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At least 289 records · Page 16Linked to original sources
PubMed1998

Fatal wounds to the thorax caused by gunshots from blank cartridges.

Lethal injuries of the thorax due to shots fired from blank cartridges calibre 8 mm are reported in three cases. The muzzle of the weapon was in contact with the left side of the breast (contact discharge) and injuries to bones were absent in all three cases. In two of the cases the pericardium was not involved but the anterior wall of the right heart ventricle was ruptured and death was due to cardiac tamponade. In the third case the pericardial sac and the left ventricle were both ruptured and the victim died due to rapid exsanguination. The cases demonstrate that the gas pressure from the exploding propellent of blank ammunition can be powerful enough to penetrate the thoracic wall.

Adolescent↗
PubMed2005

Thoraco-pleuropneumonectomy for rupture of a huge chronic hematoma of the thorax.

A 67-year-old woman with a huge chronic expanding hematoma of the thorax due to previous tuberculous pleuritis was referred to our hospital with frequent hemoptysis. The hematoma had ruptured into the lung parenchyma. The patient had undergone apical thoracoplasty 40 years earlier. To provide complete resection of the huge cavity in the costodiaphragamatic recess, thoraco-pleuropneumonectomy was performed, and the patient was able to resume daily activities a few months after the operation.

Aged↗
PubMed1994

Neurogenic tumors of the thorax.

We have conducted a retrospective review of 134 cases of neurogenic tumors of the thorax, including 66 in infants and children and 68 in adults. Nerve cell tumors were the majority in infants and children (84.8%) and were mostly malignant (67.2%). Nerve sheath tumors were more frequent in adults (73.5%). Nerve cell tumors were the most frequent tumors in males and nerve sheath tumors in females. Nineteen tumors were associated with von Recklinghausen's disease. The tumors were symptomatic in 76.4% of children and 36.7% of adults. Spinal cord compression was observed in 8 infants and children and in 2 adults. Neo-adjuvant treatment was administrated to 3 patients. Resection was complete for 80 benign tumors out of 86 (93%) and for 26 malignant tumors out of 48 (54%). Postoperative chemo- or radiotherapy (or both) was administrated to 17 children and 8 adults. The mean followup periods were 11 years for the infants and children and 8 years, 6 months for the adults. There was one postoperative death. There were no late deaths related to benign tumor. The prognosis of spinal cord compression depended on the malignancy and staging of the tumors. At 5 years postoperatively, 21 children out of 28 with neuroblastomas and 8 out of 9 with ganglioneuroblastomas were alive. The possibility of maturation of neuroblastomas and survival with hepatic metastases was confirmed. The prognosis in cases of chemodectoma depended on the extension. Patients with malignant schwannomas had very poor prognoses, especially when associated with von Recklinghausen's disease.

Adolescent↗
PubMed1986

Penetrating wounds of the thorax.

While penetrating wounds of the thorax are rather uncommon in The Netherlands, they are frequently encountered in the emergency centres of the United States. Thoracic wall penetration may occur during times of warfare, during social altercations or as a result of industrial accidents. In civilian practice, such wounds are most often the result of injury with guns, knives or other sharp objects. Patients with penetrating thoracic wounds should be expeditiously transported to a trauma centre. Pre-hospital intravenous fluids, pleural decompression and anti-shock garments are contraindicated. On arrival in the emergency room, establishment of a patent airway, administration of intravenous fluids, pleural decompression and early X-ray examination of the chest are mandatory.

Diagnostic Tests, Routine↗
PubMed1990

Disorders of the fetal thorax and abdomen.

Many disorders of the fetal thorax and abdomen can be evaluated using ultrasound. Even when a definitive diagnosis cannot be made prenatally, sonography can provide valuable clinical information regarding the nature and location of the abnormality, associated anomalies, and the presence of secondary complications. An awareness of these disorders and their sonographic appearance is important to impact upon obstetrical management and overall prognosis.

Digestive System Abnormalities↗
PubMed1990

Abnormalities of the bony thorax causing tracheobronchial compression.

A number of intrathoracic and extrathoracic causes of airway obstruction have been well documented in the literature. At times, tracheal compression may be caused by abnormalities of the bony thorax whose previously unrecognized significance can result in unexpected difficulties when extubation is attempted following a routine intubation. Alternatively, patients may develop progressive distress secondary to their skeletal abnormalities. We report on cases illustrating anomalies of the manubrium, sternum and spine which have caused significant, occasionally life-threatening, tracheal and bronchial narrowing including pectus excavatum and scoliosis. A protocol is presented detailing the appropriate methods of diagnosis and treatment of these types of deformities.

Adolescent↗
PubMed1994

Retrospective reconstruction of three-dimensional radiotherapy treatment plans of the thorax from two dimensional planning data.

PURPOSE: A method for the retrospective reconstruction of three-dimensional (3-D) radiotherapy treatment plans from two-dimensional (2-D) planning data is detailed in this paper. METHODS AND MATERIALS: With these techniques the user can register an arbitrarily shaped portal on a simulation film with a diagnostic computed tomography study of the patient and then generate the resultant 3-D dose distribution or dose-volume histogram. Seven treatment plans were reconstructed of patients who had previously undergone 3-D treatment planning for fields involving the thorax and who had had a diagnostic computed tomography (CT) scan. The dose-volume histograms and the spatial positions of the beams on the reconstructed plans were then compared to those of the original 3-D plan, which until then, were not made available to the investigators. RESULTS: The dose-volume histograms of the reconstructed plans did not differ from those of the original plans by more than 3% except in the low dose region. The error in positioning the beam in the reconstructed plan was determined to be approximately 5 mm. CONCLUSION: The technique of 3-D treatment plan reconstruction can be used, through retrospective studies, to obtain better assessments of normal tissue complication probabilities and tumor control probabilities.

Humans↗
PubMed1977

Computerized tomography in the assessment of diseases of the thorax.

Many of the diseases of the chest wall, heart, mediastinum, pleura and lungs can be successfully imaged by computerized tomography. Radiation therapy ports can be calculated and transcutaneous biopsies monitored. This paper deals with the many uses that we have had for computerized tomography in assessing diseases within the chest and thorax.

Adult↗
PubMed2004

Low-dose CT of the thorax in cancer follow-up.

PURPOSE: To evaluate the quality of low-dose computed tomography (CT) images in the follow-up of cancer patients. MATERIALS AND METHODS: We selected patients with urogenital (n = 7) or esophageal cancer (n = 13) who were attending routine follow-up between April and July 2001. After water and chest phantom studies to decide the scan parameters, postcontrast low-dose CT scans were obtained at 60 mA (45 mA s) with a smoothing kernel. Three radiologists reviewed the CT scans of the thorax independently for overall image quality and anatomic detail in both mediastinal and lung windows. They subjectively rated the images on a four-point scale (0: poor, 1: fair, 2: good, 3: excellent) according to graininess and sharpness. RESULTS: The average score of the low-dose CT for the lung window was 2.85, which was equivalent to control images. The average score for the mediastinal window was 1.77, which was lower than that of the control CT scan (2.62, P < 0.001) and almost identical to that of the chest phantom experiment. Nine of the 20 cases had abnormal findings; low-dose CT scans depicted them well and offered sufficient information for diagnosis. The radiation exposure was reduced by about half. CONCLUSION: The image quality of low-dose thoracic CT was satisfactory for both mediastinal and lung windows in the follow-up of cancer patients.

Aged↗
PubMed2005

Giant abdominal wall abscess dissecting into thorax as a complication of ESWL.

Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition. We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli.

Abdominal Abscess↗
PubMed2001

Suicidal nonfatal impalement injury of the thorax.

We treated an impalement injury of the thorax resulting from a suicide attempt in the form of a road traffic accident. The patient survived and was discharged 5 weeks after his injury. The surgical management of thoracic impalement injuries and the rationale behind a multidisciplinary approach are discussed.

Accidents, Traffic↗
PubMed2003

Mesenchymal tumours of the thorax: CT findings and pathological features.

Mesenchymal tumours of the thorax are uncommon and may originate from the muscle, bone, cartilage, vessel, nerves, fat and fibrous tissue. These tumours occur at different sites including the lung, pleura, mediastinum or chest wall. Mesenchymal tumours tend to show protean and non-specific imaging characteristics. However, in some instances, the imaging characteristics of the tumour may allow a specific diagnosis to be made, such as with lipoid or vascular tumours.

Adolescent↗
PubMed1995

Radiographic manifestations of AIDS related lymphoma in the thorax.

Intrathoracic disease in AIDS-related lymphoma (ARL) produces a range of radiographic appearances. This study aimed to determine the frequency, distribution and characteristics of these appearances. The case notes and findings on imaging of 116 consecutive cases of ARL were reviewed retrospectively. In 52 cases there were abnormalities present on chest imaging (chest radiography or chest CT scanning). In 20 patients abnormalities were judged to be due to lymphomatous involvement and in 15 cases the thorax was the major site of disease. Correlation with biopsy results from thoracic disease (9), other disease (5), or evidence of response to treatment (6) was made. The most frequent imaging findings were pleural or intrapulmonary masses (7), frequently peripheral and sometimes with cavitation. In one case this simulated mycetoma formation. Pleural effusions and mediastinal lymph nodes were also frequently present, either alone or in combination. AIDS-related lymphoma uncommonly involves the chest as a major site of disease. A pleural or intrapulmonary mass with cavitation may represent the only site of disease and in these cases CT guided biopsy is likely to provide the histological diagnosis.

Adult↗
PubMed1986

The daily reproducibility of large, complex-shaped radiotherapy fields to the thorax and neck.

A series of patients treated with complex fields to the thorax and neck utilising individually tailored shielding blocks made from low-melting-point alloy (LMPA), were investigated using treatment verification film to identify field placement errors. A total of 19 patients yielded 171 machine verification films, which were analysed. It was found that on 21% of occasions the intended treatment volume was partially shielded, by more than 1 cm, by the lead blocks prescribed to protect the lungs. On half of these occasions (11% of the total), the areas erroneously shielded contained known disease. Suggestions are made for minimising such errors in the future.

Head and Neck Neoplasms↗
PubMed1983

Meconium thorax.

A case of meconium thorax resulting from spontaneous perforation of the colon associated with a right Bochdalek's foramen, without herniation, is presented. The baby had immediate respiratory distress postpartum resulting from the meconium in the pleural cavity. No fetal distress was detected, in spite of electrode monitoring in labor, to account for the colonic perforation.

Colonic Diseases↗
PubMed1995

Resection and adjuvant immunotherapy for melanoma metastatic to the lung and thorax.

Although melanoma that metastasizes to distant sites is generally associated with a median survival of only 6 to 8 months, certain metastatic sites including the lung may carry a better prognosis than others. Surgical therapy for pulmonary metastases remains controversial because of the variable survival rates reported for previous small series. To determine the prognosis and optimal management of patients with melanoma with pulmonary metastases, we reviewed our 22-year melanoma database of over 6100 patients. Of 984 patients with metastatic melanoma involving the lung or thorax, 106 underwent resection by posterior lateral thoracotomy or median sternotomy. There were no operative deaths, and the median follow-up period for surgical patients was 55 months. The remaining 878 patients were treated without operation with immunotherapy, chemotherapy, radiation therapy, or a combination. In both treatment groups the male/female ratio was approximately 2:1. The primary lesion's Clark level of invasion and Breslow thickness and the patient's age at diagnosis of metastatic disease were not significantly different between the two groups. The 1-year, 3-year, and 5-year survival rates for surgical patients were 77%, 37%, and 27%, respectively, compared with 32%, 7%, and 3% for nonsurgical patients; these differences were highly significant (p = 0.0001). The highest 5-year survival rate (39%) occurred in those patients with a single metastatic lesion. Sixty-three percent of the surgical patients received some form of immunotherapy, compared with 34% of the nonsurgical patients. Multivariate analysis showed that resection and immunotherapy with a melanoma cell vaccine were both independent predictors of survival (p < 0.0001). These results indicate that the prognosis associated with metastatic melanoma may be less dismal than previously thought when distant metastases involve thoracic sites. We believe that surgical resection is the treatment of choice for patients with melanoma with pulmonary metastases; when combined with immunotherapy, this regimen offers the best chance for long-term survival.

Cancer Vaccines↗
PubMed1980

Lung abscess and empyema of the thorax.

Empyema is best managed by the physician familiar with the indications and principals of the various procedures used in the treatment of empyema of the thorax. The objective of each modality used to treat empyema is to drain the pleura cavity and to allow full expansion of the lung. If the infected material can be removed and the visceral and parietal pleural approximated, the body will heal the pleural infection. The procedure chosen to treat empyema greatly depends upon the phase of maturation of the empyema when treatment is begun.

Adult↗