Tracheal tumors are uncommon comprising less than 0.1% of all malignancies. Metastatic tracheal tumors, especially form the extrathoracic sites, are exceedingly rare. Ovarian cancer tends to metastasize to the serous cavities and the lymph nodes. One large autopsy study reported tracheal involvement in 1% of patients who had died from ovarian cancer. Other studies have not mentioned tracheal involvement at all. Since the main symptoms of cough, hemoptysis, or wheezing are nonspecific, patients may be initially treated for other conditions including asthma or bronchitis. Here we describe a metastatic tracheal tumor from an overain carcinoma that was initally treated for bronchial asthma.
Asthma ; Autopsy ; Bronchitis ; Cough ; Hemoptysis ; Humans ; Lymph Nodes ; Ovarian Neoplasms ; Respiratory Sounds

Tracheopathia osteoplastica is a rare, benign pathologic condition chahacterized the occurrence of numerous cartilage and bony nodules within the tissue of mucosa. We report a case of tracheopathia osteoplastica that involved both larynx and trachea. The patient was 73 years old male and had hoarseness. The neck CT showed thickened and irregular wall of the trachea extending to the level of the carina with multiple calcified nodules and plaques of bony density projecting into the lumen.
Cartilage ; Hoarseness ; Humans ; Larynx ; Male ; Mucous Membrane ; Neck ; Trachea

No abstract available.
Bronchi*

The prevention of and the controlling of symptoms, reductions in the frequency of exacerbations, and disease severity are central to the pharmacologic therapy of chronic obstructive pulmonary disease (COPD). COPD patients are inclined to be older, have more comorbidities, and use polypharmacy as a result. Long-acting inhaled muscarinic antagonists (LAMAs) is a preferred treatment modality. However, the cardiovascular (CV) safety of anti-cholinergics, including LAMA, has been an issue. In contrast, the results of the UPLIFT trial and a pooled analysis of data from 30 trials of tiotropium illustrates the association of tiotropium with reductions in the risk of all cause mortality, CV mortality and CV events. And, the UPLIFT trial provides clues regarding the additive advantages of tiotropium in COPD patients who already are using long-acting inhaled beta2 agonists and inhaled corticosteroids. Following the contribution of tiotropium as a first LAMA, new LAMAs such as aclidinium and glycopyrrolate (NVA-237) seem to be emerging.
Adrenal Cortex Hormones ; Cholinergic Antagonists ; Comorbidity ; Glycopyrrolate ; Humans ; Muscarinic Antagonists ; Polypharmacy ; Pulmonary Disease, Chronic Obstructive ; Scopolamine Derivatives ; Tiotropium Bromide

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate

BACKGROUND: Pulmonary tuberculosis is frequently accompanied with complications such as bronchiectasis, cavities, fibrosis and a deterioration of the lung function. However, there is little information available on the pathogenesis of these complications in pulmonary tuberculosis. Among the many factors involving in tissue remodeling, transforming growth factor-beta1 (TGF-beta1) is a potent stimulus of the extracellular matrix fomation and a mediator of potential relevance for airway wall remodeling. Therefore, this study examined the relationship between the radiological changes and the TGF-beta1 level in patients with pulmonary tuberculosis. METHODS: Serum and bronchoalveolar lavage fluid (BALF) were collected from total of 35 patients before treating them for active pulmonary tuberculosis, and the TGF-beta1 levels were measured using an enzyme-linked immunosorbent assay (ELISA). The BALF levels were recalculated as the epithelial lining fluid (ELF) levels using the albumin method. pulmonary function test (PFT) and high resolution computed tomography (HRCT) were performed before and after treatment. RESULTS: There was a strong correlation between the serum TGF-beta1 level and the presence of cavities (r=0.404, p=0.006), even though the BAL TGF-beta1 level showed a weak correlation with complications. In addition, there was no correlation between the TGF-beta1 levels before treatment and the changes in the PFT and HRCT during treatment. CONCLUSION: There is a correlation between the serum TGF-beta1 level and cavity formation in pulmonary tuberculosis before treatment. However, further study will be needed to confirm this.
Bronchiectasis ; Bronchoalveolar Lavage Fluid ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Fibrosis ; Humans ; Lung ; Respiratory Function Tests ; Transforming Growth Factor beta1 ; Tuberculosis, Pulmonary*

Eosinophilic lung diseases are heterogenous disorder which are characterized by the presence of pulmonary symptoms or an abnormal chest radiograph accompanied by inflammatory cellular infiltrates in the airways and lung parenchyma which contain large numbers of eosinophils. The incidence of drug-induced pulmonary disorder is increasing, with at least 40 drug entities having been reported to cause this pulmonary disease. However, nonsteroidal anti-inflammatory drugs (NSAIDs) are rarely mentioned in the lists of drugs in published articles describing drug induced eosinophilic pneumonia. The following is a case of eosinophilic pneumonia that we believe was related to ibuprofen therapy.
Anti-Inflammatory Agents, Non-Steroidal ; Eosinophils* ; Ibuprofen* ; Incidence ; Lung ; Lung Diseases ; Pulmonary Eosinophilia* ; Radiography, Thoracic

Spontaneous pneumomediastinum is defined as a clinical syndrome thatos characterized by the presence of air in the mediastinal space, which is not due to an old previous injury or surgery. The condition is caused by a sustained increase in the intraalveolar and intrabronchial pressure with extravasated air dissecting along the perivascular spaces of the mediastinum. This is an uncommon complication of sports activity. The most common symptom is chest pain. This diagnosis should be considered for younger people who present with pleuritic chest pain or dyspnea and a characteristic crackling feel (known as subcutaneous crepitation) when touching of the skin covering the chest wall or neck, and they look otherwise well with normal vital signs. Usually no treatment is required, but the mediastinal air will be absorbed faster if the patient inspires high concentrations of oxygen. We present here a case of spontaneous pneumomediastinum that occurred during a Taekwondo match, along with a review of the relevant literature.
Chest Pain ; Dyspnea ; Humans ; Mediastinal Emphysema ; Mediastinum ; Neck ; Oxygen ; Skin ; Sports ; Thoracic Wall ; Vital Signs

Sarcomatoid carcinomas of the lung are rare malignant biphasic tumors, which contain both a malignant epithelial component and a sarcomatoid component. The majority of patients are men and the mean age of onset is 60 years at the time of diagnosis. A metastasis to the regional lymph nodes and to distant organs is common. The clinical course of patients with this neoplasm is aggressive, with an overall 5-year survival rate approximating 20%. A sarcomatoid carcinoma of the lung is often observed in the large bronchi and peripheral lung field than in the trachea, and the clinical manifestations are related to their specific location. We report a case of sarcomatoid carcinoma of the lung in a 79-year-old man who presented with dyspnea on exertion.
Age of Onset ; Aged ; Bronchi ; Diagnosis ; Dyspnea ; Humans ; Lung* ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Survival Rate ; Trachea

BACKGROUND: The most widely used pulmonary function test is spirometry. It is a relatively simple and noninvasive test that measures the volume of air expelled from fully inflated lungs. However, spirometry is an effort-dependent test that requires careful instruction and the full cooperation of the test subject. Because the old patients have relatively longer expiration time than the young patients, it is difficult for both old age and technician to fulfill the end of test criteria for forced vital capacity (FVC) maneuver. In the present study, we aimed to investigate whether forced expiratory volume in six seconds (FEV6) could be utilized in place of FVC in the detection of airway obstruction for the old age. METHODS: Total 353 old age (> or =65years) were enrolled in this study and performed spirometry. Subjects were divided into two groups by FEV1/FVC as the gold standard for diagnosing obstructive airway disease; Group I: 132 patients with FEV1/FVC> or =70% , Group II: 221 patients with FEV1/FVC<70% The relationship between FVC and FEV6 values were analyzed in both groups and differences between the groups were investigated. RESULTS: The mean difference of FVC and FEV6 values (FVC-FEV6) was 138.4+/-23.0 mL (5.06+/-2.86%). This difference was found to be higher in group II (189.4+/-162.5 mL, 7.0+/-5.4%) than group I (52.9+/-47.3 mL, 1.9+/-1.5%). When FEV1/FVC is taken as the gold standard, FEV1/FEV6 had negative predictive value of 87.4% and a sensitivity of 91.4% in the detection of obstructive airway disease. Conclusion: FEV6 was a relative good candidate for parameter in the detection of airway obstruction in the old age for whom it is difficult to fulfill acceptable FVC maneuver. However, additional researches are needed to determine the usefulness of FEV6 in detecting obstructive airway disease of old age.
Airway Obstruction ; Diagnosis* ; Forced Expiratory Volume ; Humans ; Lung ; Respiratory Function Tests ; Spirometry ; Vital Capacity