original software; total area (TA, high-attenuation area (HAA >-500 HU, and low-attenuation area (LAA <-950 HU were calculated on a workstation. The %HAA and %LAA were calculated as follows: [Formula: see text], and [Formula: see text].The %HAA and %LAA respective values were 3.2±0.9 and 27.7±8.2, 3.9±1.2 and 27.6±5.9, and 6.9±2.2 and 25.4±8.7 in non-IP, mild IP, and moderate IP patients, respectively. There were significant differences in %HAA between the 3 groups of patients (P<0.001, but no differences in %LAA (P = 0.558. Multiple linear regression analysis revealed that %HAA and %LAA were negatively correlated with predicted DLco (standard partial regression coefficient [b*] = -0.453, P<0.001; b* = -0.447, P<0.001, respectively.The %HAA and %LAA values computed using 3D-cHRCT were significantly correlated with DLco and may be important quantitative parameters for both IP and emphysema.

  1. Chest Abnormalities in Juvenile-Onset Mixed Connective Tissue Disease: Assessment with High-Resolution Computed Tomography and Pulmonary Function Tests

    International Nuclear Information System (INIS)

    Aaloekken, T.M.; Mynarek, G.; Kolbenstvedt, A.; Lilleby, V.; Foerre, Oe.; Soeyseth, V.; Pripp, A.H.; Johansen, B.

    2009-01-01

    Background: Mixed connective tissue disease (MCTD) is associated with several chest manifestations. Only a few studies have focused on chest manifestations in juvenile-onset MCTD (jMCTD), and the true prevalence of pulmonary abnormalities on high-resolution computed tomography (HRCT) in these patients is unknown. Purpose: To investigate the occurrence of pulmonary abnormalities in jMCTD with particular reference to interstitial lung disease (ILD), and to evaluate a possible association between pulmonary findings and disease-related variables. Material and Methods: Twenty-four childhood-onset MCTD patients with median disease duration of 10.5 years (range 1-21 years) were investigated in a cross-sectional study by means of HRCT, pulmonary function tests (PFT), and clinical assessment. Results: Discrete ILD was identified in six patients (25%). Median extent of ILD was 2.0%, and all except one of the patients had very mild disease in which 5% or less of the parenchyma was affected. The CT features of fibrosis were mainly microcystic and fine intralobular. The most frequently abnormal PFT was carbon monoxide uptake from the lung, which was abnormal in 33% of the patients. PFT and disease duration were not significantly associated with HRCT findings of ILD. Conclusion: The prevalence of ILD in childhood-onset MCTD patients was lower than previously believed. In most of the patients with ILD, the findings were subtle and without clinical correlation. The results suggest a low extent of ILD in childhood-onset MCTD, even after long-term disease duration

  2. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.

    NARCIS (Netherlands)

    A. Gates; L. Warnock; Dr. C.P. van der Schans

    2013-01-01

    BACKGROUND: Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. OBJECTIVES: To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic

  3. NUTRITION SUPPORT COMPLICATIONS IN PATIENT WHO UNDERWENT CARDIAC SURGERY

    OpenAIRE

    Krdžalić, Alisa; Kovčić, Jasmina; Krdžalić, Goran; Jahić, Elmir

    2016-01-01

    Background: The nutrition support complications after cardiac surgery should be detected and treated on time. Aim: To show the incidence and type of nutritional support complication in patients after cardiac surgery. Methods: The prospective study included 415 patients who underwent cardiac surgery between 2010 and 2013 in Clinic for Cardiovascular Disease of University Clinical Center Tuzla. Complications of the delivery system for nutrition support (NS) and nutrition itself were analy...

  4. 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

  5. Clavicle segmentation in chest radiographs

    NARCIS (Netherlands)

    Hogeweg, L.E.; Sanchez, C.I.; Jong, P.A. de; Maduskar, P.; Ginneken, B. van

    2012-01-01

    Automated delineation of anatomical structures in chest radiographs is difficult due to superimposition of multiple structures. In this work an automated technique to segment the clavicles in posterior-anterior chest radiographs is presented in which three methods are combined. Pixel classification

  6. 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.

  7. Chest radiographic findings of leptospirosis

    International Nuclear Information System (INIS)

    Kim, Mee Hyun; Jung, Hee Tae; Lee, Young Joong; Yoon, Jong Sup

    1986-01-01

    1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases, 8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever. 2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2, massive confluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinar nodular type 3, massive confluent consolidation type 1, and increased interstitial markings type 1 respectively. 3. It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especially the case combined with Korean hemorrhagic fever.

  8. Pigmented Villonodular Synovitis in a Patient who Underwent Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Nevzat Dabak

    2014-09-01

    Full Text Available Pigmented villonodular synovitis (PVNS is a rare, benign, but a locally aggressive tumor. It is characterized by the proliferation of synovial membrane, but it can also be seen in tendon sheaths and bursae. Clinical presentation of solitary lesions include compression and locking of the joint suggesting loose bodies in the joint and a subsequent findings of an effusion, whereas diffuse lesions manifest with pain and chronic swelling. In this article, we presented a curious case of PVNS in a female patient who have been followed up due to an acetabular cystic lesion. She underwent total hip arthroplasty for severe osteoarthritis of the hip joint and associated pain. The diagnosis of PVNS was established intraoperatively. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 235-7

  9. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  10. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2013-01-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  11. 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.

  12. Changes in entrance surface dose in relation to the location of shielding material in chest computed tomography

    Science.gov (United States)

    Kang, Y. M.; Cho, J. H.; Kim, S. C.

    2015-07-01

    This study examined the effects of entrance surface dose (ESD) on the abdomen and pelvis of the patient when undergoing chest computed tomography (CT) procedure, and evaluated the effects of ESD reduction depending on the location of radiation shield. For CT scanner, the 64-slice multi-detector computed tomography was used. The alderson radiation therapy phantom and optically stimulated luminescence dosimeter (OSLD), which enabled measurement from low to high dose, were also used. For measurement of radiation dose, the slice number from 9 to 21 of the phantom was set as the test range, which included apex up to both costophrenic angles. A total of 10 OSLD nanoDots were attached for measurement of the front and rear ESD. Cyclic tests were performed using the low-dose chest CT and high-resolution CT (HRCT) protocol on the following set-ups: without shielding; shielding only on the front side; shielding only on the rear side; and shielding for both front and rear sides. According to the test results, ESD for both front and rear sides was higher in HRCT than low-dose CT when radiation shielding was not used. It was also determined that, compared to the set-up that did not use the radiation shield, locating the radiation shield on the front side was effective in reducing front ESD, while locating the radiation shield on the rear side reduced rear ESD level. Shielding both the front and rear sides resulted in ESD reduction. In conclusion, it was confirmed that shielding the front and rear sides was the most effective method to reduce the ESD effect caused by scatter ray during radiography.

  13. Non-Cardiac Chest Pain

    Science.gov (United States)

    ... PPI trial” and can be both diagnostic and therapeutic since if it relieves the chest pain it ... study the esophagus muscle contractions) and perhaps an ultrasound of the abdomen to examine the gallbladder for ...

  14. 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.

  15. American College of Chest Physicians

    Science.gov (United States)

    ... powered by the HEALTHeCAREERS Network. Account access offers benefits for job seekers and ... best patient outcomes through innovative chest medicine education, clinical research, and team-based care. With more ...

  16. 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

  17. Computed tomography of the chest

    International Nuclear Information System (INIS)

    Norsworthy, R.

    1984-01-01

    Computed tomography of the chest can be useful in gaining detailed information of lung and mediastinal pathology, and in following up lesions during and after treatment. Considerations for dynamic and standard techniques are presented

  18. Differentiation of several interstitial lung disease patterns in HRCT images using support vector machine: role of databases on performance

    Science.gov (United States)

    Kale, Mandar; Mukhopadhyay, Sudipta; Dash, Jatindra K.; Garg, Mandeep; Khandelwal, Niranjan

    2016-03-01

    Interstitial lung disease (ILD) is complicated group of pulmonary disorders. High Resolution Computed Tomography (HRCT) considered to be best imaging technique for analysis of different pulmonary disorders. HRCT findings can be categorised in several patterns viz. Consolidation, Emphysema, Ground Glass Opacity, Nodular, Normal etc. based on their texture like appearance. Clinician often find it difficult to diagnosis these pattern because of their complex nature. In such scenario computer-aided diagnosis system could help clinician to identify patterns. Several approaches had been proposed for classification of ILD patterns. This includes computation of textural feature and training /testing of classifier such as artificial neural network (ANN), support vector machine (SVM) etc. In this paper, wavelet features are calculated from two different ILD database, publically available MedGIFT ILD database and private ILD database, followed by performance evaluation of ANN and SVM classifiers in terms of average accuracy. It is found that average classification accuracy by SVM is greater than ANN where trained and tested on same database. Investigation continued further to test variation in accuracy of classifier when training and testing is performed with alternate database and training and testing of classifier with database formed by merging samples from same class from two individual databases. The average classification accuracy drops when two independent databases used for training and testing respectively. There is significant improvement in average accuracy when classifiers are trained and tested with merged database. It infers dependency of classification accuracy on training data. It is observed that SVM outperforms ANN when same database is used for training and testing.

  19. Frequency of Helicobacter pylori in patients underwent endoscopy

    Directory of Open Access Journals (Sweden)

    Ahmet Tay

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate thefrequency of Helicobacter pylori in patients underwent endoscopyeastern Anatolia.Materials and methods: The patients whose endoscopicantral biopsies were taken for any reason in our endoscopyunit in February-June 2010 period were includedand retrospectively investigated. The frequency of Helicobacterpylori was determined as separating the patientsaccording to general, sex and the age groups. Antral biopsieswere stained with hematoxylin-eosin and modified giemsamethod and examined under light microscope andreported as (+ mild, (++ moderate, (+++ severe positiveaccording to their intensities.Results: Biopsy specimens of 1298 patients were includedinto the study. The mean age was 47.5 ± 17.5 years(range 14-88 and 607 of these patients (47% were male.Histopathological evaluation revealed that, 918 of the patientswere (71% positive and 379 (29% were negativefor Helicobacter pylori. Approximately 60% of our patientshad mild, 29% had moderate and 11% had severe positivityfor Helicobacter pylori. No significant difference wasfound in the frequency of Helicobacter pylori betweenwomen and men. The frequencies of Helicobacter pyloriwere 73.2%, 71.5%, 68.6% and 70.4%, respectively, inthe age groups of 14-30 years, 31-45 years, 46-60 yearsand 61-88 years.Conclusion: The frequency of Helicobacter pylori was71% in Eastern Anatolia Region. No statistically significantdifference was found between genders and agegroups in term of the frequency of Helicobacter pylori.

  20. Aortic valve replacement with simultaneous chest wall reconstruction for radiation-induced sarcoma.

    Science.gov (United States)

    Sachithanandan, Anand; Dandekar, Uday; Grimer, Robert; Peart, Francis; Rooney, Stephen J

    2008-01-01

    Sarcomas, a rare complication of radiotherapy for breast carcinoma, have a poor prognosis. We describe a lady with previous mantle radiotherapy exposure, who developed a radiation-induced chest wall sarcoma. She underwent simultaneous aortic valve replacement (AVR) for severe aortic stenosis and excision of the sarcoma. Chest wall reconstruction was achieved with a composite marlex cement plate and a pedicled latissimus dorsi muscle flap.

  1. An unusual case of recurrent chest infections.

    LENUS (Irish Health Repository)

    Dahab, Taqua

    2017-08-01

    This case presentation relates to a 53 year old male, cachectic in appearance, who presented with progressively worsening dyspnoea, cough, intermittent haemoptysis and a history of nasal dryness ongoing over five months. The patient had received multiple courses of oral antibiotics for suspected community acquired pneumonia with no significant improvement. He was referred to our Respiratory Department for further evaluation of his symptoms. His HRCT showed right middle lobe consolidation with central cavitations. Furthermore, the transbronchial biopsy had been performed and the cytological examination revealed lipid laden macrophage with interstitial inflammatory changes. With return to the patient over the counter drug history, he described the frequent use of petroleum jelly to alleviate the symptoms of nasal dryness. This is the first report case of exogenous lipoid pneumonia presented with haemoptysis and cavitations in the HRCT.

  2. Is there a role for virtual otoscopy in the preoperative assessment of the ossicular chain in chronic suppurative otitis media? Comparison of HRCT and virtual otoscopy with surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Pandey, A.K. [University of British Columbia, Department of Radiology, St. Paul Hospital, Vancouver, BC (Canada); Bapuraj, J.R. [University of Michigan, Division of Neuroradiology, Department of Radiology, University Hospital, Ann Arbor, MI (United States); Gupta, A.K. [Post Graduate Institute of Medical Education and Research, Department of Otolaryngology, Chandigarh (India); Khandelwal, N. [Post Graduate Institute of Medical Education and Research, Department of Radiodiagnosis, Chandigarh (India)

    2009-06-15

    The aim of this study was to assess the role of virtual otoscopy and 3D ossicular reconstruction in the preoperative assessment of the ossicles in chronic suppurative otitis media. Thirty three patients of chronic suppurative otitis media with conductive deafness (air-bone gap > 35 dB) were included in this prospective study. All patients underwent axial multidetector CT. The axial CT data set was utilized for multiplanar 2D reformations as well as virtual otoscopy (VO) and 3D reconstructions. The imaging findings on these two techniques were read independently by two radiologists with respect to different parts of the ossicular chain by using a three-point scoring system and were compared with surgical findings. Both imaging techniques had comparable accuracy for evaluation of larger ossicular parts. However, for evaluation of stapes superstructure, VO/3D images were more accurate (85.29%) than 2D images (76.97%). Assessment of the lenticular process and incudostapedial joint by HRCT and 2D reformatted images was not reliable (P > 0.1); however, significant correlation (P < 0.001) was present between VO/3D and the operative findings. Virtual otoscopy improves evaluation of the ossicular chain particularly that of smaller structures such as the lenticular process, incudostapedial joint and stapes superstructure which may influence decisions regarding planning of ossiculoplasty. (orig.)

  3. Clinical outcomes and cost effectiveness of accelerated diagnostic protocol in a chest pain center compared with routine care of patients with chest pain.

    Science.gov (United States)

    Asher, Elad; Reuveni, Haim; Shlomo, Nir; Gerber, Yariv; Beigel, Roy; Narodetski, Michael; Eldar, Michael; Or, Jacob; Hod, Hanoch; Shamiss, Arie; Matetzky, Shlomi

    2015-01-01

    The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (pdiagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (pdiagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (pdiagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), pdiagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.

  4. Detection of breast abnormalities on enhanced chest CT: Correlation with breast composition on mammography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun Mi; Kang, Hee; Shin, Young Gyung; Yun, Jong Hyouk; Oh, Kyung Seung [Dept. of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

    2017-02-15

    To investigate the capability of enhanced chest computed tomography (CT) for detecting breast abnormalities and to assess the influence of breast composition on this detectability. From 2000 to 2013, 75 patients who underwent mammography, breast sonography, and enhanced chest CT within one month and had abnormalities on sonography were included. Detection rate of breast abnormality on enhanced chest CT was compared among 4 types of breast composition by the Breast Imaging Reporting and Data System. Contribution of breast composition, size and enhancement of target lesions to detectability of enhanced chest CT was assessed using logistic regression and chi-square test. Of the 75 target lesions, 34 (45.3%) were detected on enhanced chest CT, corresponding with those on breast sonography; there were no significantly different detection rates among the 4 types of breast composition (p = 0.078). Breast composition [odds ratio (OR) = 1.07, p = 0.206] and enhancement (OR = 21.49, p = 0.998) had no significant effect, but size (OR = 1.23, p = 0.004) was a significant contributing factor influencing the detectability of enhanced chest CT for breast lesions. About half of the cases (45.3%) demonstrated breast lesions on chest CT corresponding with target lesions on sonography. Breast composition defined on mammography did not affect the detectability of enhanced chest CT for breast lesions.

  5. Criteria for the selective use of chest computed tomography in blunt trauma patients

    International Nuclear Information System (INIS)

    Brink, Monique; Dekker, Helena M.; Kool, Digna R.; Blickman, Johan G.; Deunk, Jaap; Edwards, Michael J.R.; Vugt, Arie B. van; Kuijk, Cornelis van

    2010-01-01

    The purpose of this study was to derive parameters that predict which high-energy blunt trauma patients should undergo computed tomography (CT) for detection of chest injury. This observational study prospectively included consecutive patients (≥16 years old) who underwent multidetector CT of the chest after a high-energy mechanism of blunt trauma in one trauma centre. We included 1,047 patients (median age, 37; 70% male), of whom 508 had chest injuries identified by CT. Using logistic regression, we identified nine predictors of chest injury presence on CT (age ≥55 years, abnormal chest physical examination, altered sensorium, abnormal thoracic spine physical examination, abnormal chest conventional radiography (CR), abnormal thoracic spine CR, abnormal pelvic CR or abdominal ultrasound, base excess <-3 mmol/l and haemoglobin <6 mmol/l). Of 855 patients with ≥1 positive predictors, 484 had injury on CT (95% of all 508 patients with injury). Of all 192 patients with no positive predictor, 24 (13%) had chest injury, of whom 4 (2%) had injuries that were considered clinically relevant. Omission of CT in patients without any positive predictor could reduce imaging frequency by 18%, while most clinically relevant chest injuries remain adequately detected. (orig.)

  6. [Contribution of surgical margin for surgical outcome of the chest wall tumors].

    Science.gov (United States)

    Maeda, Sumiko; Yamada, Takehiro; Watanabe, Tatsuaki; Niikawa, Hiromichi; Sado, Tetsu; Noda, Masafumi; Sakurada, Akira; Hoshikawa, Yasushi; Endo, Chiaki; Okada, Yoshinori; Kondo, Takashi

    2014-01-01

    We present here our institutional review of surgical treatment for the chest wall tumors. Chest wall resections were performed on 80 patients, and subsequent chest wall reconstructions were performed on 45 patients. Primary malignant tumors in the chest wall required more extensive rib resections combined with the neighboring structures such as the sternum and the vertebral bones than benign or metastatic/recurrent tumors did. Postoperative mortality and morbidity occurred in 5 patients who underwent the sternal resection and the rib resection combined with the vertebral bodies. Primary malignant tumors in the chest wall are sarcomas originating from the bones, the cartilage tissues, and the soft tissues of the chest wall. We general thoracic surgeons may not have expertise in treating sarcomas,because primary malignant chest wall tumors are rare and a single institution has limited experiences in surgical treatment of such tumors. We should be aware that a surgical margin of primary malignant chest wall tumors is important to achieve excellent local control and better prognosis. We recommend cooperation with an orthopedic oncologist who is experienced with treating sarcomas. Not only preoperative planning but also intraoperative evaluation for the surgical margin with orthopedic oncologists is necessary for better surgical outcome.

  7. Reconstruction of chest wall using a two-layer prolene mesh and bone cement sandwich.

    Science.gov (United States)

    Aghajanzadeh, Manouchehr; Alavi, Ali; Aghajanzadeh, Gilda; Ebrahimi, Hannan; Jahromi, Sina Khajeh; Massahnia, Sara

    2015-02-01

    Wide surgical resection is the most effective treatment for the vast majority of chest wall tumors. This study evaluated the clinical success of chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich. The records of all patients undergoing chest wall resection and reconstruction were reviewed. Surgical indications, the location and size of the chest wall defect, diaphragm resection, pulmonary performance, postoperative complications, and survival of each patient were recorded. From 1998 to 2008, 43 patients (27 male, 16 female; mean age of 48 years) underwent surgery in our department to treat malignant chest wall tumors: chondrosarcoma (23), osteosarcoma (8), spindle cell sarcoma (6), Ewing's sarcoma (2), and others (4). Nine sternectomies and 34 antero-lateral and postero-lateral chest wall resections were performed. Postoperatively, nine patients experienced respiratory complications, and one patient died because of respiratory failure. The overall 4-year survival rate was 60 %. Chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich is a safe and effective surgical procedure for major chest wall defects.

  8. 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.)

  9. 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.

  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. Utility of routine postoperative chest radiography in pediatric tracheostomy.

    Science.gov (United States)

    Genther, Dane J; Thorne, Marc C

    2010-12-01

    Routine chest radiography following pediatric tracheostomy is commonly performed in order to evaluate for air-tracking complications. Routine chest radiography affords disadvantages of radiation exposure and cost. The primary objective of this study was to determine the utility of routine postoperative chest radiography following tracheostomy in pediatric patients. Secondary objectives were to compare the rates of postoperative complications by various patient and surgeon characteristics. All infants and children 18 years of age or less (n=421) who underwent tracheostomy at a single tertiary-care medical center from January 2000 to April 2009 were included in the study. A combination of data obtained from billing and administrative systems and review of electronic medical records were recorded and compiled in a database for statistical analysis. Three air-tracking complications (2 pneumothoraces and 1 pneumomediastinum) were identified in our population of 421 pediatric patients, for an incidence of 0.71% (95% CI: 0.1-2.0%). No significant relationships were found between the incidence of air-tracking complication and surgical specialty, patient age, or type of procedure (elective, urgent/emergent). Our study identified a low rate of pneumothorax and pneumomediastinum following pediatric tracheostomy. In all three cases, the pneumothorax was suspected clinically. This finding suggests that postoperative chest radiography should be reserved for cases where there is suspicion of a complication on the basis of intraoperative findings or clinical parameters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. A support vector machine classifier reduces interscanner variation in the HRCT classification of regional disease pattern in diffuse lung disease: Comparison to a Bayesian classifier

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yongjun; Lim, Jonghyuck; Kim, Namkug; Seo, Joon Beom [Department of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 138-736 (Korea, Republic of); Lynch, David A. [Department of Radiology, National Jewish Medical and Research Center, Denver, Colorado 80206 (United States)

    2013-05-15

    Purpose: To investigate the effect of using different computed tomography (CT) scanners on the accuracy of high-resolution CT (HRCT) images in classifying regional disease patterns in patients with diffuse lung disease, support vector machine (SVM) and Bayesian classifiers were applied to multicenter data. Methods: Two experienced radiologists marked sets of 600 rectangular 20 Multiplication-Sign 20 pixel regions of interest (ROIs) on HRCT images obtained from two scanners (GE and Siemens), including 100 ROIs for each of local patterns of lungs-normal lung and five of regional pulmonary disease patterns (ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation). Each ROI was assessed using 22 quantitative features belonging to one of the following descriptors: histogram, gradient, run-length, gray level co-occurrence matrix, low-attenuation area cluster, and top-hat transform. For automatic classification, a Bayesian classifier and a SVM classifier were compared under three different conditions. First, classification accuracies were estimated using data from each scanner. Next, data from the GE and Siemens scanners were used for training and testing, respectively, and vice versa. Finally, all ROI data were integrated regardless of the scanner type and were then trained and tested together. All experiments were performed based on forward feature selection and fivefold cross-validation with 20 repetitions. Results: For each scanner, better classification accuracies were achieved with the SVM classifier than the Bayesian classifier (92% and 82%, respectively, for the GE scanner; and 92% and 86%, respectively, for the Siemens scanner). The classification accuracies were 82%/72% for training with GE data and testing with Siemens data, and 79%/72% for the reverse. The use of training and test data obtained from the HRCT images of different scanners lowered the classification accuracy compared to the use of HRCT images from the same scanner. For

  13. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    International Nuclear Information System (INIS)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song

    2010-01-01

    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  14. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of)

    2010-12-15

    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  15. Designing A New CAD System for Pulmonary Nodule Detection in High Resolution Computed Tomography (HRCT Images

    Directory of Open Access Journals (Sweden)

    M Bakhshayesh Karam

    2012-07-01

    Full Text Available Background: Lung diseases and lung cancer are among the most dangerous diseases with high mortality in both men and women. Lung nodules are abnormal pulmonary masses and are among major lung symptoms. A Computer Aided Diagnosis (CAD system may play an important role in accurate and early detection of lung nodules. This article presents a new CAD system for lung nodule detection from chest computed tomography (CT images.Methods: Twenty-five adult patients with lung nodules in their CT scan images presented to the National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Tehran, Iran in 2011-2012 were enrolled in the study. The patients were randomly assigned into two experimental (9 female, 6 male, mean age 43±5.63 yrs and control (6 female, 4 male, mean age 39±4.91 yrs groups. A fully-automatic method was developed for detecting lung nodules by employing medical image processing and analysis and statistical pattern recognition algorithms.esults: Using segmentation methods, the lung parenchyma was extracted from 2-D CT images. Then, candidate regions were labeled in pseudo-color images. In the next step, some features of lung nodules were extracted. Finally, an artificial feed forward neural network was used for classification of nodules.Conclusion: Considering the complexity and different shapes of lung nodules and large number of CT images to evaluate, finding lung nodules are difficult and time consuming for physicians and include human error. Experimental results showed the accuracy of the proposed method to be appropriate (P<0.05 for lung nodule detection.

  16. Avaliação da tomografia de alta resolução versus radiografia de tórax na doença intersticial pulmonar na esclerose sistêmica High-resolution computed tomography versus chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Ana Beatriz Cordeiro de Azevedo

    2005-04-01

    Full Text Available OBJETIVO: Avaliar a acurácia da tomografia de alta resolução (TCAR do tórax em relação à radiografia simples (RX do tórax no diagnóstico de doença intersticial pulmonar relacionada à esclerose sistêmica (ES. MATERIAIS E MÉTODOS: Foram realizados TCAR e RX de tórax em póstero-anterior e perfil em 34 pacientes com diagnóstico de ES, segundo critérios do Colégio Americano de Reumatologia, e feita comparação entre as prevalências dos achados radiológicos sugestivos de doença intersticial pulmonar encontradas com estes dois métodos de imagem. RESULTADOS: Foram observadas alterações em 31 (91% das TCAR, enquanto 16 (47% dos RX de tórax se apresentavam alterados. Os achados mais freqüentes à TCAR foram: linhas septais (74%, faveolamento (56% e bandas parenquimatosas (26%, localizados predominantemente nas bases pulmonares. Os RX de tórax demonstraram áreas de infiltrado reticular em 32% dos casos e distorção parenquimatosa em 12% dos pacientes. Em 18 (53% pacientes com RX de tórax normal a TCAR revelou espessamento septal em 55%, vidro fosco em 44%, faveolamento em 38,5% e cistos em 33%. CONCLUSÃO: A TCAR é mais sensível que o RX de tórax para a investigação de envolvimento intersticial pulmonar inicial em pacientes com ES, justificando, em casos incipientes, tratamento com terapia imunossupressora.OBJECTIVE: To compare the accuracy of high-resolution computed tomography (HRCT with chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis (SSc. MATERIALS AND METHODS: HRCT scans and chest radiographs in postero-anterior and lateral views were performed in 34 patients with systemic sclerosis, according to the American College of Rheumatology preliminary criteria for the diagnosis of SSc. The prevalence of radiological findings suggestive of interstitial lung disease in SSc seen on both imaging methods was compared. RESULTS: Interstitial disease was observed on HRCT images of 31 patients

  17. The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas; CT und MRT des erworbenen Cholesteatoms: Prae- und postoperative Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, C.; Czerny, C. [Abteilung fuer Osteologie, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Gstoettner, W. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Frankfurt (Germany); Franz, P. [Univ.-Klinik fuer Hals-Nasen-Ohren-Heilkunde, Wien (Austria)

    2003-03-01

    The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [German] In dieser Arbeit wird die Rolle der hochaufloesenden Computertomographie (HRCT) und der Magnetresonanztomographie (MRT) zur Abklaerung prae- und postoperativ bedingter Komplikationen erworbener Cholesteatome beschrieben. Die Bildgebung wurde sowohl mit der HRCT als auch mit der MRT durchgefuehrt. Die HRCT und die MRT wurden in axialer und koronaler Ebene (auch

  18. Chest physiotherapy in acute bronchiolitis.

    OpenAIRE

    Webb, M S; Martin, J A; Cartlidge, P H; Ng, Y K; Wright, N A

    1985-01-01

    Forty four children with acute bronchiolitis were given twice daily chest physiotherapy in addition to standard supportive measures and were compared with 46 controls who were not given physiotherapy. There was no clinically discernable benefit on the course of their illness.

  19. Chest physiotherapy in acute bronchiolitis.

    Science.gov (United States)

    Webb, M S; Martin, J A; Cartlidge, P H; Ng, Y K; Wright, N A

    1985-11-01

    Forty four children with acute bronchiolitis were given twice daily chest physiotherapy in addition to standard supportive measures and were compared with 46 controls who were not given physiotherapy. There was no clinically discernable benefit on the course of their illness.

  20. Chest compression pauses during defibrillation attempts

    NARCIS (Netherlands)

    Deakin, Charles D.; Koster, Rudolph W.

    2016-01-01

    Purpose of review This article summarizes current knowledge of the causes and consequences of interruption of chest compressions during cardiopulmonary resuscitation. Recent findings Pauses in chest compressions occur during analysis of the heart rhythm, delivery of ventilation, interventions such

  1. Chest Pain in Adolescents—Functional Consequences

    OpenAIRE

    Goodman, Benjamin W.; Pantell, Robert H.

    1984-01-01

    In prospectively evaluating 100 cases of adolescents with chest pain (along with two control groups), 91 were found to have recurrent chest pain; fewer than 5 had a serious organic cause. Significantly higher school absenteeism occurred in patients with either chest or abdominal pain than in patients without pain. Adolescents with chest and abdominal pain were more likely to be high users of medical services than those with no pain. Most adolescents believed that persons their age could have ...

  2. Dose reduction in high-resolution MSCT. Examinations of the chest for early detection of pneumonia in immunocompromised patients

    International Nuclear Information System (INIS)

    Yamamura, J.; Adam, G.; Wedegaertner, U.; Wildberger, J.E.; Dichtl, D.; Nagel, H.D.

    2009-01-01

    Purpose: the purpose of this study was to optimize high-resolution MSCT chest protocols for the evaluation of symptomatic immunosuppressed patients with suspected pneumonia using a dose-simulating program. Materials and methods: using the MSCT (Siemens, Erlangen, Germany), 30 immunosuppressed patients with suspected pneumonia were examined with a low-dose HRCT of the chest (120 kV, 100 eff.mAs and collimation of 4 x 1 mm). A dose-simulating program was used to reconstruct the raw data at four different dose levels (70, 50, 35 und 25 mAs). For dose simulation for each mAs product, the correspondent noise level was added to the data. Images were generated with a slice thickness of 1 mm and 5 mm in the lung window. The images were then evaluated independently by two radiologists and graded on a scale of 1 to 3 points: 1 = no pneumonia, 2 = unclear, 3 = pneumonia. A receiver operating curve (ROC) analysis was performed to calculate the area under the curve (AUC). The actual dosage in mSv was calculated. The sensitivity and specificity were evaluated. Results: out of 30 patients, 7 had a normal chest finding and 23 had pneumonia. The area under the ROC curve (AUC) was 1.0 for every dosage and slice thickness. Infiltrates were detected correctly for all dosage levels. The sensitivity was 100% for all dose levels and slice thicknesses. There was one false positive finding at 35 mAs and 1 mm slice thickness. At this dose level the specificity was reduced to 93%. A reduction to 25 mAs had no influence on the detection of pneumonia. Thus, MSCT examinations of the chest can be performed with 25 mAs without missing the right diagnosis, resulting in an effective dose of 1.15 mSv (men), 1.5 mSv (women) and a CTDIvol of 2.5 mGy. (orig.)

  3. Rate of transformation and normal range about cardiac size and cardiothoracic ratio according to patient position and age at chest radiography of Korean adult man

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Young Cheol [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Lim, Cheong Hwan; Jung, Hong Ryang [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of); Kim, Yun Min [Dept. of Radiotechnology, Wonkwang Health Science University, Iksan (Korea, Republic of); Hong, Dong Hee [Dept. of Radiological Science, Far East University, Eumseong (Korea, Republic of)

    2017-06-15

    Purpose of this study is present the normal range of cardiac size and cardiothoracic ratio according to patient position(chest PA and AP) and age of Korean adult male on digital chest X - ray, And to propose a mutually compatible conversion rate. 1,024 males were eligible for this study, among 1,300 normal chest patients who underwent chest PA and low-dose CT examinations on the same day at the 'S' Hospital Health Examination Center in Seoul From January to December 2014. CS and CTR were measured by Danzer (1919). The mean difference between CS and CTR was statistically significant (p<0.01) in Chest PA (CS 135.48 mm, CTR 43.99%) and Chest AP image (CS 155.96 mm, CTR 51.75%). There was no statistically significant difference between left and right heart in chest PA and AP images(p>0.05). CS showed statistically significant difference between Chest PA (p>0. 05) and Chest AP (p<0.05). The thorax size and CTR were statistically significant (p<0.01) in both age and chest PA and AP. Result of this study, On Chest AP image CS was magnified 15%, CTR was magnified 17% compare with Chest PA image. CS and CTR were about 10% difference by changing posture at all ages.

  4. Computer-aided diagnosis in chest radiography

    NARCIS (Netherlands)

    Ginneken, B. van

    2001-01-01

    Chest radiographs account for more than half of all radiological examinations; the chest is the “mirror of health and disease”. This thesis is about techniques for computer analysis of chest radiographs. It describes methods for texture analysis and segmenting the lung fields and rib cage in a

  5. [Thymoma with Hemorrhage and Necrosis Presenting with Fever and Chest Pain;Report of a Case].

    Science.gov (United States)

    Shiiya, Haruhiko; Sakuraba, Motoki; Tanaka, Akihiko; Ishii, Yasushi; Fukazawa, Yuichiro

    2015-06-01

    A 53-year-old man was admitted to our hospital for treatment of fever and chest pain. Chest computed tomography showed an anterior mediastinal cystic tumor 39×57 mm in size surrounded by fat with edema and left pleural effusion. After one course of antibiotic administration, the edema of fat surrounding the tumor disappeared and the patient underwent scheduled tumor resection with thymectomy through a median sternotomy. Postoperative pathological examination revealed a thymoma of type AB according to the World Health Organization (WHO) classification associated with hemorrhage and necrosis. Cases of thymoma with hemorrhage or necrosis may lead to atypical presentations such as fever, acute chest pain, pleural effusion, and spontaneous regression. Clinicians should be aware of these unusual presentations of chest pain and fever due to thymoma, and consider the possibility of a differential diagnosis of an anterior mediastinal tumor.

  6. Evaluation of mosaic pattern areas in HRCT with Min-IP reconstructions in patients with pulmonary hypertension: Could this evaluation replace lung perfusion scintigraphy?

    International Nuclear Information System (INIS)

    Rossi, A.; Attinà, D.; Borgonovi, A.; Buia, F.; De Luca, F.; Guidalotti, P.L.; Fughelli, P.; Galiè, N.; Zompatori, M.

    2012-01-01

    Purpose: The aim of this study is to evaluate a possible correlation between areas of lung attenuation, found in minimum intensity projection (Min-IP) reconstruction images performed with high resolution computed tomography without contrast medium (HRCT), and areas of lung perfusion alteration, found in lung perfusion scintigraphy (LPS). Materials and methods: Two independent radiologists, unaware of LPS results, evaluated retrospectively a group of 113 patients affected by pulmonary hypertension (HP) of different aetiology. These have been examined in a period of two years in our centre both by spiral computed tomography (CT) with and without contrast-medium and by LPS. The final diagnosis was determined on clinical data, right heart catheterisation and contrast enhanced CT in angiographic phase (CTPA). We reconstructed the Min-IP images of lung parenchyma in all the cases both in HRCT without contrast-medium, and in contrast enhanced CT in angiographic phase (CTPA) in axial, sagittal and coronal planes. The obtained images were qualitatively graded into three categories of pulmonary attenuation: homogeneous, inhomogeneous with non-segmental patchy defects, inhomogeneous with segmental defects. The same criteria of classification were used also for LPS images. In the group of patients with chronic thromboembolic pulmonary hypertension (CTEPH) we also compared the number of areas of lung attenuation found in Min-IP images in HRCT without contrast-medium, and their exact localization, with not perfused areas in LPS. Gold standard for the diagnosis of pulmonary embolism was spiral contrast enhanced CT in angiographic phase (CTPA). Results: In all cases we found exact correspondence between the Min-IP images in HRCT with and without contras agent. The attenuation pattern seen on Min-IP images was concordant with those of LPS in 96 out of 113 patients (85%). In the remaining 17 cases (15%) it was discordant: in 12 cases inhomogeneous in Min-IP images (7 with non

  7. Vacuum-assisted closure device for the management of infected postpneumonectomy chest cavities.

    Science.gov (United States)

    Perentes, Jean Yannis; Abdelnour-Berchtold, Etienne; Blatter, Jeannine; Lovis, Alban; Ris, Hans-Beat; Krueger, Thorsten; Gonzalez, Michel

    2015-03-01

    Infected postpneumonectomy chest cavities may be related to chronic postpneumonectomy empyema or arise in rare situations of necrotizing pneumonia with complete lung destruction where pneumonectomy and pleural debridement are required. We evaluated the safety and efficacy of an intrathoracic vacuum-assisted closure device (VAC) for the treatment of infected postpneumonectomy chest cavities. A retrospective single institution review of all patients with infected postpneumonectomy chest cavities treated by VAC between 2005 and 2013. Patients underwent surgical debridement of the thoracic cavity, muscle flap closure of the bronchial stump when a fistula was present, and repeated intrathoracic VAC dressings until granulation tissue covered the entire chest cavity. After this, the cavity was obliterated by a Clagett procedure and closed. Twenty-one patients (14 men and 7 women) underwent VAC treatment of their infected postpneumonectomy chest cavity. Twelve patients presented with a chronic postpneumonectomy empyema (10 of them with a bronchopleural fistula) and 9 patients with an empyema occurring in the context of necrotizing pneumonia treated by pneumonectomy. In-hospital mortality was 23%. The median duration of VAC therapy was 23 days (range, 4-61 days) and the median number of VAC changes per patient was 6 (range, 2-14 days). Infection control and successful chest cavity closure was achieved in all surviving patients. One adverse VAC treatment-related event was identified (5%). The intrathoracic VAC application is a safe and efficient treatment of infected postpneumonectomy chest cavities and allows the preservation of chest wall integrity. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  8. Two K versus 4 K storage phosphor chest radiography: detection performance and image quality

    NARCIS (Netherlands)

    Koelblinger, Claus; Prokop, Mathias; Weber, Michael; Sailer, Johannes; Cartes-Zumelzu, Fabiola; Schaefer-Prokop, Cornelia

    2007-01-01

    The purpose of this study was to evaluate the effect of matrix size (4-K versus 2-K) in digital storage phosphor chest radiographs on image quality and on the detection of CT-proven thoracic abnormalities. In 85 patients who underwent a CT of the thorax, we obtained two additional posteroanterior

  9. 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)

  10. [Anterior chest wall examination reviewed].

    Science.gov (United States)

    Lo Monaco, A; Santilli, D; Trotta, F

    2002-01-01

    Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondyloarthritides 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.

  11. Anterior chest wall examination reviewed

    OpenAIRE

    F. Trotta; D. Santilli; A. Lo Monaco

    2011-01-01

    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 er...

  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 wall and hemidiaphragm reconstruction with Gore-Tex mesh and omolateral latissimus dorsi flap. A case report.

    Science.gov (United States)

    Benzo, L; Datta, G; Pau, S; Oliaro, E; Mossetti, C; Ruffini, E; Filosso, P L; Cristofori, R; Oliaro, A

    2008-12-01

    There are various method of reconstruction when chest wall resection is performed for the treatment of tumors of the chest wall. In this case a chest wall resection and reconstruction was performed using an omolateral latissimus dorsi flap, together with Gore-Tex mesh. A 42-year-old woman was diagnosed as having a huge low grade chondrosarcoma and underwent surgical resection which interested the anterior chest wall from the level of the IV to X rib and the right hemidiaphragm. Gore-Tex mesh was fixed to the residual chest wall and an ipsilateral pedicled latissimus dorsi muscle flap was placed on the alloplastic mesh. The patient was discharged from the hospital 17 days postoperatively. The postoperative course was uneventful and the wound was fine.

  14. Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?

    Directory of Open Access Journals (Sweden)

    Oshaug K

    2013-07-01

    Full Text Available Katja Oshaug, Peder A Halvorsen, Hasse Melbye General Practice Research Unit, University of Tromsø, Tromsø, Norway Background: Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD in established guidelines. Aims: We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods: In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results: Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7, followed by diminished breath sounds (OR = 5.0, and thirdly wheezes (OR = 2.3. These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion: We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. Keywords: diagnosis, COPD, physical chest examination, spirometry

  15. Glycoprotein YKL-40 Levels in Plasma Are Associated with Fibrotic Changes on HRCT in Asbestos-Exposed Subjects

    Directory of Open Access Journals (Sweden)

    Tuija Väänänen

    2017-01-01

    Full Text Available YKL-40 is a chitinase-like glycoprotein produced by alternatively activated macrophages that are associated with wound healing and fibrosis. Asbestosis is a chronic asbestos-induced lung disease, in which injury of epithelial cells and activation of alveolar macrophages lead to enhanced collagen production and fibrosis. We studied if YKL-40 is related to inflammation, fibrosis, and/or lung function in subjects exposed to asbestosis. Venous blood samples were collected from 85 men with moderate or heavy occupational asbestos exposure and from 28 healthy, age-matched controls. Levels of plasma YKL-40, CRP, IL-6, adipsin, and MMP-9 were measured with enzyme-linked immunosorbent assay (ELISA. Plasma YKL-40 levels were significantly higher in subjects with asbestosis (n=19 than in those with no fibrotic findings in HRCT following asbestos exposure (n=66 or in unexposed healthy controls. In asbestos-exposed subjects, plasma YKL-40 correlated negatively with lung function capacity parameters FVC (Pearson’s r −0.259, p=0.018 and FEV1 (Pearson’s r −0.240, p=0.028 and positively with CRP (Spearman’s rho 0.371, p<0.001, IL-6 (Spearman’s rho 0.314, p=0.003, adipsin (Spearman’s rho 0.459, p<0.001, and MMP-9 (Spearman’s rho 0.243, p=0.025. The present finding suggests YKL-40 as a biomarker associated with fibrosis and inflammation in asbestos-exposed subjects.

  16. Vascularized rib support for chest wall reconstruction using Gore-Tex dual mesh after wide sternochondral resection.

    Science.gov (United States)

    Akiba, Tadashi; Takeishi, Meisei; Kinoshita, Satoki; Morikawa, Toshiaki

    2011-11-01

    Only a few reports describe chest wall reconstruction after sternal resection using Gore-Tex dual mesh, and very few reports describe the use of a vascularized rib to support the thoracic cage. We present a case of a breast cancer patient who underwent anterior chest wall resection for recurrent sternal cancer. Her sternoclavicular joints bilaterally and lower sternum were divided using an electric saw. The bony chest wall was reconstructed using Gore-Tex dual mesh, and a vascularized rib was used to bridge the space between the clavicular heads to support the thoracic cage. The patient's postoperative course was uneventful, without complications, such as paradoxical respiration or pneumonia.

  17. High sensitive C-reactive protein assessment in patients with typical chest pain and normal coronary arteriography

    International Nuclear Information System (INIS)

    Lv Xiaojiong; Qiu Jianping

    2005-01-01

    Objective: To determine the changes of high-sensitive serum C-reactive protein (hs-CRP) in patients with typical chest pain and normal coronary arteriography. Methods: One hundred and twenty three patients were included. CRP was determined using a standard technique, and all patients underwent ECG exercise testing. Results: Plasma level of hs-CRP was significantly increased in patients with typical chest pain, coronary arteriography negative and exercise test positive. Conclusion: Inflammation may play a role in the mechanism of chest pain for patients with normal coronary angiography. (authors)

  18. Chest Pain: The Need to Consider Less Frequent Diagnosis

    Directory of Open Access Journals (Sweden)

    Pedro Magalhães

    2016-01-01

    Full Text Available Chest pain is one of the most frequent patient’s complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.

  19. The image variations in mastoid segment of facial nerve and sinus tympani in congenital aural atresia by HRCT and 3D VR CT.

    Science.gov (United States)

    Wang, Zhen; Hou, Qian; Wang, Pu; Sun, Zhaoyong; Fan, Yue; Wang, Yun; Xue, Huadan; Jin, Zhengyu; Chen, Xiaowei

    2015-09-01

    To find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images. HRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n=25, 21 males, 4 females, mean age 13.8 years, range 6-19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients. On the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (Patresia group is larger (P<0.05). The shapes of the sinus tympani were classified into three categories: the cup-shaped, the pear-shaped and the boot-shaped. Area measurement indicated that the boot-shaped sinus tympani was a special variation with a large area, which only appears in CAA group. There were a significant difference between the area of the boot-shaped group and the other two groups (P<0.05). The morphologic differences of ST and other middle ear structures can also be observed visually in 3D VR CT images. HRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Diagnostic Accuracy of Chest Ultrasonography versus Chest Radiography for Identification of Pneumothorax: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Ebrahimi, Ali; Mohammad Kazemi, Hossein; Rasouli, Hamid Reza; Asady, Hadi; Moghadas Jafari, Ali; Hosseini, Mostafa

    2014-01-01

    Background Early detection of pneumothorax is critically important. Several studies have shown that chest ultrasonography (CUS) is a highly sensitive and specific tool. The present systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of CUS and chest radiography (CXR) for detection of pneumothorax. Materials and Methods The literature search was conducted using PubMed, EMBASE, Cochrane, CINAHL, SUMSearch, Trip databases, and review article references. Eligible articles were defined as diagnostic studies on patients suspected for pneumothorax who underwent chest computed tomography (CT) scan and those assessing the screening role of CUS and CXR. Results The analysis showed the pooled sensitivity and specificity of CUS were 0.87 (95% CI: 0.81-0.92; I2= 88.89, Pultrasound performed by the emergency physician was higher than by non-emergency physician. Non-trauma setting was associated with higher pooled sensitivity (0.90; 95% CI: 0.83 – 0.98) and lower specificity (0.97; 95% CI: 0.95 – 0.99). Conclusion The present meta-analysis showed that the diagnostic accuracy of CUS was higher than supine CXR for detection of pneumothorax. It seems that CUS is superior to CXR in detection of pneumothorax, even after adjusting for possible sources of heterogeneity. PMID:25852759

  1. 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

  2. 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.)

  3. An alternative technique for anterior chest wall reconstruction: the sternal allograft transplantation.

    Science.gov (United States)

    Dell'Amore, Andrea; Cassanelli, Nicola; Dolci, Giampiero; Stella, Franco

    2012-12-01

    Sternal resection is indicated for a variety of pathological conditions, mainly neoplastic or related to sternotomy complications. Resection of the sternum generally leaves a large chest-wall defect, and reconstruction is thus the most difficult part of the operation. Correct stabilization of the anterior chest wall is very important to avoid secondary complications and respiratory failure. In the last few years, different technical solutions have been used to reconstruct the sternum. We describe our technique using a sternal allograft to reconstruct the anterior chest wall after partial or complete sternal resection. Between June 2010 and February 2012, four patients underwent sternectomy followed by anterior chest wall reconstruction using sternal allograft. The sternal allograft was harvested from a multitissue donor following Italian legislation for tissue donation. Three patients had neoplastic involvement of the sternum, and one had a complete sternal defect as a complication of a cardiac operation. We had no operative mortality. Three patients underwent partial sternal transplantation, and one underwent total sternal replacement. We had no postoperative respiratory insufficiency, infections or mechanical failure of the reconstructions. The respiratory function was preserved in all patients. The follow-up period was free from complications related to the sternal allograft implantation. The technique of sternal allograft transplantation is simple, reproducible and provides excellent functional and cosmetic results. Further studies including a larger number of patients are needed to understand the biology of the allograft and the long-term results of this technique.

  4. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    International Nuclear Information System (INIS)

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco

    2009-01-01

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of 99m Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  5. Risk Factors for Chest Pain and Fever in Patients Undergoing Pleurodesis with OK-432.

    Science.gov (United States)

    Morimoto, Yoshihito; Takei, Hidefumi; Tachibana, Keisei; Nakazato, Yoko; Tanaka, Ryota; Nagashima, Yasushi; Watanabe, Kazuhiro; Seki, Reisuke; Shinohara, Takao; Kondo, Haruhiko

    2018-02-09

    Objective In Japan, pleurodesis is often performed using OK-432. However, OK-432 may cause severe chest pain and fever. The risk factors for these complications are unclear. The aim of this study was to identify the risk factors for chest pain and fever caused by pleurodesis with OK-432. Methods The clinical data of 94 patients who underwent pleurodesis with OK-432 were retrospectively analyzed. Patients who developed chest pain (indicated by a record of rescue pain medication) and/or fever (a recorded temperature of >38°C) were identified. A logistic regression analysis was performed to determine the risk factors for these complications. Results Rescue medication for chest pain was required by 43.6% of the patients and 40.4% developed pyrexia after pleurodesis with OK-432. The univariate analysis showed that the likelihood of requiring rescue medication for chest pain was significantly increased in patients of OK-432. Furthermore, caution is advised when managing chest pain in adults of <70 years of age. Prospective studies should be performed to further investigate this issue.

  6. The role of chest physiotherapy in prevention of postextubation atelectasis in pediatric patients with neuromuscular diseases.

    Science.gov (United States)

    Bilan, Nemat; Poorshiri, Bita

    2013-01-01

    There are controversial findings in the literature on the effects of chest physiotherapy on postextubation lung collapse in pediatric age group. Therefore, we aimed to investigate the efficacy of chest physiotherapy in prevention of postextubation atelectasis in pediatric patients. In a case-control study from March 2007 to March 2011, two groups of patients (35 patients in each group) susceptible to lung collapse were enrolled in the study. The studied patients had neuromuscular diseases such as spinal muscular atrophy, Guillain-Barre syndrome, critical illness polyneuropathy/myopathy, and cerebral palsy. The patients were randomly divided into two groups (case and control); The case group underwent daily chest physiotherapy through vibrator and chest percussion and the control group was under supervision. In the latter group, the underlying disease was treated and the lung collapse was managed, if occurred. The frequency of atelectasis was lower in the case group who received prophylactic chest physiotherapy compared to the control group (16.6% vs. 40%). Chest physiotherapy as well as appropriate and regular change of position can considerably reduce the rate of pulmonary collapse in pediatric patients.

  7. A novel high vacuum chest drainage system - a pilot study.

    Science.gov (United States)

    Mrówczyński, Wojciech; Tille, Jean-Christophe; Khabiri, Ebrahim; Giliberto, Jean-Pierre; Courvoisier, Delphine S; Kalangos, Afksendiyos; Walpoth, Beat H

    2014-09-01

    To assess the safety and feasibility of use of a novel high vacuum chest drainage system (HVCDS) and its influence on the cardiovascular system compared to a conventional system (CCDS). Five anesthetized pigs underwent a median sternotomy. Three drains were placed in retrocardiac, retrosternal and left pleural positions. The animals received a HVCDS (22 Fr with 180 2-mm holes, n = 2) or a CCDS (n = 2). In the fifth animal off pump coronary artery bypass graft (OPCABG) stabilizers were tested. After chest closure animals had three 30 min runs of artificial bleeding (5 ml/min) under different negative aspiration pressures (-2, -20, -40 kPa) for both groups, followed by standardized surgical bleeding (-40 kPa - HVCDS, - 2 kPa - CCDS). Hemodynamic parameters and each drain's output were registered every 5 minutes and the residual blood was assessed. All catheters, the heart and left lung underwent macroscopic and histopathological examination. The application of the different pressures showed neither hemodynamic changes nor differences in blood drainage with both systems in two bleeding models. The HVCDS enabled drainage comparable to the CCDS but showed relevant clotting. Application of -20 kPa and -40 kPa caused macroscopic epicardial and pulmonary lesions in all tested devices including OPCABG stabilizers consisting of sub-epicardial or sub-pleural hemorrhage without myocyte or alveolar damage. The novel and conventional chest drainage systems used at pressures up to 40 kPa induced no hemodynamic instability. Both systems showed adequate equal drainage, despite major HVCDS clotting. High negative pressure drainage with both systems showed focal sub-epicardial and subpleural hemorrhage. Thus, long-term assessment of high pressure drainage and potential interaction with fragile structures (coronary bypass graft) should be carried out.

  8. Reconstruction of Anterior Chest Wall with Polypropylene Mesh: Two Primary Sternal Chondrosarcoma Cases.

    Science.gov (United States)

    Kawana, Shinichi; Yamamoto, Hiromasa; Maki, Yuho; Sugimoto, Seiichiro; Toyooka, Shinichi; Miyoshi, Shinichiro

    2017-06-01

     Primary sternal chondrosarcoma is a rare malignant tumor that is refractory to chemotherapy and radiation. Effective therapy is radical resection of the tumor. We present two patients with primary sternal chondrosarcoma who underwent a radical resection of the lower half of the sternum and bilateral ribs, followed by reconstruction with 2 sheets of polypropylene mesh layered orthogonally. The patients have maintained almost the same pulmonary function as preoperative values, with stability of the chest wall. Although there are various ways to reconstruct the anterior chest wall, reconstruction with polypropylene mesh layered orthogonally is an easy-to-use and sufficient method.

  9. 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.

  10. 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.

  11. 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

  12. The natural history of flail chest injuries

    Directory of Open Access Journals (Sweden)

    Kamil Naidoo

    2017-10-01

    Full Text Available Purpose: Flail chest (FC injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC. Methods: A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients (age > 16 years sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Results: Two hundred and ninety-three patients were identified, with a mean injury severity score (ISS of 28.9 (range 9–75, average age of 56.1 years (range of 16–100, and a male predominance (78%. Road traffic accidents accounted for 45% (n = 132 of injuries, whilst 44% were fall or jump from height (n = 129.Associated lung contusion was present in 133 patients (45% while 76% of patients were found to have 5 or more ribs involved in the flail segment (n = 223 with 96% (n = 281 having a unilateral FC. Inpatient treatment was required 19.9 days (range 0–150 days with 59% of patients (n = 173 requiring intensive care unit (ICU level care for 8.4 days (range 1–63 with 61.8% requiring mechanical ventilation (n = 107 for 10.5 days (range 1–54, and 7.8% underwent rib fixation with rib plates (n = 23.The mortality rate was found to be 14% (n = 42. A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days (6.94 vs 10.06, p = 0.18 intensive treatment unit (ITU length of stay (LOS (12.56 vs 15.53, p = 0.28 and hospital LOS (32

  13. "Anterior convergent" chest probing in rapid ultrasound transducer positioning versus formal chest ultrasonography to detect pneumothorax during the primary survey of hospital trauma patients: a diagnostic accuracy study.

    Science.gov (United States)

    Ziapour, Behrad; Haji, Houman Seyedjavady

    2015-01-01

    Occult pneumothorax represents a diagnostic pitfall during the primary survey of trauma patients, particularly if these patients require early positive pressure ventilation. This study investigated the accuracy of our proposed rapid model of ultrasound transducer positioning during the primary survey of trauma patients after their arrival at the hospital. This diagnostic trial was conducted over 12 months and was based on the results of 84 ultrasound (US) exams performed on patients with severe multiple trauma. Our index test (US) was used to detect pneumothorax in four pre-defined locations on the anterior of each hemi-thorax using the "Anterior Convergent" approach, and its performance was limited to the primary survey. Consecutively, patients underwent chest-computed tomography (CT) with or without chest radiography. The diagnostic findings of both chest radiography and chest ultrasounds were compared to the gold-standard test (CT). The diagnostic sensitivity was 78 % for US and 36.4 % for chest radiography (p radiography (not significant); the positive predictive values were 74 % for US and 80 % for chest radiography (not significant); the negative predictive values were 94 % for US and 87 % for chest radiography (not significant); the positive likelihood ratio was 10 for US and 18 for chest radiography (p = 0.007); and the negative likelihood ratio was 0.25 for US and 0.65 for chest radiography (p = 0.001). The mean required time for performing the new method was 64 ± 10 s. An absence of the expected diffused dynamic view among ultrasound images obtained from patients with pneumothorax was also observed. We designated this phenomenon "Gestalt Lung Recession." "Anterior convergent" chest US probing represents a brief but efficient model that provides clinicians a safe and accurate exam and adequate resuscitation during critical minutes of the primary survey without interrupting other medical staff activities taking place around the trauma

  14. How Often is Chest Radiography Ordered for Patients with Pediatric Asthma?

    Directory of Open Access Journals (Sweden)

    Serap Özmen

    2017-08-01

    Full Text Available Objective: Although many children with asthma can be diagnosed clinically, chest radiographs are routinely requested in asthma attacks. The aim of this study is to determine how often chest radiographs are requested and the factors affecting these requests in pediatric patients with asthma. Methods: This cross-sectional study was performed by studying the electronic radiographic records of pediatric patients with asthma who were referred to our Pediatric Allergy and Immunology Department over a six-month period. A questionnaire was designed to obtain further information from the parents of the patients. Results: The records of 100 children with bronchial asthma, aged 21 to 192 months, were evaluated. The average number of chest radiographs was 3.9±3.8 (between 1-30. Fifty-one percent of the children underwent three or more chest radiographs. There was a positive correlation between the number of chest X-rays before asthma diagnosis and the frequency of antibiotic usage (r=0.222, p=0.026. An inverse correlation was found between the number of chest radiographs and the patients’ ages and the age at which asthma was diagnosed (r=−0.335, p=0.001; r=−0.211, p=0.035, respectively. In contrast, there was a positive correlation between the number of chest X-rays and the number of hospital admissions (r=0.205, p=0.040. A positive correlation between the frequency of antibiotic usage and the annual number of hospital admissions was determined (r=0.428, p=0.000. Furthermore, a positive correlation between the frequency of antibiotic usage and the frequency of asthma attacks was observed (r=0.292, p=0.003. Conclusion: The results of our study show that the use of chest radiographs is high in cases of childhood asthma, especially in younger children.

  15. 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.

  16. Complicações pulmonares após uso de crack: achados na tomografia computadorizada de alta resolução do tórax Pulmonary complications of crack cocaine use: high-resolution computed tomography of the chest

    Directory of Open Access Journals (Sweden)

    Alexandre Mançano

    2008-05-01

    Full Text Available Relatamos os achados na tomografia computadorizada de alta resolução de um paciente que, após uso de cocaína fumada (crack, desenvolveu quadro de hemoptise, dispnéia e dor torácica súbitas. As radiografias de tórax mostravam consolidações predominando em lobos superiores. A tomografia de alta resolução evidenciava opacidades em vidro fosco, consolidações e nódulos do espaço aéreo. Nova tomografia de controle, após suspensão da droga e uso de corticóides, mostrou regressão parcial das lesões e aparecimento de escavações. A correlação entre os achados clínicos, laboratoriais e de imagem permitiu o diagnóstico de "pulmão de crack".Here, we report high-resolution computed tomography (HRCT findings in a patient who developed sudden hemoptysis, dyspnea and chest pain after smoking crack cocaine. Chest X-rays showed consolidations, primarily in the upper lobes, and HRCT scans showed ground glass attenuation opacities, consolidations and air-space nodules. A follow-up CT, after drug use discontinuation and administration of corticosteroids, showed partial resolution of pulmonary lesions and the appearance of cavitations. Clinical, imaging and laboratory findings led to a diagnosis of 'crack lung'.

  17. 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%) ...

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

    African Journals Online (AJOL)

    Patients had postero-anterior (PA) chest radiographs done in full inspiration, with a Roentgen 301 radiographic machine (GEC Medical) using the following factors; KVp = 65, focus-film distance = 150cm and 12 – 15mAs. A total of 308 confirmed HIV- positive patients had chest radiographic examinations. Ninety-nine ...

  19. Determinants of Mortality in Chest Trauma Patients

    African Journals Online (AJOL)

    Department of Surgery, Cardiothoracic Surgery Unit, 1Department of Anaesthesia, University of Uyo Teaching Hospital,. Uyo, Akwa Ibom State, Nigeria ... presentation beyond 24 h post trauma and severe chest injury with bilateral chest .... was validated and used on surgical intensive care unit admission in 2000.[14] Other ...

  20. Chest pain in sickle cell disease

    NARCIS (Netherlands)

    Tonino, S. H.; Nur, E.; Otten, H. M.; Wykrzykowska, J. J.; Hoekstra, J. B. L.; Biemond, B. J.

    2013-01-01

    The differential diagnosis of chest pain in a patient with sickle cell disease is difficult and may encompass several serious conditions, including chest syndrome, pulmonary embolism and infectious complications. In this manuscript we provide an overview on the various underlying diseases that may

  1. Making the GRADE: CHEST Updates Its Methodology.

    Science.gov (United States)

    Diekemper, Rebecca L; Patel, Sheena; Mette, Stephen A; Ornelas, Joseph; Ouellette, Daniel R; Casey, Kenneth R

    2018-03-01

    The American College of Chest Physicians (CHEST) has been at the forefront of evidence-based clinical practice guideline development for more than 2 decades. In 2006, CHEST adopted a modified system of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to support their rigorous guideline development methodology. The evolution of CHEST's Living Guidelines Model, as well as their collaborative efforts with other organizations, has necessitated improvements in their guideline development methodology. CHEST has made the decision to transition to the standard GRADE method for rating the certainty of evidence and grading recommendations in their evidence-based clinical practice guidelines, a deviation from the modified approach that was adopted in 2006. The standard GRADE approach will be used to grade recommendations in all CHEST guidelines, including updates to previously published guidelines. CHEST's adoption of a standard GRADE approach will ensure that its guideline development methodology is more consistent with that used by other organizations, will better align evidence synthesis methods, and will result in more explicit and easy to understand recommendations. Copyright © 2016 American College of Chest Physicians. All rights reserved.

  2. [Rare primary chest wall sarcoma: the synovialosarcoma].

    Science.gov (United States)

    Fekih, L; Boussoffara, L; Fenniche, S; Abdelghaffar, H; Akrout, I; Ayadi, A; Megdiche, M-L

    2011-05-01

    Malignant primary tumours occurring in the thorax encompass a large group of tumours which may arise from the lung, mediastinal structures, the pleura or the chest wall. We report the case of a 37 year old patient, who presented with left sided chest pain. On clinical examination a right sided chest wall mass was identified. Chest X Ray showed a left sided upper mediastinal opacity, associated with a left sided pleural opacity. Thoracic CT scan revealed a large mass arising from the chest wall and infiltrating the mediastinum associated with a second chest wall mass at the level of the 8(th) and 9(th) right ribs. The biopsy of the chest wall mass revealed it to be a parietal synovialosarcoma. The patient responded to chemotherapy based on ifosfamid and doxorubicin as well as mediastino-pulmonary radiotherapy. There was an improvement in the patient's clinical and radiological state but the patient died by pulmonary embolism after the 3(rd) cause of treatment. Chest wall synovialosarcoma has a poor prognosis, however, its chemosensitivity means that treatment may initially be effective. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  3. 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)

  4. Safety, feasibility, and results of exercise testing for stratifying patients with chest pain in the emergency room

    Directory of Open Access Journals (Sweden)

    Renato Machado Macaciel

    2003-08-01

    Full Text Available OBJECTIVE: To assess safety, feasibility, and the results of early exercise testing in patients with chest pain admitted to the emergency room of the chest pain unit, in whom acute myocardial infarction and high-risk unstable angina had been ruled out. METHODS: A study including 1060 consecutive patients with chest pain admitted to the emergency room of the chest pain unit was carried out. Of them, 677 (64% patients were eligible for exercise testing, but only 268 (40% underwent the test. RESULTS: The mean age of the patients studied was 51.7±12.1 years, and 188 (70% were males. Twenty-eight (10% patients had a previous history of coronary artery disease, 244 (91% had a normal or unspecific electrocardiogram, and 150 (56% underwent exercise testing within a 12-hour interval. The results of the exercise test in the latter group were as follows: 34 (13% were positive, 191 (71% were negative, and 43 (16% were inconclusive. In the group of patients with a positive exercise test, 21 (62% underwent coronary angiography, 11 underwent angioplasty, and 2 underwent myocardial revascularization. In a univariate analysis, type A/B chest pain (definitely/probably anginal (p<0.0001, previous coronary artery disease (p<0.0001, and route 2 (patients at higher risk correlated with a positive or inconclusive test (p<0.0001. CONCLUSION: In patients with chest pain and in whom acute myocardial infarction and high-risk unstable angina had been ruled out, the exercise test proved to be feasible, safe, and well tolerated.

  5. Solitary Plasmacytoma of the Chest Wall

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-03-01

    Full Text Available A previously healthy 55-year-old man with right sided lateral chest pain admitted to clinic. It was found a solid and painful mass at the right 4th rib in physical examination. Chest X-ray and thoracic computarized tomography showed an opacity measured 60x33 mm within the right chest wall destructing the 4th rib. Needle aspiration was performed from tumor and cytologic examination showed atypic plasma cell infiltration. The patient was scheduled for a chest wall resection and reconstructive surgery. Examination of a permanent section showed that the chest wall tumor was solitary plasmacytoma. There was no evidence of multiple myeloma recurrence after two years from the operation.

  6. Regionally adaptive histogram equalization of the chest.

    Science.gov (United States)

    Sherrier, R H; Johnson, G A

    1987-01-01

    Advances in the area of digital chest radiography have resulted in the acquisition of high-quality images of the human chest. With these advances, there arises a genuine need for image processing algorithms specific to the chest, in order to fully exploit this digital technology. We have implemented the well-known technique of histogram equalization, noting the problems encountered when it is adapted to chest images. These problems have been successfully solved with our regionally adaptive histogram equalization method. With this technique histograms are calculated locally and then modified according to both the mean pixel value of that region as well as certain characteristics of the cumulative distribution function. This process, which has allowed certain regions of the chest radiograph to be enhanced differentially, may also have broader implications for other image processing tasks.

  7. [Dose reduction in high-resolution MSCT examinations of the chest for early detection of pneumonia in immunocompromised patients].

    Science.gov (United States)

    Yamamura, J; Wildberger, J E; Nagel, H-D; Dichtl, D; Adam, G; Wedegärtner, U

    2009-06-01

    The purpose of this study was to optimize high-resolution MSCT chest protocols for the evaluation of symptomatic immunosuppressed patients with suspected pneumonia using a dose-simulating program. Using the MSCT (Siemens, Erlangen, Germany), 30 immunosuppressed patients with suspected pneumonia were examined with a low-dose HRCT of the chest (120 kV, 100 eff.mAs and collimation of 4 x 1 mm). A dose-simulating program was used to reconstruct the raw data at four different dose levels (70, 50, 35 und 25 mAs). For dose simulation for each mAs product, the correspondent noise level was added to the data. Images were generated with a slice thickness of 1 mm and 5 mm in the lung window. The images were then evaluated independently by two radiologists and graded on a scale of 1 to 3 points: 1 = no pneumonia, 2 = unclear, 3 = pneumonia. A receiver operating curve (ROC) analysis was performed to calculate the area under the curve (AUC). The actual dosage in mSv was calculated. The sensitivity and specificity were evaluated. Out of 30 patients, 7 had a normal chest finding and 23 had pneumonia. The area under the ROC curve (AUC) was 1.0 for every dosage and slice thickness. Infiltrates were detected correctly for all dosage levels. The sensitivity was 100 % for all dose levels and slice thicknesses. There was one false positive finding at 35 mAs and 1 mm slice thickness. At this dose level the specificity was reduced to 93 %. A reduction to 25 mAs had no influence on the detection of pneumonia. Thus, MSCT examinations of the chest can be performed with 25 mAs without missing the right diagnosis, resulting in an effective dose of 1.15 mSv (men), 1.5 mSv (women) and a CTDIvol of 2.5 mGy. For the evaluation of pneumonia in immunocompromised patients, MSCT examination of the chest can be performed with 25 mAs. Thus, radiation exposure was reduced to a quarter compared to the standard protocol.

  8. The significance of collateral vessels, as seen on chest CT, in predicting SVC obstruction

    International Nuclear Information System (INIS)

    Yeouk, Young Soo; Kim, Sung Jin; Bae, Il Hun; Kim, Jae Youn; Hwang, Seung Min; Han, Gi Seok; Park, Kil Sun; Kim, Dae Young

    1998-01-01

    To evaluate the significance of collateral veins, as seen on chest CT, in the diagnosis of superior vena cava obstruction. We retrospectively the records of 81 patients in whom collateral veins were seen on chest CT. On spiral CT(n=49), contrast material was infused via power injector, and on conventional CT(n=32), 50 ml bolus infusion was followed by 50 ml drip infusion. Obstruction of the SVC was evaluated on chest CT; if, however, evaluation of the SVC of its major tributaries was difficult, as in five cases, the patient underwent SVC phlebography. Collateral vessels were assigned to one of ten categories. On conventional CT, the jugular venous arch in the only collateral vessel to predict SVC obstruction; on spiral CT, however, collateral vessels are not helpful in the diagnosis of SVC obstruction, but are a nonspecific finding. (author). 12 refs., 2 tab., 2 figs

  9. Association of chest pain and risk of cardiovascular disease with coronary atherosclerosis in patients with inflammatory joint diseases

    Directory of Open Access Journals (Sweden)

    Silvia eRollefstad

    2015-11-01

    Full Text Available Objectives: The relation between chest pain and coronary atherosclerosis (CA in patients with inflammatory joint diseases (IJD has not been explored previously. Our aim was to evaluate the associations of the presence of chest pain and the predicted 10-year risk of cardiovascular disease (CVD by use of several CVD risk algorithms, with multi-detector computer tomography (MDCT coronary angiography verified CA. Methods: Detailed information concerning chest pain and CVD risk factors was obtained in 335 patients with rheumatoid arthritis (RA and ankylosing spondylitis (AS. In addition, 119 of these patients underwent MDCT coronary angiography.Results: Thirty-one percent of the patients (104/335 reported chest pain. Only 6 patients (1.8% had atypical angina pectoris (pricking pain at rest. In 69 patients without chest pain, two thirds had CA, while in those who reported chest pain (n=50, CA was present in 48.0%. In a logistic regression analysis, chest pain was not associated with CA (dependent variable (p=0.43. About 30% (Nagelkerke R2 of CA was explained by any of the CVD risk calculators: SCORE, Framingham Risk Score or Reynolds Risk Score.Conclusion: The presence of chest pain was surprisingly infrequently reported in patients with IJD who were referred for a CVD risk evaluation. However, when present, chest pain was weakly associated with CA, in contrast to the predicted CVD risk by several risk calculators which was highly associated with the presence of CA. These findings suggest that clinicians treating patients with IJD should be alert of coronary atherosclerotic disease also in absence of chest pain symptoms.

  10. Tuberculosis contact investigation using interferon-gamma release assay with chest x-ray and computed tomography.

    Science.gov (United States)

    Fujikawa, Akira; Fujii, Tatsuya; Mimura, Satoshi; Takahashi, Ryota; Sakai, Masao; Suzuki, Shinya; Kyoto, Yukishige; Uwabe, Yasuhide; Maeda, Shinji; Mori, Toru

    2014-01-01

    Between September 2009 and January 2010, 6 members of the Japanese Eastern Army, who had completed the same training program, were diagnosed with active tuberculosis (TB) on different occasions. The Ministry of Defense conducted a contact investigation of all members who had come into contact with the infected members. The purpose of this study was to verify the efficacy of the TB screening protocol used in this investigation. A total of 884 subjects underwent interferon-gamma release assay (IGRA) and chest X-ray. The 132 subjects who were IGRA positive or with X-ray findings suggestive of TB subsequently underwent chest computer tomography (CT). Chest CT was performed for 132 subjects. Based on CT findings, 24 (2.7%) subjects were classified into the active TB group, 107 (12.1%) into the latent tuberculosis infection (LTBI) group, and 753 (85.2%) into the non-TB group. The first 2 groups underwent anti-TB therapy, and all 3 groups were followed for 2 years after treatment. Although one subject in the active TB group experienced relapse during the follow-up period, no patient in the LTBI or non-TB groups developed TB. IGRA and chest X-ray, followed by chest CT for those IGRA positive or with suspicious X-ray findings, appears to be an effective means of TB contact screening and infection prevention.

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

    Science.gov (United States)

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

    2016-01-01

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

  12. 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.

  13. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

    International Nuclear Information System (INIS)

    Joegi, Jonas; Bajc, Marika; Ekberg, Marie; Jonson, Bjoern; Bozovic, Gracijela

    2011-01-01

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV 1 ). FEV 1 does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV 1 , symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be reported. V

  14. Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Joegi, Jonas; Bajc, Marika [Lund University, Skaane University Hospital, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Ekberg, Marie [Lund University, Skaane University Hospital, Department of Respiratory Medicine and Allergology, Institution of Clinical Sciences, Lund (Sweden); Jonson, Bjoern [Lund University, Department of Clinical Physiology, Institution of Clinical Sciences, Lund (Sweden); Bozovic, Gracijela [Lund University, Skaane University Hospital, Department of Radiology, Institution of Clinical Sciences, Lund (Sweden)

    2011-07-15

    Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation which is not fully reversible. Despite the heterogeneity of COPD, its diagnosis and staging is currently based solely on forced expiratory volume in 1 s (FEV{sub 1}). FEV{sub 1} does not explain the underlying pathophysiology of airflow limitation. The relationship between FEV{sub 1}, symptoms and emphysema extent is weak. Better diagnostic tools are needed to define COPD. Tomographic lung scintigraphy [ventilation/perfusion single photon emission tomography (V/P SPECT)] visualizes regional V and P. In COPD, relations between V/P SPECT, spirometry, high-resolution computed tomography (HRCT) and symptoms have been insufficiently studied. The aim of this study was to investigate how lung function imaging and obstructive disease grading undertaken using V/P SPECT correlate with symptoms, spirometric lung function and degree of emphysema assessed with HRCT in patients with COPD. Thirty patients with stable COPD were evaluated with the Medical Research Council dyspnoea questionnaire (MRC) and the clinical COPD questionnaire (CCQ). Spirometry was performed. The extent of emphysema was assessed using HRCT. V/P SPECT was used to assess V/P patterns, total reduction in lung function and degree of obstructive disease. The total reduction in lung function and degree of obstructive disease, assessed with V/P SPECT, significantly correlated with emphysema extent (r = 0.66-0.69, p < 0.0001) and spirometric lung function (r = 0.62-0.74, p < 0.0005). The correlation between emphysema extent and spirometric lung function was weaker. No correlation between MRC, CCQ and objective measurements was found. V/P SPECT is sensitive to early changes in COPD. V/P SPECT also has the possibility to identify comorbid disease. V/P SPECT findings show a significant correlation with emphysema extent and spirometric lung function. We therefore recommend that scintigraphic signs of COPD, whenever found, should be

  15. 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

  16. 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

  17. Factors that influence chest injuries in rollovers.

    Science.gov (United States)

    Digges, Kennerly; Eigen, Ana; Tahan, Fadi; Grzebieta, Raphael

    2014-01-01

    The design of countermeasures to reduce serious chest injuries for belted occupants involved in rollover crashes requires an understanding of the cause of these injuries and of the test conditions to assure the effectiveness of the countermeasures. This study defines rollover environments and occupant-to-vehicle interactions that cause chest injuries for belted drivers. The NASS-CDS was examined to determine the frequency and crash severity for belted drivers with serious (Abbreviated Injury Scale [AIS] 3+) chest injuries in rollovers. Case studies of NASS crashes with serious chest injuries sustained by belted front occupants were undertaken and damage patterns were determined. Vehicle rollover tests with dummies were examined to determine occupant motion in crashes with damage similar to that observed in the NASS cases. Computer simulations were performed to further explore factors that could contribute to chest injury. Finite element model (FEM) vehicle models with both the FEM Hybrid III dummy and THUMS human model were used in the simulations. Simulation of rollovers with 6 quarter-turns or less indicated that increases in the vehicle pitch, either positive or negative, increased the severity of dummy chest loadings. This finding was consistent with vehicle damage observations from NASS cases. For the far-side occupant, the maximum chest loadings were caused by belt and side interactions during the third quarter-turn and by the center console loading during the fourth quarter-turn. The results showed that the THUMS dummy produced more realistic kinematics and improved insights into skeletal and chest organ loadings compared to the Hybrid III dummy. These results suggest that a dynamic rollover test to encourage chest injury reduction countermeasures should induce a roll of at least 4 quarter-turns and should also include initial vehicle pitch and/or yaw so that the vehicle's axis of rotation is not aligned with its inertial roll axis during the initial stage

  18. 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.)

  19. Myxoinflammatory fibroblastic sarcoma of the chest wall

    Directory of Open Access Journals (Sweden)

    Yang-Fan Liu

    2017-01-01

    Full Text Available This study presents the case of an 87-year-old male who developed a huge tumor at the chest wall that limited the range of motion of the upper limb. We performed a wide excision of the tumor with chest wall reconstruction. The tumor exhibited lobulated pattern with myxoid fluid and fibrous tissue, which was accumulated by a thin capsule. The final diagnosis was myxoinflammatory fibroblastic sarcoma (MIFS, a kind of uncommon low-grade malignant tumor that extremely develops rarely in the chest wall. At this moment, we review the epidemiology, histopathologic characteristics, similar cases, and the current treatment for MIFS.

  20. Chest wall sarcomas and induction therapy.

    Science.gov (United States)

    Kucharczuk, John C

    2012-02-01

    Chest wall sarcomas are uncommon tumors. The best patient outcomes likely result from a formalized multidisciplinary treatment plan in a specialized center. No clear guidelines exist to determine whether patients with chest wall sarcomas benefit from preoperative adjuvant therapy. Most decisions are made on a case-by-case basis with little available evidence. It is unclear whether established guidelines for the more commonly occurring extremity sarcomas can be appropriately extrapolated to the care of patients with chest wall disease. The single most important factor in local control and long-term survival is a wide, complete, R0 resection. Copyright © 2012. Published by Elsevier Inc.

  1. Results of Bony Chest Wall Reconstruction with Expanded Polytetrafluoroethylene Soft Tissue Patch

    Science.gov (United States)

    Huang, Haibo; Kitano, Kentaro; Nagayama, Kazuhiro; Nitadori, Jun-ichi; Anraku, Masaki; Murakawa, Tomohiro

    2015-01-01

    Purpose: The early and long-term outcomes of bony chest wall reconstruction with expanded polytetrafluoroethylene (Gore-Tex) soft tissue patch remain a concern. No clinical study has reported the shrinkage of Gore-Tex following reconstruction to date. Methods: Thirty-seven patients who underwent bony chest wall reconstruction from 1994 to 2012 were retrospectively reviewed. Postoperative chest computed tomography images of 17 patients were examined, and shrinkage of reconstruction materials was measured and compared. Results: Gore-Tex was used for reconstruction in 18 patients, autologous materials were used in 14, Marlex mesh was used in four, and Medifit felt was used in one. No surgery-related deaths were observed. Twenty patients experienced early postoperative complications. Four patients experienced local infection. One patient with Marlex-mesh experienced empyema 33 days postoperatively. Chest drainage time in the Gore-Tex patients was significantly lower than in patients with other types of prosthetic reconstruction. No dislocation or dehiscence was found. Shrinkage of Gore-Tex was absent in 4 patients and acceptable in seven patients. No granulation formation was evident around the Gore-Tex, No significant difference in shrinkage was seen between the different materials used. Conclusion: Chest wall reconstruction with Gore-Tex was feasible with favorable early and long-term results. PMID:25641033

  2. Results of bony chest wall reconstruction with expanded polytetrafluoroethylene soft tissue patch.

    Science.gov (United States)

    Huang, Haibo; Kitano, Kentaro; Nagayama, Kazuhiro; Nitadori, Jun-ichi; Anraku, Masaki; Murakawa, Tomohiro; Nakajima, Jun

    2015-01-01

    The early and long-term outcomes of bony chest wall reconstruction with expanded polytetrafluoroethylene (Gore-Tex) soft tissue patch remain a concern. No clinical study has reported the shrinkage of Gore-Tex following reconstruction to date. Thirty-seven patients who underwent bony chest wall reconstruction from 1994 to 2012 were retrospectively reviewed. Postoperative chest computed tomography images of 17 patients were examined, and shrinkage of reconstruction materials was measured and compared. Gore-Tex was used for reconstruction in 18 patients, autologous materials were used in 14, Marlex mesh was used in four, and Medifit felt was used in one. No surgery-related deaths were observed. Twenty patients experienced early postoperative complications. Four patients experienced local infection. One patient with Marlex-mesh experienced empyema 33 days postoperatively. Chest drainage time in the Gore-Tex patients was significantly lower than in patients with other types of prosthetic reconstruction. No dislocation or dehiscence was found. Shrinkage of Gore-Tex was absent in 4 patients and acceptable in seven patients. No granulation formation was evident around the Gore-Tex, No significant difference in shrinkage was seen between the different materials used. Chest wall reconstruction with Gore-Tex was feasible with favorable early and long-term results.

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

    Science.gov (United States)

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

    2016-02-02

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

  4. Management of chest wall reconstruction after resection for cancer: a retrospective study of 22 consecutive patients.

    Science.gov (United States)

    Bosc, Romain; Lepage, Christophe; Hamou, Cynthia; Matar, Nadia; Benjoar, Marc-David; Hivelin, Michael; Lantieri, Laurent

    2011-09-01

    In this study, we report our experience on immediate reconstruction after resection of primary or metastatic chest wall tumors, to restore protective function and elasticity of chest or sternum. Between 2005 and 2009, 22 patients underwent reconstruction using a free or pedicled flap combined, or not, to alloplastic materials (Goretex®) in order to cover full-thickness defects of the chest wall after cancer surgery. Reconstruction was immediate in all cases. Mean follow-up was 27 months. Of these, 18 patients were alive at the end of the study (81.5%). Eighteen patients had malignant tumors (82%); within these patients, 12 were alive without recurrence at the end of the study (67%). The average size of the chest wall defect was 255 cm². Goretex® Mesh was used in 8 patients. All patients benefited from reconstruction with a flap: pedicled or free latissimus dorsi flap (n = 15), pedicled great omentum (n=3), deep inferior epigastric perforator free flap (n = 3), and parascapular pedicled flap (n=1). In this series, we were able to achieve long-term palliation and even cure in some patients by resecting full-thickness chest wall in local primary or recurrence of breast cancer without increasing morbidity. The same process was used successfully in association with adjuvant treatment in other tumors like skin sarcoma. We have followed a surgical algorithm according to the tumor localization and etiology.

  5. Assessment of interstitial lung disease in Sjögren's syndrome by lung ultrasound: a pilot study of correlation with high-resolution chest tomography.

    Science.gov (United States)

    Vasco, Pablo Guisado; de Luna Cardenal, Gonzalo; Garrido, Isabel Martín; Pinilla, José Manuel Luque; Rodríguez, Guadalupe Fraile; Mateo, Juan José Nava; Ruiz, Daniel Carnevalli

    2017-04-01

    The background of this study is to assess the accuracy of lung ultrasound (LUS) to diagnose interstitial lung disease (ILD) in Sjögren's syndrome (Sjs), in patients who have any alterations in pulmonary function tests (PFT) or respiratory symptoms. LUS was correlated with chest tomography (hrCT), considering it as the imaging gold standard technique to diagnose ILD. This is a pilot, multicenter, cross-sectional, and consecutive-case study. The inclusion criteria are ≥18 years old, Signs and symptoms: according to ACEG 2002 criteria, respiratory symptoms (dyspnea, cough), or any alterations in PFR. LUS was done following the International Consensus Conference on Lung Ultrasound protocol for interstitial syndrome (B pattern). Of the 50 patients in follow-up, 13 (26%) met the inclusion criteria. All were women with age 63.62 years (range 39-88). 78.6% of the cases had primary Sjs (SLE, RA, n = 2). The intra-rater reliability k is 1, according to Gwet's Ac1 and GI index (probability to concordance-e(K)-, by Cohen, of 0.52). LUS has a sensitivity of 1 (95% CI 0.398-1.0), specificity of 0.89 (95% CI 0.518-0.997), and a positive probability reason of 9.00 (95% CI 7.1-11.3) to detect ILD. The correlation of Pearson is r = 0.84 (p < 0.001). To check the accuracy of LUS to diagnose ILD, a completely bilateral criterion of yes/no for interstitial pattern was chosen, AUC reaches significance, 0.94 (0.07) (95% CI 0.81-1.0, p = 0.014). LUS reaches an excellent correlation to hrCT in Sjs affected with ILD, and might be a useful technique in daily clinical practice for the assessment of pulmonary disease in the sicca syndrome.

  6. 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)

  7. Mucopolysaccharidosis: abnormal findings on abdomen and chest excluding musculoskeletal system

    Energy Technology Data Exchange (ETDEWEB)

    KimHan, Bo Kyung; Yoon, Hye Kyung; Cho, Jae Min [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Moon, Jeung Hee; Yoon, Dae Young; Seo, Young Lan; Han, Dae Hee; Choi, Chul Soon; Bae, Sang Hoon; Yoon, Young Cheol; Park, Sang Joon [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    Mucopolysaccharidosis (MPS) is a lysosomal storage disease that causes tissue distortion and dysfunction due to the infiltration of mucopolysaccharide in connective tissue. The purpose of this study was to evaluate the characteristic findings of abdominal CT and plain chest radiography in patients with MPS. Sixty-two children with MPS diagnosed by urine analysis were involved in this study; 24 of these underwent abdominal CT and the findings were reviewed by two radiologists, who reached a consensus. Organomegaly was classified as severe, moderate or mild. On chest PA radiographs of 42 of the children, the transverse diameter of the trachea was measured and compared with that of 42 normal controls. Student's t test was used for statistical analysis. At abdominal CT, hepatomegaly was observed in 22 patients (92%; 2 severe, 15 moderate and 5 mild); and splenomegaly was present in 18 (75%; 2 severe, 4 moderate and 12 mild). Among eight patients (33%) with pancreatic enlargement, one had a severly enlarged pancreas, while in the remaining seven, enlargement was mild. Also present were inguinal hernia (n=15), umbilical hernia (n=12), undulation with thickening of the diaphragmatic crura (n=10). abnormalities related to the male genitalia (n=5) and vascular anomaly (n=3). In MPS patients, the mid-point diameter of the trachea (range, 5.6-9 mm; mean, 6.9 mm) was significantly less than in normal controls (range, 8-14 mm; mean, 10.8 mm)(p<0.001). An awareness of the characteristic abnormalities observed at abdominal CT and chest PA radiography can lead to a better understanding of MPS in children.

  8. Mucopolysaccharidosis: abnormal findings on abdomen and chest excluding musculoskeletal system

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Yoon, Dae Young; Seo, Young Lan; Han, Dae Hee; Choi, Chul Soon; Bae, Sang Hoon; Yoon, Young Cheol; Park, Sang Joon [Samsung Medical Center, Seoul (Korea, Republic of); Kim Han, Bok Yung; Yoon, Hye Kyung; Cho, Jae Min [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    Mucopolysaccharidosis (MPS) is a lysosomal storage disease that causes tissue distortion and dysfunction due to the infiltration of mucopolysaccharide in connective tissue. The purpose of this study was to evaluate the characteristic findings of abdominal CT and plain chest radiography in patients with MPS. Sixty-two children with MPS diagnosed by urine analysis were involved in this study; 24 of these underwent abdominal CT and the findings were reviewed by two radiologists, who reached a consensus. Organomegaly was classified as severe, moderate or mild. On chest PA radiographs of 42 of the children, the transverse diameter of the trachea was measured and compared with that of 42 normal controls. Student's t test was used for statistical analysis. At abdominal CT, hepatomegaly was observed in 22 patients (92%; 2 severe, 15 moderate and 5 mild); and splenomegaly was present in 18 (75%; 2 severe, 4 moderate and 12 mild). Among eight patients(33%) with pancreatic enlargement, one had a severly enlarged pancreas, while in the remaining seven, enlargement was mild. Also present were inguinal hernia (n=15), umbilical hernia (n=12), undulation with thickening of the diaphragmatic crura (n=10), abnormalities related to the male genitalia (n=5) and vascular anomaly (n=3). In MPS patients, the mid-point diameter of the trachea (range, 5.6-9 mm; mean, 6.9 mm) was significantly less than in normal controls (range, 8-14 mm; mean, 10.8 mm) (p<0.001). An awareness of the characteristic abnormalities observed at abdominal CT and chest PA radiography can lead to a better understanding of MPS in children.

  9. Chest pain following oesophageal stenting for malignant dysphagia

    International Nuclear Information System (INIS)

    Golder, Mark; Tekkis, Paris P.; Kennedy, Colette; Lath, Sadaf; Toye, Rosemary; Steger, Adrian C.

    2001-01-01

    AIM: The palliative use of self-expanding metallic stents has been widely reported to relieve dysphagia in cases of oesophageal carcinoma. Little has been documented on the severity of chest pain following oesophageal stenting. The aim of this study was to investigate the association of pain with oesophageal stenting for malignant dysphagia. METHODS: Fifty-two patients with inoperable oesophageal carcinoma underwent stent placement between 1995-1999. Daily opioid analgesic requirements (mg of morphine equivalent doses) were monitored for 3 days before and 7 days after stenting. The degree of palliation was expressed as a dysphagia score (0-3). Hospital stay, readmission days, stent complications and patient survival time were also recorded. RESULTS: Twenty-six patients (50%) required opioid analgesia for chest pain (median dose: 80 mg morphine/day) within 48 h of the procedure compared to 11 (21.2%) patients before stenting (P = 0.0041). A significant increase was evident in the analgesic consumption following stent deployment (P < 0.001). The dysphagia score improved by a median value of 1 (CI 0.25)P < 0.001, with a re-intervention rate of 11.5%. The median survival time was 40 days post stenting (range 1-120). CONCLUSION: A significant proportion of patients developed chest pain after oesophageal stenting, requiring high dose opioid analgesia. As the origin of the pain is still unknown, pre-emptive analgesia may a play role in reducing stent-related morbidity and possibly in-hospital stay. Golder, M. et al. (2001)

  10. Primary malignant chest wall tumors: analysis of 40 patients.

    Science.gov (United States)

    Bagheri, Reza; Haghi, Seyed Ziaollah; Kalantari, Mahmoud Reza; Sharifian Attar, Alireza; Salehi, Maryam; Tabari, Azadeh; Soudaneh, Maliheh

    2014-06-19

    Primary chest wall tumors originate from different constructions of thoracic wall. We report our multidisciplinary experience on primary thoracic tumor resection and thoracic reconstruction, the need to additional therapy and evaluating prognostic factors affecting survival. We performed a retrospective review of our prospectively maintained database of 40 patients treated for malignant primary chest wall tumor from 1989 to 2009. Patients were evaluated in terms of age, sex, clinical presentation, type of imaging, tissue diagnosis methods, pathology, surgical technique, early complications, hospital mortality, prevalence of recurrence and distant metastases, additional treatment, 3 years survival and factors affecting survival. Male/Female (F/M) = 1, with median age of 43.72 years. Mass was the most common symptoms and the soft tissue sarcoma was the most common pathology. Resection without reconstruction was performed in 5 patients and Thirty-five patients (87.5%) had extensive resection and reconstruction with rotatory muscular flap, prosthetic mesh and/or cement. Overall, 12.5% (5/40) of patients received neoadjuvant therapy and 75% (30/40) of patients were treated with adjuvant therapy. The 3-year survival rate was 65%. Recurrences occurred in 24 patients (60%), 14 developed local recurrences, and 10 developed distant metastases. The primary treatment modality for both local and distant recurrences was surgical resection; among them, 10 underwent repeated resection, 9 adjuvant therapy and 5 were treated with lung metastasectomy. The most common site of distant metastasis was lung (n = 7). Factors that affected survival were type of pathology and evidence of distant metastasis. Surgery with wide margin is the safe and good technique for treatment of primary chest wall tumors with acceptable morbidity and mortality.

  11. The natural history of flail chest injuries.

    Science.gov (United States)

    Naidoo, Kamil; Hanbali, Layth; Bates, Peter

    2017-10-01

    Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC). A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients (age > 16 years) sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Two hundred and ninety-three patients were identified, with a mean injury severity score (ISS) of 28.9 (range 9-75), average age of 56.1 years (range of 16-100), and a male predominance (78%). Road traffic accidents accounted for 45% (n = 132) of injuries, whilst 44% were fall or jump from height (n = 129). Associated lung contusion was present in 133 patients (45%) while 76% of patients were found to have 5 or more ribs involved in the flail segment (n = 223) with 96% (n = 281) having a unilateral FC. Inpatient treatment was required 19.9 days (range 0-150 days) with 59% of patients (n = 173) requiring intensive care unit (ICU) level care for 8.4 days (range 1-63) with 61.8% requiring mechanical ventilation (n = 107) for 10.5 days (range 1-54), and 7.8% underwent rib fixation with rib plates (n = 23). The mortality rate was found to be 14% (n = 42). A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days (6.94 vs 10.06, p = 0.18) intensive treatment unit (ITU) length of stay (LOS) (12.56 vs 15.53, p = 0.28) and hospital LOS (32.62 vs 35.24, p = 0.69). This study has successfully described the natural history of flail

  12. 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.

  13. 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 ...

  14. Digital chest radiography: collimation and dose reduction

    DEFF Research Database (Denmark)

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

    Purpose: Quality improvement of basic radiography focusing 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 of age are included in the study. The clinical research is performed between September and November 2014 where 3rd year Radiography students collect data on four Danish x-ray departments using identical procedures under guidance...... at the conference. Conclusion: Collimation improvement in basic chest radiography can reduce the radiation to female patients at chest x-ray examinations....

  15. 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 ...

  16. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    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...... 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...... 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....

  17. 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.

  18. Angina - when you have chest pain

    Science.gov (United States)

    ... gov/ency/patientinstructions/000088.htm Angina - when you have chest pain To use the sharing features on ... discusses how to care for yourself when you have angina. Signs and Symptoms of Angina You may ...

  19. 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)

  20. 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...

  1. 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.

  2. Tricuspid regurgitation after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Tone Gabrijelčič

    2013-01-01

    Conclusion: Our data support the fact that an injury of the tricuspid valve due to blunt chest trauma is rare and easily overlooked. Therefore, ultrasound of the heart should be done in all cases of blunt chest trauma. If negative, it should be repeated. Transoesophageal approach is more reliable than the transthoracic one. The gold standard for therapy is a valve repair, which should be done early enough to prevent further morbidity and mortality.

  3. Outcomes of surgery for chest wall sarcomas.

    Science.gov (United States)

    Putnam, Joe B

    2010-11-01

    Chest wall resection requires wide local excision, negative margins, and adequate reconstruction. Outcomes are generally good to excellent with wide local excision and negative margins. Mortality is nearly 0% to 1% with mild morbidity. Multispecialty surgical teams may be required for more complex situations. Early diagnosis of chest wall sarcomas, confirmation by an experienced sarcoma pathologist, and multidisciplinary discussion before treatment initiation, are all required for optimal and successful therapy.

  4. 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)

  5. Transauricular embolization of the rabbit coronary artery for experimental myocardial infarction: comparison of a minimally invasive closed-chest model with open-chest surgery

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2012-02-01

    Full Text Available Abstract Introduction To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery. Methods New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG, cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining. Results In total, 38 subjects underwent EMI with a surgical (n = 17 or endovascular (n = 21 approach. ST-segment elevation (1.90 ± 0.71 mm occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68 within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05. Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68. Conclusion The proposed model of transauricular coronary coil embolization avoids

  6. 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...

  7. 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...

  8. Ultrasound and supine chest radiograph in road traffic accident patients: a reliable and convenient way to diagnose pleural effusion

    International Nuclear Information System (INIS)

    Mumtaz, U.; Zahur, Z.; Raza, M.A.

    2017-01-01

    Background: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard. Methods: This study was conducted in PIMS and PAEC General Hospital, Islamabad from 1st January to 15th December 2015. The current study examined total of 80 trauma (blunt and penetrating) patients coming to emergency departments of both hospitals specifically those who had road traffic accident history. Their portable bed side ultrasound and supine chest radiograph were performed for assessing pleural effusion and subsequently CT scan chest was done for confirmation as it's a gold standard. Results: Using CT findings as gold standard the sensitivity, specificity, positive predictive value and negative predictive value was assessed for both ultrasonography and chest radiography and found to be 88.23%,100%, 100%, 40% and 77.94%, 100%, 100%, 55.55% respectively with diagnostic accuracy of ultrasound 90% as compared to 81.25% for supine chest x-rays when compared with gold standard. Conclusion: Ultrasound and chest x-ray can be used as a useful and suitable adjunct to CT in road traffic accident patients as these are easily available, non-invasive, no contrast required, can be performed on bed side and carries no or little radiation risk. (author)

  9. Correlation of B-Lines on Ultrasonography With Interstitial Lung Disease on Chest Radiography and CT Imaging.

    Science.gov (United States)

    Dubinsky, Theodore J; Shah, Hardik; Sonneborn, Rachelle; Hippe, Daniel S

    2017-11-01

    We prospectively identified B-lines in patients undergoing ultrasonographic (US) examinations following liver transplantation who also had chest radiography (CXR) or chest CT imaging, or both, on the same day to determine if an association between the presence of B-lines from the thorax on US images correlates with the presence of lung abnormalities on CXR. Following institutional review board (IRB) approval, patients who received liver transplants and underwent routine US examinations and chest radiography or CT imaging, or both, on the same day between January 1, 2015 through July 1, 2016 were prospectively identified. Two readers who were blinded to chest films and CT images and reports independently reviewed the US interreader agreement for the presence or absence of B-lines and performed an evaluation for the presence or absence of diffuse parenchymal lung disease (DPLD) on chest films and CT images as well as from clinical evaluation. Receiver operating characteristic (ROC) curves were constructed. There was good agreement between the two readers on the presence of absence of B-lines (kappa = 0.94). The area under the ROC curve for discriminating between positive DPLD and negative DPLD for both readers was 0.79 (95% CI, 0.71-0.87). There is an association between the presence of extensive B-lines to the point of confluence and "dirty shadowing" on US examinations of the chest and associated findings on chest radiographs and CT scans of DPLD. Conversely, isolated B-lines do not always correlate with abnormalities on chest films and in fact sometimes appear to be a normal variant. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. Evaluation of pneumonia in children: comparison of MRI with fast imaging sequences at 1.5T with chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Yikilmaz, Ali; Koc, Ali; Coskun, Abdulhakim (Dept. of Radiology, Erciyes Medical School, Kayseri (Turkey)); Ozturk, Mustafa K (Dept. of Pediatric Infectious Diseases, Erciyes Medical School, Kayseri (Turkey)); Mulkern, Robert V; Lee, Edward Y (Dept. of Radiology and Dept. of Medicine, Pulmonary Div., Children' s Hospital Boston and Harvard Medical School, Boston (United States)), email: Edward.lee@childrens.harvard.edu

    2011-10-15

    Background Although there has been a study aimed at magnetic resonance imaging (MRI) evaluation of pneumonia in children at a low magnetic field (0.2T), there is no study which assessed the efficacy of MRI, particularly with fast imaging sequences at 1.5T, for evaluating pneumonia in children. Purpose To investigate the efficacy of chest MRI with fast imaging sequences at 1.5T for evaluating pneumonia in children by comparing MRI findings with those of chest radiographs. Material and Methods This was an Institutional Review Board-approved, HIPPA-compliant prospective study of 40 consecutive pediatric patients (24 boys, 16 girls; mean age 7.3 years +- 6.6 years) with pneumonia, who underwent PA and lateral chest radiographs followed by MRI within 24 h. All MRI studies were obtained in axial and coronal planes with two different fast imaging sequences: T1-weighted FFE (Fast Field Echo) (TR/TE: 83/4.6) and T2-weighted B-FFE M2D (Balanced Fast Field Echo Multiple 2D Dimensional) (TR/TE: 3.2/1.6). Two experienced pediatric radiologists reviewed each chest radiograph and MRI for the presence of consolidation, necrosis/abscess, bronchiectasis, and pleural effusion. Chest radiograph and MRI findings were compared with Kappa statistics. Results All consolidation, lung necrosis/abscess, bronchiectasis, and pleural effusion detected with chest radiographs were also detected with MRI. There was statistically substantial agreement between chest radiographs and MRI in detecting consolidation (k = 0.78) and bronchiectasis (k = 0.72) in children with pneumonia. The agreement between chest radiographs and MRI was moderate for detecting necrosis/abscess (k = 0.49) and fair for detecting pleural effusion (k = 0.30). Conclusion MRI with fast imaging sequences is comparable to chest radiographs for evaluating underlying pulmonary consolidation, bronchiectasis, necrosis/abscess, and pleural effusion often associated with pneumonia in children

  11. Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography

    Science.gov (United States)

    Adibi, Atoosa; Nouri, Shadi; Moradi, Maryam; Shahabi, Javad

    2016-01-01

    Background: The aim of the study was to determine the correlation between clinical and echocardiographic findings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE) who underwent computed tomography pulmonary angiography (CTPA). Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from different wards for CTPA were enrolled. The frequency of different clinical presentations, risk factors, items of Wells’ criteria, and echocardiographic findings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1%) of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were significantly more frequent among patients with PTE (P < 0.05). Major surgery was the risk factor which was significantly more prevalent among patients with PTE (P < 0.05). Frequency of all criteria of Wells’ criteria, except hemoptysis, was significantly higher in patients with PTE (P < 0.05). The frequency of all studied echocardiographic variables was significantly higher in patients with PTE (P < 0.05). Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences. PMID:28255326

  12. Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2016-01-01

    Full Text Available Background: The aim of the study was to determine the correlation between clinical and echocardiographic findings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE who underwent computed tomography pulmonary angiography (CTPA. Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from different wards for CTPA were enrolled. The frequency of different clinical presentations, risk factors, items of Wells' criteria, and echocardiographic findings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1% of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were significantly more frequent among patients with PTE (P < 0.05. Major surgery was the risk factor which was significantly more prevalent among patients with PTE (P < 0.05. Frequency of all criteria of Wells' criteria, except hemoptysis, was significantly higher in patients with PTE (P < 0.05. The frequency of all studied echocardiographic variables was significantly higher in patients with PTE (P < 0.05. Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences.

  13. Psychiatric syndromes associated with atypical chest pain

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events exposure and characteristic of chest pain expression in persons with atypical chest pain and coronary patients, as well as to define predictive parameters for atypical chest pain. Method. We compared 30 patients with atypical chest pain (E group to 30 coronary patients (K group, after cardiological and psychiatric evaluation. We have applied: Mini International Neuropsychiatric Interview (MINI, The Symptom Checklist 90-R (SCL-90 R, Beck Anxiety Inventory (BAI, Holms-Rahe Scale of stress life events (H-R, Questionnaire for pain expression Pain-O-Meter (POM. Significant differences between groups and predictive value of the parameters for atypical chest pain were determined. Results. The E group participants compared to the group K were younger (33.4 ± 5.4 : 48.3 ± 6,4 years, p < 0.001, had a moderate anxiety level (20.4 ± 11.9 : 9.6 ± 3.8, p < 0.001, panic and somatiform disorders were present in the half of the E group, as well as eleveted somatization score (SOM ≥ 63 -50% : 10%, p < 0.01 and a higher H-R score level (102.0 ± 52.2 : 46.5 ± 55.0, p < 0.001. Pain was mild, accompanied with panic. The half of the E group subjects had somatoform and panic disorders. Conclusion. Somatoform and panic disorders are associated with atypical chest pain. Pain expression is mild, accompained with panic. Predictive factors for atypical chest pain are: age under 40, anxiety level > 20, somatization ≥ 63, presence of panic and somatoform disorders, H-R score > 102

  14. 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.

  15. Radiation-induced squamous cell carcinoma of the chest wall seven years after adjuvant radiotherapy following the surgery of breast cancer. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yokota, Tohru; Roppongi, Takashi; Kanno, Keiichi; Tsutsumi, Hiroyuki; Sakamoto, Ichiro; Fujii, Takanao [Numata National Hospital, Shibukawa, Gunma (Japan)

    2000-12-01

    A 54-year-old woman, who had underwent an adjuvant radiotherapy following the modified radical mastectomy in the left primary breast cancer in June 1988. She underwent second surgery and adjuvant radiotherapy (electronic radiotherapy) for recurrent breast cancer in the major pectoral muscle and received chemoimmunotherapy in May 1989. In May 1996 she complained of two ulcers of the chest wall. The ulcer biopsy findings was squamous cell carcinoma, and we diagnosed she fell the radiation-induced skin cancer. She underwent chest wall resection and reconstruction with vertical rectal abdominal musculocutaneous flap (V-RAM). However two months later her chest wall resection, she again got the recurrent squamous cell carcinoma in the right axillary lymph nodes and left pleura. The third radiotherapy and the chemotherapy with pepleomycin were uneffective on her recurrent cancer. And she died in March 1997. (author)

  16. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, S.-Y. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, J.H., E-mail: jhkate@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Y.-J. [Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  17. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    International Nuclear Information System (INIS)

    Yoo, S.-Y.; Kim, J.H.; Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N.; Kim, Y.-J.

    2011-01-01

    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  18. Reconstruction of Large Full Thickness Chest Wall Defects Following Resection of Malignant Tumors

    International Nuclear Information System (INIS)

    Khalil, E.A.; El-Zohairy, M.A.; Bukhari, M.

    2010-01-01

    Full-thickness chest wall resection is the well-established treatment for primary or metastatic chest wall tumors. Adequate surgery with large resections is always needed to achieve a radical resection in healthy tissues, leading to optimal local control of the disease. The purpose of this study is to present our experience in chest wall reconstruction after major tumor resection. Patients and Methods: Between January 2006 and January 2010, 18 consecutive patients who underwent major chest wall resections for primary or metastatic chest wall tumors were studied. All had resection of at least three ribs and immediate reconstruction. Surgical procedures, extent of the resection, resulting defects and postoperative morbidity and mortality were discussed. Results: Surgical indications included primary, recurrent and metastatic chest wall neoplasms, sarcoma and recurrent breast cancer were the most frequent diagnoses. Resection of 3 ribs was performed in 8 patients, while resection of more than 3 ribs was performed in 10 patients. Resection of sternum and adjacent costal cartilages was performed in one patient, right chest wall resections were performed in 7 patients while left chest wall resections were performed in 10 patients. Immediate repair of the defects was performed in all cases, all patient had placement of prosthesis either polypropylene or polytetrafluoroethylene, 3 patients had methylacrylate in addition to the prosthesis. Coverage w as achieved using myocutaneous flaps in 7 patients. Mechanical ventilation was needed in 11 patients with a mean duration of ventilation 2.211.8 days (range between 1- 6 days). No 30-days mortality was recorded. Four patients 22.2% developed complications, 2 patients need prolonged mechanical ventilation for respiratory insufficiency and 2 patients had partial flap necrosis and wound infection. Mean hospital stay was 10.1±3.2 days. Conclusion: Immediate reconstruction of large full thickness chest wall defects following

  19. Validation of the North American Chest Pain Rule in Prediction of Very Low-Risk Chest Pain; a Diagnostic Accuracy Study

    Directory of Open Access Journals (Sweden)

    Somayeh Valadkhani

    2017-01-01

    Full Text Available Introduction: Acute coronary syndrome accounts for more than 15% of the chest pains. Recently, Hess et al. developed North American Chest Pain Rule (NACPR to identify very low-risk patients who can be safely discharged from emergency department (ED. The present study aimed to validate this rule in EDs of two academic hospitals.Methods: A prospective diagnostic accuracy study was conducted on consecutive patients 24 years of age and older presenting to the ED with the chief complaint of acute chest pain, during March 2013 to June 2013. Chest pain characteristics, cardiac history, electrocardiogram findings, and cardiac biomarker measurement of patients were collected and screening performance characteristics of NACPR with 95% confidence interval were calculated using SPSS 21.Results: From 400 eligible patients with completed follow up, 69 (17.25 % developed myocardial infarction, 121 (30.25% underwent coronary revascularization, and 4 (2% died because of cardiac or unidentifiable causes. By using NACPR, 34 (8.50% of all the patients could be considered very low- risk and discharged after a brief ED assessment. Among these patients, none developed above-mentioned adverse outcomes within 30 days. Sensitivity, specificity, positive prediction value, and negative prediction value of the rule were 100% (95% CI: 87.35 - 100.00, 45.35 (95% CI: 40.19 - 50.61, 14.52 (95% CI: 10.40 – 19.85, and 100 (95% CI: 97.18 - 100.00, respectively.Conclusions: The present multicenter study showed that NACPR is a good screening tool for early discharge of patients with very low-risk chest pain from ED.

  20. A multidisciplinary approach to giant soft tissue sarcoma of the chest wall: A case report.

    Science.gov (United States)

    Davis, Catherine H; Yammine, Halim; Khaitan, Puja G; Chan, Edward Y; Kim, Min P

    2016-01-01

    Soft tissue sarcomas of the chest wall are exceptionally rare entities that present as painless slow growing masses. Resection is often precarious due to involvement of vital structures, and patients are left with large chest wall defects postoperatively requiring extensive reconstruction. We present a case report of a 29 year-old man who presented with a giant soft tissue sarcoma of the chest that had been growing slowly for one year prior to presentation. The patient had a biopsy that was positive for sarcoma, and PET CT demonstrated a large lobulated mass in the left chest wall with an SUV of 6.7. He received 50Gy of radiation therapy; however, the mass continued to grow in size. He subsequently underwent an en-bloc resection of the mass with latissimus and serratus muscle primary reconstruction. Final pathology showed a 27cm high-grade fibrosarcoma with prominent myxoid component. To our knowledge, this is the largest soft tissue sarcoma of the chest wall reported in the literature. Postoperatively, the patient received 6 cycles of adjuvant chemotherapy. Surgery is the mainstay of treatment, and chemotherapy and radiation are used in specific circumstances. Risk of recurrence is dependent on many factors, including histologic subtype, grade, and size of tumor. Long term surveillance with physical exam and imaging is recommended. We feel that the multidisciplinary approach is crucial for optimal management of large soft tissue sarcomas. We recommend this approach to all patients with chest wall sarcomas. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Radiation induced osteosarcoma of the chest wall

    International Nuclear Information System (INIS)

    Sugimoto, Tsutomu; Yuki, Yoshihiro; Oizumi, Hiroyuki; Iijima, Yoshiyuki; Fujishima, Tsukasa; Shimazaki, Yasuhisa

    1996-01-01

    We report a successful resection of an osteosarcoma in the chest wall developed 25 years after irradiation. A 74-year-old woman was admitted to our hospital for her swelling in the left chest wall at August 24, 1995. At 49-year-old, she had undergone an operation and postoperative irradiation for left breast cancer. A computed tomography demonstrated a mass in the left chest wall that destructed the first rib, extending into the pleural space and invaded into the left common carotid and subclavian arteries. We planned a radical resection of the mass after repeated CT scannings, since it was histopathologically diagnosed as a chondrosarcoma and showed a rapid growth. The tumor was completely removed with radical transmediastinal forequarter amputation of the partial chest wall and total left upper extremity. The left common carotid artery was partially replaced with 6 mm EPTFE vascular prosthesis. The chest wall was reconstructed with Marlex-mesh prosthesis and a myocutaneous flap. She was discharged uneventfully and has not shown any evidence of recurrence. (author)

  2. 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.

  3. 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.

  4. 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

  5. Penetrating chest injury: A miraculous life salvage

    OpenAIRE

    Santosh B Dalavi; Prakash D Gurav; Sharad S Sharad

    2013-01-01

    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 manageme...

  6. 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

  7. 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

  8. Postirradiation hemangiosarcoma of the chest wall

    International Nuclear Information System (INIS)

    Lo, T.C.M.; Silverman, M.L.; Edelstein, A.; Lahey Clinic Medical Center, Burlington, MA; Winchester Hospital, MA

    1985-01-01

    An unusual case of cutaneous hemangiosarcoma that developed on a chest wall irradiated after mastectomy for cancer is described. The patient, an elderly woman, had previously received high-dose radiation to the chest wall as well as systemic combination chemotherapy. Sarcoma developed 6 years after mastectomy and progressed rapidly. The time between radiation therapy and occurrence of cutaneous sarcoma was shorter than the median latent period reported for development of radiation-induced sarcoma. Thus, we cannot be certain that radiation was the true or sole etiologic factor. Whether the addition of systemic chemotherapy was a contributory agent is also speculative. (orig.)

  9. Myxoinflammatory fibroblastic sarcoma in the chest wall.

    Science.gov (United States)

    Narm, Kyoung Shik; Park, In Kyu; Bae, Mi Kyung; Kim, Gi Jeong

    2012-02-01

    Myxoinflammatory fibroblastic sarcoma (MIFS) is a recently defined rare tumor. It is mainly found in the upper and lower extremities of adults. Due to its high local recurrence rate and low metastatic rate, it is classified as a low grade-malignancy. Accurate diagnosis and early, wide excision are important for prognosis. Herein, we report a case of MIFS in a 35-year-old male patient that presented in an unusual location, the left chest wall. To our knowledge, this is the first reported case of MIFS in Korea and the second case to be reported within the global scientific literature involving the chest wall.

  10. Initial experience with a chest pain protocol using 320-slice volume MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Hein, Patrick A.; Romano, Valentina C.; Lembcke, Alexander; May, Juliane; Rogalla, Patrik [Charite - Universitaetsmedizin, Institut fuer Radiologie, Charite Campus Mitte, Berlin (Germany)

    2009-05-15

    We sought to determine the feasibility and image quality of 320-slice volume computed tomography (CT) angiography for the evaluation of patients with acute chest pain. Thirty consecutive patients (11 female, 19 male, mean age 63.2 {+-} 14.2 years) with noncritical, acute chest pain underwent 320-slice CT using a protocol consisting of a nonspiral, nongated CT of the entire chest, followed by a nonspiral, electrocardiography-gated CT study of the heart. Data were acquired following a biphasic intravenous injection of 90 ml iodinated contrast agent. Vessel attenuation values of different thoracic vascular territories were recorded, and image quality scored on a five-point scale by two readers. Mean attenuation was 467 {+-} 69 HU in the ascending aorta, 334 {+-} 52 HU in the aortic arch, 455 {+-} 71 HU in the descending aorta, 492 {+-} 94 HU in the pulmonary trunk, and 416 {+-} 63 HU and 436 {+-} 62 HU in the right and left coronary artery, respectively. Radiation exposure estimates ranged between 7 and 14 mSv. The CT protocol investigated enabled imaging of the thoracic aorta, coronary and pulmonary arteries with an excellent diagnostic quality for chest pain triage in all patients. This result was achieved with less contrast material and reduced radiation exposure compared with previously investigated imaging protocols. (orig.)

  11. Metastatic Sarcomatoid Squamous Cell Carcinoma of the Cervix Presenting with Chest Mass

    Directory of Open Access Journals (Sweden)

    Lilit Karapetyan

    2017-01-01

    Full Text Available Background. Sarcomatoid squamous cell carcinoma is a rare and aggressive form of cervical cancer. We report a case of metastatic sarcomatoid squamous cell carcinoma (SSCC of cervix that presented with an anterior chest wall mass. Case. A 43-year-old Hispanic female presented with a two-month history of a central chest wall mass. The patient’s only past medical history was SSCC of the cervix, stage IIB, diagnosed two years priorly. She underwent neoadjuvant chemoradiation therapy (CRT with cisplatin followed by radical hysterectomy. Surgical margins were positive which led to adjuvant CRT with carboplatin and paclitaxel. PET scan 4 months after the postoperative treatment was negative for recurrence and metastatic disease. On current presentation, the CT chest revealed anterior mediastinal destructive soft tissue mass involving sternum, and the biopsy showed SSCC. The patient received palliative radiation therapy to her chest with improvement in pain and ability to swallow. After discussing the prognosis she refused further chemotherapy and decided on hospice care. Conclusion. Despite good response to first-line therapy, SSCC tends to recur early and does not respond to second-line therapy. Radiation therapy seems to be the most effective modality for treatment, but randomized controlled trials of therapy are impractical.

  12. [Chest wall and vertebral en-bloc resection for sarcoma: ten-year experience].

    Science.gov (United States)

    Incarbone, M; Alloisio, M; Luzzati, S; Testori, A; Cariboni, U; Infante, M; Errico, V; Canevini, M; Ravasi, G

    2005-08-01

    We reviewed our ten-year experience with surgical en-bloc chest wall and vertebral resection for sarcoma invading the spine, and verified five-year survival and feasibility of this aggressive surgery. From 1994 to 1999, 13 patients underwent surgical en-bloc resection for primary sarcoma of the chest wall involving the spine. Concurrent pulmonary resection was performed in 12 cases. A single hemi-vertebrectomy was performed in 2 patients, a triple hemi-vertebrectomy in 2, a complete vertebrectomy in 4, a triple complete vertebrectomy in 5. Significative morbidity occurred in 1 patient who had lower limbs paralysis (9%). Perioperative mortality occurred in 2 patients (15.4%): 1 operative death for bleeding and 1 patients for a adult respiratory distress syndrome (ARDS). The overall five-year survival was 30.8%, excluding the 2 perioperative deaths the five-year survival resulted 36.4%. In spite of the limited number of patients, the morbidity and mortality outcome and the five-year survival leads us to think that surgery is the main therapy for primary chest wall sarcomas involving the spine. En-bloc chest wall and vertebral resection is a safe and effective treatment.

  13. 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...

  14. Neurofibromas as bilateral cystic chest wall swellings.

    African Journals Online (AJOL)

    clinical entity in our centre. This rare entity should be borne in mind when considering the differential diagnosis of benign cystic chest wall tumours. Key words: neurofibromatosis, cystic swelling, posterior ... We are reporting a single case of bilat- eral cystic degenerative changes in neurofibromas that presented clinically like ...

  15. 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 ...

  16. 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

  17. Patient doses from chest radiography in Victoria

    International Nuclear Information System (INIS)

    Cardillo, I.; Boal, T.J.; Einsiedel, P.F.

    1997-01-01

    This survey examines doses from posterior-anterior projection (PA) chest radiography at radiology practices, private hospitals and public hospitals throughout metropolitan and country Victoria. Data were collected from 111 individual X-ray units at 86 different practices. Entrance skin doses in air were measured for exposure factors used by the centre for a 23 cm thick male chest. A CDRH LucAl chest phantom was used when making these measurements. About half of the centres used grid technique and half used non-grid technique. There was a factor of greater than 10 difference in the entrance dose delivered between the highest dose centre and the lowest dose centre for nongrid centres; and a factor of about 5 for centres using grids. Factors contributing to the high doses recorded at some centres were identified. Guidance levels for chest radiography based on the third quartile value of the entrance doses from this survey have been recommended and compared with guidance levels recommended in other countries. (authors)

  18. 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

  19. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    1Neurosurgery Unit, Department of Surgery, University of Nigeria Teaching Hospital, 2Memfy's Hospital for Neurosurgery,. Enugu, Nigeria .... chest injuries. Lung contusion. Haemo-thorax. Peumo-thorax. Haemo/ pneumo-thorax. Major vessel. Total. Mortality. Extradural hematoma. 1. –. 1. –. –. 2. –. Subdural hematoma. 1. 1.

  20. 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...

  1. Coccidioidomycosis - chest x-ray (image)

    Science.gov (United States)

    This chest x-ray shows the affects of a fungal infection, coccidioidomycosis. In the middle of the left lung (seen on the ... defined borders. Other diseases that may explain these x-ray findings include lung abscesses, chronic pulmonary tuberculosis, chronic ...

  2. When to Remove a Chest Tube.

    Science.gov (United States)

    Novoa, Nuria M; Jiménez, Marcelo F; Varela, Gonzalo

    2017-02-01

    Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and experience. This article discusses recently published data on the topic and suggests opportunities for further investigation and future improvements. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. High-resolution computed tomography of the chest in children with cystic fibrosis: support for use as an outcome surrogate

    International Nuclear Information System (INIS)

    Brody, A.S.; Molina, P.L.; Klein, J.S.; Rothman, B.S.; Ramagopal, M.; Swartz, D.R.

    1999-01-01

    Background. Outcome surrogates are indicators that reflect, rather than directly measure, patient benefit. In order to provide useful results, however, outcome surrogates must be carefully chosen and must meet specific criteria. Objective. To support development of high-resolution computed tomography (HRCT) as an outcome surrogate in cystic fibrosis (CF) by demonstrating the ability of HRCT to show short-term improvement in the appearance of the lungs in children with CF. Materials and methods. HRCT was performed at admission and after discharge on 8 children during 15 admissions for acute pulmonary exacerbation of CF. Three radiologists scored each study separately, then compared admission and discharge pairs. Results. HRCT scores improved in 13/15 admissions. Mean score decreased from 25 to 22. The decrease was significant (P = 0.014). Comparison of admission and discharge scans showed improvement in peribronchial thickening (P = 0.007), mucous plugging (P = 0.002), and overall appearance (P = 0.025). Conclusion. HRCT has the potential to be a useful outcome surrogate in CF. A necessary attribute of an outcome surrogate is that it improves rapidly with effective therapy. Despite widespread belief among radiologists and pulmonologists that HRCT meets this criterion, no previous report has demonstrated this ability in children. These findings support further development of HRCT as an outcome surrogate in children with CF. (orig.)

  4. Quantitative texture-based assessment of one-year changes in fibrotic reticular patterns on HRCT in scleroderma lung disease treated with oral cyclophosphamide

    International Nuclear Information System (INIS)

    Kim, Hyun J.; Brown, Matthew S.; Elashoff, Robert; Li, Gang; Gjertson, David W.; Lynch, David A.; Strollo, Diane C.; Kleerup, Eric; Tashkin, Donald P.; Chong, Daniel; Shah, Sumit K.; Ahmad, Shama; Abtin, Fereidoun; Goldin, Jonathan G.

    2011-01-01

    The Scleroderma Lung Study showed the efficacy of cyclophosphamide in modestly improving the forced vital capacity (FVC) compared with placebo over 1 year. Using changes in texture-based scores that quantify lung fibrosis as the percentage involvement of reticulation patterns, the effectiveness of cyclophosphamide was re-assessed by examining its impact on quantitative lung fibrosis (QLF). Axial HRCT images were acquired (1-mm slice thickness, 10-mm increments) in the prone position at inspiration. A validated model for quantifying interstitial disease patterns was applied to images from 83 subjects at baseline and 12 months. Scores were calculated for six zones (upper, mid, lower of the right/left lung) and the whole lung. Average changes were compared. Correlations were performed between QLF and physiological and clinical scores. From the most severe zones identified at baseline, QLF scores decreased by 2.6% in the cyclophosphamide group, whereas they increased by 9.1% in the placebo group, leading to ∝12% difference (p = 0.0027). Between-treatment difference in whole lung QLF was ∝5% (p = 0.0190). Significant associations were observed between changes in QLF and FVC (r = -0.33), dyspnea score (r = -0.29), and consensus visual score (p = 0.0001). QLF scores provide an objective quantitative tool for assessing treatment efficacy in scleroderma-related interstitial lung disease. (orig.)

  5. Analyses of the eustachian tube and its surrounding tissues with cross sectional images by high-resolution computed tomography (HR-CT)

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Haruo; Kobayashi, Toshimitsu; Takasaki, Kenji; Kanda, Yukihiko; Nakao, Yoshiaki; Morikawa, Minoru; Ishimaru, Hideki; Hayashi, Kuniaki [Nagasaki Univ. (Japan). School of Medicine

    2000-07-01

    We attempted to image the eustachian tube (ET) and its surrounding tissues by high-resolution computed tomography (HR-CT). Twenty-two normal subjects (44 ears) without middle ear problems were studied, and a patient with severe patulous ET was also studied as an abnormal case. In our device of multiplanar reconstruction technique, we were able to obtain the clear reconstructed images of the ET lumen as well as of its surrounding tissues (bone, ET cartilage, tensor veli palatini muscle, levator veli palatini muscle, Ostmann's fat tissue, tensor tympani muscle, internal carotid artery) at any desired portion, either parallel or perpendicular to the long axis of the ET. However, the exact borders between the ET cartilage and the muscles, Ostmann's fat tissue and the tubal gland were not clearly identified. In the severe case of patulous ET, the ET lumen was widely opened at each cross-sectional image from the pharyngeal orifice to the tympanic orifice, in contrast with its being closed at the cartilaginous portion in the normal cases. In addition, the fat tissue and glands around the ET lumen were not clearly identified in this case. We suggest that this method will lead to better understanding of the ET-related diseases such as patulous ET. (author)

  6. Quantitative texture-based assessment of one-year changes in fibrotic reticular patterns on HRCT in scleroderma lung disease treated with oral cyclophosphamide

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun J.; Brown, Matthew S. [David Geffen School of Medicine, UCLA, Center for Computer Vision and Imaging Biomarker, Department of Radiological Sciences, Los Angeles, CA (United States); Elashoff, Robert [David Geffen School of Medicine, UCLA, Department of Biostatistics and Biomathematics, Los Angeles, CA (United States); Li, Gang [School of Public Health, UCLA, Department of Biostatistics, Los Angeles, CA (United States); Gjertson, David W. [School of Public Health and David Geffen School of Medicine, UCLA, Department of Biostatistics and Pathology, Los Angeles (United States); Lynch, David A. [National Jewish Health, Radiology Department, Denver, CO (United States); Strollo, Diane C. [UPMC Presbyterian, Radiology Department, Pittsburgh, PA (United States); Kleerup, Eric; Tashkin, Donald P. [David Geffen School of Medicine, UCLA, Department of Med-Pul and Critical Care, Los Angeles, CA (United States); Chong, Daniel; Shah, Sumit K.; Ahmad, Shama; Abtin, Fereidoun; Goldin, Jonathan G. [David Geffen School of Medicine, UCLA, Department of Radiological Sciences, Los Angeles, CA (United States)

    2011-12-15

    The Scleroderma Lung Study showed the efficacy of cyclophosphamide in modestly improving the forced vital capacity (FVC) compared with placebo over 1 year. Using changes in texture-based scores that quantify lung fibrosis as the percentage involvement of reticulation patterns, the effectiveness of cyclophosphamide was re-assessed by examining its impact on quantitative lung fibrosis (QLF). Axial HRCT images were acquired (1-mm slice thickness, 10-mm increments) in the prone position at inspiration. A validated model for quantifying interstitial disease patterns was applied to images from 83 subjects at baseline and 12 months. Scores were calculated for six zones (upper, mid, lower of the right/left lung) and the whole lung. Average changes were compared. Correlations were performed between QLF and physiological and clinical scores. From the most severe zones identified at baseline, QLF scores decreased by 2.6% in the cyclophosphamide group, whereas they increased by 9.1% in the placebo group, leading to {proportional_to}12% difference (p = 0.0027). Between-treatment difference in whole lung QLF was {proportional_to}5% (p = 0.0190). Significant associations were observed between changes in QLF and FVC (r = -0.33), dyspnea score (r = -0.29), and consensus visual score (p = 0.0001). QLF scores provide an objective quantitative tool for assessing treatment efficacy in scleroderma-related interstitial lung disease. (orig.)

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Izumi, Junko; Nishi, Tsunehiro; Fukuuchi, Atsushi; Takanashi, Riichiro [Mitsui Memorial Hospital, Tokyo (Japan)

    1998-09-01

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

  9. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    Directory of Open Access Journals (Sweden)

    Mehmet Özülkü

    2015-08-01

    Full Text Available Abstract Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump as compared to Group 2 (off-pump. But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893, P>0.05 for bilateral pleural effusion (P=0.780]. Left pleural effusion was encountered to be lower in Group 2 (off-pump. The difference was found to be statistically significant (P<0.05, P=0.006. Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  10. Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth

    Directory of Open Access Journals (Sweden)

    Valérie Huynh-Trudeau

    2015-01-01

    Full Text Available BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

  11. 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...

  12. Investigation of the Chest-Ear Radio Propagation Channel

    DEFF Research Database (Denmark)

    Kvist, Søren Helstrup; Jakobsen, Kaj Bjarne

    2010-01-01

    The path gain (|S21|) between antennas on the chest and at the ear is presented as a function of the position of the antenna on the chest. A monopole antenna and a printed Inverted-F Antenna (IFA) are considered for placement on the chest. The path gain is found by HFSS simulations as well...

  13. 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...

  14. 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...

  15. 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...

  16. Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2016-01-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  17. Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

    Directory of Open Access Journals (Sweden)

    Esdras Marques Lins

    2013-12-01

    Full Text Available BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours. RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6% of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

  18. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients.

    Science.gov (United States)

    Vafaei, Ali; Hatamabadi, Hamid Reza; Heidary, Kamran; Alimohammadi, Hosein; Tarbiyat, Mohammad

    2016-01-01

    Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p radiography in the initial evaluation of patients with traumatic injuries to the thoracic cavity.

  19. Chest X-ray quality in the diagnosis of pneumonia in children: from prescription to optimization

    International Nuclear Information System (INIS)

    Estevan, M.; Cotelo, E.; Hortal, M.; Iraola, I.

    2008-01-01

    Acute lower respiratory tract infection (ALRI), primarily pneumonia, is the leading cause of childhood death in developing countries. The increasing incidence of antimicrobial resistance and the high cost of vaccines lead to considering the first strategy to reduce pneumonia deaths the early detection of the disease. Case management begins with the clinical examination and may continue with the prescription of a chest x-ray. Consequently, the radiograph should meet quality standards, and radiologists and paediatricians must know how to interpret the images. Special attention should be paid on patient dose due to children radiosensitivity, high frequency and chest x rays rejection rate. This paper is a retrospective study of chest radiographs performed in 5731 children with clinical diagnosis of ALRI assisted in three Uruguayan hospitals during the three year investigation supported by the Division of Vaccines and Immunization of the Pan American Health Organization (PAHO) that had the aim of estimating the burden of pneumonia (from 2001 to 2004). It is analyzed the prescription of radiographs during the diagnosis and in later controls (2220 children assisted in two of the three hospitals). Patient doses are estimated from technical parameters and equipment specifications. The investigation also analyzes patient doses that could have been avoided if paediatricians had managed the disease according to the established protocols. Results show that 82.4 % of chest X-rays diagnosed pneumonia and that some children underwent up to ten radiographs. Significant differences were found in patient dose in the three hospitals, concluding that education on image quality on chest radiographs of radiologists, paediatricians and radiological technologists is the first and best tool for the earlier diagnosis of pneumonia in children and for the application of Radiation Protection (RP) principles in medical exposures. (author)

  20. Videothoracoscopic surgery before and after chest tube drainage for children with complicated parapneumonic effusion.

    Science.gov (United States)

    Knebel, Rogerio; Fraga, Jose Carlos; Amantea, Sergio Luis; Isolan, Paola Brolin Santis

    To evaluate the effectiveness of videothoracoscopic surgery in the treatment of complicated parapneumonic pleural effusion and to determine whether there is a difference in the videothoracoscopic surgery outcome before or after the chest tube drainage. The medical records of 79 children (mean age 35 months) undergoing videothoracoscopic surgery from January 2000 to December 2011 were retrospectively reviewed. The same treatment algorithm was used in the management of all patients. Patients were divided into two groups: in group 1, videothoracoscopic surgery was performed as the initial procedure; in group 2, videothoracoscopic surgery was performed after previous chest tube drainage. Videothoracoscopic surgery was effective in 73 children (92.4%); the other six (7.6%) needed another procedure. Sixty patients (75.9%) were submitted directly to videothoracoscopic surgery (group 1) and 19 (24%) primarily underwent chest tube drainage (group 2). Primary videothoracoscopic surgery was associated with a decrease of hospital stay (p=0.05), time to resolution (p=0.024), and time with a chest tube (ptube, and the hospital stay after videothoracoscopic surgery. No differences were observed between groups regarding the need for further surgery and the presence of complications. Videothoracoscopic surgery is a highly effective procedure for treating children with complicated parapneumonic pleural effusion. When videothoracoscopic surgery is indicated in the presence of loculations (stage II or fibrinopurulent), no difference were observed in time of clinical improvement and hospital stay among the patients with or without chest tube drainage before videothoracoscopic surgery. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  2. Reconstruction after major chest wall resection: can rigid fixation be avoided?

    Science.gov (United States)

    Hanna, Wael C; Ferri, Lorenzo E; McKendy, Katherine M; Turcotte, Robert; Sirois, Christian; Mulder, David S

    2011-10-01

    Rigid fixation is advocated as the best method to achieve good respiratory outcomes after chest wall resection at the expense of a high complication rate. The following study aims to examine the role of myocutaneous pedicled flaps, with or without soft prosthesis, in the reconstruction of small and large chest wall defects. All patients who underwent resection of chest wall tumors between 2003-2010 were identified from a prospectively entered database. Operative and postoperative outcomes were documented. Patients were stratified into 2 separate groups based on the size of the residual chest wall defect; the Small Defect (SD) group (60 cm(2)). Thirty-seven patients were identified over a 7-year period: 9 in the SD group and 28 in the LD group. Primary sarcoma was the most common indication for resection (57%). The mean size of the chest wall defect was 50.8 cm(2) in the SD group and 149.4 cm(2) in the LD group (P = .001). All patients underwent reconstruction with autologous tissue, nonrigid prosthesis, or a combination of the two. Prosthesis was used in 11% of patients in the SD group and 61% of patients in the LD group (P = .018). The rate of immediate postoperative extubation was 100% in the SD group and 89% in the LD group (P = .42). The rate of postoperative pneumonia was 7% in the LD group vs 0% in the SD group. The rate of surgical site infection was 7% in the LD group and 0% in the SD group. A subgroup analysis of the LD group demonstrated no statistical differences in any of the measured outcomes between patients in whom mesh prosthesis was used and patients in whom a myocutaneous flap alone was used. However, there was a clinical suggestion of prolonged ventilation in the subgroup where mesh was not used and of higher infection rates in the subgroup where mesh was used. Small chest wall defects can be reconstructed with pedicled myocutaneous flaps alone without compromising respiratory outcomes. In carefully selected patients with moderate size defects

  3. The combined effects of cold therapy and music therapy on pain following chest tube removal among patients with cardiac bypass surgery.

    Science.gov (United States)

    Yarahmadi, Sajad; Mohammadi, Nooredin; Ardalan, Arash; Najafizadeh, Hassan; Gholami, Mohammad

    2018-05-01

    Chest tube removal is an extremely painful procedure and patients may not respond well to palliative therapies. This study aimed to examine the effect of cold and music therapy individually, as well as a combination of these interventions on reducing pain following chest tube removal. A factorial randomized-controlled clinical trial was performed on 180 patients who underwent cardiac surgery. Patients were randomized into four groups of 45. Group A used ice packs for 20 minutes prior to chest tube removal. Group B was assigned to listen to music for a total length of 30 minutes which started 15 minutes prior to chest tube removal. Group C received a combination of both interventions; and Group D received no interventions. Pain intensity was measured in each group every 15 minutes for a total of 3 readings. Analysis of variance, Tukey and Bonferroni post hoc tests, as well as repeated measures ANOVA were employed for data analysis. Cold therapy and combined method intervention effectively reduced the pain caused by chest tube removal (P < 0.001). Additionally, there were no statistically significant difference in pain intensity scores between groups at 15 minutes following chest tube removal (P = 0.07). Cold and music therapy can be used by nursing staff in clinical practice as a combined approach to provide effective pain control following chest tube removal. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Chest radiographic manifestations of scrub typhus

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    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.

  5. 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

  6. Performance of chest ultrasound in pediatric pneumonia

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    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

  7. 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

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

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    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.

  9. Estudo comparativo entre tomografia computadorizada de alta resolução e radiografia de tórax no diagnóstico da silicose em casos incipientes Comparative study of high resolution computer-assisted tomography with chest radiograph in the diagnosis of silicosis incipient cases

    Directory of Open Access Journals (Sweden)

    ANA PAULA SCALIA CARNEIRO

    2001-07-01

    Full Text Available Introdução:A radiografia de tórax (RX ainda é, no dias atuais, o principal método de diagnóstico da silicose, seguindo-se as normas da Organização Internacional do Trabalho (OIT. A interpretação radiológica de casos iniciais é difícil, podendo ocorrer divergências mesmo entre leitores experientes. Recentemente, tem sido considerada a possibilidade de utilização da tomografia computadorizada com técnica de alta resolução (TCAR para avaliação de casos incipientes. Objetivo: Comparar os resultados da RX com a TCAR. Material e métodos: Foi avaliado um grupo inicial de 135 ex-mineiros, cujas radiografias foram examinadas por três leitores, no período de novembro de 1997 a dezembro de 1999. Indicou-se TCAR para 68 pacientes, cuja mediana de três leituras radiológicas foi menor ou igual a 1/0. As tomografias foram avaliadas por dois leitores e, em casos de divergência, houve participação de um terceiro leitor. As TCAR foram classificadas de acordo com a profusão de micronódulos em categorias de 0 a 3. Os resultados de TCAR e RX foram comparados através do teste de McNemar, coeficiente Kappa ponderado e modelos log-lineares. Resultados e conclusão: Houve boa concordância entre os métodos quanto à classificação na categoria 0, ou seja, os dois métodos mostraram-se equivalentes para excluir o diagnóstico de silicose. Porém, para o diagnóstico da doença, caracterizado por classificação na categoria 1 ou superior, não foi obtida boa concordância entre os métodos.Introduction: At present, chest radiography (CR is the main instrument used in the diagnosis of silicosis, following the International Labor Organization (ILO recommendations. In incipient cases, the interpretation of radiographs is difficult and disagreement may occur, even among experienced readers. Recently, the possibility of evaluating incipient cases by using high resolution computed tomography (HRCT has been considered. Objective: To compare CR

  10. Diagnostic accuracy of chest X-ray dose-equivalent CT for assessing calcified atherosclerotic burden of the thoracic aorta.

    Science.gov (United States)

    Messerli, Michael; Giannopoulos, Andreas A; Leschka, Sebastian; Warschkow, René; Wildermuth, Simon; Hechelhammer, Lukas; Bauer, Ralf W

    2017-12-01

    To determine the value of ultralow-dose chest CT for estimating the calcified atherosclerotic burden of the thoracic aorta using tin-filter CT and compare its diagnostic accuracy with chest direct radiography. A total of 106 patients from a prospective, IRB-approved single-centre study were included and underwent standard dose chest CT (1.7 ± 0.7 mSv) by clinical indication followed by ultralow-dose CT with 100 kV and spectral shaping by a tin filter (0.13 ± 0.01 mSv) to achieve chest X-ray equivalent dose in the same session. Two independent radiologists reviewed the CT images, rated image quality and estimated presence and extent of calcification of aortic valve, ascending aorta and aortic arch. Conventional radiographs were also reviewed for presence of aortic calcifications. The sensitivity of ultralow-dose CT for the detection of calcifications of the aortic valve, ascending aorta and aortic arch was 93.5, 96.2 and 96.2%, respectively, compared with standard dose CT. The sensitivity for the detection of thoracic aortic calcification was significantly lower on chest X-ray (52.3%) compared with ultralow-dose CT (p < 0.001). A reliable estimation of calcified atherosclerotic burden of the thoracic aorta can be achieved with modern tin-filter CT at dose values comparable to chest direct radiography. Advances in knowledge: Our findings suggest that ultralow-dose CT is an excellent tool for assessing the calcified atherosclerotic burden of the thoracic aorta with higher diagnostic accuracy than conventional chest radiography and importantly without the additional cost of increased radiation dose.

  11. Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia.

    Science.gov (United States)

    Claessens, Yann-Erick; Debray, Marie-Pierre; Tubach, Florence; Brun, Anne-Laure; Rammaert, Blandine; Hausfater, Pierre; Naccache, Jean-Marc; Ray, Patrick; Choquet, Christophe; Carette, Marie-France; Mayaud, Charles; Leport, Catherine; Duval, Xavier

    2015-10-15

    Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP. A total of 319 prospectively enrolled patients with clinically suspected CAP underwent multidetector chest CT scan within 4 hours. CAP diagnosis probability (definite, probable, possible, or excluded) and therapeutic plans (antibiotic initiation/discontinuation, hospitalization/discharge) were established by emergency physicians before and after CT scan results. The adjudication committee established the final CAP classification on Day 28. Chest radiograph revealed a parenchymal infiltrate in 188 patients. CAP was initially classified as definite in 143 patients (44.8%), probable or possible in 172 (53.8%), and excluded in 4 (1.2%). CT scan revealed a parenchymal infiltrate in 40 (33%) of the patients without infiltrate on chest radiograph and excluded CAP in 56 (29.8%) of the 188 with parenchymal infiltrate on radiograph. CT scan modified classification in 187 (58.6%; 95% confidence interval, 53.2-64.0), leading to 50.8% definite CAP and 28.8% excluded CAP, and 80% of modifications were in accordance with adjudication committee classification. Because of CT scan, antibiotics were initiated in 51 (16%) and discontinued in 29 (9%), and hospitalization was decided in 22 and discharge in 23. In CAP-suspected patients visiting the emergency unit, early CT scan findings complementary to chest radiograph markedly affect both diagnosis and clinical management. Clinical trial registered with www.clinicaltrials.gov (NCT 01574066).

  12. Immediate effects of chest physiotherapy on hemodynamic, metabolic, and oxidative stress parameters in subjects with septic shock.

    Science.gov (United States)

    dos Santos, Rafael S; Donadio, Márcio V F; da Silva, Gabriela V; Blattner, Clarissa N; Melo, Denizar A S; Nunes, Fernanda B; Dias, Fernando S; Squizani, Eamim D; Pedrazza, Leonardo; Gadegast, Isabella; de Oliveira, Jarbas R

    2014-09-01

    Septic shock presents as a continuum of infectious events, generating tissue hypoxia and hypovolemia, and increased oxidative stress. Chest physiotherapy helps reduce secretion, improving dynamic and static compliance, as well as improving secretion clearance and preventing pulmonary complications. The purpose of this study was to evaluate the immediate effect of chest physiotherapy on hemodynamic, metabolic, inflammatory, and oxidative stress parameters in subjects in septic shock. We conducted a quasi-experimental study in 30 subjects in septic shock, who underwent chest physiotherapy, without associated heart diseases and with vasopressors physiotherapy. Thirty subjects with a mean age of 61.8 ± 15.9 y and Sequential Organ Failure Assessment of 8 (range 6-10) were included. Chest physiotherapy caused a normalization of pH (P = .046) and P(aCO2) (P = .008); reduction of lactate (P = .001); and an increase in P(aO2) (P = .03), arterial oxygen saturation (P = .02), and P(aO2)/F(IO2) (P = .034), 15 min after it was applied. The results indicate that chest physiotherapy has immediate effects, improving oxygenation and reducing lactate and oxidative damage in subjects in septic shock. However, it does not cause alterations in the inflammatory and hemodynamic parameters. Copyright © 2014 by Daedalus Enterprises.

  13. Telemetry bed usage for patients with low-risk chest pain: review of the literature for the clinician.

    Science.gov (United States)

    Perkins, Jack; McCurdy, Michael T; Vilke, Gary M; Al-Marshad, Adel A

    2014-02-01

    Telemetry monitoring in patients with low-risk chest pain is highly utilized, despite the lack of quality data to support its use. To review the medical literature on the utility of telemetry monitoring in patients with low-risk chest pain and to offer evidence-based recommendations to emergency physicians. A PubMed literature search was performed and limited to human studies written in English language articles with keywords of "telemetry" and "chest pain." Studies identified then underwent a structured review from which results could be evaluated. There were 114 paper abstracts on telemetry monitoring screened; 30 articles were considered relevant. Twelve appropriate articles were rigorously reviewed and recommendations given. Insufficient data exist to support telemetry use in low-risk chest pain patients. Telemetry monitoring is unlikely to benefit low-risk chest pain patients with a normal/nondiagnostic electrocardiogram, a normal first set of cardiac enzymes, and none of the following: hypotension, rales above the bases, or pain worse than baseline angina. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. 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

  15. Ventricular septal defect following blunt chest trauma

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    Lisa Ryan

    2012-01-01

    Full Text Available We present a 32-year-old male with ventricular septal defect (VSD following blunt chest trauma. Traumatic VSD is a rare but potentially life-threatening injury, the severity, course and presentation of which are variable. While the diagnosis of myocardial injury may be challenging, cardiac troponins are useful as a screening and diagnostic test. The proposed pathophysiological mechanisms in the development of traumatic VSD are early mechanical rupture and delayed inflammatory rupture. We conducted a literature review to investigate the pathogenesis, distribution of patterns of presentation, and the associated prognoses in patients with VSD following blunt chest trauma. We found that traumatic VSDs diagnosed within 48 hours were more likely to be severe, require emergency surgery and were associated with a higher mortality. Children with traumatic VSDs had an increased mortality risk. Smaller lesions may be managed conservatively but should be followed up to detect late complications. In both groups elective repair was associated with a good outcome.

  16. Chest radiographic findings in acute paraquat poisoning

    International Nuclear Information System (INIS)

    Na, Gyeong Gyun; Lee, Mi Sook; Kim, Hee Jun; Sun, In O

    2016-01-01

    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

  17. Chest radiographic findings in acute paraquat poisoning

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    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.

  18. Injuries of the chestFNx01

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    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

  19. 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.)

  20. 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

  1. 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)

  2. 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.

  3. Unusual postirradiation sarcoma of chest wall

    International Nuclear Information System (INIS)

    Travis, E.L.; Kreuther, A.; Young, T.; Gerald, W.L.

    1976-01-01

    A sarcoma of the chest wall following postoperative radiation therapy for breast carcinoma is reported. A total of 9346 rads was delivered at a 2-cm tissue depth from two treatment courses separated by a five-year interval. The sarcoma appeared 16 years following the initial radiation course. The existence of two mesenchymal elements in the lesion led to the final diagnosis of malignant mesenchymoma. Criteria for evaluating a possible radiation-induced malignancy are discussed

  4. Tomografia computadorizada de alta resolução na silicose: correlação com radiografia e testes de função pulmonar High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests

    Directory of Open Access Journals (Sweden)

    Agnaldo José Lopes

    2008-05-01

    Full Text Available OBJETIVO: Correlacionar os parâmetros tomográficos com os de função pulmonar em portadores de silicose, bem como comparar os resultados da tomografia computadorizada de alta resolução (TCAR com os da radiografia de tórax. MÉTODOS: Foi realizado um estudo de corte transversal, em que foram avaliados 44 pacientes não-tabagistas e sem história pregressa de tuberculose. As radiografias foram classificadas de acordo com a proposta da Organização Internacional do Trabalho. Utilizando um sistema de escore semiquantitativo, os seguintes achados na TCAR foram quantificados: extensão total do envolvimento pulmonar, opacidades parenquimatosas e enfisema. Foram realizados espirometria, oscilações forçadas, avaliação dos volumes pulmonares pela técnica de diluição com hélio e medida da diffusing capacity of the lung for carbon monoxide (DLCO, capacidade de difusão do monóxido de carbono. RESULTADOS: Dos 44 pacientes estudados, 41 eram homens, com média de idade de 48,4 anos. Na análise comparativa, 4 pacientes classificados na categoria 0 pela radiografia foram reclassificados na categoria 1 pela TCAR e, enquanto a radiografia diagnosticou 23 casos de fibrose maciça progressiva, a TCAR estabeleceu esse diagnóstico em 33 doentes. Para o escore de opacidades, as maiores correlações foram observadas com as medidas de fluxo, DLCO e complacência. Já o enfisema correlacionou-se negativamente com as medidas de volume, DLCO e fluxo. Nesta amostra com predomínio de grandes opacidades (75% dos indivíduos, a deterioração da função pulmonar associou-se com a extensão das alterações estruturais. CONCLUSÕES: Na silicose, a TCAR é superior à radiografia tanto na detecção precoce da doença quanto na identificação de fibrose maciça progressiva.OBJECTIVE: To correlate tomographic findings with pulmonary function findings, as well as to compare chest X-ray findings with high resolution computed tomography (HRCT findings, in

  5. 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)

  6. VAC® for external fixation of flail chest

    Directory of Open Access Journals (Sweden)

    Rikke Winge

    2012-06-01

    Full Text Available A large anterior 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® (VAC® resulted in immediate chest wall stability and a decrease in the patient’s need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU. This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation.

  7. [TUBERCULOSIS SCREENING BY CHEST RADIOGRAPHY AMONG INTERNATIONAL STUDENTS AT JAPANESE LANGUAGE SCHOOLS IN OSAKA CITY].

    Science.gov (United States)

    Tsuda, Yuko; Matsumoto, Kenji; Komukai, Jun; Furukawa, Kanae; Saito, Kazumi; Shimouchi, Akira

    2015-10-01

    With a broader aim of controlling pulmonary tuberculosis (TB) among foreigners, here, we have reported the findings of chest radiography screening for TB among international students at Japanese language schools in Osaka city. Between April 2011 and December 2013, 4,529 international students from 19 Japanese language schools in Osaka city underwent chest radiography for TB screening. The chest radiographs were studied in reference to the student's sex, age, nationality, and date of entry to Japan as well as any health conditions present at the time of screening. We further analyzed the bacterial information and pulmonary TB classification based on chest radiography findings of students who were identified to be positive for TB. Information on the implementation of health education was also gathered. The results revealed that 52.5% of the students who underwent chest radiography came from China, 20.3 % from South Korea, and 16.3% from Vietnam. Of the students, 52.9% were male and 47.1% were female. The median age of students was 23 years (range: 14-70 years). The median number of days from the first date of entry to Japan up until the radiography screening was 63 days. Based on the chest radiography findings, 71 students (1.6%) were suspected to have TB; however, further detailed examination confirmed that 19 students (0.4%) had active TB. This percentage is significantly higher than the 0.1% TB identification rate among residents in Osaka city of the same time period (P<0.001), which was also determined by chest radiography. The median age of the 19 TB positive patients was 23 years. Among them, 14 (73.7%) were male. The median time from the date of entry to Japan to the date of the chest radiography screening was 137 days. For 16 of those students, the entry to Japan was within 1 year of the radiography. Of the 19 TB positive patients, 16 (84.2%) did not have respiratory symptoms, 15 (79.0%) had sputum smear negative results, and 17 (89.5%) had no cavity. Health

  8. Voiding patterns of adult patients who underwent hypospadias repair in childhood.

    Science.gov (United States)

    Jaber, Jawdat; Kocherov, Stanislav; Chertin, Leonid; Farkas, Amicur; Chertin, Boris

    2017-02-01

    This study aimed at evaluating the voiding patterns of adult patients who underwent hypospadias repair in childhood. Following IRB approval 103 (22.7%) of 449 adult patients who underwent hypospadias repair between 1978 and 1993 responded to the following questionnaires: International Prostate Symptom Score (I-PSS) and Short Form 12 questionnaire (SF-12). Uroflowmetry (UF) was performed for all patients. The patients were divided into three groups according to the primary meatus localization. Group I had 63 patients (61.5%) treated for glanular hypospadias, group II had 19 patients (18.4%) treated for distal hypospadias, and group III comprised the remaining 21 patients (20.4%) treated for proximal hypospadias. The mean ± SD I-PSS score for all patients who responded to the questionnaire was 2.3 ± 2.4, and UF was 21.1 ± 4.3 mL/s. The patients from groups I and III had fewer urinary symptoms compared with those of the group II: 1.3 ± 1.5, 5.5 ± 2.4, and 1.6 ± 1.4, respectively (p hypospadias repair in childhood had normal or mild voiding disturbance, with no effects on their physical or mental status. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  9. [Prognostic Analysis of Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy Using QOL-ACD].

    Science.gov (United States)

    Fukui, Yasuhiro; Kashiwagi, Shinichiro; Takada, Koji; Goto, Wataru; Asano, Yuka; Morisaki, Tamami; Noda, Satoru; Takashima, Tsutomu; Onoda, Naoyoshi; Hirakawa, Kosei; Ohira, Masaichi

    2017-11-01

    We investigated into association of quality of life(QOL)and prognosis of breast cancer patients who underwent neoadjuvant chemotherapy(NAC). We retrospectively studied 228 patients with breast cancer who were performed NAC during a period between 2007 and 2015. TheQ OL score was measured with"The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs(QOL-ACD)". We evaluate association between QOL score with antitumor effect and prognosis. Changes in the QOL score between before and after NAC were compared as well. We divided 2 groups by QOL-ACD scoreinto high and low groups. Therapeautic effect of NAC on 75 patients were pathological complete response(pCR). QOL-ACD score was not significantly associated with pCR rate in both high and low groups(p=0.199). High group was significantly associated with higher survival rate in both of disease free survival(p=0.009, logrank)and overall survival(p=0.040, logrank). QOLACD score decreased after NAC in both of pCR and non-pCR patients. In conclusion, QOL evaluation using QOL-ACD could be an indicator of breast cancer patients' prognosis who underwent NAC.

  10. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART. Copyright © 2012. Published by Elsevier Inc.

  11. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Alessandro Varrica

    2015-01-01

    Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

  13. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Directory of Open Access Journals (Sweden)

    Ai-Yun Shen

    2016-10-01

    Full Text Available Objective: To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy. Methods: A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0, 30 min during operation (T1, and 12 h after operation (T2 were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05. HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05. PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05. Conclusions: Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

  14. Non-invasive Respiratory Support in Blunt Chest Injury

    Directory of Open Access Journals (Sweden)

    T. V. Lobus

    2006-01-01

    Full Text Available Objective. To optimize the results of treatment in patients with acute respiratory failure (ARF due to lung contusion, by using the methods of non-invasive mask respiratory support. Materials and methods. The study covered 31 patients with severe blunt chest injury, multiple costal fractures, and hypoxemic ARF. The patients underwent assisted ventilation (AV in the CPAP+PSV mode through a facial or nasal mask. Physiological parameters were recorded during non-invasive mask ventilation (NIMV in the stepwise fashion. A control group comprised 25 patients with the similar severity of injury and ARF who were given conventional AV.Results. In 67.7% of the study group patients, NIMV was effective in improving oxygenation and external respiration, without exerting negative hemodynamic effects. Endotracheal intubation and AV could be avoided in these patients. Comparison of the study and control groups revealed a significant reduction in the incidence of secondary pneumonias in the NIMV group and in the duration of treatment. Mask ventilation could decrease mortality from 44% in the control group to 9.7% in the NIMV group.Conclusion. NIMV applied to patients with hypoxemic ARF in the presence of lung contusion improves pulmonary function and, in the bulk of patients, allows endotracheal intubation and AV and consequently their associated complications. When mask ventilation is employed, management of patients becomes shorter and simpler and mortality rates substantially decrease. 

  15. A new alternative for bony chest wall reconstruction using biomaterial artificial rib and pleura: animal experiment and clinical application.

    Science.gov (United States)

    Zhang, Lan-jun; Wang, Wu-ping; Li, Wei-yang; Hao, Chong-li; Li, Zhe; Wu, Qiu-liang; Wu, Rao-pan; Rong, Tie-hua

    2011-10-01

    To evaluate a new method for chest wall reconstruction using porcine-derived artificial rib and pleura in an animal experiment. Further, the clinical application was performed in five patients with large defects in the chest wall as a preliminary observation. In animal experiments, a full-thickness chest wall defect of 7 cm × 8 cm was created in 12 adult mongrel dogs. Six dogs underwent reconstruction with porcine-derived artificial ribs and pleura (test group), and six with methylmethacrylate and double polyester mesh in the form of traditional Marlex sandwich technique (control group). At follow-up of each for 3, 6, and 12 months postoperatively, a general performance assessment and thoracic radiography were performed. Gross and histopathological examinations were carried out following humane euthanasia at the time of last follow-up. In clinical application, five patients with wide tumor resection in the chest wall underwent reconstruction with porcine-derived artificial ribs and pleura as well. In animal experiment, no perioperative death or hyperpyrexia occurred and no difference in either infection or dyspnea was noted between the two groups. Postoperative radiography revealed good thoracic integrity with no evidence of collapse, deformation, or abnormal movement in the test group. In the control group, similar results were observed, except that two dogs had abnormal movement in the chest wall associated with respiration. Severe adhesions between the 'sandwich' complex and the host tissues were identified in the control group, but by contrast, only mild adhesions were noted in the test group. The non-degradable polyester mesh induced fibrous proliferation and rejection, whereas the artificial pleura was absorbed with mild fibrous hyperplasia after 12 months. In clinical application, no thoracic deformity, chronic pain, or respiratory discomfort were observed at 1 or 12 postoperative months. Porcine-derived ribs and pleura can be employed safely to create an

  16. A Pregnant Woman Who Underwent Laparoscopic Adrenalectomy due to Cushing’s Syndrome

    Directory of Open Access Journals (Sweden)

    Halit Diri

    2014-01-01

    Full Text Available Cushing’s syndrome (CS may lead to severe maternal and fetal morbidities and even mortalities in pregnancy. However, pregnancy complicates the diagnosis and treatment of CS. This study describes a 26-year-old pregnant woman admitted with hypertension-induced headache. Hormonal analyses performed due to her cushingoid phenotype revealed a diagnosis of adrenocorticotropic hormone- (ACTH- independent CS. MRI showed a 3.5 cm adenoma in her right adrenal gland. After preoperative metyrapone therapy, she underwent a successful unilateral laparoscopic adrenalectomy at 14-week gestation. Although she had a temporary postoperative adrenal insufficiency, hormonal analyses showed that she has been in remission since delivery. Findings in this patient, as well as those in previous patients, indicate that pregnancy is not an absolute contraindication for laparoscopic adrenalectomy. Rather, such surgery should be considered a safe and efficient treatment method for pregnant women with cortisol-secreting adrenal adenomas.

  17. Lymphocytic interstitial pneumonia in children with AIDS: high-resolution CT findings

    International Nuclear Information System (INIS)

    Becciolini, V.; Gudinchet, F.; Schnyder, P.; Cheseaux, J.J.

    2001-01-01

    Pulmonary involvement in children with acquired immunodeficiency syndrome (AIDS) represents a wide spectrum of diseases. Among the non-infectious, non-neoplastic affections associated with AIDS, lymphocytic interstitial pneumonia (LIP) is now a well-recognized entity, but its radiological pattern studied with high-resolution computed tomography (HRCT) has rarely been described in children. The aim of this study was to illustrate the HRCT spectrum of pulmonary involvement in children with LIP and to evaluate its usefulness in the early diagnosis of this entity. Twelve children with AIDS, aged 3-9 years (mean age 5 years 7 months), underwent chest radiographs and HRCT. A control group of 7 healthy aged-matched children was also studied in the same conditions. Diagnosis of LIP was based on clinical data and HRCT findings. Eight children of 12 had a reticulonodular pattern on chest radiographs. Two children had normal chest films and two children showed peribronchiolar thickening. High-resolution CT displayed micronodules, 1-3 mm in diameter, with a perilymphatic distribution in all patients. High-resolution CT demonstrated also subpleural nodules in children without reticulonodular opacities on chest radiographs. High-resolution CT is able to define a more specific pattern of abnormalities than conventional chest radiographs in children with LIP, allows an earlier and more confident diagnosis and may be useful for the detection of other pathologies associated with AIDS, such as opportunistic infections or superimposed malignancies. (orig.)

  18. Clinical outcomes for 14 consecutive patients with solid pseudopapillary neoplasms who underwent laparoscopic distal pancreatectomy.

    Science.gov (United States)

    Nakamura, Yoshiharu; Matsushita, Akira; Katsuno, Akira; Yamahatsu, Kazuya; Sumiyoshi, Hiroki; Mizuguchi, Yoshiaki; Uchida, Eiji

    2016-02-01

    The postoperative results of laparoscopic distal pancreatectomy for solid pseudopapillary neoplasm of the pancreas (SPN), including the effects of spleen-preserving resection, are still to be elucidated. Of the 139 patients who underwent laparoscopic pancreatectomy for non-cancerous tumors, 14 consecutive patients (average age, 29.6 years; 1 man, 13 women) with solitary SPN who underwent laparoscopic distal pancreatectomy between March 2004 and June 2015 were enrolled. The tumors had a mean diameter of 4.8 cm. Laparoscopic spleen-preserving distal pancreatectomy was performed in eight patients (spleen-preserving group), including two cases involving pancreatic tail preservation, and laparoscopic spleno-distal pancreatectomy was performed in six patients (standard resection group). The median operating time was 317 min, and the median blood loss was 50 mL. Postoperatively, grade B pancreatic fistulas appeared in two patients (14.3%) but resolved with conservative treatment. No patients had postoperative complications, other than pancreatic fistulas, or required reoperation. The median postoperative hospital stay was 11 days, and the postoperative mortality was zero.None of the patients had positive surgical margins or lymph nodes with metastasis. The median follow-up period did not significantly differ between the two groups (20 vs 39 months, P = 0.1368). All of the patients are alive and free from recurrent tumors without major late-phase complications. Laparoscopic distal pancreatectomy might be a suitable treatment for patients with SPN. A spleen-preserving operation is preferable for younger patients with SPN, and this study demonstrated the non-inferiority of the procedure compared to spleno-distal pancreatectomy. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  19. [Patients with astigmatism who underwent cataract surgery by phacoemulsification: toric IOL x asferic IOL?].

    Science.gov (United States)

    Torres Netto, Emilio de Almeida; Gulin, Marina Carvalho; Zapparoli, Marcio; Moreira, Hamilton

    2013-01-01

    Compare the visual acuity of patients who underwent cataract surgery by phacoemulsification with IOL AcrySof(®) toric implantation versus AcrySof(®) IQ and evaluate the reduction of cylindrical diopters (CD) in the postoperative period. Analytical and retrospective study of 149 eyes with 1 or more diopters of regular symmetrical keratometric astigmatism, which underwent cataract surgery by phacoemulsification. The eyes were divided into two groups: the toric group with 85 eyes and the non-toric group with 64 eyes. In the pre-operative phase, topographic data and refraction of each eye to be operated were assessed. In the postoperative phase, refraction and visual acuity with and without correction were measured. The preoperative topographic astigmatism ranged from 1.00 to 5.6 DC in both groups. Average reduction of 1.37 CD (p<0.001) and 0.16 CD (p=0.057) was obtained for the toric and non-toric group when compared to the refractive astigmatism, respectively. Considering visual acuity without correction (NCVA), the toric group presented 44 eyes (51.7%) with NCVA of 0 logMAR (20/20) or 0.1 logMAR (20/25) and the toric group presented 7 eyes (10.93%) with these same NCVA values. The results show that patients with a significant keratometric astigmatism presented visual benefits with the toric IOL implantation. The reduction of the use of optical aids may be obtained provided aberrations of the human eye are corrected more accurately. Currently, phacoemulsification surgery has been used not only for functional improvement, but also as a refraction procedure.

  20. Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy.

    Science.gov (United States)

    Liu, Changli; Du, Zhi; Lou, Cheng; Wu, Chenxuan; Yuan, Qiang; Wang, Jun; Shu, Guiming; Wang, Yijun

    2011-01-01

    To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical and clinical parameters were recorded and analyzed between the two groups. There was no significant difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN groups on the preoperative day, the 1st and 3 rd postoperative days. However, on the 7th postoperative day, there was significant difference between the two groups in 24 h urinary nitrogen, serum levels of, total protein (TP), transferrin (TF), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14th postoperative day, there was a significant difference between the two groups in terms of urinary levels of 24 h nitrogen, TP, TF, retinol binding protein, ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying in the EN and TPN groups was 0% and 20%, respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in the TPN group, respectively. EN is better than TPN for pancreatic cancer patients who received pancreaticoduodenectomy.

  1. HRCT in cystic fibrosis in patients with CFTR I1234V mutation: Assessment of scoring systems with low dose technique using multidetector system and correlation with pulmonary function tests

    International Nuclear Information System (INIS)

    Bhat, Venkatraman; Wahab, Atiqa Abdul; Garg, Kailash C; Janahi, Ibrahim; Singh, Rajvir

    2015-01-01

    Pulmonary changes in patients with cystic fibrosis (CF) with CFTR I1234V mutation have not been extensively documented. Impact of geographic influence on phenotypical expression is largely unknown. This descriptive clinical study presents the high-resolution computed tomography (HRCT) pulmonary findings and computed tomography (CT) scoring with respect to pulmonary function tests (PFT) in a small subset of CF group. We examined 29 patients between 2 and 31 years of age with CFTR I1234V mutation. HRCT and PFT were performed within 2 weeks of each other. Imaging abnormalities on HRCT were documented and analyzed by utilizing the scoring system described by Bhalla et al., Brody et al., Helbich et al.,and Santamaria et al. Efficacy of the scoring system with respect to PFT was compared. Inter-observer reliability of the scoring systems was tested using intraclass correlation (ICC) between the two observers. Spearman correlation coefficients were calculated between the scoring systems and between the scoring systems and PFT results. In our study, right upper and middle lobes were the most frequently involved sites of involvement. Bronchiectasis and peribronchial thickening were the most frequent imaging findings. Scores with all four scoring systems were reproducible, with good ICC coefficient of 0.69. There was good agreement between senior radiologists in all scoring systems. We noted pulmonary imaging abnormalities in a large majority (96%) of our CF patients. There was no significant difference in the CT scores observed from various systems. The CT evaluation system by Broody is detailed and time consuming, and is ideal for research and academic setup. On the other hand, the systems by Bhalla and Santamaria are easy to use, quick, and equally informative. We found the scoring system by Santamaria preferable over that of Bhalla by virtue of additional points of evaluation and ease of use, and therefore better suited for busy clinical practice

  2. Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Department of Medical Radiology, Institute of Diagnostic Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Flohr, Thomas G. [Computed Tomography CTE PA, Siemens Medical Solutions, Forchheim (Germany)

    2007-12-15

    The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1{+-}16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1{+-}6 HU comparing right and left coronary artery and 56{+-}9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291{+-}65 HU in the ascending aorta, 334{+-}93 HU in the pulmonary trunk, and 285{+-}66 HU and 268{+-}67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

  3. Radiological study of the chest using the digital method (FCR 101)

    International Nuclear Information System (INIS)

    Ferri, G.; Battolla, L.; Palla, L.; D'Alessandro, F.; Torri, T.; Tagliagambe, A.

    1991-01-01

    A computed radiography system with solid state detectors (FCR 101) was employed to evaluate the quality of digital images, with optimal and progressively lowered doses, in the study of the chest. Routine chest radiographs of in patients with no pathologic conditions of the chest were studied. The patients were divided into 3 groups: each patient in group A underwent two radiographs, one at 100% andthe other at 50% exposure; patients in group B were imaged with 100% and 25% doses, and those in group C received 50% and 25% exposure. Several parameters were employed for image evaluation, and a value was given to each of them (1=good, 2=sufficient, 3=insufficient). Upon comparison of the average values obtained, we observed that the digital technique allowed a most accurate and well-defined representation of the examined parameters at 100% exposure dose and that a 50% reduction did not decrease the informative content of the least. A 25% reduction, however, determined a high degree of background noise and a subsequent, though slight, loss of information

  4. Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward.

    Science.gov (United States)

    Ticinesi, Andrea; Lauretani, Fulvio; Nouvenne, Antonio; Mori, Giulia; Chiussi, Giulia; Maggio, Marcello; Meschi, Tiziana

    2016-07-01

    Our aim was to compare the accuracy of lung ultrasound (LUS) and standard chest x-ray (CXR) for diagnosing pneumonia in older patients with acute respiratory symptoms (dyspnea, cough, hemoptysis, and atypical chest pain) admitted to an acute-care geriatric ward. We enrolled 169 (80 M, 89 F) multimorbid patients aged 83.0 ± 9.2 years from January 1 to October 31, 2015. Each participant underwent CXR and bedside LUS within 6 hours from ward admission. LUS was performed by skilled clinicians, blinded to CXR results and clinical history. The final diagnosis (pneumonia vs no-pneumonia) was established by another clinician reviewing clinical and laboratory data independent of LUS results and possibly prescribing chest contrast-enhanced CT. Diagnostic parameters of CXR and LUS were compared with McNemar test on the whole cohort and after stratification for Rockwood Clinical Frailty Scale. Diagnostic accuracy for pneumonia (96 patients) was significantly higher in LUS (0.90, 95% confidence interval [CI] 0.83-0.96) compared with CXR (0.67, 95%CI 0.60-0.74, P pneumonia, particularly in those with frailty. A wider use of LUS should be implemented in this setting.

  5. Utility of Low Fidelity Manikins for Learning High Quality Chest Compressions.

    Science.gov (United States)

    Girish, Meenakshi; Rawekar, Alka; Jose, Sujo; Chaudhari, Umesh; Nanoti, Girish

    2018-03-01

    Primarily, to measure the adequacy of chest compression depth after training on low fidelity manikins and secondarily to assess the comparative experience of the learners on high fidelity and low fidelity simulators. An observational cohort study in which seventy-two first year postgraduate students underwent a Basic Life Support (BLS) workshop conducted by AHA accredited BLS trainers and they were then required to perform on a high fidelity manikin to objectively record the quality of their performance. There were 34 (47.22%) male and 38 (52.77%) female participants. CPR skills, as judged by checklist of sequential actions and visual inspection during the BLS training on low fidelity simulators (LFS) were correctly performed by majority (95.89%) participants. However, none of the participants could achieve the recommended depth for high quality chest compressions. The participants' perception of degree of realism and their practical experience on both the types of manikins were similar. Low fidelity manikins are useful for training CPR in sequential manner but fail to impart quality of chest compressions as per AHA recommendations.

  6. Two K versus 4 K storage phosphor chest radiography: detection performance and image quality

    International Nuclear Information System (INIS)

    Koelblinger, Claus; Weber, Michael; Sailer, Johannes; Cartes-Zumelzu, Fabiola; Prokop, Mathias; Schaefer-Prokop, Cornelia

    2007-01-01

    The purpose of this study was to evaluate the effect of matrix size (4-K versus 2-K) in digital storage phosphor chest radiographs on image quality and on the detection of CT-proven thoracic abnormalities. In 85 patients who underwent a CT of the thorax, we obtained two additional posteroanterior storage phosphor chest radiographs, one with a matrix size of 3,520 x 4,280 (=4-K) and the other with a matrix size of 1,760 x 2,140 (=2-K). Acquisition, processing and presentation parameters were identical for all radiographs. Two radiologists evaluated the presence of mediastinal, pleural, and pulmonary abnormalities on hard copies of the radiographs, applying ROC analysis. In addition, four radiologists were asked to subjectively rank differences in image quality and to assess the demarcation of anatomic landmarks comparing the images in a blinded side-by-side manner. These data were analyzed using a two-sided binomial test with a significance level of P<0.05. Both tests, the ROC analysis of the detection performance and the binomial test of the subjective quality ratings, did not reveal significant differences between the two matrix sizes. Compared to 2-K radiographs, 4-K storage phosphor chest radiographs do not provide superior detection performance or image quality when evaluated in identical hard copy formats. (orig.)

  7. Normal mediastinal and hilar lymph nodes in children on multi-detector row chest computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Jong, Pim A. de; Nievelstein, Rutger-Jan A. [University Medical Center Utrecht and Wilhelmina Children' s Hospital, Department of Radiology, Utrecht (Netherlands)

    2012-02-15

    To study normal mediastinal and hilar lymph nodes on multi-detector chest computed tomography (CT). A cohort of 120 children aged 1-17 years underwent emergency CT, including the chest, after high-energy trauma. Axial 5-mm reconstructions were evaluated for lymph nodes at hilar and various mediastinal levels and the short-axis diameters were measured. At least one lymph node was found in 115 (96%) children, with subcarinal (69%), lower paratracheal (64%) and hilar (60%) nodes being most common. Up to 10 years of age most lymph nodes were smaller than or equal to 7 mm. In older children lymph nodes measuring up to 10-mm-short-axis diameter were found. Lymph nodes were rare along the mammary vessels, at lower oesophageal and at prevascular and posterior mediastinal levels in children. Mediastinal and hilar lymph nodes are more common than previously thought, probably because of increased detection by modern multi-detector CT. Lymph node location and age have to be taken into account when evaluating lymph nodes in the paediatric chest. (orig.)

  8. Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

    International Nuclear Information System (INIS)

    Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem; Seifert, Burkhardt; Flohr, Thomas G.

    2007-01-01

    The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1±16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1±6 HU comparing right and left coronary artery and 56±9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291±65 HU in the ascending aorta, 334±93 HU in the pulmonary trunk, and 285±66 HU and 268±67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

  9. Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients.

    Science.gov (United States)

    de Sá, Rafaela Barros; Pessoa, Maíra Florentino; Cavalcanti, Ana Gabriela Leal; Campos, Shirley Lima; Amorim, César; Dornelas de Andrade, Armèle

    2017-08-01

    This study evaluated the immediate effects of respiratory muscle stretching on chest wall kinematics and electromyographic activity in COPD patients. 28 patients with COPD were randomized into two groups: 14 to the treatment group (TG) and 14 to the control group (CG). The TG underwent a stretching protocol of the rib cage muscles, while the CG remained at rest under similar conditions. After a single session, TG increased the tidal volume of the pulmonary rib cage (Vrcp) (p=0.020) and tidal volume of abdominal rib cage (Vrca) (p=0.043) variations and their percentages in relation to the thoracic wall, Vrcp% (p=0.044) and Vrca% (p=0.022). Also, TG decreased the end-expiratory Vrcp (p=0.013) and the end-inspiratory Vrcp (p=0.011) variations. In addition, there was a reduction in respiratory rate (RR) (p=0.011) and minute volume (MV) (p=0.035), as well as an increase in expiratory time (Te) (p=0.026). There was also an immediate reduction in sternocleidomastoid (p=0.043) and upper trapezium (p=0.034) muscle electrical activity. Then, the study supports the use of stretching to improve COPD chest wall mobility with positive effects on chest wall mechanics, on volume distribution and electromyography. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Fluoroscopically guided automated gun biopsy of chest lesions: diagnostic accuracy and complications

    International Nuclear Information System (INIS)

    Oh, Hee Sul; Han, Young Min; Choi, Ki Chul and others

    1998-01-01

    To determine the diagnostic accuracy and frequency of complications of fluoroscopyguided transthoracic needle biopsy, using an automated gun biopsy system. We retrospectively reviewed 86 patients who underwent automated gun biopsy between October 1995 and October 1996. An 18-gauge cutting needle was used in all cases. All biopsies were performed under fluoroscopic guidance by one interventional radiologist. Tissue sufficient for histologic diagnosis was obtained in 73 of 86 biopsies(84.9%). Fifty-six lesions were malignent and 30 were benign. Sensitivity and diagnostic accuracy for malignant lesions were 87.5% and 87.5%, respectively while cell type specificity in malignant diagnosis was 91.7%(11/12). Sensitivity and diagnostic accuracy for benign lesions were 80.0% and 73.3%, respectively. Postbioptic pneumothorax occurred in three of 86 biopsies(3.5%), one of which required placement of a chest tube. Automated gun biopsy is a simple, safe method for the diagnosis of focal chest lesions. An automated biopsy device offers high diagnostic accuracy in casis involving malignant and benign lesions of the chest, and is particularly useful for determining malignant cell type and specific diagnosis of benign lesions.=20

  11. High-frequency chest-wall compression during the 48 hours following thoracic surgery.

    Science.gov (United States)

    Allan, James S; Garrity, Julie M; Donahue, Dean M

    2009-03-01

    Postoperative pneumonia continues to be a leading cause of mortality and morbidity after thoracic surgery. High-frequency chest-wall compression (HFCWC) is an established therapeutic adjunct for patients with chronic pulmonary disorders that impair bronchopulmonary secretion clearance. We studied the feasibility of applying HFCWC following thoracic surgery. Twenty-five consecutive adult patients who underwent a variety of thoracic operations received at least one HFCWC treatment in the first 2 postoperative days, along with routine postoperative care. HFCWC was applied at 12 Hz, for 10 min. Routine hemodynamic and pulse oximetry data were collected before, during, and after HFCWC. We also collected qualitative data on patient tolerance and preference for HFCWC versus percussive chest physiotherapy. No major adverse events were encountered. Hemodynamic and pulse oximetry values remained stable before, during, and after HFCWC. Eighty-four percent of the subjects reported little or no discomfort during therapy, and the subjects who expressed a preference preferred HFCWC to conventional chest physiotherapy by more than two to one. HFCWC is a safe, well-tolerated adjunct after thoracic surgery. The observation of hemodynamic stability is especially important, considering that the patients were studied in the early postoperative period, during epidural analgesia.

  12. Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

    International Nuclear Information System (INIS)

    Sugawara, Akitomo; Shigematsu, Naoyuki; Nakashima, Jun; Kunieda, Etsuo; Nagata, Hirohiko; Mizuno, Ryuichi; Seki, Satoshi; Shiraishi, Yutaka; Kouta, Ryuichi; Oya, Mototsugu

    2011-01-01

    The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125 I seeds. We reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125 I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration. A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration. We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90

  13. Multilevel en bloc spondylectomy and chest wall excision via a simultaneous anterior and posterior approach for Ewing sarcoma.

    Science.gov (United States)

    Samartzis, Dino; Marco, Rex A W; Benjamin, Robert; Vaporciyan, Ara; Rhines, Laurence D

    2005-04-01

    A case study of a patient with Ewing sarcoma of T8 and T9 with paravertebral and chest wall involvement, who underwent neoadjuvant chemotherapy and subsequent multilevel en bloc spondylectomy and chest wall excision using a simultaneous anterior and posterior approach. To show the feasibility of treating Ewing sarcoma of the thoracic spine with paravertebral and chest wall extension by multiagent chemotherapy followed by a multilevel en bloc spondylectomy and chest wall excision using a simultaneous anterior and posterior approach. Ewing sarcoma is a primary malignant bone tumor that occasionally involves the spinal column. Most patients with Ewing sarcoma of the spine are treated with systemic chemotherapy followed by definitive local control. Radiation therapy is the usual mode of local control in these patients because the spinal column has historically been considered a surgically inaccessible site where wide surgical margins are difficult to obtain. However, en bloc spondylectomy techniques have been described that can probably further decrease the risk of local recurrence, thereby minimizing or even eliminating the need for radiation therapy. To our knowledge, a combined en bloc spondylectomy and chest wall excision in a patient with Ewing sarcoma in the spine has not been previously reported. Neoadjuvant chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide was administered. After completion of the chemotherapy, an en bloc spondylectomy of T8 and T9 with removal of the chest wall was achieved using a simultaneous anterior and posterior approach to the spine. A stackable carbon fiber cage filled with autograft and allograft bone was inserted between T7 and T10. The spine was stabilized with anterior and posterior instrumentation. The chest wall was reconstructed with contoured polymethylmethacrylate and polypropylene (Marlex, Textile Development Associates, Inc., Franklin Square, NY) mesh. The patient maintained normal neurologic function

  14. High-resolution CT in patients with chronic airflow obstruction: correlation with clinical diagnosis and pulmonary function test

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Ki Taek; Kang, Eun Young; Rhee, Ji Yong; Kim, Jin Hyung; Choi, Jung Ah; Cho, Jae Yoen; Oh, Yu Whan; Suh, Won Hyuck [College of Medicine, Korea University, Seoul (Korea, Republic of)

    2000-06-01

    To determine the utility of HRCT in the diagnosis of chronic airflow obstruction and to correlate the morphologic abnormalities revealed by this modality with functional impairment in patients with chronic airflow obstruction. This study involved 80 patients with chronic airflow obstruction who underwent HRCT and a pulmonary function test. Final clinical diagnosis in these patients was determined by a chest physician on the basis of clinical features, bronchoscopy, pulmonary function test, and HRCT. In order to diagnose and determine the extent of areas of decreased attenuation revealed by HRCT (the CT score), the findings of HRCT were retrospectively reviewed by two radiologists, who reached a consensus. Clinical and HRCT diagnoses were then compared, and the rate of agreement between them was calculated. The relationship between the extent of areas of decreased attenuation revealed by HRCT and by FEV1/FVC was evaluated using Correl's account and Student's unpaired t-test. The agreement rate between clinical and HRCT diagnoses was 77.5% (62/80). The rates for bronchiectasis (88.9%, 24/27), emphysema (93.9%, 31/33), and bronchiolitis obliterans (100%, 6/6) were considerably higher than those for chronic bronchitis and bronchial asthma. The correlation rate between CT score and FEV1/FVC was significant in bronchiectasis (p less than 0.05; r: -0.76) and bronchiolitis obliterans (p less than 0.01; r: -0.66), but not in cases involving emphysema, bronchial asthma, or chronic bronchitis (p greater than 0.05). HRCT is valuable in the diagnosis and prediction of physiologic impairment in patients with bronchiectasis and bronchiolitis obliterans, but has limited value in those with emphysema, chronic bronchitis or asthma. (author)

  15. 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)

  16. 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.

  17. 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.

  18. Titanium plate fixation of flail chest

    OpenAIRE

    Muhammad Nadeem; Hibbut-ur-Rauf Naseem; William F. Stendardi; Kathryn D. Bass

    2018-01-01

    Introduction: We present short and long term outcomes of titanium rib plating in two pediatric patients with traumatic flail chest. Cases: Patient 1 is a 12 year old male ATV driver with left thorax handlebar impalement with a flail segment of ribs 4–8. He was unable to wean from the ventilator by hospital day (HD) 4 and had titanium plating of ribs 4–7. He was extubated on postoperative day (POD) 1 and discharged home on POD 5. He returned to contact sports at 6 months. Patient 2 is a 13 ...

  19. 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

  20. An unusual case of chest pain

    Directory of Open Access Journals (Sweden)

    Gabriella Nucera

    2016-07-01

    Full Text Available We report the case of a 40-year-old woman presenting during the night to the emergency department for thoracic pain and pain in the upper arm. An electrocardiogram (ECG showed diffuse ST segment elevation. A coronarography (CVG showed spontaneous dissection of the interventricular anterior artery. Many patients present with chest pain to emergency departments (ED. Spontaneous coronary artery dissection (SCAD should be considered in any young patient, especially young women, without a history of coronary heart disease or risk factors, who presents with an acute myocardial infarction or cardiac arrest.

  1. 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.)

  2. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  3. [A case of esophageal cancer with a funnel chest].

    Science.gov (United States)

    Takemura, Manabu; Matsuyama, Takeshi; Nishibeppu, Keiji; Matsumura, Atsushi; Ogino, Shiro; Mugitani, Tatsuro; Akami, Toshikazu; Shimode, Yoshikazu

    2013-11-01

    Esophageal cancer is a disease that is difficult to manage before and after surgery and is associated with a high in-hospital mortality rate despite there being reports of improved outcomes after multidisciplinary treatment. Meanwhile, although funnel chest is generally a subclinical condition, patients with this deformity may sometimes present with cardiac failure and chest pain. We report a case of advanced esophageal cancer with a funnel chest deformity that was very difficult to reconstruct after thoracoscopy-assisted resection.

  4. [Rib fractures after chest physiotherapy: a report of 2 cases].

    Science.gov (United States)

    Chanelière, C; Moreux, N; Pracros, J-P; Bellon, G; Reix, P

    2006-11-01

    The 2000 French consensus conference for acute viral bronchiolitis management underlined the fundamental role of chest physiotherapy. According to Chalumeau and al., rib fractures were found out in 1/1000 children hospitalized for bronchiolitis or pneumonia. However, such complication of chest physiotherapy is exceptional. We report 2 cases with third to sixth lateral rib fractures after chest physiotherapy in infants with bronchiolitis. Despite the rarity of these complications, clinicians must keep in mind this etiology while facing rib fractures in infants.

  5. Triple Rule Out versus CT Angiogram Plus Stress Test for Evaluation of Chest Pain in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Kelly N. Sawyer

    2015-10-01

    Full Text Available Introduction: Undifferentiated chest pain in the emergency department (ED is a diagnostic challenge. One approach includes a dedicated chest computed tomography (CT for pulmonary embolism or dissection followed by a cardiac stress test (TRAD. An alternative strategy is a coronary CT angiogram with concurrent chest CT (Triple Rule Out, TRO. The objective of this study was to describe the ED patient course and short-term safety for these evaluation methods. Methods: This was a retrospective observational study of adult patients presenting to a large, community ED for acute chest pain who had non-diagnostic electrocardiograms (ECGs and normal biomarkers. We collected demographics, ED length of stay, hospital costs, and estimated radiation exposures. We evaluated 30-day return visits for major adverse cardiac events. Results: A total of 829 patients underwent TRAD, and 642 patients had TRO. Patients undergoing TRO tended to be younger (mean 52.3 vs 56.5 years and were more likely to be male (42.4% vs. 30.4%. TRO patients tended to have a shorter ED length of stay (mean 14.45 vs. 21.86 hours, to incur less cost (median $449.83 vs. $1147.70, and to be exposed to less radiation (median 7.18 vs. 16.6mSv. No patient in either group had a related 30-day revisit. Conclusion: Use of TRO is feasible for assessment of chest pain in the ED. Both TRAD and TRO safely evaluated patients. Prospective studies investigating this diagnostic strategy are needed to further assess this approach to ED chest pain evaluation.

  6. 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)

  7. Cariporide enables hemodynamically more effective chest compression by leftward shift of its flow-depth relationship.

    Science.gov (United States)

    Kolarova, Julieta D; Ayoub, Iyad M; Gazmuri, Raúl J

    2005-06-01

    When given during closed-chest resuscitation, cariporide (4-isopropyl-methylsulfonylbenzoyl-guanidine methanesulfonate; a selective inhibitor of the Na(+)/H(+) exchanger isoform-1) enables generation of viable perfusion pressures with less depth of compression. We hypothesized that this effect results from greater blood flows generated for a given depth of compression. Two series of 14 rats each underwent 10 min of untreated ventricular fibrillation followed by 8 min of chest compression before defibrillation was attempted. Compression depth was adjusted to maintain an aortic diastolic pressure (ADP) between 26 and 28 mmHg in the first series and between 36 and 38 mmHg in the second series. Within each series, rats were randomized to receive cariporide (3 mg/kg) or NaCl (0.9%; control) before chest compression was started. Blood flow was measured using 15-mum fluorescent microspheres. Less depth of compression was required to maintain the target ADP when cariporide was present in both series 1 (13.6 +/- 1.2 vs. 16.6 +/- 1.2 mm; P < 0.001) and series 2 (15.3 +/- 1.0 vs. 18.9 +/- 1.5 mm; P < 0.001). Despite less compression depth, the cardiac index in cariporide-treated rats was comparable to control rats in series 1 (11.1 +/- 0.7 vs. 11.3 +/- 1.4 ml.min(-1).kg(-1); P = not significant) but higher in series 2 (15.5 +/- 2.3 vs. 9.9 +/- 1.4 ml.min(-1).kg(-1); P < 0.05). Increases in compression depth (from series 1 to series 2) increased myocardial, cerebral, and adrenal blood flow in cariporide-treated rats. We conclude that cariporide enhances the efficacy of closed-chest resuscitation by leftward shift of the flow-depth relationship.

  8. The thoracoplastic approach to chest wall reconstruction: preliminary results of a multidisciplinary approach to minimize morbidity.

    Science.gov (United States)

    Basta, Marten N; Fischer, John P; Lotano, Vincent E; Kovach, Stephen J

    2014-12-01

    Chest wall reconstruction remains challenging because of the variable nature of the defect. Muscle-sparing approaches have been described but are not widely applied today. The authors reviewed an institutional experience with chest wall reconstruction and describe the thoracoplastic approach, which aims to optimize flap selection. A retrospective review was conducted identifying all patients undergoing chest wall reconstruction performed by the senior author. Demographic information and operative characteristics were detailed and factors were analyzed for association with postoperative outcomes. Outcomes were also compared for conventional versus thoracoplastic groups. Forty-five patients underwent chest wall reconstruction at an average age of 54.2 ± 16.3 years. Sarcomas were most common (51 percent), followed by breast (16 percent) and lung (11 percent). The average number of ribs resected was 3.2 ± 1.4, with an average defect size of 212 ± 185 cm2. The most commonly used flaps included the latissimus dorsi and pectoralis major (72 percent). Mesh was incorporated in 58 percent of repairs and operative time was 6.2 ± 2.5 hours. The incidence of surgical complications was 23 percent, most commonly wound infection and nonhealing wound (20 percent). The thoracoplastic approach, used in 14 patients, demonstrated no differences in outcomes with follow-up of 14 months. Operative time was nearly identical, and the thoracoplastic group required significantly less blood products when transfused. Latissimus dorsi and pectoralis major flaps were used more frequently in the thoracoplastic group, although this did not reach significance (78.6 percent versus 69.2 percent). The thoracoplastic approach appears to be safe and effective when compared with conventional methods. Although definitive conclusions cannot be drawn, the authors' early experience is promising. The authors believe applying these principles improves aesthetic and functional outcomes and preserves the

  9. 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.

  10. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  11. Assessment of quality of life in patients who underwent minimally invasive cosmetic procedures.

    Science.gov (United States)

    de Aquino, Marcello Simão; Haddad, Alessandra; Ferreira, Lydia Masako

    2013-06-01

    There are increasingly more patients seeking minimally invasive procedures, which have become more effective and safer in reducing the signs of facial aging. This study included 40 female adult patients who voluntarily underwent selected minimally invasive procedures (filling with hyaluronic acid and botulinum toxin injection) for facial rejuvenation. All patients were followed for a period of 6 months. They were evaluated with the use of questionnaires, a quality-of-life questionnaire (DLQI), the self-esteem scale of Rosenberg (EPM/Rosenberg), and a pain scale. The minimally invasive procedures resulted in improvement in quality of life and self-esteem, which were stronger the first 3 months after the procedures but remained at a higher level than that before treatment, even after 6 months. Hyaluronic acid with lidocaine in the formula is more comfortable for the patient as it makes the injection less painful. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision.

    Science.gov (United States)

    Uzun, Hakan; Bitik, Ozan; Kamburoğlu, Haldun Onuralp; Dadaci, Mehmet; Çaliş, Mert; Öcal, Engin

    2015-06-01

    Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.

  13. [A survey of perioperative asthmatic attack among patients with bronchial asthma underwent general anesthesia].

    Science.gov (United States)

    Ie, Kenya; Yoshizawa, Atsuto; Hirano, Satoru; Izumi, Sinyuu; Hojo, Masaaki; Sugiyama, Haruhito; Kobayasi, Nobuyuki; Kudou, Kouichirou; Maehara, Yasuhiro; Kawachi, Masaharu; Miyakoshi, Kouichi

    2010-07-01

    We investigated the risk factor of perioperative asthmatic attack and effectiveness of preventing treatment for asthmatic attack before operation. We performed retrospective chart review of one hundred eleven patients with asthma underwent general anesthesia and surgical intervention from January 2006 to October 2007 in our hospital. The rate of perioperative asthmatic attack were as follows; 10.2% (5 in 49 cases) in no pretreatment group, 7.5% (3 in 40 cases) in any pretreatments except for systemic steroid, and 4.5% (1 in 22 cases) in systemic steroid pretreatment group. Neither preoperative asthma severity nor duration from the last attack had significant relevancy to perioperative attack rate. The otolaryngological surgery, especially those have nasal polyp and oral surgery had high perioperative asthma attack rate, although there was no significant difference. We recommend the systemic steroid pretreatment for asthmatic patients, especially when they have known risk factor such as administration of the systemic steroid within 6 months, or possibly new risk factor such as nasal polyp, otolaryngological and oral surgery.

  14. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures

    Directory of Open Access Journals (Sweden)

    Zeba Snježana

    2007-01-01

    Full Text Available Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .

  15. Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria.

    Science.gov (United States)

    Osifo, O D; Osaigbovo, E O

    2008-06-01

    To determine the prevalence and spontaneous resolution of congenital hydrocele diagnosed in male neonates who underwent circumcision at our centre. All male neonates presented for circumcision at the University of Benin Teaching Hospital, Benin City, Nigeria between January 2002 and December 2006 were examined for the presence of hydrocele. Those diagnosed with this condition were recruited and followed up in a surgical outpatient clinic for 2 years. The number of cases of spontaneous resolution and age at which this occurred were documented on a structured pro forma. A total of 2715 neonates were circumcised and 128 (4.7%) were diagnosed with 163 cases of hydrocele, while 27 cases in 25 (0.9%) children failed to resolve at the age of 2 years. Neonatal hydrocele was bilateral in 112 (68.7%), and there were 20 (12.3%) right and 31 (19.0%) left. Among those with hydrocele, 28.1% were delivered preterm and resolution was spontaneous in many of them, with no observed significant statistical difference to those delivered full term (P=0.4740). Of the 163 hydrocele cases, 136 (83.4%) resolved spontaneously by age 18 months with peak resolution at 4-6 months. No spontaneous resolution occurred after 18 months and no hydrocele-related complication occurred during follow up. Neonates with congenital hydrocele should be observed for spontaneous resolution for at least 18 months before being subjected to surgery.

  16. Stress and Quality of Life for Taiwanese Women Who Underwent Infertility Treatment.

    Science.gov (United States)

    Cheng, Ching-Yu; Stevenson, Eleanor Lowndes; Yang, Cheng-Ta; Liou, Shwu-Ru

    2018-04-28

    To describe the psychological stress and quality of life experienced by women who underwent fertility treatment in Taiwan. Cross-sectional, correlational study. Recruitment was conducted and questionnaires administered at a reproductive medicine center in Chiayi City, Taiwan. Informed consent to participate was obtained from 126 women who sought fertility treatment at the center. The Chinese Fertility Problem Inventory and Fertility Quality of Life scale were used to measure participants' levels of fertility-related stress and fertility-related quality of life. Descriptive statistics, correlation, and regression analysis were used. Overall, participants reported low levels of fertility-related stress and fertility-related quality of life; however, they had relatively high levels of stress related to need for parenthood. Women who were older, had greater body mass indexes, and consumed coffee regularly had lower fertility-related quality of life. Social and relationship concerns and stress related to need for parenthood were significant predictors of low fertility-related quality of life. In a culture in which childbearing is generally an expectation and an important part of family life, women who experience infertility are at risk to experience fertility-related stress. Social support and family consultation might be offered to improve women's fertility-related quality of life. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  17. [Current development in therapy of congenital funnel chest].

    Science.gov (United States)

    Ji, Kai; Luan, Jie

    2012-12-01

    To review the current development in therapy of congenital funnel chest. Recent literature concerning the development of the treatment method for congenital funnel chest was extensively reviewed and summarized. The main therapies for congenital funnel chest are thoracoplasty (Ravitch sternum elevation procedure and minimal invasive Nuss procedure) and prosthesis implantation. The magnetic mini-mover procedure and the vacuum bell are still in the research phase. Besides the improvement in function, the requirement in appearance after surgery is also improved in the treatment of congenital funnel chest. The minimally invasive surgery and non-invasive procedures could be expected in the future.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Primary synovial sarcoma of the posterior chest wall.

    Science.gov (United States)

    Hung, Jung-Jyh; Chou, Teh-Ying; Sun, Chih-Hao; Liu, Jung-Sen; Hsu, Wen-Hu

    2008-06-01

    Synovial sarcoma is a malignant soft-tissue tumor that most commonly occurs in the extremities of young adults. Only several cases of synovial sarcomas of the chest wall and pleura had been reported. We present a 24-year-old man who had right back pain, chest pain, dyspnea, and intermittent fever from a huge primary synovial sarcoma of the right posterior chest wall. Multimodality therapies, including surgical resection, and chemotherapy and radiation therapy were applied, but the tumor progressed rapidly and the patient died 6 months after diagnosis. Prompt diagnosis and aggressive surgical resection is mandatory for primary synovial sarcoma of the chest wall because of its aggressive behavior.

  3. Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography.

    Science.gov (United States)

    Matsumoto, Shokei; Sekine, Kazuhiko; Funabiki, Tomohiro; Orita, Tomohiko; Shimizu, Masayuki; Hayashida, Kei; Kazamaki, Taku; Suzuki, Tatsuya; Kishikawa, Masanobu; Yamazaki, Motoyasu; Kitano, Mitsuhide

    2016-01-01

    An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the usefulness of OXR in the diagnosis of the occult pneumothorax and to compare OXR with ultrasonography. All consecutive blunt chest trauma patients with clinically suspected pneumothorax on arrival at the emergency department were prospectively included at our tertiary-care center. The patients underwent OXR and ultrasonography, and underwent computed tomography scans as the gold standard. Occult pneumothorax size on computed tomography was classified as minuscule, anterior, or anterolateral. One hundred and fifty-nine patients were enrolled. Of the 70 occult pneumothoraces found in the 318 thoraces, 19 were minuscule, 32 were anterior, and 19 were anterolateral. The sensitivity and specificity of OXR for detecting occult pneumothorax was 61.4 % and 99.2 %, respectively. The sensitivity and specificity of lung ultrasonography was 62.9 % and 98.8 %, respectively. Among 27 occult pneumothoraces that could not be detected by OXR, 16 were minuscule and 21 could be conservatively managed without thoracostomy. OXR appears to be as good method as lung ultrasonography in the detection of large occult pneumothorax. In trauma patients who are difficult to transfer to computed tomography scan, OXR may be effective at detecting occult pneumothorax with a risk of progression.

  4. A novel high vacuum chest drainage system – a pilot study*

    Science.gov (United States)

    Tille, Jean-Christophe; Khabiri, Ebrahim; Giliberto, Jean-Pierre; Courvoisier, Delphine S.; Kalangos, Afksendiyos; Walpoth, Beat H.

    2014-01-01

    Aim To assess the safety and feasibility of use of a novel high vacuum chest drainage system (HVCDS) and its influence on the cardiovascular system compared to a conventional system (CCDS). Material and methods Five anesthetized pigs underwent a median sternotomy. Three drains were placed in retrocardiac, retrosternal and left pleural positions. The animals received a HVCDS (22 Fr with 180 2-mm holes, n = 2) or a CCDS (n = 2). In the fifth animal off pump coronary artery bypass graft (OPCABG) stabilizers were tested. After chest closure animals had three 30 min runs of artificial bleeding (5 ml/min) under different negative aspiration pressures (–2, –20, –40 kPa) for both groups, followed by standardized surgical bleeding (–40 kPa – HVCDS, – 2 kPa – CCDS). Hemodynamic parameters and each drain's output were registered every 5 minutes and the residual blood was assessed. All catheters, the heart and left lung underwent macroscopic and histopathological examination. Results The application of the different pressures showed neither hemodynamic changes nor differences in blood drainage with both systems in two bleeding models. The HVCDS enabled drainage comparable to the CCDS but showed relevant clotting. Application of –20 kPa and –40 kPa caused macroscopic epicardial and pulmonary lesions in all tested devices including OPCABG stabilizers consisting of sub-epicardial or sub-pleural hemorrhage without myocyte or alveolar damage. Conclusions The novel and conventional chest drainage systems used at pressures up to 40 kPa induced no hemodynamic instability. Both systems showed adequate equal drainage, despite major HVCDS clotting. High negative pressure drainage with both systems showed focal sub-epicardial and subpleural hemorrhage. Thus, long-term assessment of high pressure drainage and potential interaction with fragile structures (coronary bypass graft) should be carried out. PMID:26336441

  5. 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.

  6. 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

  7. [Airway injuries due to blunt chest trauma].

    Science.gov (United States)

    Okabayashi, Kan; Hamatake, D; Yoshida, Y; Nakajima, H; Shirakusa, T; Yamasaki, S

    2006-10-01

    Although the incidence of blunt chest trauma is very high, the mediastinal tracheobronchial injuries are quite rare. The airway injuries are thought to be one of the most urgent clinical conditions in thoracic surgery, and we are requested to make not only a rapid and sharp diagnosis but also an appropriate treatment plan considering combined injuries. We present 9 cases of tracheobronchial injuries due to blunt chest trauma in recent years. The average age of these patients is 26.1 years, and they are consisted of 6 male and 3 female. The cause of trauma is traffic accident in 7, and occupational crane accident in 2. Bronchoplasty were done in 5 cases (right main bronchus in 2, left main bronchus in 1, trunks intermediate bronchus in 1, and the spur between middle and lower lobe in 1), membranous-tracheoplasty with right pneumonectomy in 1, left pneumonectomy in 1, conservative treatment in 2. Postoperative mortality is occurred in 1 case who was suffering from multiple injuries including severe head injury and contralateral lung contusion. Tracheobronchial plasties should be chosen if possible to preserve lung function for the patient suffering from airway injuries.

  8. 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%).

  9. Reduced-dose chest CT with 3D automatic exposure control vs. standard chest CT: Quantitative assessment of emphysematous changes in smokers’ lung parenchyma

    International Nuclear Information System (INIS)

    Koyama, Hisanobu; Ohno, Yoshiharu; Yamazaki, Youichi; Matsumoto, Keiko; Onishi, Yumiko; Takenaka, Daisuke; Yoshikawa, Takeshi; Nishio, Mizuho; Matsumoto, Sumiaki; Murase, Kenya; Nishimura, Yoshihiro

    2012-01-01

    Objectives: To determine the capability of reduced-dose chest CT with three-dimensional (3D) automatic exposure control (AEC) on quantitative assessment of emphysematous change in smoker’ lung parenchyma, compared to standard chest CT. Methods: Twenty consecutive smoker patients (mean age 62.8 years) underwent CT examinations using a standard protocol (150 mAs) and a protocol with 3D-AEC. In this study, the targeted standard deviations number was set to 160. For quantitative assessment of emphysematous change in lung parenchyma in each subject using the standard protocol, a percentage of voxels less than −950 HU in the lung (%LAA −950 ) was calculated. The 3D-AEC protocol's %LAA was computed from of voxel percentages under selected threshold CT value. The differences of radiation doses between these two protocols were evaluated, and %LAAs −950 was compared with the 3D-AEC protocol %LAAs. Results: Mean dose length products were 780.2 ± 145.5 mGy cm (standard protocol), and 192.0 ± 95.9 (3D-AEC protocol). There was significant difference between them (paired Student's t test, p −950 and 3D-AEC protocol %LAAs. In adopting the feasible threshold CT values of the 3D-AEC protocol, the 3D-AEC protocol %LAAs were significantly correlated with %LAAs −950 (r = 0.98, p < 0.001) and limits of agreement from Bland–Altman analysis was 0.52 ± 4.3%. Conclusions: Changing threshold CT values demonstrated that reduced-dose chest CT with 3D-AEC can substitute for the standard protocol in assessments of emphysematous change in smoker’ lung parenchyma.

  10. Long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal reconstruction.

    Science.gov (United States)

    Tazuke, Yuko; Okuyama, Hiroomi; Uehara, Shuichiro; Ueno, Takehisa; Nara, Keigo; Yamanaka, Hiroaki; Kawahara, Hisayoshi; Kubota, Akio; Usui, Noriaki; Soh, Hideki; Nomura, Motonari; Oue, Takaharu; Sasaki, Takashi; Nose, Satoko; Saka, Ryuta

    2015-12-01

    The aim of this study was to evaluate the long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal/alimentary reconstruction. We reviewed the medical records of four long-term survivors of tracheal agenesis and collected the following data: age, sex, type of tracheal agenesis, method of reconstruction, nutritional management, and physical and neurological development. The patients consisted of three boys and one girl, who ranged in age from 77 to 109months. The severity of their condition was classified as Floyd's type I (n=2), II (n=1), or III (n=1). Mechanical respiratory support was not necessary in any of the cases. Esophageal/alimentary reconstruction was performed using the small intestine (n=2), a gastric tube (n=1), and the esophagus (n=1). The age at esophageal reconstruction ranged from 41 to 55months. All of the cases required enteral nutrition via gastrostomy. Three of the patients were able to swallow a small amount of liquid and one was able to take pureed food orally. The physical development of the subjects was moderately delayed-borderline in childhood. Neurological development was normal in two cases and slightly delayed in two cases. None of the long-term survivors of tracheal agenesis required the use of an artificial respirator, and their development was close to normal. Future studies should aim to elucidate the optimal method for performing esophageal reconstruction to allow tracheal agenesis patients to achieve their full oral intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Shantavasinkul, Prapimporn Chattranukulchai; Omotosho, Philip; Corsino, Leonor; Portenier, Dana; Torquati, Alfonso

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for obesity and results in long-term weight loss and resolution of co-morbidities. However, weight regain may occur as soon as 1-2 years after surgery. This retrospective study aimed to investigate the prevalence of weight regain and possible preoperative predictors of this phenomenon after RYGB. An academic medical center in the United States. A total of 1426 obese patients (15.8% male) who underwent RYGB during January 2000 to 2012 and had at least a 2-year follow-up were reviewed. We included only patients who were initially successful, having achieved at least 50% excess weight loss at 1 year postoperatively. Patients were then categorized into either the weight regain group (WR) or sustained weight loss (SWL) group based upon whether they gained≥15% of their 1-year postoperative weight. Weight regain was observed in 244 patients (17.1%). Preoperative body mass index was similar between groups. Body mass index was significantly higher and percent excess weight loss was significantly lower in the WR group (Pweight regain was 19.5±9.3 kg and-.8±8.5 in the WR and SWL groups, respectively (Pweight loss. Moreover, a longer duration after RYGB was associated with weight regain. Multivariate analysis revealed that younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The present study confirmed that a longer interval after RYGB was associated with weight regain. Younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The findings of this study underscore the complexity of the mechanisms underlying weight loss and regain after RYGB. Future prospective studies are needed to further explore the prevalence, predictors, and mechanisms of weight regain after RYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  12. Evaluation of patients who underwent resympathectomy for treatment of primary hyperhidrosis.

    Science.gov (United States)

    de Campos, José Ribas Milanez; Lembrança, Lucas; Fukuda, Juliana Maria; Kauffman, Paulo; Teivelis, Marcelo Passos; Puech-Leão, Pedro; Wolosker, Nelson

    2017-11-01

    Video thoracoscopic sympathectomy is the recommended surgical treatment for primary hyperhidrosis and has a high success rate. Despite this high success rate, some patients are unresponsive and eventually need a resympathectomy. Few studies have previously analysed exclusively the results of these resympathectomies in patients with primary hyperhidrosis. None of the studies have objectively evaluated the degree of response to surgery or the improvement in quality of life after resympathectomies. This is a retrospective study, evaluating 15 patients from an initial group of 2300 patients who underwent resympathectomy after failure of the primary surgical treatment. We evaluated sympathectomy levels of resection, technical difficulties, surgical complications preoperative quality of life, response to treatment and quality-of-life improvement 30 days after each surgery. Regarding gender, 11 (73.3%) patients were women. The average age was 23.2 with SD of 5.17 years, and the mean body mass index was 20.9 (SD 2.12). Ten patients had major complaints about their hands (66%) and 5 (33%) patients about their forearms. A high degree of response to sympathectomy occurred in 73% of patients. In 11 of these patients, the improvement in quality of life was considered high, 3 showed a mild improvement and 1 did not improve. No major complications occurred; the presence of adhesions was reported in 11 patients and pleural drainage was necessary in 4 patients. Resympathectomy is an effective procedure, and it improves the quality of life in patients with primary hyperhidrosis who failed after the first surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  13. Surgical outcomes of 380 patients with double outlet right ventricle who underwent biventricular repair.

    Science.gov (United States)

    Li, Shoujun; Ma, Kai; Hu, Shengshou; Hua, Zhongdong; Yang, Keming; Yan, Jun; Chen, Qiuming

    2014-09-01

    The study objective was to report the outcomes of biventricular repair in patients with double outlet right ventricle. Patients with double outlet right ventricle who underwent biventricular repair at Fuwai Hospital from January 2005 to December 2012 were included. Patients were excluded if double outlet right ventricle was combined with atrioventricular septal defect, heterotaxy syndrome, atrioventricular discordance, or univentricular physiology. A total of 380 consecutive patients with a mean age of 1.9 ± 2.1 years (range, 1 month to 6 years) were included. Varied types of biventricular repair were customized individually. Follow-up was 90.4% complete, and the mean follow-up time was 3.4 ± 3.9 years. There were 17 (4.5%) early deaths and 7 (2.1%) late deaths. Preoperative pulmonary hypertension was the only risk factor for early mortality. Postoperative significant left ventricular outflow tract obstruction was present in 9 survivors. Patients with noncommitted ventricular septal defect had a longer crossclamp time, longer cardiopulmonary bypass time, and higher incidence of postdischarge left ventricular outflow tract obstruction. There were 4 reoperations, all of which were caused by subaortic left ventricular outflow tract obstruction. All of the pressure gradients were decreased to less than 20 mm Hg after the modified Konno procedure with an uneventful postoperative course. Optimal results of varied types of biventricular repair for double outlet right ventricle have been acquired. Although noncommitted ventricular septal defect is technically difficult, the outcomes of patients are favorable. Late-onset left ventricular outflow tract obstruction is the main reason for reoperation but can be successfully relieved by the modified Konno procedure. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  14. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

    Directory of Open Access Journals (Sweden)

    Ja Young Jeon

    Full Text Available The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15% patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069. In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

  15. Realistic Chest Tube Simulator Using Pork Belly with Skin

    Directory of Open Access Journals (Sweden)

    Donald Patrick Mebust

    2017-07-01

    Full Text Available Audience: The pork belly chest tube simulator is designed to instruct Emergency Medicine residents and Emergency Medicine-bound students. Introduction: Chest tube insertion is an essential procedural skill that must be mastered by practicing emergency and surgical providers. It is a lifesaving procedure indicated in cases of pneumothorax, hemothorax, chylothorax, empyema, esophageal/gastric rupture into the pleural space, and traumatic arrest.1,2 These critical patients require immediate decompression and evacuation of pleural space pathology. Therefore, chest tube insertion must be performed competently and expeditiously to prevent further morbidity and mortality. Performed improperly, chest tube placement can lead to ineffective decompression as well as life threatening visceral and vascular injury. Overall complications rates have been quoted up to 37%.3,4 Simulation offers a safe and effective method to master such procedural techniques. Unfortunately, many chest tube simulators are expensive5 or do not offer a realistic simulation experience. Therefore, we have designed an economical device that has a life-like feel, very similar to human skin and tissue. Objective: The purpose of this model is to teach residents and students how to competently perform and properly secure a surgical chest tube. Methods: This chest tube simulator uses a piece of pork belly that includes skin with underlying muscle and fascia. This tissue is placed over wooden strips and foam tape which are a proxy for human ribs and pleura. This chest wall anatomy allows the learner to locate landmarks, palpate intercostal spaces on real skin, and perform blunt dissection with a realistic “pop” of pleural tissue. Finally, since chest tube dislodgment is a common and unfortunate cause of morbidity and mortality, this chest wall design allows the learner to practice the essential and various techniques of securing the chest tube to real skin.

  16. Pulmonary Metastasis from Rectal Cancer on Chest CT Is Correlated with 3T MRI Primary Tumor Location

    International Nuclear Information System (INIS)

    Han, Na Yeon; Kim, Min Ju; Park, Beon Jin; Sung, Deuk Jae; Chung, Kyoo Byung; Oh, Yu Whan

    2011-01-01

    To evaluate the association between the incidence of pulmonary metastasis on chest CT and the location of the primary tumor on rectal MRI. One hundred and nine consecutive patients with rectal adenocarcinoma underwent chest CT and 3T rectal MRI. Two radiologists classified the tumor on MRI as an upper (> 10 cm from the anal verge), mid (5-10 cm), or lower rectal tumor (< 5 cm) by consensus. All chest CT scans were retrospectively reviewed for the presence of metastasis. We used Fisher's exact test to evaluate the correlation between the incidence of pulmonary metastasis with the location of the rectal cancer and the Mantel-Haenszel test to control for local tumor stage. We only included the 60 patients with upper (n = 26) or lower (n = 34) rectal cancer, because of the complicated venous drainage system of the mid rectum. Among these, 9 (15%) showed evidence of pulmonary metastasis on chest CT and almost all (89%, 8/9) patients had lower rectal cancer. The incidence of pulmonary metastasis between the two groups was statistically different (p < 0.05) when local tumor stage was controlled. The incidence of pulmonary metastasis was significantly higher for lower than upper rectal cancers when the T-stage of the tumor was accounted for.

  17. Crackle analysis for chest auscultation and comparison with high-resolution CT findings

    International Nuclear Information System (INIS)

    Kawamura, Takeo; Matsumoto, Tsuneo; Tanaka, Nobuyuki; Matsunaga, Naofumi; Kido, Shoji; Jiang Zhongwei

    2003-01-01

    The purpose of our study was to clarify the correlation between respiratory sounds and the high-resolution CT (HRCT) findings of lung diseases. Respiratory sounds were recorded using a stethoscope in 41 patients with crackles. All had undergone inspiratory and expiratory CT. Subjects included 18 patients with interstitial pneumonia and 23 without interstitial pneumonia. Two parameters, two-cycle duration (2CD) and initial deflection width (IDW) of the ''crackle,'' were induced by time-expanded waveform analysis. Two radiologists independently assessed 11 HRCT findings. An evaluation was carried out to determine whether there was a significant difference in the two parameters between the presence and absence of each HRCT finding. The two parameters of crackles were significantly shorter in the interstitial pneumonia group than the non-interstitial pneumonia group. Ground-glass opacity, honeycombing, lung volume reduction, traction bronchiectasis, centrilobular nodules, emphysematous change, and attenuation and volume change between inspiratory and expiratory CT were correlated with one or two parameters in all patients, whereas the other three findings were not. Among the interstitial pneumonia group, traction bronchiectasis, emphysematous change, and attenuation and volume change between inspiratory and expiratory CT were significantly correlated with one or two parameters. Abnormal respiratory sounds were correlated with some HRCT findings. (author)

  18. Chest physiotherapy in preterm infants with lung diseases

    Directory of Open Access Journals (Sweden)

    Cota Francesco

    2010-09-01

    Full Text Available Abstract Background In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes. Methods The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6 weeks - mean (DS - and birth weight of 1430 (423 g - mean (DS -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure, or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulations, the NIPS score and the PIPP score were recorded; cerebral ultrasound scans were performed on postnatal days 1-3-5-7, and then weekly. Results In this population the first phase of Vojta's 'reflex rolling' caused an increase of PtcO2 and SatO2 values. No negative effects on PtcCO2 and respiratory rate were observed, NIPS and PIPP stress scores remained unmodified during the treatment; in no patient the intraventricular haemorrhage worsened in time and none of the infants developed periventricular leucomalacia. Conclusions Our experience, using the Vojta method, allows to affirm that this method is safe for preterm neonates, but further investigations are necessary to confirm its positive effects and to evaluate long-term respiratory outcomes.

  19. [Detection of lung nodules. New opportunities in chest radiography

    NARCIS (Netherlands)

    Pötter-Lang, S.; Schalekamp, S.; Schaefer-Prokop, C.M.; Uffmann, M.

    2014-01-01

    Chest radiography still represents the most commonly performed X-ray examination because it is readily available, requires low radiation doses and is relatively inexpensive. However, as previously published, many initially undetected lung nodules are retrospectively visible in chest radiographs.The

  20. 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

  1. 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 ...

  2. 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 ...

  3. Palpation for muscular tenderness in the anterior chest wall

    DEFF Research Database (Denmark)

    Christensen, H.W.; Vach, W.; Manniche, C.

    2003-01-01

    of the anterior chest wall with all subjects sitting. Each dimension was rated as absent or present for tenderness or pain for each location. All examinations were carried out according to a standard written procedure. RESULTS: Based on a pooled analysis of data from palpation of the anterior chest wall, we found...

  4. 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 ...

  5. 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] ...

  6. Lung mass, right upper lung - chest x-ray (image)

    Science.gov (United States)

    This picture is a chest x-ray of a person with a lung mass. This is a front view, where the lungs are the two dark areas and ... visible in the middle of the chest. The x-ray shows a mass in the right upper lung, ...

  7. ORIGINAL ARTICLES Complications of tube thoracostomy for chest ...

    African Journals Online (AJOL)

    2009-02-01

    Feb 1, 2009 ... Laws D, Neville E, Duffy J. BTS guidelines for the insertion of a chest drain. Thorax 2003; 58. (suppl II): ii53-ii59. 6. Hyde J, Sykes T, Graham T. Reducing morbidity from chest drains. BMJ 1997; 314: 914. 7. American College of Surgeons Committee on Trauma. Thoracic trauma. In: Advanced Trauma.

  8. Feasibility of Early Diagnosis and Treatment of Acute Chest ...

    African Journals Online (AJOL)

    Acute chest syndrome is a serious complication and one of the causes of mortality in sickle cell disease. Twenty eight year old male was admitted in our hospital with fever, severe chest pain and haemolytic crisis. He was treated with intravenous antibiotics, fluids, parenteral analgesics and blood transfusion. Severe ...

  9. An Atypical Cause of Atypical Chest Pain

    Directory of Open Access Journals (Sweden)

    Ahmad Zaheen

    2014-01-01

    Full Text Available The present report describes a case involving a 57-year-old HIV-positive man who presented with acute retrosternal chest pain accompanied by 24 h of fever. Septic arthritis of the manubriosternal joint was diagnosed based on magnetic resonance imaging findings in addition to Staphylococcus aureus bacteremia. To the authors’ knowledge, the present case is only the 12th reported case of manubriosternal septic arthritis, and the first in an HIV-positive patient. Early diagnosis and treatment can circumvent the need for surgical intervention. Based on the present case report and review of the literature, the authors summarize the epidemiology, appropriate imaging and suggestions for antibiotic therapy for this rare presentation.

  10. 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.

  11. 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%)

  12. Digital chest radiography diagnosis using CRT monitors

    International Nuclear Information System (INIS)

    Fukuhisa, Kenjiro; Iinuma, T.A.; Matsumoto, Tohru; Kaneko, Masahiro; Ikeda, Shigeto; Inamoto, Kazuo; Nishitani, Hiroshi; Ando, Yutaka.

    1987-01-01

    Five direct chest X-ray films were digitized at resolution of 5 pixels/mm aperture using a drum scanner, performeds suitable contrast adjustment spatial frequency enhancements and displayed on 2 kinds of CRT systems. One of the CRT systems had 1,500 x 2,000 pixels in resolution and another had 1,024 x 1,024 pixels, respectively. The screen sizes of both system were almost same as the original full-size film. The digital images which were non-processed, processed as above and partially enlarged images were interpreted by 24 physicians including 7 practitioners using two CRT monitors. The readers subjectively evalueted the goodness of image quality for the digital images displayed on the two CRT monitors. As the results of statistic analysis for the data of image reading, it is concluded that digital image reading with CRT monitor is available with suitable image processing methods. (author)

  13. Chest tuberculosis: Radiological review and imaging recommendations

    Science.gov (United States)

    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. PMID:26288514

  14. Chest tuberculosis: Radiological review and imaging recommendations

    Directory of Open Access Journals (Sweden)

    Ashu Seith Bhalla

    2015-01-01

    Full Text Available 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.

  15. 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.

  16. Diagnosing Myocardial Contusion after Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Zahra Alborzi

    2016-10-01

    Full Text Available A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored.

  17. Chest magnetic resonance imaging: a protocol suggestion*

    Science.gov (United States)

    Hochhegger, Bruno; de Souza, Vinícius Valério Silveira; Marchiori, Edson; Irion, Klaus Loureiro; Souza Jr., Arthur Soares; Elias Junior, Jorge; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Escuissato, Dante Luiz; Mançano, Alexandre Dias; Araujo Neto, César Augusto; Guimarães, Marcos Duarte; Nin, Carlos Schuler; Santos, Marcel Koenigkam; Silva, Jorge Luiz Pereira e

    2015-01-01

    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. PMID:26811555

  18. 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.

  19. Relationships (I) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with the ILO International Classification of Radiographs of Pneumoconioses for parenchymal abnormalities.

    Science.gov (United States)

    Tamura, Taro; Suganuma, Narufumi; Hering, Kurt G; Vehmas, Tapio; Itoh, Harumi; Akira, Masanori; Takashima, Yoshihiro; Hirano, Harukazu; Kusaka, Yukinori

    2015-01-01

    The International Classification of High-resolution Computed Tomography (HRCT) for Occupational and Environmental Respiratory Diseases (ICOERD) has been developed for the screening, diagnosis, and epidemiological reporting of respiratory diseases caused by occupational hazards. This study aimed to establish a correlation between readings of HRCT (according to the ICOERD) and those of chest radiography (CXR) pneumoconiotic parenchymal opacities (according to the International Labor Organization Classification/International Classification of Radiographs of Pneumoconioses [ILO/ICRP]). Forty-six patients with and 28 controls without mineral dust exposure underwent posterior-anterior CXR and HRCT. We recorded all subjects' exposure and smoking history. Experts independently read CXRs (using ILO/ICRP). Experts independently assessed HRCT using the ICOERD parenchymal abnormalities grades for well-defined rounded opacities (RO), linear and/or irregular opacities (IR), and emphysema (EM). The correlation between the ICOERD summed grades and ILO/ICRP profusions was evaluated using Spearman's rank-order correlation. Twenty-three patients had small opacities on CXR. HRCT showed that 21 patients had RO; 20 patients, IR opacities; and 23 patients, EM. The correlation between ILO/ICRP profusions and the ICOERD grades was 0.844 for rounded opacities (p<0.01). ICOERD readings from HRCT scans correlated well with previously validated ILO/ICRP criteria. The ICOERD adequately detects pneumoconiotic micronodules and can be used for the interpretation of pneumoconiosis.

  20. Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.

    Science.gov (United States)

    Dobbins, James T; McAdams, H Page; Sabol, John M; Chakraborty, Dev P; Kazerooni, Ella A; Reddy, Gautham P; Vikgren, Jenny; Båth, Magnus

    2017-01-01

    Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve