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Clinical Anatomy (New York, N.Y.) Apr 2019The heart is a remarkably complex organ. Teaching its details to medical students and clinical trainees can be very difficult. Despite the complexity, accurate... (Review)
Review
The heart is a remarkably complex organ. Teaching its details to medical students and clinical trainees can be very difficult. Despite the complexity, accurate recognition of these details is a pre-requisite for the subsequent understanding of clinical cardiologists and cardiac surgeons. A recent publication promoted the benefits of virtual reconstructions in facilitating the initial understanding achieved by medical students. If such teaching is to achieve its greatest value, the datasets used to provide the virtual images should themselves be anatomically accurate. They should also take note of a basic rule of human anatomy, namely that components of all organs should be described as they are normally situated within the body. It is almost universal at present for textbooks of anatomy to illustrate the heart as if removed from the body and positioned on its apex, the so-called Valentine situation. In the years prior to the emergence of interventional techniques to treat cardiac diseases, this approach was of limited significance. Nowadays, therapeutic interventions are commonplace worldwide. Advances in three-dimensional imaging technology, furthermore, now mean that the separate components of the heart can readily be segmented, and then shown in attitudinally appropriate fashion. In this review, we demonstrate how such virtual dissection of computed tomographic datasets in attitudinally appropriate fashion reveals the true details of cardiac anatomy. The virtual approach to teaching the arrangement of the cardiac components has much to commend it. If it is to be used, nonetheless, the anatomical details on which the reconstructions are based must be accurate. Clin. Anat. 32:288-309, 2019. © 2019 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
Topics: Anatomy; Cardiology; Heart; Humans; Imaging, Three-Dimensional; Models, Anatomic; Thoracic Cavity; Tomography, X-Ray Computed
PubMed: 30675928
DOI: 10.1002/ca.23340 -
Journal of Thoracic Oncology : Official... Sep 2014Anterior mediastinal masses are relatively uncommon, include a wide variety of entities, and often pose a diagnostic challenge for clinicians. In this article, available... (Review)
Review
Anterior mediastinal masses are relatively uncommon, include a wide variety of entities, and often pose a diagnostic challenge for clinicians. In this article, available data is assembled in a clinically oriented manner to develop a structured approach to evaluation of these patients. Attention to age and gender, combined with identification of certain radiographic and clinical characteristics, allows a presumptive diagnosis to be established in most patients. This structure efficiently guides what additional workup is needed.
Topics: Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Mediastinum; Radiography
PubMed: 25396306
DOI: 10.1097/JTO.0000000000000294 -
International Journal of Molecular... Mar 2021The thoracic and peritoneal cavities are lined by serous membranes and are home of the serosal immune system. This immune system fuses innate and adaptive immunity, to... (Review)
Review
The thoracic and peritoneal cavities are lined by serous membranes and are home of the serosal immune system. This immune system fuses innate and adaptive immunity, to maintain local homeostasis and repair local tissue damage, and to cooperate closely with the mucosal immune system. Innate lymphoid cells (ILCs) are found abundantly in the thoracic and peritoneal cavities, and they are crucial in first defense against pathogenic viruses and bacteria. Nanomaterials (NMs) can enter the cavities intentionally for medical purposes, or unintentionally following environmental exposure; subsequent serosal inflammation and cancer (mesothelioma) has gained significant interest. However, reports on adverse effects of NM on ILCs and other components of the serosal immune system are scarce or even lacking. As ILCs are crucial in the first defense against pathogenic viruses and bacteria, it is possible that serosal exposure to NM may lead to a reduced resistance against pathogens. Additionally, affected serosal lymphoid tissues and cells may disturb adipose tissue homeostasis. This review aims to provide insight into key effects of NM on the serosal immune system.
Topics: Animals; Homeostasis; Humans; Immune System; Inflammation; Lymphocytes; Nanostructures; Peritoneal Cavity; Serous Membrane; Thoracic Cavity
PubMed: 33807632
DOI: 10.3390/ijms22052610 -
Ugeskrift For Laeger Nov 2022Injection augmentation of the vocal cords is a recognized treatment modality in patients with glottal closure deficiency caused by paresis or paralysis of the vocal... (Review)
Review
Injection augmentation of the vocal cords is a recognized treatment modality in patients with glottal closure deficiency caused by paresis or paralysis of the vocal cord. The treatment can improve voice quality and also quality of life. It is preferable to minimize waiting time for the procedure for patients with lung cancer and mediastinal involvement, because the one-year mortality is above 40%, as argued in this review.
Topics: Humans; Vocal Cords; Quality of Life; Mediastinum; Lung Neoplasms; Palliative Care
PubMed: 36426831
DOI: No ID Found -
BMJ Case Reports Jan 2014Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include...
Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include adhesions, abscess formation and subsequent infections. Gossypiboma occurs as a result of not using radio-opaque sponges, poorly performed sponge counts, inadequate wound explorations on suspicion and misread intraoperative radiographs. Therefore, this event can be avoided if strict preventive measures are taken. Moreover, further complications can be avoided following the correct and early diagnosis of gossypiboma. Gossypiboma is an important topic as it carries great medicolegal consequences for the surgeon. We have presented three cases of intrathoracic gossipiboma following previous cardiothoracic surgeries. They presented years after their surgeries, with features varying from patient to patient, ranging from cough and fever to no sypmtoms at all. CT scan only showed a mass lesion in all cases, therefore we proceeded for CT-guided biopsy which was also found to be inconclusive. It was only after entering the thoracic cavity via video-assisted thoracoscopy/thoracotomy that the diagnosis was made and sponges were taken out successfully. All our cases recovered with no further complications.
Topics: Aged; Coronary Artery Bypass; Diagnosis, Differential; Foreign Bodies; Heart Valve Prosthesis Implantation; Humans; Lung; Male; Mediastinum; Middle Aged; Mitral Valve Insufficiency; Postoperative Complications; Reoperation; Surgical Sponges; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed
PubMed: 24403384
DOI: 10.1136/bcr-2013-201814 -
The British Journal of Radiology Feb 2023Advances in imaging technology have dramatically increased the resolution of CT and improved detection of disease; these advances also have led to an increase in...
Advances in imaging technology have dramatically increased the resolution of CT and improved detection of disease; these advances also have led to an increase in incidentalomas or incidental findings that often do not represent significant disease. Incidental findings on thoracic CT are common and can be problematic and expensive to evaluate. Thoracic imagers often are having to make recommendations for appropriate management which adds to the burden. Thoracic CT incidental findings are broad and include those of the lungs, heart, mediastinum, pleura, chest wall, thoracic soft tissues as well as the lower neck and upper abdomen. Of these, incidental pulmonary nodules have garnered the most interest over the years, but all incidentals may be proven to represent significant disease. In the USA, the American College of Radiology has generated white papers on incidentals that have proven useful. Currently, a number of investigations to utilize artificial intelligence for qualification and management of incidentals are ongoing. Likewise, the radiology/imaging community must support efforts to collaboratively address incidental findings and management concerns. As such, continued efforts to establish guidelines for appropriate identification, classification and management of incidentals is important to improve patient care and assure fiscally responsible assessment.
Topics: Humans; Artificial Intelligence; Tomography, X-Ray Computed; Neck; Mediastinum; Thoracic Wall; Incidental Findings
PubMed: 35315291
DOI: 10.1259/bjr.20211368 -
The Journal of Thoracic and... Jun 2018
Topics: Humans; Lung Neoplasms; Mediastinum
PubMed: 29455955
DOI: 10.1016/j.jtcvs.2018.01.039 -
Medical Physics Nov 2020This manuscript describes a dataset of thoracic cavity segmentations and discrete pleural effusion segmentations we have annotated on 402 computed tomography (CT) scans...
This manuscript describes a dataset of thoracic cavity segmentations and discrete pleural effusion segmentations we have annotated on 402 computed tomography (CT) scans acquired from patients with non-small cell lung cancer. The segmentation of these anatomic regions precedes fundamental tasks in image analysis pipelines such as lung structure segmentation, lesion detection, and radiomics feature extraction. Bilateral thoracic cavity volumes and pleural effusion volumes were manually segmented on CT scans acquired from The Cancer Imaging Archive "NSCLC Radiomics" data collection. Four hundred and two thoracic segmentations were first generated automatically by a U-Net based algorithm trained on chest CTs without cancer, manually corrected by a medical student to include the complete thoracic cavity (normal, pathologic, and atelectatic lung parenchyma, lung hilum, pleural effusion, fibrosis, nodules, tumor, and other anatomic anomalies), and revised by a radiation oncologist or a radiologist. Seventy-eight pleural effusions were manually segmented by a medical student and revised by a radiologist or radiation oncologist. Interobserver agreement between the radiation oncologist and radiologist corrections was acceptable. All expert-vetted segmentations are publicly available in NIfTI format through The Cancer Imaging Archive at https://doi.org/10.7937/tcia.2020.6c7y-gq39. Tabular data detailing clinical and technical metadata linked to segmentation cases are also available. Thoracic cavity segmentations will be valuable for developing image analysis pipelines on pathologic lungs - where current automated algorithms struggle most. In conjunction with gross tumor volume segmentations already available from "NSCLC Radiomics," pleural effusion segmentations may be valuable for investigating radiomics profile differences between effusion and primary tumor or training algorithms to discriminate between them.
Topics: Algorithms; Benchmarking; Carcinoma, Non-Small-Cell Lung; Humans; Lung; Lung Neoplasms; Pleural Effusion; Thoracic Cavity; Tomography, X-Ray Computed
PubMed: 32749075
DOI: 10.1002/mp.14424 -
Jornal Brasileiro de Pneumologia :... Jun 2022
Topics: Humans; Mediastinum; Thorax
PubMed: 35703621
DOI: 10.36416/1806-3756/e20220158 -
Medicina 2023Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most...
Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most commonly occurs in the adrenal gland, it has also been reported at extra-adrenal sites. We present the case of a 65-year-old woman with a primary mediastinal myelolipoma. Computer tomographic scan of the thorax showed an ovoid tumor with well-defined borders of 6.5 × 4.2 cm, located in the posterior mediastinum. A transthoracic biopsy of the lesion was made, and the microscopic observation revealed hematopoietic cells and mature adipose tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, histopathological examination is essential for the definitive diagnosis.
Topics: Female; Humans; Aged; Mediastinum; Myelolipoma; Thoracic Surgery, Video-Assisted; Radionuclide Imaging; Adrenal Gland Neoplasms
PubMed: 37379542
DOI: No ID Found