• Title/Summary/Keyword: 흉곽

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The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygenation and the Amount of Lung Secretions in Premature Infants with Respiratory Distress Syndrome (호흡곤란증 미숙아에 있어 기관지 흡인술전의 흉곽진동법이 산소화와 기관지 분비물의 양에 미치는 영향)

  • Ahn, Young Mee
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.591-601
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    • 1998
  • 미숙아에 있어 주로 표면활성제의 부족으로 인한 호흡곤란증은 미숙아 사망의 주원인이 된다. 호흡곤란증의 치료목적은 적절한 환기를 통해 체내 산소화를 유지시키는 것이다. 인공호흡기 치료를 받는 미숙아에게 필수적인 간호중재인 기관지 흡인술은 그 효과를 극대화하기 위해 흉곽진동법과 같이 사용될 수도 있다. 그러나 미숙아를 대상으로 하는 흉곽진동법은 그 중재의 안전성이나 효과에 대한 과학적 검증 없이 시행되고 있는 실정이다. 이에 본 연구는 호흡곤란증 미숙아에 있어 기관지 흡인술 이전에 행하여지는 흉곽진동법이 산소화와 기관지 분비물에 미치는 영향을 연구하기 위해 실시되었다. 이를 위해 20명의 호흡곤란증 미숙아를 대상으로 대상자내 반복실험연구가 설계되었다. 독립변수는 기관지흡인술이전에 흉곽진동이고 종속 변수는 산소 포화도, 심박동수, 그리고 기관지 분비물의 양이었다. 각 대상자는 무작위 순서에 따라 한번은 흉곽진동없이 흡인을, 나머지 한번은 흉곽진동과 흡인의 두 가지 형태의 흡인을 경험 하였다. 연구 결과, 기관지 흡인술이전에 흉곽진동을 실시하든, 안하든 산소포화도와 심박동수의 변화양상에는 차이가 없었다. 그러나, 융곽진동법을 실시한 경우가 실시안한 경우에 비해 더 많은 양의 기관지 분비물을 흡인하였다. 이는 기관지 흡인술 이전에 실시하는 흉곽진동법이 미숙아의 체내에 부가적 산소소모를 초래하지 않는 반면, 기도로부터 더 많은 분비물을 흡인하는데 효과적임을 시사한다.

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Availability of Bone Scan in Chest Trauma Patients (흉곽부위 골절에 대한 골스캔의 유용성 고찰)

    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1085-1088
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    • 1998
  • Background: In trauma patients, bony thorax are exposured to the trauma in many cases. With simple x-ray, we can not detect all definitive bony abnormalities, especially in less severe cases. Bone scan is very sensitive diagnostic method in such cases. Materials and methods: We experienced 680 cases and results were as follows. Results: 1. Diagnostic sensitivity was 97.4% and false negative rate was 2.6%. 2. In sensitivity study, the time factor(when we perform bone scan) was the most important thing according to trauma pattern. In rib fracture, sensitive test time was after 1 week. In sternal fracture, sensitive test time was after 1 week, too. In costochondral junction fracture and combined cases, it was after 3 days. Conclusions: We recommend timely using of bone scan as definitive diagnostic method in bony thorax trauma patients.

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Early Tailoring Thoracoplasty in Patients Undergoing Pulmonary Resection (폐의 부분 절제시 조기 변형식 흉곽성형술의 임상적 의의)

  • Lee, Sam-Yun;Yang, Hyeon-Ung;Choe, Jong-Beom;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.396-401
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    • 1997
  • Tailoring thoracoplasty is employed prior to, following, or concomitant with pulmonary resection when it is anticipated that insufHclent lung tissue will remain to fill the pleural space following a pulmonary resection. This study reviewed a series of eight patients treated with tailoring thoracoplasty between 1990 and 1995. Indications were to close a persistent space In four patients and to tailor the thoracic cavity to accept diminished lung volume concomitant with a pulmonary resection in the other four patients. The primary underlying disease was lung cancer in three patients and pulmonary tuberculosis In five patients, two of whom had concomitant aspcrgilloma, two, pneumothora , and one, empyema with bronchopleural fistula. In four patients with a prior pulmonary resection, the tailoring thoracoplasty was performed within eight days after the resection surgery. There was no failure to accommodate the thoracic cavity to insufficient lung tissue, even though two patients needed a second thoracoplasty. We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural space and to accommodate diminished lung volume with acceptable cosmetic results Early, after, or concomitant with pulmonary resection in selected patients.

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Scapulothoracic Dissociation during Arresting - A Case Report - (체포 과정에서 발생한 견갑 - 흉곽 해리 - 증례보고 -)

  • Kim, Hyoung-Soo;Yoo, Jeong-Hyun;Yeom, Ju-Sang;Bae, Won-Ha
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.146-150
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    • 2008
  • Scapulothoracic dissociation is a rare injury caused by blunt force or massive traction to the anterolateral shoulder girdle with disruption of scapulothoracic articulation. This injury is characterized by massive soft-tissue swelling of the shoulder with intact skin, lateralization of damaged scapular. It frequently is accompanied by various musculoskeletal injuries and neurovascular injuries. 33-year-old man sustained a scapulothoracic dissociation without fracture and Vascular injuries during arresting. We report diagnostic method, clinical finding and non-operative management with literatures.

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Traumatic Forequarter Amputation - A Case Report - (외상성 견갑 흉곽간 절단 - 증례 보고 -)

  • Cho, Chul-Hyun;Lee, Kyung-Jae
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.66-69
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    • 2008
  • Traumatic forequarter amputation is an extremely rare and life-threatening injury. It is caused by blunt trauma or tremendous traction force, and the prognosis is very poor because of the involvement of massive associated injury. Traumatic forequarter amputation has been rarely reported in the English language clinical literature, but has never been reported in Korea. We report a case of traumatic forequarter amputation caused by a conveyor belt that was treated with emergency resuscitation and surgery, with an accompanying review of the literature.

Comparison of Chest Mobility, Diaphragm Movement, and Lung Capacity Between With and Without Bras in a Healthy 20s Adult Women (건강한 20대 성인여성의 브래지어 착용 여부에 따른 흉곽 가동성과 가로막 움직임 및 폐활량에 대한 비교)

  • Jeong, Ah-Reum;Lee, Ji-Hyun;Choung, Sung-Dae
    • Journal of the Korea Convergence Society
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    • v.12 no.3
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    • pp.281-286
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    • 2021
  • This study aims to compare chest mobility, diaphragm contraction, and lung capacity when wearing a bra and per breast size. The subjects of this study included 10 adult women who were attending Chungnam B University: 5 women who wear underwear size 75A (group A) and 5 who wear underwear size 85B (group B). The chest mobility using a tape measure, the diaphragm contraction using ultrasound, and the lung capacity was measured using a Pony FX before and after bra wear. The chest mobility and diaphragm contraction were significantly reduced when bras were worn in group A and B. Lung capacity was significantly decreased only in group A. There was no significant difference between the groups. This study suggests that women's bras can have a negative effect on diaphragm movement, chest mobility, and lung capacity.

Thymus Size and Its Relationship to Perinatal Diseases; Respiratory Distress Syndrome and Intrauterine Growth Retardation (흉선의 크기와 주산기 질환들과의 관계)

  • Chung, Sun Mi;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.855-861
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    • 2002
  • Purpose : Thymus size can be affected by several factors and perinatal diseases can be estimated by its size. The purpose of this study was to search for a relationship between cardiothymic/thoracic(CT/T) ratio and perinatal diseases such as neonatal respiratory distress syndrome(RDS) and intrauterine growth retardation(IUGR) by measuring the width of the cardiothymic shadow at the level of the carina and dividing it by the width of the thorax at the costophrenic angles. Methods : A clinical study was conducted on newborn infants with RDS(n=51), IUGR(n=27), and premature rupture of membranes(PROM, n=48), who were admitted at NICU of Catholic University of Daegu from June 2000 to Oct. 2001. CT/T ratio was measured within six hrs of age, at 2-3 days of age, and at 5-7 days of age. Results : CT/T ratios of RDS group, IUGR group, and PROM group were $0.46{\pm}0.07$, $0.32{\pm}0.04$. $0.36{\pm}0.06$, respectively. CT/T ratios of RDS group within 6hrs of age, at 2-3 days of age, and at 5-7 days of age were $0.43{\pm}0.07$, $0.34{\pm}0.06$, $0.25{\pm}0.04$, respectively. There were statistically significances among the RDS group, the IUGR group, and the PROM group and in the RDS group at different times. Regression for gestational age among three groups was not statistically significant but correlation for gestational age in the entire groups was statistically significant. CT/T ratio between normal spontaneous vaginal delivery and c-section among three groups was not statistically significant. CT/T ratios with dexamethasone-treated group and untreated group was not statistically significant. Conclusion : We concluded that thymus size differed significantly in the perinatal diseases such as RDS and IUGR, and so can be used as an early diagnostic tool for perinatal diseases.

Clinical Results Following Early Tailoring Thoracoplasty in Patients Undergoing Pulmonary Resection (폐의 부분절제수술를 시술받은 환자에서 조기 변형식 흉곽성형수술에 따른 임상결과)

  • Choi, Soon-Ho;Cha, Byung-Ki;Lee, Mi-Kyung;Park, Kwon-Jae;Lee, Sam-Youn;Choi, Jong-Bum
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.485-491
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    • 2007
  • Background: Thoracoplasty has become a rarity in current clinical practice, although it has been widely employed for well over a century as a procedure for reducing the capacity of the thoracic cavity. Yet we have perform tailoring thoracoplasty following or concomitant with pulmonary resection in 20 patients. The aim of this study is to evaluate the early and late clinical results and also the significance of tailoring thoracoplasty. Material and Method: From March 1995 to June 2005, modified thoracoplasty following or concomitant with pulmonary resection was performed in 20 patients out of a total of 298 pulmonary resections for closing air leaks and for treating persistent pleural space following pulmonary resections, and to tailor the thoracic cavity to accept a diminished lung volume. Of the 20 patients, 14 patients had tailoring thoracoplasty performed concomitant with pulmonary resection, and the remaining 6 patients also had tailoring thoracoplasty performed following pulmonary resection. The subjects ages ranged from 24 to 77 (mean $59.1{\pm}6.4$) and a male preponderance was noted (17 : 3); the number of left and right surgeries was equal. The preoperative primary underlying diseases were lung cancer in 7 patients, pneumothorax with giant bullous change in 6 patients, bronchiectasis in 2 patients, previous pulmonary tuberculosis associated with aspergilloma in 2 patients, empyema with fibrothorax in 2 patients and multiple lung abscesses & destruction due to previous trauma in 1 patient. The operative methods were apicolysis and subperiosteal removal of the 2nd, 3rd and 4th ribs (the costochondral junction to the posterior portions of the ribs) with preservation of the first rib and compression of the anterior chest via cotton bags and elastic bandages. Result: The mean duration of the air leaks after thoracoplasty was $1.6{\pm}0.2$ days (range: $0{\sim}7$ days) and the mean duration of an indwelling chest tube was 7 days (range: $5{\sim}11$ days); the mean duration of hospitalization was $19.2{\pm}2.8$ days (range: $8{\sim}47$ days). The postoperative complications were wound infection (2) and pneumonia (2); reoperation was done due to bleeding (1) in one patient who underwent concomitant thoracoplasty and there was 1 case of wound infection (1) after postresection thoracoplasty. The mortality was 1 patient in the early phase and 4 patients in the late phase. Conclusion: We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural spaces and to accommodate the diminished lung volume with acceptable cosmetic results when this procedure is combined with pulmonary resection in selected patients.

Perforation of Intrathoracic Stomach after Ivor Lewis Operation for Esophageal Cancer - 2 cases report - (식도암 수술후 흉곽내 위 천공 -치험 2례-)

  • Lee, Young;Hwang, Eui-Doo;Hwang, Kyung-Hwan;Yoon, Su-Young;Na, Myung-Hoon;Yu, Jae-Hyun;Lim, Seung-Pyung
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.911-914
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    • 1998
  • We report our experience with 2 cases of perforation of intrathoracic stomach after Ivor Lewis operation for esophageal cancer. There was no problem in the anastomotic site, but the drainage from pleural cavity increased after oral intake. The stomach perforation was proved by rethoracotomy. The perforation site was repaired by sutures with pedicled intercostal muscle.

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Effects of Inspiratory Muscle Training on Diaphragm Thickness, Pulmonary Function, and Chest Expansion in Chronic Stroke Patients (흡기근 저항훈련이 만성 뇌졸중 환자의 횡격막 두께와 폐기능에 미치는 효과)

  • Jung, Ju-Hyeon;Kim, Nan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.1
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    • pp.59-69
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    • 2013
  • 연구목적: 본 연구는 만성 뇌졸중 환자를 대상으로 흡기근 저항훈련이 횡격막 두께와 폐기능 및 흉곽 확장에 미치는 효과를 알아보고자 수행하였다. 연구방법: 연구 대상자는 총 29명(남자 17명, 여자 12명)으로 흡기근 저항훈련군(15명)과 대조군(14명)으로 분류하였다. 모든 대상자는 6개월 이상된 만성 뇌졸중 환자로 일반적인 신경발달치료를 받고 있으며, 같은 기간 동안 흡기근 저항훈련군에 역치부하 흡기근육 단련기(threshold IMT device)를 제공하고 주 3회${\times}$1회 20분씩 6주간 시행하였다. 마비측과 비마비측 횡격막 두께측정을 위해 초음파의 7.5MHz linear probe를 사용하여 최대 흡기시(Tdi.con)와 휴식시(Tdi.rel)의 두께를 측정하고 수축률(TR)을 계산하였다. 또한 폐 활량계를 사용하여 노력성 폐활량을 측정하였으며, 줄자를 사용하여 흉곽 확장을 측정하였다. 연구결과: 6주간 중재 후 흡기근 저항훈련군에서 최대흡기시 횡격막 두께(Tdi.con)와 수축률(TR)은 유의한 증가를 보였다(p<.05). 1초간 노력성 호기량 ($FEV_1$)과 최대 호기 속도(PEF)도 유의한 증가를 보였으나(p<.05), 노력성 폐활량(FVC)과 1초간 노력성 호기량의 노력성 폐활량에 대한 비($FEV_1$/FVC), 흉곽 확장은 유의한 증가는 보이지 않았다(p>.05). 결론: 본 연구는 만성뇌졸중 환자를 대상으로 흡기근 저항훈련의 적용이 횡격막의 수축력과 폐기능 및 흉곽 확장력을 향상시켜 호흡근의 협응력을 증가시키고, 비활동성으로 인해 감소된 운동내성을 증가하게 함으로써 향후 재활에서 만성 뇌졸중 환자에게 2차적인 기능향상에 도움을 줄수 있을 것으로 보여진다.