Respiration; international review of thoracic diseases
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Case Reports
Bilateral hilar enlargement as a presenting sign of multiple primary bronchogenic carcinoma.
An asymptomatic patient presented with a chest roentgenogram showing bilateral hilar enlargement compatible with stage II sarcoidosis. However, evaluation revealed double primary bronchogenic carcinoma. A possible pitfall in the non-pathologic diagnosis of sarcoidosis and the implications of double primary bronchogenic carcinoma are discussed.
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The purposes of this study were (1) to confirm whether there were any differences between observed and predicted scores based on age, height, and sex in forced vital capacity (FVC), 1-second forced expiratory volume (FEV1.0), FEV1.0/FVC ratio, functional residual capacity (FRC), total lung capacity (TLC, FRC/TLC ratio, residual volume (RV), RV/TLC ratio, diffusing capacity of lungs for carbon monoxide (DCO), alveolar-capillary permeability (k'CO), and alveolar volume (VA) for 2 middle-aged non-smoking men who trained for and competed in three annual 26.2-mile marathon races and (2) to determine the magnitude and direction of changes in the observed scores for the three annual tests. The subjects trained from 45 to 70 miles/week for 52 weeks during the 3-year period. In the week after their annual marathon run they were measured in the above pulmonary variables. ⋯ Likewise, subject B improved three pulmonary variables (FRC, FRC/TLC ratio, and k'CO) and had small decreases in function of the other eight variables. It is not possible to draw statistical inferences to other populations from this data, but it does indicate that these subjects are in a state of good-to-great pulmonary health. Although random variations may account for some of the changes for these 2 subjects, it is possible that marathon training has inhibited some of the deterioration in pulmonary function as predicted from the regression with age by Kory.