Spontaneous pneumothorax is one of the most common conditions encountered in thoracic surgery. This condition can be treated conservatively or surgically based on indications and guidelines. Traditional surgical management includes pleurodesis (mechanical or chemical) in addition to bullectomy if the bullae can be identified. Mechanical pleurodesis is usually performed by surgical pleurectomy or pleural abrasion. In this case report, we present a case of a young patient with spontaneous pneumothorax who needed a surgical intervention. We performed a new, innovative surgical technique for surgical pleurectomy where we used carbon dioxide for dissection of the parietal pleura (capnodissection). This technique may provide similar efficiency to the traditional procedure but with less risk of bleeding and complications.

Bullous lung disease caused by tuberculosis is rare, and complications have a poor prognosis with uncertain pathophysiologic mechanisms. We describe a 29-year-old male patient who was admitted to the emergency department due to bilateral tension pneumothorax, which was complicated by bronchopleural fistula. This was managed with the placement of chest tubes, continuity of anti-TB drug treatment, and Heimlich valve placement.

Striae distensae is a common cutaneous phenomenon that begins as reddish linear atrophic plaques (striae rubra) that over time progress to silvery-white coloration (stria alba). Striae distensae in rare occasions becomes edematous, ulcerative, emphysematous, or urticated. Bullous striae distensae is a sequela of conditions causing interstitial edema along with systemic glucocorticoids use. To our knowledge, only eight cases of bullous striae distensae have been reported in the literature. Herein, we report a 17-year-old female, known case of nephrotic syndrome, presented to our clinic with abdominal fluid-fill cutaneous lesions only for 5 days. She had used systemic glucocorticoids for more than a decade before she was labeled as steroid resistant nephrotic syndrome. Cushingoid body habitus were observed during physical examination, in addition to translucent bullae overlying her previously known stretch marks. Punch biopsy of the lesions revealed dermal edema with thinned collagen bundles. Based on these clinicopathological findings, a diagnosis of bullous striae distensae was made. Awareness of this rare complication and unusual clinical presentation is fundamental to avoid unnecessary and excessive interventions whether investigatory or therapeutic in order to provide appropriate management of the underlying condition.

BACKGROUND: Canine middle ear effusion (MEE) is usually asymptomatic, being an incidental finding when computed tomography or magnetic resonance imaging (MRI) of the head is performed for other reasons unrelated to otic disease. The clinical relevance of the presence of material in the tympanic bulla (TB) remains uncertain, and more detail about its prevalence and appearance in MRI are required.
OBJECTIVE: To assess the prevalence of presence of material within the TB of French bulldogs (FB) with no clinical signs suggestive of otitis (externa, media or interna) that underwent high-field MRI for other medical reasons.
METHODS: Two hundred fifty-two TB of 126 FB were included in this study.
METHODS: Nonexperimental retrospective study in which MRI images were evaluated by a board-certified veterinary radiologist.
RESULTS: Fifty-eight per cent of the dogs had material in the TB lumen (46% of the TB) and 59% were bilaterally affected. The signal intensity of this material related to the grey matter was variable on T1w and mainly hyperintense on T2w sequences.
CONCLUSIONS: FB are predisposed to MEE. This is important when assessing imaging studies of TB of FB with chronic otitis externa, as high percentage of cases may have concurrent MEE. MRI findings in FB with MEE are characterised by a hyperintense signal to the grey matter on T2w in most cases and variable on T1w sequences.
UNASSIGNED: Ein Erguss im Mittelohr des Hundes (MEE) ist normalerweise asymptomatisch; es handelt sich dabei um einen Zufallsbefund, wenn eine Computertomografie oder eine Kernspintomografie (MRI) des Kopfes aus anderen Gründen durchgeführt wird, die mit der Ohrerkrankung nichts zu tun hat. Die klinische Relevanz des Auftretens von Material in der tympanischen Bulla (TB) ist ungewiss; es sind mehr Details über seine Prävalenz und das Auftreten im MRI nötig. ZIEL: Eine Beurteilung des Auftretens von Ablagerungen innerhalb der TB von Französischen Bulldoggen (FB) ohne klinische Anzeichen, die auf eine Otitis (externa, media oder interna) hinweisen, bei denen aus anderen medizinischen Gründen ein Hochfeld MRI durchgeführt wurde.
UNASSIGNED: Zweihundertzweiundfünfzig TB von 126 FB wurden in die Studie aufgenommen.
UNASSIGNED: Es handelt sich um eine nicht‐experimentelle retrospektive Studie, bei der MRI‐Bilder durch einen Board‐zertifizierten Veterinär‐Radiologen evaluiert wurden.
UNASSIGNED: Achtundfünfzig Prozent der Hunde hatten Ablagerungen im Lumen der TB (46% der TB) und 59% waren auf beiden Seiten betroffen. Die Signalintensität dieser Ablagerungen im Vergleich zur grauen Substanz war bei T1w variabel und bei T2w Sequenzen hauptsächlich hyperintens.
UNASSIGNED: FB sind prädisponiert für MEE. Diese Tatsache ist wichtig bei der Beurteilung von bildgebenden Studien der TB bei FB mit chronischer Otitis externa, da ein hoher Prozentsatz der Fälle gleichzeitig einen MEE haben könnte. MRI‐Befunde bei FB mit MEE sind in den meisten Fällen durch ein hyperintenses Signal der grauen Substanz bei T2w und einem variablen Signal bei T1w Sequenzen charakterisiert.
背景: 犬中耳分泌物(MEE)通常是无症状的，这是通过与耳疾病无关的其他原因进行头部计算机断层扫描或磁共振成像(MRI)偶然发现的。鼓室大泡(TB)中存在物质的临床相关性仍不确定，需要更多关于其患病率和MRI表现的细节。 目的: 评估无中耳炎(外耳道、中耳炎或中耳炎)临床症状的法国斗牛犬(FB)因其他医学原因接受高场MRI检查，提示鼓泡内存在物质的发生率。 动物: 研究中包括126 只法斗的252 个鼓泡。 材料和方法: 非实验性回顾性研究，由委员会认证的放射科兽医评估MRI图像。 结果: 58%的犬(46%的TB)的鼓泡腔中有物质，59%的犬双侧都有物质。这种与灰质相关的物质信号强度在T1w上表现多样，并且在T2w序列上主要是高密度信号。 结论与临床相关性: 法斗易产生中耳分泌物。这在评估法斗的鼓泡和慢性外耳道炎时影像学研究很重要，因为高比例的病例可能同时发生MEE。在大多数情况下，伴有MEE的法斗的MRI表现以T2w的灰质高密度信号为特征，而T1w序列是不确定的。.
BACKGROUND: Un épanchement dans l\'oreille moyenne (EOM) canin est généralement asymptomatique, et apparait comme une découverte fortuite lors d\'un examen tomodensitométrique ou d\'une imagerie par résonance magnétique (IRM) de la tête effectuée pour d\'autres raisons non liées à une maladie auriculaire. La pertinence clinique de la présence de matériel dans la bulle tympanique (BT) reste incertaine, et il est nécessaire d\'obtenir plus de détails sur sa prévalence et son aspect à l\'IRM.
OBJECTIVE: Évaluer la prévalence de la présence de matériel dans la BT de bouledogues français (BF) ne présentant aucun signe clinique évocateur d\'une otite (externe, moyenne ou interne) et ayant subi une IRM à haut champ pour d\'autres raisons médicales.
UNASSIGNED: Deux cent cinquante‐deux BT de 126 BF ont été inclues dans l\'étude. MATÉRIELS ET MÉTHODES: Étude rétrospective non expérimentale dans laquelle les images IRM ont été évaluées par un radiologue vétérinaire certifié. RÉSULTATS: Cinquante‐huit pour cent des chiens présentent du matériel dans la lumière de la BT (46 % des BT) et 59 % sont affectés de façon bilatérale. L\'intensité du signal de ce matériel lié à la matière grise était variable en T1w et principalement hyperintense sur les séquences T2w.
UNASSIGNED: Les BF sont prédisposés à l\'EOM. Ceci est important lors de l\'évaluation des études d\'imagerie de la BT des BF atteints d\'otite externe chronique, car un pourcentage élevé de cas peut présenter une EOM concomitante. Les résultats de l\'IRM chez les BF atteints d\'EOM sont caractérisés par un signal hyperintense de la substance grise en T2w dans la plupart des cas et variable sur les séquences T1w.
背景: 犬の中耳滲出液(MEE)は通常無症状であり、耳疾患とは無関係な他の理由で頭部のコンピュータ断層撮影(CT)や磁気共鳴画像法(MRI)を施行した際に偶発的に発見される。鼓室胞(TB)内の物質の存在の臨床的関連性は依然として不明であり、その有病率およびMRIにおける外観についてのより詳細な情報が必要である。 目的: 本研究の目的は、耳炎を示唆する臨床症状(外耳炎、中耳炎、内耳炎)のないフレンチ・ブルドッグ(FB)で、他の医学的理由から高磁場MRIを受けた際の鼓室内物質の有病率を評価することであった。 供試動物: 126頭のフレンチブルドッグの252個の鼓室胞を対象とした。 材料と方法: 非実験的レトロスペクティブ研究で、MRI画像を認定獣医放射線科医が評価した。 結果: 58%の犬が鼓室胞内腔に物質を認め(鼓室胞の46%)、59%が両側性であった。灰白質と比較したこの物質の信号強度は、T1wでは変化し、T2wシーケンスでは主に高強度であった。 結論と臨床的意義: フレンチ・ブルドッグは中耳に滲出液を認めやすい。このことは、慢性外耳炎を有するフレンチ・ブルドッグの鼓室胞の画像検査を評価する際に重要である。なぜなら高い割合でMEEを併発している可能性があるからだ。MEEを有するフレンチ・ブルドッグにおけるMRI所見は、ほとんどの症例でT2wで灰白質より高強度信号が特徴的であり、T1wシーケンスでは変化した。.
UNASSIGNED: A efusão da orelha média (EOM) canina é geralmente assintomática, sendo um achado incidental quando a tomografia computadorizada ou ressonância magnética (RM) de crânio é realizada por outros motivos não relacionados à doença otológica. A relevância clínica da presença de material na bula timpânica (BT) permanece não esclarecida, sendo necessários mais detalhes sobre sua prevalência e aparência na ressonância magnética.
OBJECTIVE: Avaliar a prevalência da presença de material na TB de buldogues franceses (BF) sem sinais clínicos sugestivos de otite (externa, média ou interna) submetidos a ressonância magnética de alto campo por outras causas clínicas.
UNASSIGNED: Duzentos e cinquenta e duas BT de 126 BF foram incluídos no estudo. MATERIAIS E MÉTODOS: Estudo retrospectivo não experimental no qual as imagens de ressonância magnética foram avaliadas por um radiologista veterinário certificado.
RESULTS: Cinquenta e oito por cento dos cães apresentavam material no lúmen da BT (46% da BT) e 59% foram acometidos bilateralmente. A intensidade do sinal deste material relacionado à substância cinzenta foi variável em T1w e principalmente hiperintensa em T2w. CONCLUSÃO E RELEVÂNCIA CLÍNICA: Os BF são predispostos à EOM. Isto é importante na avaliação de exames de imagem de BT ou BF com otite externa crônica, pois uma alta porcentagem de casos pode apresentar EOM concomitante. Os achados de ressonância magnética em BF com EOM são caracterizados por um sinal hiperintenso da substância cinzenta em T2w na maioria dos casos e variável nas sequências em T1w.
INTRODUCCIÓN: El derrame del oído medio (MEE) canino suele ser asintomático, siendo un hallazgo incidental cuando se realiza una tomografía computerizada o una resonancia magnética (MRI) de la cabeza por otros motivos no relacionados con la enfermedad ótica. La relevancia clínica de la presencia de material en la bulla timpánica (TB) sigue siendo incierta y se requieren más detalles sobre su prevalencia y apariencia en la resonancia magnética.
OBJECTIVE: Evaluar la prevalencia de presencia de material dentro de la TB de bulldogs franceses (FB) sin signos clínicos sugestivos de otitis (externa, media o interna) sometidos a resonancia magnética de campo alto por otras razones médicas.
UNASSIGNED: Se incluyeron en el estudio 252 TB de 126 FB. MATERIALES Y MÉTODOS: Estudio retrospectivo no experimental en el que las imágenes de resonancia magnética fueron evaluadas por un radiólogo veterinario certificado.
RESULTS: El cincuenta y ocho por ciento de los perros tenían material en la luz de la TB (46% de las TB) y el 59% estaban afectados bilateralmente. La intensidad de la señal de este material relacionado con la sustancia gris fue variable en secuencias T1w y principalmente hiperintensa en secuencias T2w. CONCLUSIÓN Y RELEVANCIA CLÍNICA: los FB están predispuestos a MEE. Esto es importante a la hora de evaluar estudios de imagen de TB de FB con otitis externa crónica, ya que un alto porcentaje de casos pueden tener MEE concurrentes. Los hallazgos de MRI en FB con MEE se caracterizan por una señal hiperintensa de la sustancia gris en secuencias T2w en la mayoría de los casos y variable en secuencias T1w.

暂无摘要。

TNPM is a benign, transient, neonatal pustulosis requiring no active treatment. Diagnosis is clinical, characterized by a vesiculopustular eruption, healing with residual hyperpigmented macules. Before diagnosing TNPM, serious conditions including skin infections should be excluded. This case was unusual in that vesiculobullae predominated, with a notable absence of simple pustules.

Spontaneous pneumomediastinum (SPM), an increasingly documented complication of COVID-19 infection, usually presents with retrosternal chest pain and dyspnea but can present atypically. In this case, an exceptionally rare presentation could have led to inappropriate management and a poor outcome. Here, a previously healthy 41-year-old Afro-Caribbean male non-smoker presents with acute airway compromise due to SPM. Conservative management proved effective, with anxiolysis to mitigate patient self-induced lung injury (PSILI) and oxygen supplementation via a non-rebreather mask to increase the resolution rate till the patient stabilized over the following days. The sequelae of the lung insult were noted in subsequent imaging, showing the formation of many subpleural bullae. Our case demonstrates the need for a high index of suspicion for pneumomediastinum among teams caring for COVID-19 cases. It also highlights the potential need for follow-up for further research on pulmonary sequelae.

暂无摘要。

UNASSIGNED: Bullous pemphigoid (BP) is considered the most common bullous autoimmune disorder, characterized by autoantibodies directed against hemidesmosomes in the skin and mucous membranes. It usually affects elderly individuals in the sixth through eighth decades of life, with an average age at onset of 65 years. Only a few cases have been reported in children and teenagers.
UNASSIGNED: Herein, we report a 17-year-old boy who presented with a pruritic vesicular rash on his arms and legs accompanied by erythema. He was treated at the beginning with topical lotion and acyclovir, but the rash kept deteriorating and eventually bullae appeared, involving also his mouth. A dermatologist was consulted and diagnosed him with BP, and he was treated accordingly.
UNASSIGNED: BP is the most prevalent autoimmune bullous illness, caused by autoantibodies against hemidesmosomes in the basement membrane of skin and mucosal surfaces, which in turn attract immune cells, including T-cells and neutrophils, and activate them, which causes damage to and separation of keratinocytes, resulting in the bullous formation. Diagnosis can be accomplished by recognizing clinical symptoms supported by histopathological and immunofluorescence testing. Steroids, whether topical or systemic, are the cornerstone treatment; depending on the extent of the disease, other immunosuppressant drugs can be used as a second line.
UNASSIGNED: BP manifestations are polymorphic; physicians should keep in mind that they may present with non-bullous, pruritic lesions, which may persist for some days to several months before bullae appear. Although this disease is rare in the young population, it should be considered in the differential diagnosis of bullous lesions.

Ribociclib, a cyclin-dependent kinase 4/6 inhibitor, is a novel targeted therapy for advanced-stage breast cancer. Although ribociclib-induced cutaneous side effects have been previously noted, they have not been well documented. Herein, we present a case of ribociclib-induced phototoxicity, which manifested as dyschromia over sun-exposed forearms and neck initially and as bullae formation subsequently. A 71-year-old woman with metastatic breast cancer developed dyschromia after daily treatment with ribociclib (600 mg) for 7 months. Skin biopsy of the pigmented lesion revealed interface dermatitis with melanin incontinence and dyskeratotic cells and ballooning keratinocytes with loss of melanocytes in the basal layer. Further, clefting at the basal layer of epidermis was noted in a more hyperpigmented field. Fontana-Masson staining revealed melanophages in the dermis. Human Melanoma Black-45 staining revealed decreased melanocyte numbers in the epidermis above the cleft. Immunohistochemical analyses revealed activated CD1a+ epidermal Langerhans cells and infiltrating CD4+ and CD8+ T cells in the epidermis and dermis, thereby indicating type IV hypersensitivity that was associated with damage to keratinocytes and melanocytes. To prevent progression of bullous dermatitis, we advised the patient to discontinue ribociclib and prescribed oral and topical prednisolone. Due to the risk of phototoxicity, we educated the patient on sun-protection strategies. The patient\'s skin lesions subsided during the 2 months of treatment. Phototoxicity with dyschromia is a rare but significant ribociclib-induced cutaneous side effect. Early diagnosis, rapid ribociclib withdrawal, protection from sunlight, and prompt treatment are critical for preventing subsequent severe bullous dermatosis.