• 대한방사선기술학회지:방사선기술과학
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• 제45권4호
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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.

• Journal of Chest Surgery
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• 제26권8호
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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.

• Tuberculosis and Respiratory Diseases
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• 제69권5호
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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.

• Journal of Chest Surgery
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• 제42권4호
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• pp.497-501
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• 2009

배경: 비디오흉강경하 폐 쐐기절제수술 후 흉관을 통한 지속적인 공기유출과 흉수배액은 퇴원할 준비가 되어있는 환자의 흉관 제거를 지연시킬 수 있다. 저자는 Heimlich valve가 부착된 Panda Pneumothorax set를 장착하여 외래에서 흉관 관리를 시행한 37명의 환자를 관찰하였다. 대상 및 방법: 2005년 1월부터 2007년까지 294명에서 비디오흉강경하 폐 쐐기절제술과 흉막유착술을 시행하였다. 이중 37명의 환자가 Panda Pneumothorax set with Heimlich valve를 이용한 외래에서의 흉관 관리를 위한 대상에 적합하였다. 환자들은 쓰여진 주의사항을 받았고 Panda set사용에 대한 믿음을 보여 주었다. 환자들은 공기누출과 흉수배액의 만족할만한 소실 후 흉관 제거를 위해서 병원에 복귀하였다. 결과: Panda Pneumothorax set를 착용하고 퇴원한 환자[평균 4.7$\pm$1.4일(3$\sim$6일)]는 착용하지 않았던 환자[평균 입원일은 6.2$\pm$5일(4$\sim$9일)]와 비교할 때 보다 장기간의 입원을 하였다. 그리고 또한 Panda Pneumothorax set환자의 경우 퇴원 후 외래에서 평균 9.8$\pm$1.6일(8$\sim$15일)만에 성공적으로 흉관을 제거할 수 있었다. 주요한 합병증은 없었으며 4명의 환자에서 사소한 합병증을 보였다. 36/37명(97.3%)에서 순탄하고 성공적인 외래에서의 흉관 관리를 경험하였다. 걸론: Panda set를 이용한 성공적인 외래에서의 흉관 관리를 선택된 36명의 환자에서 성실히 수행할 수 있었다. 이런 프로그램은 결과적으로 명백한 병원비 절약을 이룰 수 있었고 조기퇴원을 가능케 하여 환자의 만족감을 증가시켰다.

• 방사선산업학회지
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• 제11권3호
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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.

• Journal of Chest Surgery
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• 제36권8호
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• pp.627-629
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• 2003

흉부둔상에 의한 심막기종은 매우 드물다. 교통사고에 의해 응급실로 내원한 환자로 초기 흉부단순 촬영에서는 발견되지 않았으나, 흉부단층촬영상 좌측 기흉과 함께 심막기종이 발견되어 좌측 흉막에 관을 삽입한 후 해결된 경우가 있어 보고한다.

• Journal of Chest Surgery
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• 제47권4호
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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.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1128-1131
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• 1997

대정맥의 손상은 아직도 높은 사망률을 나타낸다. 성공적인 치료의 핵심은, 신속히 손상을 인식하고 지혈 을 시행하는 것이다. 저자들은, 수술 후 발생한 만성 농흉 환자에서 흉관 삽입시 발생한 하대정맥 천공 1례 를 치험하였기에 보고하는 바이다. 38세 남자환자가 D병원예서 우측하엽의 소세포암으로 6차례 항암약물치료를 시행받은 후 우측 하엽 절제술을 시 행받았고 만성농흉으로 치료받았다. 본 환자는 흉관을 제거한 후 본 원으로 전원되어서, 다시 흉관을 삽입하였다. 흉관을 통해 검붉은 피가 배출되어서 대혈관 손상 의심하에,흉 부CT, m), 혈관촬영 등을 시행하여 우심방 하방의 하대정맥 천공을 확인한 후, 우측 개흉술을 시행하였다 하대정맥의 손상 부위를 Prolene 4-0을 사용하여 단순 봉합하였다. 환자는 현재 외래 추적 관찰중으로 특별한 문제없이 지내고 있다.

• 중환자간호학회지
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• 제1권1호
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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.

• Journal of Chest Surgery
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• 제23권5호
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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.