26 research outputs found

    Orbital Metastases as the First Manifestation of Lung Adenocarcinoma

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    Reduction in visual acuity due to orbital metastasis is rarely the first sign of lung cancer and very few cases have been published in the literature. Here we report a rare case of lung adenocarcinoma with orbital metastasis as the first presenting sign. The incidence of primary tumors that metastasize to the orbit is approximately 7%. In 19% of the cases, there is no history of cancer when the patient presents with ophthalmic symptoms, and in 10%, the primary site remains obscure despite intensive systemic evaluation. Our patient showed a partial improvement in vision after successful combination of chemotherapy and radiotherapy. Blurred vision due to orbital metastasis as the primary symptom of lung cancer is very uncommon. A great index of suspicion is essential when an orbital lesion appears

    A case of typical pulmonary carcinoid tumor treated with bronchoscopic therapy followed by lobectomy

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    Carcinoid bronchopulmonary tumors represent approximately 25% of all carcinoid tumors and 1%–2% of all lung neoplasms. The most common symptoms are: persistent cough, asthma-like wheezing, chest pain, dyspnea, hemoptysis and obstructive pneumonitis. We present a case of a young adult diagnosed with a typical carcinoid tumor. The diagnosis was established on the basis of imaging examination and bronchoscopic biopsy. The patient was treated with bronchoscopic electrocautery therapy to relieve the obstructed airway, followed by surgical lobectomy in order to entirely remove the exophytic damage. This approach was not only a palliative management to bronchial obstruction but also avoided pneumonectomy. Recent studies support the use of such interventional resection methods, as they may result in a more conservative surgical resection

    Hydrocarbon pneumonitis following liquid paraffin aspiration during a fire-eating performance: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Hydrocarbon pneumonitis is an acute, intense pneumonitis resulting from aspiration of volatile hydrocarbon compounds with low viscosity and surface tension, most of which are members of the paraffin, naphthene and aromatic classes.</p> <p>Case presentation</p> <p>Six hours after participating in a party for teenagers, a 16-year-old boy developed dyspnea, cough, a fever (39°C) and chest pain. A chest radiograph showed infiltration in the right middle lobe. The patient reported alcohol abuse during the party and an episode of vomiting a few hours thereafter. He also reported practicing a fire-eating performance at the party using liquid paraffin, but was unaware of inhaling any of it. The radiographic infiltration was diagnosed as an aspiration pneumonia and he was treated at the local health center with antibiotics. Five days later, because of clinical deterioration, he was referred to a pulmonary clinic. A chest computed tomography scan was performed which showed consolidation with an air bronchogram in the right middle lobe and areas of atelectasis and ground glass opacities in the middle and lower right lobes. Spirometry revealed severe restriction of lung function. A bronchoscopy revealed inflamed, hyperemic mucosa. Bronchoalveolar lavage fluid revealed lipid-laden alveolar macrophages, which were detected by lipid staining, and neutrophilia. The patient was finally diagnosed with hydrocarbon pneumonitis and he was treated with systemic steroids and antibiotics. After 6 days of treatment there was complete clinical and significant radiologic regression.</p> <p>Conclusion</p> <p>Hydrocarbon pneumonitis should be included in the differential diagnosis of pneumonias. Recent exposure to volatile hydrocarbons provides a basis for clinical diagnosis, as symptoms and radiologic findings are not specific.</p

    Oxidative and pre-inflammatory stress in wedge resection of pulmonary parenchyma using the radiofrequency ablation technique in a swine model

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    <p>Abstract</p> <p>Background</p> <p>Radiofrequency ablation (RFA) is a thermal energy delivery system used for coagulative cellular destruction of small tumors through percutaneous or intraoperative application of its needle electrode to the target area, and for assisting partial resection of liver and kidney. We tried to evaluate the regional oxidative and pre-inflammatory stress of RFA-assisted wedge lung resection, by measuring the MDA and tumor Necrosis Factor Alpha (TNF-α) concentration in the resected lung tissue of a swine model.</p> <p>Method</p> <p>Fourteen white male swines, divided in two groups, the RFA-group and the control group (C-group) underwent a small left thoracotomy and wedge lung resection of the lingula. The wedge resection in the RFA-group was performed using the RFA technique whereas in C-group the simple "cut and sew" method was performed. We measured the malondialdehyde (MDA) and TNF-α concentration in the resected lung tissue of both groups.</p> <p>Results</p> <p>In C-group the MDA mean deviation rate was 113 ± 42.6 whereas in RFA-group the MDA mean deviation rate was significantly higher 353 ± 184 (p = 0.006). A statistically significant increase in TNF-α levels was also observed in the RFA-group (5.25 ± 1.36) compared to C-group (mean ± SD = 8.48 ± 2.82) (p = 0.006).</p> <p>Conclusion</p> <p>Our data indicate that RFA-assisted wedge lung resection in a swine model increases regional MDA and TNF-a factors affecting by this oxidative and pre-inflammatory stress of the procedure. Although RFA-assisted liver resection can be well tolerated in humans, the possible use of this method to the lung has to be further investigated in terms of regional and systemic reactions and the feasibility of performing larger lung resections.</p

    Subclavian thrombosis in a patient with advanced lung cancer: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Lung cancer is now considered the most common cause of death among cancer patients. Although target biological regimens have emerged in recent years for non-small cell lung carcinoma, the survival and quality of life of patients with this condition still remain low. The five-year survival rate for all stages of lung cancer is 17% or less.</p> <p>Case presentation</p> <p>We describe the case of a 53-year-old Caucasian woman who was diagnosed with advanced stage IIIa (T2aN<sub>2</sub>M<sub>0</sub>) non-small cell lung carcinoma (adenocarcinoma) and underwent a complete left upper lobectomy three years ago. After two and a half years of follow-up, she suddenly presented with facial edema and venous distension and was immediately treated for superior vena cava syndrome. Because of a diagnostic check, a major clot was detected in the right subclavian vein. Our patient was informed about treatment options, and she was taken to the catheterization laboratory for percutaneous stenting of the superior vena cava to restore superior vena cava patency.</p> <p>Conclusion</p> <p>Lung cancer has a vast number of complications. Superior vena cava syndrome and thrombosis should be considered upon the presentation of a patient with obstructive symptoms. In this case report, even though we expected the clot to be on the side of the former lesion, it was present on the opposite side. Treatment should also start immediately in these patients with clinical suspicion of thrombosis to avoid further complications, even in cases with a differential diagnosis problem. Finally, although patients with non-small cell lung carcinoma have a high incidence of thromboembolic events, anticoagulant treatment is given only as maintenance therapy after a first event occurs.</p

    Hydrotherapy (Project Hydriades)

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    Natural resources are being used for the maintenance of health. According to the Law 3498/2006 of the Greek Parliament the natural health spas must be validated for their therapeutic properties. The Association of Municipalities and Communities of Health Springs of Greece signed a contract with the Research Committee of the Aristotle University of Thessaloniki, Greece, in order to conduct the research programme: ‘Study for the documentation of the therapeutic properties of the thermomineral waters’. The main aim of the project is: (1) the study of biological and therapeutic parameters of the natural health sources, (2) the identification of the indications and contraindications of hydrotherapy. Aims parallel to the main ones have been also set

    Peripheral neuropathies in patients with chronic obstructive airways disease COAD

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    In the present study 28 patients with COAD (25 men and 3 women) were examined clinically and electrophysiologically as well as 21 aged matched controls. Seventeen COAD patients were reexamined after a period of 6-18 months. The respiratory function data include FEV₁, FVC, PO₂, 6 minutes test, dyspnea score (Cotes Scale). The neurophysiological examination dealt with medium, ulnar, peronial, tibial and sural nerves. Terminal latencies, M-response amplitude, evoked muscle action potentials and conduction velocities were studied. We also examined the cardiorespiratory reflexes {which are mediated from the Autonomic Nervous System} in 20 of the 28 patients with COAD and in 12 subjects of the control group. The cardiorespiratory reflexes examined in our study were: heart rate response to Valsava manoeuvre, heart rate variation during deep breathing and heart rate response to standing, systolic blood pressure response after standing and diastolic blood pressure response to sustain handgrip. From the clinical neurological and neurophysiological examination of the COAD patients 14 were normal, 10 had mild peripheral neuropathy (5-10% reduction of conduction velocities in two of the three examined nerves of the lower limbs and touch sensory disturbances) and 4 had severe clinical peripheral neuropathy. 10 subjects of the control group had mild symptoms of peripheral neuropathy and 11 were normal. The statistical analysis of neurorophysiological data show a significant reduction of the conduction velocities of the lower limb nerves (peronial, tibial and sural) in COAD patients compared with that of the control group. The percentange of the patients with abnormal F-waves latency of the lower limb nerves was statistically significantly higher in COAD patients compared to the subjects of the control group. The correlation between the respiratory function data and the motor conduction velocities of the lower limb nerves was statistically significant. A statistically significant impairment of the cardiorespiratory reflexes was also observed in patients with COAD compared to the control group. We conclude that the patients with COAD developed signs of peripheral neuropathy {mainly neurophysiological} in the lower limbs, as well as impairment of the autonomic nervous system. The possible cause of these findings is probably the effect of hypoxic on the peripheral nerves.Στη μελέτη αυτή εξετάστηκαν κλινικά και νευροφυσιολογικά 28 ασθενείς με ΧΑΠ καθώς και 21 φυσιολογικά άτομα της αντίστοιχης ηλικίας . Δεκαεπτά από τους ασθενεί ς αυτούς επανελέγχθηκαν για δεύτερη φορά μετά από διάστημα 6-18 μηνών. Στα παραπάνω περιστατικά μελετήθηκαν οι παρακάτω παράμετροι της αναπνευστικής λειτουργίας: PO₂ , PCO₂, FEV₁, FVC, δοκιμασία βάδισης 6 λεπτών, δείκτης δύσπνοιας κατά Cotes. Η νευροφυσιολογική μελέτη αφορούσε πέντε νεύρα: το μέσο, το ωλένιο, το περονιαίο, το κνημιαίο και το γαστροκνημιαίο τα οποία εξετάσθηκαν ως προς τον Λανθάνοντα Χρόνο, το εύρος δυναμικού και την ταχύτητα αγωγής του νεύρου. Επιπλέον 20 από τους ασθενείς με ΧΑΠ και 12 από τα φυσιολογικά άτομα ελέγθηκαν ως προς τα καρδιοαναπνευστικά αντανακλαστικά, τα οποία ρυθμίζονται από το Αυτόνομο Νευρικό Σύστημα (ΑΝΣ) και τα οποία ήταν: η διακύμανση του καρδιακού ρυθμού στη δοκιμασία Valsava, η μεταβολή της καρδιακής συχνότητας σε βαθιές αναπνευστικές κινήσεις , οι διακυμάνσεις του καρδιακού ρυθμού στην έγερση, η πτώση της συστολικής πίεσης στην έγερση και η αύξηση της διαστολικής πίεσης μετά από ισομετρική προσπάθεια. Από την κλινική νευρολογική και νευροφυσιολογική εξέταση των ασθενών με ΧΑΠ 14 είχαν φυσιολογικό Περιφερικό Νευρικό Σύστημα, 4 είχαν "πλήρη" σημεία περιφερικής νευροπάθειας, με >10% ελάττωση της ταχύτητας αγωγής οε δύο τουλάχιστον από τα τρία εξετασθέντα νεύρα των κάτω άκρων που συνοδευόταν από εξάλειψη των τενοντίων αντανακλαστικών και μυοδερματικές ατροφίες , ενώ 10 είχαν "ήπια" συμπτωματολογία" ΠΝ με μικρή (5-10%) ελάττωση της ταχύτητας αγωγής σε δύο τουλάχιστον από τα τρία εξετασθέντα νεύρα των κάτω άκρων και διαταραχές της επιπολής αισθητικότητας. Από τα φυσιολογικά άτομα 10 είχαν μικρή (5-10%) ελάττωση της ταχύτητας αγωγής αε δύο τουλάχιστον από τα τρία εξετασθέντα νεύρα των κάτω άκρων και διαταραχές της επιπολής αισθητικότητας και 11 είχαν φυσιολογικό Περιφερικό Νευρικό Σύστημα. Από την ανάλυση των νευροφυσιολογικών παραμέτρων της νευρικής αγωγιμότητας βρέθηκε ότι υπήρχε στατιστικά σημαντική ελάττωση της ταχύτητας αγωγής των νεύρων των κάτω άκρων των ασθενών με ΧΑΠ, σε σχέση με τα φυσιολογικά άτομα. Επιπλέον υπήρχε στατιστικά σημαντικό ποσοστό ασθενών με παθολογικό Λανθάνοντα Χρόνο F-κυμάτων, σε σχέση με τα άτομα της ομάδας ελέγχου. Τα αποτελέσματα αυτά είναι αναπαραγώγιμα στους 17 ασθενείς, που επανελέγχθηκαν μετά από 6-18 μήνες. Η σύγκριση των ταχυτήτων αγωγής του ερεθίσματος στα νεύρα των κάτω άκρων με τις παραμέτρους της αναπνευστικής λειτουργίας έδειξε στατιστικά σημαντική συσχέτιση μεταξύ της FEV₁, της FVC, της ΡΟ₂, της δοκιμασίας κόπωσης 6 λεπτών και του βαθμού δύσπνοιας των εξετασθέντων ατόμων με τις ταχύτητες αγωγής των νεύρων των κάτω άκρων. Επιπλέον οι δοκιμασίες ελέγχου του ΑΝΣ ήταν επηρεασμένες σε στατιστικά σημαντικότερο βαθμό στους ασθενείς με ΧΑΠ, σε σχέση με τα φυσιολογικά άτομα. Συμπεραίνεται ότι ασθενείς με ΧΑΠ παρουσιάζουν συμπτώματα περιφερικής νευροπάθειας {κυρίως νευροφυαιολογικά} στα κάτω άκρα, όπως και διαταραχές της λειτουργίας του ΑΝΣ. Το πιθανό αίτιο της βλάβης των περιφερικών νεύρων είναι η υποξυγοναιμική προσβολή των νευρικών ινών των νεύρων αυτών
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