• Title/Summary/Keyword: Chest decubitus

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A Study on Change Image According to Recumbent Position Holding Time for Patient Safety (In Chest Lateral Decubitus Examination) (환자안전을 고려한 횡와위 유지시간에 따른 영상변화에 관한 연구 (흉부 측와위 촬영 시))

  • Kim, Ki-Jin;Jeong, Chang-Min;Yoo, Se-Jong;Choi, Won-Jin;Kim, Jeong-Ho
    • Journal of the Korea Safety Management & Science
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    • v.18 no.1
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    • pp.147-152
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    • 2016
  • Chest lateral decubitus is a chest examination to determine the persence of pleural fluid in thorax. In this study, we prepare recumbent holding position time standard of chest lateral decubitus. The records of 15 patients with chest lateral decubitus between May and Jun. Recumbent holding time is 30, 60, 90, 120, 180, 210, 240 seconds. The result is fluid level change between 0.88mm to 9.63. Fluid heigh change between 9.9 percent to 42.5 percent. We can confirm fluid level change with chest decubitus image. The proper time for fluid level change is 180 seconds.

Utility Comparison of Chest Lateral Decubitus Projection with AP and PA Position (흉부 측와위 촬영 시 전후방향과 후전방향 검사의 유용성 비교)

  • Choi, Guirack
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.233-238
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    • 2013
  • Chest lateral decubitus radiation exposure PA be carried out in general, but emergency patient or the patient's discomfort in the body examination had a lot of inconvenience. In this study, we compared AP and PA image quality, patient safety, and analysis of the examination effectiveness between the two tests was to evaluate the usefulness. Pleurisy or pneumothorax in patients with suspected or diagnosed chest lateral decubitus radiation exposure 30 consecutive patients (male 20 patients, 10 females) were included in the study. Image quality evaluation method microstructure of lung, wide areas of diagnosis, a clear air-fluid interface, the patient rotate, cardiac shadow and sharp diaphragmatic was based on Department of Radiology specialist, division of pulmonology resident blind test was evaluated by four people. Chest decubitus by radiation exposure the AP and PA position examination the usefulness of comparative analysis Image quality in the AP and PA, whereas there was no significant difference in attitude, Stability of the patient and Radiation's examination efficiency AP position compared to the position of PA scores were higher. PA position does not require a examination may be of AP position in a position to suggest that.

Evaluation on Organ Dose and Image Quality by Changing kVp and Ion Chamber Combination while Taking Digital Chest Lateral Decubitus PA Projection (디지털 흉부 측와위 후전방향 검사 시 Ion chamber조합 설정과 관전압 변화에 따른 장기선량 및 화질 평가)

  • Lee, Jin-Soo;Park, Hyong-Hu
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.316-323
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    • 2015
  • In this study, we analyzed radiation dose and MTF with setting of Ion chamber and changing kVp so that we are able to suggest acquiring optimized diagnostic images and minimizing patient dose. we assumed right lateral decubitus position among chest decubitus projection and set 7 combination of Ion chamber. By changing kVp(100, 110, 120, 130kVp), we exposed x-ray five times respectively and calculated average value after measuring entrance dose. we input the entrance dose value to PCXMC Monte carlo simulation tool and calculated organ dose and effective dose. Then we did physical image evaluation with MTF for the purpose to compare image quality. As a result, the high kVp, entrance dose is reduced. As change of ion chamber, when selecting second ion chamber, both organ dose and effective dose were the lowest. In contrast, selecting first ion chamber was the highest. MTF is superior to set second Ion chamber and using 120 kVp. Consequently, when taking chest right lateral decubitus using Digital radiography, the optimized combination which have both reducing dose efficiently without declining image quality and aquring good qualified image is set 120 kVp and selecting second Ion chamber.

A Case of Pleural Effusion Associated with Acute Hepatits A (A형 간염에 동반된 흉막 삼출 1예)

  • Kim, Dong Il;Park, Jae Ock;Kim, Chang Hwi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.243-246
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    • 2005
  • Pleural effusion represents a rare complication of acute hepatitis A infection. Twelve year-old girl was admitted with complaints of general weakness, nausea and icteric sclerae. She also complained of right chest pain. Right decubitus view of chest radiograph showed pleural fluid accumulation. Laboratory findings were as follows: AST/ALT 1692/1970 IU/L, total/direct bilirubin 4.48/3.66 mg/dL and HA IgM Ab (+). On the seventh day of hospitalization, her general condition was much improved and chest radiography showed resolved pleural effusion.

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Video-Assisted Thoracic Surgery Esophagectomy

  • Park, Seong Yong
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.279-285
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    • 2021
  • Thoracoscopic esophagectomy for esophageal cancer can be performed in multiple positions, such as the lateral decubitus position or prone position, using various techniques. Each approach has its own advantages and disadvantages, and surgeons can select an appropriate approach based on their preferences. Except for the reduction of pulmonary complications, the benefits of thoracoscopic esophagectomy, including oncologic outcomes, have not been proven scientifically. This review describes the approaches and procedures of thoracoscopic esophagectomy and presents scientific evidence for this procedure.

Traumatic Cervical Spinal Cord Injury Patient with Jejunal Perforation (외상성 경부 척수 손상 환자에서 동반된 소장 천공 : 증례보고)

  • Go, Seung Je;Yoon, Jeung Seuk;Yun, Jung Ho
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.319-322
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    • 2013
  • A 66 year-old woman had cervical spinal cord injury by an automobile. We performed emergency operation for partial quadriplegia. She recovered from motor weakness gradually, but complained of abdominal distension and mild dyspnea. A physical examination of her abdomen did not have tenderness and rebound tenderness. She underwent a decubitus view of chest X-ray due to aggravated dyspnea at postoperative 4 days. We detected free air gas of abdomen and immediately identified a cause of pneumoperitoneum by abdominal computed tomography. We performed an emergent laparotomy and confirmed a jejunal perforation. After an operation, she recovered well and is under rehabilitation.

The Effect of Body Positioning on Physiologic Index in Patients with Unilateral Lung Disease (편측성 폐질환 환자의 체위변경이 생리적 지표에 미치는 영향)

  • Cho, Jee Yeon;Lee, Hyang Yeon
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.122-133
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    • 2000
  • The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

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A Case of Pulmonary Gangrene Associated with Obstructive Pneumonia Due to Non-small Cell Lung Carcinoma (위치에 따라 이동하는 종괴를 포함한 공동으로 진행된 비소세포폐암에 동반된 폐렴)

  • Kim, Sung-Jun;Um, Tae-Chan;Moon, Kwie-Ae;Kim, Phil-Ho;Kim, Sang-Hyun;Jeoung, Byung-Oh;Lee, Hyuk-Pyo;Kim, Joo-In;Yum, Ho-Kee;Choi, Soo-Jeon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.591-595
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    • 1999
  • Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has more extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular lymph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.

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Effect of Posture on the Distribution of Pulmonary Ventilation in Patients with Increased Closing volume (폐쇄용적(Closing Volume)이 증가된 만성 폐질환 환자에서 체위에 따른 폐환기량의 변화)

  • Kim, Young-Tae;Kim, Mee-Kyung;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Ryu, Jin-Sook;Lee, Myung-Hae;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.631-637
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    • 1993
  • Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.

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First Successful Dynamic Cardiomyoplasty in Korea (심근 성형술 1례 보고)

  • ;;;;;;;;Igor Dubrovski, Ph.D.
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.393-397
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    • 1998
  • A 25-year-old man with viral cardiomyopathy and chronic active hepatitis successfully underwent dynamic cardiomyoplasty for the first time in Korea on July 30, 1996. The patient had been intermittently dyspneic for 5 years and was admitted to our center twice because of heart failure. For the past 2 years, he was NYHA functional class III status with a left ventricular ejection fraction(LVEF) of around 30%. The patient was born with scoliosis and showed a short stature. The liver function showed elevated liver enzymes, and hepatitis B antigen was positive. The liver biopsy revealed chronic active hepatitis. The preoperative echocardiogram showed decreased left ventricular function with grade II mitral and grade II tricuspid regurgitation with dilated left and right atrium. Recently his symptoms worsened and we decided to perform a dynamic cardiomyoplasty. The left latissmus dorsi muscle(LDM) was mobilized and tested with lead placement on his right lateral decubitus position. The patient was positioned into supine and, after median sternotomy, the heart was wrapped with the mobilized muscle. The Russian made cardiomyostimulator(EKS-445) and leads (Myocardial PEMB for heart and PEMP-1 for LDM) were used. The total operation time was 8 hours and there were no perioperative episodes. Postoperatively the LDM had been trained for a 10 week period and currently the stimulation ratio is maintained at 1:4. The postoperative LVEF did not increase with the value of 30-35%. However, the patient feels better postoperatively with slightly increased activity.

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