• Title/Summary/Keyword: Chest auscultation

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Traumatic Ventricular Septal Defect Secondary to Nonpenetrating Chest Trauma -A Case Report- (비관통성 외상에 의한 심실중격결손증 -수술치험 1례-)

  • 홍기표
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.161-165
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    • 1994
  • We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

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Development of a Multi-Modal Physiological Signals Measurement-based Wearable Device for Heart Sounds Analysis (멀티 모달 생체 신호 측정이 가능한 심음 분석 웨어러블 장치 개발에 관한 연구)

  • Lee, Soo Min;Lee, Mi Ran;Wei, Qun;Park, Hee Joon
    • Journal of Korea Multimedia Society
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    • v.25 no.9
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    • pp.1251-1256
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    • 2022
  • Auscultation of heart sounds using a stethoscope is the basic method to diagnose the cardiovascular disease and observation of abnormalities. However, the heart sound transmitted to the ear through the stethoscope is greatly affected by internal sounds such as organ movement or breathing. In addition, the user's experience significantly influences the accuracy of the auscultation result. Therefore, in this paper, we developed a wearable device that simultaneously measures heart sound and PPG signals for cardiac condition monitoring. The structure of the proposed device is designed to simultaneously measure heart sound and PPG signals when worn on a finger and placed on the chest. A prototype was implemented according to the design structure, and it was confirmed that the performance of measurements and collection for physiological signals was excellent through experiments.

Coronary Arteriovenous Fistula Draining into the Main Pulmonary Artery (폐동맥으로 유입되는 관상동정맥루수술치험 1례)

  • 김학제
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.143-147
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    • 1988
  • Congenital coronary arteriovenous fistula is a communication of a coronary artery with one of the atria, ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. We had a successful surgical experience with 63 year-old-female patient who complained substernal chest pain on exertion for 8 years. On auscultation, a continuous murmur was heard at the left second to third intercostal space along the left sternal border. The right cardiac catheterization was revealed to 4% oxygen step up between right ventricle to main pulmonary artery, and Qp/Qs was 1.3:1. The selective coronary arteriography showed markedly tortuous dilated vessel which originated from left coronary artery draining into the main pulmonary artery. The operation performed to mid portion of tortuous and dilated fistula by multiple ligation with 3-0 Mersilene and suture ligation with pledgetted 3-0 Prolene on distal draining site, Postoperative course were uneventful without any symptoms and complications.

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Pericarditis Arisen from Liver Abscess: Report of 2 Cases (간농양에 병발한 심낭염 치험 2례)

  • 서충헌
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.140-143
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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Thymolipoma associated with spontaneous pneumothorax: report of a case (자연기흉을 합병한 흉선지방종의 치험례)

  • 이철범
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.135-139
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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A Study on the Principles of Regional Perspirations (부위별(部位別) 한출(汗出)의 기전(機轉)에 대한 연구(硏究))

  • Lyu, Jeong-Ah;Jeong, Chang-Hyun
    • Journal of Korean Medical classics
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    • v.22 no.1
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    • pp.71-85
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    • 2009
  • For having good therapeutic value, putting the ideal of diagnosis and treatment based on overall analysis of symptoms and signs[辨證施治] into practice is very important, so the Eastern Medicine's peculiar diagnosis without interference by the western medical diagnosis is very important. The peculiar method of Eastern Medicine's diagnosis is four methods of diagnosis(四診法), a joint term for inspection, auscultation and olfaction, interrogation, pulse feeling and palpation. In the process of interrogation[問診], from analyzing the perspiration phase, doctor can get various physical information. Especially perspiration from particular region can be a clue for founding focus or cause of disease. This thesis divide the phase of perspiration into eight bodily region, perspiration from all body, head, face, back, chest and armpit, stomach, pubic region and lower part, hands and feet, and inquire the possible causes and principles of these perspirations. In conclusion, the regional perspiration can be a clue point out the origin of fever and condition of Gi(氣) flow. Perspiration from head, back, chest and armpit, hands and feet means that certain fever cannot extend to the outside of body, and at the same time, means the Gi(氣) flow of outside is being intercepted. So the perspirations from that region become an object of medical treatment.

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A Clinical Study on Postoperative Changes of Electrocardiographic Findings in Patients with PDA (동맥관개존증의 술후 심전도변화에 관한 임상적 연구)

  • Lee, Sin-Yeong;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.43-49
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    • 1986
  • At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.

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Clinical report on the improvement of the symptoms of pneumonia by the aqueous extract of Platycodon grandiflorum (24년생 장생도라지 약침액(藥鍼液)의 폐렴 증상 개선효과에 대한 임상례)

  • Kim, Sook-Kyeng;Choi, Sung-Gwun;Lim, Hyi-Jeong;Moon, Ik-Ryoul;Park, Hyeong-Seon;Oh, Su-Jin
    • Journal of Pharmacopuncture
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    • v.4 no.3
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    • pp.59-67
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    • 2001
  • Objective: The purpose of this report is to prove the clinical effect of Platycodon grandiflorum aqueous extract on pneumoniae patients. Methods: We used the aqueous extract of Platycodon grandiflorum to treat two pneumoniae patients. It was injected into five acupuncture points, which was Chondol(天突:CV22) 1 point, Pyesu(肺兪 : BL13) 2 point, and Kworumsu(厥陰兪: BL14) 2 point. Results & conclusions: We have used the aqueous extract of 24-year-old JK for treating the patients suffering from lung diseases, and have experienced the actual effects. Of the treated, two pneumonia-involved patients showed apparent improvement in simple chest X-ray and clinical symptoms. The patients were treated with JK (Jang-saeng platycodon) aqueous extract 25 and 22 times individually. The results were as follows. 1. The symptoms including coughing, phlegm, and fever were improved in two cases. 2. The lung infiltration in simple chest X-ray decreased and the WBC count was kept within normal range in two cases. 3. Side effect such as itching was not found in the process of JK aqueous extract treatment. 4. The criteria for pneumonia are fever, coughing with purulent phlegm, pleural chest pain, the evidence of new infiltration in simple chest X-ray, sign of lung sclerosis in auscultation, increase of WBC count, etc. But they may not be the proper objective diagnostic standards. So we had trouble in statistic process and numerical interpretation. Putting these results together, the JK aqueous extract is considered to be effective in treating patients for pneumonia, and the continuous research and accumulation of data is needed.

Congenital Aortic Valvular Stenosis: report of a case (선천성 대동맥판막 협착증 치험 1례)

  • 김병열
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.350-354
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    • 1979
  • The incidence of congenital aortic valvular stenosis has been known rare, and approximately 3-6% of congenital heart diseases. Recently, we experienced 1 case of congenital aortic valvular stenosis, and which was corrected surgically under extracorporeal circulation successfully. A 11 years old male pt. was admitted to N.M.C. because of dyspnea, dizziness, chest pain and episode of syncope. An auscultation, harsh systolic murmur [Gr. IV/VI] was noted at aortic area and also palpable strong thrill. ECG showed LVH c strain pattern and suspicious LVH finding in simple chest P-A film. In Lt. cardiac catheterization, abrupt pressure change [110mmHg] between LV & Aorta was noted across the aortic valve. And aortic insufficiency was absent, well visualized both coronary arteries and suspicious bicuspid aortic valve in aortography. Valve form was bicuspid, large one was noncoronary cusp and another cusp was Rt. & Lt. coronary cusp which was interpositioned rudimentary commissure. Central aortic orifice was about 5ram in diameter. Valvulotomy was done along the fusioned commissure between noncoronary cusp and Rt. & Lt.coronary cusp, and then short incision was added between Rt. coronary cusp & Lt. coronary cusp. Immediate postoperative course smooth but unknown cardiac arrest was noted in POD second day. Complete recovery was done without sequelae by resuscitation. After operation, clinical symptoms were subsided but systolic murmur [Gr. II/VI] was audible at aortic area, diastolic murmur was absent. ECG showed still remained LVH but much decreased R wave voltage in Lt. precordial leads. Simple chest P-A showed no interval changes compared to preop film. Control Lt. heart catheterization revealed still remained pressure gradient [40ramrig] between LV & Aorta. But much decreased pressure gradient compared to preop pressure gradient [110mmHg].

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Adaptive Noise Canceller of Single Channel For Heart Sound Enhancement (심음 향상을 위한 단일채널 적응 잡음 제거기)

  • Lee, Chul-Hyun;Kim, Pil-Un;Lee, Yun-Jung;Chang, Yong-Min;Bae, Keun-Sung;Cho, Jin-Ho;Kim, Myoung-Nam
    • Journal of Korea Multimedia Society
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    • v.13 no.7
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    • pp.973-982
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    • 2010
  • In this paper, we proposed the single-channel adaptive noise canceller for the enhancement of heart sound (HS) in the auscultation signal. In case of either normal or emergency, a HS diagnosis is difficult due to the various signal source in the chest. Therefore, the HS enhancement is necessary. The conventional active noise canceller(ANC) has two channel, main signal and reference signal. For signal channel, the reference signal in ANC was generated by the proposed HS analyser and BS-Gate based on the characteristic of HS. This reference signal is suitable to the ANC condition. Experimental data were acquisited from MP36, SS30L in BIOPAC Inc., By the experiment, we confirmed that the proposed single-channel ANC was efficient for HS enhancement. And by the comparison with active linear enhancement, it was validate that the proposed ANC is not affected by the variation of a heartbeat.