• Title/Summary/Keyword: Chest tube

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The Study of Appropriate X-ray Tube Angle for the Anterior-posterior Chest Radiography Using S-align Function (S-align 기능을 이용한 흉부 전·후 방향 검사 시 적절한 X선관 각도에 관한 연구)

  • Park, Myeong-Ju;Joo, Young-Cheol;Kim, Min-Suk;Yuk, Jeong-Won;Kim, Han-Yong;Kim, Dong-Hwan
    • Journal of radiological science and technology
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    • v.45 no.4
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    • pp.299-304
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    • 2022
  • This study uses the 'S-align' function to present a reference value of the X-ray tube angle for the realization of an image similar to that of the chest PA image during chest AP radiography. This study targeted dummy phantom and used a 17"×17" DR image receptor. The irradiation conditions were 110 kVp, 160 mA, 50 ms, and the distance between the central X-ray and the image receptor was set to 180 cm and 110 cm, respectively. The end of the catheter was placed at the 11th thoracic height to indicate the nasogastric tube. In the case of lung apex length measurement, the mean value of measurement was 30.53±0.47 in PA. T 0°, TCA 5~25°, TCE 5~15° were 21.07±0.29, 27.60±0.21, 34.13±0.44, 39.86±0.31, 45.96±0.61 mm, 54.13±0.37 mm, 16.16±0.46 mm, 9.81±0.35 mm, 2.75±0.30 mm, respectively. For the depth of the catheter end, the average value measured at PA was 6.70±0.31 mm. T 0°, TCA 5~25°, TCE 5~15° were 15.72±0.38 mm, 24.10±0.50 mm, 29.24±0.86 mm, 34.35±0.35 mm, 41.06±1.08 mm, 48.07±0.38 mm, 12.85±0.25 mm, 7.92±0.36 mm, 3.01±0.39 mm, respectively. The length of the lung apex was similar to that of chest PA when the angle of incidence was adjusted from 5° to 10° in the leg direction, and the depth of the catheter tip was most similar when the X-ray tube angle was incident at 10° in the head direction. Therefore, To change the X-ray tube angle according to the purpose of the examination during the chest AP radiography using 'S-align' function is considered necessary.

A technique for insertion of a long T-tube in tracheal stenosis (기관 협착에서 Long T-tube의 삽입 방법)

  • 백만종
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.664-666
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    • 1993
  • A technique for insertion of a long silicone T-tube in patient with critical stenosis and high-risk resection and primary anastomosis of long segment of the distal trachea is presented. It was not easy to insert a long T-tube by existing methods because of flexibility of a T-tube and tightness of stenosis. So we used a silastic endotracheal tube and guiding wire as stylet of a T-tube. During insertion, ventilation was normally maintained through the lumen of endotracheal tube. This provided rapid relief from airway obstruction and asphyxation and is a easy, safe and effective method to restore patency of the major airways.

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Epidural Emphysema Associated with Subcutaneous Emphysema after Chest Tube Placement: A Case Report (흉관 삽입 후 발생한 피하 기종을 동반한 척추 경막외 기종: 증례 보고)

  • Rho, Ji-Young;Yoo, Seung-Min;Cho, Young-Ah;Lee, Sang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.5
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    • pp.389-391
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    • 2010
  • Spinal epidural emphysema is rare and has been described secondary to following medical intervention, such as lumbar puncture and epidural analgesia, pneumothorax or pneumomediastinum, degenerative disk disease, epidural abscess, and trauma. Rarely, it occurs after chest tube placement. We report a case of spinal epidural emphysema incidentally noted on HRCT after chest tube placement.

Outpatient Chest Tube Management with Using a Panda Pneumothorax Set with a Heimlich Valve (Panda Pneumothorax Set with Heimlich Valve에 의한 외래에서의 흉관 관리)

  • Choi, Soon-Ho;Lee, Mi-Kyung;Ryu, Dae-Woong
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.497-501
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    • 2009
  • Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

Comparison of Noise and Doses of Low Dose and High Resolution Chest CT for Automatic Tube Current Modulation and Fixed Tube Current Technique using Glass Dosimetry (유리선량계를 이용한 관전류자동조절기법과 고정관전류기법에서 저선량 및 고해상 흉부CT의 노이즈 및 선량 비교)

  • Park, Tae Seok;Han, Jun Hee;Jo, Seung Yeon;Lee, Eun Lim;Jo, Kyu Won;Kweon, Dae Cheol
    • Journal of Radiation Industry
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    • v.11 no.3
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    • pp.131-137
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    • 2017
  • To compare the radiation dose and image noise of low dose computed tomography (CT) and high resolution CT using the fixed tube current technique and automatic tube current modulation (CARE Dose 4D). Chest CT and human anthropomorphic phantom were used the RPL (radiophotoluminescence) dosimeters. For image evaluation, standard deviation of mean CT attenuation coefficient and CT attenuation coefficient was measured using ROI analysis function. The effective dose was calculated using CTDIvol and DLP. CARE Dose 4D was reduced by 74.7% and HRCT by 64.4% compared to the fixed tube current technique in low dose CT of chest phantom. In CTDIvol and DLP, the dose of CARE Dose 4D was reduced by fixed tube current technique. For effective dose, CARE Dose 4D was reduced by 47% and HRCT by 46.9% compared to the fixed tube current method, and the dose of CARE Dose 4D was significantly different (p<.05). Noise in the image was higher than that in the fixed tube current technique. Noise difference in the image of CARE Dose 4D in low dose CT was significant (p<.05). The low radiation dose and the noise difference of the CARE Dose 4D were compared with the fixed tube current technique in low dose CT and HRCT using chest phantom. The radiation doses using CARE Dose 4D were in accordance with the national and international dose standards. CARE Dose 4D should be applied to low dose CT and HRCT for clinical examination.

A Case of the Pneumopericardium Following Blunt Chest Trauma (흉부둔상에 의한 심막기종: 치험 1예)

  • 김오곤
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.627-629
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    • 2003
  • The pneumopericardium following blunt chest trauma is exceedingly unusual. A patient was admitted to the emergency room after a motorcycle accident. Pneumopericardium and left pneumothorax were not detected on initial chest AP, but they were detected on chest computed tomograpy and resolved completely after chest tube insertion into the left pleural space.

Early Outcomes of Single-Port Video-Assisted Thoracic Surgery for Primary Spontaneous Pneumothorax

  • Kang, Do Kyun;Min, Ho Ki;Jun, Hee Jae;Hwang, Youn Ho;Kang, Min-Kyun
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.384-388
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    • 2014
  • Background: Recently, single-port video-assisted thoracic surgery (VATS) has been proposed as an alternative to the conventional three-port VATS for primary spontaneous pneumothorax (PSP). The aim of this study is to evaluate the early outcomes of the single-port VATS for PSP. Methods: VATS was performed for PSP in 52 patients from March 2012 to March 2013. We reviewed the medical records of these 52 patients, retrospectively. Nineteen patients underwent the conventional three-port VATS (three-port group) and 33 patients underwent the single-port VATS (single-port group). Both groups were compared according to the operation time, number of wedge resections, amount of chest tube drainage during the first 24 hours after surgery, length of chest tube drainage, length of hospital stay, postoperative pain score, and postoperative paresthesia. Results: There was no difference in patient characteristics between the two groups. There was no difference in the number of wedge resections, operation time, or amount of drainage between the two groups. The mean lengths of chest tube drainage and hospital stay were shorter in the single-port group than in the three-port group. Further, there was less postoperative pain and paresthesia in the single-port group than in the three-port group. These differences were statistically significant. The mean size of the surgical wound was 2.10 cm (range, 1.6 to 3.0 cm) in the single-port group. Conclusion: Single-port VATS for PSP had many advantages in terms of the lengths of chest tube drainage and hospital stay, postoperative pain, and paresthesia. Single-port VATS is a feasible technique for PSP as an alternative to the conventional three-port VATS in well-selected patients.

Perforation of IVC by Chest Draings Tube -Report A Case (흉강삽관술시 하대정맥 천공 치험 1례)

  • Jeong, Won-Seok;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1128-1131
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    • 1997
  • Injuries to versa cave continue to be associated with a high mortality. Essentials to successful treatment are immediate recognition of the injury and prompt control of the hemorrhage. We have experienced one case of inferior versa java perforation by a chest rainage tube in the patient with post-operative chronic empyema thoracic. The patient was 38-year old male who was taken RLL lobectomy after 6 cycle of chemotherapy due to small cell carcinoma in the RLL & suffered from post-operative chronic empyema thoracis at D hospital. He moved to our hospital for further evaluation with accidental removal of chest drainge tube. We inserted closed drainage tube and dark blood gushed out abruptly just after insertion of the drainage tube. CTscan, MRI, and angiogram were performed and showed the perforation of IVC just below RA. The IVC was repaired using simple interrupted 4-0 Prolene suture through right posterolateral thoracotomy. The patient recovered without event and doing well until now.

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The effects of cold therapy on pain related to chest tube removal in patients with coronary artery bypass graft surgery (냉요법 적용이 관상동맥 우회술 환자의 흉관 제거시 통증에 미치는 효과)

  • Jeon, Mi-Kyeong;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.1 no.1
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    • pp.33-45
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    • 2008
  • Purpose: Patients who underwent a coronary artery bypass graft surgery(CABG) experienced the unpleasant emotions and discomfort when their chest tube was removed. The purpose of this study was to evaluate the effects of cold therapy on pain related to chest tube removal(CTR) in CABG patients. Methods: Fifty adult patients undergoing CABG were recruited in a prospective, double blinded study. Subjects were divided into the experimental group and the control group considering their sex and age. The pretest data were obtained 20 minutes before CTR. Patients in the experimental group, received cold therapy for 10 minutes before CTR. Pain sense and intensity were determined immediately after CTR and at 10 minutes after CTR. Results: The total score of pain sense immediately after CTR of the experimental group was significantly lower than that of the control group(t=-3.703, p=.003). And scores of pain intensity immediately after CTR in the experimental group were significantly lower than that of the control group(t=-3.073, p=.001). But, there was no significant difference in the score of pain intensity 10 minutes after CTR between the experimental and the control group(t=1.759, p=.085). Conclusion: The cold therapy would be recommended as an effective and nonpharmacologic nursing intervention for relieving pain in patients undergoing CTR.

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Clinical Evaluation of Thoracic Empyema (농흉에 대한 임상적 고찰 - 109례 -)

  • 심재영
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.899-904
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    • 1990
  • One hundred and nine Patients with thoracic empyema were treated at the Chosun university hospital from Jul. 1983 to Sep. 1989. Seventy-nine[72.5%] of the empyemas were adults and 30[27.5%] patients were under fifteen-year children. 29 patients[26.6%] were associated with pulmonary tuberculosis, 23[21.1%] occurred as pneumonia, and 13[11.9%] were unknown. The cardinal symptoms were dyspnea, chest pain, fever, coughing. When used as the initial mode of drainage, repeat thoracentesis was successful in only 46 of 93 cases[49. 5%]. Rib resection, however, provided cure or controlled in 7 cases[100%]. And decortication showed high cure rate in 19 of 24 cases[79.2%] Eventual control or cure of empyema was achieved in 90 patients[89.6%], whereas 7 patients[6.4%] died [3 from their empyema and 4 with empyema as an active problem at the time of death]. of all empyema-caused deaths occurred in patients who underwent chest tube drainage as the most invasive treatment modality. Chest tube drainage was often inadequate and more aggressive management was likely to result in fewer treatment failure and fewer total procedure. Early rib resection was recommended.

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