Central airway stenosis may be a manifestation of benign or malignant lesions and can be a life threatening condition. There are different surgical and endoscopic modalities for treatment of these lesions. Balloon bronchoscopy is an interventional pulmonologic modality and can be performed under direct vision or fluoroscopic guidance. This technique can be used along with other interventional m...

271 A 25-year-old man of Pakistani origin born in the United Kingdom was admitted with a 3-day history of chest tightness and palpitations. The chest tightness was central and heavy in nature with no radiation. Palpitations were regular, and both symptoms occurred in paroxysms of up to 10 seconds. He had never experienced these symptoms before. He had a medical history of well-controlled asthma...

A 63-year-old man with previous combat-related Agent Orange exposure and no healthcare contact for 40 years presented to his primary care physician with dyspnea on exertion, orthopnea, and bilateral lower extremity edema. Electrocardiography reportedly showed sinus rhythm, and transthoracic echocardiography demonstrated moderate left ventricular hypertrophy with normal systolic function. New on...

INTRODUCTION Hepatolithiasis is an uncommon entity in Singapore. We reviewed the cases presented to our institution (a 1200-bedded restructured hospital) over a 5-year period. MATERIAL AND METHODS Twelve cases of hepatolithiasis were treated between December 1995 and July 2000 representing 0.77% of gallstone disease operated on in the same period. The clinical presentation, investigations, tr...

We report a case series of dopamine dysregulation syndrome, previously known as hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies, now designated as Lees’ syndrome.

A 34-year-old man with a 2-year history of unexplained steroid-refractory polyneuropathy, lower-extremity edema, and monoclonal gammopathy presented to our tertiary care center with 3 days of rapidly progressive dyspnea. The patient’s vital signs were notable for a temperature of 37.0oC, heart rate of 122 bpm, blood pressure of 80/60 mm Hg, respiratory rate of 22 breaths per minute, and oxygen ...

A 35-year-old woman with no past medical history presented to her local emergency room with 2 days of fevers, chills, and myalgias. She was febrile with a temperature of 102°F, blood pressure of 95/60 (72) mm Hg, heart rate of 110 bpm, respiratory rate of 20 breaths per minute, and an oxygen saturation of 100% on 2 L oxygen. The physical examination was notable for cool extremities, clear lungs...