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Fulltext Neurothekeoma palpebrae in association with multiple superficial angiomyxomas: Tegumental Angiomyxoma-Neurothekeoma syndrome (TAN syndrome)

Kah TA, Yong KC, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e67.
PMID: 24765328 DOI: 10.4081/cp.2011.e67

We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors' knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma.

Matched MeSH terms: Thorax
Fulltext Metastatic Bone Disease Secondary to Bronchial Adenocarcinoma in a Patient with Paget's Disease of the Bone

Lim KP, Kok WH, Kamaruddin NA

J ASEAN Fed Endocr Soc, 2018;33(1):63-68.
PMID: 33442113 DOI: 10.15605/jafes.033.01.11

A 69-year-old female complained of intermittent left hip pain for the past 3 years. Biochemical tests revealed normal serum calcium and phosphorus with markedly raised alkaline phosphatase. MRI of the hip revealed extensive marrow signal abnormalities at the left pelvic bone, while CT of the thorax revealed a spiculated lung nodule at the left lower lung lobe. In order to diagnose either primary, metastatic bone tumour or Paget's disease of the bone (PDB), an open biopsy of the left iliac bone was performed. The histopathology of bone biopsy of the left iliac bone was consistent with PDB. A CT guided biopsy of the lung mass done later revealed adenocarcinoma of the lung. She had 18F-FDG PETCECT Scan for staging evaluation and result was suggestive of new bony metastases. Patient was started on IV Zoledronic acid for treatment of the PDB. In view of the stage 4 lung adenocarcinoma with bony metastases, patient was scheduled for palliative chemotherapy.

Matched MeSH terms: Thorax
Fulltext Loculated transudative pleural effusion masquerading as right upper lobe consolidation in a haemodialysis patient

Kho SS, Tay PS, Lee J, Tie ST

AME Case Rep, 2017;1:4.
PMID: 30263991 DOI: 10.21037/acr.2017.09.05

Pleural effusion is a common encounter in renal failure patients and frequently possess a diagnostic challenge to clinician especially when it was exudative. Fortunately, transudative pleural effusion secondary to fluid overload remains the commonest cause of pleural effusion in haemodialysis patients. Frequent thoracocentesis enhance pleural inflammation and potentially complicate further this challenging clinical presentation. We report a middle-aged gentleman with advanced chronic kidney disease presented with dyspnea and new right upper lobe consolidation on chest roentograph. He had a history of recurrent bilateral pleural effusion secondary to fluid overload and hence multiple attempts of thoracocentesis were performed. Medical thoracoscopy performed previously yielded non-specific pleuritis. Flexible bronchoscopy demonstrates normal airway with negative microbiological studies. Computed tomography (CT) of the thorax shown a loculated hypodense pleural effusion at the apical region of the right upper lobe. Ultrasound guided thoracocentesis anteriorly yield 400 mL of clear straw color fluid which was transudative by Light's criteria. Post tapping chest X-ray shown complete resolution of right upper lobe consolidation and patient reports immediate relieve of dyspnea. Patient was started on regular effective haemodialysis and pleural effusion did not recur during follow up. Loculated pleural effusion masquerading as mediastinal tumour had been reported but pleural effusion that conformed to the contour of a lung lobe is rare. This case highlights the atypical but unique presentation of a transudative pleural effusion and demonstrates the risk of repeated thoracocentesis complicating a simple clinical presentation.

Matched MeSH terms: Thorax
Lo, the ever confounding nipple shadow!

Boo WH, Chan YC

Malays Fam Physician, 2020;15(3):79-82.
PMID: 33329866

The discovery of a solitary pulmonary nodule (SPN) on chest imaging can be alarming for both the clinician and the patient. In the absence of a uniform guideline, managing SPN is nothing short of challenging for primary care physicians (PCPs). We present a case here of a patient presenting with prolonged cough who also displayed unilateral SPN on her chest radiograph. Through further examination, this presence was later shown to be a nipple shadow simulating SPN, and the patient was spared unnecessary testing and psychological distress.

Matched MeSH terms: Thorax
Fulltext Kashima operation: an endoscopic phonosurgery by laser for bilateral vocal cord palsy

Alamgir Chowdhury, M., Farid Hossain Chowdhury, Khaled Bin Shahabuddin, Tofazzal Hossain, A.B.M., Shaila Kabir

Borneo Journal of Medical Sciences, 2021;15(1):31-35.
MyJurnal

Complete or partial restriction of the vocal cords usually occurs due to cancer, neurologic causes or mechanical causes like huge neck mass, trauma to the neck, viral infection, and sometimes iatrogenic during surgery. Bilateral vocal cord palsy is a severe condition that can lead to significant problems in breathing, speaking, and swallowing. If any patient presents with stridor, it requires urgent surgical airway management followed by specific treatment. A case of viral bilateral abductor vocal cord palsy in a 41-year-old female is reported here. The patient presented with stridor, and immediate tracheostomy was done. The stridor developed first 3 months earlier followed by cold and fever for a week. The stridor worsened gradually and leads to a state of commencing immediate tracheostomy. There was no history of trauma to the neck or any neck surgery. All basic laboratory blood test was within the normal limit. The laryngoscopic examination showed both vocal cords were immobile and almost median position with a small gap at the posterior commissure. Chest and neck plain X-ray along with computed tomography scan of neck was normal which ruled out the other causes of bilateral vocal cord palsy. The patient subsequently underwent successful left posterior cordectomy by laser, and decannulation of tracheostomy was done, known as Kashima operation.

Matched MeSH terms: Thorax
Fulltext Image quality and radiation dose comparison in medium and high kilovoltage for digital pa chest radiography

Moey, Soo-Foon, Nur Farah Hani Muhd Jaafar, Nursyahirah Saidin

International Journal of Allied Health Sciences, 2019;3(4):954-966.
MyJurnal

Introduction: Various medium and high tube potentials were utilized to conduct chest x-rays. There
are advantages and disadvantages with regards to image quality and radiation dose when using
medium and high kilovoltage (kVp) technique. However, radiographers have misconstrued
understanding pertaining to the choice of tube potential as well as grid usage when performing chest radiography. Methods: The experimental study was conducted using the PBU-50 phantom by exposing it with medium kVp utilizing grid and non-grid as well as high kVp with grid. All images obtained were evaluated using the modified evaluation criteria for PA chest established by the Commission of European Communities, 1996 whilst the dose area product (DAP) was determined using the Dose Area Product (DAP) meter. The value obtained from the DAP meter was converted to entrance surface dose (ESD) usingCALDOSE_X5.0 software and mathematical formula. Results: The Wilcoxon Signed-Rank Test indicated a significant difference in ESD when using medium and high kVp; Z= -2.666, p

Matched MeSH terms: Thorax
Fulltext Eye tracker as an implied social presence: awareness of being eye-tracked induces social-norm-based looking behaviour

Wong HK, Stephen ID

J Eye Mov Res, 2019 Aug 05;12(2).
PMID: 33828723 DOI: 10.16910/jemr.12.2.5

Human behaviour is not only influenced by the physical presence of others, but also implied social presence. This study examines the impact of awareness of being eye-tracked on eye movement behaviour in a laboratory setting. During a classic yes/no face recognition task, participants were made to believe that their eye movements were recorded (or not recorded) by eye trackers. Their looking patterns with and without the awareness of being eye-tracked were compared while perceiving social (faces, faces-and-bodies) and non-social (inanimate objects) video stimuli. Area-of-interest (AOI) analysis revealed that misinformed participants (who were not aware that their eye movements were being recorded) looked more at the body (chest and waist) compared to informed participants (who believed they were being eye-tracked), whereas informed participants fixated longer on the mouth and shorter on the eyes of female models than misinformed participants did. These findings highlight the potential impact of an awareness of being eye tracked on one's eye movement pattern when perceiving a social stimulus. We conclude that even within laboratory settings an eye tracker may function as an implied social presence that leads individuals to modify their eye movement behaviour according to socially-derived inhibitory norms.

Matched MeSH terms: Thorax
Fulltext Evaluation of radiation dose and image quality following changes to tube potential (kVp) in conventional paediatric chest radiography

Ramanaidu S, Sta Maria R, Ng Kh, George J, Kumar G

Biomed Imaging Interv J, 2006 Jul;2(3):e35.
PMID: 21614244 MyJurnal DOI: 10.2349/biij.2.3.e35

A study of radiation dose and image quality following changes to the tube potential (kVp) in paediatric chest radiography.

Matched MeSH terms: Thorax
Evaluation of a new predictive equation for automated calculation of size-specific dose estimate (SSDE) in CT imaging

Osman ND, Abdulkadir MK, Shuaib IL, Nasirudin RA

Radiography (Lond), 2024 Jan;30(1):237-244.
PMID: 38035439 DOI: 10.1016/j.radi.2023.11.012

INTRODUCTION: The adoption of size-specific dose estimate (SSDE) in clinical practice is still limited owing to the tedious and complex manual measurement of individual patient size for the clinical calculation of SSDE. Thus, the automation of SSDE is imperative. This study aims to evaluate a predictive equation for the automated calculation of SSDE.
METHODS: A user-friendly software was developed to accurately predict the individual size-specific dose estimation of paediatric patients undergoing computed tomography (CT) scans of the head, thorax, and abdomen. The software includes a calculation equation developed based on a novel SSDE prediction equation that used a population's pre-determined percentage difference between volume-weighted computed tomography dose index (CTDIvol) and SSDE with age. American Association of Physicists in Medicine (AAPM RPT 204) method (manual) and segmentation-based SSDE calculators (indoseCT and XXautocalc) were used to assess the proposed software predictions comparatively.
RESULTS: The results of this study show that the automated equation-based calculation of SSDE and the manual and segmentation-based calculation of SSDE are in good agreement for patients. The differences between the automated equation-based calculation of SSDE and the manual and segmentation-based calculation are less than 3%.
CONCLUSION: This study validated an accurate SSDE calculator that allows users to enter key input values and calculate SSDE.
IMPLICATION FOR PRACTICE: The automated equation-based SSDE software (PESSD) seems a promising tool for estimating individualised CT doses during CT scans.

Matched MeSH terms: Thorax
Fulltext Emergency lung-sparing surgical repair of a complete transection of the right mainstem bronchus due to blunt chest trauma

Sachithanandan A, Tan YS, Abdul Muis J, Rapi AR, Mohd Arif MN, Badmanaban B, et al.

Med J Malaysia, 2014 Apr;69(2):92-4.
PMID: 25241820 MyJurnal

Traumatic chest injury with complete tracheo- bronchial disruption is uncommon and occurs in approximately 1% of motor vehicle accidents (MVA) (1,2). Such injuries carry a high mortality and patients rarely survive transfer to hospital. A high index of suspicion facilitates early diagnosis. Early operative intervention is vital for survival. We describe a rare case of traumatic complete disruption of the right mainstem bronchus (RMB) due to blunt chest trauma. The transected airway was reanastomosed emergently avoiding a lung resection.

Matched MeSH terms: Thorax
Fulltext Deep Mining Generation of Lung Cancer Malignancy Models from Chest X-ray Images

Horry M, Chakraborty S, Pradhan B, Paul M, Gomes D, Ul-Haq A, et al.

Sensors (Basel), 2021 Oct 07;21(19).
PMID: 34640976 DOI: 10.3390/s21196655

Lung cancer is the leading cause of cancer death and morbidity worldwide. Many studies have shown machine learning models to be effective in detecting lung nodules from chest X-ray images. However, these techniques have yet to be embraced by the medical community due to several practical, ethical, and regulatory constraints stemming from the "black-box" nature of deep learning models. Additionally, most lung nodules visible on chest X-rays are benign; therefore, the narrow task of computer vision-based lung nodule detection cannot be equated to automated lung cancer detection. Addressing both concerns, this study introduces a novel hybrid deep learning and decision tree-based computer vision model, which presents lung cancer malignancy predictions as interpretable decision trees. The deep learning component of this process is trained using a large publicly available dataset on pathological biomarkers associated with lung cancer. These models are then used to inference biomarker scores for chest X-ray images from two independent data sets, for which malignancy metadata is available. Next, multi-variate predictive models were mined by fitting shallow decision trees to the malignancy stratified datasets and interrogating a range of metrics to determine the best model. The best decision tree model achieved sensitivity and specificity of 86.7% and 80.0%, respectively, with a positive predictive value of 92.9%. Decision trees mined using this method may be considered as a starting point for refinement into clinically useful multi-variate lung cancer malignancy models for implementation as a workflow augmentation tool to improve the efficiency of human radiologists.

Matched MeSH terms: Thorax
Correlation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXA

Amin MFM, Zakaria WMW, Yahya N

Skeletal Radiol, 2021 Dec;50(12):2525-2535.
PMID: 34021364 DOI: 10.1007/s00256-021-03801-z

OBJECTIVES: CT examination can potentially be utilised for early detection of bone density changes with no additional procedure and radiation dose. We hypothesise that the Hounsfield unit (HU) measured from CT images is correlated to the t-scores derived from dual energy X-ray absorptiometry (DXA) in multiple anatomic regions.
MATERIALS & METHODS: Data were obtained retrospectively from all patients who underwent both CT examinations - brain (frontal bone), thorax (T7), abdomen (L3), spine (T7 & L3) or pelvis (left hip) - and DXA between 2014 and 2018 in our centre. To ensure comparability, the period between CT and DXA studies must not exceed one year. Correlations between HU values and t-scores were calculated using Pearson's correlation. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was used to determine threshold HU values for predicting osteoporosis.
RESULTS: The inclusion criteria were met by 1043 CT examinations (136 head, 537 thorax, 159 lumbar and 151 left hip). The left hip consistently provided the most robust correlations (r = 0.664-0.708, p thorax T7 and lumbar L3 showed average correlations (range of r values is 0.497-0.679, p 0.05.
CONCLUSION: HU values derived from the hip, T7 and L3 provided a good to moderate correlation to t-scores with a good prediction for osteoporosis. The suggested optimal thresholds may be used in clinical settings after external validations are performed.

Matched MeSH terms: Thorax
Contactless respiration rate measurement using optical method and empirical mode decomposition

Gan KB, Yahyavi ES, Ismail MS

Technol Health Care, 2016 Sep 14;24(5):761-8.
PMID: 27163300 DOI: 10.3233/THC-161161

BACKGROUND: At the emergency triage center, assessment of the present of the danger signs and measurement of vital signs are measured according to the guidelines. The respiration rate is still posing a challenge to the doctor as it is impractical to use conventional devices. Attaching measurement devices to the patient will induce artificial measurements (self-awareness stress effects) besides being time-consuming. Currently, the medical officers visually count the number of times the chest movement in a minute, sometimes poses cultural challenges especially for female patients.
OBJECTIVE: The main objective of this paper is to develop a robust algorithm to extract respiration rate using the contactless displacement sensor.
METHODS: In this study, chest movements were used as an indicative of inspiration and expiration to measure respiratory rate using the contactless displacement sensor. The contactless optical signals were recorded from 32 healthy subjects in four different controlled breathing conditions: rest, coughing, talking and hand movement to obtain the motion artifacts that the patients may have in the emergency department. The Empirical mode decomposition (EMD) algorithm was used to derive continuous RR signal from the contactless optical signal.
RESULTS: The analysis showed that there is a good correlation (0.9702) with RMSE of 0.33 breaths per minutes between the contact respiration rate and contactless respiration rate using empirical mode decomposition method.
CONCLUSION: It can be concluded that the empirical mode decomposition method can extract the respiration rate of the contactless optical signal from chest movement.

Matched MeSH terms: Thorax/physiology*
Computed tomography of the thorax with 3D reconstruction in penetrating chest injury

Michael A, Yahya ZO, Mdrazali I, Hanif H

Med J Malaysia, 2017 02;72(1):75-76.
PMID: 28255150 MyJurnal

Penetrating chest wounds is less common but more deadly then blunt trauma. Majority of penetrating chest trauma can be managed conservatively with observation and simple thoracotomy. This case report highlights a bizarre occupational hazard causing a penetrating chest injury and the option of non-invasive management with the aid of computed tomography with 3D reconstruction.

Matched MeSH terms: Thorax
Fulltext Chest imaging features of patients afflicted with Influenza A (H1N1) in a Malaysian tertiary referral centre

Bux S, Mohd Ramli N, Ahmad Sarji S, Kamarulzaman A

Biomed Imaging Interv J, 2010 Oct-Dec;6(4):e35.
PMID: 21611071 MyJurnal DOI: 10.2349/biij.6.4.e35

This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis.

Matched MeSH terms: Thorax
CT examination effective doses in Saudi Arabia

Sulieman A, Mahmoud MZ, Serhan O, Alonazi B, Alkhorayef M, Alzimami K, et al.

Appl Radiat Isot, 2018 Nov;141:261-265.
PMID: 30054177 DOI: 10.1016/j.apradiso.2018.07.011

Patient effective doses and the associated radiation risks arising from particular computed tomography (CT) imaging procedures are assessed. The objectives of this research are to measure radiation doses for patients and to quantify the radiogenic risks from CT brain and chest procedures. Patient data were collected from five calibrated CT modality machines in Saudi Arabia. The results are from a study of a total of 60 patients examined during CT procedures using the calibrated CT units. For CT brain and chest, the mean patient effective doses were 1.9 mSv (with a range of 0.6-2.5 mSv) and 7.4 mSv (with a range of 0.5-34.8 mSv) respectively. The radiogenic risk to patients ranged from between 10-5 and 10-4 per procedure. With 65% of the CT procedure cases diagnosed as normal, this prompts re-evaluation of the referral criteria. The establishment of diagnostic reference levels (DRL) and implementation of radiation dose optimisation measures would further help reduce doses to optimal values.

Matched MeSH terms: Thorax
Fulltext COVID-19 Deep Learning Prediction Model Using Publicly Available Radiologist-Adjudicated Chest X-Ray Images as Training Data: Preliminary Findings

Che Azemin MZ, Hassan R, Mohd Tamrin MI, Md Ali MA

Int J Biomed Imaging, 2020;2020:8828855.
PMID: 32849861 DOI: 10.1155/2020/8828855

The key component in deep learning research is the availability of training data sets. With a limited number of publicly available COVID-19 chest X-ray images, the generalization and robustness of deep learning models to detect COVID-19 cases developed based on these images are questionable. We aimed to use thousands of readily available chest radiograph images with clinical findings associated with COVID-19 as a training data set, mutually exclusive from the images with confirmed COVID-19 cases, which will be used as the testing data set. We used a deep learning model based on the ResNet-101 convolutional neural network architecture, which was pretrained to recognize objects from a million of images and then retrained to detect abnormality in chest X-ray images. The performance of the model in terms of area under the receiver operating curve, sensitivity, specificity, and accuracy was 0.82, 77.3%, 71.8%, and 71.9%, respectively. The strength of this study lies in the use of labels that have a strong clinical association with COVID-19 cases and the use of mutually exclusive publicly available data for training, validation, and testing.

Matched MeSH terms: Thorax
Fulltext Biomechanics Analysis of the Firefighters' Thorax Movement on Personal Protective Equipment during Lifting Task Using Inertial Measurement Unit Motion Capture

Yunus MNH, Jaafar MH, Mohamed ASA, Azraai NZ, Amil N, Zein RM

Int J Environ Res Public Health, 2022 Oct 31;19(21).
PMID: 36361112 DOI: 10.3390/ijerph192114232

Back injury is a common musculoskeletal injury reported among firefighters (FFs) due to their nature of work and personal protective equipment (PPE). The nature of the work associated with heavy lifting tasks increases FFs' risk of back injury. This study aimed to assess the biomechanics movement of FFs on personal protective equipment during a lifting task. A set of questionnaires was used to identify the prevalence of musculoskeletal pain experienced by FFs. Inertial measurement unit (IMU) motion capture was used in this study to record the body angle deviation and angular acceleration of FFs' thorax extension. The descriptive analysis was used to analyze the relationship between the FFs' age and body mass index with the FFs' thorax movement during the lifting task with PPE and without PPE. Sixty-three percent of FFs reported lower back pain during work, based on the musculoskeletal pain questionnaire. The biomechanics analysis of thorax angle deviation and angular acceleration has shown that using FFs PPE significantly causes restricted movement and limited mobility for the FFs. As regards human factors, the FFs' age influences the angle deviation while wearing PPE and FFs' BMI influences the angular acceleration without wearing PPE during the lifting activity.

Matched MeSH terms: Thorax
Bioaccumulation and depuration of anthracene in Penaeus monodon (Fibricius) through food ingestion

Ong PT, Yong JC, Chin KY, Hii YS

Chemosphere, 2011 Jul;84(5):578-84.
PMID: 21529890 DOI: 10.1016/j.chemosphere.2011.03.059

Understanding on the bioaccumulation and depuration of PAHs (polycyclic aromatic hydrocarbons) in Penaeus monodon is important in seafood safety because it is one of the most popular seafood consumed worldwide. In this study, we used anthracene as the precursor compound for PAHs accumulation and depuration in the shrimp. Commercial feed pellets spiked with anthracene were fed to P. monodon. At 20 mg kg(-1) anthracene, P. monodon accumulated 0.1% of the anthracene from the feed. P. monodon deputed the PAH two times faster than its accumulation. The shrimp reduced its feed consumption when anthracene content in the feed exceeded 20 mg kg(-1). At 100 mg kg(-1) anthracene, P. monodon started to have necrosis tissues on the posterior end of their thorax. The bioaccumulation factor (BAF), uptake rate constant (k(1)) and depuration rate constant (k(2)) of anthracene in P. monodon were 1.15×10(-3), 6.80×10(-4) d(-1) and 6.28×10(-1) d(-1), respectively. The depuration rate constant is about thousand times higher than the uptake rate constant and this indicated that this crustacean is efficient in depurating hydrocarbons from their tissue.

Matched MeSH terms: Thorax/drug effects; Thorax/metabolism; Thorax/pathology
Fulltext Azygos continuation of the inferior vena cava in carcinoma of oesophagus.

Mubarak, M.Y.

International Medical Journal Malaysia, 2008;7(2):57-61.
MyJurnal

The azygos system enlarges in cases of obstruction to the superior vena cava or inferior vena cava and result in increase blood flow through the system. Azygos continuation of the inferior vena cava is usually congenital and asymptomatic. The azygos vein is the sole drainage of the blood from the lower half of the body to the heart. It is crucial to identify the anomaly as it might involve in the surgical planning of tumours in the thorax or abdomen. Computed Tomography is a non-invasive technique and provide important information about the tumour and the vascular anomaly.

Matched MeSH terms: Thorax

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