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Query: UMLS:C0034067 (emphysema)
11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced a case of progressive giant bulla which ruptured and disappeared on chest roentgenogram. The patient was a 60-year-old male who had been treated with home oxygen therapy for chronic pulmonary emphysema. One year after initiating home oxygen, emphysematous bulla occurred and expanded to become giant bulla which occupied 3/4 of the right hemithorax. Although we attempted to persuade him to undergo surgery for bullectomy, he refused. While being followed as an outpatient, sudden right anterior chest pain occurred, and dyspnea was markedly alleviated at the same time. Chest roentgenogram revealed right pneumothorax and pleural effusion, and the giant bulla subsequently receded. The patient has been stable for the approximately one year period since, without evidence of recurrence. It is rare for giant bullae to cause a pneumothorax. In addition, there are no previous reports in the literature with a clinical course such as that experienced by our patient.
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PMID:[A case of giant bulla which ruptured and disappeared on chest roentgenogram]. 808 48

Twenty-nine patients (16 males, 13 females) with spontaneous pneumothorax admitted into Hospital Universiti Sains Malaysia, Kubang Kerian, from September 1984 to September 1990 were reviewed. Their ages ranged from newborn to 75 years. The commonest chief presenting symptom was dyspnoea (69%), followed by chest pain (35%). Four patients had chronic obstructive airway disease, 7 had pneumonia, 2 had pulmonary tuberculosis, one patient had emphysema while 4 patients had multiple underlying lung disorders. The left and right lungs were involved with equal frequency. Bilateral pneumothorax occurred in one patient. Most patients had a single episode of pneumothorax but recurrent pneumothoraces occurred in 3 patients (10%). Six patients were observed conservatively, 20 patients required chest tube insertion alone and 3 patients also required pleurodesis. Death occurred in 8 patients (28%) mainly due to coexisting infection and respiratory failure.
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PMID:Spontaneous pneumothorax: a review of 29 admissions into Hospital Universiti Sains Malaysia 1984-90. 826 58

TV-assisted thoracoscopic surgery was performed under local anesthesia by through a single access port to control a continuing air leak in spontaneous pneumotorax. A 75-year-old man was admitted with severe dyspnea and right-sided chest pain. The chest X-ray film showed right lung collapse. A right spontaneous pneumothorax was diagnosed and was treated by chest tube drainage. However, the lung did not re-expand because of a continuing air leak and subcutaneous emphysema developed. TV-assisted thoracoscopic surgery was performed under local anesthesia to treat the persistent air leak on day 12. By endoscopy, the ruptured bulla was double-ligated with an Endoloop through a single access port using lung forceps combined with endoscope. The air leak subsequently ceased and the lung re-expanded. This method is minimally invasive and is very suitable for controlling a continuing air-leak causing spontaneous pneumothorax in a patient.
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PMID:[TV-assisted thoracoscopic surgery with a lung forceps combined with thoracoscope under local anesthesia for spontaneous pneumothorax with a persistent air leak--a single access port approach]. 828 35

A case of spontaneous pneumomediastinum with cervical emphysema is reported. Spontaneous pneumomediastinum may complicate processes that decrease pulmonary interstitial pressure or increase intraalveolar pressure leading to alveolar rupture. Free air may then tract along blood vessels and decompress into the soft tissues of the neck. Clinical symptoms include neck and chest pain, dysphonia, and shortness of breath. Care is supportive unless the patient has a history of trauma or foreign body aspiration. Symptoms typically resolve within days.
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PMID:Spontaneous pneumomediastinum. 830 30

We report two cases of mediastinal emphysema occurring without etiologic factor. Chest pain and subcutaneous emphysema are the most prevalent symptoms. In the absence of oesophagus related symptoms, a single chest radiograph is usually sufficient to make the diagnosis. In this paper, we recall the main radiographic signs, physio-pathological mechanisms, and differential diagnosis of spontaneous pneumomediastinum.
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PMID:[Idiopathic spontaneous pneumomediastinum: a not to be mistaken diagnosis in chest pain]. 856 82

We encountered three patients with spontaneous pneumomediastinum. All three (two men and one woman) were previously healthy. They complained of chest pain or dyspnea. On admission, physical examination revealed subcutaneous emphysema. Chest roentgenograms and computed tomograms revealed pneumomediastinum and subcutaneous emphysema. All other findings were normal. All patients were treated with bed rest and all recovered in 7 to 9 days. Pneumomediastinum recurred in one patient after 20 months.
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PMID:[Three patients with spontaneous pneumomediastinum, including one in whom pneumomediastinum recurred]. 858 24

The objective of this study was to examine the presentation and clinical course of patients with asthma and pneumomediastinum (PNMD). A retrospective chart review was performed from a computer-generated list of all patients discharged from an urban children's hospital between 1981 and 1991 with the diagnoses of asthma and PNMD. Thirty cases and 30 controls with asthma, matched for age and sex, were identified. The incidence of PNMD and asthma was 0.3%. Mean age was 11.8 years with a male:female ratio of 1.15:1. Chest pain was reported in 27% of patients and 13% of controls (P = 0.17). There was no difference in presenting respiratory rate, heart rate, or systolic blood pressure between cases and controls, nor was there a difference in respiratory distress by modified Wood-Downes scale. Fifty percent of patients had room air oxygen saturation measured at presentation. There was a significant difference in mean oxygen saturation between those with PNMD and those without (90.4 vs 94.1 %; P = 0.03). Subcutaneous emphysema was detected in 73% of cases versus none in controls (P < 0.001; positive predictive value (PPV) = 100%). Sixty-seven percent of patients with PNMD had repeat radiographs during hospitalization. Of these x-rays, 85% showed no change in, improvement, or complete resolution of the PNMD. Three patients (15%) developed a small increase in the PNMD. No patient developed pneumothorax, pneumopericardium, or deterioration in cardiovascular status. PNMD is a rare complication of asthma. Subcutaneous emphysema was the most useful predictor of PNMD in asthma. Chest pain and diminished oxygen saturation should heighten suspicion. Further complications of PNMD were exceedingly rare, and all patients recovered uneventfully, suggesting that attention to excellent treatment for the acute exacerbation may be sufficient in most instances of PNMD.
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PMID:Pneumomediastinum in childhood asthma. 885 17

A 61-year-old man with pulmonary emphysema was admitted due to acute exacerbation of chronic respiratory failure and a complaint of chest pain. A chest CT scan on admission showed aneurysmal dissection from the ascending aorta to the descending aorta. Analgesia was noted below the fourth thoracic vertebra, which supplies the accessory respiratory muscles including the intercostal muscles. Even after recovery from circulatory failure, his chest muscles were weak and he could not be removed from mechanical ventilation. An autopsy revealed ischemia of the spinal cord at the T4 level. In contrast, The C3 level of the spinal cord, which supplies the diaphragm, was intact. Paralysis of accessory respiratory muscles including intercostal muscles may have caused the continuation of the respiratory failure. This case shows the importance of accessory respiratory muscles in maintaining chest wall movement in patients with chronic pulmonary emphysema.
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PMID:[Spinal cord ischemia caused by dissecting aortic aneurysm in a patient with acute exacerbation of pulmonary emphysema]. 907 Nov 61

To assess the value of thoracoscopy in malignant pleural effusions, the procedure and results of thoracoscopy by using a fiberoptic bronchoscope and a rigid cold-light thoracoscope in 130 cases with malignant pleural effusion are reported. The overall diagnostic rate was 91.5% (119/130). The malignant pleural mesothelioma in 24 cases and metastatic cancers in 95 cases were histopathologically confirmed. Talcum powder, tetracycline and Corynebacterium parvum were separately sprayed through thoracoscope into pleural cavity in 69, 10 and 10 patients, and the success rates of complete and lasting pleurodesis were 87.0%, 5/10 and 8/10 respectively. Postoperative complications included transient fever and chest pain, local subcutaneous emphysema in 6 cases and tumor seeding at thoracoscopy site in 4 cases. It is concluded that thoracoscopy is simple, safe, reliable and of high practical value in the diagnosis of malignant pleural effusions and in assessment before exploratory thoracotomy, and that transendoscopical administration of drugs for pleurodesis is a very effective method for controlling malignant pleural effusions. The efficacy of the talc poudrage is better than tetracycline and Corynebacterium parvum.
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PMID:[Thoracoscopy in malignant pleural effusions]. 920 45

A 35-year-old woman was admitted to the hospital because of severe coughing and right-sided chest pain. She had worked on a farm for 13 years. For the preceding 2 years, she noticed a productive cough, a mild fever, and dyspnea after working in a barn for longer than 6 hours. Chest radiological examinations revealed low lung volumes, especially in the right upper lobe, and diffuse small granular shadows in both lung fields. Pathological examinations of lung specimens, which were obtained by transbronchial lung biopsy, showed alveolitis and granulomas in the interstitium. Micropolyspora faeni organisms were detected in hay from the barn. A M. faeni serum precipitation test revealed that her serum had antibodies against that organism. From these findings, we gave her a diagnosis of chronic farmer's lung. Prednisolone was given because her dyspnea and hypoxemia had increased. During the steroid treatment, bilateral pneumothorax and mediastinal emphysema developed. Bullae were removed surgically because she did not respond well to medical treatment. Although steroid administration may have caused these complications, bilateral pneumothorax and mediastinal emphysema are rare in patients with chronic farmer's lung.
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PMID:[Farmer's lung complicated by bilateral pneumothorax and mediastinal emphysema]. 929 99


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