A twenty-seven-year-old male was admitted with cough, sputum production, dyspnea and weight loss. Postero-anterior chest x-ray showed bilateral, diffuse reticulonoduler infiltration. He had received tuberculosis treatment in the past and he had been on carbamazepine for 8 years for a seizure disorder. Three sputum smear examinations for acid-fast bacilli were negative. Pulmonary function tests revealed FVC of 2.35L (51 %), FEV1 of 2.12 L (54 %), FEV1/FVC of 90 %, DLCO of 39 % and DLCO/VA of 75 %. Fiberoptic bronchoscopy was normal. Transbronchial lung biopsy and bronchial washing were nondiagnostic. Right mini-thoracotomy and open lung biopsy were performed. Pathologic examination revealed diagnosis of lymphocytic interstitial pneumonitis. Carbamazepine was withdrawn after neurological consultation. The patient was clinically and functionally well two months later. Computed tomography of the thorax was completely normal. The patient was consideredto be compatible with carbamazepine-induced lymphocytic interstitial pneumonitis.

Yellow Nail Syndrome (YNS)’ is a clinical condition characterized with the yellow colouring of the nails, pleural effusion, bronchectasis, sinusitis, and lymphedema. The ethiology of YNS is unknown. It is widely accepted that this syndrome is originated from an anomaly of the lymphatic vessels and there is no Mendelian inheritance. Male and female ratio is equal. The most significant finding is the yellow colouring of the nails and can be misdiagnosed as fungal infection in some cases. Pleural effusion and sinusitis findings should accompany this condition and can be encountered with some malignant and autoimmune diseases. Nail findings can regress with the treatment of the underlying malignant diseases. Rare cases associated with tuberculosis or myocardial infarction has also been reported. Alpha-tocopherol is reported to be effective in the treatment of YNS in the literature. In this study we present a rare case 40 years old male YNS patient enclosing accompany the syndrome like coughing, shortness of breath, sputum production, stertorous respiration and yellow colouring of the nails.

Tracheobronchopathia osteochondroplastica is a rare benign disorder involving the trachea and major bronchi. In this paper, a case of tracheobronchopathia osteochondroplastica was presented. A 60 year-old man was admitted with cough and dyspnea for four years. Computed tomography of the thorax showed an irregularity in the wall of trachea. Bronchoscopic examination revealed multiple white, irregular nodules on the lateral and anterior walls of the trachea extending to the left and right main bronchi. Pathologic diagnosis of bronchoscopic biopsy was tracheobronchopathia osteochondroplastica.

Pulmonary nocardiosis is an important opportunistic infection that is seen in patients with immunosuppresion. This infection which is caused by nocardia spesies can be observed in acute, subacute or chronic forms. The infection rarely involves extrothorasic sites as brain and subcutaneus tissue. Due to the difficulties in the diagnosis, mortality of this infection is high although it has a spesific treatment. A sistemic nocardiosis case presented with high fever and recurrent pneumonia without any immunsupresive disease other then diabetes was presented here with the rewiew of literature due to difficulties in making a diagnosis and rare occurance in our country.

A seventy-seven years old female with a complaining of backache for three weeks was hospitalized in orthopedics clinic. Metastatic lesions at T6 corpus and T7, T8, T12 vertebrae with a mass lesion of 5.5 cm longest diameter obliterating intermediate bronchus leading to volume loss in the right lung lower lobe was observed at thoracal tomography. The endobronchial mass lesion obliterating the right intermediate bronchus was observed in fiberoptic bronchoscopy. The histopathologic diagnosis of the mass was a carcinoid tumor. Levels of serotonin and 5-hydroxy indol acetic acid in blood and urine were normal. Compression to medulla spinalis was observed in MRI of thoracolombar spine. Thoracic hemilaminectomy-laminotomy was performed. The histopathologic diagnosis of surgical resection biopsy of T6 vertebra was reported as the infiltration of atypical carsinoid tumor. The chemoradiotherapy was applied to the patient.

Pulmonary tumorlet is a collection of cellular crusts less than 5 mm which is composed of multifocal neuroendocrin cells. They are often discovered incidentally. A 65 years old male case who underwent left lower lobectomy for bronhiectasis was presented. Multiple tumorlet on bronchiectasic basis were detected in the histopathological examination of the surgical specimen.

Complicated pulmonary hydatid cyst disease can mimic tuberculosis, lung cancer, empyema and abscess. The diagnosis of complicated pulmonary hydatid cysts may not be easy. Bronchoscopy is not a routine procedure in hydatid cyst disease. However, it is inevitable when clinical and radiological appearance is atypical. A pulmonary hydatid cyst disease case with atypical clinical and radiological findings diagnosed by fiberoptic bronchoscopy was presented in this case report.

Cases of sarcoidosis rarely present with pneumothorax. Case is a 57-year-old woman. She has been having complaints of cough for the past four years. The patient received corticosteroid treatment for sarcoidosis for 16 months, and visited our clinic one month after she voluntarily terminated her treatment due to an increase in complaints of cough. In her physical examination, her right hemithorax responded less to general respiration during pulmonary examination. Her lung PA X-ray demonstrated a pneumothorax line in her left hemithorax. There was an increase in dyspnea and right sided chest pain during the clinical follow-up, a day after hospitalization. The PA X-ray demonstrated a pneumotorax in the right hemithorax. Bilateral tube thoracostomy was applied on the patient and mediastinoscopy was performed. Due to the rareness of concomitant bilateral pneumothorax and sarcoidosis, what kind of information was presented in the light of literature in our case.

Contralateral pneumothorax after pneumonectomy is a rare critical condition with high morbidity and mortality rates. In this study, a case of contralateral pneumothorax in the post-operative period which occured soon after left pneumonectomy for non-small cell lung carcinoma is presented with the related literature.

Tracheal diverticulum (TD) is a rare benign condition characterised by invaginations of the tracheal wall resulting in paratracheal air cysts. Sixty nine years old female patient admitted to our clinic with chest pain, prolonged cough for 3 months and dyspnea. She had no smoking history. Physical examination, chest X-ray and pulmonary function test results were normal. Air filled lesion with 1 cm in dimension on right paratracheal area connected to tracheal lumen was determined on thorax computed tomography. Patient was diagnosed as TD. TD is usually located on the right wall of trachea as in our patient. Majority of patients are asymptomatic, however diverticulum can retain secretions and act as reservoir for secretions predisposing recurrent infections. TD incidence may be as high as 2%, although rarely reported in clinical practice and literature. Therefore, clinicians should keep in mind TD for patients presenting with chronic cough particularly if chest radiograph and spirometry are normal.

Tracheo-esophageal voice prosthesis is currently the most successful and the principal method of voice and speech in patients undergoing total laryngectomy. Spontaneous dislodgement leading to tracheal aspiration is a rare complication. A 60 years old male living alone who underwent total laryngectomy with no radiotherapy for laryngeal carcinoma 3 years ago, admitted to our emergency department with a sudden shortness of breath. Chest radiography revealed atelectasis on the left lower lobe. Diagnostic flexible fiberoptic bronchoscopy showed Provox voice prosthesis at the level of bifurcation to left secondary bronchus. The device is successfully removed with biopsy forceps. As far as we know this case is the first Provox voice prosthesis aspiration case report which has been observed a more distal location from the main carina. In conclusion, chest and ENT physicians should know such long-term complications in laryngectomized patients.

Objectives:
To systematically review the literature on the current data in managing accidental hypothermia victims in the pre-hospital and hospital settings.
Methods:
We identified studies published from 1 January 1977 through 31 May 2012 by searching the MEDLINE, EMBASE and CINAHL and database of the National Library of Medicine. In addition, hand search of the bibliographies of retrieved articles in order to find additional sources was also performed. Initial search terms were 'definition of hypothermia', 'prehospital management', 'hospital management', and 'rewarming techniques' ''. We used standardized abstraction instruments to extract data on study characteristics, hierarchy of research design, study quality, risk factors, and laboratory predictors.
Findings:
Accidental hypothermia occurs due to body heat redistribution between core and peripheral tissues as well as imbalance between heat loss and production. Hypothermia may develop within a few minutes after immersion in cold water or exposure to cold weather. However, in debilitated victims or in the elderly it can occur slowly over many days by continuous exposure to milder cold temperature. The prognosis in accidental hypothermia depends to great extent on the degree and duration of the hypothermia, patient's premorbid condition, and the degree of exhaustion and metabolic derangement that result from the physiologic attempts to compensate for the heat loss.
Interpretations and implications:
Several studies demonstrated that the rapid and adequate recovery of the hypothermia victims depends on a well orchestrated management strategy both at the pre- and in- hospital levels. Management of deep hypothermia require rapid internal rewarming in order to support body core organs but all possible precautions should be undertaken to minimize the risk of "rewarming shock". On the other hand, for lesser degrees of hypothermia, recoverability depends more on the adequacy of hospital supportive care than on the method of rewarming. Such care require a medical team with very well understanding of the pathophysiologic that accompanied hypothermia and the implications of various treatment strategies.