• Title/Summary/Keyword: Chest auscultation

검색결과 38건 처리시간 0.033초

Idiopathic Arterial Thromboembolism(ATE) in a Turkish Angora Cat (터키산 앙고라(Turkish Angora) 고양이에서 발생한 특발성 동맥 색전혈전증(arterial thromboembolism: ATE) 1례)

  • Han, Sung-Kuk;Kim, Jung-Hyun;Jeong, Soon-Wuk;Park, Hee-Myung;Park, Chul;Yoo, Jong-Hyun
    • Journal of Veterinary Clinics
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    • 제25권1호
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    • pp.23-26
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    • 2008
  • A 2-year-old, female, Turkish Angora cat was presented due to hindlimb paralysis with 2-day history of vomiting and depression. Physical examination revealed weak femoral pulse and cyanotic footpads of hind limbs. Chest auscultation, thoracic radiography, and electrocardiogram were no remarkable. Abdominal ultrasonography showed suspected hyperechoic thrombus in abdominal aorta. Underlying causes of the arterial thromboembolism were not found on multiple diagnostic examinations and the cat was diagnosed as idiopathic saddle thromboembolism. Despite 4-week regimen with heparin sodium, aspirin, and diltiazem, the hind limbs were progressively and irreversibly necrotized. Therefore, coxofemoral amputation was performed. After surgery, the clinical condition of this cat returned to normal without further complications.

A Case of Formation of Interbronchial Fistula Complicated by Long-standing Bronchial Foreign Body (장기간 체류한 기관지내 이물에 합병된 기관지간 누공 형성 1예)

  • Lee, Jong-Hyun;Kim, Sung-Jun;Lee, Duk-Young;Chou, Jong-Dae;Jung, Su-Lyong;Na, In-Kyun;Kim, Dong-Wook;Lee, Jin-Kwan
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.882-887
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    • 1998
  • In healthy adults, diagnosis of aspiration of foreign body into tracheobronchial tree is not difficult because various symptoms such as dyspnea, coughing, or cyanosis develop when foreign body is aspirated into tracheobronchial tree. But unless a clear history of an aspiration event can be obtained, diagnosis will be delayed. Early complications of tracheobronchial foreign body aspiration include asphyxia, cardiac arrest, dyspnea, laryngeal edema, and cyanosis. Late complications include pneumonia, lung abscess, bronchiectasis, hemoptysis, bronchial stenosis, and polyp. Treatment is removal of foreign body by operation or bronchoscopy. Currently, flexible bronchoscopy is preferred in adults than rigid bronchoscopy. A 36-year-old male visited to Dongkang hospital due to productive coughing and dyspnea. On auscultation, focal inspiratory wheezing was heard. On chest PA, mild emphysematous change was seen Flexible bronchoscopy was done. Bronchoscopically, mucoid impaction, surrounding inflammation, foreign body lodged in the right lower lobe bronchus, and interbronchial fistula(between right middle and lower lobe bronchus) were seen Foreign body($2.4\{times}1.3cm$ sized antacid package) was removed by flexible bronchoscopy. Later, history of aspiration of a piece of antacid package was found. We report a case of recurrent bronchitis with interbronchial fistula as a result of occult aspiration of foreign body with review of the literatures.

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Performance comparison of lung sound classification using various convolutional neural networks (다양한 합성곱 신경망 방식을 이용한 폐음 분류 방식의 성능 비교)

  • Kim, Gee Yeun;Kim, Hyoung-Gook
    • The Journal of the Acoustical Society of Korea
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    • 제38권5호
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    • pp.568-573
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    • 2019
  • In the diagnosis of pulmonary diseases, auscultation technique is simpler than the other methods, and lung sounds can be used for predicting the types of pulmonary diseases as well as identifying patients with pulmonary diseases. Therefore, in this paper, we identify patients with pulmonary diseases and classify lung sounds according to their sound characteristics using various convolutional neural networks, and compare the classification performance of each neural network method. First, lung sounds over affected areas of the chest with pulmonary diseases are collected by using a single-channel lung sound recording device, and spectral features are extracted from the collected sounds in time domain and applied to each neural network. As classification methods, we use general, parallel, and residual convolutional neural network, and compare lung sound classification performance of each neural network through experiments.

Management of Pulmonary Hypertension Due to Brachycephalic Obstructive Airway Syndrome in a Dog

  • Song, Yunji;Kim, Yeji;Kim, Jihyun;Kim, Kwon-Neung;Oh, Songju;Kim, Ha-Jung
    • Journal of Veterinary Clinics
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    • 제39권5호
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    • pp.240-245
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    • 2022
  • A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.

Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation (승모판 폐쇄 부전증에서 발생한 국소적 폐부종 1예)

  • Yoon, Young Gul;Bang, Do Seok;Park, Bum Chul;Lee, Sung Hoon;Kim, Jae Su;Park, Yol;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Han, Sang Hoon;Park, Sang Hoon;Lim, Jun Cheol;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • 제59권4호
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    • pp.432-435
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    • 2005
  • An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The $O_2$ saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

A study on Palpation of the back-shu points (배유혈(背兪穴) 안진(按診)에 관(關)한 고찰(考察))

  • Hong, Mun-Yeup;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • 제8권2호
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    • pp.155-173
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    • 2000
  • The diagnosis in Oriental medicine is done by inspection, auscultation and olfaction, interrogation, four diagnostics of pulse feeling and palpation, and various system of identification like identification according to Qi(vital energy), Xue and body fluids, identification according to fair principles, identification according to principles of Wei, Qi, Ying and Xue, identification according to Sanjiao(the triple heater), identification according to four type physical constitution. Sometimes, symptoms and diagnosis techniques according to symptoms is selectively applied for the diagnosis. Among them the pulse feeling and palpation diagnosis technique using the sense of finger and palm of the hand is divided into feeling of pulse and palpation and pressing maneuver. Pressing maneuver is a diagnosis technique pressing and rubbing the affected part in order to attain data of identification including inside and outside condition of the body with regard to the nature, condition and relative seriousness of disease. There are palpation of the skin, palpation the hand and foot, palpation the chest and the abdomen, palpation shu points in pressing maneuver. The diagnosis of the Back Shu points is a technique to examine the change of disease condition from pressure ache, spontaneous ache, tension, relaxation, solidification revealed through channels and collaterals. I investigates starting disease and an attack of disease of twelve pulse and pulse condition through the study relative to the substance and technique of pressing maneuver, and adjusts diagnosis techniques of a region for acupuncture and matters to be attended. The conclusions are as follows. 1. The Shu or stream points in which pathogenic factors go are important to medical treatment of dormant diseases like bowels disease, cold symptom complex and insufficiency symptom complex. 2. Disease classified by system is diagnosed by the condition of process part like pro-trusion, cave-in, tension, relaxation, pressure ache through palpating the Shu or stream points, that is pressing upward or downward left and right sides of the backbone process by hands. 3. In real clinic pressing maneuver of one's back side is very important to patient's diagnosis treatment. Thus, pressing maneuver of one's back side have to be done without omission. 4. Diagnosis must be accomplished through the perception about the diversity of diagnosis technique of bowels disease, the exact knowledge about pressing maneuver of one's back side for enlargement of treatment range and rising of treatment rate, and pressing maneuver of the Shu or the stream points.

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Statistical Analysis of Patients Referred to Pediatric Cardiology Clinic for Diagnosis of Heart Disease (심장질환의 진단을 위해 의뢰된 환아들에 대한 자료 분석)

  • Choi, Kwang-Hae;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.49-54
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    • 2000
  • Background: Echocardiography is rapidly establishing itself as the primary diagnostic technique for investigation of children with heart diseases, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analyzed data on the patients referred to the pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. Methods: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. Results: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(67 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6% (26R cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral ed to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia01.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia. 13 cases(3.0%); normal heart. 144 cases(33.6%). Conclusion: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patients were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Therefore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

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The Clinical Features of Pertussis in Infancy (영아 백일해의 임상 양상)

  • Kim, Soon Ju;Kim, Sang-Eun;Kim, Jong-Hyun;Lee, Jung-Hyun;Oh, Jin Hee;Koh, Dae Kyun;Sung, Hwa Young;Yu, Jae-Yon
    • Pediatric Infection and Vaccine
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    • 제16권2호
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    • pp.167-174
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    • 2009
  • Purpose : Pertussis was very common in the past, but reported cases have dramatically decreased. The improvement of vaccination programs and unreadiness of laboratory confirmation seems to have developed this situation. This study investigated the frequency of pertussis among infants with a paroxysmal cough and compared the clinical characteristics between infants with and without pertussis. Methods : Between June and November 2006, 27 infants admitted to the hospital that were 15-90 days old with a history of a cough for more than seven days were enrolled. The cough was described as: paroxysmal, whooping, and post-tussive vomiting. PCR and cultures for Bordetella pertussis with nasopharyngeal aspirates were obtained. The patients were divided into two groups: (1) the pertussis group that had positive results by PCR or culture; (2) the control group that had negative results by PCR and culture. Clinical and laboratory characteristics were compared between the two groups. Results : Among the 27 cases, five (18.5%) were finally diagnosed with pertussis. Only one out of the five pertussis cases was initially diagnosed with a pertussis-like syndrome on admission. Compared to the group without pertussis, the pertussis group had a significantly higher frequency of: no fever (P =0.043), a paroxysmal cough (P =0.040), cyanosis (P =0.001), non-immunized status for DTaP (P =0.047), normal auscultation (P =0.028), normal chest X-ray findings (P =0.027), high absolute lymphocyte count (P =0.039), and low CRP (P =0.046). The patients with the diagnosis of pertussis had a significantly longer duration of coughing (27.2${\pm}$10.6 vs. 12.6${\pm}$5.6 days, P =0.039). Conclusion : Pertussis should be suspected in any infant with typical symptoms of pertussis in addition to: a persistent cough without fever, accompanied by paroxysms or cyanosis prior to the age of DTaP immunization. Active laboratory confirmation should be carried out to confirm more cases with pertussis.

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