Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumomediastinum cases admitted to our Respiratory Intensive Care Unit during the past 15 years are reviewed. After excluding secondary and iatrogenic pneumomediastinum, spontaneous pneumomediastinum was diagnosed in seven patients being all of them males. The causative conditions were status asthmaticus in four patients, intense cough in two and Valsalva manoeuver in one patient. The most frequent symptoms were dyspnea, chest pain and odynophagia. Subcutaneous emphysema appeared in six patients and there was associated pneumothorax in two cases. ECG was normal in six patients. All cases of spontaneous pneumomediastinum had a satisfactory evolution with conservative treatment resolving in four to eight days.
 ...
PMID:[Spontaneous pneumomediastinum in adults]. 227 Mar 26

A case of pneumatic esophageal rupture secondary to distension from compressed air was reported. The patient, a 69-year-old man who was repairing an automobile tire suddenly exploded. The blast was directed into the open mouth. He was admitted to our hospital 12 hours after the onset with the complaint of chest pain and dyspnea. Subcutaneous emphysema was seen in the neck. The chest roentgenogram revealed a partial right hydropneumothorax. The diagnosis of esophageal rupture was established by Gastrographin swallowing study. Operation was performed 46 hours after the onset. Primary closure of the middle thoracic esophagus was judged to be impossible because of a 6 cm longitudinal laceration with contaminated pyothorax. Thereafter, total esophagectomy was indicated. Esophageal reconstruction using the pediculated gastric tube was performed throughout the retrosternal route. The leakage of esophagogastrostomy in the cervical area occurred in early postoperative stage. Re-esophagogastrostomy was successfully carried out 6 weeks after the first surgery. He is uneventful 6 months after the operation. We have not found any reports of surgical cases with pneumatic esophageal rupture treated by this approach in the literature.
 ...
PMID:[A case of accidental pneumatic rupture of the esophagus]. 232 88

Two cases of spontaneous pneumomediastinum and subcutaneous emphysema were reported. The first cases was a 21-year-old man who had a past history of recurrent spontaneous pneumothorax. The second was a healthy 20-year-old man. They were admitted to our hospital because of dyspnea and chest pain, which occurred at or after vocal exercise for Xiao-lin Temple boxing. Physically, a mediastinal crunch on auscultation heard over the cardiac apex and the left sternal border (Hamman's sign) was recognized in the first case, and subcutaneous emphysema was palpated in both cases. The chest X-ray films revealed intramediastinal air and subcutaneous emphysema in both cases. We diagnosed these patients as spontaneous pneumomediastinum because of no underlying disease. This is a report of rare cases of spontaneous pneumomediastinum occurring at the same time, and one of the mechanism causing them was considered to be a sudden increase in intrathoracic pressure due to the vocal exercise of chinese boxing.
 ...
PMID:[Two cases of spontaneous pneumomediastinum due to Xiao-lin Temple boxing vocal exercise]. 235 76

Twenty-eight patients suffered 32 episodes of ALS (air leak syndrome) between 1974 and 1985 at the Department of Pediatrics of the National Minami-Fukuoka Chest Hospital. The highest incidence was observed between ten and twelve years of age and in the autumn. Their chief complaints were chest pain, sore throat and some pains in other parts. Pneumomediastinum associated with subcutaneous emphysema was observed in 50%; this was the most common type of ALS. Chest X-ray findings showed free air in the left mediastinum in 20 of 22 patients with pneumomediastinum. Free air in the left mediastinum is considered to be a diagnostic finding for ALS.
 ...
PMID:Air leak syndrome (ALS) as complication of asthma. 250 28

An alcoholic man with known reflux esophagitis and Barrett's esophagus developed fever, epigastric pain, subcutaneous crepitus, and leukocytosis from an esophageal perforation at a Barrett's ulcer. Possible risk factors for perforation in this patient included alcoholism, severe gastroesophageal reflux, corticosteroid therapy, noncompliance with antacid and H2 blocker therapy, and the presence of acid-secreting parietal cells in the Barrett's epithelium. Five cases of this complication have previously been reported in a review of the literature, which included 536 cases of Barrett's esophagus or esophageal perforation. This entity may present with a clinical triad of a patient (a) in acute distress with fever and epigastric or noncardiac chest pain and without signs of peritonitis, (b) with symptoms of or known gastroesophageal reflux, and (c) with chest examination revealing subcutaneous crepitus, or chest roentgenogram revealing subcutaneous emphysema, pneumomediastinum, or hydropneumothorax.
 ...
PMID:Esophageal perforation at a Barrett's ulcer. 258 67

Chemical pleurodesis induced with fibrin glue (fibrinogen 1.0 g, thrombin 500 mu, 2% CaCl2 10 ml, tranexamic acid 10 ml) was performed in 6 cases with spontaneous pneumothorax in whom surgery was not indicated because of various reasons, such as low pulmonary function or old age. These cases were complicated with left pneumonectomy, bilateral emphysema, pulmonary tuberculosis and interstitial pneumonia. In all cases, favorable results were obtained and there was no recurrence. As side effects, only transient low grade fever and slight chest pain were observed with no liver damage or pleural thickening. These results suggest that chemical pleurodesis induced with fibrin glue is very useful in the treatment of inoperable spontaneous pneumothorax.
 ...
PMID:[Chemical pleurodesis induced with fibrin glue in the treatment of inoperable spontaneous pneumothorax]. 261 97

A 67-year-old woman was admitted to our hospital with chest pain and dyspnea which occurred suddenly after vomiting. She was well until admission except for cholelithiasis and hypertension which had been pointed out 3 years earlier. Arterial blood gas analysis showed hypoxemia without hypercapnea. Chest X-ray examination on admission revealed intra-mediastinal air with a niveau behind the heart which compressed the vasculature of the left lower lobe and a small amount of air in the regions adjacent to the trachea, left main bronchus and aortic arch. The serial chest radiographs showed pneumomediastinum, subcutaneous emphysema, pneumothorax and pleural effusion in that order within 16 hours after the onset. The diagnosis of esophageal rupture was made by CT scan of the chest performed after oral administration of Gastrografin, which demonstrated extravasation of contrast medium into the mediastinum. Surgical treatment including eversion stripping and esophagogastrostomy was performed 23 hours after the onset. Pathological examination of the removed specimens revealed a rupture of the lower portion of the esophagus originated in the gastric ulcer of the cardia. In spite of intensive care, she died 45 days after surgery because of renal failure. It was considered that the most important point in the early diagnosis of esophageal rupture was to suspect this disease based on the gastric symptoms followed by the respiratory symptoms and to demonstrate pneumomediastinum in chest X-ray. Chest CT scan performed after the oral administration of contrast medium could be an useful and non-invasive diagnostic procedure.
 ...
PMID:[A case of esophageal rupture confirmed by chest CT: characteristic changes in chest radiographs]. 261 3

Two characteristics, volatility and biotransformation, make mercury somewhat unique as environmental toxicant, and make mercury poisoning as one of occupational diseases in the industry. Acute mercury vapor poisoning is a rare event. It often occurs during industrial accident or ignorant experiment. We report a case, a 28-year-old male waterworks technician, who developed dyspnea, cough, chest pain, metallic taste and ache in the whole body three hours after heating approximately 30 ml of liquid mercury during an experiment. Diarrhea with tarry stool occurred the next day. Chest roentgenogram revealed diffuse pulmonary infiltrates similar to pulmonary edema in both lungs, and was complicated by pneumomediastinum and subcutaneous emphysema later. The concentration of mercury in the plasma was over the toxic level. The urinary excretion of mercury greatly exceeded normal value. During hospitalization, the patient's liver and renal function tests were both normal. He was treated with penicillamine, 300 mg every six hours orally for 10 days in addition to a support treatment and oxygen therapy. He was discharged on the 15th hospital day with partial resolution of pulmonary infiltrates and was free of symptom.
 ...
PMID:[Acute pneumonitis caused by inhalation of mercury vapor--report of a case]. 276 70

Sixty-nine patients with perforation of the esophagus were treated at the University of California, San Francisco, from 1977 to 1988. The perforation was iatrogenic in 33 (48%) of the patients, spontaneous in 8 (12%), and a result of external trauma in 23 (33%). Clinical findings included chest pain in 36 (52%) of 69 patients, subcutaneous emphysema in 22 (32%) of 59 patients, and pneumomediastinum in 21 (36%) of 59 patients. Esophagograms demonstrated the perforation in 40 (93%) of 43 patients. Treatment delays of more than 24 hours occurred in about half of spontaneous and iatrogenic perforations, but when the perforation was due to external trauma, treatment was delayed infrequently. Operative therapy in 59 (86%) of the patients included primary closure in 44 patients, drainage alone in 9 patients, and Celestin tube placement in 1 patient. Four patients with benign strictures had esophagectomy, and 4 patients with achalasia had Heller myotomy in addition to closure of the perforation. Eight (12%) of the patients were treated nonoperatively. For thoracic perforations, nonoperative treatment was reserved for patients who were diagnosed late but who had minimal evidence of sepsis. Seven (10%) of the patients died. Factors that influenced outcome included cause of perforation, anatomic location, and patient age. Our study shows that a high index of suspicion, aggressive use of esophagography, and individualized treatment are necessary for the best results when treating esophageal perforation.
 ...
PMID:Esophageal perforation. 280 86

Spontaneous transmural esophageal perforation is a rare condition with high morbidity and mortality. It is traditionally associated with alcohol abuse. Experience of the syndrome at a large medical center in Israel, a country where alcohol is not a national problem, is reviewed, and eight cases are described. The clinical picture was varied and confusing, only one patient presenting with the classic triad of vomiting, chest pain and subcutaneous emphysema, though abdominal pain occurred in six cases. The diagnosis consequently was delayed (average 2.8 days) in three patients and two died undiagnosed. Contrast studies, when performed, were diagnostic. Early rupture (less than 24 hours) was treated with primary repair (n = 3). Late rupture (greater than 24 hours) was successfully managed by drainage alone (without esophageal exclusion) in three cases, but required long hospital stay (mean 52 days). Five of the six patients diagnosed ante mortem survived. Late reconstructive procedures were not required. The key to successful outcome is awareness of the condition, with early diagnosis and aggressive surgical intervention--repair or drainage.
 ...
PMID:Spontaneous transmural rupture of esophagus--Boerhaave's syndrome. 281 19


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>