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California Medicine May 1961The surgical correction of a deformity of the anterior chest wall is becoming more frequent as knowledge regarding causes increases and as better results are achieved....
The surgical correction of a deformity of the anterior chest wall is becoming more frequent as knowledge regarding causes increases and as better results are achieved. The present etiological concept of an excessive costal cartilage growth has prompted surgeons to perform total excision of the involved costal cartilages. The operation used in 27 patients included in the present study incorporated this principle and, in addition, the use of a temporary pin support until the flaccid chest wall becomes firm enough to resist a flail motion.
Topics: Cartilage; Costal Cartilage; Humans; Hyaline Cartilage; Hyperostosis; Knowledge; Orthotic Devices; Ribs; Thoracic Wall; Thorax
PubMed: 13705160
DOI: No ID Found -
PloS One 2019Combined computed tomography (CT) occurs when one anatomical area is simultaneously imaged both without and with contrast, or two overlapping anatomical areas are imaged... (Clinical Trial)
Clinical Trial
OBJECTIVE
Combined computed tomography (CT) occurs when one anatomical area is simultaneously imaged both without and with contrast, or two overlapping anatomical areas are imaged concurrently. While this has been studied in a Traditional Medicare population, it has not been studied in other populations subject to prior authorization. This study explores between-facility variation in ordering and receiving orders to render combined CT in a mixed commercial and Medicare Advantage population.
METHODS
Orders for CT abdomen (without/with contrast), CT thorax (without/with contrast), and concurrent CT brain and sinus authorized by a prior authorization company from 2013-2017, pertaining to patients with commercial or Medicare Advantage health plans from one national insurer, were extracted. Orders were issued and rendered by both hospitals and nonhospitals. The analysis was performed separately for each anatomical area in two ways: orders were grouped by ordering facility, and by designated rendering facility. For each facility, the ratio of combined to total orders was calculated, and analysis of variance was used to determine whether there were significant differences in this rate by year. The association between health plan type and combined imaging rates was assessed.
RESULTS
Combined rates [ratio±standard deviation] for abdomen, thorax, and brain/sinus were 0.306±0.246, 0.089±0.142, and 0.002±0.01 respectively when the analysis was conducted according to ordering facility, and 0.311±0.178, 0.096±0.113, and 0.001±0.006 when the analysis was conducted according to designated rendering facility. Combined CT abdomen and CT thorax rates decreased monotonically from 2013 to 2017, decreases that were significant (P < .01) regardless of whether orders were grouped by ordering or rendering facility. Combined CT abdomen and CT thorax rates significantly differed between orders pertaining to people with commercial and Medicare Advantage plans.
DISCUSSION
Variability was greater when orders were grouped by ordering facility, rather than rendering facility. Health plan type may influence whether a patient receives combined CT.
Topics: Abdomen; Female; Humans; Male; Medicare Part C; Neuroimaging; Outpatients; Practice Patterns, Physicians'; Thorax; Tomography, X-Ray Computed; United States
PubMed: 31725755
DOI: 10.1371/journal.pone.0224735 -
Anatomical Record (Hoboken, N.J. : 2007) Feb 2017The human ribcage expands and contracts during respiration as a result of the interaction between the morphology of the ribs, the costo-vertebral articulations and...
In Vivo 3D Analysis of Thoracic Kinematics: Changes in Size and Shape During Breathing and Their Implications for Respiratory Function in Recent Humans and Fossil Hominins.
The human ribcage expands and contracts during respiration as a result of the interaction between the morphology of the ribs, the costo-vertebral articulations and respiratory muscles. Variations in these factors are said to produce differences in the kinematics of the upper thorax and the lower thorax, but the extent and nature of any such differences and their functional implications have not yet been quantified. Applying geometric morphometrics we measured 402 three-dimensional (3D) landmarks and semilandmarks of 3D models built from computed tomographic scans of thoraces of 20 healthy adult subjects in maximal forced inspiration (FI) and expiration (FE). We addressed the hypothesis that upper and lower parts of the ribcage differ in kinematics and compared different models of functional compartmentalization. During inspiration the thorax superior to the level of the sixth ribs undergoes antero-posterior expansion that differs significantly from the medio-lateral expansion characteristic of the thorax below this level. This supports previous suggestions for dividing the thorax into a pulmonary and diaphragmatic part. While both compartments differed significantly in mean size and shape during FE and FI the size changes in the lower compartment were significantly larger. Additionally, for the same degree of kinematic shape change, the pulmonary thorax changes less in size than the diaphragmatic thorax. Therefore, variations in the form and function of the diaphragmatic thorax will have a strong impact on respiratory function. This has important implications for interpreting differences in thorax shape in terms of respiratory functional differences within and among recent humans and fossil hominins. Anat Rec, 300:255-264, 2017. © 2016 Wiley Periodicals, Inc.
Topics: Adult; Aged; Animals; Biomechanical Phenomena; Diaphragm; Female; Hominidae; Humans; Male; Middle Aged; Respiration; Respiratory Muscles; Ribs; Thorax; Tomography, X-Ray Computed
PubMed: 27762077
DOI: 10.1002/ar.23503 -
Seminars in Ultrasound, CT, and MR Oct 1998Spiral CT with three-dimensional (3D) display can provide a rapid noninvasive examination of the vascular system and has been shown to have a wide range of clinical... (Review)
Review
Spiral CT with three-dimensional (3D) display can provide a rapid noninvasive examination of the vascular system and has been shown to have a wide range of clinical applications in the thorax, including imaging of the aorta, pulmonary vasculature, and venous abnormalities. Three-dimensional images can provide views of the imaging volume from innumerable viewing angles for both the radiologist and referring clinician, and potentially obviate invasive procedures such as angiography. In this article, we will review many of these applications of spiral CT angiography with 3D displays. Emphasis is placed on study design, protocol selection, and display of pathology.
Topics: Angiography; Radiography, Thoracic; Thorax; Tomography, Emission-Computed
PubMed: 9800252
DOI: 10.1016/s0887-2171(98)90019-1 -
British Medical Journal Feb 1952
Topics: Funnel Chest; Thorax
PubMed: 14896154
DOI: No ID Found -
The Indian Medical Gazette Aug 1952
Topics: Humans; Thoracic Surgery; Thoracic Surgical Procedures; Thorax
PubMed: 13022082
DOI: No ID Found -
Edinburgh Medical Journal Mar 1949
Topics: Thoracoplasty; Thorax
PubMed: 18144519
DOI: No ID Found -
British Medical Journal Aug 1955
Topics: Congenital Abnormalities; Funnel Chest; Thorax
PubMed: 13240106
DOI: 10.1136/bmj.2.4935.362-a -
Scientific Reports Jul 2020Sexual dimorphism is an important feature of adult thorax morphology, but when and how sex-related differences in the ribcage arise during ontogeny is poorly known....
Sexual dimorphism is an important feature of adult thorax morphology, but when and how sex-related differences in the ribcage arise during ontogeny is poorly known. Previous research proposed that sex-related size differences in the nasal region arise during puberty. Therefore, we explore whether ribcage sexual dimorphism also arises at that time and whether this sexual dimorphism is maintained until old age. We measured 526 (semi)landmarks on 80 CT-based human ribcage reconstructions, on individuals ranging from 7 to 65 year-old. The 3D coordinates were submitted to the Procrustes superimposition and analyzed. Our results show that the trajectories of thorax size and shape between sexes diverge at around 12 years of age, and continue slightly diverging until old age. The differential ontogenetic trends cause adult male ribcages to become deeper, shorter, and wider than female. Our results are consistent with the evidence from the cranial respiratory system, with the development of sexual dimorphism probably related to changes in body composition during puberty combined with changes in the reproductive system.
Topics: Adolescent; Adult; Aging; Child; Female; Humans; Male; Sex Factors; Skull; Thorax; Young Adult
PubMed: 32612141
DOI: 10.1038/s41598-020-67664-5 -
Computer Methods and Programs in... Apr 2024High-frequency chest wall compression (HFCC) therapy by airway clearance devices (ACDs) acts on the rheological properties of bronchial mucus to assist in clearing...
BACKGROUND AND OBJECTIVE
High-frequency chest wall compression (HFCC) therapy by airway clearance devices (ACDs) acts on the rheological properties of bronchial mucus to assist in clearing pulmonary secretions. Investigating low-frequency vibrations on the human thorax through numerical simulations is critical to ensure consistency and repeatability of studies by reducing extreme variability in body measurements across individuals. This study aims to present the numerical investigation of the harmonic acoustic excitation of ACDs on the human chest as a gentle and effective HFCC therapy.
METHODS
Four software programs were sequentially used to visualize medical images, decrease the number of surfaces, generate and repair meshes, and conduct numerical analysis, respectively. The developed methodology supplied the validation of the effect of HFCC through computed tomography-based finite element analysis (CT-FEM) of a human thorax. To illustrate the vibroacoustic characteristics of the HFCC therapy device, a 146-decibel sound pressure level (dB) was applied on the back-chest surface of the model. Frequency response function (FRF) across 5-100 Hz was analyzed to characterize the behaviour of the human thorax with the state-space model.
RESULTS
We discovered that FRF pertaining to accelerance equals 0.138 m/sN at the peak frequency of 28 Hz, which is consistent with two independent experimental airway clearance studies reported in the literature. The state-space model assessed two apparent resonance frequencies at 28 Hz and 41 Hz for the human thorax. The total displacement, kinetic energy density, and elastic strain energy density were furthermore quantified at 1 µm, 5.2 µJ/m, and 140.7 µJ/m, respectively, at the resonance frequency. In order to deepen our understanding of the impact on internal organs, the model underwent simulations in both the time domain and frequency domain for a comprehensive analysis.
CONCLUSION
Overall, the present study enabled determining and validating FRF of the human thorax to roll out the inconsistencies, contributing to the health of individuals with investigating gentle but effective HFCC therapy conditions with ACDs. This innovative finding furthermore provides greater clarity and a tangible understanding of the subject by simulating the responses of CT-FEM of the human thorax and internal organs at resonance.
Topics: Humans; Vibration; Chest Wall Oscillation; Lung; Mucus; Thorax
PubMed: 38359553
DOI: 10.1016/j.cmpb.2024.108062