• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.525-532
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• 2018

This study is filmed by applying the axial angle variation of the X-ray tube instead of the patient's position change during the perimetric examination of the ribs. A Reference image with the rib oblique examination using a chest phantom and experimental images applied with a six-phase variation in the axial angle by increasing $5^{\circ}$ tube angle each from $5^{\circ}{\sim}30^{\circ}$ from the vertical incident direction of the chest phantom to the right horizontal axis were obtained. For the quantitative comparative evaluation of the images, SNR and CNR were calculated for regions of interest in the experimental images based on the reference image. Also, the left-right rib ratio in the reference image and the left-right rib ratio in the experimental images are measured and compared. As a result of the study, the experimental images with a tube angle of $25^{\circ}$ were best shown in the measurements of the SNR, CNR and left-right rib ratio compared to the reference image with a standard examination method. The modified rib examinations will consider useful, if it is difficult to maintain the patient's examination position.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.750-759
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• 1986

Spontaneous pneumothorax is usually seen in young adult male. And typically, the patient is a tall, thin, 20- to 30-year-old male. Usually the pneumothorax results from rupture of a pulmonary bleb. Author reviewed 66 cases of spontaneous pneumothorax experienced in the Dept. of Thoracic & Cardiovascular Surgery, Pusan National University Hospital, since Jan., 1980 to Aug., 1986. The clinical data were summarized as follows: 1. The age distribution of spontaneous pneumothorax: 17 to 34 years old and mean age was 25.3 years. 2. The sex distribution of spontaneous pneumothorax: 52 in men, 14 in women and the ratio was 3.7:1. 3. Chest dimension in male patients: Maximum posteroanterior distance [MPA], MPA/Maximum width [MW]: Significantly smaller than control group. Distance from second to tenth rib on left [L2-10], Distance from second rib on right to diaphragm [R2-D], R2-D/MW: Significantly larger than control group. 4. Chest dimension in female patients: MPA, MW: Significantly smaller than control group. Distance from second rib on left to diaphragm [L2-D], Distance from second to tenth rib on right [R2-10], R2-D, L2-10/MW, L2-D/MW, R2-10/MW, R2-D/MW: Significantly larger than control group.

• Tuberculosis and Respiratory Diseases
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• v.48 no.1
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• pp.45-53
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• 2000

Background: The literature on variations of rib is limited. Very little has been written in the radiological journal of this country on the subject. It seemed of interest to investigate the nature and incidence of congenital variations in a series of routine chest roentgenograms. The topic of rib variations has not been covered extensively in the radiological journals in Korea. This has presented an opportunity to investigate the nature, type, shape and incidences of congenital rib variations in normal Korean adults from a series of routine roentgenograms. Methods: Chest radiographs of 5,000 adults, who visited our hospital for a routine check-up or for employment physical examinations from January 1996 to September 1998, were consecutively reviewed. The sex distribution consisted of 2,827 male males and 2,173 female females(ratio of 1.3:1) with the age range aged between 19 and 65 years(mean age: 34.6 years) were included. The chest PAs were analyzed for the presence, type, location, and shape of the rib variations. From this data the incidence of each type of variations was calculated. Results: Seventy-six of the 5,000 adults(1.52%), 63 male(2.23%) and 13 female(0.6%), showed 88 cases of rib variation(Table 1). The most common variation was the bifid rib(n=35), followed by hypoplasia of the rib(n=22), flaring of the rib(n=18), bridging of the ribs(n=7), cervical ribs(n=3), and fusion of between ribs(n=3)(Table 2). The bifid rib(Table 1) was found most frequent in the right fourth rib(12/35, 34.3%), followed by the left fifth rib(6/35, 17.1%) and right third rib(6/35, 17.1%). Hypoplasia of the rib was common in first rib(20/22, 90.9%). Flaring of the rib was common at fourth rib(8/18, 44.4%, right and left combined), and bridging between ribs was common between first and second rib(3/7, 42.9%). Conclusion : The percentage of incidence of rib variations in adults was 1.52%. Bifid rib was the most common variation, followed by hypoplasia, flaring, bridging, cervical rib, and fusion of ribs, in decreasing order.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.944-949
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• 1993

Clinical analysis were performed on 247 cases of thoracic trauma, those were admitted & treated at the department of thoracic & cardiovascular surgery,Hanyang University Hospital during the period from Jan,1989 to June,1992. Age distribution of those was from 2 to 80 years old & mean age was 38 years old. The ratio of male to female patient was 186:61 [3:1].This ratio revealed high incidence in male patient. The most common cause of trauma was traffic accident in this series.The modes of injury were as follows: traffic accident 124 cases[50.2%],fall down 52 cases[21.05%], stab wound 47 cases[19.03%] and gun-shut wound 1 case.Ellapse time from accident to admission were 141 cases [57.09%] under 6 hr.Rib fracture were observed in 159 cases[64.37%], hemo or pneumothorax were observed 134 cases[54.25%] of total cases and location distributed Right:Left:Both[74:112:37], in left predominant. Conservative,non-operative treatment were performed in 128 cases and operation[open thoracotomy] 32 cases.Mortality was 1.6%[4 cases] & most common cause of death were due to irreversible shock with brain edema. Conclusively, more evaluation & co-operation of other department were expected treatment & better prognosis.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.111-121
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• 1985

A clinical analysis was performed on 312 cases of the chest trauma experienced at department of thoracic surgery, Chosun University Hospital during the past 6 years 10 months period from January 1978 to October 1984. 1. The ratio of male to female patient of the chest trauma was 3.1:1 in male predominance and age from 20 to 50 occupied 71.2% of the total cases. 2. The most common cause of the chest trauma was traffic accidents [45.5%] in this series. 244 cases [78.2%]were injured due to non-penetrating injuries and the remainders [68 cases, 21.8%] were injured due to penetrating injuries. 3. The frequently injured site of the chest trauma was left side of the chest [56.4%], the right side was 33% and the both side was 10.6%. 4. The most common symptoms were chest pain and dyspnea, and common signs were diminished breathing sound and subcutaneous emphysema. 5. The Hemothorax, Pneumothorax, Hemopneumothorax, and Hemopericardium were observed in 190 cases [60.9%] of the total cases, and etiologic distribution revealed 76.5% due to penetrating injuries and 56.6% due to non-penetrating injuries. 6. The rib fractures were observed in 210 cases [67.3%] of the total cases and the most common site of the rib fracture was 6th rib 140 cases [19.2%]. The common site of the rib fracture was from 4th rib to 7th rib [63.8%]. 7. The lung injuries were observed in 150 cases [48.1%] and the other organ injuries were observed in 260 cases [83.3%]. 8. Conservative treatment including thoracentesis were performed in 153 cases [49.1%], Closed thoracotomy with water seal drainage were performed in 112 cases [35.9%], and open thoracotomy were performed in 45 cases [14.4%]. 9. The complications of the chest trauma were developed in 63 cases [20.2%] and the common complications were atelectasis, wound infection and pneumonitis etc. 10. Overall mortality was 0.96% [3 cases] and the cause of death was bacteremia, hypovolemic shock, heart failure and pulmonary edema.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.715-722
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• 1987

A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1213-1220
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• 1990

During the period of January 1979 to December 1988, 220 patients with empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School Hospital. There were 167 males[75.9%] and 53 females[24.1%] ranging from 18 days to 76 years of age. Occurrence ratio of left and right empyema was 1 : 1.9. The underlying pathologic lesions of empyema were pneumonia[30.9%], pulmonary tuberculosis[22.7%], chest trauma[8.6%] and postoperative complications. In bacteriologic study, staphylococcus, pseudomonas and streptococcus accounted for 26.4%, 11.8% and 9% respectively, and 25% were not identified. Surgical treatment modalities were thoracentesis[10 patients, 4.5%], closed thoracostomy[132, 60%], closed rib resection drainage[4.2, 6%], modified Eloesser’s operation[37, 16.8%], decortication[27, 12.3%], decortication with pulmonary resection[6, 2.7%], thoracoplasty[2, 0.9%], muscle flap closure [1, 0.5%], and staged pneumonectomy[1, 0.5%], The mortality rate was 2.3% and the complications were sepsis[9 patients]. acute renal failure[4], and paralytic ileus[3].

• Journal of Chest Surgery
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• v.29 no.1
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• pp.79-85
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• 1996

A clinical evaluation was performed on 305 cases of chest trauma experienced at the department of the Thoracic and Cardiovascular Surgery, Dae Jeon Eul Ji Hospital, during the period from March 1991 to November 1994. Age distribution was from 4 to 85 years, the mosts common age groups were 4-th, 5th and 6th decades. The ratio of male to female was 229:76(3:1), the ratio showed male predominance, the most common cause of trauma was traffic accidents in nonpenetrating trauma and stab wounds in penetrating trauma. Hemothorax, pneumothorax, and hemopneumothorax were observed in 159 cases (52.1 %) of total cases, Rib fracture was observed in 236 cases (77.4%) of total cases, location distribution was right : left : Both (102 : 142 : 45), with left predominant, rib fracture commonly involved from the 3th to 8th rib. Lag period from accident to admission was 155 cases (50.8%) under 6hr The principles of therapy for early complications of chest trauma were rapid r expansion of the lungs by thoracentesis 5 cases(1.6%) and closed thoracostomy 1-42 cases(46.6%), but open thoracotomy had to be done on 17 cases (5.6%) because of massive bleeding 13 cases or ruptured diaphragm, foreign body. Conservative nonoperative treatment was 140 cases (45.9%). Overall mortality rate was Bcases (2.6%) and common causes of the death were respiratory insufficiency and shock.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.37-44
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• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.205-213
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• 1977

In order to evaluate the therapeutic effect of thoracostomy on the patients with pathological changes in pleural cavity which were caused by various etiological factors, a clinical study was carried out during a period of 5 and half years from May 1972 to September 1977 in the department of thoracic surgery, Hanyang University Hospital, and the following results were obtained. Of a total of 264 patients, 205 cases were male, and 59 female, exhibiting the ratio of male to female being 3.5 to 1. The pathological changes in pleural cavity could occur at any age from 4 months after birth to 76 years old, the peak incidence being in the third decade in either male or female. The incidence decreased in the second, fifth and fourth decade in order. The type of pathological changes observed and their frequencies of occurrences were 93 cases [35.2%] in pneumothorax, 62 cases [23.5%] in hemothorax, 48 cases [18.2%] in pyothorax, 46 cases [17. 4%] in hemopneumothorax, 13 cases [4.9%] in hydropneumothorax, and one case each in hydrothorax and chylothorax. The incidence of the primary diseases which predisposed the pathological changes in pleural cavity were, 119 cases [45-1%] in trauma, 64 cases [24.2%]in lung tuberculosis, 38 cases [14.4%] in pneumonia or empyema, 14 cases [5.3%] in lung emphysema and blebs, 13 cases [4.9%] in process after thoracotomy, 3 cases [1.1%] each in lung malignant tumor and lung paragonimiasis, one case in mechanical ventilator and 9 cases [3.4%] in unknown origin. The pathological changes in pleural cavity were located in the right side of the cavity in 124 cases, in the left side in 133 cases and in both sides in 7 cases, indicating that the difference between the incidence of the left and rightside occurences was insignificant. Of 93 cases of pneumothorax studied, 63 cases were found to have been tension pneumothorax and 30 cases non-tension pneumothorax, showing greater prevalence of tension type over non-tension type. Of 119 cases of trauma observed, 82 cases were accompanied with rib fractures and 37 cases were without any fracture [non-bone fracture]. Patients with the rib fractures were characterized by multiple rib fractures and multiple double fractures of ribs, accompanying with or without fracture of bones other than ribs, and patients with non-bone fracture were characterized by penetrating stab wound and blunt trauma. Of 264 cases who received thoracostomy, 207 cases [78.4%] demonstrated that their pathological changes in pleural cavity were removed and subsided by a simple measure of thoracostomy. In 43 cases [16.3%], various surgical measures including radical operation and thoracotomy were required for complete healing, since their pathological changes were not abolished by thoracostomy alone. The rest 14 cases [5.3%] were expired following thoracostomy.