No abstract available.
Child* ; Humans ; Middle Lobe Syndrome*

No abstract available.
Diagnosis* ; Middle Lobe Syndrome* ; Thorax*

Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. A 63-year-old male was admitted our hospital complaining of a cough. Chest computerized tomography and bronchoscopy showed collapse of right middle lobe and foreign body in the bronchus intermedius. After open thoracotomy and bronchotomy, foreign body was removed and collapsed middle lobe was ventilated. Herein we report a case of middle lobe syndrome caused by occult foreign body in the bronchus intermedius.
Bronchi* ; Bronchoscopy ; Cough ; Foreign Bodies* ; Humans ; Male ; Middle Aged ; Middle Lobe Syndrome* ; Thoracotomy ; Thorax

Right middle lobe syndrome (RMLS) is defined as a transient or recurrent, chronic collapse of the middle lobe of the right lung by certain pathologic conditions. RMLS is a relatively uncommon condition having multiple etiologies and various clinical presentations. Two patients were referred to Hallym University Sacred Heart Hospital, one for the treatment of coughing and the other for the treatment of pneumonia. A diagnosis of RMLS was identified through X-ray and computed tomography image evaluation for each condition. Bronchoscopy revealed mucus obstruction in the right middle lobe bronchus. Biopsy of the aspirated mucus showed mucus containing many eosinophils and Charcot-Leyden crystals. After removal of impacted mucus, clinical and radiological improvements were observed in both patients. Therefore, eosinophilic mucus impaction can be considered a potential cause of RMLS, irrespective of any underlying asthmatic symptoms.
Adult* ; Biopsy ; Bronchi ; Bronchoscopy ; Cough ; Diagnosis ; Eosinophils* ; Heart ; Humans ; Lung ; Middle Lobe Syndrome* ; Mucus ; Pneumonia

Although lipomas are common benign tumors in humans, endobronchial lipomas are quitely rare. Up to date, about 60 cases have been reported in the English literature. But endobronchial lipomas causing middle lobe syndrome were only 4 cases. These benign slow-growing tumors generally occur in the proximal portion of the lobar or segmental bronchi and originate from fatty tissue that is normally present in the bronchial tree. Smoking or chronic inflammation may be important in the pathogenesis of these tumors. Bronchoscopy is the definite diagnostic tool but, in general, open thoracotomy is required for diagnosis and treatment. Here, we present a case of endobronchial lipoma, with a review of the literature.
Adipose Tissue ; Bronchi ; Bronchoscopy ; Diagnosis ; Humans ; Inflammation ; Lipoma* ; Middle Lobe Syndrome* ; Smoke ; Smoking ; Thoracotomy

Benign pulmonary tumors are rare entities, and among them bronchial lipomas are the most uncommon. Up to date, about 80 cases have been reported in the English literature. But, the bronchial lipoma with extrabronchial growth causing middle lobe syndrome and pneumonia is extremely rare. Bronchial lipomas, mainly arising from normal fatty tissue of the proximal portion of the lobar or segmental bronchi, are histologically benign. But if diagnosis and treatments are delayed, they can produce extensive pulmonary parenchymal damage and irreversible brochiectasis distally. So whenever possible, the treatment of choice is resection by means of bronchoscopy via early diagnosis. But if endoscopic removal is not possible because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy or if the nature of the tumor is unclear, surgery is necessary, with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma. We present a case of bronchial lipoma with extrabronchial growth, with a review of the literature and report of an unusual case.
Adipose Tissue ; Bronchi ; Bronchoscopy ; Diagnosis ; Early Diagnosis ; Lipoma* ; Middle Lobe Syndrome* ; Pneumonectomy ; Pneumonia*

Kluver-Bucy Syndrome (KBS) is consisting of hyperorality, emotional blunting, hypersexuality, altered dietary habits, visual and auditory agnosia. It has been reported in variable neurological diseases. However, only a few cases reported in epilepsy. We report a patient with unilateral temporal lobe epilepsy who presents transient hyperorality during seizure. A 46-year-old man has complex partial seizures which were abdominal aura followed by hyperorality and hand automatisms. Hyperorality was characterized by putting patient's hand or seizure button into his mouth. Brain MRI demonstrated right hippocampal sclerosis. The interictal and ictal SPECT suggested right temporal lobe dysfunction, and PET showed bitemporal hypometabolism. Rhythmic ictal activities were arising from right temporal region when patient presented hyperorality. We speculate that transient hyperorality in this patient could be a symptom of KBS. This case suggests that transient KBS can be occurred in a unilateral temporal lobe epilepsy when ictal discharges cause bitemporal dysfunction during temporal lobe seizure.
Agnosia ; Brain ; Epilepsy ; Epilepsy, Temporal Lobe ; Food Habits ; Hand ; Humans ; Kluver-Bucy Syndrome ; Middle Aged ; Mouth ; Sclerosis ; Seizures ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Alzheimer's disease is a chronic neurodegenerative condition, mostly affecting the medial temporal lobe and associated neocortical structures. In this report, we present a rare clinical manifestation of this disease. CASE REPORT: A 61-year-old female with word finding difficulty and memory disturbances was diagnosed with Alzheimer's disease. Two years later, she complained of right homonymous hemianopia without optic ataxia, ocular apraxia, and simultagnosia. No findings other than parenchymal disease were apparent in magnetic resonance imaging and laboratory tests. CONCLUSIONS: In this case, in a patient initially diagnosed with Alzheimer's dementia with progressive disease, we found only homonymous hemianopia, without signs of Balint's syndrome or Gerstmann's syndrome. After careful investigation showing that Alzheimer's dementia with visual symptom was not associated with parenchymal disease, we concluded a case of atypical variant of Alzheimer's disease.
Alzheimer Disease ; Apraxias ; Ataxia ; Dementia* ; Female ; Gerstmann Syndrome ; Hemianopsia* ; Humans ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Temporal Lobe

Allergic bronchopulmonary aspergillosis (ABPA) is infrequently documented in children with asthma. Although collapse is not uncommon, middle lobe syndrome (MLS) as a presentation of ABPA is rather a rarity. A 9-year-old female child with asthma presented with increase in intensity of symptoms along with a right midzone patchy consolidation on a chest radiograph. In addition, an ill-defined opacity abutting the right cardiac border with loss of cardiac silhouette was noted. A right lateral view confirmed a MLS, which was further corroborated by high resolution computed tomography. Central bronchiectasis was also observed, which prompted a work-up for ABPA. The child met 7/8 major diagnostic criteria for ABPA. She was then initiated on oral prednisolone that resulted in a marked clinical improvement within a fortnight. Radiological clearance occurred at 3 months with inflation of the middle lobe. ABPA presenting with MLS in a child is yet to be reported. A high index of suspicion is required to establish the diagnosis of ABPA in a child presenting with MLS. This would obviate the invasive investigations usually done to ascertain the cause of MLS.
Aspergillosis, Allergic Bronchopulmonary ; Asthma ; Bronchiectasis ; Child ; Diagnosis ; Female ; Humans ; Inflation, Economic ; Middle Lobe Syndrome ; Prednisolone ; Radiography, Thoracic

OBJECTIVETo study the changes of pulmonary function in children with right lung middle lobe syndrome before and after treatment.

METHODSThirty children with right lung middle lobe syndrome were classified into two age groups: < or =4 years old and >4 years old. Pulmonary function was tested by the 2600-type and the MIR-type pulmonary function spirometry in the < or =4 years and the >4 years age groups, respectively before and after treatment. Terminal flows/peak expiratory flow (25/PF) and the percentage of tidal volume to peak tidal expiratory flow (% V-PF) were measured in the <4 years age group. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were measured in the >4 years age group.

RESULTSThe values of 25/PF and %V-PF in the < or =4 years age group were 0.42+/-0.08 and 0.28+/-0.03, respectively before treatment. The values were improved after treatment (0.58+/-0.12 and 0.39+/-0.06 respectively) (P<0.05). The values of FVC, FEV1 and PEF were 1.75+/-0.32, 1.36+/-0.52 and 2.56+/-0.78, respectively in the >4 years age group before treatment. The values were also improved after treatment (2.37+/-0.78, 2.08+/-0.65 and 3.68+/-0.80 respectively) (P<0.05).

CONCLUSIONSThere are significant differences in the pulmonary function before and after treatment in children with right lung middle lobe syndrome. The pulmonary function can return to normal after treatment.

Child ; Child, Preschool ; Female ; Forced Expiratory Volume ; Humans ; Infant ; Lung ; physiopathology ; Male ; Middle Lobe Syndrome ; physiopathology ; Vital Capacity