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Journal of Personalized Medicine Feb 2022This study aimed to investigate the effects of tumor-rib distance and dose-dependent rib volume on radiation-induced rib fractures (RIRFs) in patients with breast...
This study aimed to investigate the effects of tumor-rib distance and dose-dependent rib volume on radiation-induced rib fractures (RIRFs) in patients with breast cancer. We retrospectively included 510 women with breast cancer who underwent surgical resection with adjuvant radiotherapy. The tumor-rib distance was measured using preoperative computed tomography (CT) images. Postoperative chest wall thickness and dose-dependent rib volumes, which are absolute rib volumes receiving >20 Gy (V20), 30 Gy (V30), 40 Gy (V40), 45 Gy (V45), and 50 Gy (V50), were measured from the stimulation CT images for radiation treatment planning. We assessed the relationship of RIRF with tumor-rib distance, postoperative chest wall thickness, and dose-dependent rib volumes. Patients with high values of tumor-rib distance and postoperative chest wall thickness had significantly lower risks of RIRF than those with low values. Patients with high values of V20, V30, V40, V45, and V50 had significantly higher risks of RIRF than those with low values. In a multivariate analysis, tumor-rib distance and all five dose-dependent rib volumes, as well as osteoporosis and radiation field, were independent risk factors for RIRF. Tumor-rib distance and dose-dependent rib volume were independent risk factors for RIRF in patients with breast cancer.
PubMed: 35207728
DOI: 10.3390/jpm12020240 -
Journal of Applied Physiology... Aug 2016When the diaphragm contracts, pleural pressure falls, exerting a caudal and inward force on the entire rib cage. However, the diaphragm also exerts forces in the cranial... (Review)
Review
When the diaphragm contracts, pleural pressure falls, exerting a caudal and inward force on the entire rib cage. However, the diaphragm also exerts forces in the cranial and outward direction on the lower ribs. One of these forces, the "insertional force," is applied by the muscle at its attachments to the lower ribs. The second, the "appositional force," is due to the transmission of abdominal pressure to the lower rib cage in the zone of apposition. In the control condition at functional residual capacity, the effects of these two forces on the lower ribs are nearly equal and outweigh the effect of pleural pressure, whereas for the upper ribs, the effect of pleural pressure is greater. The balance between these effects, however, may be altered. When the abdomen is given a mechanical support, the insertional and appositional forces are increased, so that the muscle produces a larger expansion of the lower rib cage and, with it, a smaller retraction of the upper rib cage. In contrast, at higher lung volumes the zone of apposition is decreased, and pleural pressure is the dominant force on the lower ribs as well. Consequently, although the force exerted by the diaphragm on these ribs remains inspiratory, rib displacement is reversed into a caudal-inward displacement. This mechanism likely explains the inspiratory retraction of the lateral walls of the lower rib cage observed in many subjects with chronic obstructive pulmonary disease (Hoover's sign). These observations support the use of a three-compartment, rather than a two-compartment, model to describe chest wall mechanics.
Topics: Computer Simulation; Diaphragm; Humans; Models, Biological; Muscle Contraction; Pleural Cavity; Respiratory Mechanics; Rib Cage; Stress, Mechanical; Thoracic Wall
PubMed: 27283911
DOI: 10.1152/japplphysiol.00268.2016 -
Seminars in Plastic Surgery Feb 2021Pseudarthrosis is a difficult complication often seen in patients with complex spinal pathology. To supplement existing neurosurgical approaches to cervicothoracic... (Review)
Review
Pseudarthrosis is a difficult complication often seen in patients with complex spinal pathology. To supplement existing neurosurgical approaches to cervicothoracic spinal instrumentation and fusion, novel vascularized rib bone grafts can be utilized in patients at high risk for failed spinal fusion. In this article, we discuss the indications, benefits, surgical technique, feasibility, and limitations of using rib vascularized rib bone grafts to augment spinal fusion.
PubMed: 33994876
DOI: 10.1055/s-0041-1725985 -
Monaldi Archives For Chest Disease =... Sep 2017Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib...
Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib cyst is considered a rare surgical entity and its presence must be followed by removal for histology examination. We present here the case of an aneurysmal rib cyst to a young 33-year-old female. The tumor was presented as an expanding left anterior second rib mass during a self-breast examination. Chest x-ray showed a shadow on the left upper lung area and CT scan revealed a large multicystic mass in the anterolateral left 2nd rib protruding underneath the thoracic major muscle. We discuss the clinicopathological characteristics of this tumor and its surgical management along with a short literature review.
Topics: Adult; Aftercare; Bone Cysts, Aneurysmal; Female; Humans; Ribs; Thoracic Wall; Thoracotomy; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29424198
DOI: 10.4081/monaldi.2017.860 -
Developmental Biology Dec 2020The importance of skeletal muscle for rib development and patterning in the mouse embryo has not been resolved, largely because different experimental approaches have...
The importance of skeletal muscle for rib development and patterning in the mouse embryo has not been resolved, largely because different experimental approaches have yielded disparate results. In this study, we utilize both gene knockouts and muscle cell ablation approaches to re-visit the extent to which rib growth and patterning are dependent on developing musculature. Consistent with previous studies, we show that rib formation is highly dependent on the MYOD family of myogenic regulatory factors (MRFs), and demonstrate that the extent of rib formation is gene-, allele-, and dosage-dependent. In the absence of Myf5 and MyoD, one allele of Mrf4 is sufficient for extensive rib growth, although patterning is abnormal. Under conditions of limiting MRF dosage, MyoD is identified as a positive regulator of rib patterning, presumably due to improved intercostal muscle development. In contrast to previous muscle ablation studies, we show that diphtheria toxin subunit A (DTA)-mediated ablation of muscle progenitors or differentiated muscle, using MyoD or HSA-Cre drivers, respectively, profoundly disrupts rib development. Further, a comparison of three independently derived Rosa26-based DTA knockin alleles demonstrates that the degree of rib perturbations in MyoD/DTA embryos is markedly dependent on the DTA allele used, and may in part explain discrepancies with previous findings. The results support the conclusion that the extent and quality of rib formation is largely dependent on the dosage of Myf5 and Mrf4, and that both early myotome-sclerotome interactions, as well as later muscle-rib interactions, are important for proper rib growth and patterning.
Topics: Alleles; Animals; Body Patterning; Gonadotropin-Releasing Hormone; Mice, Transgenic; Muscle, Skeletal; MyoD Protein; Myogenic Regulatory Factor 5; Myogenic Regulatory Factors; Ribs
PubMed: 32768399
DOI: 10.1016/j.ydbio.2020.07.015 -
International Journal of Mining Science... Jan 2021The National Institute for Occupational Safety and Health (NIOSH) conducted a comprehensive monitoring program in a room-and-pillar mine located in Southern Virginia....
The National Institute for Occupational Safety and Health (NIOSH) conducted a comprehensive monitoring program in a room-and-pillar mine located in Southern Virginia. The deformation and the stress change in an instrumented pillar were monitored during the progress of pillar retreat mining at two sites of different geological conditions and depths of cover. The main objectives of the monitoring program were to better understand the stress transfer and load shedding on coal pillars and to quantify the rib deformation due to pillar retreat mining; and to examine the effect of rib geology and overburden depth on coal rib performance. The instrumentation at both sites included pull-out tests to measure the anchorage capacity of rib bolts, load cells mounted on rib bolts to monitor the induced loads in the bolts, borehole pressure cells (BPCs) installed at various depths in the study pillar to measure the change in vertical pressure within the pillar, and roof and rib extensometers installed to quantify the vertical displacement of the roof and the horizontal displacement of the rib that would occur during the retreat mining process. The outcome from the monitoring program provides insight into coal pillar rib support optimization at various depths and geological conditions. Also, this study contributes to the NIOSH rib support database in U.S coal mines and provides essential data for rib support design.
PubMed: 38798751
DOI: 10.1016/j.ijmst.2020.10.001 -
Computational and Mathematical Methods... 2022Rib fractures are common injuries caused by chest trauma, which may cause serious consequences. It is essential to diagnose rib fractures accurately. Low-dose thoracic...
Rib fractures are common injuries caused by chest trauma, which may cause serious consequences. It is essential to diagnose rib fractures accurately. Low-dose thoracic computed tomography (CT) is commonly used for rib fracture diagnosis, and convolutional neural network- (CNN-) based methods have assisted doctors in rib fracture diagnosis in recent years. However, due to the lack of rib fracture data and the irregular, various shape of rib fractures, it is difficult for CNN-based methods to extract rib fracture features. As a result, they cannot achieve satisfying results in terms of accuracy and sensitivity in detecting rib fractures. Inspired by the attention mechanism, we proposed the CFSG U-Net for rib fracture detection. The CSFG U-Net uses the U-Net architecture and is enhanced by a dual-attention module, including a channel-wise fusion attention module (CFAM) and a spatial-wise group attention module (SGAM). CFAM uses the channel attention mechanism to reweight the feature map along the channel dimension and refine the U-Net's skip connections. SGAM uses the group technique to generate spatial attention to adjust feature maps in the spatial dimension, which allows the spatial attention module to capture more fine-grained semantic information. To evaluate the effectiveness of our proposed methods, we established a rib fracture dataset in our research. The experimental results on our dataset show that the maximum sensitivity of our proposed method is 89.58%, and the average FROC score is 81.28%, which outperforms the existing rib fracture detection methods and attention modules.
Topics: Humans; Image Processing, Computer-Assisted; Neural Networks, Computer; Rib Fractures; Tomography, X-Ray Computed
PubMed: 36035283
DOI: 10.1155/2022/8945423 -
Academic Forensic Pathology Dec 2016Fractures are commonly found in cases regarded as child abuse. The most commonly encountered fractures are to the ribs and the metaphyses. This paper examines the... (Review)
Review
Fractures are commonly found in cases regarded as child abuse. The most commonly encountered fractures are to the ribs and the metaphyses. This paper examines the specificity of the classical metaphyseal lesion (CML) and rib fractures as hallmarks of child abuse. Recently, vitamin D deficiency (rickets) has been proposed as an alternative cause for the appearances typically described in CML. The literature in this area is examined. Rib fractures have also been highly associated with child abuse, particularly posterior rib fractures. As well as metabolic bone disease, resuscitation has been examined as a cause of rib fractures in young children. The current literature remains strongly supportive of rib fractures and metaphyseal fractures being indicators of child abuse.
PubMed: 31239932
DOI: 10.23907/2016.056 -
The Korean Journal of Thoracic and... Aug 2017Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the... (Review)
Review
Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures.
PubMed: 28795026
DOI: 10.5090/kjtcs.2017.50.4.229 -
Micromachines Jan 2022This article presents a novel cross-rib micro-channel (MC-CR) heat sink to make fluid self-rotate. For a thermal test chip (TTC) with 100 w/cm, the cross-ribs...
This article presents a novel cross-rib micro-channel (MC-CR) heat sink to make fluid self-rotate. For a thermal test chip (TTC) with 100 w/cm, the cross-ribs micro-channel were compared with the rectangular (MC-R) and horizontal rib micro-channel (MC-HR) heat sinks. The results show that, with the cross-rib micro-channel, the junction temperature of the thermal test chip was 336.49 K, and the pressure drop was 22 kPa. Compared with the rectangular and horizontal ribs heat sink, the cross-rib micro-channel had improvements of 28.6% and 14.3% in cooling capability, but the pressure drop increased by 10.7-fold and 5.5-fold, respectively. Then, the effects of the aspect ratio (λ) of micro-channel in different flow rates were studied. It was found that the aspect ratio and cooling performance were non-linear. To reduce the pressure drop, the inclination (α) and spacing (S) of the cross-ribs were optimized. When α = 30°, S = 0.1 mm, and λ = 4, the pressure drop was reduced from 22 kPa to 4.5 kPa. In addition, the heat dissipation performance of the rectangular, staggered fin (MC-SF), staggered rib (MC-SR) and cross-rib micro-channels were analyzed in the condition of the same pressure drop, MC-CR still has superior heat dissipation performance.
PubMed: 35056296
DOI: 10.3390/mi13010132