• Title/Summary/Keyword: Chest tube

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Complete Transsection of Right Main Bronchus by Blunt Trauma -A Case Report- (둔상에 의한 우측 주기관지 완전 절단 치험 1례)

  • 조원민
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.924-927
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    • 1995
  • Main bronchial injury after blunt trauma is very rare in all bronchial injuries and the pathogenesis is variable and not well known in everycases. We report a case of complete transsection of right main bronchus by blunt trauma. This 24-year old patient was transferred from a local hospital with a chest tube. Because of the severe subcutaneous emphysema and tension pneumothorax, we inserted one more chest tube resulting no obvious interval change. With the impression of bronchial injury, we performed an exploratory thoracotomy. We couldn't proceed bronchoscopy in the operation room because of his unstable vital sign. After opening of the chest wall, we could identify completely transsected right main bronchus. We anastomosed the bronchus with 4~0 Vicryl interruptedly. After operation, the patient was recovered without any complication.

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Investigation of Tube Voltage Range using Dose Comparison based on Effective Detector Exposure Index in Chest Radiography (흉부 X-ray 검사 시 선량 비교를 활용한 유효 Detector Exposure Index 기반의 적절한 관전압 범위 제안)

  • Shim, Jina;Lee, Youngjin
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.139-145
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    • 2021
  • This study is to confirm the range of tube voltage for Chest X-ray in DR system by comparing with dose area product (DAP) and effective dose in efficient detector exposure index (DEI) range. GE definium 8000 was used to for the phantom study. The range of tube voltage is 60~130 kVp and of mAs is 2.5~40 mAs. The acquired images were classified into efficient DEI groups, then calculated effective dose with DAP by using a PC-Based Monte Carlo Program 2.0. The signal to noise ratio (SNR) was measured at 4 regions, including the thoracic spine, the lung area with the ribs, the lung area without the ribs, and the liver by using Picture Archiving and Communication System. The significance of the group for each tube voltage was verified by performing the kruskal-wallis test and the mann-whitney test as a post-test. When set to 4 groups dependned on the tube voltage, DAP showed significant differences; 60 kVp and 80 kVp, and 60 kVp and 90 kVp (p= 0.034, 0.021). Effective dose exhibited no statistically significant differences from the all of the group (p>0.05). SNR exhibited statistically significant differences from the all of the group in the liver except compared to 80 kVp and 90 kVp (p<0.05). Therefore, high tube voltages of 100 kVp or more need to be reconsidered in terms of patient dose and imaging in order to represent an appropriate chest X-ray image in a digital system.

A Novel Mediastinal Drainage Tube for Mediastinitis

  • Yhang, Jun Ho;Jang, In-Seok;Kim, Sung Hwan;Park, Hyun Oh;Kang, Dong Hoon;Choi, Jun Young
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.378-379
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    • 2015
  • Mediastinitis is a life-threatening disease, and effective drainage is needed to treat mediastinitis with abscess formation. We recommend an alternative drainage method using chest tube binding with a Silastic Penrose drainage tube. The use of a Silastic Penrose drainage tube may help to manage mediastinitis with abscess formation. This method facilitates effective draining and prevents tissue adhesion.

Diagnostic Video-Assisted Thoracic Surgery (진단목적의 비디오 흉강경 수술)

  • Baek, Hyo-Chae;Hong, Yun-Ju;Lee, Du-Yeon;Park, Man-Sil
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.542-547
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    • 1996
  • All patients who underwent video-assisted thoracic surgery (VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were 111 with 57 male and 54 female, and the mean age was 49 years (range 1 to 74). Multiple biopsies from more than one location were performed in 17 patients , pleural biopsies were performed In 49 patients, lung biopsies in 43 patients, mediastinal mass or Iymph node biopsies in 33 patients, and two pericardium biopsies and one dia- phragm biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia , the rest were performed under general anesthesia. In patients who underwent lung biopsy, the mean age was 49.1 ye rs (range 22~ 73). The operating time was 40 to 170 minutes (mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted from 1 to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thorn- cotomy had to be done due to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube. In the pleural biopsy group, the mean age was 49 years (range 17~ 74). The operating time was 25 to 80 minutes (mean 49), intravenous or intramuscular injection for pain control was needed 0 to 20 times (mean 3.6), and the chest tube was i.nserted for 0 to 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients. In the Iymph node biopsy roup, the mean age was 44.2 years (range 1 ~ 68). The operating time was )0 to 3)5 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one patient, a diagnosis was not possible and a chest tube was kept in place for longer than 7 days in 7 patients. In the multiple biopsy group, the mean age was 53.1 years(range 20~ 71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). The chest tube was kept in place for 1 to 16 days (mean 7.9).

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The Effect of Fibrin Glue as a Prevention Against Spontaneous Pneumothorax (Fibrin Glue가 자연기흉의 재발에 미치는 영향)

  • 이석열
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.570-578
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    • 1991
  • The spontaneous pneumothorax is the sudden collapse of the lung usually by air leakage from the ruptured sub-pleural bleb and has high recurrence rate. For prevention against recurrence, many drugs such as tetracycline, talcum powder, quinacrine, etc. have been used but the effects are not satisfactory. We reduced the recurrence rate successfully by the fibrin glue instillation through the chest tube. From the January 1989 to September 1990, we have managed 65 patients of spontaneous pneumothorax with closed thoracostomy and fibrin glue[fibrinogen 1gm/50ml with approtinin 3, 000kIU /ml, thrombin 5, 000IU /ml in 3% each 10ml] instillation through the chest tube. And we compared the results with those of 106 patients of spontaneous pneumothorax who were managed only by the closed thoracostomy from January 1985 to December 1988. Only the patients who visited our hospital with recurrence were considered as the recurred cases but the others were considered as not recurred. And the removal of chest tubes usually done 3 days after cessation of air leakage or 2 days after fibrin glue instillation Statistical analysis was done by X2-test. The results were as followings: 1. The recurrence rate of fibrin glue instillation group was lower than that of non-instillation group[1st attack: 15.1% versus 27.6% p<0, 05, the 2nd attack: 33.3% versus 73.7% p<0.01, the total 18.5% versus 35.8% p<0.01]. 2. The mean duration of chest tube drainage in the fibrin glue instillation group was shorter than non-instillation group[4.24$\pm$1.36 days versus 4.48$\pm$1.73 days p<0.05]. 3. The mean duration of hospitalization was shorter in the instillation group [8.12$\pm$3.5 days versus 10.8$\pm$3.8 days p<0.05] The complications were transient mild fever, chest pain, pleural effusion in 46 cases of 65 patients, but those didn`t make any problem. We concluded that the fibrin glue is effective in the reduction of recurrence rate, obliteration of air leakage and duration of hospitalization.

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Optimization of Image Quality according to Sensitivity and Tube Voltage in Chest Digital Tomosynthesis (디지털 흉부단층합성검사에서 감도와 관전압 변화에 따른 영상 최적화)

  • Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.12 no.4
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    • pp.541-547
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    • 2018
  • To evaluate the effect of dose and image quality for Chest Digital Tomosynthesis(CDT) using sensitivity and tube voltage(kV). CDT images of the phantom were acquired varying sensitivity 200, 320, 400 according to set tube voltage of 125 kV and 135 kV. The dose and Dose Area Product(DAP) according to change of sensitivity and kV were evaluated and Image quality was evaluated by PSNR, CNR, SNR using Image J. Dose were lowered 14~23% less than sensitivity 200, 125 kV and DAP were lowered 13~26% less than sensitivity 200, 125 kV. PSNR were over 27 dB, which were significant value and CNR, SNR were better as sensitivity value was lower. But there were different statistical significant to each item. CNR and SNR were not statistically significant at sensitivity 320, 135 kV(P>0.05). CDT can improve image quality with lower radiation dose using better than quality and correction power at digital radiography system.

A Study on Radiographic Equipments and Situation for the Chest (흉부(胸部)의 X선촬영(線撮影) 및 촬영장치(撮影裝置) 현황(現況)에 관(關)한 조사(調査))

  • Ko, Shin-Gwan;An, Bong-Seon
    • Journal of radiological science and technology
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    • v.8 no.2
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    • pp.3-9
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    • 1985
  • From the study on the chest radiologic equipments and situations of university hospitals, general hospitals, and radiologic clinics located in Seoul area and Choong-cheong province, the author got conclusions as follows : 1. The rectfication methods of the equipments were employing mainly single or three-phase full wave, and 78% of the examined were using single phase full wave. 2. The focal sizes in case of small focus were less than 1.0mm in chest-only use, and more than 1.0mm in 81% of combined use. The focal sizes in case of large focus were more than 1.6mm in 78% of the total. 3. Maximum ratings of x-ray tubes were 47% at 125 kVp maximum tube voltage and 41% at 150kVp. The maximum tube currentes higher than 500mA were shown in 72% of all the examined. And the maximum exposure time was the range of 5-8sec. 4. Grid was not used in the 66% of all the hospitals. Equipment for chest-only was employing 10:1 grid ratio and the 2.0-2.9mmAl of total filtration formed 38% of all the examined. 5. In the processing time of exposed film, 68% of all was 90sec, and only 20% of all the examined used optimum developing temperature according to this condition. 6. In the radiographic conditions, more than 50% used low tube voltages lower than 70 kVp and only 3% of all the equipments used high tube voltages higher than 100 kVp. The 46.9% of all the equipments 300mA, and 53% of all used shorter exposure time less than 1/20(0.05) sec. 7. In the monthly average number of radiographs, 44% of all was x-ray the radiographs.

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A Study on the Optimization of Image Quality and Dose in Chest PA Digital Radiography (디지털 흉부 방사선 검사의 화질과 선량의 최적화에 관한 연구)

  • Park, Han Sol;Kim, Myeong Seong;Jung, Hong-Moon;Lee, Jong Woong
    • Journal of the Korean Society of Radiology
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    • v.11 no.1
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    • pp.55-61
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    • 2017
  • There are no recommended test conditions for digital photography in Chest PA examinations. However, each company recommends shooting examinations of the high voltage applied to the previous analog examination. The condition that satisfies the value of 200 ~ 800 which is the recommended Exposure Index value recommended by Philips was selected, and the dose was evaluated by Monte Carlo simulation, and the SNR and CNR were compared. As a result, it was possible to reduce the effective dose up to 77% by controlling the tube voltage, tube current, and additional filter, not the conventional high voltage imaging method. Although there were some differences according to the test conditions, the image evaluation results were similar to the images. We will compare the exposure dose according to changes in tube voltage, tube current, and additional filter at the digital chest radiograph and evaluate the image quality of the image to propose optimal conditions.

Analysis of Image Quality and Scan Dose when Applying Reconstruction Algorithm Changes to Chest CT Scans (흉부 CT 스캔에서 재구성 알고리즘 변화적용 시 화질과 스캔 선량 분석)

  • Hyeon-Ju Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.6
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    • pp.819-825
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    • 2023
  • In this study, among chest CT examination conditions, the tube voltage was changed to 100 and 80 kVp and the reconstruction algorithm was changed to FBP, ASIR-V, and DLIR to compare and analyze changes in examination dose and image quality. As a result, when applying ASIR-V and DLIR at a tube voltage of 100 kVp, which is lower than the existing tube voltage, the dose is lowered while achieving image quality most similar to that when applying 120 kVp and FBP. especially, DLIR reconstructed images had excellent SNR and CNR at all tube voltages. In addition, the SSIM index was analyzed to be closest to 1, showing the highest similarity to the original image. Therefore, when performing repeated chest CT examinations, the application of DLIR can reduce the examination dose by about 29.7%, which is expected to help solve some of the biggest problems with CT examinations, namely radiation exposure due to the examination.