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At least 397 records · Page 22Linked to original sources
PubMed1982

A technique for bioinstrumentation of the thorax of miniature swine.

A surgical technique for sternal thoracotomy was developed for use in miniature swine. An incision was made from the midpoint of the neck to the tip of the xiphoid cartilage. The thorax was entered by dividing the sternum along its long axis with an electric oscillating saw. The thoracotomy was closed with 3-mm wide polyester fiber umbilical tapes placed around each sternebrae to appose the cut surfaces. The technique provided good access to the cranial vena cava, both atria and appendages, both ventricles, great cardiac veins, coronary sinus, ascending aorta and arch, and the pulmonary artery. Miniature swine tolerated this procedure well. It appeared to be less painful than lateral approaches and produced fewer pleural adhesions because only the mediastinum was entered.

Animals↗
PubMed1982

[Somatic radiation risk in conventional tomography of the skull and thorax].

The somatically significant dose index can be considered as a measure for the somatic radiation risk to which the population is exposed. Figures are stated for conventional tomography of the skull and thorax. These are compared with the corresponding data for other x-ray examinations, especially computerised tomography.

Dose-Response Relationship, Radiation↗
PubMed1982

[Dilemmas related to expectant or acute stages in closed injuries of the thorax and abdomen].

Non penetrating injuries of thorax, abdomen and thoraco-abdominal injuries, following its etiology, pathogenesis, and pathoanatomical substrate are also with consequent clinical manifestations, very complicated diagnostico-therapeutical problem. The surgeon is often i dilemma, which the therapy will be the most adequate for the patient and the time for the decision is usually short. In the report, various types of nonpenetrating injuries are analysed, and relating to its nature and the grade of severity, the proper therapy is discussed. We suppose that in situations like that, along with numerous tests, the explorations should be used and applied in doubtful cases, so it can only enables right diagnosis and in such way adequate therapy in the period of the time the surgeon can count on.

Abdominal Injuries↗
PubMed1978

Leiomyosarcoma of the thorax.

Leiomyosarcoma within the thorax is a rare lesion. This report describes an endobronchial lesion presenting with atelectasis, a parenchymal lesion presenting as a mass, and a rare extra-pleural lesion arising in the chest wall. The prognosis is generally poor; our 3 patients died within about 1 year of diagnosis.

Adult↗
PubMed1978

[Isolated rupture of the pericardium after closed trauma of the thorax (author's transl)].

Rupture of the pericardium after closed trauma of the thorax is rare. There are two main clinical presentations: one of severe thoracic trauma with hemothorax requiring an operation which permits the diagnosis, the other of pain and pericardial signs on auscultation which should attract attention. The treatment requires closure of the pericardial tear as a routine owing to the risk of fatal complications due to dislocation of the heart.

Adult↗
PubMed1980

[Examination of the lung with radionuclides in severe trauma of the thorax (author's transl)].

If there is a discrepancy between radiological findings and clinical state after massive trauma of the thorax, nuclear medicine examination is useful as is shown by a case report. Mostly it is possible to clarify the nature of abnormal masses in the lung by perfusion scintigraphy of the lung or/and inhalation of radionuclide. These examinations should be performed to control the further development of intrapulmonary alterations.

Accidents↗
PubMed1980

[The luxation of the heart following a blunt trauma to the thorax. A case report (author's transl)].

We report a rare complication in a patient who suffered blunt trauma to the thorax. During suturing of the ruptured aorta, distal to the subclavian artery, cardiac arrest occurred. For half an hour the pupils remained fixed and dilated, despite intensive reanimation efforts. It was then realised, that the heart had been displaced through a pericardial defect. Following its reposition the patient recovered without any signs of cerebral damage.

Adult↗
PubMed1994

Access to the thorax by incision.

BACKGROUND: For years the standard access to the thorax has been by posterolateral or other muscle cutting thoracotomy incisions. These are accompanied by significant discomfort and often limitation of shoulder girdle movement. To obviate these distressing features, the less traumatic median sternotomy was recommended. In the last ten years, several types of mini or axillary thoracotomies have been described. We believe that the vertical axillary thoracotomy is the best of these incisions as no major muscles are divided, it can be created rapidly, and exposure is excellent. STUDY DESIGN: We compared the operative approaches from the point of view of the duration of postoperative hospitalization, the length of the operating time, the incidence of postoperative atelectasis, and persistence of incisional pain. RESULTS: The vertical axillary thoracotomy showed a definite advantage in all these categories. CONCLUSIONS: These findings suggest that the vertical axillary thoracotomy is the incision of choice for most thoracic procedures as the incision is small and quickly made. Because there is limited division of muscles, the convalescence is smooth and uncomplicated.

Axilla↗
PubMed1994

Cavernous lymphangioma of the thorax: MRI findings.

Cavernous lymphangiomas of the thorax are extremely rare. We encountered an 11-year-old boy with such a disorder. Magnetic resonance imaging (MRI) showed numerous small rounded and tubular structures within the mediastinal mass; we believe these represent dilated lymphatic channels.

Child↗
PubMed1994

[The role of computed tomography (CT) of the thorax in defining the anatomical extent in bronchogenic carcinoma (BC)].

A series of 129 carriers of non-small cell bronchogenic carcinoma (BC), in whom computed tomography (CT) of the thorax was performed as part of the preoperative study, are presented. The results of CT were compared with those of thoracotomy in terms of sensitivity (SEN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV). Thoracic wall (prevalence 0.18): SEN, SP, PPV and NPV were 0.65, 0.92, 0.63 and 0.92, respectively. In peripheral tumors these values were 0.85, 0.90, 0.69 and 0.96, respectively. CT demonstrating invasion of the thoracic wall thus requires confirmation for the purpose of surgical staging. If CT reveals an intact wall, however, surgery may take place immediately. Malignant mediastinal lymph nodes: (prevalence 0.36): SEN, SP, PPV, and NPV were 0.70, 0.89, 0.78 and 0.84, respectively. For peripheral tumors these values were 0.78, 0.93, 0.82 and 0.91, respectively. CT demonstrating malignant mediastinal lymph nodes should be confirmed by mediastinoscopy. If mediastinal malignancy is not observed by CT, thoracotomy may be performed in peripherally located tumors; in centrally located tumors, however, the absence of adenopathy should be confirmed by mediastinoscopy.

Carcinoma, Bronchogenic↗
PubMed1993

[Thorax--an atlas of radiographic images of childhood lung diseases].

At the Paediatric Clinic of the Institute for Postgraduate Medical Training in the University Thomayer Hospital in Prague an extensive archive of rare X-ray findings from the field of child pneumology was assembled which is used for postgraduate medical training. To facilitate physical manipulation of the documents the X-ray pictures were transferred to a computer data base. For storage the Thorax programme was used which is distributed on CD-ROM. The authors discuss the use of this programme in practice. At present the data base comprises 529 digitalized X-ray pictures of 149 case-histories of pulmonary diseases of child patients.

CD-ROM↗
PubMed1993

Helical computed tomography scanning of the thorax and abdomen.

We applied helical CT to examinations of the abdomen and thorax. Scanning was performed continuously while the couchtop of the CT scanner was shifted at a constant speed. The entire lung field could be scanned during a single holding of the breath when the couchtop speed was 20 mm/s. Tumors as small as 3 mm were detected. The diagnostic detectability and accuracy of helical CT were far superior to those of conventional chest radiography. During abdominal examination, the target organ could be scanned at any specified phase (preferably arterial) during the injection of contrast medium. We detected very small hepatic tumors which could not be detected by conventional CT. Helical CT produced continuous data, which was reconstructed to display three-dimensional images. Helical CT could be used in mass screening for the detection of early lung cancer and in computer-aided diagnosis.

Abdominal Neoplasms↗
PubMed1995

Intermodality, retrospective image registration in the thorax.

UNLABELLED: The purpose of this study was to develop an accurate, retrospectively applicable procedure for registering thoracic studies from different modalities in a short amount of time and with minimal operator intervention. METHODS: CT and PET studies were acquired from six patients. The pleural surfaces in both image sets were determined by segmenting based on 50% of the maximum soft-tissue value in the study. These surfaces were converted into three-dimensional volumes and used to register the CT and PET studies in three dimensions using a sum of least squares fitting approach. The registered PET study was then displayed in a hot metal scale overlayed on top of the gray scale CT study. The accuracy of the fit was evaluated through a phantom study and preliminary clinical evaluation. RESULTS: A phantom study was performed to determine the limits of this technique. The accuracy was determined to be less than 2.3 mm in the x and y direction and 3 mm in the z direction. Preliminary clinical evaluation was also performed with encouraging results. CONCLUSION: This technique accurately registers PET and CT images of the thorax, retrospectively, without the need for external fiducial markers or other a priori action.

Aged↗
PubMed1996

[Ultra-low-dose spiral (helical) CT of the thorax: a filtering technique].

To reduce the radiation dose from spiral (helical) CT, a custom-made aluminium filter was installed in the X-ray tube and a reduction of effective tube current was attempted. A pronounced reduction of effective tube current, namely, 6 and 3 mA, was achieved with 26 and 37 mm thick aluminium filters, respectively. Visualization of normal lung structure was accomplished with both 6 and 3 mA settings. However, images of 3 mA failed to delineate mediastinal structures because of marked beam hardening resulting from the bone structure of the thoracic inlet. Six mA was considered the lowest dose setting of spiral (helical) CT of the thorax that could be used for lung cancer screening.

Adult↗
PubMed1997

[Digital radiography of the thorax].

Digital radiography of the thorax can, now be substituted to conventional chest radiography. Computed radiography with phosphor plates and the new selenium detector are emphasized. The major image processing are explained. Successively the main other methods of digital radiography are described: scanning equalization radiography, laser-digitized radiography and multiwire proportional chambers. Then the advantages and the drawbacks of chest computed radiography are extensively reviewed.

Humans↗
PubMed1997

[Can diagnosis and subsequent trauma management of the multiple trauma patient with blunt thoracic trauma be improved by early computerized tomography of the thorax?].

OBJECTIVE: The aim of this prospective study was to evaluate, whether early thoracic computed tomography (TCT) is superior to routine chest x-ray (CXR) in the diagnostic work up of blunt thoracic trauma and whether these additional informations influence subsequent therapeutical decisions in the early management of severely injured patients. PATIENTS AND METHODS: In a prospective study of 103 consecutive patients with clinical or radiological signs of chest trauma (94 multiple injured patients with chest trauma, 9 patients with isolated chest trauma) with an average ISS of 30 and an average AIS thorax of 3 initial CXR and TCT were compared after first assessment in our emergency department of a level I trauma center. RESULTS: In 67 patients (65%) TCT detected major complications of chest trauma, that have been missed on CXR [lung contusion (n = 33), pneumothorax (n = 27), residual pneumothorax after chest tube placement (n = 7), hemothorax (n = 21), displaced chest tube (n = 5), diaphragmatic rupture (n = 2), myocardial rupture (n = 1)], in 11 patients only minor additional pathologic findings (dystelectasis, small pleural effusion) were visualized on TCT and in 14 patients CXR and TCT showed the same pathological results. 11 patients had both CXR and TCT without pathological findings. The TCT scan was significantly more effective than routine CXR in detecting lung contusions (p < 0.001), pneumothorax (p < 0.005) and hemothorax (p < 0.05). In 42 patients (41%) the additional TCT findings resulted in a change of therapy: chest tube placement or chest tube correction of pneumothoraces or large hemothoraces (n = 31), change in mode of ventilation and respiratory care (n = 14), influence on the management of fracture stabilization (n = 12), laparotomy in cases of diaphragmatic lacerations (n = 2), bronchoscopy for atelectasis (n = 2), exclusion of aortic rupture (n = 2), endotracheal intubation (n = 1), pericardiocentesis (n = 1). CONCLUSIONS: TCT is highly sensitive in detecting thoracic injuries after blunt chest trauma and is superior to routine CXR in visualizing lung contusions, pneumo- and hemothorax. Early TCT influences therapeutic management in a considerable subset of patients. We therefore recommend TCT in the primary diagnostic work up of multiple injured patients with suspected chest trauma, because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications and improve outcome of severely injured patients with blunt chest trauma.

Adolescent↗
PubMed1998

[Effect of collimation and pitch on radiation exposure and image quality in spiral CT of the thorax].

PURPOSE: The aim of the study was to optimize the scan parameters for spiral-CT of the thorax. METHODS: Using a Somatom AR-SP (Siemens AG, Erlangen) CT-unit, four different scanning protocols (collimation/table feed) were compared: A (5/10), B (10/10), C (10/15), D (10/20). High contrast resolution in the xy-plane and in the z-direction were investigated with special phantoms. Noise levels were measured using a water phantom, the radiation exposure of lung parenchyma was investigated using an Alderson-Rande-Phantom. An anthropoid chest phantom was scanned to compare the image quality of the four protocols. RESULTS: Protocol A showed the best resolution in the z-direction; the resolution in the xy-plane was equal for all protocols. Image noise in the center of the water phantom was 58 HU for protocol A and 40 HU for the other three. The following equivalent organ dose were measured for lung parenchyma: A 14 mSv, B 29 mSv, C 20 mSv, D 14 mSv. CONCLUSION: Scanning protocols with small collimation and a pitch of 2 are characterised by low radiation exposure and excellent resolution in the z-direction. These parameters seem to be most suitable for lung scanning.

Diagnostic Imaging↗