Precordial Area Research Articles

Prevalence of classic and non-classic pain sites of coronary artery disease: a cross-sectional study

Study objectiveThis study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms.MethodsThis cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients’ demographics and previous medical history were documented to investigate any potential associations with non-classic pain.Results62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant.ConclusionNon-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.

Carbon Dioxide Embolism During Laparoscopic Right Hepatectomy: A Case Report

Complications of laparoscopic surgery include carbon dioxide (CO2) embolism, primarily caused by the entry of CO2 gas into blood vessels or solid organs. If significant clinical symptoms occur, timely intervention is crucial as it can be life-threatening. We report a case of CO2 embolism during laparoscopic right hepatectomy. The patient was a 37-year-old male with no history of liver or kidney dysfunction. During the procedure, there were two episodes of oxygen desaturation (SpO2), and the second episode was accompanied by a significant drop in blood pressure and an increase in heart rate. However, there was no sudden decrease in the end-tidal CO2 partial pressure (ETCO2). Simultaneously, a grinding murmur was auscultated in the precordial area, and foamy blood was aspirated from the right internal jugular vein catheter. This article describes a case of CO2 embolism during laparoscopic surgery and provides a summary of its causes, clinical manifestations, diagnosis, and treatment. It is hoped that this article will contribute to the timely recognition and management of such cases, thereby preventing any potential adverse outcomes for patients.

Cardiovascular pathologies in post-covid syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Objective Problems of cardiovascular system and kidney function often follows the disease of Covid-19. Our aim was revealing and evaluation of cardiovascular disorders and kidney problems in patients who recovered from Covid-19. Materials and methods 46 patients with Covid-19 infection, aged 29 to 64, were examined upon entering the clinic and after 2 months in outpatient department. (38 were women and 8 men, average age was 46, 1+_10.3 years). Along with clinical laboratory examination, echocardiography and ECG-Holter monitoring was performed in dynamic. Daily proteinuria, creatinine clearance and glomerular filtration rate were calculated. Patients who previously had arterial hypertension or any other disease of the cardiovascular system were not included in the study. Results of the study: Among the complaints that patients revealed 2 months after clinical onset of Covid-19, most frequent was discomfort and stinging pain in precordial area without irradiation that was not related to physical exertion. Cardialgia was observed in acute period and after two months in 30% and 25% of patients, respectively. 15% of patients revealed shortness of breath and palpitations during slight physical exertion in the acute period, while at repeated examination the specified symptom remained in 6%. Special attention was paid in our study to the dynamics of blood pressure. 24% of patients had elevated blood pressure at baseline. Blood pressure readings was increased in 28% of patients after 14 days. The average values of blood pressure during two months were 135, 5+_14.3 mmHg - systolic and 89.7+_10.7 mmHg- diastolic. After 2 months 26% of patients maintained arterial hypertention (AH) within the first stage. According to echocardiographic data, ventricular diastolic dysfunction was observed in 58% of patients in acute period and in 44% after two months. There were no signs of myocardial systolic dysfunction in dynamics. During the initial examination, diminished creatinine clearance (<90ml/min) and glomerular filtration rate (<90ml/min/1.73m2) disorders were observed in 42% and 62% of patients, respectively and microalbuminuria in 69% of patients. After 2 months microalbuminuria was maintained in 60% of patients, while decreased renal function (creatinine clearance and GFR) was observed in 33% of patients. Conclusion Cardialgia, AH and signs of diastolic dysfunction were the main clinical manifestations of cardiovascular system dysfunction. The data of our study shows that probability of the formation of AH is highly increased after Covid-19 infection. Long-lasting microalbuminuria and a decrease in the renal filtering capabilities can also be revealed in every third patient after Covid-19 infection. The results of the study indicate the necessity of the monitoring of the patients after Covid-19 for timely diagnosis of AH and kidney disfunction to prevent development of unexpected cardiovascular events and kidney failure.

PO-03-198 A NOVEL ELECTROCARDIOGRAPHIC MODEL FOR DEFINITE DRUG INDUCED BRUGADA SYNDROME.

Clinical, electrocardiographic, and genomic factors associated with the development of the drug induced type 1 Brugada pattern (DI-T1BP), in response to sodium channel blocker provocation (SCBP) have been investigated. These prior analyses have mostly been concerned with the prediction of the DI-T1BP rather than the strength of the diagnosis of Brugada syndrome (BrS). To analyse and compare the ECG response to SCBP with Ajmaline in a cohort of healthy subjects (Healthy Controls) and clinical patients with a DI-T1BP and a Shanghai Score (SS) ≥3.5 (Definite-BrS group). From an existing clinical cohort of consecutive patients investigated at our centre between 2010 - 2022, we identified those with a DI-T1BP and a SS ≥3.5. Respondents to a national advertisement for healthy volunteers completed an online medical questionnaire. Those fulfilling inclusion criteria were invited to undergo further evaluation with eligible subjects undergoing a diagnostic ajmaline challenge. Digital ECG acquisition facilitated the development of automated measurements. A univariable analysis following by a multivariable analysis were undertaken to compare ECG characteristics between the two groups. A logistic regression analysis was performed to identify ECG characteristics that accurately associated with the definite drug induced BrS patient group. Two-hundred-and-forty-eight volunteers completed an online questionnaire, 103 accepted an invitation to undergo further screening and 100 were recruited into the healthy control (HC) group including three with a DI-T1BP. From a cohort of 1241 consecutive patients undergoing ajmaline provocation, 372 had a DI-T1BP and 166 had a DI-T1BP and SS ≥3.5. Of the ECG characteristics investigated, ajmaline induced changes (delta) in precordial QRS area (mv/ms), Anterior STJ point amplitude (μV) and S wave duration in lead II (ms), were independent predictors of definite BrS, Table 1.0. A model incorporating these 3 ECG characteristics was an outstanding discriminator with an area under the curve of 0.937 [95% confidence interval 0.907 – 0.966], P<0.01, Figure 1. This novel predictive model demonstrates excellent discrimination between patients with definite BrS and healthy controls. Further refinement of this model in clinical patients with DI-T1BP and SS <3.5 will identify additional clinical characteristics that can be incorporated into a clinical-ECG diagnostic model.

Interrupted aortic arch – case report

Interrupted aortic arch is a rare ductal-dependent congenital heart malformation, accounting for 1.5% of all MCC, 2 in 100,000 cases of live newborns are diagnosed with IAA. We present the case of a 3-month-old infant who came to our clinic on the recommendation of the family doctor. On clinical examination, he presented an affected general state, peri oronasal cyanosis during moments of agitation, grade III/6 systolic murmur present throughout the precordial area, heart rate = 160 beats/min, respiratory rate = 45 breaths/min, SaO2 = 86 – 91% in atmospheric air, liver 4 cm below the costal rim. Echocardiography revealed a complete ductal-dependent congenital heart malformation, interrupted aortic arch, persistence of ductus arteriosus, wide muscular ventricular septal defect, hypoplasia of the ascending aorta. The angioCT examination confirmed the diagnoses from the echocardiography. During the genetic examination, the suspicion of DiGeorge syndrome was raised, which is why MLPA for microdeletions was required. The first therapeutic act performed was represented by maintaining the patency of the arterial channel. The patient was transferred to a clinic in Italy for the surgical intervention.

A Rare Case of Ulcerative Colitis with Diffuse Parenchymal Lung Disease, Spontaneous Pneumomediastinum and Subcutaneous Emphysema

A 50-year-old male, a tobacco smoker, who was known to have ulcerative colitis presented with dry cough, chest pain, dysponea and frequent passage of blood and mucous mixed stools. Physical examination revealed clubbing, subcutaneous emphysema of upper chest and auscultatory findings of crunching sound over pre-cordial area and basal crepitations. Spirometry was suggestive of restrictive pattern. High resolution computed tomography (HRCT) of thorax revealed pneumomediastinum, subcutaneous emphysema, bilateral diffuse centrilobular nodules and ground-glass haziness with mosaic pattern along with posterior basal fibrotic changes. The present case documents the uncommon pulmonary involvement of spontaneous pneumomediastinum and subcutaneous emphysema diffuse parenchymal lung disease, in a patient with ulcerative colitis.

Çocuk Kardiyoloji polikliniğine göğüs ağrısı şikayetiyle başvuran hastaların tanısal değerlendirilmesi: Covid 19 pandemisinin etiyolojiye etkisi.

Aim: The aim of this study was to evaluate the etiology of chest pains and demographic data of these patients, and to investigate the effect of the COVID-19 pandemic on these variables. Material and Methods: The study included patients who presented with complaints of chest pain at the Paediatric Cardiology Clinic between November 2019 and August 2020. The patients were separated into two groups from the date of when restrictions to daily life were implemented because of the COVID-19 pandemic in Turkey, as Group 1 who presented before March 2020, and Group 2 who presented after March 2020. Results: Evaluation was made of a total of 251 patients comprising 136 (54.2%) females and 115 (45.8%) males with a mean age of 11.6 ± 2.9 years. The chest pain was felt most often in the precordial area (46.2%) as a needle pricking (64.9%). The cause of the chest pain was determined to be the musculoskeletal system (55%), psychogenic (16.3%) and idiopathic (13.5%) respectively. A cardiac reason was determined in 2.8% of the patients. In the comparisons of the two groups, psychogenic reasons were seen more in Group 2 after the pandemic, and more patients had been referred by a physician and from rural areas (p&amp;lt;0.05). Conclusion: To prevent repeated polyclinic presentations with non-cardiac chest pain, and unnecessary and lengthy tests, the concerns of families must be eliminated. After the beginning of the COVID-19 pandemic, there was determined to be an increase in children with chest pains of psychogenic cause.

Development of a leakage monitoring system in isolated limb perfusion with portable gamma camera

Isolated limb perfusion (ILP) is a method for treating unresectable lesions of limbs in patients with melanoma or sarcoma by using high doses of tumor necrosis factor alpha and melphalan. This high doses can result in high systemic toxicity if there is a drug leak from the isolated circulation of the limb to the systemic. This makes it imperative to monitor the leakage rate (F(%)) during the infusion, currently performed with radiotracers. The objective of this work was to develop a leakage monitoring protocol as accurate as possible to ensure safe ILP. Material and methodWe built a phantom with three compartments (body, limb and precordial area) and a high sensitivity collimator fitted to a portable gamma camera. We simulate ILP with scheduled leaks every 10 min from 1% to 9% (theorical F(%)). We mesured F(%) using two equation: one is the proposed in the literature and another corrected by decay of the radioisotope. We test the optimal radiopharmaceutical doses to minimize the detector dead time error and compare F(%) mesured by both equations regarding the theoretical F(%).The leakage monitoring protocol was used in 17 ILP of 16 patients and an analysis of the recorded data was performed. ResultsWe found significant differences between F(%) mesured using the first equation and theoretical F(%), obtaining results very adjusted to the theorical after applying the decay correction. Conclusionsthe decay correction of the radioisotope is a simple manner to carry out the procedure more safely, reducing the error in the calculation of F(%).

Desarrollo de un protocolo de monitorización de fuga en perfusión de miembro aislado con gammacámara portátil

Isolated limb perfusion (ILP) is a method for treating unresectable lesions of limbs in patients with melanoma or sarcoma by using high doses of tumor necrosis factor alpha and melphalan. These high doses can result in high systemic toxicity if there is a drug leak from the isolated circulation of the limb to the systemic. This makes it imperative to monitor the leakage rate (F[%]) during the infusion, currently performed with radiotracers. The objective of this work was to develop a leakage monitoring protocol as accurate as possible to ensure safe ILP. Material and methodWe built a phantom with 3compartments (body, limb and precordial area) and a high sensitivity collimator fitted to a portable gammacamera. We simulate ILP with scheduled leaks every 10minutes from 1% to 9% (theorical F[%]). We mesured F(%) using 2equation: one is the proposed in the literature and another corrected by decay of the radioisotope. We test the optimal radiopharmaceutical doses to minimize the detector dead time error and compare F(%) mesured by both equations regarding the theoretical F(%).The leakage monitoring protocol was used in 17 ILP of 16 patients and an analysis of the recorded data was performed. ResultsWe found significant differences between F(%) mesured using the first equation and theoretical F(%), obtaining results very adjusted to the theorical after applying the decay correction. ConclusionsThe decay correction of the radioisotope is a simple manner to carry out the procedure more safely, reducing the error in the calculation of F(%).

Cardiac Tamponade and Laceration of Right Ventricle in Blunt Thoracic Injury: A Case Report

Introduction. Cardiac tamponade caused by blunt thoracic injuries is a rare case with a high mortality rate. Generally, patients with blunt cardiac injury were not survived before they reach the hospital. We present the case of a 50-year-old man was admitted to our emergency department after a motorcycle hit the cart he was pushing on the street, and then the handle hit the chest. He presented with hemodynamically unstable and a bruised on precordial area, then he went into cardiac arrest. Standard CPR was done for 2 minutes, continued with intubation and ROSC. FAST showed fluid in the pericardial sac. After doing pericardiocentesis, an amount of blood about +/- 40 mL was aspirated. A median sternotomy was performed, and lacerations were found in the right ventricle and right ventricle pulmonary junction.

The Role of Ultrasound for Detecting Occult Penetrating Cardiac Wounds in Hemodynamically Stable Patients.

There is evidence in favor of using the ultrasound as the primary screening tool in looking for an occult cardiac injury. We report on a prospective single-center study to determine the diagnostic accuracy of chest ultrasound for the diagnosis of occult penetrating cardiac wounds in a low-resource hospital from a middle-income country. Data were collected prospectively. We included all consecutive patients 14years and older who presented to the Emergency Trauma Unit with (1) penetrating injuries to the precordial area and (2) a systolic blood pressure ≥ 90mmHg (hemodynamically stable). The main outcome measures were sensitivity, specificity, and positive and negative predictive values of ultrasound compared with those of the pericardial window, which was the standard test. A total of 141 patients met the inclusion criteria. Our results showed that for diagnosing an occult cardiac injury, the sensitivity of the chest ultrasonography was 79.31%, and the specificity was 92.86%. Of the 110 patients with a normal or negative ultrasound, six had a positive pericardial window. All of these patients had left hemothoraces. None of them required further cardiac surgical interventions. We found that ultrasound was 79% sensitive and 92% specific for the diagnosis of occult penetrating cardiac wounds. However, it should be used with caution in patients with injuries to the cardiac zone and simultaneous left hemothorax.

Acupuncture on treating angina pectoris: A systematic review.

Background:Coronary heart disease angina pectoris is a common clinical symptom in patients with coronary heart disease, due to coronary atherosclerotic stenosis or sputum leading to coronary insufficiency, myocardial transient ischemia, hypoxia caused by precordial pain as the main clinical manifestations Group syndrome. Coronary heart disease angina causes coronary blood flow insufficiency, cannot meet the normal activities of myocardial cells, leading to myocardial ischemia or necrosis. When the disease occurs, there is paroxysmal and crushing pain in the precordial area of the patient. Therefore, we recognize the importance of the disease and have paid enough attention. Clinical studies in recent years have found that the use of acupuncture in the treatment of angina pectoris has a good clinical application prospect. This study was conducted to study the effect of using acupuncture to treat angina pectoris.Methods and analysis:We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet, Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to November 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of angina pectoris.Ethics and dissemination:This systematic review will evaluate the efficacy and safety of acupuncture for angina pectoris. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial.Registration number:PROSPERO CRD42019138003.

Giant Intrapericardial Myxoma Adjacent to the Left Main Coronary Artery

A 62-years-old woman was admitted to the hospital because of chronic cough, expectoration of thick mucus, hoarseness and tightness in the precordial area. Computed Tomography (CT) examination revealed the presence of a giant intrapericardial tumor with the dimensions of 80 × 38 × 32 mm. It was located anteriorly and laterally to the left atrium, posteriorly to the pulmonary trunk and the ascending aorta. This hypodense change modeled the left atrium without evidence of invasion. CT coronary angiography and 3-dimensional reconstruction were applied to enable precise planning of cardiac surgery. CT evaluation confirmed that it is possible to remove the tumor without damage to the adjacent left main coronary artery. The patient underwent cardiac surgery with sternotomy and cardiopulmonary bypass. A cohesive, smooth, vascularized tumor pedunculated to the left atrial epicardium was visualized. The location and dimensions corresponded to those determined by CT scan examination. The entire tumor was successfully dissected together with adjacent adipose and fibrous tissue. Histological evaluation revealed the presence of myxoid cells, blood vessels, degenerative changes, and microcalcifications embedded in profuse hyalinized stroma. Those histological features enabled identification of the intrapericardial tumor as a myxoma. Follow-up CT examination did not demonstrate any signs of recurrence of the myxoma. According to our knowledge, a myxoma located inside the pericardial sac has never been described before.

Clinical manifestation and surgical treatment analysis of five cases with biatrial myxoma

BackgroundCardiac myxomas (CMs) are a major primary heart tumor which often causes unexpected symptoms or sudden death. Among CMs, biatrial myxomas are even rare. This study was designed to investigate the clinical characteristics and surgical treatment of 5 cases with biatrial myxoma, to summarize the treatment experience and the effect of short-to-mid-term prognosis. MethodsFive patients with biatrial myxoma were included in this study. The patients' relative literature, chest X-ray, body-surface electrocardiogram, and ultrasonic cardiogram (UCG) were used to investigate the clinical characteristics. The experience of surgical treatment and perioperative treatment were analyzed. ResultsAmong the 5 cases, patients had presented discomfort of precordial area and cardiac insufficiency symptoms such as dyspnea and chest discomfort. There were characteristic changes on echocardiography (ECG). All patients accepted resection of both tumor and its basement tissue. Their symptoms were all improved after surgery, no deaths occurred. ConclusionIn conjunction with clinical features, diagnostic clue and echocardiography, the detectable rate of biatrial myxoma could be significantly improved. Early diagnosis showed good effect on prognosis.

Influence de la religion dans la somatisation dépressive en Afrique

This study explored the link between religious practice and depressive somatization process in the Togolese sociocultural context. It was a descriptive cross-sectional study conducted from January 16 to December 30, 2011 at the University Clinic of Psychiatry and Medical Psychology of the Lomé Sylvanus Olympio University Hospital. The study included 144 depressed patients amongst which 96 women (66.66%) and 48 men (33.34%) with a mean age of 35.54 years (range 15 and 58 years) and a sex ratio of two for women. Among them, 84 were married (58.33%), 47 were single (32.64%) and 13 were divorced (9.03%). Only 12 of them did not attend school (8.33%) while 132 did it (91.67%), of which 24 attended primary schools (16.66%), 72 attended secondary schools (50%) and 36 attended higher schools (25.01%). By religious affiliations, 96 were Christians (66.67%) from all denominations including Pentecostals (16%) and 8% Protestants. Muslims comprised 16 members (11.11%) and 32 were animists (22.22%). The various pains (58.33%), digestive disorders (45.14%) and warm sensations of the body-type burns (36.10%) were the main manifestations of depressive suffering. The abdomen (36.10%), the precordial region (32.63%) and the head were the principal invested areas of somatization. The precordial and joint pains represented 66.75% and 27% respectively in men, pruritus and abdominal disorders accounted for 80% and 90% in women. There was a strong relationship between the unconscious choice of certain body areas of somatization and the sex of patients (corrected χ2=156.47; P<0.000; C=0.5). Muslims somatized preferentially on the skin and ano-genital organs while Animists and Christians have mainly invested precordial and abdominal areas. The analysis of variance (ANOVA) showed a relationship between the number of years of religious practice and somatization areas (F=9.07 threshold at P>0.001). The authors found that if depressive somatization is frequent, the probability of investing in an organ in such situations is reversely proportional to sex and the number of years spent in the religious practice.

Relationship between Traube's space and body mass index

Objectives: Traube’s space is located in the precordial area of the anterior chest wall and is used in the evaluation of spleen size;therefore, proper evaluation during physical examination is extremely important. The aim of this study was to evaluate the associationbetween Traube’s space, detected by Castell’s method, and body mass index (BMI). Methods: Twenty-one male and 14 female subjects were evaluated by the same physician with percussion method, in 2007and 2010. Traube’s space was determined on the thoracic wall and its shape was drawn on transparent paper. The drawingswere scanned and the images were transferred to a personal computer (PC). The area of Traube’s space on each imagewas calculated using Digimizer software. BMI was calculated by the body weight/(height)2 formula. The data were evaluated with SPSS 13.0 software. To compare the data obtained in 2007 and 2010, the Wilcoxon signed-rank test was used. Results: The BMI of males increased by 9.24% in three years, and the surface area of Traube’s space in males decreased by 36.02% in this period. The differences in BMI and Traube’s space were statistically significant (p 0.05). The surface area of Traube’s space of females decreased by 28.23% in this period, the difference was statistically significant (p<0.05). Conclusion: The data obtained in this study are suggested to be useful for evaluation of Traube’s space and spleen size during physical examination in terms of gender and BMI. Keywords: body mass index; female; male; Traube’s space

Evaluation of Traube's space using a novel computer-assisted method

Objectives : Traube’s space, used to detect spleen enlargement, is at the precordial area on the anterior wall of the chest. In this respect, correct assessment of this area during physical examination is very important. The aim of this study was to evaluate the area of Traube’s space by percussion that is known to be sensitive and specific over 70% and assess effects of gender and defecation habit on the space area. Methods: Thirty-four males and 32 females participated in the study, examined by the same physician. Traube’s space was determined on the chest wall by percussion. Images of Traube’s space were drawn on a transparent paper using certain reference points for each participant. All images were scanned and measurements were done by AutoCAD 2004 software. Weight and height of the individuals were also measured and their defecation information for the morning they participated in the study was also inquired. Results: In the males, weight, height, body mass index (BMI) and Traube’s space values were significantly higher than those of females (p 0.05). Conclusion: The results of this study may be useful for the evaluation of Traube’s space and spleen enlargement during physical examination. Keywords: percussion; physical examination; splenomegaly; Traube’s space

Robotic-assisted left upper lobectomy.

The patient, a 53-year-old woman, was admitted due to “lesion in the left lung found during health check-up 2 years ago” and “a space-occupying lesion in the upper lobe of left lung”. Two years ago, chest CT during health checkup showed a ground-glass opacity (GGO) at the edge of the upper lobe of left lung. However, no special treatment was given. Ten days ago, the patient visited our hospital due to spinal joint conditions. Chest CT showed a spaceoccupying lesion in the upper lobe of left lung. The lesion has slightly irregular border and unclear margin, with mild pleural retraction. The lesion was slightly enlarged compared with that in the CT image 2 years ago. The patient’s complaints did not include cough/expectoration, chest tightness, shortness of breath, low fever, night sweats, nausea, vomiting, abdominal distension, diarrhoea, heart palpitations, or discomfort of precordial area. His mental status, physical performance, appetite, and sleep were normal, and the body weight did not obviously change. Urination and defecation were normal.

Robotic-assisted left upper lingual segmentectomy.

The patient, a 50-year-old woman, was admitted due to “repeated hemoptysis for more than half a year” and “bronchiectasis”. The patient began to cough up blood without obvious causes about 6 months ago. The blood was bright red in color, and the patient spitted about 6 times during each attack. No special treatment was given. She spitted up 9 times of fresh blood again 1 month ago and then visited a local hospital. Chest CT showed that the lingular bronchus of left upper lobe showed cystic and cylindrical dilatation, along with thickened walls. Small dotted and patchy intensities were visible around it. Left bronchial dilation accompanied with peribronchitis was considered. The condition was not remarkably improved after anti-inflammatory and hemostatic treatment. She then visited our hospital for further management. After outpatient consultation, she was admitted due to “bronchiectasis”. The patient’s complaints did not include cough, chest tightness, shortness of breath, low fever, night sweats, nausea, vomiting, abdominal distension, diarrhea, heart palpitations, or discomfort of precordial area. His mental status, physical performance, appetite, and sleep were normal, and the body weight did not obviously change. Urination and defecation were normal.

Robotic-assisted right middle lobectomy for poorly differentiated squamous cell carcinoma.

The patient, a 73-year-old men, was admitted due to “sputum with blood for one month” and “mass in the right middle lung lobe”. One month ago, he developed cough and expectoration with blood-stained sputum. Two weeks ago, chest CT showed a soft-tissue mass with irregular border in the lateral segments of the right middle lung lobe. Bronchoscopy detected a mass at the bronchial orifice in the lateral segments of the right middle lung lobe. No malignant cell was detected at biopsy pathology. The patient’s complaints did not include low fever, night sweats, nausea, vomiting, abdominal distension, diarrhoea, heart palpitations, or discomfort of precordial area. His mental status, physical performance, appetite, and sleep were normal, and the body weight did not obviously change. Urination and defecation were normal.