Sample records for bronchography

  1. A simple method of selective bronchography

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    Han, Man Chung; Ha, Sung Whan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)


    The value of bronchography in the diagnosis of pulmonary diseases, especially of bronchial diseases, is well known and bronchography is an essential procedure for evaluation of bronchial diseases. And, by visualization of a selected bronchial tree, lobar or segmental, we can obtain roentgenograms of superior quality and of higher diagnostic accuracy. In addition, the procedure can be carried out safely in patients with low respiratory reserve and samples for pathology and bacteriology can be obtained. And there is another therapeutic possibility of introducing drugs intrabronchially through the catheter. Authors introduce a simple new technique of selective bronchography which is a combination of transglottic intubation and Seldinger method. The technique is summarized as follows, 1. Anesthetize oral cavity, pharynx and larynx with 2% lidocaine. 2. Under fluoroscopic control, Nelaton catheter is introduced over a wire mandarin, as authors previously reported. 3. After removal of wire mandarin, angiographic guide wire is inserted through the catheter into the trachea. 4. Then, the Nelaton catheter is withdrawn and is changed with preshaped angiographic catheter, just as in introduction of catheter in arteriography. We carried out 18 cases of selective bronchography with this technique and selection of lobar, segmental and subsegmental bronchi was carried out without difficulty.

  2. Thoracoscopic lung segmentectomy simulated by a tailor-made virtual lung: computed bronchography and angiography. (United States)

    Akiba, Tadashi; Morikawa, Toshiaki; Ohki, Takao


    We describe the benefits of simulating an anatomical lung segmentectomy using multidetector computed tomography bronchography and angiography (tailor-made virtual lung). Preoperative determination of the anatomical intersegmental plane is possible by visualizing the segmental bronchi and pulmonary vein branches. This advanced technique could be useful during thoracoscopic anatomical segmentectomy for lung cancer.

  3. Value of virtual tracheobronchoscopy and bronchography from 16-slice multidetector-row spiral computed tomography for assessment of suspected tracheobronchial stenosis in children

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    Honnef, Dagmar; Wildberger, Joachim E.; Das, Marco; Hohl, Christian; Mahnken, Andreas H.; Guenther, Rolf W.; Staatz, Gundula [University Hospital RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Barker, Michael [University Hospital RWTH Aachen, Department of Pediatrics, Aachen (Germany)


    To evaluate the value of dose-reduced 16-slice multidetector-row spiral computed tomography (16-MDCT) using virtual tracheobronchoscopy (VTB) and virtual bronchography (VBG) in children with suspected tracheobronchial stenosis. 12 children (4 d to 3 years, body weight 1.2 kg to 13.5 kg) with stridor and suspected tracheobronchial stenosis were examined by contrast-enhanced low-dose 16-MDCT. Conventional axial slices, MPRs, VTB, and VBG were calculated. Image findings were correlated with the results of fiberoptic bronchoscopy (12 out of 12) as a gold standard and subsequent surgery (8 out of 12). VTB and VBG demonstrated the fiberoptic bronchoscopically suspected tracheal stenosis in 11 of 12 children due to vascular compression because of the brachiocephalic trunk (6), a double aortic arch (2), a vascular compression of the left main bronchus (2), and a right aberrant subclavian artery (1). Eleven out of 12 stenoses were correctly depicted by conventional axial slices, MPRs, VTB, and VBG. Dose reduction was 79 to 85.8% compared to a standard adult chest CT. Dose-reduced 16-MDCT with the use of VTB and VBG is effective for the evaluation of tracheobronchial stenosis in children and correlates well with fiberoptic bronchoscopy. (orig.)

  4. [Bronchus dystopia with emphysema and solitary lung cyst in children]. (United States)

    Römer, K H; Thal, W; Motsch, H


    Occasionally bronchial dystopia may be the cause of lobular emphysema. Only by bronchoscopy and bronchography exact diagnosis is possible. For therapy in children the methods of lung resection should be taken into consideration.

  5. CT in childhood allergic bronchopulmonary aspergillosis

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    Shah, A.; Bhagat, R.; Panchal, N. (Delhi Univ. (India). Vallabhabhai Patel Chest Inst.); Pant, C.S. (Institute of Nuclear Medicine and Allied Sciences, Delhi (India). Imaging Div.)


    CT of the thorax done during acute severe asthma in two paediatric patients demonstrated central bronchiectasis, a sine qua non for the diagnosis of allergic bronchopulmonary aspergillosis. Bronchography, regarded as the gold standard, was done subsequently on recovery. A comparative segmental analysis revealed that CT was able to identify immediately 24 of 27 segments which showed central bronchiectasis on bronchography. Early diagnosis with the aid of CT enabled immediate intervention which may have helped to prevent further lung damage in the paediatric patients. (orig.).

  6. Tracheobronchomegaly with multiple diverticula: a case report

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    Park, Chan Sup; Kim, Joung Sook [College of Medicine, Inha University, Incheon (Korea, Republic of)


    Chest radiograhs revealed evidences of dilatation of the trachea and both main bronchi, multiple air bubbles around the trachea and focal bronchopneumonia in right lower lobe. Tracheobronchomegaly is a rare condition characterized by marked dilatation of the trachea and main bronchi and frequently associated with tracheal diverticulosis, bronchiectasis, and recurrent lower respiratory tract infection. Mounier-Kuhn, in 1932, was the first to associate the presence of tracheobronchomegaly with the clinical syndrome of chronic, recurrent respiratory tract infection. Tracheobronchomegaly is believed to be extremely rare. To date, only 92 cases have been reported in the literatures. We recently encountered a case of tracheobronchomegaly associated with multiple diverticula formation. The diagnosis was made by chest radiography, computed tomography (CT), bronchography, and CT taken immediately after the bronchography.

  7. Unilateral pulmonary agenesis associated with tracheal stenosis : a case report

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    Lee, Yong Suk; Yoon, Chong Hyun; Kim, Kyung Sook; Kim, Ki Soo; Pi, Soo Young [Univ. of Ulsan, Ulsan (Korea, Republic of). Colle. of Medicine


    Unilateral pulmonary agenesis is a rare congenital anomaly and is frequently associated with other congenital anomalies. We report a case of left pulmonary agenesis associated with congenital tracheal stenosis in a newborn infant. Simple chest radiographs showed an overinflate right lung and mediastinal shifting to the left side. Chest ST and reconstructed three-dimensional images showed left pulmonary agenesis and tracheal stenosis. These anomalies of the tracheobronchial system were confirmed by bronchography. (author). 10 refs., 3 figs.

  8. Diagnostic radiology of thoracic diseases. Textbook and atlas. 4. compl. rev. and enl. ed.; Radiologische Diagnostik der Thoraxerkrankungen. Lehrbuch und Atlas

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    Lange, Sebastian


    The book on diagnostic radiology of thoracic diseases covers the following topics: diagnostic techniques and normal diagnostic findings using x-ray radiography, CT, scintigraphy, angiography, bronchography, ultrasonography and NMR imaging; malformations; infections; emphysema, chronic lung diseases and asthma; inhalation damage and pneumoconiosis; neoplasm; vascular diseases; thorax injuries, pleura diseases, heart diseases, mediastinum diseases; midriff diseases; thoracic wall diseases; pathological pattern in CT; radiological indications and differential diagnostics; thoracic interventions.


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    This report is founded on reports written in April 1987 by Robert Hettel for angiography operations at the Stanford Synchrotron Research Laboratory (SSRL) and a subsequent report covering angiography operations at the National Synchrotron Light Source (NSLS); BNL Informal Report 47681, June 1992. The latter report has now been rewritten in order to accurately reflect the design and installation of a new medical safety system at the NSLS X17B2 beamline Synchrotron Medical Research Facility (SMERF). Known originally as the Angiography Personnel Protection Interlock (APPI), this system has been modified to incorporate other medical imaging research programs on the same beamline and thus the name has been changed to the more generic Medical Personnel Protection Interlock (MPPI). This report will deal almost exclusively with the human imaging (angiography, bronchography, mammography) aspects of the safety system, but will briefly explain the modular aspects of the system allowing other medical experiments to be incorporated.

  10. Type II congenital cystic pulmonary malformation in an esophageal lung. (United States)

    Martínez-Martínez, Blanca E; Furuya, María Elena Yuriko; Martínez-Muñiz, Irma; Vargas, Mario H; Flores-Salgado, Rosalinda


    A seven-month-old girl, born prematurely (birth weight 1000 g) from a twin pregnancy, was admitted to hospital due to recurrent pneumonia and atelectasis. She experienced cough and respiratory distress during feeding. The right hemithorax was smaller than the left, with diminished breath sounds and dullness. Chest x-rays revealed decreased lung volume and multiple radiolucent images in the right lung, as well as overdistention of the left lung. An esophagogram revealed three bronchial branches arising from the lower one-third of the esophagus, corresponding to the right lung and ending in a cul-de-sac. A diagnosis of esophageal lung was established. On bronchography, the right lung was absent and the trachea only continued into the left main bronchus. Echocardiography and angiotomography revealed agenesis of the pulmonary artery right branch. The surgical finding was an esophageal right lung, which was removed; the histopathological diagnosis was type II congenital pulmonary airway malformation in an esophageal lung.

  11. Physical properties and biocompatibility of UHMWPE-derived materials modified by synchrotron radiation. (United States)

    Bykova, Iu; Weinhardt, V; Kashkarova, A; Lebedev, S; Baumbach, T; Pichugin, V; Zaitsev, K; Khlusov, I


    The applications of synchrotron radiation (SR) in medical imaging have become of great use, particularly in angiography, bronchography, mammography, computed tomography, and X-ray microscopy. Thanks to recently developed phase contrast imaging techniques non-destructive preclinical testing of low absorbing materials such as polymers has become possible. The focus of the present work is characterization and examination of UHMWPE-derived materials widely used in medicine, before and after their exposure to SR during such testing. Physical properties, such as wettability, surface energy, IR-spectroscopy, roughness, optical microscopy, microhardness measurements of UHMWPE samples were studied before and after SR. The relationship between a growth of UHMWPE surface hydrophilicity after SR and surface colonization by stromal cells was studied in vitro. Obtained results demonstrate that SR may be used as prospective direction to examine bulk (porous) structure of polymer materials and/or to modify polymer surface and volume for tissue engineering.

  12. Primary ciliary dyskinesia

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    Plavec Goran


    Full Text Available In patients with chronic respiratory diseases that last since the early childhood, primary ciliary dyskinesia (PCD needs to be considered. Four patients reviewed in this paper were with typical disease history and clinical picture, as well as clear ciliary axonema damage. Complete examination was performed in all the patients, including bronchoscopy with bronchography, and the examination of the biopsy samples of respiratory airways’ mucous membrane, obtained by transmission electron microscope (TEM. In two of the patients spermatozoa were also examined by TEM. Large anatomic deffects of airways were found in all the patients, but pulmonary function was normal (except in one case, representing one of PCD’s significant characteristics. First two cases fulfilled the criteria for Kartagener’s syndrome, which was initially sufficient for the diagnosis of PCD.

  13. Prevalence, age distribution and aetiology of bronchiectasis: a retrospective study on 144 symptomatic patients. (United States)

    Scala, R; Aronne, D; Palumbo, U; Montella, L; Giacobbe, R; Martucci, P; Del Prato, B


    The incidence of bronchiectasis (BCT) has probably decreased in developed countries in recent years, but reliable statistical data on its occurrence are still lacking. The aim of the present study was to retrospectively evaluate the prevalence, age distribution and aetiology of BCT, diagnosed in a selected series of symptomatic patients of a Western country by using bronchography. The authors analysed the main known predisposing and associated conditions (PACs), and the occurrence and age distribution of BCT in 144 consecutive patients who underwent bronchological examination (fibreoptic bronchoscopy and bronchography) in the years 1987-1994 because of recurrent purulent bronchitis and/or haemoptysis. The overall prevalence of BCT was 34% (49/144); its age distribution was: 17.2% (0-10 yrs), 43.7% (11-20 yrs), 38% (21-30 yrs), 37.5% (31-40 yrs), 33.3% (41-50 yrs), 40% (51-60 yrs), and 20% (61-70 yrs). Thirty-one PACs were found in 29/144 patients of the whole study group. The prevalence of BCT was significantly higher in the subgroup of 29 patients with PACs than in the subgroup of 115 patients without PACs (75.9% versus 23.5%; p dermatomiositis (one), and toxin inhalation (one). The authors conclude that bronchiectasis still occurs in a large percentage of symptomatic patients of a developed country in the post-antimicrobial era, especially in the second to sixth decades, as well as in the presence of predisposing and associated conditions; its aetiology remains unknown in more than half of cases.

  14. The evaluation of radiological and clinical findings of bronchiectasis

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    Yoo, Jung Keun; Kang, Sung Ihn; Kim, Kil Jung; Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul [Chosun University College of Medicine, Kwangju (Korea, Republic of)


    Bronchiectasis means a permanent abnormal dilatation off one or more large bronchi owing to destruction of the elastic and muscular components of the bronchial wall. Radiological study is the most important and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for the precise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases of bronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years from January 1980 to December 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34 cases (70.8%) were male and 14 cases (29.2%) were female. Peak incidence was in second decade. 2. Chronic cough productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts of pneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases (47.9%). Others are no sign in 17 cases (35.4%), wheezing in 11 cases (22.9%) and digit clubbing in 3 cases (6.3%). 3. The presumed causes were composed of not known in 30 cases (62.5%)> and complications of measles in 7 cases (14.6%), pertussis in 5 cases (10.4%) and pneumonia in 4 cases (8.3%). Two cases were Kartagener's syndrome and unilateral hyperlucent lung. 4. Plain chest common radiological findings was accentuation of lung marking in 36 cases (85.7%), the others are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies, decreased affected lung volume, air-fluid, level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases (22.9%) and the disease was much more often involved left lung than right. The most commonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segment of the lower lobe. The type of bronchiectasis is cylindrical in 22 cases (45.8%), varicose in

  15. The Main Technical Points of Thoracoscopic Anatomical Lung Segment Resection

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    Liang CHEN


    Full Text Available Thoracoscopic segmentectomy is technically much more meticulous than lobectomy, due to the complicated anotomical variations of segmental bronchi and vessels. Preoperative three-dimensional computed tomography bronchography and angiography, 3D-CTBA could reveal the anatomical structures and variations of the segmental bronchi/vessels and locate the pulmonary nodules, which is helpful for surgery planning. Preoperative nodule localization is of vital importance for thoracoscopic segmentectomy. Techniques involved in this procedure include dissection of the targeted arteries, bronchus and intra-segmental veins, retention of the inter-segmental veins, identification of the inter-segmental boarder with the inflation-deflation method and seperation of intra-segmental pulmonary tissues by electrotome and/or endoscopic staplers. The incision margin for malignant nodules should be at least 2 cm or the diameter of the tumor. Meanwhile, sampling of N1 and N2 station lymph nodes and intraoperative frozen section is also necessary. The complication rate of thoracoscopic segmentectomy is comparatively low. The anatomic relationship between pulmonary segments and lobes is that a lobe consists of several irregular cone-shaped segments with the inter-segmental veins lies between the segments. Our center has explored a method to separate pulmonary segments from the lobe on the basis of cone-shaped principle, and we named it “Cone-shaped Segmentectomy”. This technique could precisely decide and dissect the targeted bronchi and vessels, and anatomically separate the inter-segmental boarder, which ultimately achieve a completely anatomical segmentectomy.

  16. Current studies and future perspectives of synchrotron radiation imaging trials in human patients

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    Longo, Renata, E-mail: [Department of Physics, University of Trieste, via Valerio 2 3410 Trieste (Italy); INFN- sezione di Trieste, via Valerio 2 3410 Trieste (Italy)


    The coherent and monochromatic x-ray beams available at the synchrotron radiation (SR) laboratories are ideal tools for the development and the initial application of new imaging techniques. In the present paper the history of the clinical studies in k-edge subtraction imaging with SR is summarized, including coronary angiography and bronchography. The results of the recent trial in phase-contrast mammography at Elettra (Trieste, Italy) are discussed, in order to assess the clinical impact of the new imaging modality and the potential interest in its translation to clinical practice. The direct measurement of linear attenuation coefficient obtained during the SR mammography trial is also discussed. The new program of phase-contrast breast CT under development at Elettra is presented. Recently, 3D breast imaging (tomosynthesis and cone beam breast CT) has been introduced in clinical practice with significant improvement in diagnostic accuracy. The aim of this research is to study the contribution of the phase-contrast to the image quality of breast CT. Increasing the image quality of the x-ray medical images at the level of the results obtained at the SR laboratories is highly desirable, hence the promising techniques for the translation of the phase-contrast imaging to the hospitals are briefly discussed.

  17. A Study of Variations of the Branching Patterns of right Upper Lobar Bronchus by Corrosive Cast Method

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    SV Solanki


    Full Text Available Introduction: Respiratory system is the basic prerequisite for living organisms. So precise knowledge of normal anatomy and various dimensions of human respiratory tract is inevitable. The right upper lobe bronchus is prevailingly trifurcates into apical, anterior and posterior segmental bronchi. Material and Methods: The present study was done on 28 tracheo-bronchial casts prepared by corrosive cast method in the anatomy department of B. J. medical college of Ahmedabad, Gujarat, India from 2011 to 2013. Result and Observation: In 16 specimens (57% normal trifurcate branching pattern was seen in right upper lobar bronchus. Most common variation observed was bifurcate pattern in right upper lobar bronchus in 36% of specimens. In 7% specimens quadrivial pattern was seen in right upper lobar bronchus in which it divided into four bronchi. Conclusion: The knowledge of anatomy and variation in branching pattern of the tracheo-bronchial tree enables the physicians to recognize clinical picture and pathology of human lungs, as well as the application of therapeutic and diagnostic methods like tracheal intubation, bronchoscopy, bronchography and postural drainage etc.

  18. Type II Congenital Pulmonary Airway Malformation in an Esophageal Lung

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    Blanca Estela Martínez-Martínez


    Full Text Available A seven-month-old girl, born prematurely (birth weight 1000 g from a twin pregnancy, was admitted to hospital due to recurrent pneumonia and atelectasis. She experienced cough and respiratory distress during feeding. The right hemithorax was smaller than the left, with diminished breath sounds and dullness. Chest x-rays revealed decreased lung volume and multiple radiolucent images in the right lung, as well as overdistention of the left lung. An esophagogram revealed three bronchial branches arising from the lower one-third of the esophagus, corresponding to the right lung and ending in a cul-de-sac. A diagnosis of esophageal lung was established. On bronchography, the right lung was absent and the trachea only continued into the left main bronchus. Echocardiography and angiotomography revealed agenesis of the pulmonary artery right branch. The surgical finding was an esophageal right lung, which was removed; the histopathological diagnosis was type II congenital pulmonary airway malformation in an esophageal lung.

  19. Immunoglobulin E anaphylaxis in rabbits: mechanisms of pulmonary resistance and compliance changes. (United States)

    Habib, M P; Dunn, A M; Sobonya, R E; Baumgartener, C C; Newell, J D; Halonen, M


    Factors causing changes in pulmonary resistance and dynamic compliance with immunoglobulin (Ig) E anaphylaxis in spontaneously breathing rabbits were assessed in ventilated rabbits using tantalum bronchography and wet-to-dry wt ratios. Ventilated rabbits demonstrated changes in resistance and compliance similar to spontaneously breathing rabbits. Chlorpheniramine pretreatment prevented increases in resistance but not decreases in compliance. Anaphylaxis constricted small (less than 1 mm) airways 20.9 +/- 16.0% (mean +/- SD) and intermediate (between 1 and 3 mm) airways 21.8 +/- 19.8%. Chlorpheniramine (10 mg/kg) prevented small airway changes and attenuated those in intermediate airways. Chlorpheniramine prevented histamine-induced constriction of small (23.6 +/- 15.7%) and intermediate (17.6 +/- 15.0%) airways. Lung wet-to-dry wt ratios were unchanged. Changes in resistance and compliance during rabbit IgE anaphylaxis are not due to changes in tidal volume or frequency. Histamine, via H1 receptors, is the principal mediator of pulmonary resistance increases but not dynamic compliance reductions. Chlorpheniramine-sensitive increases in resistance are caused by constrictions of intermediate and small airways, whereas the chlorpheniramine-resistant decrease in compliance is not caused directly by constriction of the smallest measurable airways (0.25 mm) or changes in lung water.

  20. 小儿先天性肺不发育和发育不良的X线诊断(附13例X线分析)%An Analyses of X-ray Diagnosis of 13 Cases of Congenital Pulmonary Agenesis and Hypoplasia in Children

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    陈豹; 顾海滨; 赵晨


    Objective:To evaluate the efficacy of imaging diagnisis of congenital pulmonary agenesis and hypoplasia in children.Methods:The 13 cases of congenital pulmonary agenesis and hypoplasia were veritfied by bronchcscopy and operation or pathology the characteristics of the X-ray,CT and bronchography were analysed.Results:the X-ray features included:(1)capacity decreased and density increased of diseased lung;(2)small hilar pulmonis;(3)mediastinum shifted to the affected side.Conclusion:Radiography is a good procedure in diagnosis of the most cases of congenital pulmonary agenesis and hypoplasia.%目的:评价X线检查对小儿先天性肺不发育和发育不良的诊断作用。方法:对13例先天性肺不发育和发育不良经支气管镜检、手术或病理证实的X线平片、CT扫描、支气管造影分析其影像学表现。结果:本病X线检查的影像特征为:(1)患肺容积小、密度增高;(2)小肺门;(3)纵隔移向患侧。结论:X线检查对先天性肺不发育和发育不良是一很好的诊断方法。

  1. Radiologic and Clinical Outcomes with Special Reference to Tumor Involvement Pattern after Stent Placement for Malignant Bronchial Obstructions

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    Shin, Ji Hoon; Song, Ho-Young; Kim, Kyung-Rae; Kim, Jin Hyoung (Dept. of Radiology and Research Inst. of Radiology, Univ. of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea)); Kim, Sang Wee; Lee, Dae-Ho; Hong, Sang-Beom (Internal Medicine, Univ. of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea))


    Background: Location of tumor within the tracheobronchial tree as well as its severity can affect the clinical outcome of patients who undergo airway stent placement. Purpose: To evaluate radiologic and clinical outcome, including survival data, with special reference to proposed tumor involvement pattern, in patients with malignant bronchial strictures. Material and Methods: A total of 35 patients who underwent stent placement for malignant bronchial strictures were enrolled over a 9-year period. Tumor involvement pattern was divided into three types based on computed tomography (CT) scans and selective bronchography. Type I was defined as tumor involving only the main stem bronchus; type II, tumor involving the bronchus intermedius and/or the lower lobar bronchus without involvement of the lower-lobe segmental bronchus; and type III, tumor involving the lower lobar bronchus with involvement of the lower-lobe segmental bronchus. Tumor stage, lung collapse/infiltration, radiologic improvement, clinical improvement, and survival were compared according to the tumor involvement pattern. Results: Tumor involvement pattern was of type I, II, and III in 14, 13, and eight patients, respectively. When comparisons were made between types I/II and type III to evaluate the influence of lower-lobe segmental bronchial involvement, radiologic and clinical improvement was significantly lower in type III than in types I/II, while advanced stage, lung collapse/infiltration, and median overall survival were not significantly different between types I/II and type III. Conclusion: In patients with malignant bronchial obstructions involving the lower-lobe segmental bronchus, clinicians must be aware of the possibility of less radiologic and clinical improvement following stent placement


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    唐琦峰; 钱燕宁; 张洪兴


    目的:研究静脉注射利多卡因对芬太尼诱导的咳嗽反应的影响.方法:择期行全麻手术病人60例,随机分为3组,Ⅰ组在芬太尼注射前1分钟静脉注射利多卡因(1mg/kg),Ⅱ组在芬太尼注射前1分钟静脉注射利多卡因(2mg/kg),Ⅲ组为对照组.分别观察芬太尼注射后的咳嗽反射情况,咳嗽1-2次为轻微,3-4次为中等,5次以上为重度.结果:Ⅰ组、Ⅱ组和Ⅲ组咳嗽反应的发生率为分别为25%、30%和65%,Ⅰ组、Ⅱ组咳嗽反应的发生率明显低于Ⅲ组(P<0.05),Ⅰ组和Ⅱ组比较无明显差别(P>0.05).结论:芬太尼注射前1分钟静脉注射利多卡因1mg或2mg可有效减轻芬太尼诱导的咳嗽反射;芬太尼注射前1分钟静脉注射利多卡因的量对减轻芬太尼诱导的咳嗽反射区别不大.%Fentanyl is commonly used as a pre-induction adjunct because of its quick onset,short duration of action,intense analgesia,and cardiovascular stability,but a pre-induction bolus dose of fentanyl elicits cough.Fentanyl-induced cough is common but has not been viewed as a serious anesthetic problem.Intravenous lidocaine suppresses the cough reflex during endotracheal intubation,extubation,bronchography,bronchoscopy and laryngoscopy[1-3].It has been found effective when given intravenously to suppress the cough reflex of endotracheal intubation and cough induced by manual displacement of the endotracheal tube and instillation of distilled water into the trachea in anesthetized patients[2].We evaluated the different dose of lidocaine for suppression of fentanyl-induced cough in this randomized,prospective and placebo-controlled study.


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    -up was observed a total regression of the bilioptysis and disappearance of the jaundice after the seventh postoperative day. The patient was submitted to bronchography that did not reveal anatomical changes on the right lowers bronchi by biliary flood. The patient is on the seventh postoperative year without any evidence of the disease.

  4. Adult pulmonary sequestration: diagnostic role of angiography; Il sequestro polmonare nell'adulto. Contributo diagnostico dell'angiografia

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    Ettorre, G.C.; Francioso, G.; Fracella, M.R.; Strada, A.; Rizzo, A. [Bari Univ., Bari (Italy). Dipt. di Medicina Interna e Medicina Pubblica, Sezione Diagnostica per Immagini


    The diagnosis of pulmonary sequestration is based on demonstration of mal developed lung tissue, feeding on abnormal systemic level. It has been investigated the role of angiography in the diagnosis of pulmonary sequestration in adult patients. 1987 to 1998 it was examined 9 patients with suspected pulmonary sequestration who were subsequently submitted to surgery. The patients were 3 women and men; 6 of them were symptomatic and 3 asymptomatic. Six patients were examined with CT of chest and upper abdomen, thoracoabdominal aortography and selective arteriography of the abnormal vessel; one patient also submitted to left angiopneumography. One patient underwent bronchography and another one MRI. An unquestionable diagnosis was made in 8 cases, namely 6 of intralobar and 2 of extralobar sequestration, and confirmed surgically. The only questionable case was diagnosed at histology as extralobar pulmonary sequestration atypically fed by thin branches from the left diaphragmatic artery. Angiography demonstrated the abnormal arterial feeding typical of pulmonary sequestration in all cases but one. The evidence of venous drainage was the key sign to diagnose extra- versus intralobar sequestration. Therefore it can be concluded that angiography remains an essential tool in the diagnosis of pulmonary sequestration, notwithstanding the great potentials of Helical CT of MR angiography. [Italian] Scopo di questo lavoro e' presentare la diagnosi di sequestro polmonare che si basa sulla dimostrazione di tessuto polmonare displasico irrorato da un vaso anomalo d'origine sistemica. Si riporta il ruolo sostenuto dall'angiografia nella diagnosi e nell'inquadramento nosologico di tale malattia nei soggetti adulti. Dal 1987 al 1998, sono stati osservati con il sospetto di sequestro polmonare e successivamente sottoposti a intervento chirurgico 9 pazienti, 3 femmine e 6 maschi: 6 erano sintomatici, 3 asintomatici. Sono stati studiati con TC del torace e dell