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1.
A unique case of traumatic pulmonary food embolism.
Lanzillotta, F, Visonà, SD, Ballardini, M, Javan, GT, Osculati, A
Journal of forensic and legal medicine. 2020;:101907
Abstract
We report a unique case of post-traumatic pulmonary food embolism, due to a lethal blunt force trauma occurred in a traffic accident. The subject was a 37-year old man, victim of a road traffic accident while he was riding his motorbike. A forensic autopsy, followed by histological examination, was ordered in order to find out the cause of death and to assess the compatibility of the lesions with the dinamic of the accident. Autopsy revealed a blunt force thoraco-abdominal trauma responsible of the death. The most interesting histological evidences concerned lungs. Here, inside arterious and arteriolar pulmonary vessels, we identified crystal-like corpuscles, of various shape and size, sometimes aggregated in small masses and thin vegetal fibers, refracting at polarized light, both PAS-positive and meat fibers shadows. The presence of alimentary material in the pulmonary vessels was explained by a pulmonary food embolism. The occurring of this kind of embolism implies a communication between the viscera lumen and the venous circulation of his wall (through a small wall rupture) in presence of cardiocirculatory activity, and provides, therefore, a strong proof of vitality.
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2.
A case of secondary syphilis with pulmonary involvement and review of the literature.
Visuttichaikit, S, Suwantarat, N, Apisarnthanarak, A, Damronglerd, P
International journal of STD & AIDS. 2018;(10):1027-1032
Abstract
Syphilis is a sexually transmitted systemic infection caused by Treponema pallidum. We report a case of a heterosexual, HIV-positive man who presented with secondary syphilis and a lung abscess. A bacterial lung abscess was suspected and a computed tomography-guided percutaneous needle aspiration of the lung abscess was performed. Direct pulmonary involvement by T. pallidum was suggested by a positive PCR result on the aspirated fluid specimen. The clinical signs of secondary syphilis improved, and the lung abscess was resolved after treatment with benzathine penicillin G and amoxicillin-clavulanate. The final diagnosis was secondary pulmonary syphilis. Few reports of secondary syphilis with pulmonary involvement have been reported to date.
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3.
Increased IL-17RA and IL-17RC in End-Stage COPD and the Contribution to Mast Cell Secretion of FGF-2 and VEGF.
Roos, AB, Mori, M, Gura, HK, Lorentz, A, Bjermer, L, Hoffmann, HJ, Erjefält, JS, Stampfli, MR
Respiratory research. 2017;(1):48
Abstract
Mast cells are accumulated in advanced chronic obstructive pulmonary disease (COPD), and interleukin (IL)-17 signaling plays a role in disease progression. The expression, localization and functional relevance of IL-17 receptor (R)A and IL-17RC was explored in COPD by immunodetection, and functional assays.IL-17RA and IL-17RC was increased in very severe COPD, and expressed by mast cells. Increased secretion of the pro-angiogenic basic fibroblast growth factor and vascular endothelial growth factor was observed in vitro-maintained mast cells stimulated with IL-17A. Expression of these mediators was confirmed in end-stage COPD. Thus, accumulation of mast cells in COPD may contribute to vascular remodeling.
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4.
[Case report: respiratory symptoms in a competitive swimmer].
Gudmundsson, G
Laeknabladid. 2013;(2):83-5
Abstract
A young competitive swimmer consulted a physician because of respiratory symptoms. He was found to have a normal spirometry. Bronchial asthma was diagnosed based on bronchial challenge test and appropriate treatment started. An overview is given on the rules of the National Sports Association on the treatment of asthma, which asthma medications are banned and how to apply for an exemption. Diagnostic studies for asthma are reviewed. In addition to spirometry before and after bronchodilatation, bronchial challenge tests and exercise tests are used. An overview of pathophysiology of swimmer's asthma is given and how it is connected to chloride that is used as a disinfectant. The incidence of asthma among competitive swimmers is reviewed.
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5.
From the archives of the AFIP: pulmonary alveolar proteinosis.
Frazier, AA, Franks, TJ, Cooke, EO, Mohammed, TL, Pugatch, RD, Galvin, JR
Radiographics : a review publication of the Radiological Society of North America, Inc. 2008;(3):883-99; quiz 915
Abstract
Pulmonary alveolar proteinosis (PAP) may develop in a primary (idiopathic) form, chiefly during middle age, or less commonly in the setting of inhalational exposure, hematologic malignancy, or immunodeficiency. Current research supports the theory that PAP is the result of pathophysiologic mechanisms that impair pulmonary surfactant homeostasis and lung immune function. Clinical symptomatology is variable, ranging from mild progressive dyspnea to respiratory failure. There is a strong association with tobacco use. The predominant computed tomographic feature of PAP is a "crazy-paving" pattern (smoothly thickened septal lines on a background of widespread ground-glass opacity), often with lobular or geographic sparing. The radiologic differential diagnosis of crazy-paving includes pulmonary edema, pneumonia, alveolar hemorrhage, diffuse alveolar damage, and lymphangitic carcinomatosis. Definitive diagnosis is made with lung biopsy or bronchoalveolar lavage specimens that reveal intraalveolar deposits of proteinaceous material, dissolved cholesterol, and eosinophilic globules. Symptomatic treatment includes whole-lung lavage, and multiple procedures may be required. New therapies directed toward the identified defect in immune defense have met with moderate clinical success.
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6.
Idiopathic pulmonary haemosiderosis revisited.
Ioachimescu, OC, Sieber, S, Kotch, A
The European respiratory journal. 2004;(1):162-70
Abstract
Idiopathic pulmonary haemosiderosis is a rare cause of diffuse alveolar haemorrhage of unknown aetiology. It occurs most frequently in children, has a variable natural history with repetitive episodes of diffuse alveolar haemorrhage, and has been reported to have a high mortality. Many patients develop iron deficiency anaemia secondary to deposition of haemosiderin iron in the alveoli. Examination of sputum and bronchoalveolar lavage fluid can disclose haemosiderin-laden alveolar macrophages (siderophages), and the lung biopsy shows numerous siderophages in the alveoli, without any evidence of pulmonary vasculitis, nonspecific/granulomatous inflammation, or deposition of immunoglobulins. Contrary to earlier reports, corticosteroids alone or in combination with other immunosuppressive agents may be effective for either exacerbations or maintenance therapy of idiopathic pulmonary haemosiderosis.
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7.
[Pulmonary actinomycosis diagnosed through transbronchial lung biopsy (TBLB)].
Oki, Y, Morishita, M, Kato, H, Tokudome, M, Sanji, H, Kamasawa, R, Tetsu, K, Miyara, H, Watanabe, K, Hara, K
Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society. 2003;(3):202-6
Abstract
Pulmonary actinomycosis is a rather rare chronic pulmonary infection. Its diagnosis may be difficult without biopsy, because its culture from sputum or bronchial secretion is rarely successful. We report a case of pulmonary actinomycosis diagnosed by means of TBLB. A 57-year-old man was admitted to our hospital because of hemosputum. The chest radiograph at the first visit revealed a nodular lesion in the right middle lobe. The biopsy examination showed sulfur granules of which PAS-positive mycelium was arranged in a radiating pattern. On the basis of these findings, we diagnosed pulmonary actinomycosis. So far, there have been only 4 reported cases of pulmonary actinomycosis diagnosed by TBLB in Japan. TBLB is worth trying in the diagnosis of pulmonary actinomycosis, because it can avoid surgical procedures, if successful.