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50 NORTH CAROLINA MEDICAL JOURNAL February, 1944 Fig. 1 rests. Fluoroscopic examination of the chest, except where there is fairly marked compression of the lung, cannot be relied upon for diagnosis; for small areas of collapse, particularly over the apex, will be overlooked. Indeed, even in the x-ray photograph such areas may be difficult to find, and the radiographs should be taken with considerable care. Fluoroscopic examination is helpful in following the progress of a patient with spontaneous pneumothorax; and frequently by having the patient exhale and cough one will be able to detect the presence of a small apical collapse which otherwise might not have been noted. When the lung is put into motion by coughing, the margin may be seen more easily. The intracutaneous injecton of 1/10 cc. of Koch's old tuberculin should be done as soon as the diagnosis of pneumothorax is established. If the reaction is negative, that is sufficient evidence that the pneumothorax is non-tuberculous. A positive test, however, does not establish the diagnosis of tuberculosis; for in our experience the percentage of positive reactors is approximately the same that one would normally expect to find in this age group. Among the 16 patients on whom we had records of intracutaneous tuberculin tests prior to the onset of pneumothorax, 7 were negative and 9 were positive. All the patients with previous positive Fig. 2 reactions had been given an x-ray examination, which had been reported as negative for active tuberculosis. Radiographs of the chests of all our patients failed to show any evidence of active tuberculosis after the lung had completely re-expanded. All except 2 patients showed in the beginning a small collection of fluid at the costophrenic angle which disappeared as the patient improved and the lung re-expanded. One patient developed a large collection of fluid which required thoracentesis. This fluid was a light straw color in appearance and contained many red blood cells and white blood cells. Guinea-pig hioculation and cultures of this fluid were negative. Seventeen patients were afebrile throughout their hospital stay. Three showed slight elevations of temperature, which ranged at times as high as 101 F. In one of these cases the fever was due to a coincident acute upper respiratory infection; in another it was due to the large collection of fluid; and in the third it was unexplained. In 12 cases the pneumothorax occurred on the right side, and in 8 on the left. Two patients had chronic bronchial asthma. The average period of hospital confinement was fourteen days. This figure includes a hospital stay of forty-four days for one patient whose pneumothorax had completely disappeared at the end of the first ten days, but who was kept
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1944 |
Identifier | NCHH-17-005 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 5 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-005.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-005 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 50 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1944 |
Identifier | NCHH-17-005-0058 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed51944medi_0058.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 5 |
Issue Number | 2 |
Page Number | 50 |
Health Discipline | Medicine |
Full Text | 50 NORTH CAROLINA MEDICAL JOURNAL February, 1944 Fig. 1 rests. Fluoroscopic examination of the chest, except where there is fairly marked compression of the lung, cannot be relied upon for diagnosis; for small areas of collapse, particularly over the apex, will be overlooked. Indeed, even in the x-ray photograph such areas may be difficult to find, and the radiographs should be taken with considerable care. Fluoroscopic examination is helpful in following the progress of a patient with spontaneous pneumothorax; and frequently by having the patient exhale and cough one will be able to detect the presence of a small apical collapse which otherwise might not have been noted. When the lung is put into motion by coughing, the margin may be seen more easily. The intracutaneous injecton of 1/10 cc. of Koch's old tuberculin should be done as soon as the diagnosis of pneumothorax is established. If the reaction is negative, that is sufficient evidence that the pneumothorax is non-tuberculous. A positive test, however, does not establish the diagnosis of tuberculosis; for in our experience the percentage of positive reactors is approximately the same that one would normally expect to find in this age group. Among the 16 patients on whom we had records of intracutaneous tuberculin tests prior to the onset of pneumothorax, 7 were negative and 9 were positive. All the patients with previous positive Fig. 2 reactions had been given an x-ray examination, which had been reported as negative for active tuberculosis. Radiographs of the chests of all our patients failed to show any evidence of active tuberculosis after the lung had completely re-expanded. All except 2 patients showed in the beginning a small collection of fluid at the costophrenic angle which disappeared as the patient improved and the lung re-expanded. One patient developed a large collection of fluid which required thoracentesis. This fluid was a light straw color in appearance and contained many red blood cells and white blood cells. Guinea-pig hioculation and cultures of this fluid were negative. Seventeen patients were afebrile throughout their hospital stay. Three showed slight elevations of temperature, which ranged at times as high as 101 F. In one of these cases the fever was due to a coincident acute upper respiratory infection; in another it was due to the large collection of fluid; and in the third it was unexplained. In 12 cases the pneumothorax occurred on the right side, and in 8 on the left. Two patients had chronic bronchial asthma. The average period of hospital confinement was fourteen days. This figure includes a hospital stay of forty-four days for one patient whose pneumothorax had completely disappeared at the end of the first ten days, but who was kept |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-005.pdf |
Document Sort | all; nchh-17 |
Article Title | Spontaneous Pneumothorax: Diagnosis And Prognosis |
Article Author | E. Mcg. Hedgpeth; W. R. Berryhill; W. G. Morgan; Robert E. Stone; F. G. Patterson; Ruby A. Smith |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-005 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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