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Anterior Chest Wall (anterior + chest_wall)
Selected AbstractsAcneiform lesions in Becker's nevus and breast hypoplasiaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2002Jorge Santos-Juanes PhD An 18-year-old woman was referred for the evaluation of a dull gray macule on the left breast. From the age of 13 years, the patient noted breast asymmetry beginning with the development of the left breast and the presence of a pigmented stain on its border. Physical exploration revealed hypoplasia of the left breast and a homogeneous, light brown macule on the side of the breast (Fig. 1) without infiltration. Papules and pustules were located mainly around the Becker's nevus on the left anterior chest wall. Biopsy specimens with Fontana's stain disclosed a hyperpigmented acanthotic epidermis. A diagnosis of Becker's nevus, acne, and hypoplasia of the breast was made. Figure 1. Hypoplasia of the left breast and a homogeneous light brown macule with acneiform lesions [source] Four-dimensional sonography with B-flow imaging and spatiotemporal image correlation for visualization of the fetal heartJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2008Toshiyuki Hata MD Abstract Purpose. To use B-flow imaging with 4-dimensional (4D) sonography and spatiotemporal image correlation (STIC) in the evaluation of normal fetal heart and congenital heart disease during pregnancy. Method. Volume data sets of the fetal heart were acquired with automated transverse and longitudinal sweeps of the anterior chest wall. We studied 13 normal fetuses and 2 fetuses with congenital heart disease (1 double-outlet right ventricle and 1 hypoplastic left heart syndrome) at gestation ages ranging from 13 to 39 weeks using transabdominal 4D B-flow sonography with STIC (4D BF-STIC). Results. 4D BF-STIC demonstrated dynamic angiographic features in both normal and abnormal fetal hearts. 4D BF-STIC images could not be obtained in 2 normal fetuses at 18.1 and 33.1 weeks because of the high fetal heart rate and inappropriate fetal position. In normal fetal heart, characteristic hemodynamic changes in both atria and ventricles were clearly demonstrated in systole and diastole. 4D BF-STIC also allowed visualization of the relationship, size, and course of the outflow tracts, thus helping the examiner to better understand the relationships between the vessels. In a case of hypoplastic left heart syndrome, dramatic hemodynamic changes including the right atrium, right ventricle, and pulmonary artery were evident. In a case of double-outlet right ventricle with ventricular septal defect, left-to-right shunt flow through a ventricular septal defect was clearly shown, as were great arteries originating in parallel from the right ventricle. Conclusion. 4D BF-STIC provides a means of real-time 3-dimensional evaluation of fetal intracardiac and extracardiac hemodynamics in the second and third trimesters. This novel technique assists in the evaluation of fetal cardiac hemodynamics and may play an important role in future fetal cardiac research and in the evaluation of congenital heart disease in the fetus. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008. [source] Life-threatening haemorrhage from a sternal metastatic hepatocellular carcinomaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2000Chih-Yen Chen Abstract Rupture of the tumour is a catastrophic complication of hepatocellular carcinoma. The prognosis in patients with a ruptured hepatocellular carcinoma is usually unfavourable. We describe a 46-year-old man who suffered from visible massive tumour haemorrhage due to a hepatitis B-related hepatocellular carcinoma that metastasized to the sternal bone. The prominent tumour mass was bulging over the anterior chest wall on the sternum of the patient, and bled spontaneously. This episode of life-threatening haemorrhage was stopped by surgical ligation of the bleeding site. Palliative radiotherapy shrank the tumour mass size and prevented further possible bleeding. This is likely to be the first reported case with a visible spontaneous tumour bleeding from a sternal metastatic hepatocellular carcinoma. [source] Noninvasive Study of Ventricular Preexcitation Using Multichannel MagnetocardiographyPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1p2 2003RICCARDO FENICI FENICI, R., et al.: Noninvasive Study of Ventricular Preexcitation Using Multichannel Magnetocardiography. In clinical practice, noninvasive classification of ventricular preexcitation (VPX) is usually done with ECG algorithms, which provide only a qualitative localization of accessory pathways. Since 1984, single or multichannel magnetocardiograpy (MMCG) has been used for three-dimensional localization of VPX sites, but a systematic study comparing the results of ECG and MMCG methods was lacking. This study evaluated the reliability of MMCG in an unshielded electrophysiological catheterization laboratory, and compared VPX classification as achieved with the five most recent ECG algorithms with that obtained by MMCG mapping and imaging techniques. A nine-channel direct current superconducting quantum interference device (DC-SQUID) MMCG system (sensitivity is 20 fT/Hz0.5) was used for sequential MMCG from 36 points on the anterior chest wall, within an area20 × 20 cm. Twenty-eight patients with Wolff-Parkinson-White syndrome were examined at least twice, on the same day or after several months to test the reproducibility of the measurements. In eight patients, the reproducibility of MMCG was also evaluated using different MCG instrumentation during maximal VPX and/or atrioventricular reentrant tachycardia induced by transesophageal atrial pacing via a nonmagnetic catheter. The results of VPX localization with ECG algorithms and MMCG were compared. Equivalent current dipole, effective magnetic dipole, and distributed currents imaging models were used for the inverse solution. MMCG classification of VPX was found to be more accurate than ECG methods, and also provided additional information for the identification of paraseptal pathways. Furthermore, in patients with complex activation patterns during the delta wave, distributed currents imaging revealed two different activation patterns, suggesting the existence of multiple accessory pathways. (PACE 2003; 26[Pt. II]:431,435) [source] Poster 2, Acne fulminans: part of the spectrum of SAPHOBRITISH JOURNAL OF DERMATOLOGY, Issue 6 2007S.L. Chua A 13-year-old boy was admitted to hospital with severe back pain and systemic upset. He had commenced isotretinoin 25 mg (0·5 mg kg,1) daily 17 days previously for severe acne unresponsive to oral erythromycin. Isotretinoin was stopped after 4 days due to severe lower back pain. On admission, he was unable to mobilize and the pain was uncontrolled with oral morphine sulphate. Investigations showed leucocytosis and neutrophilia. Magnetic resonance imaging of the vertebrae showed multiple areas of high signal consistent with an inflammatory process such as osteomyelitis. Oral prednisolone 40 mg daily and ibuprofen controlled the pain within 2 days. Sulfasalazine (1 g twice daily) was commenced 10 days later. The re-introduction of isotretinoin 5 mg daily 12 days after admission precipitated severe back pain, necessitating 3 days of intravenous methylprednisolone. The oral prednisolone dose has been reduced over 6 weeks and stopped. The acne is currently controlled with clindamycin, although there is marked scarring. Acne fulminans is a rare condition characterized by sudden onset of severe acne and systemic features such as fever, leucocytosis and arthralgia.1 Osteomyelitic lesions are a recognized feature. In 1987, the term SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was proposed to describe a clinical entity with skin, joint and bone manifestations. Associated skin conditions include severe acne, psoriasis and palmoplantar pustulosis. Reported sites of osteoarticular involvement include the anterior chest wall, vertebrae, pelvis and mandible.2 Our patient clearly has acne fulminans and fulfils the criteria for SAPHO syndrome. We believe this condition will be increasingly recognized by dermatologists. References 1 Karvonen S. Acne fulminans: report of clinical findings and treatment of twenty-four patients. J Am Acad Dermatol 1993; 28:572,9. 2 Hayem G, Bouchaud-Chabot A, Benali K et al. SAPHO syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum 1999; 29:159,71. [source] | ||||||||||