Abnormalities in the velocity and pattern of myocardial shortening on tissue Doppler imaging (TDI) have been proposed to aid in the noninvasive diagnosis of coronary artery disease (CAD).
We investigated the diagnostic value of post-systolic shortening (PSS), a delayed ejection velocity of the myocardium after the closure of the aortic valve, on TDI in the diagnosis of CAD among patients with chest pain and normal resting wall motion on standard 2D echocardiography.
Eighty consecutive patients (49% female) with typical ischemic chest pain but without prior myocardial infarction, coronary revascularization, arrhythmia, or heart failure, who had no regional wall motion abnormalities on resting echocardiography revascularization, arrhythmia, or heart failure, who had no regional wall motion abnormalities on resting echocardiography at 2 levels (basal and mid left ventricle [LV]) in each of the 4 LV walls (i.e., septal, anterior, inferior, and lateral). Coronary angiography was performed and interpreted per standard clinical protocols.
Compared to the patients with normal coronaries, those with angiographic CAD showed significantly increased myocardial isovolumic relaxation time (IVRT) velocity (P 4.0 m/sec, a positive PSS velocity had about 65% sensitivity and 85% specificity with a positive predictive value > 90% in predicting angiographic CAD.
Among patients with chest pain and normal LV wall motion on 2D echocardiography, a prominent and prolonged IVRT on TDI may help predict the presence of significant CAD.

Abnormalities in the velocity and pattern of myocardial shortening on tissue Doppler imaging (TDI) have been proposed to aid in the noninvasive diagnosis of coronary artery disease (CAD)..
We investigated the diagnostic value of post-systolic shortening (PSS), a delayed ejection velocity of the myocardium after the closure of the aortic valve, on TDI in the diagnosis of CAD among patients with chest pain and normal resting wall motion on standard 2D echocardiography..
Eighty consecutive patients (49% female) with typical ischemic chest pain but without prior myocardial infarction, coronary revascularization, arrhythmia, or heart failure, who had no regional wall motion abnormalities on resting echocardiography and who were scheduled to undergo coronary angiography, were selected. TDI was performed in each patient before coronary angiography at 2 levels (basal and mid left ventricle [LV]) in each of the 4 LV walls (i.e., septal, anterior, inferior, and lateral). Coronary angiography was performed and interpreted per standard clinical protocols..
Compared to the patients with normal coronaries, those with angiographic CAD showed significantly increased myocardial isovolumic relaxation time (IVRT) velocity (P 4.0 m/sec, a positive PSS velocity had about 65% sensitivity and 85% specificity with a positive predictive value > 90% in predicting angiographic CAD..
Among patients with chest pain and normal LV wall motion on 2D echocardiography, a prominent and prolonged IVRT on TDI may help predict the presence of significant CAD..

Airway mucus is difficult to clear and to improve lung function clearance of mucus is necessary. The deep coughing, chest physiotherapy, high frequency chest wall oscillation etc. are some of the best methods to clear excessive mucus from lung airways. In this article we analysed the behavior of fluid flow between parallel walls , where both walls are porous and the flow is induced by the oscillation of these walls and pressure gradient; which is applicable for clearance of mucus from lung airways. Generalized couette flow is applicable to model the oscillation of parallel walls, however the laminar flow of viscous fluid is taken under consideration. The generalized Navier-Stokes equations are applied to make various hypotheses and finite difference scheme is used to solve the problem numerically. Effect of wall oscillation, wall porosity, pressure due to porous media on mucus clearance and particle aspect ratio on the deposition of nonspherical nanoparticles are analysed graphycally after simulating the problem on MATLAB R2013a by user defind code. Simulation show an excellent agreement of unsteady flow of viscous fluid at large values of time and significant correlation between pressure gradient and porosity of walls, frequency of wall oscillation and their imapct on mucus clearance are obtained. In addion it is observed that fluid and particle velocity are increased with the enhancement of media porosity, breathing frequency and aspect ratio. The aim of this paper is to study the influence of wall movement, wall porosity, pressure on wall, wall oscillating frequency on the clearance of mucus from lung airways.

Mesenchymal hamartoma of the chest wall is a rare benign tumor found in infants and young children. We present a male neonate with bilateral multifocal mesenchymal hamartoma of the chest wall since birth causing deformity of the chest wall and respiratory symptoms. Mesenchymal hamartoma is often unilateral and solitary, but multifocality could be expected in the absence of the malignancy. Mesenchymal hamartoma of the chest wall in infants should always be considered as the differential diagnosis of the chest wall masses in young children.

Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North Africa, Australia, and Iran. Although the liver and lung are the most common involved organs, but the other organs in human body also can be involved by hydatid cyst. Chest wall involvement by hydatid cyst is a rare condition, which may be misdiagnosed as chest wall tumor in the endemic areas. Herein, we presented a case of primary chest wall hydatid cyst mimicking chest wall tumor.

Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function.. Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes..Patients and We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration. Inspiratory volumes and peak flows were measured using a flow meter for all three chest wall states: intact chest, left-sided flail chest (segmental fractures of ribs 3 - 7), and post-fracture open reduction and internal fixation (ORIF) of the chest wall with a pre-contoured rib specific plate fixation system.. A wide variation in the mean inspiratory volumes and peak flows were measured between specimens; however, the effect of a flail chest wall and the subsequent internal fixation of the unstable rib fractures was consistent across all samples. Compared to the intact chest wall, the inspiratory volume decreased by 40 ± 19% in the flail chest model (P = 0.04). Open reduction and internal fixation of the flail chest returned the inspiratory volume to 130 ± 71% of the intact chest volumes (P = 0.68). A similar 35 ± 19% decrease in peak flows was seen in the flail chest (P = 0.007) and this returned to 125 ± 71% of the intact chest following ORIF (P = 0.62).. Negative pressure inspiration is significantly impaired by an unstable chest wall. Restoring mechanical stability of the fractured ribs improves respiratory outcomes similar to baseline values..

Tuberculosis remains a formidable challenge to health care providers in developing countries and chest wall tuberculosis is a rare entity. Its clinical presentation may resemble a pyogenic abscess or chest wall tumor. There is still controversy regarding the diagnosis and treatment of chest wall tuberculosis. During a 10-year period (1998–2009), 12 cases with chest wall tuberculosis were managed by our team. Patients’ medical records were retrospectively reviewed. After confirming the diagnosis by histopathological examination, patients underwent surgical management. There were 8 male and 4 female patients. Patients’ age ranged from 4 to 60 years. Eight patients had a fluctuating abscess and 4 had a chest wall mass. Surgical procedure was drainage along with debridement in 6 patients, wide debridement along with rib resection in 2 patients and wide debridement along with chest wall resection and reconstruction in 4 patients. Recurrence of cold abscess and fistula formation were detected in 2 patients after a follow-up of 1 to 5 years. Outcome of patients with chest wall tuberculosis was good. chest wall tuberculosis mimics symptoms and signs of chest wall tumors or abscesses. The combination of symptoms and radiographic findings suggests the diagnosis of tuberculosis. Wide debridement and resection are shown to have lower rates of fistula formation, sinus formation and recurrence. Medical treatment must be started immediately after surgery. (Tanaffos2010; 9(3): 28-32)

Primary malignant tumors of the chest wall are rare and include about 5 percent of all chest wall tumors. Primary osteosarcoma of the rib has very low prevalence and mostly exists in young age. Case Report: We present a 70-year-old man with a very large tumor of the chest wall, becoming gradually larger, for about 30 years. It underwent resection and reconstruction and was reported to be well differentiated osteosarcoma in pathological study.

Male breast enlargement as gynecomastia may be as a sign of underlying systemic diseases. Male breast malignancy is also considered in differential diagnosis. We present a young man with primary chest wall lymphoma as gynecomastia, without pre-existing problem or other disease. Here, we present his clinical manifestation, management, and his early outcome. Chest wall lymphoma as an initial presentation of isolated chest wall mass in males is a rare clinical entity and its presentation as gynecomastia is even extremely unusual.

The purpose of this study was to evaluate the characteriscs of TomoDirect (TD) plans compared to convenonal TomoHelical (TH) plans in chest wall irradiaon in paents with breast cancer.
TD and TH plans for only chest wall were retrospecvely created for 30 paents previously treated with TH technique in our clinic. The beam angles were arranged to cover PTV chest wall and to minimize doses to OARs, ipsilateral lung and contralateral breast in TD plan. The prescribed dose was 50 Gy in 25 fracons.
The mean treatment mes were similar in TH and TD (310.8 and 309 s, respecvely, p> 0.05). There was no difference between the values of CI and HI of both plans (p>0.05). The values of Dmean, V5 and V20 of the ipsilateral lung in TD plan was significantly lower than that in TH plan for all 30 paents (p0.05).
Both of TH and TD plans produce acceptable target dose coverage in chest wall RT. Considering the risk of low-dose radiaon to the crical organs; TD mode improve dose distribuon.