• Title/Summary/Keyword: Chest wall pain

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Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.190-199
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    • 2022
  • Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Clinical Review of Chest Wall Tumors (흉벽종양의 임상적 고찰)

  • 김상형
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.343-348
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    • 1977
  • The author reviewed 10 patients of chest wall tumors which were operated during 7 years, from 1970 to 1976, in Department of Thoracic and Cardiovascular Surgery in Chonnam University Hospital. Benign tumors were 6 patients, malignant tumors were 2 patients and metastatic tumors were 2 patients. Benign tumors were more than malignant tumors, but total cases were small, so, statistical analysis was not enough. Specific symptoms of chest wall tumor were swelling due to mass and pain. All cases had swelling due to mass and 4 cases [40%] had pain. Dyspnea was noted in metastatic tumors. The review of the literatures was also done.

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Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report

  • Robin Deville;Justin Issard;Anna Vayssette;Jalal Assouad
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.449-451
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    • 2023
  • We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient's pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found Propionibacterium acnes. Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.

A Clinical Review of Chest Wall Tumors: 21 Cases (흉벽종양 21례에 대한 임상적 고찰)

  • 성상현
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.12-14
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    • 1982
  • 21 cases of the chest wall tumors that were operated and proved by pathologically at the dept. of thoracic & cardlovascular surgery, SNUH during 16 years from 1965 to 1981 were reviewed. The results are as follows: 1.Benign tumors were 11 cases. Primary malignant tumors were 7 cases. Metastatic tumors were 3 cases. 2.Incidence rate of male to female was 1.5:1. 3.Main symptoms were palpable mass [52.4%] and localized chest pain [14.3%]. 4.Locations of tumors were rib [61.9%], soft tissues and muscle [33.3%] and sternum [4.8%]. We excluded the Tbc, rib carles from the chest wall tumors.

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Surgical Management of Chest Wall Tumors (흉벽 종양의 외과적 치료)

  • 박계현
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.547-554
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    • 1991
  • From May 1965 to December 1990, 78 patients with chest wall tumors were operated on. The mean age of the patients was 31.5 years with 50 male and 28 female patients. Forty-nine cases[62.8%] were developed at bony or cartilaginous wall and 29 cases[37.2%] at soft tissue of chest wall. Thirty-two of them[41.0%] were malignant, either primary or metastatic, and 46 tumors[59.0%] were histologically benign. For 55 patients who were operated on since 1982, 6 surgical biopsies. 39 tumor excisions, and 11 wide excisions with chest wall reconstruction were done. Preoperative factors favoring diagnosis of malignant neoplasm were; 1] old-aged male patient, 2] bone or cartilaginous tumors, 3] involvement of multiple ribs, 4] complaint of pain, 5] large size on palpation[larger than 4cm]. With proper diagnosis and management plan, we think, operations of chest wall tumors can give good results.

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Tuberculous chest wall abscess (결핵성 흉벽농양)

  • Jo, Gyu-Seok;U, Se-Yeong
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.140-143
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    • 1984
  • We have experienced 30 patients of tuberculous chest wall abscess which was surgically treated at Kyung Hee University hospital during 6 years from Jan, 1978 to Dec, 1983. We analyze 30 cases of clinical findings and surgically treated, and 20 cases of chest X-rays are available. The results of this sturdy are as follows: 1.Sex ratio ; Male: Female = 1:1.72. 2.Chief complaints are fluctuated mass with or without tenderness or pain and pus from wound. 3.Out of 20 cases of chest x-rays revealed 8 cases of osteolytic lesion, 11 cases of soft tissue swelling, 5 cases of pleural changes and 4 cases of negative findings. 4.We resected partially 43 ribs of 30 patients [average: 1.43 resected] in tuberculous chest wall abscess. 5.Operative methods of tuberculous chest wall abscess were partial resection of destructed or denuded periosteum of ribs and curettage of its surrounding tissues in operative field.

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Clinical Evaluation of Chest Wall Tumors -Review of 33 Cases- (흉벽종양 33례에 대한 임상적 고찰)

  • Lee, Mun-Geum;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.778-783
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    • 1995
  • The incidence of chest wall tumor is rare than those of other portions of the body. The chest wall tumors need special attention about their diagnosis and management than other tumors. From March, 1985 to September, 1994, 33 patients with chest wall tumor underwent surgical treatment, and those were consisted of 28 benign tumors and 5 malignant tumors arising from soft tissue, rib and sternum.Benign tumors were included 11 lipoma, 4 cysticercosis, 2 chondroma and 1 each of fibroma, dermatofibroma, osteochondroma, fibrous dysplasia and hemangioma,and 6 other cases. Malignant chest wall tumors were included 2 metastatic carcinoma,1 each of giant cell tumor, chondrosarcoma and epithelioid sarcoma.Sex ratio of male to female was 1.5:1, and the range of age was 16 to 72 years,and the mean age was about 40 years. Clinical manifestations of chest wall tumor were palpable mass[55% , pain[21% ,tender mass[9% , growing mass[9% and asymptomatic[9% .The all cases were treated surgically, the results were as follows:Local excision 16 cases, wide resection 12 cases, wide resection with chemotherapy 3 cases, each one case of wide resection with radiotherapy and wide resection with chest wall reconstruction.

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Malignant lymphoma [non-Hodgkin`s lymphoma] at left posterior chest wall (흉벽에 발생한 악성 임파종 [Non-Hodgkin`s lymphoma] 수술 치험 1예)

  • 김송명
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.176-182
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    • 1983
  • Malignant lymphoma in chest wall is a rare form of extranodal variety as occasionally localized tumor. The primary site is suggested from rib or soft tissue, but the incidence in rib is higher than soft tissue. The patient, a male, aged 32, noted a swelling and pain over the left lower posterior chest from 3 months prior to admission. Roentgenograms revealed bony destruction in left 9, & 19th ribs posteriorly and associated chest wall mass which was ill defined uncleared margination. Under diagnosis of malignant tumor, the operation was performed and the tumor mass resected widely with en bloc technique than the fascia lata was grafted at chest wall defect. The histology of specimen was disclosed as malignant lymphoma, non-Hodgkin`s diffuse lymphocytic poorly differentiated form. The radio-and chemotherapy were combined post-operatively and the complete remission is acquired.

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Postinfarction Left Ventricular Free Wall Rupture (급성 심근경색후 좌심실벽 파열 -2례보고-)

  • 김도균
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.834-838
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    • 2000
  • Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.

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Effect of Posterior-Anterior Mobilization of the Thoracic Spine on Pain, Respiratory Function, and Thoracic Circumference in Patients With Chronic Low Back Pain

  • Park, Ju-jung;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.25 no.4
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    • pp.37-45
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    • 2018
  • Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.