1/8. bronchiectasis: the 'other' obstructive lung disease.bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to mind as a possible cause. Chronic airway inflammation leads to bronchial dilation and destruction, resulting in recurrent sputum overproduction and pneumonitis. Once the diagnosis is confirmed, any potential predisposing conditions should be aggressively sought. The relapsing nature of bronchiectasis can be controlled with antibiotics, chest physiotherapy, inhaled bronchodilators, proper hydration, and good nutrition. In rare circumstances, surgical resection or bilateral lung transplantation may be the only option available for improving quality of life. prognosis is generally good but varies with the underlying syndrome.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/8. Pseudomembranous tracheobronchitis caused by aspergillus.Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have aspergillus pseudomembranes of their lower tracheobronchial tree. steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/8. Diffuse bacterial bronchiolitis with bronchiolar pneumonia in adults.Three patients had diffuse reticulonodular shadowing on chest roentgenogram, dyspnea, cough, purulent sputum, airways obstruction, variable fever, and leukocytosis. Lung tissue from two showed inflammatory exudate in bronchioles and peribronchiolar alveoli; all had multiple isolates of either haemophilus influenzae or streptococcus pneumoniae from sputum or lung tissue. When examined in the context of similar syndromes reported by others under different labels in the past, these observations suggest that this is a specific clinical entity, which is both uncommon and serious. Despite initial misdiagnosis in all three cases, the two patients in whom the true nature of the disease was promptly recognized had complete recovery after the institution of appropriate antibacterial therapy. The most accurate and appropriate term for this entity is diffuse bacterial bronchiolitis with bronchiolar pneumonia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/8. Acute laryngeal obstruction in a patient with chronic bronchitis.An unusual case of acute respiratory obstruction due to a laryngeal cyst is described. The mixed inspiratory and expiratory nature of this obstruction is discussed, and its implications for diagnosis and anaesthetic management. Alternative forms of management, especially those of transtracheal insufflation and transtracheal ventilation, and their possible complications are considered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/8. Thermal degradation products from an ethylene methacrylic acid copolymer-partial metal salt as the cause of industrial bronchitis.A self-employed physician developed industrial bronchitis due to the inhalation of fumes arising from the heating of a molded ethylene methacrylic acid copolymer-partial metal salt (Surlyn) in the basement of his home. Symptoms resolved following removal from exposure. A number of known irritants are given off as degradation products of Surlyn ionomer resin, including acrolein, aldehydes, and methacrylic acid. This case is unusual because of the nature of exposure and an unexpected fall in forced expiratory volume in 1 second after provocation testing.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/8. Diffuse panbronchiolitis with multiple tumorlets. A quantitative study of the Kultschitzky cells and the clusters.An autopsy case of diffuse panbronchiolitis with incidentally observed multiple tumorlets was reported. Quantitative study revealed the distribution and number of single Kultschitzky cell and its cluster. These cells were more frequently observed in the present case than in 20 control cases, and moreover, they tended to occur more frequently in the pulmonary segment in which tumorlets were found and there was an apparent transition of them into tumorlets. Immunohistochemically, gastrin-releasing peptide, calcitonin, and serotonin were demonstrable in the cells which consisted of both tumorlets and Kultschitzky cell clusters. It is suggested that the Kultschitzky cell is a precursor cell of the tumorlet and that tumorlet is benign, being hyperplastic in nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/8. bronchiolitis fibrosa obliterans in adults.Clinical, roentgenologic, and physiologic manifestations of three adult patients with biopsy-proved bronchiolitis fibrosa obliterans illustrate the varied clinical features of the different stages of this disease and emphasize the rapidly progressive nature of the disorder in some patients. Although the chronic stage of bronchiolitis fibrosa obliterans has not been shown previously to respond to corticosteroid therapy, both of our patients with this stage of the disease had a dramatic response to high-dose prednisone. Furthermore, our one patient with the acute stage of the disease had complete resolution of his disease with treatment. Our experience suggests that early diagnosis and treatment are important in determining the clinical course of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/8. Serial sputum cell counts in the management of chronic airflow limitation.This case study illustrates the usefulness of serial induced sputum cell counts from cytospins to investigate the nature of airway inflammation in a patient presumed to have prednisone-dependent asthma for 30 yrs. She had bronchiectasis and chronic airflow limitation. Exacerbations of breathlessness were associated with an increase in chronic airflow limitation with little or no sputum. Induced sputum showed elevated total cell and neutrophil counts at each exacerbation with no increase in the proportion of eosinophils. Pathogenic bacteria were cultured at each flare-up. The dose of prednisone was reduced progressively and each exacerbation was treated with an appropriate antibiotic without increasing the dose of prednisone, as was the case previously. The infections were associated with bronchiectasis of the right upper lobe which was removed. Examination of the specimen confirmed neutrophilic infiltration and did not show the usual airway structural changes of asthma. These results provide further evidence of the value of sputum cell counts in practice, in this case to prevent overtreatment with prednisone in a patient with recurrent deteriorations in airflow which were due to recurrent infections.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |