• Journal of Chest Surgery
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• 제31권7호
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• pp.730-734
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• 1998

Background: It is important to know the location, number, size and shape of bullae before thoracotomy or VATS bullectomy. Chest X-ray and chest CT may be used but with some limitation. The purpose of this study was to compare the diagnostic value of thoracography with that of chest X-ray in preoperative detection of bullae. Meterial and Method: Thoracography was performed by injection of non-ionic water-soluble dye into pleural space in 22 primary spontaneous pneumothoraces, which underwent thoracotomy or VATS bullectomy. Chest X-ray and thoracography were compared through operative finding. Results: Sensitivity and accuracy of thoracography(75% and 72.7%) were higher than those of chest X-ray(30% and 36.4%). However, specificity of thoracography(50%) was lower than that of chest X-ray (100%). There were no complications during or after thoracography. Conclusion: Thoracography is a safer and more useful method for preoperative detection of bullae when compared with chest X-ray.

• The Journal of the Korea Contents Association
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• 제12권10호
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• pp.340-348
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• 2012

To evaluate the usefulness of tomosynthesis in the chest area, simple radiograph, low-dose CT, and tomosynthesis examinations were performed, and their absorbed doses were compared, and finally the images were evaluated. The absorbed dose recorded with the simple Radiograph examination was $0.33{\pm}0.27$ mGy, that of low-dose CT $1.26{\pm}0.56$ mGy, and that of tomosynthesis $0.55{\pm}0.02$ mGy, which indicate significance differences in absorbed doses among the examinations(p<0.001). Based on the evaluations of the images, The simple radiograph scores were $1.66{\pm}0.72$, $1.61{\pm}0.63$, and $1.57{\pm}0.73$, respectively; low-dose CT scores were $2.92{\pm}0.26$, $2.91{\pm}0.29$, and $2.88{\pm}0.32$, respectively; and tomosynthesis scores were $2.69{\pm}0.51$, $2.76{\pm}0.43$, and $2.66{\pm}0.61$, respectively. That is, there were statistically significant differences among the examinations(p<0.001), although there was no significant difference between low-dose CT and tomosynthesis examinations. Therefore, tomosynthesis is judged to be a useful examination that can minimize radiation doses to patients during chest examinations and enhance diagnostic efficacy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 대한기관식도과학회 1987년도 제21차 학술대회 연제순서 및 초록
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• pp.18.2-18
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• 1987

Plastic bronchitis는 길고, 분지된 기관지원주(bronchial cast)의 형성과 기관지원주의 현미경 검사상, 염증세포를 포함하고 있는 농후한 점액의 층상 구조를 특징으로 하는 질환으로, 과거에는 fibrinous bronchitis, pseudomembranous bronchitis 그리고 Hoffman's bronchitis로 불려졌으며, 소아와 성인에서 발생하는 드문 질환으로 알려져 있다. 본 교실에서는 갑작스러운 발열, 기침 및 호흡 곤란을 동반하고, 흉부 단순 X-선 검사상 좌측 흉부에 무기폐 소견을 보인 19개월 남아에서, 기관지경 검사를 시행하여 제거한 조직의 육안 및 광학현미경 검사상 plastic bronchitis를 의심할 수 있는 1례를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제55권6호
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• pp.551-559
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• 2003

Background : Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. Method : We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. Results : The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. Conclusion : The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.

• 건강소식
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• 제36권2호
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• pp.20-22
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• 2012

응급실에 30대 젊은 남자가 숨차다고 방문하였다. 흉부방사선 검사에서 검게 보여야 할 오른쪽 폐가 하얗다. 물이 차서 보이는 현상이라 단순하게 폐렴인가? 결핵인가? 정밀검사를 하였다. 흉부컴퓨터 단층촬영, 오른쪽 폐에 덩이가 보이고 물이 차있다. 기관지 내시경 검사를 하고 고인 물을 뽑았다. 핏물이다. 암이 강력히 의심된다. 너무 젊다. 자세한 병력 청취에서 15세부터 흡연을 시작했다고 한다. 보건복지부 중앙 암 등록본부의 자료에 의하면 우리나라 2008년 통계에서 평균 수명으로 계산하였을 때 30% 정도는 암이 발생한다고 보고되고 있다. 그 중 폐암은 남자에게서 위암 다음으로 많은 빈도를 차지하고, 여자에게는 다섯 번째이다.

• Tuberculosis and Respiratory Diseases
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• 제39권1호
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• pp.15-23
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• 1992

Background: The prognosis of lung cancer remains poor and early detection and curative surgery is still the most effective treatment for many. In the early detection of lung cancer, sputum cytology and simple chest x-ray are used, but both of these tests are far from being perfect. So we studied the characteristics of patients diagnosed as lung cancer without demonstrable mass lesion on simple chest x-ray to help in the early diagnosis of lung cancer. Methods: We conducted a retrospective study on 11 subjects who were diagnosed as lung cancer at Seoul National University Hospital between August 1986 and June 1989 and had no demonstrable mass lesion on simple chest x-rays. Results: Ten of 11 patients were male, 8 had a history of smoking, most frequent symptoms were sputum, cough, and hemoptysis, and 3 patients either had wheezing or stridor. In 3 of the cases, although there were no mass lesion, there were ill-defined infiltration, major fissure thickening, and fibrostreaky density mimiking tuberculosis where the tumor was eventually found and in one patient tumor was masked by a rib shadow. Also in one case, lateral chest film demonstrated a retrocardiac mass. Both bronchoscopy and computed tomogram were useful in the localization of the tumor. Seven of 11 had relatively early disease (less than StageII). Four of 11 are still alive without any evidence of recurrence between 2 and a half and 4 years after the operation. Conclusion: We conclude that in patients with respiratory symtoms in whom cancer cannot be ruled out, sputum cytology and lateral chest x-rays should be taken and that if necessary further studies like computed tomogram and bronchoscopy should be done to aid in the early diagnosis of lung cancer.

• Journal of Chest Surgery
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• 제42권2호
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• pp.226-232
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• 2009

Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

• Clinical and Experimental Pediatrics
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• 제45권11호
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• pp.1311-1316
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• 2002

단순 흉부 X-선 사진은 흉곽내에 공기를 함유하고 있는 폐실질, 심장과 대혈관을 포함한 연부조직, 그리고 흉곽을 이루는 골격 등의 다양한 조직으로 이루어진 3차원적인 해부학적 구조물을 X-선 film이라는 2차원적 평면에 흑백의 음영으로 표현하는 검사이다. 뿐만아니라 이들 구조물들이 전후, 좌우로 겹쳐져 있어 병변이 쉽게 가려질 수 있고, 폐실질 질환 뿐만 아니라 심장 질환 또한 폐실질의 변화를 유발시킬 수 있으므로, 단순히 각 질환의 X-선 소견에 대한 지식을 습득하는 것보다는 병인과 해부학적인 지식에 대한 이해를 기본으로 X-선 판독에 임하는 것이 중요하다. 또한 환자들의 임상 증상과 부합되지 않는 X-선 소견이 관찰되거나, 치료 도중 임상 경과와 판독소견이 일치되지 않는다면 방사선과 전문의와의 긴밀한 의견교환이 진단과 치료에 중요하리라 생각된다.

• Journal of Chest Surgery
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• 제34권12호
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• pp.937-943
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• 2001

Background: The aims of this study are to determine the predicting factors related with cardiovascular injuries in sternal fractures and to suggest the indication of emergency echocardiography. Material and Method: A retrospective review of the Ewha Womans University Mok-Dong Hospital trauma registry revealed 40 patients, that visited the hospital with a sternal fracture a over 5-year period. We analyzed 4 factors as predicting factors; 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, and 4) Revised Trauma Score(RTS). We, also, assessed the utility of conventional study methods involving cardiovascular injuries, such as ECG, chest X-ray, and enzyme level. Based on the methods, we inferred an indication for emergency echocardiography in sternal fractures. Result: Statistically significant predicting factors were the presence of a past medical history involving cardiovascular system and abnormal RTS on admission. Usage of emergency echocardiography depended upon the predicting factors and the results from conventional evaluations. We can now suggest the indications of emergency echocardiography in sternal fractures as 1) if more than two studies reveal abnormality without any significant predicting factors, and 2) if more than one study reveals abnormality with any significant predicting factors. Conclusion: The past medical history involving cardiovascular system and initial vital signs imply the presence of cardiovascular injuries in sternal fractures. And if needed, emergency echocardiography should be performed.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.388-402
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• 1996

Background : To compare the diagnostic accuracies of High-resolution CT(HRCI) and chest radiography in the diagnosis of diffuse infiltrative lung disease(DILD). Methods : This study included ninety-nine patients with a diagnosis of acute or chronic DILD, representing 20 different diseases. Twelve normal subjects were included as control. The disease state was confirmed either pathologically or clinically. Radiographs and CT scans were evaluated separately by three independent observers without knowledge of clinical and pathologic results. The observers listed three most likely diagnoses and recorded degree of confidence. Results : The sensitivity of HRCT in the detection of DILD was 98.9% compared to 97.9% of chest radiography. Overall, a correct first-choice diagnosis was made in 48% using chest radiographs and in 60% using HRCT images. The correct diagnosis was among the top-three choices in 64% when chest radiographs were used, and in 75% when HRCT images were reviewed. Overally a confident diagnosis was reached more often with HRCT(55%) than with chest radiography(26%). The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis and lymphangitic carcinomatosis. Conclusion : HRCT is confirmed to be superior to conventional radiography in the detection and accurate diagnosis of DILD. HRCT is especially valuable in the diagnosis of usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis, and lymphangitic carcinomatosis.