Endobronchial metastasis of testicular germ cell tumor

Endobronchial metastasis (EBM) of extrapulmonary malignancies is rarely reported; on the other hand, germ cell tumors (GCTs) are extremely rare. This report describes a case of a testicular germ cell tumor presenting as a polypoid endobronchial mass. A 48-year-old male patient had a history of hemoptysis for several weeks. He had undergone orchiectomy due to testicular GCT 20 years ago. Computerized tomography of the thorax obtained endobronchial polypoid lesion in the right intermediate bronchus. Rigid bronchoscopy was applied; right intermediate bronchus was obliterated with a polypoid lesion. The lesion was coagulated with argon plasma coagulation, and debris was removed by biopsy forceps. Pathological examination of the specimen was somatic-type GCT. No recurrence was observed during the follow-up of the patient. We want to present our case to emphasize the importance of distinguishing EBM from primary lung carcinoma which treatment and survival are quite different

Seroprevalence of Toxocara antibodies in patients with adult asthma

Toxocariasis is a common worldwide infection. Asthma, considered to be one of the most common chronic diseases, is a serious global health problem. Toxocara may be a possible etiologic agent of asthma. The aim of this study was to investigate whether there is an association between adult asthma and Toxocara sero-prevalence. Fifty three adult patients with asthma participated in the study. All patients had an age of disease onset of 20 years or older. Blood samples were tested for the presence of Toxocara antibodies using enzyme-linked immunosorbent assay (ELISA)

Multiplanar and two-dimensional imaging of central airway stenting with multidetector computed tomography

<p>Abstract</p> <p>Background</p> <p>Multidetector computed tomography (MDCT) provides guidance for primary screening of the central airways. The aim of our study was assessing the contribution of multidetector computed tomography- two dimensional reconstruction in the management of patients with tracheobronchial stenosis prior to the procedure and during a short follow up period of 3 months after the endobronchial treatment.</p> <p>Methods</p> <p>This is a retrospective study with data collected from an electronic database and from the medical records. Patients evaluated with MDCT and who had undergone a stenting procedure were included. A Philips RSGDT 07605 model MDCT was used, and slice thickness, 3 mm; overlap, 1.5 mm; matrix, 512x512; mass, 90 and kV, 120 were evaluated. The diameters of the airways 10 mm proximal and 10 mm distal to the obstruction were measured and the stent diameter (D) was determined from the average between D upper and D lower.</p> <p>Results</p> <p>Fifty-six patients, 14 (25%) women and 42 (75%) men, mean age 55.3 ± 13.2 years (range: 16-79 years), were assessed by MDCT and then treated with placement of an endobronchial stent. A computed tomography review was made with 6 detector Philips RSGDT 07605 multidetector computed tomography device. Endobronchial therapy was provided for the patients with endoluminal lesions. Stents were placed into the area of stenosis in patients with external compression after dilatation and debulking procedures had been carried out. In one patient the migration of a stent was detected during the follow up period by using MDCT.</p> <p>Conclusions</p> <p>MDCT helps to define stent size, length and type in patients who are suitable for endobronchial stinting. This is a non-invasive, reliable method that helps decisions about optimal stent size and position, thus reducing complications.</p

Lymph node characteristics of sarcoidosis with endobronchial ultrasound

Background: Sonographic features of lymph nodes on endobronchial ultrasound (EBUS) have been shown to be useful in prediction of malignancy in mediastinum and hilum. The aim of this study was to assess the utility of morphologic features of mediastinal and/or hilar lymph nodes obtained by EBUS in patients with sarcoidosis. Materials and Methods: We retrospectively reviewed the records of 224 patients with mediastinal/hilar lymph node enlargements who underwent EBUS for diagnostic purpose. The lymph nodes were characterized based on the EBUS images as follows: (1) Size; based on short-axis dimension, = 1 cm, (2) shape; oval or round, (3) margin; distinct or indistinct, (4) echogenicity; homogeneous or heterogeneous, (5) presence or absence of central hilar structure, and (6) presence or absence of granular (sandpaper) appearance. Results: One hundred (24.4%) nodes exhibited indistinct margins while 309 (75.6%) had distinct margins. One hundred and ninety nine (48.7%) nodes were characterized as homogeneous, and 210 (51.3%) nodes as heterogeneous. Granular appearance was observed in 130 (31.8%) lymph nodes. The presence of granules in lymph nodes on EBUS had the highest specificity (99.3%) for the diagnosis of sarcoidosis. Logistic regression analysis revealed the finding of distinct margin alone as an independent predictive factor for the diagnosis of sarcoidosis. Conclusions: The presence of granular appearance in lymph nodes by EBUS had the highest specificity (99.3%) for the diagnosis of sarcoidosis. Lymph nodes having distinct margins tend to suggest sarcoidosis

Combination and comparison of two models in prognosis of pulmonary embolism: Results from TUrkey Pulmonary Embolism Group (TUPEG) study

WOS: 000335910900010PubMed ID: 24690480Background: Clinical parameters, biomarkers and imaging-based risk stratification are widely accepted in pulmonary embolism(PE). The present study has investigated the prognostic role of simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: This prospective cohort study included a total of 1078 patients from a multi-center registry, with objectively confirmed acute symptomatic PE. The primary endpoint was all-cause mortality during the first 30 days, and the secondary endpoint included all-cause mortality, nonfatal symptomatic recurrent PE, or nonfatal major bleeding. Results: Of the 1078 study patients, 95 (8.8%) diedwithin 30 days of diagnosis. There was no significant difference between non-low-risk patients ESC [12.2% (103 of 754;)] and high-risk patients as per the sPESI [11.6% (103 of 796)] for 30-day mortality. The nonfatal secondary endpoint occurred in 2.8% of patients in the the sPESI low-risk and 1.9% in the ESC low-risk group. Thirty-day mortality occurred in 2.2% of patients the sPESI low-risk and in 2.2% the ESC low-risk group (P = NS). In the present study, in the combination of the sPESI low-risk and ESC model low-risk mortality rate was 0%. Conclusions: The sPESI andthe ESCmodel showed a similar performance regarding 30-daymortality and secondary outcomes in the present study. However, the combination of these two models appears to be particularly valuable in PE. (C) 2014 Elsevier Ltd. All rights reserved

Is the Perioperative Period No Longer a Problem for Adult Asthmatics under Control?-OPERA Study

OBJECTIVES: Asthma is a global problem and chronic condition that persists through patient's entire life, during which the possibility of a surgical procedure is common. An accurate clinical and functional evaluation of respiratory functions and asthma control is needed in patients undergoing surgical procedures and requiring general anesthesia. The aim of this study was to disclose any possible relation between postoperative complications and some pre- and postoperative factors