scholarly journals A bimodal approach to thymic carcinoma with pericardial sac invasion

2019 ◽  
Vol 12 (3) ◽  
pp. e229136
Author(s):  
Adnan Ahmed ◽  
Sarthak Soin ◽  
Sabah Patel
Keyword(s):  
Thymic Carcinoma ◽  
Radiation Treatment ◽  
Upper Airway ◽  
Disease Status ◽  
Treatment Modalities ◽  
Rare Tumour ◽  
X Ray ◽  
Tumour Extension ◽  
Facial Swelling ◽  
Chest X Ray

Thymic carcinoma is a rare tumour of the thymus, representing less than 1% of thymic malignancies. 1 It has an annual incidence of 0.15–0.32 per 1 00 000 person-years. 2 It is found incidentally in 30% of the patients as an opacity on chest X-ray or with non-specific complaints of persistent cough, chest pain, fatigue, shortness of breath, arm and facial swelling, and upper airway congestion related to tumour extension. We present the case of a 59-year-old man with a history of Graves’ disease status post radiation treatment presenting with cough and left lingual opacity on chest X-ray, confirmed to be thymic carcinoma with pericardial invasion and lymph node metastasis. We aim to discuss the presentation, treatment modalities and outcome associated with this rare tumour.

scholarly journals 806. 2013–2015 Nationwide Tuberculosis Contact Investigation in Childcare Centers and Schools in Korea

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S289-S289
Author(s):  
Woosuck Suh ◽  
Jong-Hyun Kim ◽  
Ji Hyen Hwang ◽  
Sodam Lee ◽  
Kang-Hee Lee ◽  
...  
Keyword(s):  
School Setting ◽  
Age Groups ◽  
Disease Status ◽  
Childcare Centers ◽  
X Ray ◽  
Contact Investigation ◽  
Chest X Ray ◽  
Latent Tb ◽  
The Republic ◽  
Latent Tb Infection

Abstract Background The Republic of Korea has the highest incidence rate of tuberculosis (TB) among members of the OECD, reported as 78.8/100,000 population in 2016. In response, a state-run intensive contact investigation for TB is being conducted. More effective TB control requires an epidemiologic emphasis on the diagnosis and treatment of latent TB infections in children and adolescents, compared with other age groups. Here we present an analysis of data from the childcare center and school contact investigation by the Korea Centers for Disease Control and Prevention (CDC) in 2013–2015. Methods Data collected from index patients included age, sex, occupation, disease status, results of AFB smear/culture, and chest x-ray. Data collected from contacts included age, sex, results of serial tuberculin skin test (TST), and chest x-ray. Congregate settings included childcare centers, kindergartens, elementary and secondary schools, and age groups were stratified as follows: 0–4 years, 5–12 years, and 13–18 years. TSTs were considered positive if induration ≥10 mm on the first test (TST1) or demonstrated an increase ≥6 mm over the induration of TST1 on repeat testing after 8 weeks (TST2). Results Of the 197,801 subjects with data collected, 173,998 were eligible and included in our analysis. TST1 results were available for 159,346 (91.6%) and when results were positive, induration was 10–14 mm in 7.6% and ≥15 mm in 1.5%. TST2 results were available for 119,797 (82.7%) of the 144,904 with negative TST1, and conversion rate was 9.0%. Altogether considering TST1 and TST2, 17.3% contacts had latent TB infections. Positive rates of TST significantly decreased with age: 20.3% in 0–4 years, 18.8% in 5–12 years, 17.1% in 13–18 years. Conclusion In this 3-year school-setting contact investigation, 17.3% contacts were diagnosed with latent TB infection, as demonstrated by TST reactions. Positive rates of TST significantly but mildly decreased with age. Disclosures All authors: No reported disclosures.

scholarly journals Ekstraksi Benda Asing pada Kavum Nasi Melalui Bronkoskopi

2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Upper Airway ◽  
The United States ◽  
Foreign Body Aspiration ◽  
Lower Airway ◽  
X Ray ◽  
Tracheobronchial Foreign Body ◽  
Chest X Ray ◽  
The Right

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.

scholarly journals Delayed Upper-Airway Injury after Accidental Alkaline Ingestion

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Matthew F. Ryan ◽  
Mindy Fernandez ◽  
Karen Laauwe
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Upper Airway ◽  
Acute Injury ◽  
Upper Endoscopy ◽  
Shortness Of Breath ◽  
X Ray ◽  
Airway Injury ◽  
Chest X Ray ◽  
Alkaline Cleaning

A 62-year-old man presented to the emergency department one week after accidentally drinking an alkaline cleaning agent stored in unlabeled bottle. The day of the incident the patient presented to an outside hospital where he was admitted for an upper endoscopy of the esophagus which was found to be negative for acute injury. An initial chest X-ray taken the day of the incident was also found to be normal. After discharge the patient continued to have a sore throat and marked dysphagia which caused him to vomit repeatedly. Moreover, the patient began to develop chest pain with associated shortness of breath. We present a case of delayed airway injury and tracheal thickening and associated chest pain after alkaline ingestion and we discuss herein the pathophysiology and management of alkaline ingestions.

Lund–Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients

2019 ◽  
Vol 33 (3) ◽  
pp. 294-301 ◽  
Author(s):  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Takaya Higaki ◽  
Tomoyasu Tachibana ◽  
Toru Rikimaru ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Function ◽  
Pulmonary Function ◽  
Paranasal Sinus ◽  
Chronic Cough ◽  
Eosinophil Count ◽  
Upper Airway ◽  
Peripheral Blood Eosinophil ◽  
X Ray ◽  
Chest X Ray

Background A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined. Objective The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities. Methods A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund–Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms. Results The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV1.0) and the FEV1.0/forced vital capacity ratio negatively correlated with Lund–Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count. Conclusion The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund–Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.

scholarly journals Deep learning-based chest X-ray age serves as a novel biomarker for cardiovascular aging

2021 ◽  
Author(s):  
Hirotaka Ieki ◽  
Kaoru Ito ◽  
Mike Saji ◽  
Rei Kawakami ◽  
Yuji Nagatomo ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Performance ◽  
Deep Neural Network ◽  
Disease Status ◽  
Sex Estimation ◽  
X Ray ◽  
Chest X Ray ◽  
Cardiovascular Aging ◽  
The Difference ◽  
Age And Sex

AbstractChest X-ray (CXR) is one of the most commonly performed medical imaging tests. Although aging, sex and disease status have been known to cause changes in CXR findings, the extent of these effects has not been fully characterized. Here, we present a deep neural network (DNN) model trained using more than 100,000 CXRs to estimate the patient’s age and sex solely from CXRs. Our DNN exhibited high performance in terms of estimating age and sex, with Pearson’s correlation coefficient between the actual and estimated age of above 0.9 and an area under the ROC curve of 0.98 for sex estimation. The difference between the actual and estimated age is large in CXRs with abnormal findings, suggesting that the estimated age (“CXR age”) can be a biomarker for disease status. Furthermore, by applying our DNN to CXRs of consecutive 1,562 hospitalized heart failure patients, we demonstrated that an elevated CXR age is not only associated with aging-related diseases, such as hypertension and atrial fibrillation, but also a worse outcome of heart failure. Given these results, our new concept “CXR age” serves as a novel biomarker for cardiovascular aging and can help clinicians to predict, prevent, and manage cardiovascular diseases.

scholarly journals Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity

Blood ◽  
1981 ◽  
Vol 57 (1) ◽  
pp. 90-94 ◽  
Author(s):  
BW Dana ◽  
BG Durie ◽  
RF White ◽  
DW Huestis
Keyword(s):  
Amphotericin B ◽  
Pulmonary Toxicity ◽  
Disease Status ◽  
Concomitant Administration ◽  
Control Group ◽  
Concomitant Therapy ◽  
X Ray ◽  
Chest X Ray ◽  
Neutropenic Patients ◽  
Indication For Treatment

Abstract One hundred and ninety-five series of granulocyte transfusions in 144 patients were evaluated with respect to possible severe pulmonary toxicity from concomitant administration of granulocytes and amphotericin B. Dyspnea as a side effect of granulocyte transfusion was equally common among patients receiving amphotericin B and those in a matched control group not receiving amphotericin B. Granulocyte transfusions and amphotericin B were given simultaneously in 35 transfusion series, involving 32 patients. Respiratory deterioration, defined as the appearance of new pulmonary infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients developing respiratory deterioration were similar to those not developing respiratory deterioration in age, diagnosis, disease status, duration of concomitant therapy, and outcome, but more often had positive fungal cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8 patients, the episodes of respiratory deterioration were readily explained by congestive heart failure, by simultaneous bacteremia or fungemia, or by fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin reaction (responsive to steroids) and the other 2 had unexplained, but reversible respiratory deterioration. We concluded that concomitant administration of granulocyte transfusions and amphotericin B is not associated with unexpected or rapidly fatal pulmonary toxicity and when appropriate, can be safely accomplished.

scholarly journals Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity

Blood ◽  
1981 ◽  
Vol 57 (1) ◽  
pp. 90-94 ◽  
Author(s):  
BW Dana ◽  
BG Durie ◽  
RF White ◽  
DW Huestis
Keyword(s):  
Amphotericin B ◽  
Pulmonary Toxicity ◽  
Disease Status ◽  
Concomitant Administration ◽  
Control Group ◽  
Concomitant Therapy ◽  
X Ray ◽  
Chest X Ray ◽  
Neutropenic Patients ◽  
Indication For Treatment

One hundred and ninety-five series of granulocyte transfusions in 144 patients were evaluated with respect to possible severe pulmonary toxicity from concomitant administration of granulocytes and amphotericin B. Dyspnea as a side effect of granulocyte transfusion was equally common among patients receiving amphotericin B and those in a matched control group not receiving amphotericin B. Granulocyte transfusions and amphotericin B were given simultaneously in 35 transfusion series, involving 32 patients. Respiratory deterioration, defined as the appearance of new pulmonary infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients developing respiratory deterioration were similar to those not developing respiratory deterioration in age, diagnosis, disease status, duration of concomitant therapy, and outcome, but more often had positive fungal cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8 patients, the episodes of respiratory deterioration were readily explained by congestive heart failure, by simultaneous bacteremia or fungemia, or by fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin reaction (responsive to steroids) and the other 2 had unexplained, but reversible respiratory deterioration. We concluded that concomitant administration of granulocyte transfusions and amphotericin B is not associated with unexpected or rapidly fatal pulmonary toxicity and when appropriate, can be safely accomplished.

scholarly journals Have You Seen My Teeth? A Case with an Extraordinary Radiologic Finding

2016 ◽  
Vol 02 (01) ◽  
pp. e49-e50 ◽  
Author(s):  
Serdar Evman ◽  
Yelda Tezel ◽  
Melis Evman ◽  
Çagatay Tezel
Keyword(s):  
Emergency Department ◽  
Main Bronchus ◽  
Upper Airway ◽  
Rigid Bronchoscopy ◽  
Acute Dyspnea ◽  
Radiologic Finding ◽  
Partial Obstruction ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

A 55-year-old man was admitted to the emergency department with severe dyspnea and hoarseness, starting immediately after a hypotensive syncope attack at home. Pulmonary auscultation revealed generalized stridor and right-sided wheezing, with no finding in the upper airway on direct laryngoscopy. Chest X-ray and computed thorax tomography revealed a high-density foreign body on the carina, causing partial obstruction in the right main bronchus. The fractured dental plate, probably aspirated during the syncope attack, was successfully removed by rigid bronchoscopy. The postoperative period was uneventful and the patient was discharged on the same day. Rapid physical and radiologic examination of patients with severe acute dyspnea is vital for determining the treatment modality and preventing any potential mortality.

Adolescent with facial swelling

2019 ◽  
pp. edpract-2019-317654
Author(s):  
Wen Shen Looi ◽  
Si Hui Goh ◽  
Colin Jingxian Tan ◽  
Kheng Wei Yeoh ◽  
Michaela Su-Fern Seng
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Vital Signs ◽  
List Type ◽  
X Ray ◽  
Normal Limits ◽  
Facial Swelling ◽  
The Face ◽  
Vena Cava Syndrome ◽  
Chest X Ray

BackgroundA previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).Figure 1(A) Patient before the onset of symptoms. (B) Patient at presentation.QuestionsWhat is the most likely diagnosis?Superior vena cava syndromeAngioedemaAnasarcaDiphtheriaDescribe the chest X-ray (figure 2).What are the acute concerns?What investigations would you order?Figure 2Chest X-ray of the patient at presentation.Answers can be found on page 02.

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