Impact factor and its role in academic promotion

anterior lower thorax. The lower chest wall, liver, pericardium, base of right lung and heart were impregnated with shot pellets, giving the classical multiple ‘‘star burst’’ appearance. (fig. 1a). Extensive debridement of the chest wall wound was performed, with the removal of numerous lead shots. Intracardiac and intrapulmonary shots were left in situ and successfully managed conservatively [5]. He remained asymptomatic. Injuries were monitored by serial CT scans and echocardiograms, which later showed evidence of embolisation of multiple shots into the lung (fig. 1b). C.S.H. Ng, M.W.T. Kwok and R.H.L. Wong Dept of Surgery, The Chinese University of Hong Kong, China.