• Title/Summary/Keyword: Chest

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The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain

  • Kim, Yong Joo;Shin, Eun Jung;Kim, Nam Su;Lee, Young Ho;Nam, Eun Woo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.261-267
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    • 2015
  • Purpose: Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients. Methods: The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients. Results: Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement. Conclusion: Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations.

Distribution of the Scatter Ray on Chest X-ray Examinations (흉부 X선 촬영 시 산란선 분포 연구)

  • Cho, Pyong-Kon
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.255-260
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    • 2012
  • This study aims to examine the generation of scatter rays by dividing it into the presence of the subject at the chest X-ray examination, the X-ray tube and detector in the X-ray room, the front of the patient window, the outside of the entrance door of the patient waiting room, opening of the entrance door, the outside of the radiological technologist's entrance door, and the opening of the radiological technologist's entrance door, etc. When there is a subject, as the subject is thicker, more scatter rays occur at each of the spots for measurement. And when the entrance door is closed at the measurement, fewer scatter rays are generated.

Effects of Implementing Artificial Intelligence-Based Computer-Aided Detection for Chest Radiographs in Daily Practice on the Rate of Referral to Chest Computed Tomography in Pulmonology Outpatient Clinic

  • Wonju Hong;Eui Jin Hwang;Chang Min Park;Jin Mo Goo
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.890-902
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    • 2023
  • Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

Dedifferentiated Chondrosarcoma of the Rib Masquerading as a Giant Chest Wall Tumor in a Teenage Girl: An Unusual Presentation

  • Abraham, Viju Joseph;Devgarha, Sanjeev;Mathur, Rajendra Mohan;Sisodia, Anula;Yadav, Amita
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.427-430
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    • 2014
  • Chondrosarcoma of the chest wall is a rare primary neoplasm found to occur in elderly men. Patients present with an enlarging, painful, anterior chest wall mass arising from either the vicinity of the costochondral junction or the sternum. Treatment includes wide resection with appropriate chest wall reconstruction. We report an unusual presentation of this uncommon tumor occurring as a huge chest wall mass in a young teenage girl.

Korean Medicine Treatment for Chronic Atypical Chest Pain Diagnosed as Coronary Artery Disease: A Case Report (관상동맥질환으로 진단된 만성 비정형 흉통의 한의진료 경과 : 증례보고)

  • Kim, Eunmi;Jo, Hee-Geun
    • The Journal of Internal Korean Medicine
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    • v.41 no.4
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    • pp.688-698
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    • 2020
  • Background: The aim of this study was to determine the overall effects and the clinical effect of Korean medicine treatment on chronic atypical chest pain. Case Report: A 56-year-old male patient suffering from chronic atypical chest pain was treated with herbal medicine and acupuncture. We used the Baseline Dyspnea Index (BDI), Pittsburgh Sleep Quality Index (PSQI), and a verbal numerical rating score (VNRS) to assess the patient's symptoms. The administration of the new herbal medicine and local acupuncture point stimulation improved the chest pain and dyspnea symptoms. No side effects were observed during the treatment. Conclusions: The study findings suggest that Korean medicine treatments, such as herbal medicine and local acupuncture point stimulation, may be effective as treatments for atypical chest pain and secondary symptoms in patients with coronary artery disease.

Tuberculous chest wall abscess (결핵성 흉벽농양)

  • Jo, Gyu-Seok;U, Se-Yeong
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.140-143
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    • 1984
  • We have experienced 30 patients of tuberculous chest wall abscess which was surgically treated at Kyung Hee University hospital during 6 years from Jan, 1978 to Dec, 1983. We analyze 30 cases of clinical findings and surgically treated, and 20 cases of chest X-rays are available. The results of this sturdy are as follows: 1.Sex ratio ; Male: Female = 1:1.72. 2.Chief complaints are fluctuated mass with or without tenderness or pain and pus from wound. 3.Out of 20 cases of chest x-rays revealed 8 cases of osteolytic lesion, 11 cases of soft tissue swelling, 5 cases of pleural changes and 4 cases of negative findings. 4.We resected partially 43 ribs of 30 patients [average: 1.43 resected] in tuberculous chest wall abscess. 5.Operative methods of tuberculous chest wall abscess were partial resection of destructed or denuded periosteum of ribs and curettage of its surrounding tissues in operative field.

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A Clinical Evaluation of 1,110 Chest Trauma (흉부 손상 1,110례에 대한 임상적 고찰)

  • 조용준
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1013-1019
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    • 1992
  • A clinical evaluation was performed on 1, 110 cases of chest trauma treated at the Department of Chest Surgery, Chonnam University Hospital, during the past 23 years from January 1968 to June 1990. The ratio of male to female was 5.5: 1. The most common causes of chest trauma was stab wounds in penetrating trauma and traffic accidents in nonpenetrating trauma. The most common injuries in chest trauma were hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. Hemothorax or pneumothorax was observed in 592 cases [53.3%] of the total cases and rib fracture was observed in 527 cases[47.5%] of the total cases. Rib fracture was prevalent from the 3th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and other organ injuries. Open thoracotomy was performed in 163 cases[14.7%] and conservative nonoperative treatment in the others. Overall mortality rate was 8.5%[94 cases], and common causes of the death were shock and respiratory insufficiency.

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An Optimal Algorithm for Enhancing the Contrast of Chest Images Using the Frequency Filters Based on Fuzzy Logic

  • Shin, Choong-Ho;Jung, Chai-Yeoung
    • Journal of information and communication convergence engineering
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    • v.15 no.2
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    • pp.131-136
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    • 2017
  • Chest X-ray image cannot be focused in the same manner as optical lenses and the resultant image generally tends to be slightly blurred. Therefore, appropriate methods to improve the quality of chest X-ray image have been studied in this paper. As the frequency domain filters work well for slight blurring and moderate levels of additive noises, we propose an algorithm that is particularly suitable for enhancing chest image. First, the chest image using Gaussian high pass filter and the optimal high frequency emphasis filter shows improvements in the edges and contrast of the flat areas. Second, as compared to using histogram equalization where each pixel of chest image is characterized by a loss of detail and much noises, in using fuzzy logic, each pixel of chest image shows the detail preservation and little noise.

A Modified Technique for the Correction of Funnel Chest (함몰흉 교정의 변형수기)

  • 이상호
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.806-811
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    • 2000
  • Background : The authors have modified the method of Ravitch technique. Material and Method ; This technique was applied to 6 patients out of 18 patients who underwent corrective surgery from May 1987 to July 1999. The technique is quite different from that of Ravitch. We did not divide the intercostal muscle bundles from the laterals of sternum and the Akin's struts were placed retrosternally crossing the chest horizontally to prevent flail motion during immediate post-operative period and retraction of the sternum afterwards. Anterior sternal osteotomy instead of the posterior one was performed for the latest 3 cases which made operative procedure more simple and easy. The struts were removed one year later. Result : Compared to the hospital stay of the patients who received standard Ravitch method that of the six cases who received our modification was definitely shortened from 13.1 days to 8.3 days(p<0.0000). Flail motion was not noted in any patient and chest wall stability was obtained more easily with this technique. Conclusion : Our modification is recommendable for correction of funnel chest in regards to shorter operation time better chest wall stability shorter hospital stay and less complication.

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One Case of Surgical Treatment for Chylothorax following Closed Thoracic Injury (폐쇄성 흉부손상후 발생한 유미흉 1례 보고)

  • 정황규
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.379-382
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    • 1988
  • We have experienced a case of right side chylothorax following closed chest injury. A 35-year-old man in his car was accidentally collided against obstacles on September 19, 1986 resulting in a contusion on right anterior chest wall. The only complaint noted on admission was right chest pain. Chest X-ray showed near total radiopaque density of right thorax. Conservative treatment of closed tube thoracostomy at right pleural cavity through midaxillary 7th intercostal space had been continued for 25 days without improvement. Chyle outflow through the chest tube was averaging 1,700cc per day. Oversewing of the thoracic duct and pleura by silk and pledgetted prolene sutures were done. There was no complication and recurrence till postoperative 20 days. Chylothorax following closed chest injury was never reported in this country, and will be a interesting clinical case report.

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