Cases reported "Respiration Disorders"

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1/40. Trepopnea due to recurrent lung cancer.

    Trepopnea is a condition whereby breathing may be comfortable in one position but difficult or labored in another. A unique case with trepopnea due to recurrent lung cancer with right main pulmonary artery stenosis and left main bronchus obstruction is presented. The patient had developed trepopnea 3 months earlier, but developed orthopnea shortly before he was admitted to our hospital. An emergent wall stent implantation was performed via the right femoral vein in the sitting position with the patient's leg stretched out. The symptoms and respiratory function improved after stent implantation.
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ranking = 1
keywords = obstruction
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2/40. Unexpectedly severe sleep and respiratory pathology in patients with amyotrophic lateral sclerosis.

    Daytime fatigue and sleep disturbance are frequent complaints in patients with amyotrophic lateral sclerosis (ALS). However, polysomnographic data are sparse. Nocturnal respiratory insufficiency may occur despite nearly normal daytime pulmonary function. We describe the clinical presentation and polysomnographic findings in two patients with clinically and electrophysiologically confirmed ALS with minimal weakness but excessive daytime sleepiness. polysomnography in the first patient showed a respiratory disturbance index of 43.5, and profound oxygen desaturations to 62%. The second patient had prolonged periods of hypoventilation, with oxygen saturations oscillating between 86 and 83%. Both patients showed severe sleep maintenance insomnia with a sleep efficiency < 40% and frequent arousals while asleep. Application of continuous positive airway pressure (CPAP) restored normal nocturnal ventilation, blood oxygenation and sleep parameters in the first patient; compliance, however, was poor. The second patient was unable to tolerate CPAP. We conclude that ALS patients with excessive daytime sleepiness or insomnia should undergo polysomnography to adequately diagnose nocturnal respiratory insufficiency and sleep disturbance. compliance with treatment, however, may be poor.
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ranking = 16.846907178346
keywords = airway
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3/40. Superior vena cava thrombosis causing respiratory obstruction successfully resolved by stenting in a small bowel transplant candidate.

    A 4 year old child was referred for small bowel transplantation. He had superior vena cava obstruction secondary to numerous central venous line placements; alternative routes for long term central venous access were compromised by extensive venous occlusive disease. Patency for the superior vena cava was re-established with stenting, which allowed for radiological placement of another central venous line. Long term survival in infants and young children with intestinal failure is dependent on adequate central venous access for the administration of parenteral nutrition. Line sepsis and physical damage to the catheter often necessitates multiple central venous catheter placements during their early life and these children are at risk of catheter related veno-occlusive disease. Recurrent sepsis and the loss of satisfactory venous access for the administration of parenteral nutrition is life threatening and is an indication for intestinal transplantation in up to 41% of patients reported by the small bowel registry.
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ranking = 5
keywords = obstruction
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4/40. diagnosis of anomalous innominate artery syndrome by spiral CT with 3D reconstruction of the airway: report of one case.

    Stridor in infants is a symptom that indicates partial obstruction of the large airways. Vascular rings are an unusual cause of tracheal compression which can induce stridor in infants and children. We report a 4-month-old boy with recurrent wheezing and stridor for 2 months. Spiral computed tomography (CT) and three-dimensional (3D) reconstruction aided in the diagnosis of external compression on the trachea by an innominate artery. Successful relief of the airway's obstruction was achieved by aortopexy. Three months after surgery, he was symptom free without any medication.
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ranking = 103.08144307008
keywords = airway, obstruction
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5/40. Gastro-oesophageal reflux in children with severe respiratory symptoms--clinical spectrum and management.

    Respiratory symptoms in children may be associated with underlying gastro-oesophageal reflux (GOR). We reviewed the case notes of 20 children who presented to us from June 1993 to June 1994 with respiratory symptoms and GOR. The patients consisted of 16 Malays, two Chinese and two Indians with equal number of males and females. Their age at diagnosis was less than one year in 17 patients. The earliest age at presentation was at the third day of life. All patients had major respiratory manifestations i.e. recurrent wheezing, recurrent cough and pneumonia. In addition, three patients had stridor and six patients had apparent life threatening episodes (ALTE). Fourteen patients required ventilation because of respiratory failure. diagnosis of GOR was based on clinical grounds supported by barium oesophagogram in seven patients and ultrasound examination in 11 patients. Eight patients were fundoplicated because of ALTE and recurrent severe bronchospasm. On follow up, 14 patients had hyperactive airways requiring inhaled bronchodilator and steroid therapy.
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ranking = 16.846907178346
keywords = airway
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6/40. Malignant ectomesenchymoma of the nose. Case report and review of the literature.

    To the best of our knowledge, a malignant ectomesenchymoma of the nose has not yet been reported. This rare tumour is composed of a mesenchymal element--usually a rhabdomyosarcoma--and a neuroectodermal element, often a neuroblastoma or a malignant schwannoma. Most malignant ectomesenchymomas have been found in children (mainly boys), but 5 adult cases, including our case, have also been reported. A 62-year-old man presented with a nasal obstruction on the right side of the nose. Diagnostic nasal endoscopy revealed a mass in the dorsal part of the right nasal cavity, which was treated by endoscopic surgery. The postoperative course was uneventful, and subsequent radiotherapy well tolerated. Since rhabdomyosarcoma is the most common component of this neoplasm, the treatment protocol for rhabdomyosarcoma would have appeared appropriate. This report reviews the literature, summarises the pathological features and possible histogenesis of the tumour, and outlines recommended treatments for malignant ectomesenchymoma.
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ranking = 1
keywords = obstruction
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7/40. Upper airway dysfunction in olivopontocerebellar atrophy.

    We report the findings in a patient known to have olivopontocerebellar atrophy who developed respiratory distress, inspiratory stridor, and maximum inspiratory and expiratory flow volume loops. Treatment with carbidopa-levodopa gave symptomatic relief.
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ranking = 67.387628713386
keywords = airway
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8/40. apnea and the elongated uvula.

    Four cases of respiratory distress and apnea associated with an elongated uvula are presented. In all cases, the uvula was found to intermittently fall onto the epiglottis and vocal cords. In all four patients, resection of the uvula led to resolution of all airway symptoms. It is hypothesized that the uvula, touching the vocal cords, caused intermittent laryngospasm and subsequent symptoms of cough, airway obstruction, and cyanosis. The anatomic reasons for such phenomenon are discussed.
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ranking = 67.692253061103
keywords = airway obstruction, airway, obstruction
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9/40. Preoperative aspiration for anterior mediastinal cyst with respiratory distress.

    We report a 5-month-old boy who presented with an anterior mediastinal cystic teratoma. Pre-operative symptoms of respiratory distress secondary to airway obstruction were markedly reduced by percutaneous aspiration. Aspiration was also beneficial in easily ventilating the baby during the surgical procedure.
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ranking = 50.845345882756
keywords = airway obstruction, airway, obstruction
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10/40. Misdiagnosis of respiratory dyskinesia.

    Respiratory dyskinesia consists of involuntary movements of the respiratory musculature and manifests as irregular respiratory rate, tachypnoea and grunting. It is probably an underrecognized condition and hence is easily misdiagnosed. Two patients with respiratory dyskinesia are reported. One patient was misdiagnosed as suffering from generalized anxiety disorder and the second as having chronic obstructive airway disease. Features useful for clinical differentiation are discussed.
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ranking = 16.846907178346
keywords = airway
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