Preferential Distribution of Lobar Emphysema and Atelectasis in Bronchopulmonary Dysplasia

PEDIATRICS ◽  
1979 ◽  
Vol 63 (1) ◽  
pp. 130-134
Author(s):  
Fergus M.B. Moylan ◽  
Daniel C. Shannon
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Lower Lobe ◽  
Preferential Distribution ◽  
Regional Lung Function ◽  
Regional Lung ◽  
Prolonged Apnea ◽  
Lobar Emphysema ◽  
The Right ◽  
Lost To Follow Up

The chest roentgenograms of 142 neonates who survived mechanical ventilation for respiratory distress syndrome (N = 99) and prolonged apnea (N = 43) were reviewed. Thirty-seven infants had bronchopulmonary dysplasia (BPD) and 17 of these developed lobar hyperinflation of the right lower lobe and collapse of the right upper lobe. Regional lung function was measured with a xenon 133 technique in three of these infants and in five other patients who either died or were lost to follow-up. All had BPD with right lower lobe overinflation. Ventilation was less in the lower regions than the upper regions bilaterally ( P <.001), indicating that the hyperinfiation of the lower lobes was not compensatory for upper lobe collapse but was due to emphysema. Mean regional perfusion was equal in the upper and lower regions of the chest. This preferential distribution of lobar emphysema and ipsilateral atelectasis in BPD tended to present and regress simultaneously, but in many infants it lasted as long as eight weeks. Only one infant with persistent atelectasis developed pneumonia. The best mode of therapy appears to be supportive.

Sight-threatening progressive corneo-scleral involvement in porphyria cutanea tarda

2021 ◽  
Vol 14 (10) ◽  
pp. e245160
Author(s):  
Sonali Prasad ◽  
Vidhata Vidhata ◽  
Subhash Prasad
Keyword(s):  
Porphyria Cutanea Tarda ◽  
Clinical Manifestations ◽  
Ocular Involvement ◽  
Slit Lamp ◽  
Uroporphyrinogen Decarboxylase ◽  
Progressive Loss ◽  
The Right ◽  
Lost To Follow Up ◽  
Test Serum

Porphyria cutanea tarda is the most common type of porphyria. It is associated with a deficiency of uroporphyrinogen decarboxylase enzyme responsible for heme synthesis. Clinical manifestations are predominantly dermatological and very rarely present with ocular involvement. Although scleral thinning in the interpalpebral area is a well-documented entity, sight-threatening corneal involvement is rarely described. We, herein report a case of a 58-year-old man who presented with ocular surface dryness, photophobia and mild redness. Slit-lamp biomicroscopy revealed corneo-scleral thinning in both eyes. The diagnosis was confirmed with a urine porphyrin test, serum iron and serum ferritin levels. We started him on conservative management after which he was lost to follow-up. He presented again after 6 years with total corneal opacification and progressive loss of vision in the right eye.

scholarly journals Adult Coats Disease Presenting as Subfoveal Nodule

2018 ◽  
Vol 9 (1) ◽  
pp. 232-237 ◽  
Author(s):  
Salim Z. Asaad ◽  
Nazimul Hussain
Keyword(s):  
Retinal Vessel ◽  
Fundus Fluorescein Angiography ◽  
The Third ◽  
Macular Lesion ◽  
Corrected Visual Acuity ◽  
Coats Disease ◽  
The Right ◽  
Lost To Follow Up ◽  
Best Corrected Visual Acuity

A 21-year-old female presented with decreased vision in the right eye. Best corrected visual acuity was 6/60 in the right eye and 6/6 in the left eye. Funduscopy of the right eye revealed a subfoveal nodule with surrounding exudates and temporal peripheral retinal vessel telangiectasia with exudation. The patient underwent retinal laser in the areas of telangiectatic vessels and capillary non-perfusion as seen on fundus fluorescein angiography. It was combined with an intravitreal injection of bevacizumab which was repeated twice at monthly intervals. The macular lesion and peripheral vessels along with subretinal exudates showed resolution during the course of treatment. However, the patient was lost to follow-up and returned 5 months later when examination revealed increased macular fibrosis. In the literature, the reported presentation of subfoveal nodule in Coats disease is during the first decade. It progresses to macular fibrosis within a few months. This case illustrates that subfoveal nodule before macular fibrosis in Coats disease may present later, even up to the third decade.

Phaeohyphomycotic osteomyelitis in the femur of a cat

2009 ◽  
Vol 11 (10) ◽  
pp. 878-880 ◽  
Author(s):  
Michal O. Hess
Keyword(s):  
Physical Examination ◽  
Distal Femur ◽  
Lytic Lesion ◽  
High Dose ◽  
Dimorphic Fungus ◽  
Cytological Examination ◽  
The Right ◽  
Lost To Follow Up ◽  
Deep Fungal Infection

A 4-month-old castrated male domestic shorthair cat was presented for a right hind leg lameness of 1-week duration. Physical examination revealed a painful swelling over the right distal femur. A radiograph of the right stifle revealed an extensive lytic lesion involving the distal metaphysis of the right femur. Cytological examination of a needle aspirate was consistent with a deep fungal infection. A pigmented dimorphic fungus was isolated in pure culture from a representative needle aspirate from the lesion. The patient improved substantially after 5 weeks of high-dose itraconazole therapy, although it was subsequently lost to follow-up.

scholarly journals Fatal congenital lobar emphysema in a puerpera: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanyi Gan ◽  
Liang Xia ◽  
Yushang Yang ◽  
Qiang Pu ◽  
Lunxu Liu
Keyword(s):  
Left Lung ◽  
Middle Lobe ◽  
Left Hemithorax ◽  
Recurrent Pneumonia ◽  
Mediastinal Shift ◽  
Life Threatening ◽  
Right Middle Lobe ◽  
Lobar Emphysema ◽  
The Right

Abstract Background Congenital lobal emphysema (CLE) is a developmental lung abnormality usually diagnosed in the neonatal period and is rarely observed in adults. Adults with CLE are usually asymptomatic and only a small fraction may present with coughing, recurrent pneumonia and respiratory distress. In imaging studies, the most frequently affected lobe of CLE is the left upper lobe, followed by the right middle lobe. However, multilobar involvement with severe mediastinal shift is extremely rare. Case presentation We report a case of fatal CLE in a 28-year-old puerpera with postpartum respiratory failure. Chest computed tomography (CT) revealed emphysema of the right upper, middle and lower lobes resulting in adjacent atelectasis. Hyperinflation of the right upper lobe crossed the midline, leading to a deviation of the mediastinal structure to the left hemithorax and severe compression of the left lung. Conclusions Early and timely diagnosis of CLE with routine follow-up is necessary for patients. CLE, especially with multilobar involvement or mediastinal shift, could be life-threatening and should be promptly and aggressively treated to prevent severe complications.

scholarly journals Result of the arc of movement of lower cervical spine after seven years of arthroplasty

2014 ◽  
Vol 13 (3) ◽  
pp. 185-187
Author(s):  
Luis Claudio de Velleca e Lima ◽  
Fernando Gritsch Sanchis
Keyword(s):  
Cervical Spine ◽  
Cervical Disc ◽  
Lower Cervical Spine ◽  
Lateral Bending ◽  
Disc Disease ◽  
Cervical Disc Replacement ◽  
The Right ◽  
Lost To Follow Up ◽  
Surgery Center

OBJECTIVE: To quantify the mobility of the lower cervical spine after seven years of total cervical disc replacement at two levels. METHOD: This clinical study was designed randomly and prospectively at the spine surgery center at the Hospital Nossa Senhora das Graças, in Canoas, RS-Brazil and at the Hospital Don João Becker, in Gravataí, RS-Brazil. Seventeen patients were included in the study that was designed to compare the data obtained from annual and sequential manner until the end of seven years. A comparison was made with the prior range of motion (ROM) of each patient. All patients were diagnosed with not tractable symptomatic cervical degenerative disc disease with two adjacent levels between C-3 and C-7. RESULTS: A total of patients underwent TDR in two levels and at the end of seven years, only one patient was lost to follow-up. The pre and postoperative ROM was the same in the first three years however after the fourth year there was a gradual decline with a loss of 12% of preoperative ROM in flexion, 21% in extension and 23% in the right and left lateral bending at the end of seven years. CONCLUSIONS: The clinical outcome of this study is evidence level IV in evaluating the ROM for Moby-C(r) for TDR in two adjacent levels at the lower cervical spine. These results show that the ROM is maintained during the first three years, gradually declining after that.

scholarly journals Meningococcal Pneumonia in a Young Healthy Male

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Abdullah M. Al Alawi
Keyword(s):  
Emergency Department ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
Cell Counts ◽  
History Of ◽  
Chest X Ray ◽  
White Blood Cell Counts ◽  
The Right ◽  
Local Guideline

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Laboratory analysis showed raised white blood cell counts and elevated inflammation markers. Chest X-ray showed right lower lobe consolidation. Intravenous(IV) ceftriaxone and doxycycline were started for the management of community-acquired pneumonia as per the local guideline. Later, on admission, blood culture was positive for Neisseria meningitidis (N. meningitidis). Ceftriaxone was continued for 4 days, and the patient was discharged while being on oral amoxicillin (1 gm TDS) for another 3 days. He remained well during the outpatient follow-up.

scholarly journals Chronic cough in a patient with stable ulcerative colitis: a rare but important extraintestinal manifestation of inflammatory bowel disease

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227066 ◽  
Author(s):  
Thomas Chad ◽  
Jeremy Brown
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Lower Lobe ◽  
Gas Transfer ◽  
Extraintestinal Manifestation ◽  
Sputum Production ◽  
Inflammatory Bowel ◽  
The Right

A 74-year-old woman presented to her general practitioner with cough and occasional sputum production. Having failed to respond to courses of antibiotics in the community, she was referred to the thoracic medicine clinic. High-resolution CT chest revealed cylindrical bronchiectasis predominantly in the right lower lobe. Lung function revealed preserved FEV1 and FVC but reduced gas transfer values. Bronchiectasis secondary to ulcerative colitis was diagnosed. Inhaled corticosteroid therapy was initiated, with good clinical response noted at 6 monthly follow-up. Remission was sustained with tapering of the steroid dose. Recognition of respiratory complications in cases of inflammatory bowel disease is likely still poor among clinicians. Although rare, a working knowledge of principles of investigation and management will aid timely diagnosis and treatment, potentially preventing progression of respiratory disease.

Metastatic Angiosarcoma Masquerading as Diffuse Pulmonary Hemorrhage

2001 ◽  
Vol 125 (12) ◽  
pp. 1562-1565
Author(s):  
Camilo Adem ◽  
Marie-Christine Aubry ◽  
Henry D. Tazelaar ◽  
Jeffrey L. Myers
Keyword(s):  
Differential Diagnosis ◽  
Soft Tissues ◽  
Pulmonary Hemorrhage ◽  
Additional Patient ◽  
Autopsy Examination ◽  
Vascular Channels ◽  
Clinical Considerations ◽  
The Right ◽  
Lost To Follow Up

Abstract Context.—Diffuse pulmonary hemorrhage is an uncommon presenting manifestation of angiosarcoma. Objective.—To review the clinical, radiologic, and pathologic findings of patients with metastatic angiosarcoma who presented with diffuse pulmonary hemorrhage. Design.—Patients fulfilling inclusion criteria were identified from the consultation files. Clinical and radiologic data were obtained from referring pathologists. Histologic slides were reviewed in all patients. Results.—Our patients included 6 men and 1 woman, aged 31 to 73 years; 4 patients were younger than 40 years. Six patients presented with hemoptysis, and all had diffuse abnormalities on radiographic studies. Clinical considerations prior to biopsy included pulmonary hemorrhage syndrome (n = 2), acute respiratory failure (n = 1), and infection (n = 1). Metastatic disease was included in the differential diagnosis in only 1 patient. None had a diagnosis of malignancy prior to lung biopsy. All biopsies showed hemorrhage associated with atypical epithelioid and spindle cells, forming anastomosing vascular channels, distributed along and within lymphatics and arteries. Neoplastic cells were immunoreactive for factor VIII–related protein or CD31 in all cases for which special stains were available. Three patients with complete follow-up died of their disease. Primary sites were discovered in all 3 patients who underwent autopsy examination. Two tumors arose in the heart and 1 in the pelvic soft tissues. One additional patient had a likely primary site identified in the right atrium by cardiac ultrasound and was subsequently lost to follow-up. Conclusion.—Angiosarcoma should be included in the differential diagnosis of diffuse pulmonary hemorrhage, especially in young adults.

scholarly journals Spontaneous Cataractous Lens Extrusion in a Patient with Corneal Melting

2020 ◽  
Vol 11 (2) ◽  
pp. 177-180
Author(s):  
Bader AlQahtani ◽  
Ahmad Abdelaal ◽  
Ehab Karamallah
Keyword(s):  
Corneal Vascularization ◽  
Surgery Patient ◽  
Body Sensation ◽  
Cataractous Lens ◽  
History Of ◽  
Compliance To Treatment ◽  
The Right ◽  
Lost To Follow Up ◽  
Corneal Melting

Purpose: The aim of this report is to describe an unusual case of cataractous lens extrusion through a diseased cornea in the absence of any history of trauma or surgery. Patient and Methods: An elderly female with a history of blepharitis, corneal vascularization, and scarring presented with foreign body sensation, mild ocular pain, and a brunescent cataractous lens extruding through an area of corneal melt of the right eye after being lost to follow-up. The patient was operated urgently and then referred to a specialized eye hospital for further management. Conclusion: In the setting of social neglect and poor compliance to treatment and appointments, consequences of common ophthalmic conditions can lead to serious vision and organ-threatening complications. These might require prompt medical and surgical attention.

scholarly journals Long-Term Follow-Up of Adamantinoma of the Tibia Complicated by Metastases and a Second Unrelated Primary Cancer: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Brendan R. Southam ◽  
Alvin H. Crawford ◽  
David A. Billmire ◽  
James Geller ◽  
Daniel Von Allmen ◽  
...  
Keyword(s):  
Inguinal Lymph Node ◽  
Lower Lobe ◽  
Wide Resection ◽  
Low Grade ◽  
Long Bones ◽  
Primary Cancer ◽  
Long Term Follow Up ◽  
The Right

Adamantinoma is a rare, low-grade malignant tumor of the bone which grows slowly and typically occurs in the diaphysis of long bones, particularly in the tibia. Adamantinomas have the potential for local recurrence and may metastasize to the lungs, lymph nodes, or bone. We report a case of a 14-year-old female with a tibial adamantinoma who underwent wide resection with limb salvage and has subsequently been followed up for 18 years. The patient went on to have both a local soft tissue recurrence 5 years after the resection and metastases to both an inguinal lymph node and the right lower lobe of the lung 8 years after that recurrence, all of which have been treated successfully with marginal resections. Unique to this case, the patient was also incidentally found to have chromophobe-type renal cell carcinoma when undergoing a partial nephrectomy to resect a presumed metastasis of her adamantinoma. Genetic testing has not revealed any known genetic predisposition to cancer.

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