• Title/Summary/Keyword: Artificial pneumothorax

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A Case of Successful Treatment by Artificial Pneumothorax in Cavitary Pulmonary Tuberculosis with Treatment Failure (공동을 동반한 난치성 폐결핵 환자에서 인공 기흉법으로 치료 성공 1예(II))

  • Rhee, Myung-Seon;Kim, Kyung-Ho;Cho, Dong-Il;Rhu, Nam-Soo;Kim, Jae-Won
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.725-729
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    • 1993
  • A case of cavitary pulmonary tuberculosis with persistent positive bacilli due to resistant strain was treated successfully with artificial pneumothorax with antituberculosis chemotherapy. Negative conversion of Tubercle bacilli was noticed by four months on sputum smears and by 11 months on sputum cultures after the starting of artificial pneumothorax. The cavitary lesion was collapsed by 13 months. Artificial pneumothorax is one of the collapse therapies of pulmonary tuberculosis which had been used widely in the early 20th century before the era of antituberculosis chemotherapy. Nowadays, this method is almost neglected due to its inferiority in efficacy as compared to chemotherapy and complications. But we recommend considering this method when no other measure is likely to be useful in open cavitary lesion.

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Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

  • Eom, Jeong Ho;Lee, Myung Goo;Lee, Chang Youl;Kwak, Kyong Min;Shin, Won Jae;Lee, Jung Wook;Kim, Seong Hoon;Choi, Sang Hyeon;Park, So Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.106-110
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    • 2015
  • The prevalence of pneumothorax cases among Intensive Care Unit patients who require mechanical ventilation ranges from 4%-15%. A pneumothorax remains one of the most serious complications of positive pressure ventilation. It can be diagnosed in a critically ill patient through a physical examination or radiographic studies that include chest radiographs, ultrasonography, or computed tomography scanning. However, in a critically ill patient, the diagnosis of a pneumothorax is often complicated by other diseases and by difficulties in imaging sick and unconscious patients. Although electrocardiogram changes associated with a pneumothorax have been described for many years, there has been no report of such among patients who require mechanical ventilation. In this paper, we report 2 cases of a spontaneous pneumothorax with paroxysmal supraventricular tachycardia in patients who required invasive mechanical ventilation due to acute respiratory failure.

Effects of Atelectasis on Surface Activity of lung in Rabbits (무기폐(無氣肺)가 폐표면활성도(肺表面活性度)에 미치는 영향에 관(關)한 실험적(實驗的) 연구(硏究))

  • Woo, Jong Soo;Cho, Kwang Hyun;Kim, Jong Won;Sohn, Mal Hyun;Sihn, Kun Soo;Kim, Jin Shik
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.109-116
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    • 1976
  • The effects of atelectasis on surface activity of lung extracts were examined in rabbits. Experimental atelectasis was produced in rabbits by artificial pneumothorax and surface tension properties were measured on saline extracts of lung 24 hrs, 48 hrs, one week and four weeks after the induction of pneumothorax. The results were as follows; 1) The minimum surface tension of excised lung extracts 24 hrs after pneumothorax was significantly increased to 28.3 0.41 dynes/cm, and the stability index was significantly decreased to 0.30 from normal value of 0. 87. 2) In the group which was re-expanded 24 hours, later from pneumothorax the surface activity was returned to almost normal range 24 hrs after reexpansion of collapsed lung, 3) When the atelectasis was continued by mechanical means, the extracts of atelectatic lung showed progressive decrease in surface activity, but it was found that surface activity returned to normal level after four weeks even the presence of atelectasis. 4) These observations suggest to us that atelectasis per se does not cause an increase in surface tension of lung extracts, and even in prolonged atelectasis the re-expansion of collapsed lung may be possible when the mechanical cause of atelectasis was excluded.

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Cavitary Lung Abscess Mistaken for Pneumothorax after Drainage of Pus (배농후 기흉으로 오인된 공동성 폐농양)

  • Hong, Bum-Kee;Chang, Jung-Hyun;Kim, Se-Kyu;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.449-453
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    • 1993
  • A 64-year-old male was admitted due to abruptly developed, severe dyspnea via local clinic. He had been a heavy smoker and alcoholic for a long time. Chest PA showed huge haziness in right upper lung field. Sputum culture for bacteriology was positive for Klebsiella pneumoniae. Immediately, appropriate antibiotics were administered and artificial ventilation was started. On 40th hospital day, simple chest roentgenogram taken due to sudden aggravated dyspnea showed marked hyperlucency in right upper lung field, suggestive of rupture of abscess cavity and resultant pneumothorax. At that time, chest tube was inserted but air leakage from the chest tube persisted. Chest CT scan taken after chest tube insertion showed the tube inserted into a thin-walled cavity in the above lesion. on 84th hospital day, right upper lobectomy with decortication was performed. Pathologically, cavittary lung abscess was diagnosed on the findings of partial re-epithelialization of ciliated columnar epithelium with severe pulmonary vascular occlusion and extensive fibrous pleural adhesions.

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Watch Out for the Early Killers: Imaging Diagnosis of Thoracic Trauma

  • Yon-Cheong Wong;Li-Jen Wang;Rathachai Kaewlai;Cheng-Hsien Wu
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.752-760
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    • 2023
  • Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

A Deep Learning Model for Judging Presence or Absence of Lesions in the Chest X-ray Images (흉부 디지털 영상의 병변 유무 판단을 위한 딥러닝 모델)

  • Lee, Jong-Keun;Kim, Seon-Jin;Kwak, Nae-Joung;Kim, Dong-Woo;Ahn, Jae-Hyeong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.2
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    • pp.212-218
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    • 2020
  • There are dozens of different types of lesions that can be diagnosed through chest X-ray images, including Atelectasis, Cardiomegaly, Mass, Pneumothorax, and Effusion. Computed tomography(CT) test is generally necessary to determine the exact diagnosis and location and size of thoracic lesions, however computed tomography has disadvantages such as expensive cost and a lot of radiation exposure. Therefore, in this paper, we propose a deep learning algorithm for judging the presence or absence of lesions in chest X-ray images as the primary screening tool for the diagnosis of thoracic lesions. The proposed algorithm was designed by comparing various configuration methods to optimize the judgment of presence of lesions from chest X-ray. As a result, the evaluation rate of lesion presence of the proposed algorithm is about 1% better than the existing algorithm.

Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?

  • Son, Ho Sung;Lee, Sung Ho;Darlong, Laleng Mawia;Jung, Jae Seong;Sun, Kyung;Kim, Kwang Taik;Kim, Hee Jung;Lee, Kanghoon;Lee, Seung Hun;Lee, Jong Tae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.124-128
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    • 2014
  • Background: A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. Methods: We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. Results: The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. Conclusion: Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.

Annual report of thoracic and cardiovascular surgery in Korea [II] (흉부외과 진료통계( II ) -1992년-)

  • Sun, Kyung;Kwak, Young-Tae;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.163-169
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    • 1993
  • This is the result of the annual statistic analysis of thoracic and cardiovascular surgical cases in 1992 Korea. Overall 17, 520 cases of surgery [11, 732 cases of thoracic surgery by 54 institutes / 5, 788 cases of cardiovascular surgery by 48 institutes] were done. 1. Tumor [N=2, 532] : Lung was the most frequently involved organ by tumor [54.9%],and the remainders were mediastinum [16.2%] / esophagus [14.8%] / chest wall [11.7%] / tracheobronchus [1.3%] / pleura [1.1%] in order. Of 1, 082 cases of primary lung cancer surgery,the frequency of cell type was squamous [62.6%] / adeno [21.6%] / small cell [7.1%] / large cell [2.7%]. Of 411 cases of mediastinal tumor surgery,the frequency of cell type was neurogenic [28.8%] / thymoma [27.6%] / teratoma [17.7%] / congenital cystic [17.2%]. Of 376 cases of esophageal tumor surgery,primary cancer were the most [85.4%]. 2. Infection [N=3, 157] : Pleura was the most frequently involved organ [59.0%],and the remainders were lung [31.3%] / chest wall [8.6%] / mediastinum [1.1%] in order. 3. Miscellaneous [N=6, 043] : Lung and pleural disease esp. pneumothorax [85.1%] was the most frequent surgical indication. The remainders were chest wall anomaly [3.4%] / benign esophageal disease [3.4%] / diaphragmatic pathology [2.4%] / myasthenia [1.4%] in order. Of 85 cases of thymectomy for myasthenia gravis,thymoma was noted in 58.8%. 1. Congenital heart disease [N=3, 363] : The ratio of noncyanotic to cyanotic heart disease was 3:1. Of 2, 516 cases of noncyanotic heart disease,the frequency of disease entity was VSD [44.1%] / ASD [26.0%] / PDA [19.4%] / PS [3.3%],and that of 847 cases of cyanotic heart disease was TOF [29.4%] / ECD [15.6%] / TGA [9.7%] / DORV [7.6%]. Overall mortalities were 2.1% in noncyanotic and 12.2% in cyanotic heart surgery. 2. Acquired heart disease [N=1, 929] : Of 1, 422 cases of valvular surgery,single mitral pathology was the most frequent candidate [48.0%],and total 1, 574 prosthetic valves which were mainly mechanical [95.6%] were used. Of 376 cases of coronary surgery,triple vessel was the most [35.9%],and the frequency of bypassing grafts was great saphenous vein [52.9%] / internal mammary artery [44.7%] / artificial vessel [2.4%]. Overall mortalities were 3.4% in valvular and 4.5% in coronary surgery. 3. Pericardium,Cardiac tumor,Arrhythmia,Aortic aneurysm,Assist device,and Pacemaker : There were no specific changes compared to previous survey1]. This nation-wide inquiry will be continued and reported annually by KTCS Society.

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