• Title/Summary/Keyword: Chest

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Clinical experience of ventilator therapy in chest trauma (인공호흡기 치료를 받은 흉부외상 환자의 임상적 고찰)

  • 서강석
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.59-63
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    • 1993
  • A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

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Reconstruction of Thoracic Wall Defect in Tumors of Chest Wall -Report of Four Cases- (흉벽에 발생한 종양 -흉벽 재건술 4례-)

  • 이선희;김세화;이홍균
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.29-36
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    • 1975
  • We have experienced 49 cases of tumors of chest wall at St. Mary`s Hospital from Jan. 1963 to Dec.1974. In four cases of them, the reconstruction of chest wall defects performed. 1] Out of 49 cases of tumors of the chest wall, 27 cases were benign tumors, 14 cases metastatic malignant tumors, and 8 cases primary malignant tumors. 2] Twenty-six cases [50%] of tumors of the chest wall were on the bony cage. Among them benign tumors were 9 cases [35%], metastatic malignant tumors 14 cases [53%], and primary malignant tumors 3 cases [12%]. Of these, 24 cases were located on the ribs and 2 cases on the sternum.3] The malignant tumors of bony chest wall were excised in en bloc resection including involved ribs. The wide defects of bony chest wall were reconstructed by means of displacement of neighboring ribs and mobilized diaphragm, in the two osteogenic sarcomas of rib, and of prosthesis with silastic sheets in one rhabdomyosarcoma and one metastatic adenocarcinoma of lung.

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Comparison of quality of 30:2 vs. 2:30 CPR in manikins (심폐소생술 방법 변화에 따른 quality 비교 - 30:2와 2:30 비교분석실험 -)

  • Uhm, Tai-Hwan;Yoou, Soon-Kyu;Choi, Hea-Kyung;Jung, Ji-Yeon
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.3
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    • pp.71-81
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    • 2010
  • Purpose: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended the ratio of chest compression to ventilation ratio to 30:2 from 2005 CPR guideline to 2010 CPR guideline. However, current studies have shown that the hands-off time was > 10 seconds with that method. For this reason, we devised new CPR method that a ventilation to chest compression ratio of 2:30 to reduce pt assessment time and skipped the assessment step of carotid artery pulse would be a more effective way to reduce the hands-off time & the time to set the CPR. According to the more detailed purpose are listed below. 1) We would like to confirm efficiency of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 to reduce the hands-off time & the time to set the CPR. 2) We would like to evaluate possibility of increasing for chest compression accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 3) We would like to evaluate possibility of increasing for ventilation accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 Methods: According to 2005 American Heart Association Guidelines, 60 paramedic students(20 students X freshmen, sophomore, junior) performed 5 cycles of 3~ chest compressions : 2 ventilations after A, B, C evaluation with Laerdal Resusci R Anne SkillReporters. After 5 minutes rest, the 60 students performed 5 cycles of 2 ventilations : 30 chest compressions after A, B evaluation with the manikins between 13 and 17 September 2010. The short reports including speed & accuracy of chest compression, respiratory, CPR cycle were gained from the manikins. Hands-off times were measured by assistants. Results: Recently, the importance of high quality CPR was emphasized in order to perform the CPR faster and more accurate. To find out improving the conventional CPR method, we switch the procedure of the compression and the ventilation. By switching the procedure back and forth, we are able to compare the effectiveness of CPR between two type of CPR method which are 2:30 and 30:2 methods. 2:30 is that the breaths is delivered twice, first and perform 30 compressions while 30:2 perform 30 compressions first and give 2 breaths followed by the ABC method. Also, we verify the effectiveness of the hands off time, compression accuracy of the compression through the comparison of the two procedure as mentioned earlier. Consequently research verified that 2:30 is the efficient by providing faster set up delivering more accurate chest compression. Conclusion: 2:30 can minimize a time delay from cardiac standstill until starting the chest compression. In addition, hands-off time which is an interruption in chest compression can be shortened by 2:30 method, which result to effective oxygenation of coronary artery & maintenance of the bloodstream. Once again, performing the 2:30 method provide lessen hands off time and increase the accuracy of the chest compression.

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Chest Injuries due to Blunt Chest Trauma (둔좌상에 의한 흉부손상의 임상적 관찰)

  • Jin, Jae-Kwon;Park, Choo-Chul;Yoo, Seh-Young
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.418-423
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    • 1979
  • Chest injuries due to blunt trauma often result in severe derangements that lead to death. And we have to diagnose and treat the patients who have blunt chest trauma immediately and appropriately. A clinical analysis was made on 324 cases of chest injury due to blunt trauma experienced at department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyung Hee University during 8-year period from 1972 to 1979. Of 324 patients of blunt chest injuries, there were 189 cases of rib fracture, 121 of hemothorax or/and pneumothorax, 108 of soft tissue injury of the chest wall only, 41 of lung contusion, 24 of flail chest, 13 of scapular fracture, 7 of diaphragmatic rupture and others. The majority of blunt chest injury patients were traffic accident victims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 3rd decade and 4th decade [60%] and 238 patients were male comparing to 86 of female [Male: Female = 3:1 ]. In the patients who have the more number of fractured ribs, the more incidence of intrathoracic injury and intraabdominal organ damage were found. The principal associated injuries were head injury on 58 cases, long bone fractures on 37, skull fractures on 12, pelvic fractures on 10, renal injuries on 6 and intraabdominal organ injuries on 5 patients. The principle of early treatment of chest injury due to blunt trauma were rapid reexpansion of the lung by closed thoracotomy which was indicated on 96 cases, but open thoractomy was necessary on 14 cases because massive bleeding, intrapleural hematoma and/or fibrothorax, or diaphragmatic laceration-On 15 cases who were young and have multiple rib fracture with severe dislocation delayed elective open reduction of the fractured ribs with wire was done on the purpose of preserving normal active life. The over all mortality was 2.8% [9 of 324 cases] due to head injury on 3 cases, massive bleeding on 2,wet lung syndrome, acute renal failure on 1 and septicemia on 1 patient.

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A Case of Focal Reexpansion Pulmonary Edema after Chest Tube Insertion (흉관 삽관 후 발생한 국소성 재팽창성 폐부종 1예)

  • Chung, Hye Kyoung;Jang, Won Ho;Kim, Yang Ki;Lee, Young Mok;Hwang, Jung Hwa;Kim, Ki-Up;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.59-62
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    • 2009
  • Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

Interpretation of chest bind(結胸) in Donguisusebowon(東醫壽世保元) based on the chest bind disease of the Soyang pattern (『동의수세보원(東醫壽世保元)』의 결흉(結胸) 해석 - 소양인 결흉을 중심으로 -)

  • Jang, Woo-Chang
    • Journal of Korean Medical classics
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    • v.28 no.4
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    • pp.99-119
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    • 2015
  • Objectives : This study aims to compare and analyze the contents and logic of Lee Jema's chest bind theory of the Soyang pattern with that of the traditional perspective since Shanghanlun, and to further investigate its underlying meaning and evaluate its value. Methods : Study chest bind related arguments of Lee through historical, demonstrative and positive investigation. First, contrast related texts starting from Shanghanlun, followed by reasoning based on general medical logic. Finally review clinical case studies from texts and papers for verification. Results : According to Lee, the key to diagnosis and treatment in preventing major chest bind which is a severe condition in the exterior cold pattern of the Soyang constitution, is to disperse fluid bind using GanSui(甘遂) in the water counterflow and vomiting(水逆嘔吐) stage prior to the major chest bind symptoms of stiffness and pain in the lower chest(心下硬痛), and reducing phlegm-rheum using DoJeokGangGiTang(導赤降氣湯) in the beginning stages of chest bind. HyeongBangDoJeokSan(荊防導赤散) is the main formula in treating phlegm-rheum, a causal factor to chest bind, modified according to the 'treat the three burners separately(三焦分治)' theory of the DaoChiSan(導赤散) section in WanBingHuiChun (萬病回春) to accomodate the Soyang constitution. Conclusions : If we follow Lee's diagnosis and treatment system on chest bind, it will allow us to diagnose chest bind in the earlier stages and secure safe treatment.

Comparison of the Equivalent Dose of the Lens Part and the Effective Dose of the Chest in the PET/CT Radiation Workers in the Nuclear Medicine Department (핵의학과 PET/CT실 방사선작업종사자의 수정체 부위의 등가선량과 흉부의 유효선량의 측정 비교)

  • Son, Sang-Joon;Park, Jeong-Kyu;Jung, Dong-Kyung;Park, Myeong-Hwan
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.209-215
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    • 2019
  • Comparison of the effective dose of the chest and the equivalent dose of the lens site in the radiation workers working at four medical institutions with the PET / CT room located in one metropolitan city and province from April 1 to June 30, 2018 Respectively. Radioactive medicine were measured at the time of dispensing and at the time of injection. In this experiment, the average dispensing time per patient was 5.7 minutes and the average injection time was 3.1 minutes. The equivalent dose at the lens site was $0.78{\mu}Sv/h$ for 1 mCi, and the effective dose for chest was $0.18{\mu}Sv/h$ per 1 mCi. The equivalent dose at the lens site during injection was $0.88{\mu}Sv/h$ per mCi and the effective dose of chest was $0.20{\mu}Sv/h$ per mCi. The daily effective dose of the chest was $0.9{\pm}0.6{\mu}Sv$ and the equivalent dose of the lens site was $3.6{\pm}1.4{\mu}Sv$ during daily dosing for 20 days. The effective dose of the chest during the day was $0.6{\pm}0.5{\mu}Sv$ and the equivalent dose of the lens was $2.2{\pm}1.0{\mu}Sv$. At the time of dispensing, the equivalent dose of the lens was $0.187{\pm}0.035mSv$, the effective dose of the chest was $0.137{\pm}0.055mSv$, the equivalent dose of the lens was $0.247{\pm}0.057mSv$, and the effective dose of the monthly chest was $0.187{\pm}0.021mSv$. As a result of the corresponding sample test, the equivalent dose and the effective dose of the chest, the effective dose of the chest, the effective dose of the chest, the effective dose of the chest, The equivalent dose of the lens and the effective dose of the chest were statistically significant (p<0.05) with a significance of 0.000. However, there was no statistically significant difference (p>0.05) between the equivalent dose and the effective dose of the chest, the equivalent dose of the lens at the time of injection, and the effective dose of the chest at 0.138 and 0.230, respectively.

Psychoanalytic Observations on Chest Pain (흉통(胸痛)의 정신분석적(精神分析的) 고찰(考察) -두사람의 증례(症例)를 중심으로-)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.1
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    • pp.98-106
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    • 1995
  • This study presents the cases of two patients suffering from chest pain as the chief complaint and refers to related literatures to reveal the psychoanalytic meaning of chest pain. In the first case, the patient who was balked of the desire to be loved complained of her pain in the chest She had been bereaved of her husband and felt deserted by someone on whom she depended, and these experiences caused the chest pain. The drive related to this chest pain in a dependent and aggressive one. The second case, the chest pain of a 28-year-old unmarried woman, resulted from Oedipal conflict Her Oedipal conflict did not resolve successfully for the exessive sexual stimulation in her childhood such as her experiences of witnessing the primal scenes sleeping with her parents in the same room, even under a same blanket In addition, there were some other traumas which prevented her from that conflict: Her father bathed her until her puberty: She saw her father's back view as he urinated in a jerry: She heard her parents' frequent quarrels. This patient felt guilty about desire of Oedipal incest, and chest pain seemed to occur as a kind of self-inflicted punishment.

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Primary Leiomyosarcoma of the Left Lower Posterior Chest wall with Lung Metastasis - One Case Report - (폐 전이를 동반한 원발성 흉벽 평활근육종 - 1례 보고 -)

  • 김대현;김범식;박주철;조규석
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.764-767
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    • 2002
  • An unusual case of primary leiomyosarcoma at the left lower posterior chest wall with metastasis to the right lung parenchyme is presented. The patient was a 43-year-old man who was asymptomatic but a slow growing hard mass was noted at the left lower posterior chest wall. The chest computed tomography showed a tumor at the left lower posterior chest wall with multiple metastasis to the right lung. The left lower posterior chest wall mass was examined by percutaneous needle aspiration and it was revealed as rhabdomyosarcoma histologically. En bloc resection to the left lower posterior chest wall tumor and metastasectomy to the multiple nodules in the right lung were done and pathological examination finally revealed primary leiomyosarcoma at the left lower posterior chest wall with multiple metastasis to the right lung. Chemotherapy was scheduled as adjunctive measure.