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Sample records for bronchoscopy

  1. Interventionist Bronchoscopy

    International Nuclear Information System (INIS)

    Interventional bronchoscopy includes endoscopic diagnostic procedures through rigid bronchoscope, such as transcarinal puncture and principally, therapeutic bronchoscopy using lasers tends and endoscopic radiation. This is a review of our experience in this field, analyzing 36 transcarinal punctures with goods results in 10 cases (27%), 100 patients for whom it used laser in tracheobronchial disorders with satisfactory results in 81,5% and the placement of 8 Dumon's tends with different results, according to the tracheal pathology. The management of tracheal benign stenosis is controversial. It has had good results in 56,5% over 23 patients for whom we used endoscopic management

  2. Bronchoscopy in lipoid pneumonia.

    OpenAIRE

    Kameswaran, M.; Annobil, S H; Benjamin, B.; Salim, M.

    1992-01-01

    Forcible administration of rendered animal fat to infants is a tradition in south western Saudi Arabia. Accidental inhalation may result in a resistant form of lipoid pneumonia. A series of 24 cases of lipoid pneumonia, 22 of which were diagnosed by bronchoscopy with bronchial lavage and microscopic examination of the aspirate, are reported. The technique is described briefly and the results analysed. A high index of suspicion together with bronchoscopy and bronchial lavage of all cases of re...

  3. Bronchoscopy Simulation: A Brief Review

    Science.gov (United States)

    Davoudi, Mohsen; Colt, Henri G.

    2009-01-01

    More than 500,000 flexible bronchoscopies are performed annually by chest physicians in the United States (Ernst et al., Chest 123:1693-1717, 2003). Indications include diagnosis of lung cancer and airway tumors, benign strictures, pulmonary infections, and treatment of central airway obstruction, emphysema, and intraepithelial lesions such as…

  4. Bronchoscopy

    Science.gov (United States)

    ... VC, Martin TR, et al., eds. Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 22. Reynolds HY. Respiratory structure and function: mechanisms and ... . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap ...

  5. Participation in research bronchoscopy: a literature review.

    Science.gov (United States)

    Martinsen, Einar Marius Hjellestad; Leiten, Elise Orvedal; Bakke, Per Sigvald; Eagan, Tomas Mikal Lind; Grønseth, Rune

    2016-01-01

    Bronchoscopy is the preferred method for collecting biological samples from the lower airways of subjects in clinical research. However, ensuring participation in clinical research can be challenging when the research includes an invasive procedure. For this report we reviewed the literature to look for information on participation in research bronchoscopy studies to better design our own study, the Bergen COPD Microbiome study (MicroCOPD). We performed a systematic literature search on participation in research bronchoscopy studies in February 2014 using the search engines of PubMed and EMBASE. The literature search resulted in seven relevant papers. Motivation was an end point in six of the seven papers, but reasons for declining participation and recruitment strategies also seemed important. Human subjects participate in research bronchoscopy studies for personal benefit and altruistic reasons. Inconvenience associated with research, in addition to fear of procedures, is considered a barrier. Radio, especially news stations, generated the most inquiries for a clinical study involving bronchoscopy. There is a lack of information on participation in research bronchoscopy studies in the literature. A bronchoscopy study has been initiated at Haukeland University Hospital, Bergen, Norway, to examine the role of the microbiome in COPD, and participation will be explored as a substudy. PMID:26847517

  6. Subconjunctival haemorrhage from bronchoscopy: A case report

    Directory of Open Access Journals (Sweden)

    Huey Ying Lim

    2015-01-01

    Full Text Available Flexible bronchoscopy has been available for almost five decades. It has evolved as one of the most commonly used invasive diagnostic and therapeutic procedure in pulmonology, and its scope of applications is progressively expanding with the addition of new adjunct technologies such as endobronchial ultrasound, bronchial Thermoplasty, and navigational bronchoscopy. It is a safe procedure with complications ranging from fever, infiltrates, hypoxemia, bleeding, pneumothoraces and death, with most significant complications being bleeding and pneumothorax. We report a case of subconjuctival haemorrhage as an immediate complication of bronchoscopy. To our knowledge this is the first report documenting this rare complication.

  7. Achieving competency in bronchoscopy: challenges and opportunities.

    Science.gov (United States)

    Fielding, David I; Maldonado, Fabien; Murgu, Septimiu

    2014-05-01

    Bronchoscopy education is undergoing significant changes in step with other medical and surgical specialties that seek to incorporate simulation-based training and objective measurement of procedural skills into training programmes. Low- and high-fidelity simulators are now available and allow learners to gain fundamental bronchoscopy skills in a zero-risk environment. Testing trainees on simulators is currently possible by using validated assessment tools for both essential bronchoscopy and endobronchial ultrasound skills, and more tools are under development for other bronchoscopic techniques. Educational concepts including the 'flipped classroom' model and problem-based learning exercises are increasingly used in bronchoscopy training programmes. These learner-centric teaching modalities require well-trained educators, which is possible thorough the expansion of existing faculty development programmes. PMID:24689877

  8. Virtual hybrid bronchoscopy using PET/CT data sets

    Science.gov (United States)

    Englmeier, Karl-Hans; Seemann, Marcus D.

    2007-03-01

    The aim of this study was to demonstrate the possibilities, advantages and limitations of virtual bronchoscopy using data sets from positron emission tomography (PET) and computed tomography (CT). Eight consecutive patients with lung cancer underwent PET/CT. PET was performed with F-18-labelled 2-[fluorine-18]-fluoro-2-deoxy-D: -glucose ((18)F-FDG). The tracheobronchial system was segmented with a volume-growing algorithm, using the CT data sets, and visualized with a shaded-surface rendering method. The primary tumours and the lymph node metastases were segmented for virtual CT-bronchoscopy using the CT data set and for virtual PET/CT-bronchoscopy using the PET/CT data set. Virtual CT-bronchoscopy using the low-dose or diagnostic CT facilitates the detection of anatomical/morphological structure changes of the tracheobronchial system. Virtual PET/CT-bronchoscopy was superior to virtual CT-bronchoscopy in the detection of lymph node metastases (P=0.001), because it uses the CT information and the molecular/metabolic information from PET. Virtual PET/CT-bronchoscopy with a transparent colour-coded shaded-surface rendering model is expected to improve the diagnostic accuracy of identification and characterization of malignancies, assessment of tumour staging, differentiation of viable tumour tissue from atelectases and scars, verification of infections, evaluation of therapeutic response and detection of an early stage of recurrence that is not detectable or is misjudged in comparison with virtual CT-bronchoscopy.

  9. Assessment of competence in simulated flexible bronchoscopy using motion analysis

    DEFF Research Database (Denmark)

    Collela, Sara; Svendsen, Morten Bo Søndergaard; Konge, Lars;

    2015-01-01

    intermediates and 9 experienced bronchoscopy operators performed 3 procedures each on a bronchoscopy simulator. The Microsoft Kinect system was used to automatically measure the total deviation of the scope from a perfectly straight, vertical line. Results: The low-cost motion analysis system could measure the...

  10. Flexible fiberoptic bronchoscopy service; an aid to patient management

    LENUS (Irish Health Repository)

    Marathe, N

    2016-02-01

    The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Luke’s General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Luke’s Hospital were studied. In total, 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before bronchoscopy services were started locally. Fifteen (14%) patients were referred for Endobronchial Ultrasound (EBUS) after diagnostic procedure performed at St. Luke’s Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic bronchoscopies performed for malignancy at St. Luke’s Hospital have rightly increased references for EBUS at Tertiary care Unit

  11. Endosonography vs conventional bronchoscopy for the diagnosis of sarcoidosis

    DEFF Research Database (Denmark)

    von Bartheld, Martin B; Dekkers, Olaf M; Szlubowski, Artur;

    2013-01-01

    Tissue verification of noncaseating granulomas is recommended for the diagnosis of sarcoidosis. Bronchoscopy with transbronchial lung biopsies, the current diagnostic standard, has moderate sensitivity in assessing granulomas. Endosonography with intrathoracic nodal aspiration appears to be a pro...

  12. Importance of flexible bronchoscopy in decannulation of tracheostomy patients

    Directory of Open Access Journals (Sweden)

    Leonardo Brand Rodrigues

    2015-04-01

    Full Text Available OBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheostomized patients aged between 19 and 87 years, with tracheal stent for a mean of 46 ± 28 days and with clinical criteria for decannulation. They were submitted to tracheostomy tube occlusion tolerance testfor 24 hours, and then to flexible bronchoscopy. We described and classified the diagnosed laryngotracheal changes. We compared the clinical criteria for decannulation indication with the bronchoscopy-diagnosed laryngotracheal injuries that contraindicated decannulation. We identified the factors that could interfere in decannulation and evaluated the importance of bronchoscopy as part of the process. RESULTS: Forty (80.4% patients had laryngotracheal alterations. Of the 40 patients considered clinically fit to decannulation, eight (20% (p = 0.0007 presented with laryngotracheal injuries at bronchoscopy that contraindicated the procedure. The most frequent laryngeal alteration was vocal cords lesion, in 15 (29% individuals, and granuloma, the most prevalent tracheal lesion, in 14 (27.5% patients. CONCLUSION: flexible bronchoscopy showed a large number of laryngotracheal injuries, the most frequent being the vocal cords injury in the larynx and the granuloma in the trachea, which contributed to increase the decannulation procedure safety.

  13. Optical coherence tomography in conjunction with bronchoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Ascedio Jose; Takimura, Celso Kiyochi; Lemos Neto, Pedro Alves; Figueiredo, Viviane Rossi, E-mail: ascedio@gmail.com [Servico de Endoscopia Respiratoria, Hospital das Clinicas, Universidade de Sao Paulo (FM/USP), SP (Brazil)

    2012-07-01

    To evaluate the feasibility of and the potential for using optical coherence tomography in conjunction with conventional bronchoscopy in the evaluation of the airways. Methods: This was a pilot study based on an ex vivo experimental model involving three animals: one adult New Zealand rabbit and two Landrace pigs. An optical coherence tomography imaging catheter was inserted through the working channel of a flexible bronchoscope in order to reach the distal trachea of the animals. Images of the walls of the trachea were systematically taken along its entire length, from the distal to the proximal portion. Results: The imaging catheter was easily adapted to the working channel of the bronchoscope. High-resolution images of cross sections of the trachea were taken in real time, precisely delineating microstructures, such as the epithelium, submucosa, and cartilage, as well as the adventitia of the anterior and lateral tracheal walls. The corresponding layers of the epithelium, mucosa, and cartilage were clearly differentiated. The mucosa, submucosa, and trachealis muscle were clearly identified in the posterior wall. Conclusions: It is feasible to use an optical coherence tomography imaging catheter in combination with a flexible bronchoscope. Optical coherence tomography produces high resolution images that reveal the microanatomy of the trachea, including structures that are typically seen only on images produced by conventional histology. (author)

  14. Interventional bronchoscopy in the management of thoracic malignancy.

    Science.gov (United States)

    Hardavella, Georgia; George, Jeremy

    2015-09-01

    Interventional bronchoscopy is a rapidly expanding field in respiratory medicine offering minimally invasive therapeutic and palliative procedures for all types of lung neoplasms. This field has progressed over the last couple of decades with the application of new technology. The HERMES European curriculum recommendations include interventional bronchoscopy skills in the modules of thoracic tumours and bronchoscopy [1]. However, interventional bronchoscopy is not available in all training centres and consequently, not all trainees will obtain experience unless they rotate to centres specifically offering such training. In this review, we give an overview of interventional bronchoscopic procedures used for the treatment and palliation of thoracic malignancy. These can be applied either with flexible or rigid bronchoscopy or a combination of both depending on the anatomical location of the tumour, the complexity of the case, bleeding risk, the operator's expertise and preference as well as local availability. Specialised anaesthetic support and appropriately trained endoscopy staff are essential, allowing a multimodality approach to meet the high complexity of these cases. PMID:26632425

  15. Interventional bronchoscopy in the management of thoracic malignancy

    Directory of Open Access Journals (Sweden)

    Georgia Hardavella

    2015-09-01

    Interventional bronchoscopy is a rapidly expanding field in respiratory medicine offering minimally invasive therapeutic and palliative procedures for all types of lung neoplasms. This field has progressed over the last couple of decades with the application of new technology. The HERMES European curriculum recommendations include interventional bronchoscopy skills in the modules of thoracic tumours and bronchoscopy [1]. However, interventional bronchoscopy is not available in all training centres and consequently, not all trainees will obtain experience unless they rotate to centres specifically offering such training. In this review, we give an overview of interventional bronchoscopic procedures used for the treatment and palliation of thoracic malignancy. These can be applied either with flexible or rigid bronchoscopy or a combination of both depending on the anatomical location of the tumour, the complexity of the case, bleeding risk, the operator’s expertise and preference as well as local availability. Specialised anaesthetic support and appropriately trained endoscopy staff are essential, allowing a multimodality approach to meet the high complexity of these cases.

  16. Establishing Pass/Fail Criteria for Bronchoscopy Performance

    DEFF Research Database (Denmark)

    Konge, Lars; Clementsen, Paul; Larsen, Klaus Richter;

    2012-01-01

    Background: Several tools have been created to assess competence in bronchoscopy. However, educational guidelines still use an arbitrary number of performed procedures to decide when basic competency is acquired. Objectives: The purpose of this study was to define pass/fail scores for two...... perform on each item of the test. Results: Using the contrasting-groups method we found a standard that would fail all novices and pass all consultants. A clear pass related to prior experience of 75 procedures. The consequences of using the extended Angoff method were also acceptable: all trainees who...... had performed less than 50 bronchoscopies failed the test and all consultants passed. A clear pass related to 80 procedures. Conclusions: Our proposed pass/fail scores for these two methods seem appropriate in terms of consequences. Prior experience with the performance of 75 and 80 bronchoscopies...

  17. Oxygen supplementation is required in healthy volunteers during bronchoscopy with lavage

    Science.gov (United States)

    Hypoxemia can complicate bronchoscopy. Common causes of hypoxemia during bronchoscopy include preexisting lung disease, upper airway obstruction, pneumothorax and bleeding secondary to either transbronchial lung biopsy or another interventional bronchoscopic procedure, hypoventil...

  18. Evaluation of bioaerosol exposures during hospital bronchoscopy examinations.

    Science.gov (United States)

    Lavoie, Jacques; Marchand, Geneviève; Cloutier, Yves; Hallé, Stéphane; Nadeau, Sylvie; Duchaine, Caroline; Pichette, Gilbert

    2015-02-01

    During hospital bronchoscopy examinations, aerosols emitted from the patient's during coughing can be found suspended in the ambient air. The aerosols can contain pathogenic microorganisms. Depending on their size, these microorganisms can remain in the air for a long time. The objective of this study was to measure the sizes and concentrations of the biological and non-biological particles produced during bronchoscopy examinations, and to propose preventive or corrective measures. Two bronchoscopy rooms were studied. An aerodynamic particle sizer (UV-APS) was used to establish the concentrations of the particles present and their size distributions. This instrument determines the aerodynamic diameter of the aerosols and can distinguish fluorescent (bioaerosols) and non-fluorescent particles. Reference concentrations were measured before the start of the examinations (morning background concentrations). They were used as comparison levels for the concentrations measured during and at the end of the bronchoscopies. In parallel, computational fluid dynamics (CFD) made it possible to isolate and understand different factors that can affect the concentration levels in bronchoscopy rooms. The concentrations of the non-fluorescent and fluorescent particles (bioaerosols) were significantly higher (p ≤ 0.05) during the bronchoscopy examinations than the reference concentrations. For the investigated factors, the bioaerosol concentrations were significantly higher during bronchoscope insertion tasks. The time required at the end of the day for the bioaerosols to reach the morning reference concentrations was about fifteen minutes. The average particle sizes were 2.9 μm for the fluorescent particles (bioaerosols) and 0.9 μm for the non-fluorescent particles. Our models based on computational fluid dynamics (CFD) enabled us to observe the behaviour of aerosols for the different rooms. PMID:25275615

  19. Bronchial carcinoid tumor: helical CT and virtual bronchoscopy

    International Nuclear Information System (INIS)

    The authors reported a case of a 61 years old man with recurrent neumonia of the inferior right lobe diagnosed by a chest radiography. A complementary helical CT showed an endobronquial mass on the right intermediate bronchus. Virtual bronchoscopy contributed to a better definition of this lesion, confirmed by a real bronchoscopy. The lesion was diagnosed as a carcinoid tumor by a bronchial biopsy. After surgery (sleeve resection of the tumor) the patient did not show any recurrence of his broncho-neumonic clinical features. (author)

  20. Reliable and Valid Assessment of Clinical Bronchoscopy Performance

    DEFF Research Database (Denmark)

    Konge, Lars; Larsen, Klaus Richter; Clementsen, Paul;

    2012-01-01

    interrater reliability was high, with Cronbach's a = 0.86. Assessment of 3 bronchoscopies by a single rater had a generalizability coefficient of 0.84. The correlation between experience and performance was good (Pearson correlation = 0.76). There were significant differences between the groups for all...

  1. Tension pneumothorax during flexible bronchoscopy in a nonintubated infant.

    Science.gov (United States)

    Chan, Ian A; Gamble, Jonathan J

    2016-04-01

    We describe the case of a tension pneumothorax occurring during flexible bronchoscopy in a nonintubated infant. The pneumothorax likely occurred secondary to wall source oxygen insufflation via the bronchoscope without sufficient gas egress. The use of wall source oxygen via the bronchoscope working channel is inherently dangerous and should be avoided. PMID:26740408

  2. EMLA Cream is an Effective Topical Anesthetic for Bronchoscopy

    Directory of Open Access Journals (Sweden)

    Benjamin Sohmer

    2004-01-01

    Full Text Available BACKGROUND: EMLA cream (AstraZeneca Inc, Canada (1:1 eutectic mixture of lidocaine 2.5% and prilocaine 2.5% has traditionally been used for topical anesthesia of the skin. Recent reports of EMLA's use for anesthesia of the oral mucosa suggest an application in topical anesthesia for bronchoscopy.

  3. The Efficacy of Rigid Bronchoscopy for Foreign Body Aspiration

    Directory of Open Access Journals (Sweden)

    Farooq Ahmad Ganie

    2014-01-01

    Full Text Available The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia. The patients’ demographic information along with clinical characteristics and their outcome were recorded and reported. The mean age of the children was 13.3±3.6 years. There were 32 (58.2% females and 23 (41.8% males. The frequent symptom was an attack of chocking followed by cough. The predominant sign was wheezing. Rigid bronchoscopy was successful in removing foreign body from 52(94.5% patients. Three (5.5% patients who had undergone thoracotomy with bronchotomy needed exploration, after failure of bronchoscopy to remove the foreign body. There was no mortality in our series. Average hospital stay was 12 hours. It could be concluded that rigid bronchoscopy is modality of choice in management of foreign body aspiration especially in pediatric population.

  4. Disinfecting endoscopes: how not to transmit Mycobacterium tuberculosis by bronchoscopy.

    OpenAIRE

    Leers, W. D.

    1980-01-01

    Mycobacterium tuberculosis was cultured from the bronchial washings of two patients who underwent bronchoscopy consecutively with the same bronchoscope. Active pulmonary tuberculosis was later confirmed in the first patient, whereas the second patient had clinical and serologic evidence of infection with respiratory syncytial virus. The bronchoscope had been cleaned with an iodophor disinfectant, which had not destroyed the tubercle bacilli. The agent recommended for chemical disinfection of ...

  5. The effect of music during bronchoscopy: A meta-analysis.

    Science.gov (United States)

    Tam, Wilson W S; Lo, Kenneth K H; Hui, David S C

    2016-01-01

    Bronchoscopy is considered a stressful procedure performed on patients. Hence, the use of music to ease the anxiety of patients has been examined in various studies, but the results have been inconclusive. The aim of this review is to synthesize the findings of previous studies on the effects of music therapy on the physiological outcomes of patients undergoing bronchoscopy. An electronic database search was performed to identify the literature. Random-effects model was used to combine the results, and meta-regression was used to explore the heterogeneity. Seven studies with 829 subjects were included. Results showed that the combined mean differences (95% confidence interval) for systolic and diastolic blood pressure were -11.99 (-15.82, -6.57) and -4.84 (-7.78, -1.90) mm Hg, respectively, whereas that for heart rate was -10.57 (-16.63, -4.51) beats per minute. In conclusion, listening to music reduced blood pressure and heart rate among patients undergoing bronchoscopy. PMID:26764267

  6. Bronchoscopy in some tertiary grade A hospitals in China: two years' development

    Institute of Scientific and Technical Information of China (English)

    NIE Xiao-meng; CAI Gang; SHEN Xian; YAO Xiao-peng; ZHAO Li-jun; HUANG Yi; HAN Yi-ping; BAI Chong; LI Qiang

    2012-01-01

    Background Although bronchoscopy has been widely performed in China,little has been known about its current state and development.In order to investigate the clinical application of bronchoscopy and make instructions for future education and development,the Chinese Society of Respiratory Diseases conducted postal surveys in both 2008 and 2010 in China.Method Questionnaires were sent to 40 tertiary grade A hospitals in 2008 and 58 tediary grade A hospitals in 2010 to investigate bronchoscopies performed in 2007 and 2009 respectively.Results Thirty (75%) hospitals returned the completed questionnaires in 2008 and forty-one (71%) hospitals in 2010.All the respondents possessed flexible bmnchoscopes.Fifty percent of the respondents had less than five in 2007,while more than 50% of the respondents had 5-9 bronchoscopes in 2009.All the respondents performed a radiograph or CT scan before bronchoscopy.Percentage of general anesthesia and no pre-medication before bronchoscopy increased,while atropine usage decreased in 2009 compared to 2007.Dudng bronchoscopy,pulse oximetry was the most widely used monitoring method.Most respondents used the nasal route to perform routine bronchoscopy.After the procedure,they used sinks to wash and glutaraldehyde to disinfect the bronchoscopes.The total number of flexible bronchoscopies performed during 2007 was 37 874 and the average was 1262.Whereas in 2009,the total number was 60 178 and the average was 1468.Diagnostic bronchoscopy was more widely used than therapeutic bronchoscopy.The mortality rate was 0.076% in 2007 and 0.032% in 2009.Conclusions The two surveys,to some extent,reflected the current status and development of bronchoscopy in China.The results are worthy of future education and developing of new guidelines.Regular surveys and monitoring of bronchoscopies across China are needed.

  7. Using Performance in Multiple Simulated Scenarios to Assess Bronchoscopy Skills

    DEFF Research Database (Denmark)

    Konge, Lars; Arendrup, Henrik; Buchwald, Christian von;

    2011-01-01

    using a standardized scoring form. Methods: The test was administered on a virtual reality bronchoscopy simulator to a total of 42 test subjects (14 senior consultants, 14 trainees and 14 medical students). The inter-rater reliability of the test procedure was explored according to examination of test...... competency is established. No former assessment instrument has been able to distinguish between trainees and experts. Objectives: The aim of this study was to explore the validity and reliability of a new assessment procedure relating to testing operators across multiple tasks with increasing difficulty...

  8. Training on a new, portable, simple simulator transfers to performance of complex bronchoscopy procedures

    DEFF Research Database (Denmark)

    Loumann Krogh, Charlotte; Konge, Lars; Bjurström, Johanna Margareta;

    2013-01-01

    Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable.......Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable....

  9. ASSESSMENT OF THE RESULTS OF FIBER-OPTIC BRONCHOSCOPY

    Directory of Open Access Journals (Sweden)

    Gh. Derakhshan Deylami

    1997-07-01

    Full Text Available 3000 patients, having undergone fiber - optic bronchoscopy (FOli over 10 years, in our Hospital were evaluated. Thec aim of this study was to determine the prevalence of lung cancer in Iran and their correlation with somking and to study the clinical anil radiological signs in different cancers ami the role of fiber-optic bronchoscopy in their diagnosis and the hazards of this method, 'llxe correlation between smoking and the signs and symptoms wax quite significant (p<0.05 and the clinical and radiological signs were more prominent in those such as miners, directly exposed to environmental pollutants. Cough was the most common symptom in our study. 'Ihe right lung holvement was slightly more than that of the left lung and the most common radiological ft titling was mass lesions (38.4% in men and 19.4% in women. Reticulonodular pattern was present in 3.8% of men and 6.2% of women. All the patients underwent the procedure almsot without premedication and no complication was seen in this aspect. 'Hie complications in our patients were tow and mainly included hemorrhage, respiratory distress, anil rarely ischemia and cardiac arrhyth'tma. The most common neoplasm was squamous cell carcinoma, adenocarcinoma, small cell carcinoma and large cell carcinoma.

  10. Fiberoptic bronchoscopy and computed tomography in esophageal carcinoma with tracheobronchial invasion

    International Nuclear Information System (INIS)

    Pre-operative fiberoptic bronchoscopy and comuted tomography (CT) were performed on 33 patients with advanced esophageal carcinoma, and the accuracy of the diagnosis by fiberoptic bronchoscopy and/or CT were compared in terms of evaluatin of tracheobronchial invasion of the esophageal carcinoma. Fiberoptic bronchoscopy had 100% sensitivity and 45% specificity, with an overall accuracy of 65% in the diagnosis of tracheobronchial invasion. CT had 55% sensitivity and 68% specificity, with 64% overall accuracy. The accuracy rate was equivalent in both fiberoptic bronchoscopy and CT. In conclusion, fiberoptic bronchoscopy seems evaluated first in the diagnosis of tracheobronchial invasion of esophageal carcinoma, followed by CT in confirming the site and grade of the involvement. (author)

  11. Comparison of autofluorescence imaging bronchoscopy and white light bronchoscopy for detection of lung cancers and precancerous lesions

    Directory of Open Access Journals (Sweden)

    Wang Y

    2013-07-01

    Full Text Available Yan Wang,1,* Qing Wang,2,* Jing Feng,1,3 Qi Wu41Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Respiratory Department of the First People's Hospital of Kunming, Yunnan, People's Republic of China; 3Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA; 4Respiratory Department of Tianjin Haihe Hospital, Tianjin, People’s Republic of China *These two authors contributed equally to this workBackground: The purpose of this paper was to compare the sensitivity, specificity, and overall diagnostic performance of autofluorescence imaging bronchoscopy (AFI versus white light bronchoscopy (WLB in the detection of lung cancers and precancerous lesions by meta-analysis.Methods: We performed a literature search using the PubMed and EMBASE databases to identify studies published between March 1991 and March 2012. Article selection, quality assessment, and data extraction were then performed. The pooled sensitivity, specificity, diagnostic odds ratio, and area under the curve of the summary receiver operating characteristic for AFI versus WLB were calculated using Stata version 12.0 software.Results: Six studies were included in the meta-analysis. The pooled sensitivity of AFI and WLB was 0.89 (95% confidence interval [CI] 0.81–0.94 and 0.67 (95% CI 0.46–0.83 and the pooled specificity of AFI and WLB was 0.64 (95% CI 0.37–0.84 and 0.84 (95% CI 0.74–0.91, respectively. The diagnostic odds ratio for AFI and WLB was 14.5 (95% CI 3.76–55.63 and 10.9 (95% CI 3.12–38.21, and the area under the curve for AFI and WLB was 0.89 (95% CI 0.86–0.92 and 0.85 (95% CI 0.81–0.88, respectively. The pooled positive and negative likelihood ratios were 2.5 (95% CI 1.21–4.97 and 0.17 (95% CI 0.08–0.36 for AFI, and the corresponding values for WLB were 4.3 (95% CI 2.13–8.52 and 0.39 (95% CI 0.21–0.73. The pooled positive likelihood ratio for AFI and

  12. ROLE OF FIBREOPTIC BRONCHOSCOPY IN EVALUATION OF PL EURAL EFFUSION CASES

    Directory of Open Access Journals (Sweden)

    Somnath

    2013-04-01

    Full Text Available ABSTRACT: Fibreoptic bronchoscopy which is usually used as a d iagnostic modality in many tacheobronchial pathologies is not routinely recomm ended for evaluating patients with pleural effusion. Present study was conducted in a tertiary care hospital in Rajahmundry where bronchoscopy is in regular use. Among 59 cases of ple ural effusion in which fibreoptic bronchoscopy was performed, the bronchial aspirate re ports were compared with the reports of the pleural fluid analysis. It was observed that out of the 59 patients only in 19 patients the diagnosis could be established. In comparison to the pleural fluid analysis report the yield was better. As per as tubercular pleural effusion is conc erned the bronchoscopic yield was good. We conclude in the study that fiberoptic bronchoscopy ca n be used as a diagnostic tool in the cases of pleural effusion where cause is unknown.

  13. Impact of multimedia information on bronchoscopy procedure: is it really helpful?

    Directory of Open Access Journals (Sweden)

    Ersin Gunay

    2015-01-01

    Full Text Available Aim: In this study, we aimed to investigate the effect of written informed consent and comprehensive multimedia information on the anxiety level of patients, consumption of sedatives, difficulties during bronchoscopy, complications and duration of procedure. Methods: 150 patients undergoing bronchoscopy were included to this study. They were randomized into two groups Multimedia information group (MIG, n = 75 and written-informed consent group (WICG, n = 75. Signed written informed consent was obtained from all patients. Patients in MIG group watched comprehensive multimedia presentation. State anxiety scores of all patients were evaluated with State and Trait anxiety inventory (STAI-S. Results: STAI-S score of patients in MIG (40.31 ± 8.08 was lower than patients in WICG (44.29 ± 9.62 (P = 0.007. Satisfaction level was higher in MIG (P = 0.001. Statistically higher difficulties during "passage through vocal cords" and "interventions during bronchoscopy" were present in WICG group (P = 0.013 and P = 0.043, respectively. Total midazolam dose during bronchoscopy, and duration of bronchoscopy were statistically lower in MIG patients (P < 0.001 and P = 0.045, respectively. Difficulties during "waiting period", "passage through nasal/oral route", "applications of local anesthesia" and "complication frequency" were similar in both groups. Conclusion: Besides reducing the state anxiety, multimedia information can reduce the dose of sedation, shorten the processing duration and reduce the difficulties during bronchoscopy.

  14. Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

    Science.gov (United States)

    Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

    2013-01-01

    The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN. PMID:22496316

  15. [Application of Interventional Bronchoscopy in Pulmonary Peripheral Lesions].

    Science.gov (United States)

    Wang, Hui; Huang, Linian

    2016-08-20

    Lung cancer is the leading cause of cancer-related mortality worldwide. A low cure rate of lung cancer is not only attributed to intrinsic aggressive biological behavior, but also little attention to lung cancer screening. With lung screening methods continuous progress, peripheral pulmonary lesions detection rate gradually increased. Currently, a transbronchial approach using a bronchoscope or computed tompgraphy (CT) guided transthoracic needle aspiration/biopsy have been the most generally accepted methods for diagnosing peripheral pulmonary lesions. However, conventional bronchoscopy has a poor diagnostic yield and CT-guided approach has high rates of pneumothorax for such peripheral pulmonary lesions. Therefore, clinicians will be challenged with the task of providing the means to provide a safe and minimally invasive method of obtaining accurate tissue diagnostics for the pulmonary peripheral lesions. New bronchoscopic interventional diagnosis technologies have recommended in clinical gradually. They can effectively improve the peripheral pulmonary lesions diagnosis rate, shorten the time of diagnosis, and make the patients get timely and effective treatment. In this paper, we reviewed briefly available technologies to aid clinicians in attempts at minimally invasive techniques. PMID:27561808

  16. The utility of the fiberoptic bronchoscopy in the esophageal cancer

    International Nuclear Information System (INIS)

    The paper establishes the utility of the fiber- optic bronchoscopy (FOB) studies performed in patients with esophageal cancer (EC) and confirm the possibility of tracheo-bronchial compromise. We carry out a descriptive study in 226 patients with esophageal cancer during 1991 to 1996 in the Instituto Nacional de Cancerologia of Colombia (INC). We excluded the patients with previous treatments: radiotherapy or surgery, and others primary cancers with metastases on the esophagus. We analyzed gastric, intestinal and general symptoms, smoking habits, primary cancer location, histological types, radiologic findings, fob findings, micro and macroscopes, and results of the samples: transbronchial, endobronchial biopsies, bronchi alveolar lavage and brush. We included 158 patients, 110 male and 48 female, with age between 32 and 83 years, symptoms duration average of 5,2 months. The most significant were cough, dysphonia and sputum. The location of EC was statistics significance only in the upper third escamocelular type. The significant radiological findings were: parenchymal nodules and interstitial infiltrates, the significant fob findings were: fistula endobronchial infiltration endobronchial mass and vocal cords palsy. The zones with more compromise were trachea, principal bronchi and vocal cords. Only 17 patients were positives in the samples; comparing the histopathologic findings (biopsies) as the gold standard with fob findings the sensitivity was 100%, specificity 35%, positive predictive value 15.6% and negative predictive value 100%

  17. Submucosal Hemangioma of the Trachea in an Infant: Diagnosis and Follow-Up with 3D-CT/Bronchoscopy

    Science.gov (United States)

    Choi, Jungwha; Im, Soo Ah; Kim, Jee Young

    2016-01-01

    Introduction: Infantile hemangiomas of the airway are diagnosed at bronchoscopy as part of the investigation of stridor or other respiratory symptoms. Here, we present three-dimensional computed tomography (3D-CT)/bronchoscopy findings of submucosal subglottic hemangioma missed at bronchoscopy. Case Presentation: We report on the clinical usefulness of 3D-CT/bronchoscopy as the primary diagnostic tool and follow-up method in the evaluation of suspected airway infantile hemangiomas, especially when the hemangioma is the submucosal type. Conclusions: 3D-CT/bronchoscopy will reduce the need for invasive laryngoscopic studies and help to diagnose submucosal hemangiomas undetected on laryngoscope. Additionally, 3D-CT/bronchoscopy will help evaluating the extent of the lesion, degree of airway narrowing, and treatment response. PMID:26848371

  18. Complications of bronchoscopy for foreign body removal : Experience in 1,035 cases

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    Hasdiraz Leyla

    2006-01-01

    Full Text Available Background: Tracheobronchial foreign body aspirations, which threaten lives in childhood, also carry potential risks during and after bronchoscopy. The aim of this study is to review complications and pre-cautions that need to be taken against possible risks. Methods: From 1987 to 2005, bronchoscopy was done in 1035 children in our department on suspicion of foreign body aspiration. The average age of these patients, mostly male (55%, was 4.1 years. Medical history, physical examination, radiological methods and bronchoscopy were used in the diagnosis. Bronchoscopy was applied under general anaes-thesia, and the respiratory and cardiac systems were closely observed for 4 hours after the process. Results: Nine hundred eleven of 1035 patients (88% had a foreign body in the tracheobronchial system. In 42 of the patients, infection required aggressive medication; in 30, hypoxia and bradycardia occurred as a result of obstruction during bronchoscopy; in 37, laryngeal edema, laryn-geal spasm and/or bronchospasm required ventilation support; in 6 pa-tients, tracheobronchial system bleeding occurred; in 2 patients pneu-mothorax occurred, in 1 patient pneumomediastinum was observed and 6 patients needed thoracotomies because of foreign body aspiration. In this series there were 8 deaths. Conclusion: Bronchoscopy, performed for tracheobronchial foreign body aspiration, carries a potential life-threatening risk during and after the process. The clinician needs to be aware of these risks, take proper precautions, and perform bronchoscopy by taking the medical condition of the patient and characteristics of the inspired foreign body into con-sideration.

  19. Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2014-01-01

    Full Text Available Background and Aim: Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure. Materials and Methods: A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India. Results: Thirty-eight rigid bronchoscopies (50 procedures were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65 min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal. Conclusions: Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

  20. Advanced bronchoscopy for the diagnosis of peripheral pulmonary lesions.

    Science.gov (United States)

    Asano, Fumihiro

    2016-07-01

    Bronchoscopy to examine peripheral pulmonary lesions is performed using a bronchoscope with an outer diameter of 5-6mm under fluoroscopy, but the diagnostic yield can be insufficient. Problems with transbronchial biopsy include a limited range of bronchoscope insertion, difficulty in guiding a bronchoscope and biopsy instruments to lesions, and insufficient confirmation of the arrival of biopsy instruments at the target lesion; as such, new techniques have been used to overcome these individual problems. Radial-endobronchial ultrasound is used to identify peripheral pulmonary lesions and sampling sites. In a meta-analysis, the diagnostic yield, that of lesions smaller than 2cm, and complication rate were 73, 56.3, and 1.0%, respectively. Virtual bronchoscopic navigation is a method to guide a bronchoscope to peripheral lesions under direct vision using virtual bronchoscopic images of the bronchial route, and the diagnostic yield, that of 2-cm or smaller lesions, and complication rate were 73.8, 67.4, and 1.0%, respectively. Electromagnetic navigation utilizes electromagnetism; the diagnostic yield was 64.9-71%, and the pneumothorax complication rate was 4% for this modality. Ultrathin bronchoscopes can be advanced to the peripheral bronchus under direct vision in contrast to normal-size bronchoscopes, and the diagnostic yield and pneumothorax complication rates were reported to be 63 and 1.5%, respectively. The overall diagnostic yield of these new techniques on meta-analysis was 70%, a higher yield than that obtained with conventional transbronchial biopsy. Each technique has advantages and disadvantages, and the investigation of appropriate combinations corresponding to individual cases is necessary. PMID:27424820

  1. Bronchoscopy as a supplement to computed tomography in patients with haemoptysis may be unnecessary

    Directory of Open Access Journals (Sweden)

    Klaus Nielsen

    2016-06-01

    Full Text Available Background: Haemoptysis is a common symptom and can be an early sign of lung cancer. Careful investigation of patients with haemoptysis may lead to early diagnosis. The strategy for investigation of these patients, however, is still being debated. Objectives: We studied whether the combination of computed tomography (CT and bronchoscopy had a higher sensitivity for malignant and non-malignant causes of haemoptysis than CT alone. Methods: The study was a retrospective, non-randomised, two-centre study and included patients who were referred from primary care for the investigation of haemoptysis. Results: A total of 326 patients were included in the study (mean age 60.5 [SD 15.3] years, 63.3% male. The most common aetiologies of haemoptysis were cryptogenic (52.5%, pneumonia (16.3%, emphysema (8.0%, bronchiectasis (5.8% and lung cancer (4.0%. In patients diagnosed with lung cancer, bronchoscopy, CT and the combination of bronchoscopy and CT had a sensitivity of 0.61, 0.92 (p<0.05 and 0.97 (p=0.58, respectively. In patients with non-malignant causes of haemoptysis, most aetiologies were diagnosed by CT and comprised mainly pneumonia, emphysema and bronchiectasis. Bronchoscopy did not reveal these conditions and the sensitivity to these conditions was not increased by combining CT and bronchoscopy. Conclusions: CT can stand alone as a diagnostic workup for patients with haemoptysis referred to an outpatient clinic. Bronchoscopy does not identify any malignant aetiologies not already diagnosed by CT. Combining the two test modalities does not result in a significant increase in sensitivity for malignant or non-malignant causes of haemoptysis.

  2. Routine examination for tuberculosis is still indicated during bronchoscopy for pulmonary infiltrates

    DEFF Research Database (Denmark)

    Laub, Rasmus Rude; Sivapalan, Pradeesh; Wilcke, Torgny;

    2015-01-01

    INTRODUCTION: Tuberculosis (TB) can present in numerous ways and can be radiological indistinguishable from cancer. In several guidelines for bronchoscopy (FOB) in low-incidence areas, a Mycobacterium tuberculosis test is only recommended when TB is clinically suspected. Due to the expenses assoc...

  3. Comparison of Total Intravenous Anesthesia (TIVA with Inhalation Anesthesia in Pediatric Bronchoscopy

    Directory of Open Access Journals (Sweden)

    Majid Razavi

    2013-12-01

    Full Text Available Background: Because of airway stimulations during the bronchoscopy and lack of direct access to the airway, preferred method of anesthesia for rigid bronchoscopy is already controversial. In this study we compared inhalation anesthesia with total intravenous anesthesia (TIVA for rigid bronchoscopy. Method and Materials: 30 patients aged 2-6 years were chosen divided on two same groups. Anesthesia in group I maintained with halothane and in group II maintained with remifentanil and propofol. Oxygenation, heart rate, respiratory rate, coughing, bucking, laryngospasm, bronchospasm were evaluated during and after surgery. Also Operation success and surgeon’s satisfaction were recorded as well.Results: Demographic findings were the same in both groups. Oxygenation and heart rate were more stable in group II (P=0.047 and P=0.026 respectively but there was no significant difference in respiratory rate between two groups (P=1. Success rate was also similar in both groups but surgeon’s satisfaction was significantly higher in TIVA (P=0.003. There was not any significant different between complications in two groups. Conclusion: We suggest TIVA for rigid bronchoscopy because of better oxygenation, more homodynamic stability, surgeon’s satisfaction, lack of air pollution and less interference with surgeon’s visual field.

  4. Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy

    DEFF Research Database (Denmark)

    Kolmos, H J; Lerche, A; Kristoffersen, Kirsten Lydia; Rosdahl, V T

    1994-01-01

    Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination was the...

  5. Pneumomediastinum and (bilateral pneumothorax after high energy trauma: Indications for emergency bronchoscopy

    Directory of Open Access Journals (Sweden)

    Martijn R. Groenendijk

    2014-01-01

    Full Text Available High energy trauma may cause injury to tracheobronchial structures. This is sometimes difficult to diagnose immediately. Pneumomediastinum and (bilateral pneumothorax seen on a CT-scan of the thorax may suggest possible damage to central airways. Emergency bronchoscopy should be performed to detect and locate a possible tracheobronchial injury.

  6. Posture influences patient cough rate, sedative requirement and comfort during bronchoscopy: An observational cohort study

    Science.gov (United States)

    2011-01-01

    Objectives To investigate differences between semi-recumbent and supine postures in terms of cough rate, oxygen desaturation, sedative use, and patient comfort during the initial phase of bronchoscopy. Methods Consecutive bronchoscopy patients (n = 69) participated in this observational cohort study. Posture was determined by the bronchoscopist's usual practice. Patient demographics, spirometry, pulse, and SpO2 were recorded. The initial phase was defined as the time from bronchoscopy insertion to visualisation of both distal main bronchi. Cough rate, peak pulse, nadir SpO2, oxygen supplementation, and sedative use during the initial phase were recorded. A post-procedure questionnaire was administered to the patient and the attending nurse. Results 36 patients had bronchoscopy in the semi-recumbent posture, 33 in the supine posture. 3 of 5 bronchoscopists performed in both postures. There were no differences in baseline parameters between the groups. The semi-recumbent posture resulted in significantly less cough (mean (SD) 3.6 (2.3) vs. 6.1 (4.5) coughs/min, p = 0.007) and less fentanyl use (70 (29) vs. 88 (28) mcg, p = 0.011) in the initial phase. There were no significant differences in the nadir SpO2, fall in SpO2, oxygen supplementation, or increase in pulse rate between the groups. On 100 mm visual analogue scale, nurse perception of patient discomfort was lower in the semi-recumbent position (23 (21) vs. 39 (28) mm, p = 0.01), and there was a trend towards less patient perceived cough in the semi-recumbent group (28 (25) vs. 40 (28) mm, p = 0.06). Conclusions Bronchoscopy performed in the semi-recumbent posture results in less cough and sedative requirement, and may improve patient comfort. PMID:22074355

  7. The effect of fibreoptic bronchoscopy in acute respiratory distress syndrome: experimental evidence from a lung model.

    Science.gov (United States)

    Nay, M-A; Mankikian, J; Auvet, A; Dequin, P-F; Guillon, A

    2016-02-01

    Flexible bronchoscopy is essential for appropriate care during mechanical ventilation, but can significantly affect mechanical ventilation of the lungs, particularly for patients with acute respiratory distress syndrome. We aimed to describe the consequences of bronchoscopy during lung-protective ventilation in a bench study, and thereby to determine the optimal diameter of the bronchoscope for avoiding disruption of the protective-ventilation strategy during the procedure. Immediately following the insertion of the bronchoscope into the tracheal tube, either minute ventilation decreased significantly, or positive end-expiratory pressure increased substantially, according to the setting of the inspiratory pressure limit. The increase in end-expiratory pressure led to an equivalent increase in the plateau pressure, and lung-protective ventilation was significantly altered during the procedure. We showed that a bronchoscope with an external diameter of 4 mm (or less) would allow safer bronchoscopic interventions in patients with severe acute respiratory distress syndrome. PMID:26559154

  8. Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy

    International Nuclear Information System (INIS)

    The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 ± 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted. (orig.)

  9. Peripheral pulmonary carcinoid tumor diagnosed by endobronchial-ultrasound-guided bronchoscopy.

    Science.gov (United States)

    Tanaka, Ayaka; Akamatsu, Hiroaki; Kawabata, Hiroki; Ariyasu, Hiroyuki; Nakamura, Yasushi; Yamamoto, Nobuyuki

    2016-03-01

    A 45-year-old Japanese woman complained of uncontrolled hypertension and face swelling. She was diagnosed with Cushing's syndrome with secretion of adrenocorticotropic hormone. Fluorodeoxyglucose positron emission tomography-computed tomography revealed a 2 × 2 cm mass in her left lung, with high standardized maximum uptake value. She underwent bronchoscopy with endobronchial ultrasound via a guide-sheath. Surgical resection of her left upper lung was performed, and pathological examination showed a typical carcinoid tumor. After lung resection, she recovered from her subjective symptoms. Diagnosis of peripheral carcinoid tumor of the lung is generally difficult. Here, we introduce a case of peripheral pulmonary carcinoid tumor diagnosed by endobronchial-ultrasound-guided bronchoscopy. PMID:26839693

  10. Image-guided bronchoscopy for histopathologic diagnosis of pure ground glass opacity: a case report.

    Science.gov (United States)

    Chavez, Christine; Sasada, Shinji; Izumo, Takehiro; Nakamura, Yukiko; Tsuta, Koji; Tsuchida, Takaaki

    2014-06-01

    Guided bronchoscopy has been found to be useful for the diagnosis of solid peripheral pulmonary lesions (PPLs) but more evidence on ground glass opacities (GGOs), especially those without a solid component, are lacking. A 69-year-old male, asymptomatic, heavy smoker was referred to our department for non-surgical diagnosis of a focal pure GGO in the right upper lobe that was found incidentally on computed tomography (CT). Transbronchial biopsy (TBB) with the aide of endobronchial ultrasound with a guide sheath (EBUS-GS), virtual bronchoscopic navigation (VBN), and fluoroscopy was performed for sampling. There were no complications after the procedure. The diagnosis of adenocarcinoma with lepidic growth pattern was established from the fourth and fifth TBB specimens and was confirmed on subsequent surgical resection. Image-guided bronchoscopy with TBB was successful for the diagnosis of a pure GGO. Use of a larger biopsy device may be helpful for the histopathologic diagnosis of lung adenocarcinoma with lepidic growth. PMID:24977033

  11. Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Rio, F.G. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Diaz Lobato, S. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Pino, J.M. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Atienza, M. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Viguer, J.M. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Villasante, C. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain)); Villamor, J. (Depts. of Respiratory Diseases, Radiology and Pathology, La Paz Hospital, School of Medicine, Autonoma Univ., Madrid (Spain))

    1994-09-01

    The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 [+-] 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted. (orig.).

  12. Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP?

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the diagnostic potential of virtual endoscopy (VE) and to compare it with axial CT slices, multiplanar reconstructions (MPR), minimal intensity projections (mIP), and bronchoscopy in patients diagnosed with bronchogenic carcinoma. Thirty patients underwent a spiral CT. Axial CT images were transferred to an Onyx workstation (Silicon Graphics, Sun Microsystems, Mountain View, Calif.) for performing virtual endoscopy. Accuracy for this procedure was tested by three radiologists on a monitor in comparison with axial CT slices, MPR, mIP, and bronchoscopy concerning the localization and degree of stenoses. Endoluminal tumors were identified by virtual bronchoscopy with no statistically significant difference of localization or grading of stenosis in comparison with bronchoscopy, axial CT slices, MPR and mIP. Axial CT slices, MPR, and mIP showed poorer results with over- or underestimation of stenoses compared with VE and bronchoscopy. Passing of stenoses was only possible with VE in 5 patients. Virtual endoscopy is a non-invasive method for identification of endoluminal tumors and is comparable to real bronchoscopy. (orig.)

  13. Distributed practice. The more the merrier? A randomised bronchoscopy simulation study

    OpenAIRE

    Bjerrum, Anne Sofie; Eika, Berit; Charles, Peder; Hilberg, Ole

    2016-01-01

    Introduction: The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice.Method: Twenty physicians in training were randomly...

  14. Distributed practice. The more the merrier? A randomised bronchoscopy simulation study

    OpenAIRE

    Anne Sofie Bjerrum; Berit Eika; Peder Charles; Ole Hilberg

    2016-01-01

    Introduction: The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice. Method: Twenty physicians in training were randoml...

  15. Landiolol reduces hemodynamic responses to bronchoscopy-assisted suctioning in intubated ICU patients

    OpenAIRE

    Tochikubo, Junpei; Adachi, Yushi U.; Ejima, Tadashi; Numaguchi, Atsushi; Matsuda, Naoyuki; Sato, Shigehito; Shiiya, Norihiko

    2014-01-01

    Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective effects of landiolol against the cardiovascular responses during bronchoscopic endotracheal suctioning. This study enrolled 15 patients requiring orotracheal intubation in an ICU. All of the patients required endotracheal suctioning using fiber bronchoscopy while sedated at a Ramsay Scal...

  16. 3D pulmonary airway color image reconstruction via shape from shading and virtual bronchoscopy imaging techniques

    Science.gov (United States)

    Suter, Melissa; Reinhardt, Joseph M.; Hoffman, Eric A.; McLennan, Geoffrey

    2005-04-01

    The dependence on macro-optical imaging of the human body in the assessment of possible disease is rapidly increasing concurrent with, and as a direct result of, advancements made in medical imaging technologies. Assessing the pulmonary airways through bronchoscopy is performed extensively in clinical practice however remains highly subjective due to limited visualization techniques and the lack of quantitative analyses. The representation of 3D structures in 2D visualization modes, although providing an insight to the structural content of the scene, may in fact skew the perception of the structural form. We have developed two methods for visualizing the optically derived airway mucosal features whilst preserving the structural scene integrity. Shape from shading (SFS) techniques can be used to extract 3D structural information from 2D optical images. The SFS technique presented addresses many limitations previously encountered in conventional techniques resulting in high-resolution 3D color images. The second method presented to combine both color and structural information relies on combined CT and bronchoscopy imaging modalities. External imaging techniques such as CT provide a means of determining the gross structural anatomy of the pulmonary airways, however lack the important optically derived mucosal color. Virtual bronchoscopy is used to provide a direct link between the CT derived structural anatomy and the macro-optically derived mucosal color. Through utilization of a virtual and true bronchoscopy matching technique we are able to directly extract combined structurally sound 3D color segments of the pulmonary airways. Various pulmonary airway diseases are assessed and the resulting combined color and texture results are presented demonstrating the effectiveness of the presented techniques.

  17. Diagnostic Yield of Fiberoptic Bronchoscopy (FOB in Three Common Lung Conditions at a Rural Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Nimit V Khara

    2013-08-01

    Conclusion: Routine flexible bronchoscopy technique has a reasonably high diagnostic yield in current clinical practice. Our study concludes that the diagnostic yield of FOB at our rural setting is comparable with the studies from other centres within the country and abroad. The procedure is more useful in diagnosis when combined with a sound clinical judgment and other supportive investigations. [Natl J Med Res 2013; 3(4.000: 392-395

  18. Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Orholm, M; Lundgren, Jens Dilling; Nielsen, T L; Iversen, Johan

    1990-01-01

    did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed, it is...... safe, and it is highly sensitive. The advantage of an early diagnosis compensates for a rather high frequency of negative examinations....

  19. Distributed practice. The more the merrier? A randomised bronchoscopy simulation study

    OpenAIRE

    Bjerrum, Anne Sofie; Eika, Berit; Charles, Peder; Hilberg, Ole

    2016-01-01

    Introduction The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice. Method Twenty physicians in training were randomly ...

  20. Peripheral pulmonary carcinoid tumor diagnosed by endobronchial‐ultrasound‐guided bronchoscopy

    OpenAIRE

    Tanaka, Ayaka; Akamatsu, Hiroaki; Kawabata, Hiroki; Ariyasu, Hiroyuki; Nakamura, Yasushi; Yamamoto, Nobuyuki

    2015-01-01

    Abstract A 45‐year‐old Japanese woman complained of uncontrolled hypertension and face swelling. She was diagnosed with Cushing's syndrome with secretion of adrenocorticotropic hormone. Fluorodeoxyglucose positron emission tomography‐computed tomography revealed a 2 × 2 cm mass in her left lung, with high standardized maximum uptake value. She underwent bronchoscopy with endobronchial ultrasound via a guide‐sheath. Surgical resection of her left upper lung was performed, and pathological exam...

  1. Image-guided bronchoscopy for histopathologic diagnosis of pure ground glass opacity: a case report

    OpenAIRE

    Chavez, Christine; Sasada, Shinji; Izumo, Takehiro; Nakamura, Yukiko; Tsuta, Koji; Tsuchida, Takaaki

    2014-01-01

    Guided bronchoscopy has been found to be useful for the diagnosis of solid peripheral pulmonary lesions (PPLs) but more evidence on ground glass opacities (GGOs), especially those without a solid component, are lacking. A 69-year-old male, asymptomatic, heavy smoker was referred to our department for non-surgical diagnosis of a focal pure GGO in the right upper lobe that was found incidentally on computed tomography (CT). Transbronchial biopsy (TBB) with the aide of endobronchial ultrasound w...

  2. AUTOFLUORESCENCE BRONCHOSCOPY AS A MODALITY FOR EARLY DIAGNOSIS OF LUNG CANCER

    OpenAIRE

    KAW Nugraha; IDM Artika

    2013-01-01

    Lung cancer has become a complicated health problem in the world. In 2005, approximately 172,500 people diagnosed with lung cancer in the United States. In Indonesia, lung cancer ranks fourth highest. Lung cancer is also the most common cause of death from cancer, so we need appropriate early detection modality to reduce the number of deaths from lung cancer. Compared with other modalities that currently available, Autofluorescence Bronchoscopy (AFB) seems to have better accuracy in early dia...

  3. Incidence of Fever and Bacteriemia Following Flexible Fiberoptic Bronchoscopy: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Babak Sharif-Kashani

    2010-12-01

    Full Text Available The latest American Heart Association (AHA statement for preventing infectious endocarditis, has not recommended prophylactic antibiotic therapy prior to fiberoptic bronchoscopy (FB except for patients with preexisting predisposing cardiac conditions. Our aim was to determine the incidence of bacteriemia and fever following FB in our experience and compare with those which have been mentioned in AHA guideline as well as other studies. Venous blood of 85 consecutive patients was evaluated for both aerobic and anaerobic cultures before (for detecting possible previous bacteriemia and after FB. None of the patients were treated with antibiotics prior to the procedure. All the patients were examined during the first 24 hours after FB for detecting fever defined as temperature more than 38 °C. Positive hemocultures were noted in 7 (8.2 % patients after FB examination. Coagulase negative Staphylococcus, coagulase positive Staphylococcus, beta haemolytic Streptococcus, Citrobacter freundii and Streptococcus viridans were found in 4, 1, 1 and 1 cultures of patients, respectively. By excluding 6 contaminated samples, the rate of bacteriemia reduced to 1 (1.1% patient in whom the identical pathogen (Streptococcus viridans was found both in bronchial lavage and venous blood culture. We also found fever in 9 (10.5 % cases in the first 24 hours following the bronchoscopy. Our results were in consistent with AHA recommendations regarding prevention of infectious endocarditis as a practical gridline in patients who schedule for FB. Besides, transient fever following bronchoscopy is a common self-limited event which does not need medical intervention.

  4. The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy

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    Tarik Umutoglu

    2015-10-01

    Full Text Available ABSTRACTINTRODUCTION:Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy.MATERIALS AND METHODS:In this randomized, controlled, crossover study; patients aged between 0 and 15 years who underwent flexible fiberoptic bronchoscopy procedure having American Society of Anesthesiologists I---II risk score were included. Patients having risk of difficult intubation, intubated or patients with tracheostomy, and patients with reduced neck mobility or having cautions for neck mobility were excluded from this study. After obtaining best glottic view at the neutral position, patients were positioned jaw trust with open mouth, jaw trust with teeth prottution, head tilt chin lift and triple airway maneuvers and best glottis scores were recorded.RESULTS:Total of 121 pediatric patients, 57 girls and 64 boys, were included in this study. Both jaw trust with open mouth and jaw trust with teeth prottution maneuvers improved the glottis view compared with neutral position (p 0.05. Head tilt chin lift and triple airway maneuvers improved glottis view when compared with both jaw trust with open mouth and jaw trust with teeth prottution maneuvers and neutral position (p 0.05.

  5. Role of fibreoptic bronchoscopy in haemoptysis: an analysis of 157 patients

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    Naveed Nazir Shah

    2015-09-01

    Results: In patients with haemoptysis with normal CXR, a diagnosis was established in 54.5% by FOB while 38.6% had a normal bronchoscopy. An endoscopic diagnosis of bronchitis was made in 22.7% patients. In only 9.1% patients an endobronchial mass was seen on bronchoscopy, and all of them were more than 40 years of age. Active bleeding/bleeding site was localized in 18.1% patients. In patients with abnormal chest roentgenogram who underwent FOB, a definitive diagnosis was established in 75.4% cases with active bleeding/ bleeding site localized in 59.6%. Thirty five percent were having an endobronchial mass. Of all the patients who underwent FOB for recurrent haemoptysis, active bleeding/bleeding site was localized in 48.4% patients. Bleeding site was localized in 62.9% patients who underwent early FOB, while the yield was lower (29.4% in patients who underwent delayed FOB. Conclusions: Fibreoptic bronchoscopy (FOB is an important and useful investigation in patients of haemoptysis in determining the bleeding site and etiology of haemoptysis. Early FOB has higher yield in localizing the bleeding site than delayed FOB. [Int J Res Med Sci 2015; 3(9.000: 2386-2393

  6. Safety of performing fiberoptic bronchoscopy in critically ill hypoxemic patients with acute respiratory failure

    Science.gov (United States)

    Cracco, Christophe; Fartoukh, Muriel; Prodanovic, Hélène; Azoulay, Elie; Chenivesse, Cécile; Lorut, Christine; Beduneau, Gaëtan; Bui, Hoang Nam; Taille, Camille; Brochard, Laurent; Demoule, Alexandre; Maitre, Bernard

    2013-01-01

    Background Safety of fibreoptic bronchoscopy (FOB) in nonintubated critically ill patients with acute respiratory failure have not been extensively evaluated. We aimed to measure the incidence of intubation and need to increase ventilatory support following FOB and to identify predictive factors of this event. Methods A prospective multicenter observational study was carried out in 8 French adult intensive care units. 169 FOB performed in patients with a PaO2/FiO2 ratio equal or less than 300 were analyzed. Our main end point was intubation rate. The secondary end point was rate of increased ventilatory support defined as greater than a 50% increase in oxygen requirement, the need to start non invasive-positive pressure ventilation (NI-PPV) or increase NI-PPV support. Results Within 24 hours, an increase in ventilatory support was required following 59 (35%) bronchoscopies, of which 25 (15%) led to endotracheal intubation. The existence of chronic obstructive pulmonary disease (COPD) (OR:5.2 [1.6–17.8], p=0.007) or immunosuppression (OR : 5.4 [1.7–17.2], p=0.004) were significantly associated with the need for intubation in multivariable analysis. None of the baseline physiological parameters including the PaO2/FiO2 ratio was associated with intubation. Conclusion Bronchoscopy is often followed by an increase in ventilatory support in hypoxemic critically ill patients, but less frequently by the need for intubation. COPD, immunosuppression are associated with a need for invasive ventilation in the following 24 hours. PMID:23070123

  7. Airway wall thickness assessment: a new functionality in virtual bronchoscopy investigation

    Science.gov (United States)

    Saragaglia, A.; Fetita, C.; Brillet, P. Y.; Prêteux, F.; Grenier, P. A.

    2007-03-01

    While classic virtual bronchoscopy offers visualization facilities for investigating the shape of the inner airway wall surface, it provides no information regarding the local thickness of the wall. Such information may be crucial for evaluating the severity of remodeling of the bronchial wall in asthma and to guide bronchial biopsies for staging of lung cancers. This paper develops a new functionality with the virtual bronchoscopy, allowing to estimate and map the information of the bronchus wall thickness on the lumen wall surface, and to display it as coded colors during endoluminal navigation. The local bronchus wall thickness estimation relies on a new automated 3D segmentation approach using strong 3D morphological filtering and model-fitting. Such an approach reconstructs the inner/outer airway wall surfaces from multi-detector CT data as follows. First, the airway lumen is segmented and its surface geometry reconstructed using either a restricted Delaunay or a Marching Cubes based triangulation approach. The lumen mesh is then locally deformed in the surface normal direction under specific force constraints which stabilize the model evolution at the level of the outer bronchus wall surface. The developed segmentation approach was validated with respect to both 3D mathematicallysimulated image phantoms of bronchus-vessel subdivisions and to state-of-the-art cross-section area estimation techniques when applied to clinical data. The investigation in virtual bronchoscopy mode is further enhanced by encoding the local wall thickness at each vertex of the lumen surface mesh and displaying it during navigation, according to a specific color map.

  8. 3D image fusion and guidance for computer-assisted bronchoscopy

    Science.gov (United States)

    Higgins, W. E.; Rai, L.; Merritt, S. A.; Lu, K.; Linger, N. T.; Yu, K. C.

    2005-11-01

    The standard procedure for diagnosing lung cancer involves two stages. First, the physician evaluates a high-resolution three-dimensional (3D) computed-tomography (CT) chest image to produce a procedure plan. Next, the physician performs bronchoscopy on the patient, which involves navigating the the bronchoscope through the airways to planned biopsy sites. Unfortunately, the physician has no link between the 3D CT image data and the live video stream provided during bronchoscopy. In addition, these data sources differ greatly in what they physically give, and no true 3D planning tools exist for planning and guiding procedures. This makes it difficult for the physician to translate a CT-based procedure plan to the video domain of the bronchoscope. Thus, the physician must essentially perform biopsy blindly, and the skill levels between different physicians differ greatly. We describe a system that enables direct 3D CT-based procedure planning and provides direct 3D guidance during bronchoscopy. 3D CT-based information on biopsy sites is provided interactively as the physician moves the bronchoscope. Moreover, graphical information through a live fusion of the 3D CT data and bronchoscopic video is provided during the procedure. This information is coupled with a series of computer-graphics tools to give the physician a greatly augmented reality of the patient's interior anatomy during a procedure. Through a series of controlled tests and studies with human lung-cancer patients, we have found that the system not only reduces the variation in skill level between different physicians, but also increases biopsy success rate.

  9. Bronchoscopy: Diagnostic and Therapeutic for Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Bauer, Thomas L; Berkheim, David B

    2016-07-01

    The bronchoscope has gone through much advancement from its origin as a thin metal tube. It has become a highly sophisticated tool for clinicians. Both rigid and the flexible bronchoscopes are invaluable in the diagnosis and treatment of non-small cell lung cancer. Treatment of this disease process hinges on accurate diagnosis and lymph node staging. Technologies, such as endobronchial ultrasound, navigational bronchoscopy, and autofluorescence, have improved efficacy of endobronchial diagnosis and sample collection. If a patient is not a candidate for surgery and has a complication from a centrally located mass, the bronchoscope has been used to deliver palliative therapies. PMID:27261910

  10. Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Orholm, M; Lundgren, Jens Dilling; Nielsen, T L;

    1990-01-01

    During a six-month period, 40 consecutive fiberoptic bronchoscopic procedures including bronchoalveolar lavage, bronchial brushing and forceps biopsy were performed in local anaesthesia on 34 HIV-infected males presenting symptoms compatible with Pneumocystis carinii pneumonia. In 23 examinations...... did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed, it is...

  11. Methylene Blue-Aided In Vivo Staining of Central Airways during Flexible Bronchoscopy

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    Sabine Zirlik

    2012-01-01

    Full Text Available Background. The early diagnosis of malignant and premalignant changes of the bronchial mucosa remains a major challenge during bronchoscopy. Intravital staining techniques are not new. Previous small case series suggested that analysis of the bronchial mucosal surface using chromoendoscopy allows a prediction between neoplastic and nonneoplastic lesions. Objectives. The aim of the present study was to evaluate chromobronchoscopy as a method to identify malignant and premalignant lesions in the central airways in a prospective manner. Methods. In 26 patients we performed chromoendoscopy with 0.1% methylene blue during ongoing flexible white light bronchoscopy. Circumscribed lesions in central airways were further analyzed by biopsies and histopathologic examination. Results. In the majority of cases neither flat nor polypoid lesions in the central airways were stained by methylene blue. In particular, exophytic growth of lung cancer did not show any specific pattern in chromobronchoscopy. However, a specific dye staining was detected in one case where exophytic growth of metastatic colorectal cancer was present in the right upper lobe. In two other cases, a circumscribed staining was noted in unsuspicious mucosa. But histology revealed inflammation only. Conclusions. In contrast to previous studies, the present findings clearly indicate that chromobronchoscopy is not useful for early detection of malignant or premalignant lesions of the central airways.

  12. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Ferretti, G.R.; Kocier, M.; Calaque, O.; Coulomb, M. [Service Central de Radiologie et Imagerie Medicale, INSERM EMI 9924, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Arbib, F.; Pison, C. [Departement de Medecine Aigue Specialisee (DMAS), CHU Grenoble, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Righini, C. [Service d' Oto Rhino Laryngologie, CHU Grenoble, BP 217, 38043, Grenoble Cedex 9 (France)

    2003-05-01

    The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

  13. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

    International Nuclear Information System (INIS)

    The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

  14. Fibreoptic bronchoscopy without sedation: Is transcricoid injection better than the "spray as you go" technique?

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    Alka Chandra

    2011-01-01

    Full Text Available Aim: The aim of the study was to compare transcricoid injection with "spray as you go" technique for diagnostic fibreoptic bronchoscopy, to perform the procedure without sedation and to record any complication or side effects. Methods: Sixty patients belonging to the age group 20-70 years, undergoing diagnostic bronchoscopy over a period of 6 months, were randomly selected and divided into two groups alternatively to receive 3 ml of 4% lignocaine by a single transcricoid puncture (group I or 2 ml of 4% lignocaine instilled through the bronchoscope on to the vocal cords and further 1 ml of 2% lignocaine into each main bronchus (group II. Additional dose of lignocaine as required was given in both the groups. All patients were given intramuscular atropine 0.6 mg, 20 min before the procedure. Nebulisation with 3 ml of 4% lignocaine was given to all patients. The time from nasal insertion of the bronchoscope to reach the carina was recorded, and the total dose of lignocaine required in both the groups was calculated and compared. The cough episodes during the procedure, systolic blood pressure, and pulse rate were compared before the procedure and 5 min after the procedure in both the groups. A 0-10 visual analogue scale (VAS was used to assess discomfort 30 min after the procedure. Results: The time to reach carina was more in group II (P<0.02, and cough episodes were also more in group II (P<0.05 than in group I. The vitals before the procedure were comparable in both the groups, but 5 min after the procedure the vitals were more stable in group I than in group II, and the total dose of lignocaine required in group II was more than in group I (P<0.001. However, the VAS score was comparable in both the groups. Conclusion: Transcricoid puncture for diagnostic bronchoscopies without sedation was associated with no complication and discomfort and required lesser dose of local anaesthetic with more stable vitals and good conditions for bronchoscopists.

  15. Improving patient safety after rigid bronchoscopy in adults: laryngeal mask airway versus face mask – a pilot study

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    Nisi F

    2015-04-01

    Full Text Available Fulvio Nisi,1 Antonio Galzerano,1 Gaetano Cicchitto,2 Francesco Puma,3 Vito Aldo Peduto1 1Department of Anesthesiology, Intensive Care and Pain Therapy Centre, 2Department of Pneumology and Respiratory Medicine, 3Department of Thoracic Surgery, AO Santa Maria della Misericordia, Perugia, Italy Background: There are still no clear guidelines in the literature on per procedural bronchoscopic management for anesthesiologists, and few relevant datasets are available. To obtain rapid recovery from anesthesia, it is often necessary to keep patients in the recovery room for several hours until they become clinically stable. In this study, we tested the hypothesis that the laryngeal mask airway (LMA enables better respiratory and hemodynamic recovery than the oxygen face mask (FM in patients undergoing rigid bronchoscopy. Methods: Twenty-one patients undergoing elective bronchoscopy of the upper airway were randomized to ventilation assistance with FM or LMA after a rigid bronchoscopy procedure under general anesthesia. The primary endpoint was duration of post-surgical recovery and the secondary endpoints were postoperative hemodynamic and respiratory parameters. Assessment of the study endpoints was performed by an intensive care specialist blinded to the method of ventilation used. The statistical analysis was performed using the Fisher’s Exact test for nominal data and the Student's t-test for continuous data. Results: There was no statistically significant difference in post-procedural time between the two groups (P=0.972. The recovery parameters were significantly better in the LMA group than in the FM group, with significantly fewer desaturation, hypotensive, and bradycardic events (P<0.05. Conclusion: We conclude that the LMA may be safer and more comfortable than the FM in patients undergoing rigid bronchoscopy. Keywords: face mask, laryngeal mask airway, anesthesiology, rigid bronchoscopy, safety 

  16. Virtual bronchoscopy of pediatric patients based on multislice spiral CT (MSCT): initial clinical experience

    International Nuclear Information System (INIS)

    We demonstrate the benefit of the accelerated examination based on multislice spiral CT (MSCT) in the pediatric patient which has not been reported so far. Material and methods: MSCT (tube voltage 120 kV, tube current 110 mA, 4x1 mm slice thickness, 500 ms rotation time, pitch 6) was performed on a CT scanner of the latest generation (Volume Zoom, Siemens Corp., Forchheim, Germany). In total we examined 11 patients. Results: In all patients we obtained sufficient data for 3D reconstruction avoiding general anesthesia. 6/11 examinations were described to be without pathological finding. A definite diagnosis was obtained in 10 patients. Virtual bronchoscopy could avoid other invasive diagnostic examination in 8/11 patients. (orig.)

  17. Clinical value of virtual bronchoscopy in early diagnosis of central malignant lung neoplasm in high risk patients

    International Nuclear Information System (INIS)

    Virtual bronchoscopy (CT-VB) is a recently developed 3D visualization technique that employs thin-section spiral computed tomographic data of the thorax for non-invasive evaluation of the tracheo-bronchial tree. The purpose of this study was to compare the efficacy of multislice-CT virtual bronchoscopy in detecting early endobronchial manifestation of central lung cancer with that of flexible fiberoptic bronchoscopy. For this purpose, a group of 50 high risk patients (cigarette pack-years, long standing history of COLD) underwent both FOB and CT-VB investigation. Multislice CT was performed using the following parameters: collimation, 1 mm; pitch factor, 0.937-1.375; reconstruction interval, 0.8 mm and postprocessing was based on volume rendering technique. Images of eight standard tracheo-bronchial sections were obtained from each patient both during FOB and CT-VB and were independently interpreted respectively by a pneumologist and a bronchiseptica. Airway evaluation was based on the analysis of changes in the mucosal architecture, the shape of the ostia and of the carinae and on the presence of secretion deposits as early signs of tumor onset. The sensitivity of virtual bronchoscopy in discriminating diseased from healthy patients was 94 % and its specificity 65 %. Its positive predictive value 56 % and its negative predictive value 96 %. According to the ROC analysis, except for the assessment of the secretion deposits, the other three criteria evaluated separately during virtual bronchoscopic assessment of the airways contributed equally in discriminating diseased from disease-free patients (areas under curve ranging between 0,797 and 0,845). The best AUC was associated with the evaluation of the sum of all three parameters together (0,858). Nevertheless, FOB and CT-VB results in the evaluation of the shape of the ostia resulted to agree moderately while just a fair agreement was observed with respect to the evaluation of the mucosal architecture and of the

  18. Veno-arterial ECMO for rescue of severe airway hemorrhage with rigid bronchoscopy after pulmonary artery thromboendarterectomy.

    Science.gov (United States)

    Chacón-Alves, Silvia; Pérez-Vela, Jose Luis; Grau-Carmona, Teodoro; Domínguez-Aguado, Helena; Marín-Mateos, Helena; Renes-Carreño, Emilio

    2016-07-01

    Pulmonary endarterectomy (PEA) is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We present a patient with airway obstruction and acute respiratory failure due to large blood clots obstructing the trachea and main left bronchus. This condition was accompanied by right ventricle failure and cardiogenic shock. A venoarterial ECMO system was used for cardiopulmonary support before extracting the clots and clearing the airway by rigid bronchoscopy. PMID:27229321

  19. Comparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia.

    Science.gov (United States)

    Jakobsen, C J; Ahlburg, P; Holdgård, H O; Olsen, K H; Thomsen, A

    1991-04-01

    Twenty-four consecutive patients scheduled for fiberbronchoscopy were randomized to receive double-blind either intravenous (1.5 mg/kg) or laryngotracheal (3 mg/kg) lidocaine to evaluate the influence on post-bronchoscopic laryngospasm, pain in the throat and coughing. Plasma lidocaine concentrations were analyzed 5, 15, 30 and 60 min after administration. None of the patients demonstrated laryngospasm or pain in the throat during the first hour after bronchoscopy. Patients receiving topical lidocaine coughed significantly more than patients receiving intravenous lidocaine, with a median number of coughs of 20 compared to 4, during the first hour (P less than 0.01). The plasma lidocaine concentrations were significantly higher after intravenous than after topical administration (P less than 0.001). After intravenous administration the plasma lidocaine concentrations exceeded the accepted level for potential toxicity in five out of 11 patients, but none of the patients developed toxic symptoms and no side-effects were observed. PMID:2038931

  20. Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

    International Nuclear Information System (INIS)

    Since introduction of multislice CT scanners into clinical practice, virtual brochoscopy has gained a lot of quality and diagnostic potential. Nevertheless it does not have established place in diagnostics of tracheal and bronchi disorders and its potential has not been examined enough. Nowadays a majority of bronchial tree variants and lesions are revealed by bronchofiberoscopy, which is an objective and a relatively safe method, but has side effects, especially in higher-risk subjects. Therefore noninvasive techniques enabling evaluation of airways should be consistently developed and updated. Material consisted of 100 adults (45 female, 55 male) aged between 18 and 65 years (mean 40 years, median 40.5 years, SD 14.02), who underwent chest CT examination by means of a 16-slice scanner. Every patient had normal appearance of chest organs, with the exception of minor abnormalities that did not alter airways route. Divisions of bronchial tree to segmental level were evaluated and assigned to particular types by means of virtual bronchoscopy projection. In case of difficulties MPR or MinIP projection was used. The frequency of lobar bronchi divisions other than the typical ones was in: right upper lobar bronchi 45%, left 55%; middle lobar bronchi 21%, lingula 26%; right lower lobar bronchi 28%, left 29%. Subsuperior bronchus or bronchi were found on the right side in 44% and on the left side in 37%. No dependency between types of bronchial divisions on different levels was found

  1. Anatomy and bronchoscopy of the porcine lung. A model for translational respiratory medicine.

    LENUS (Irish Health Repository)

    Judge, Eoin P

    2014-09-01

    The porcine model has contributed significantly to biomedical research over many decades. The similar size and anatomy of pig and human organs make this model particularly beneficial for translational research in areas such as medical device development, therapeutics and xenotransplantation. In recent years, a major limitation with the porcine model was overcome with the successful generation of gene-targeted pigs and the publication of the pig genome. As a result, the role of this model is likely to become even more important. For the respiratory medicine field, the similarities between pig and human lungs give the porcine model particular potential for advancing translational medicine. An increasing number of lung conditions are being studied and modeled in the pig. Genetically modified porcine models of cystic fibrosis have been generated that, unlike mouse models, develop lung disease similar to human cystic fibrosis. However, the scientific literature relating specifically to porcine lung anatomy and airway histology is limited and is largely restricted to veterinary literature and textbooks. Furthermore, methods for in vivo lung procedures in the pig are rarely described. The aims of this review are to collate the disparate literature on porcine lung anatomy, histology, and microbiology; to provide a comparison with the human lung; and to describe appropriate bronchoscopy procedures for the pig lungs to aid clinical researchers working in the area of translational respiratory medicine using the porcine model.

  2. Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Yu-Lun Lo

    Full Text Available OBJECTIVES: There are safety issues associated with propofol use for flexible bronchoscopy (FB. The bispectral index (BIS correlates well with the level of consciousness. The aim of this study was to show that BIS-guided propofol infusion is safe and may provide better sedation, benefiting the patients and bronchoscopists. METHODS: After administering alfentanil bolus, 500 patients were randomized to either propofol infusion titrated to a BIS level of 65-75 (study group or incremental midazolam bolus based on clinical judgment to achieve moderate sedation. The primary endpoint was safety, while the secondary endpoints were recovery time, patient tolerance, and cooperation. RESULTS: The proportion of patients with hypoxemia or hypotensive events were not different in the 2 groups (study vs. control groups: 39.9% vs. 35.7%, p = 0.340; 7.4% vs. 4.4%, p = 0.159, respectively. The mean lowest blood pressure was lower in the study group. Logistic regression revealed male gender, higher American Society of Anesthesiologists physical status, and electrocautery were associated with hypoxemia, whereas lower propofol dose for induction was associated with hypotension in the study group. The study group had better global tolerance (p<0.001, less procedural interference by movement or cough (13.6% vs. 36.1%, p<0.001; 30.0% vs. 44.2%, p = 0.001, respectively, and shorter time to orientation and ambulation (11.7±10.2 min vs. 29.7±26.8 min, p<0.001; 30.0±18.2 min vs. 55.7±40.6 min, p<0.001, respectively compared to the control group. CONCLUSIONS: BIS-guided propofol infusion combined with alfentanil for FB sedation provides excellent patient tolerance, with fast recovery and less procedure interference. TRIAL REGISTRATION: ClinicalTrials. gov NCT00789815.

  3. Flexible bronchoscopy during non-invasive positive pressure mechanical ventilation: are two better than one?

    Science.gov (United States)

    Scala, Raffaele

    2016-09-01

    Flexible bronchoscopy (FBO) and non-invasive positive pressure ventilation (NIPPV) are largely applied in respiratory and general intensive care units. FBO plays a crucial role for the diagnosis of lung infiltrates of unknown origin and for the treatment of airways obstruction due to bronchial mucous plugging and hemoptysis in critical patients. NIPPV is the first-choice ventilatory strategy for acute respiratory failure (ARF) of different causes as it could be used as prevention or as alternative to the conventional mechanical ventilation (CMV) via endotracheal intubation (ETI). Some clinical scenarios represent contraindications for these techniques such as severe ARF in spontaneous breathing patients for FBO and accumulated tracheo-bronchial secretions in patients with depressed cough for NIPPV. In these contexts, the decision of performing ETI should carefully consider the risk of CMV-correlated complications. An increasing amount of published data suggested the use of FBO during NIPPV in ARF in order to avoid/reduce the need of ETI. Despite a strong rationale for the combined use of the two techniques, there is not still enough evidence for a large-scale application of this strategy in all different clinical scenarios. The majority of the available data are in favor of the "help" given by NIPPV to diagnostic FBO in high-risk spontaneously breathing patients with severe hypoxemia. Preliminary findings report the successful "help" given by early FBO to NIPPV in patients with hypoxemic-hypercapnic ARF who are likely to fail because of hypersecretion. Synergy of FBO and NIPPV application is emerging also to perform ETI in challenging situations, such as predicted difficult laringoscopy and NPPV failure in severely hypoxemic patients. This combined approach should be performed only in centers showing a wide experience with both NIPPV and FBO, where close monitoring and ETI facilities are promptly available. PMID:27012292

  4. Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images

    Directory of Open Access Journals (Sweden)

    Dinesh K Sundarakumar

    2011-01-01

    Full Text Available Aims: To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. Settings and Design: It was a prospective study involving 150 patients with symptoms of major airway disease. Materials and Methods: Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB, minimal-intensity projection (minIP, and multiplanar reformatted (MPR images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion. Results: MPR images had the highest degree of agreement with FB (Κ = 0.76 in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51 in this regard. The distal visualization was best on MPR images (84.2%, followed by axial images (80.7%, whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62. Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40. Conclusion: Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.

  5. Cost-effectiveness of CT thorax and bronchoscopy in haemoptysis with normal CXR for exclusion of lung cancer

    International Nuclear Information System (INIS)

    As fibre-optic bronchoscopy and CT thorax become more widely used, patients with haemoptysis who had normal chest x-ray radiography (CXR) and sputum results are more commonly offered both CT and bronchoscopy to exclude lung cancer. Doctors who are under possible litigation pressure arising from missed diagnoses of lung cancer are often exhaustive in their investigations, even when the haemoptysis has been transient. The present study aims to investigate the number of cancer patients who can be detected with the two investigations, and compare recent similar study results with archive results. We found that despite the use of more efficient investigation tools, the yield is paradoxically much lower and, hence, less cost-effective than that of previous studies. The likely reason is that doctors tend to over-investigate, even for short-term, minimal blood-streaked sputum, which is common among simple bronchitis. In order to be more cost-effective, these investigations should be used more selectively and for high risk patients such as those with prolonged haemoptysis and those who are heavy smokers. Copyright (2002) Blackwell Science Pty Ltd

  6. Fetal bronchoscopy as a useful procedure in a case with prenatal diagnosis of congenital microcystic adenomatoid malformation.

    Science.gov (United States)

    Cruz-Martinez, Rogelio; Méndez, Antonio; Perez-Garcilita, Oscar; Monroy, Araceli; Aguilar-Vidales, Karla; Cruz-Martinez, Miriam Alejandra; Martinez-Morales, Cecilia

    2015-01-01

    Massive microcystic congenital cystic adenomatoid malformation (CCAM) and bronchial atresia are associated with a high perinatal mortality secondary to lung hypoplasia and cardiac dysfunction, and fetal intervention should be considered to improve prognosis. Therapeutic options include open fetal surgery with pulmonary resection, fetal sclerotherapy and fetoscopy. We present a case with a severely enlarged left lung without ultrasound signs of dilated airways compatible with the diagnosis of microcystic CCAM, hydrops and severe contralateral lung hypoplasia that was treated successfully at 30 weeks of gestation by fetal bronchoscopy, through which bronchial atresia was identified at the end of the left mainstem bronchi and permeabilized by laser ablation. After fetal surgery, weekly follow-up showed a progressive decrease in the affected lung size and an increase in the contralateral hypoplastic lung size, demonstrating normal dimensions of both lungs at 34 weeks of gestation, reversal of the mediastinal shift, and complete disappearance of hydrops. A healthy neonate was delivered uneventfully at term with no need for respiratory support, and the boy is now doing well at 15 months of age. This report demonstrates that in cases with prenatal diagnosis of large microcystic CCAM, fetal bronchoscopy can be used to refine the diagnosis of bronchial atresia and as a therapeutic tool with good outcome. PMID:25138479

  7. Role of virtual and flexible bronchoscopy in the management of a case of unnoticed foreign body aspiration presented as nonresolving pneumonia in an adult female.

    Science.gov (United States)

    Kshatriya, Ravish Manmohan; Khara, Nimit V; Paliwal, Rajiv P; Patel, Sateesh N

    2016-01-01

    It is not so common to aspirate foreign body in normal adults without any predisposing factors as compared to children and those with the altered neurological state. Endobronchial foreign bodies are one of the causes of obstructive pneumonia and difficult to diagnose as signs and symptoms are often nonspecific. However, once they are diagnosed, they can generally be removed, leading to rapid and drastic resolution of symptoms. Bronchoscopy is the gold standard in the identification and localization of an airway foreign body and also for better management of the ailment. However with the help of virtual bronchoscopy one can decide the location of the foreign body before any invasive intervention and being noninvasive it can be performed in follow-up easily to check the patency of airways. It is not possible to detect the exact size of foreign body with the virtual bronchoscopy. In this article, we report a case of unnoticed foreign body aspiration in a 49-year-old female patient who was initially treated for pneumonia. However, due to nonresolution of opacity contrast enhanced computed tomography thorax with virtual and flexible bronchoscopy were performed, which revealed a foreign body in the right lower lobe bronchus that was removed with biopsy forceps in piecemeal. In her follow-up visit, she underwent virtual broncoscopy that revealed clear airways. Thus, detailed history and high index of suspicion is required for nonresolving pneumonias that may occur due to unnoticed foreign body/ies in an adult. PMID:27578936

  8. 005. History of the recently established bronchoscopy unit of the pulmonology clinic of lamia’s general hospital

    Science.gov (United States)

    Manos, Emmanouil; Gkika, Dimitrs; Kolovos, Dimitrios; Giannakou, Georgia; Pathiaki, Eirini; Mavromati, Evagelia; Divani, Smaroula; Vardouli, Anna; Tsiligrou, Vaina; Karkanis, Konstantinos; Angel, Jacob

    2015-01-01

    Objective The Bronchoscopy Unit of General Hospital of Lamia provides the necessity of six counties in Thessalia and Central Greece. The first bronchoscopy was performed during Christmas of 2012 while from the opening (February 14th, 2014), the unit is presenting an increasing activity (in number and variety of medical practice). Methods From December 21st in 2012 to September 15th in 2014, were performed 158 bronchoscopic examinations in 152 patients (hospitalized and outpatients), 130 men and 28 women, with an average age 72.4 (29 to 89) years old. There were accomplished 80 biopsies (bronchial, transbronchial), 83 brushing, collected 57 cultures for common bacteria and 86 for och-bacilli (acid-fast microscopy in 12), 20 conventional transbronchial needle aspiration (TBNA), two transbronchial biopsies, seven BAL, 25 bronchial toilets in elderly patients and were removed two foreign bodies (one bone segment surrounding by granulomatous tissue and one segment of animal bowel-“kokoretsi”). Results We observed gradual increase of the incoming patients [Quarterly: 5(1st-3rd/2013), 14(4th-6th/2013), 17(7th-9th/2013), 21(10th-12th/2013), 32(1st-3rd/2014), 38(4th-6th/2014), 31(6th-Middle 9th/2014)]. There were diagnosed 70 cases of lung cancer in 93 patients (75.3%) {12 small cell lung carcinoma (SCLC), 57 non-small cell lung carcinoma (NSCLC) [28 squamous, 25 adenocarcinomas, one combo (adeno- and squamous carcinoma), one BAC και two suspicious samples for cancer]}. 49/49 were diagnosed in evident endobronchial lesion (100%) and 21/44 in non-revealing bronchoscopy (47.8%). Biopsy confirmed diagnosis in 52/93, brushing in 31/93, ΤΒΝΑ alone in 4/8 while washing alone in 3/93 patients. Five cases of active tuberculosis were diagnosed (4 M. Τuberculosis, 1 M. Smegmatis), two cases of sarcoidosis, one metastatic (uroepithelial) carcinoma, four cases of granulomatic tissue, one lipoid pneumonia, one sarcomatoid carcinoma of the lung, while the cultures isolated

  9. A Time Series Observation of Chinese Children Undergoing Rigid Bronchoscopy for an Inhaled Foreign Body: 3149 Cases in 1991-2010

    OpenAIRE

    Xu Zhang; Wen-Xian Li; Yi-Rong Cai

    2015-01-01

    Background: In China, tracheobronchial foreign body (TFB) aspiration, a major cause of emergency episode and accident death in children, remains a challenge for anesthetic management. Here, we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration. Methods: This was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB)....

  10. Early fiberoptic bronchoscopy during non-invasive ventilation in patients with decompensated chronic obstructive pulmonary disease due to community-acquired-pneumonia

    OpenAIRE

    Scala, Raffaele; Naldi, Mario; Maccari, Uberto

    2010-01-01

    Introduction Inefficient clearance of copious respiratory secretion is a cause of non-invasive positive pressure ventilation (NPPV) failure, especially in chronic respiratory patients with community-acquired-pneumonia (CAP) and impaired consciousness. We postulated that in such a clinical scenario, when intubation and conventional mechanical ventilation (CMV) are strongly recommended, the suction of secretions with fiberoptic bronchoscopy (FBO) may increase the chance of NPPV success. The obj...

  11. Dysphonia in geriatric cases always needs fiberoptic laryngoscopy/bronchoscopy: Spindle cell carcinoma of larynx, a rare entity

    Directory of Open Access Journals (Sweden)

    Shivaji Patil

    2016-01-01

    Full Text Available Spindle cell (sarcomatoid carcinoma is a rare variant of squamous cell carcinoma (SCC. It compromises of 2–3% of laryngeal cancers. Tumor arises from the oral cavity, tonsil larynx, and pharynx. Tumor is majority times misdiagnosed as reactive lesions or mesenchymal malignancies. It is considered to be a biphasic tumor that is composed of an SCC (in situ or invasive and spindle cell carcinoma (SpCC with sarcomatous appearance. In this case report, 61-year-male with minimal throat pain and acute onset dysphonia misdiagnosed and treated as a case of bronchial asthma with gastroesophageal reflux confirmed to have exophytic laryngeal growth is the cause for clinical presentation. We performed fiberoptic laryngoscopy and diagnosed to have SpCC of larynx. High index of suspicion is a must in geriatric cases with documented history of smoking and fiberoptic laryngoscopy/bronchoscopy found to be crucial in the evaluation. Histopathology expertise in surgical oncology is essential while planning treatment.

  12. Automated Rotational Percussion Bed and Bronchoscopy Improves Respiratory Mechanics and Oxygenation in ARDS Patients Supported with Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Sharma, Nirmal S; Wille, Keith M; Bellot, S Christopher; Diaz-Guzman, Enrique

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) has been used to provide "lung rest" through the use of low tidal volume (6 ml/kg) and ultralow tidal volume (pressures in two patients on volume control ventilation, while the driving pressures (inspiratory pressure) to attain the desired tidal volumes in patients on pressure control ventilation also decreased. In addition, mean partial pressure of oxygen in arterial blood (PaO2)/fraction of inspired oxygen (FiO2) ratio (109 pre-ARPB vs. 157 post-ARPB), positive end-expiratory pressure (10 cm H2O vs. 8 cm H2O), and FiO2 (0.88 vs. 0.52) improved after initiation of ARPB. The improvements in the respiratory mechanics and oxygenation helped us to initiate early ECMO weaning. Based on our experience, the use of chest physiotherapy, frequent body repositioning, and bronchoscopy may be helpful in the management of pulmonary secretions in patients supported with ECMO. PMID:26771392

  13. SafAIRway: an airway training for pulmonologists performing a flexible bronchoscopy with nonanesthesiologist administered propofol sedation: A prospective evaluation.

    Science.gov (United States)

    Schulze, Melanie; Grande, Bastian; Kolbe, Michaela; Kriech, Sarah; Nöthiger, Christoph B; Kohler, Malcolm; Spahn, Donat R; Franzen, Daniel

    2016-06-01

    Nonanesthesiologist administered propofol (NAAP) sedation for flexible bronchoscopy is controversial, because there is no established airway management (AM) training for pulmonologists. The aim was to investigate the performance and acceptance of a proposed AM algorithm and training for pulmonologists performing NAAP sedation. The algorithm includes using 3 maneuvers including bag mask ventilation (BMV), laryngeal tube (LT), and needle cricothyrotomy (NCT). During training (consisting of 2 sessions with a break of 9 weeks in between), these maneuvers were demonstrated and exercised, followed by 4 consecutive attempts to succeed with each of these devices. The primary outcome was the improvement of completion time needed for a competent airway. Secondary outcomes were the trainees' overall reactions to the training and algorithm, and the perceptions of psychological safety (PS). The 23 staff members of the Department of Pulmonology performed a total of 552 attempts at AM procedures (4 attempts at each of the 3 maneuvers in 2 sessions), and returned a total of 42 questionnaires (4 questionnaires were not returned). Median completion times of LT and NCT improved significantly between Sessions 1 and 2 (P = 0.005 and P = 0.04, respectively), whereas BMV was only marginally improved (P = 0.05). Trainees perceived training to be useful and expressed satisfaction with this training and the algorithm. The perception of PS increased after training. An AM algorithm and training for pulmonologists leads to improved technical AM skills, and is considered useful by trainees and raised their perception of PS during training. It thus represents a promising program. PMID:27281093

  14. Utility of Flexible Bronchoscopy in Intensive Care Unit: Experience of Türkiye Yüksek İhtisas Education and Research Hospital

    Directory of Open Access Journals (Sweden)

    Sema Turan

    2010-12-01

    Full Text Available Objective: Fiberoptic bronchoscopy (FOB is the most frequently used tool for invasive pulmonary evaluation with high diagnostic yield and low incidence of major complications. These advantages led to increasing use of FOB in intensive care units. In this article, we discussed our experiences of FOB applications in mechanical ventilated critically ill patients. Materials and Methods: We investigated FOB procedures of 118 patients on mechanical ventilation for respiratory failure in intensive care unit retrospectively. All patients’ demographic data, indications, complications and arterial blood gas analyses belong to before and after bronchoscopy were evaluated. Results: FOB indications of the patients were 55.1% for mucoid plug clearance, 9.3% for treatment of atelectasia, 7.6% for identifying hemorrhagic foci, 17.8% for tracheostomy management, 6.8% for bronchoalveolar lavage and 3.4% for exploratory purposes. Overall complication rate of FOB was 11.9%. Arterial blood gas analyses statistically improved after FOB. Conclusion: In this study, we observed that FOB is being performed with many different indications and acceptable complication rates in our intensive care unit and also contributes to diagnose and treatment of intensive care patients. (Journal of the Turkish Society of Intensive Care 2010; 8: 48-53

  15. Lack of efficacy of pre bronchoscopy inhaled salbutamol on symptoms and lung functions in patients with pre-existing airway obstruction

    Science.gov (United States)

    Mohan, Anant; Momin, Indrajit; Poulose, Rosemary; Mohan, Charu; Madan, Karan; Hadda, Vijay; Guleria, Randeep; Pandey, RM

    2016-01-01

    Background: Fiberoptic bronchoscopy (FOB) may exaggerate symptoms and lung functions in patients with pre-existing airway obstruction. Interventions which can alleviate or minimize this procedure-related bronchospasm, especially in this high-risk group are, therefore, required. Methods: A double-blinded randomized controlled trial was conducted to evaluate the efficacy of 400 μg of inhaled salbutamol on patients with spirometric evidence of airflow obstruction planned for FOB. Patient's dyspnea, procedure tolerability, and change in spirometry were assessed before and after the procedure. Results: A total of 50 patients were enrolled (78% males), with a mean (standard deviation) age of 49.8 (6.2) years. There was a significant fall in % predicted FEV1 within each group compared to their respective pre-bronchoscopy values. However, no significant difference in the % predicted or absolute FEV1 level was observed between the two groups. Similarly, although both groups experienced increased dyspnea immediately following FOB, this difference was not significant between the two groups either on the Borg or visual analog scale scales. Pre-FOB anxiety levels and the tolerability of the procedure as assessed by the bronchoscopist were similar in both groups. Conclusion: FOB in patients with pre-existing airway obstruction aggravates cough and dyspnea, with a concomitant decline in FEV1 and FVC. The administration of pre-FOB inhaled salbutamol does not have any significant beneficial effect on procedure-related outcomes.

  16. Anesthesia for bronchoscopy.

    Science.gov (United States)

    Abdelmalak, Basem B; Gildea, Thomas R; Doyle, D John

    2012-01-01

    Bronchoscopic procedures are at times intricate and the patients often very ill. These factors and an airway shared with the pulmonologist present a clear challenge to anesthesiologists. The key to success lies in the understanding of both the underlying pathology and procedure being performed combined with frequent two-way communication between the anesthesiologist and the pulmonologist. Above all, vigilance and preparedness are paramount. Topics discussed in this review include anesthesia for advanced diagnostic procedures as well as for interventional/ therapeutic procedures. The latter includes bronchoscopic tracheal balloon dilation, tracheobronchial stenting, endobronchial electrocautery, bronchoscopic cryotherapy and other techniques. Special situations, such as tracheoesophageal fistula and mediastinal masses, are also considered. PMID:22762465

  17. Wireless capsule endo bronchoscopy

    Directory of Open Access Journals (Sweden)

    Baratz DM

    2014-03-01

    Full Text Available No abstract available. Article truncated at 150 words. Case Presentation History of Present Illness A 67 year-old man presents 10 days after swallowing a capsule endoscopy camera that was never retrieved. The wireless capsule was swallowed asymptomatically for evaluation of heme positive stools after negative upper and lower endoscopies. Patient noted that the evening after swallowing the camera he developed mild shortness of breath and cough. The cough and shortness of breath were persistent and worsened while lying down and when moving positions. He denied prior issues with swallowing or aspiration. Review of Systems Negative other than what is noted above. PMH, SH, and FH Past medical history: coronary artery disease, peripheral vascular disease, hyperlipidemia Surgical history: femoral-popliteal bypass, previous shoulder and back surgery Social history: 1 pack/day of cigarettes for 50 years, prior alcohol usage but not current, no illicit drugs Family history: no pulmonary diseases Physical Exam Vital signs: temperature 36.7º C, heart rate 86 beats per minute ...

  18. The potential regimen of target-controlled infusion of propofol in flexible bronchoscopy sedation: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Ting-Yu Lin

    Full Text Available Target-controlled infusion (TCI provides precise pharmacokinetic control of propofol concentration in the effect-site (Ce, eg. brain. This pilot study aims to evaluate the feasibility and optimal TCI regimen for flexible bronchoscopy (FB sedation.After alfentanil bolus, initial induction Ce of propofol was targeted at 2 μg/ml. Patients were randomized into three titration groups (i.e., by 0.5, 0.2 and 0.1 μg/ml, respectively to maintain stable sedation levels and vital signs. Adverse events, frequency of adjustments, drug doses, and induction and recovery times were recorded.The study was closed early due to significantly severe hypoxemia events (oxyhemoglobin saturation <70% in the group titrated at 0.5 μg/ml. Forty-nine, 49 and 46 patients were enrolled into the 3 respective groups before study closure. The proportion of patients with hypoxemia events differed significantly between groups (67.3 vs. 46.9 vs. 41.3%, p = 0.027. Hypotension events, induction and recovery time and propofol doses were not different. The Ce of induction differed significantly between groups (2.4±0.5 vs. 2.1±0.4 vs. 2.1±0.3 μg/ml, p = 0.005 and the Ce of procedures was higher at 0.5 μg/ml titration (2.4±0.5 vs. 2.1±0.4 vs. 2.2±0.3 μg/ml, p = 0.006. The adjustment frequency tended to be higher for titration at 0.1 μg/ml but was not statistically significant (2 (0∼6 vs. 3 (0∼6 vs. 3 (0∼11. Subgroup analysis revealed 14% of all patients required no further adjustment during the whole sedation. Comparing patients requiring at least one adjustment with those who did not, they were observed to have a shorter induction time (87.6±34.9 vs. 226.9±147.9 sec, p<0.001, a smaller induction dose and Ce (32.5±4.1 vs. 56.8±22.7 mg, p<0.001; 1.76±0.17 vs. 2.28 ±0.41, p<0.001, respectively, and less hypoxemia and hypotension (15.8 vs.56.9%, p = 0.001; 0 vs. 24.1%, p = 0.008, respectively.Titration at 0.5 μg/ml is risky for FB sedation. A

  19. Pneumocystis carinii pneumonia in AIDS patients: clinical course in relation to the parasite number found in routine specimens obtained by fiberoptic bronchoscopy

    DEFF Research Database (Denmark)

    Orholm, M; Nielsen, T L; Holten-Andersen, W; Lester, Anne; Kolmos, H J

    1992-01-01

    The aim of this study was to evaluate whether the amount of Pneumocystis carinii organisms found at fiberoptic bronchoscopy (FB) performed on HIV-positive patients correlated to the character of the P. carinii pneumonia (PCP). A consecutive series of 105 patients presented with 131 episodes of...... pulmonary symptoms requiring FB, and in 75 of these episodes a diagnosis of PCP was made. Specimens were stained with Giemsa and methenamine silver nitrate and the number of parasites found was given as: numerous, many, few or none. The following signs and symptoms were registered: cough, dyspnoea, fever......, loss of weight, chest radiograph, haemoglobin, WBC, CD4 cell count, PO2 and HIV p24 antigen. The PCP was characterized by the clinical course: mild, moderate, severe, and by the outcome: pulmonary healthy, pulmonary insufficiency and death. No correlations between the number of P. carinii organisms and...

  20. Papel da fibrobroncoscopia no diagnóstico de pacientes com suspeita de tuberculose pulmonar Role of the fiberoptic bronchoscopy in the diagnosis of patients with suspected pulmonary

    Directory of Open Access Journals (Sweden)

    Anna Luiza Summers Caymmi

    2004-02-01

    que representam diagnósticos diferenciais.BACKGROUND: Pulmonary tuberculosis is an infectious disease of high prevalence and incidence. The use of sputum bacilloscopy is a sure and speedy way of reaching a diagnosis. However as 30% to 50% of the bearers of pulmonary tuberculosis have a negative sputum smear or have no sputum the fiber bronchoscopy acquires a special importance. OBJECTIVES: To evaluate the sensitivity of the specimens collected by means of the fiber bronchoscopy (brochoalveolar lavage and transbronchial biopsy for the diagnosis of patients suspected of having pulmonary tuberculosis, without confirmation by sputum bacilloscopy. METHOD: By review of the ledgers of fiber bronchoscopies carried out from March 1997 to March 2001, we identified and included in the study patients over 18 years of age and referred with suspicion of tuberculosis and at least three negative sputum smears. Data regarding age, gender, changes detected at thorax imaging and endoscopy were collected. RESULTS: Fifty-two patients with ages ranging from 19 to 77 years (median of 39, were included, 58% were of the male gender and 37% were patients from the Official Health System. Prevailing finding at chest X-ray was the alveolar infiltrate (80%. In 35 patients tuberculosis was the final diagnosis (one with associated neoplasia; in 28 patients (80% diagnosis was achieved by bronchoscopy. Other diagnoses disclosed by bronchoscopy were neoplasias, histoplasmosis chronic eosinophil alvelolitis, pneumonia by Pneumocystis carinii and pulmonary fibrosis. CONCLUSION: results of this study point to the use of fiber bronchoscopy in patients suspect of tuberculosis, not diagnosed thorough sputum bacilloscopy, not only for pulmonary tuberculosis but also of those that represent differential diagnoses.

  1. Clinical study in fiberoptic bronchoscopy with a laryngeal mask airway%喉罩在无痛支气管镜中应用的分析

    Institute of Scientific and Technical Information of China (English)

    苗劲柏; 芮燕; 陈硕; 张文谦; 胡滨; 李辉

    2014-01-01

    Objective To evaluate the usefulness and safety of bronchoscopy by the laryngeal mask airway (LMA) compared with by nose and by mouth.Methods Between April 2009 and Dec 2012, we prospectively studied 150 analgesia brochoscopy in the operating theater of the our hospital.All the patients were randomly assigned by computer to LMA group , non-LMA by nose group ( NLBN ) and non-LMA by mouth group(NLBM) according the way of bronchoscopy.Each group had 50 cases.We recorded the time of bronchoscopy just through subglottic , total operation time , the times of blood oxygen less than 80%so as to suspend procedure and so on.Results Intergroup comparisons showed no difference in gender , age, and the successful rate of biopsy ( P>0.05).The time of bronchoscopy just through subglottic in LMA group was lower than that in NLBN group and in NLBM group significantly (P0.05).Also, total operation time of LMA group was higher than that of others (P 0.05).There were 19 patients presented with nasal discomfort after operations in NLBN Group.The patients in all the three groups had no bad memory or fear , and the acceptance rate of reoperation was all 100%.In general, as to the cases of the patients who presented with pharyngeal discomfort and abnormal pronunciation , there was significance difference between LMA Group and NLBN Group and also between LMA Group and NLBM Group , while the difference between NLBN Group and NLBM Group was not statistically significan.Conclusion The use of the LMA during FFB is safe, provides excellent patient comfort , reduces the time of bronchoscopy just through subglottic so as to decrease the total operation time , and is better to control the situation of patient in operation.%目的:前瞻性研究比较静脉麻醉下经喉罩、经口腔和经鼻腔进行纤维支气管镜检查活检的手术安全性。方法2009年4月至2012年12月共150例患者接受无痛支气管镜检查,按随机方法分为喉罩组、非喉罩经鼻组(经鼻组

  2. Virtual bronchoscopy of pediatric patients based on multislice spiral CT (MSCT): initial clinical experience; Virtuelle Bronchoskopie am Kind unter Verwendung der Mehrzeilen-Spiral-CT: erste klinische Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, J.; Laufer, U.; Jendreck, M.; Kickuth, R.; Schilling, E.M.; Liermann, D. [Katholisches Marienhospital Herne (Germany). Klinik fuer Radiologische Diagnostik und Nuklearmedizin

    2000-07-01

    We demonstrate the benefit of the accelerated examination based on multislice spiral CT (MSCT) in the pediatric patient which has not been reported so far. Material and methods: MSCT (tube voltage 120 kV, tube current 110 mA, 4x1 mm slice thickness, 500 ms rotation time, pitch 6) was performed on a CT scanner of the latest generation (Volume Zoom, Siemens Corp., Forchheim, Germany). In total we examined 11 patients. Results: In all patients we obtained sufficient data for 3D reconstruction avoiding general anesthesia. 6/11 examinations were described to be without pathological finding. A definite diagnosis was obtained in 10 patients. Virtual bronchoscopy could avoid other invasive diagnostic examination in 8/11 patients. (orig.) [German] Wir berichten von unseren Erfahrungen mit der bislang noch nicht beschriebenen, durch die Anwendung der Mehrzeilen-Spiral-Computertomographie (MSCT) verbesserten virtuellen Bronchoskopie des Kleinkindes. Material und Methode: Die MSCT (120 kV Roehrenspannung, 110 mA Roehrenstrom, Schichtdicke 4x1 mm, Pitch 6, 500 ms Rotationszeit) wurde an einem Computertomographen der neusten Generation durchgefuehrt (Volume Zoom, Siemens AG, Forchheim). Insgesamt wurden 11 Patienten untersucht. Ergebnisse: Bei allen Patienten konnten fuer die 3D-Nachbearbeitung verwendbare Datensaetze ohne Durchfuehrung einer Narkose erhoben werden. Eine definitive Diagnose wurde anhand der virtuellen Bronchoskopie in 10 Faellen erhoben, hiervon wurden 6 Untersuchungen als unauffaellig bezueglich des Tracheobronchialsystems beschrieben. Die virtuelle Bronchoskopie konnte eine weitere invasive diagnostische Untersuchung in 8/11 Faellen vermeiden. (orig.)

  3. A Time Series Observation of Chinese Children Undergoing Rigid Bronchoscopy for an Inhaled Foreign Body: 3149 Cases in 1991-2010

    Directory of Open Access Journals (Sweden)

    Xu Zhang

    2015-01-01

    Full Text Available Background: In China, tracheobronchial foreign body (TFB aspiration, a major cause of emergency episode and accident death in children, remains a challenge for anesthetic management. Here, we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration. Methods: This was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB. Data including the clinical characteristics of patients and TFB, anesthetic method, and postoperative severe complications were analyzed by different periods. Results: During the 20-year study period, the charts of 3149 patients who underwent RB for suspected inhaled TFB were reviewed. There were 2079 male and 1070 female patients (1.94:1. A nut (84% was the most commonly inhaled object. The study revealed a 9% (n = 284 overall rate of severe postoperative complications related to severe hypoxemia, laryngeal edema, complete laryngospasm, pneumothorax, total segmental atelectasis, and death with incidences of 3.2%, 0.9%, 1.3%, 0.3%, 0.3%, and 0.1%, respectively. The rates of preoperative airway impairment, negative findings of TFB, and adverse postoperative events have been on the rise in the past 5 years. Conclusions: The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods. Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period. An active respiratory symptom was commonly seen in the groups with negative findings.

  4. A Time Series Observation of Chinese Children Undergoing Rigid Bronchoscopy for an Inhaled Foreign Body: 3149 Cases in 1991-2010

    Institute of Scientific and Technical Information of China (English)

    Xu Zhang; Wen-Xian Li; Yi-Rong Cai

    2015-01-01

    Background:In China,tracheobronchial foreign body (TFB) aspiration,a major cause of emergency episode and accident death in children,remains a challenge for anesthetic management.Here,we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration.Methods:This was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB).Data including the clinical characteristics of patients and TFB,anesthetic method,and postoperative severe complications were analyzed by different periods.Results:During the 20-year study period,the charts of 3149 patients who underwent RB for suspected inhaled TFB were reviewed.There were 2079 male and 1070 female patients (1.94:1).A nut (84%) was the most commonly inhaled object.The study revealed a 9% (n =284) overall rate of severe postoperative complications related to severe hypoxemia,laryngeal edema,complete laryngospasm,pneumothorax,total segmental atelectasis,and death with incidences of 3.2%,0.9%,1.3%,0.3%,0.3%,and 0.1%,respectively.The rates of preoperative airway impairment,negative findings of TFB,and adverse postoperative events have been on the rise in the past 5 years.Conclusions:The survey results confirmed that hypoxemia remains the most common postoperative complication in different periods.Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period.An active respiratory symptom was commonly seen in the groups with negative findings.

  5. A study of usefulness of washes and brush cytology with respect to histopathology in diagnosis of lung malignancy by using fiberoptic bronchoscopy

    Directory of Open Access Journals (Sweden)

    Abhishek Bandyopadhyay

    2016-01-01

    Full Text Available Background: Examination of specimens obtained through flexible fiberoptic bronchoscope is important and often the initial diagnostic technique performed in patients with suspected malignant lung lesion. Aims: To evaluate the usefulness of cytological findings of bronchial washings (pre-and post-bronchoscopy and bronchial brushing in the diagnosis of lung malignancy with histopathology of bronchial biopsy, taking the latter as the confirmatory diagnostic test. Settings and Design: It was a cross-sectional observational study conducted in a tertiary care center. Subjects and Methods: A total of fifty patients with suspected lung malignancy (clinically and radiologically were included in this nonrandomized cross-sectional study. Bronchial brushings were obtained from all fifty cases. Prebiopsy bronchial washing (washing collected before the brushing and biopsy procedure and postbiopsy washing (washing at the end of the procedure were collected. Results: Prebiopsy (prebrushing and postbiopsy washing showed high specificity of 92.31%, but a very low sensitivity of 32.43% and 35.14%, respectively. Sensitivity and specificity of brushing were found to be 74.36% and 81.82%, respectively. Positive predictive value of prebiopsy (prebrushing washing, postbiopsy washing and brushing are 92.31%, 93.55%, and 92.86%, respectively. There was no significant difference in sensitivity between prebiopsy (prebrushing and postbiopsy washing (Fisher exact probability test; PA= 0.99. However, there was statistically significant difference between sensitivity of brushing with prebiopsy (prebrushing washing (Fisher exact probability test; PA = 0.0012793 and postbiopsy washing (Fisher exact probability test; PA = 0.00310282. Conclusions: Bronchial washing cytology in combination with brush cytology aids in the early diagnosis of lung malignancy in addition to histopathology.

  6. The efficacy of bronchoscopy combined with chemotherapy on bronchial tuberculosis%纤支镜结合化疗对支气管结核的疗效评价

    Institute of Scientific and Technical Information of China (English)

    陶宁; 田雨

    2012-01-01

    目的 探讨分析纤支镜结合化疗对支气管结核的治疗效果.方法 选取2004年1月~ 2010年9月我院收治80例已确诊为支气管结核病的患者为研究对象,随机将其分为观察组40例和对照组40例.观察组患者应用纤支镜结合化疗的方案治疗,对照组以单纯化疗方案治疗.一疗程后比较两组纤支镜、X线检查结果和痰菌转阴状况.结果 应用纤支镜局部注药与全身化疗结合治疗支气管结核具有更好的疗效,比较结果有显著性差异(P<0.05).结论 纤支镜下局部注药结合全身化疗可达到控制病菌扩增的目的,对支气管结核的治疗具有重大意义.%Objective To investigate the treatment of bronchial tuberculosis by bronchoscopy combined with chemotherapy. Methods 80 cases of bronchial tuberculosis patients in our hospital from January 2004 to September 2010 were selected for this study. The 80 cases were randomly divided into observation group of 40 patients and control group of 40 patients. The observation group was treated with bronchoscopy combined with chemotherapy and the control group was treated with chemotherapy alone. After a course of treatment , the results of bronchoscopy, X-ray and sputum negative status were compared between two groups. Results The observation group had better efficacy than the control group, and there were significant differences between the two groups ( P < 0. 05 ) . Conclusion The treatment of bronchoscopy combined with chemotherapy can control the spreading of bacteria, and has great significance in the treatment of bronchial tuberculosis.

  7. SU-C-BRA-07: Virtual Bronchoscopy-Guided IMRT Planning for Mapping and Avoiding Radiation Injury to the Airway Tree in Lung SAbR

    Energy Technology Data Exchange (ETDEWEB)

    Sawant, A; Modiri, A; Bland, R; Yan, Y; Ahn, C; Timmerman, R [University of Texas SouthWestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Post-treatment radiation injury to central and peripheral airways is a potentially important, yet under-investigated determinant of toxicity in lung stereotactic ablative radiotherapy (SAbR). We integrate virtual bronchoscopy technology into the radiotherapy planning process to spatially map and quantify the radiosensitivity of bronchial segments, and propose novel IMRT planning that limits airway dose through non-isotropic intermediate- and low-dose spillage. Methods: Pre- and ∼8.5 months post-SAbR diagnostic-quality CT scans were retrospectively collected from six NSCLC patients (50–60Gy in 3–5 fractions). From each scan, ∼5 branching levels of the bronchial tree were segmented using LungPoint, a virtual bronchoscopic navigation system. The pre-SAbR CT and the segmented bronchial tree were imported into the Eclipse treatment planning system and deformably registered to the planning CT. The five-fraction equivalent dose from the clinically-delivered plan was calculated for each segment using the Universal Survival Curve model. The pre- and post-SAbR CTs were used to evaluate radiation-induced segmental collapse. Two of six patients exhibited significant segmental collapse with associated atelectasis and fibrosis, and were re-planned using IMRT. Results: Multivariate stepwise logistic regression over six patients (81 segments) showed that D0.01cc (minimum point dose within the 0.01cc receiving highest dose) was a significant independent factor associated with collapse (odds-ratio=1.17, p=0.010). The D0.01cc threshold for collapse was 57Gy, above which, collapse rate was 45%. In the two patients exhibiting segmental collapse, 22 out of 32 segments showed D0.01cc >57Gy. IMRT re-planning reduced D0.01cc below 57Gy in 15 of the 22 segments (68%) while simultaneously achieving the original clinical plan objectives for PTV coverage and OAR-sparing. Conclusion: Our results indicate that the administration of lung SAbR can Result in significant injury to

  8. SU-C-BRA-07: Virtual Bronchoscopy-Guided IMRT Planning for Mapping and Avoiding Radiation Injury to the Airway Tree in Lung SAbR

    International Nuclear Information System (INIS)

    Purpose: Post-treatment radiation injury to central and peripheral airways is a potentially important, yet under-investigated determinant of toxicity in lung stereotactic ablative radiotherapy (SAbR). We integrate virtual bronchoscopy technology into the radiotherapy planning process to spatially map and quantify the radiosensitivity of bronchial segments, and propose novel IMRT planning that limits airway dose through non-isotropic intermediate- and low-dose spillage. Methods: Pre- and ∼8.5 months post-SAbR diagnostic-quality CT scans were retrospectively collected from six NSCLC patients (50–60Gy in 3–5 fractions). From each scan, ∼5 branching levels of the bronchial tree were segmented using LungPoint, a virtual bronchoscopic navigation system. The pre-SAbR CT and the segmented bronchial tree were imported into the Eclipse treatment planning system and deformably registered to the planning CT. The five-fraction equivalent dose from the clinically-delivered plan was calculated for each segment using the Universal Survival Curve model. The pre- and post-SAbR CTs were used to evaluate radiation-induced segmental collapse. Two of six patients exhibited significant segmental collapse with associated atelectasis and fibrosis, and were re-planned using IMRT. Results: Multivariate stepwise logistic regression over six patients (81 segments) showed that D0.01cc (minimum point dose within the 0.01cc receiving highest dose) was a significant independent factor associated with collapse (odds-ratio=1.17, p=0.010). The D0.01cc threshold for collapse was 57Gy, above which, collapse rate was 45%. In the two patients exhibiting segmental collapse, 22 out of 32 segments showed D0.01cc >57Gy. IMRT re-planning reduced D0.01cc below 57Gy in 15 of the 22 segments (68%) while simultaneously achieving the original clinical plan objectives for PTV coverage and OAR-sparing. Conclusion: Our results indicate that the administration of lung SAbR can Result in significant injury to

  9. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

    Directory of Open Access Journals (Sweden)

    Mingyue Luo

    Full Text Available To evaluate the diagnostic value of multidetector CT (MDCT and its multiplanar reformation (MPR, volume rendering (VR and virtual bronchoscopy (VB postprocessing techniques for primary trachea and main bronchus tumors.Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6, tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16, extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1, longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1, morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1 and extents (mild, n = 5; moderate, n = 7; severe, n = 19, distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10, and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density

  10. 支气管镜检查在儿科临床中的应用%Use of flexible fiberoptic bronchoscopy in pediatric clinical practice

    Institute of Scientific and Technical Information of China (English)

    Peter J. Mogayzel, Jr.; 张倩倩; 赵顺英; 刘玺诚

    2010-01-01

    The role of flexible fiberoptic bronchoscopy (FFB) in the evaluation of pediatric lung disease has expanded dramatically since the original description of the procedure by Wood and Fink in 1978.FFB can be used to evaluate airway anatomy, obtain secretions for culture and biochemical analysis and obtain airway cells or parenchymal tissues for evaluation. Both the upper and lower airway can be examined during FFB. Visual examination can diagnose a variety of congenital abnormalities ( Table 1 ). During FFB a dynamic evaluation of the airways, including the movement of the glottis, vocal cords and lower airways during the respiratory cycle can be performed. These observations can diagnose airway collapse due to malacia or obstruction due to external compression. Additionally, the diameter of the airway lumen and character of the airway mucosa can easily be evaluated. FFB can also identify airway obstruction by secretions and mucus plugs, blood, foreign bodies or masses. Bronchoalveolar lavage (BAL) allows collection of airway and alveolar secretions for evaluation of cellular and immunologic components, evidence of infection and cytology. Therapeutic lavage can be used to treat atelectasis by removing secretions obstructing airways. This approach can be helpful in children with inspissated secretions obstructing both large and small airways ( Figure 1 ). Therapeutic lavage has also been used in the treatment of alveolar proteinosis. Bronchial brushing can add information to bronchoscopic examination by obtaining airway epithelial cells for cytology, to identify intracellular pathogens and to evaluate cilia. Studies have demonstrated the utility of bronchial brushings for the isolation, characterization and culture of primary epithelial cells from children with asthma. Endobronchial biopsies are used for histopathological and immunocytochemical analysis and microbiological culture. Biopsies are often performed to assess cilia function and architecture. In addition

  11. Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho Use of virtual bronchoscopy in children with suspected foreign body aspiration

    Directory of Open Access Journals (Sweden)

    Tiago Neves Veras

    2009-09-01

    Full Text Available A aspiração de corpo estranho (ACE para o trato respiratório é um problema comum em pacientes pediátricos, em especial abaixo dos três anos de idade. Na avaliação radiológica inicial, cerca de 30% dos pacientes apresentam radiograma de tórax normal. A tomografia com broncoscopia virtual (BV pode auxiliar no diagnóstico precoce desse quadro e seu pronto manejo. O tratamento definitivo se dá com a retirada do corpo estranho através de broncoscopia rígida e mediante anestesia geral. O objetivo deste trabalho foi descrever o uso da BV na abordagem de dois pacientes com suspeita de ACE e realizar uma revisão da literatura sobre este tópico. Os dois pacientes tiveram início súbito de sintomas respiratórios e relato de tosse ou engasgo com alimentos antecedendo o quadro. Os pacientes foram submetidos à BV, e foi detectada a presença de corpo estranho endobrônquico em ambos os casos, com remoção posterior por broncoscopia rígida convencional em um caso. A BV é um método não-invasivo recente e com potencial para detectar a presença de corpo estranho na via respiratória em crianças. Em casos selecionados, BV pode auxiliar na localização correta do corpo estranho e até mesmo evitar o procedimento de broncoscopia rígida na ausência de corpo estranho.Foreign body aspiration (FBA into the tracheobronchial tree is a common problem in children, especially in those under three years of age. Preliminary radiological evaluation reveals normal chest X-rays in nearly 30% of such patients. Tomography-generated virtual bronchoscopy (VB can facilitate the early diagnosis and rapid management of these cases. The definitive treatment is the removal of the foreign body by means of rigid bronchoscopy under general anesthesia. The objective of this study was to describe the use of VB in two patients with suspicion of FBA, as well as to review the literature regarding this topic. The two patients presented with sudden onset of respiratory

  12. 经支气管镜确诊的2168例肺癌的临床特点分析%Analysis of Clinical Features of 2 168 Confirmed Cases of Lung Cancer Diagnosed by Bronchoscopy

    Institute of Scientific and Technical Information of China (English)

    张宇; 于力克; 谢海燕; 胡韦华; 郝可可; 夏宁

    2011-01-01

    Objective To investigate the clinical characteristics of confirmed cases of lung cancer diagnosed by bronchoscopy. Methods A retrospective analysis was conducted to study the clinical features such as gender,age,pathologic type,lesion location,bronchoscopic image and sampling method of 2,168 confirmed cases of lung cancer diagnosed by bronchoscopy. Results The sex ratio (M/F) was 4.8 : 1 and the peak incidence was between 60 to 69 years of age. The most common pathologic type was squamous cell carcinoma (44.56%),followed by adenocarcinoma (25.92%) and small cell lung cancer (18.27%). Squamous cell carcinoma had the highest incidence rate (50.61%) a-mong men,while adenocarcinoma had the highest rate among women (56.18%). The positive rates diagnosed by forceps biopsy,brush biopsy,bronchial alveolar lavage and transbronchial needle aspiration were 81.60%,49.37%, 18.24% and 62.65% respectively. The positive rate by forceps biopsy combined with brush was 89.06%. Conclusion Bronchoscopy is an important approach in the diagnosis of lung cancer. The incidence and pathologic type of lung cancer vary depending on age and gender. Bronchoscopy and improving biopsy technique can markedly increase the diagnostic rate and help in early diagnosis of lung cancer.%分析经支气管镜确诊肺癌的临床特点.方法 回顾性分析经支气管镜确诊为肺癌的2 168例患者的性别、年龄、病理类型、病变部位、镜下表现、取材方法等特点.结果 该组患者男女比例为4.8:1,60~69岁为发病年龄高峰.鳞癌是最主要的病理类型(占44.56%),其次为腺癌(占25.92%)和小细胞癌(占18.27%).男性鳞癌发病率最高(占50.61%),女性腺癌发病率最高(占56.18%).钳检、刷检、支气管肺泡灌洗、经支气管镜针吸的诊断阳性率分别为81.60%、49.37%、18.24%和62.65%,钳检联合刷检阳性率为89.06%.结论 支气管镜检查是诊断肺癌的重要手段.不同年龄、不同性别的肺癌患者发病不同,病

  13. Estudo comparativo do diagnóstico de câncer pulmonar entre tomografia computadorizada e broncoscopia Comparative study between computed tomography and bronchoscopy in the diagnosis of lung cancer

    Directory of Open Access Journals (Sweden)

    Christopher Oliveira

    2010-08-01

    Full Text Available OBJETIVO: Analisar a tomografia computadorizada e a broncoscopia no diagnóstico do câncer pulmonar e verificar a eficácia destas técnicas perante a presença desta doença. Os parâmetros idade, gênero, hábitos tabágicos, tipos histológicos, estadiamento e terapêutica foram, igualmente, analisados. MATERIAIS E MÉTODOS: Foram analisados 70 pacientes do Serviço de Pneumologia do Hospital Distrital da Figueira da Foz, Coimbra, Portugal, que realizaram ambas as técnicas em estudo, tendo-se confirmado ou não a presença de câncer pulmonar. RESULTADOS: Diagnosticaram-se 37 tumores pulmonares, 23 casos no gênero masculino e 14 no feminino. Histologicamente, 40,54% eram adenocarcinomas, seguido do carcinoma escamoso (32,43% dos casos e do carcinoma de pequenas células (18,92%. O estadiamento mostrou 6,70% no estádio IB, 23,30% no estádio IIIA comparativamente ao IIIB com 36,70%, encontrando-se 33,30% dos doentes no estádio IV. A quimioterapia isolada foi efetuada em 75,7% dos doentes. A sensibilidade da broncoscopia foi de 83,8%, a especificidade, de 81,8%, e a precisão, de 82,8%. A sensibilidade da tomografia computadorizada foi de 81,1%, a especificidade, de 63,6%, e a precisão, de 72,8%. CONCLUSÃO: Os resultados da broncoscopia confirmaram a sua importância no diagnóstico do câncer pulmonar, pela dependência deste no exame anatomopatológico do tecido ou células, obtido por várias técnicas de biópsia. A tomografia computadorizada apresentou boa sensibilidade, de 81,1%, contudo, a sua especificidade, de apenas 63,6%, resulta do número de falso-positivos (36,4%.OBJECTIVE: To analyze the role of computed tomography and bronchoscopy in the diagnosis of lung cancer, evaluating the effectiveness of these techniques in the presence of this disease. Parameters such as age, gender, smoking habits, histological types, staging and treatment were also analyzed. MATERIALS AND METHODS: The sample of the present study included 70

  14. Broncoscopia no diagnóstico de tuberculose pulmonar em pacientes com baciloscopia de escarro negativa Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results

    Directory of Open Access Journals (Sweden)

    Márcia Jacomelli

    2012-04-01

    Full Text Available OBJETIVO: Avaliar a acurácia diagnóstica da broncoscopia em pacientes com suspeita clínica ou radiológica de tuberculose, com baciloscopia negativa ou incapazes de produzir escarro. MÉTODOS: Estudo transversal prospectivo de 286 pacientes com suspeita clínica/radiológica de tuberculose pulmonar e submetidos à broncoscopia - LBA e biópsia transbrônquica (BTB. As amostras de LBA foram testadas por pesquisas diretas e culturas de BAAR e de fungos, e as de BTB por exame histopatológico. RESULTADOS: Dos 286 pacientes estudados, a broncoscopia contribuiu para o diagnóstico em 225 (79%: tuberculose pulmonar em 127 (44%; inflamações crônicas inespecíficas em 51 (18%; pneumocistose, infecções fúngicas ou nocardiose em 20 (7%; bronquiolite obliterante com pneumonia em organização, alveolites ou pneumoconioses em 14 (5%; neoplasias pulmonares ou metastáticas em 7 (2%; e micobacterioses não tuberculosas em 6 (2%. Para o diagnóstico de tuberculose, o LBA mostrou sensibilidade e especificidade de 60% e 100% respectivamente, havendo um aumento importante da sensibilidade quando associado à biópsia (84% e à baciloscopia após a broncoscopia (94%. Complicações controláveis decorrentes do procedimento ocorreram em 5,6% dos casos. CONCLUSÕES: A broncoscopia representa um método diagnóstico confiável para pacientes com tuberculose pulmonar, apresentando baixos índices de complicações. A associação de biópsia transbrônquica ao lavado broncoalveolar elevou a sensibilidade diagnóstica do método e permitiu o diagnóstico diferencial com outras doenças.OBJECTIVE: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. METHODS: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to

  15. Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos Flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults

    Directory of Open Access Journals (Sweden)

    Ascedio José Rodrigues

    2012-06-01

    Full Text Available OBJETIVO: Determinar a taxa de sucesso da broncoscopia flexível como primeira opção na remoção de corpos estranhos das vias aéreas em adultos. MÉTODOS: Estudo retrospectivo de todos os pacientes adultos (acima de 18 anos com aspiração de corpo estranho submetidos a broncoscopia no Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, em São Paulo (SP. RESULTADOS: A amostra foi constituída por 40 pacientes adultos, com média de idade de 52 anos (variação: 18-88 anos. A mediana do tempo de permanência do corpo estranho na via aérea foi de 15 dias (variação: 12 h a 10 anos. Todos os pacientes foram submetidos primeiramente a broncoscopia flexível diagnóstica. A retirada do corpo estranho por meio de broncoscopia flexível foi bem-sucedida em 33 dos pacientes (82,5%. Em 1 paciente, um objeto metálico alojado na árvore brônquica distal requereu o uso de fluoroscopia. Seis pacientes (15% foram submetidos a broncoscopia rígida devido a dispneia induzida por corpo estranho traqueal, em 2, e porque o corpo estranho era muito grande para as pinças flexíveis, em 4. A broncoscopia falhou em apenas 1 paciente, que portanto necessitou de broncotomia. CONCLUSÕES: Embora a broncoscopia rígida seja considerada o padrão ouro na remoção de corpos estranhos na via aérea, nossa experiência mostrou que a broncoscopia flexível pode ser utilizada segura e eficientemente no diagnóstico e tratamento de pacientes adultos estáveis.OBJECTIVE: To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults. METHODS: This was a retrospective study of all adult patients (over 18 years of age with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of São Paulo School of Medicine Hospital das Clínicas, located in São Paulo, Brazil. RESULTS: The study sample comprised 40 adult patients

  16. Uso de mascarilla laríngea para fibrobroncoscopía en lactantes durante ventilación mecánica USE OF LARYNGEAL MASK WHILE FLEXIBLE BRONCHOSCOPY IS PERFORMED IN INFANTS UNDER MECHANICAL VENTILATION

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    CECILIA ALVAREZ G.

    2002-04-01

    Full Text Available La mascarilla laríngea (ML se utiliza para el manejo de la vía aérea en adultos y niños bajo anestesia general con el objetivo de evitar la intubación traqueal y su uso se ha extendido para fibrobroncoscopía bajo anestesia general. Durante ventilación mecánica (VM la fibrobroncoscopía (FB se limita a tubos endotraqueales (TET > 4,5 mm de diámetro ya que el fibrobroncoscopio con canal de succión más pequeño es de 3,5 mm. Nuestro objetivo fue evaluar la utilidad de la ML para FB en niños sometidos a VM con TET Laryngeal mask (LM has been used to manage airways during general anesthesia, in both children and adults, to avoid tracheal intubation. Lately its use has been extended to perform flexible bronchoscopy (FB. In an infant under mechanical ventilation (MV, most of FB require an endotracheal tube # 4.5 because the smallest instrument with a suction channel has a 3.5 mm diameter. Our objective was to evaluate the use of LM while performing FB in patients on MV. Patients were sedated (atropine- midazolam and vecuronium, and monitored with transcutaneous oxygen saturation and cardiorespiratory monitor in an Intensive Care Unit setup. LM was introduced, and its position was verified by clinical auscultation. FB Olympus BF C-30, with 3.5 mm diameter was used. From December 1997 to October 1998 eleven procedures were done in 6 patients. Their mean age was 6.2 months (range: 0.5-33, weight 4.9 kg (2.7-10.5. MV parameters were FiO2 0.45 (0.4-1, MIP 28.4 cm H2O (20-60 and PEEP 5,18 cm H2O (3-8. In all patients we used LM # 1.0, with an internal diameter 5.25 mm. Indications for FB were: atelectasis (6, tracheobronchomalacia (2, hemoptisis (2 and subglotic stenosis (1. LM was introduced during the first attempt in 9 procedures, without complications. We maintained positive pressure ventilation without displacements of LM. After the FB, the patients were reintubated, with similar parameters compared to prior procedure. To sum up, we found

  17. Pulmonary carcinoma. Diagnosis and bronchoscopy treatment

    International Nuclear Information System (INIS)

    The paper makes reference to the pulmonary carcinoma in USA, it relates the detection resources like the x-ray, tomography and magnetic resonance, laser, Brachytherapy, fluorescence, cryotherapy between other techniques and topics

  18. Advances in bronchoscopy for lung cancer

    Directory of Open Access Journals (Sweden)

    Samjot Singh Dhillon

    2012-01-01

    Full Text Available Bronchoscopic techniques have seen significant advances in the last decade. The development and refinement of different types of endobronchial ultrasound and navigation systems have led to improved diagnostic yield and lung cancer staging capabilities. The complication rate of these minimally invasive procedures is extremely low as compared to traditional transthoracic needle biopsy and surgical sampling. These advances augment the safe array of methods utilized in the work up and management algorithms of lung cancer.

  19. Advances in bronchoscopy for lung cancer

    Science.gov (United States)

    Dhillon, Samjot Singh; Dexter, Elisabeth U.

    2012-01-01

    Bronchoscopic techniques have seen significant advances in the last decade. The development and refinement of different types of endobronchial ultrasound and navigation systems have led to improved diagnostic yield and lung cancer staging capabilities. The complication rate of these minimally invasive procedures is extremely low as compared to traditional transthoracic needle biopsy and surgical sampling. These advances augment the safe array of methods utilized in the work up and management algorithms of lung cancer. PMID:23346012

  20. Endobronchial ultrasound: A new innovation in bronchoscopy

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    Balamugesh T

    2009-01-01

    Full Text Available Technical development in last two decades has made it possible for pulmonologists to do endobronchial ultrasound (EBUS. With EBUS mini-probe, the multilayered structure of the tracheobronchial wall can be analyzed better than any other imaging modality. Instead of fluoroscopic guided biopsy, EBUS can be used to biopsy peripheral lesions. EBUS-transbronchial needle aspiration has proved valuable for mediastinal lymph node staging of lung cancer. Studies have shown that EBUS is cost-effective as it reduces the need for more morbid and costly invasive procedure like mediastinoscopy or thoracotomy. Prospective studies are needed in India to see how EBUS will help in populations with high prevalence of tuberculosis.

  1. Interventional bronchoscopy with the use of mechanical ventilation by larynx mask or tracheal intubation under general anesthesia%经喉罩或气管插管连接行常规机械通气在全身麻醉介入治疗手术中的安全性

    Institute of Scientific and Technical Information of China (English)

    王婷; 张杰; 王娟; 党斌温; 徐敏; 裴迎华; 张晨阳

    2011-01-01

    Objective To explore and evaluate the technique of performing interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia.Methods From July 2009 to January 2010,29 patients received interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia.Airway pressure and tidal volume before and after bronchoscope insertion,arterial blood gas analysis during interventional bronchoscopy,complications and operation time were recorded.The factors influencing ventilation effects were evaluated.Results All the patients' condition were kept stable during interventional bronchoscopy and no severe complications occurred.Tidal volume was reduced by 27.1%,while peak airway pressure,plateau pressure and mean airway pressure were increased by 63.1%,43.7% and 32.4% following insertion of the bronchoscope respectively.Patients using tracheal intubation had their peak pressure increased by 79.3%,which was higher than that of patients using larynx mask (55.3%).Conclusions Interventional bronchoscopy by using mechanical ventilation with larynx mask or tracheal intubation under general anesthesia was safe and reliable.Although peak airway pressure increased following insertion of bronchoscope,the mean airway pressure was maintained in a low level.When performing interventional bronchoscopy during mechanical ventilation,the inside diameter of larynx mask and tracheal intubation should be as large as possible to minimize airway pressure and auto-PEEP.%目的 探索并评价使用喉罩或气管插管联合常规机械通气在介入治疗手术中的应用价值.方法 纳入2009年7月至2010年1月收入首都医科大学附属北京天坛医院呼吸科在全身麻醉下经喉罩或气管插管联合常规机械通气条件下接受气管镜介入治疗的患者29例,其中男19例,女10例,年龄19 ~74岁,平均(47±18)岁.观察手术前后的气

  2. 丙泊酚与瑞芬太尼靶控输注联合高频通气在纤维支气管镜术中的应用%The efficacy of the target-controlled infusion of propofol and remifentanil with high frequency jet ventilation in fiber-optic bronchoscopy

    Institute of Scientific and Technical Information of China (English)

    张斌; 王汉兵; 罗昌辉; 何万有; 林森; 刘洪珍; 杨承祥

    2012-01-01

    目的 本研究探讨丙泊酚复合瑞芬太尼靶控输注联合高频通气在诊断性纤维支气管镜(纤支镜)术中应用的可行性.方法 88例拟行诊断性纤支镜术患者随机分为常规适度镇静组(PF组,n=42)和高频通气靶控输注组(PRH组,n=46),PF组静注芬太尼50μg及丙泊酚1.5mg/kg,术中根据患者意识、体动和咳嗽情况每次静注丙泊酚20 mg,PRH组静脉血浆靶控输注丙泊酚和瑞芬太尼,初始血浆靶浓度分别为4 μg/ml和4 ng/ml,并行高频通气,术中根据情况调整瑞芬太尼靶浓度.观察记录患者的SpO2、MAP、HR、咳嗽评分、动脉血PCO2、纤支镜检查时间、意识恢复时间、低氧血症发生率、患者满意度评分等指标.结果 PF组平均SpO2、最低SpO2均明显低于PRH组,低氧血症发生率明显高于PRH组(P<0.01).于术前即刻、到达隆突时PF组MAP显著高于,HR明显快于PRH组(P<0.01).PF组咳嗽评分明显高于,患者满意度评分明显低于PRH组(P<0.05或P<0.01);PF组纤支镜检查时间明显长于PRH组(P<0.05).结论 丙泊酚和瑞芬太尼靶控输注联合高频通气应用于诊断性纤支镜术安全有效,与常规适度镇静相比,可减少术中低氧血症的发生率,降低咳嗽评分,维持血流动力学平稳.%Objective To evaluate the efficacy and safety of the target-controlled infusion (TCI) of propofol and remifentanil for deep sedation with high frequency jet ventilation (HFJV) in diagnostic fiber-optic bronchoscopy. Methods A total of eighty-eight consecutive patients scheduled for flexible bronchoscopy were randomly assigned to receive propofol plus fentanyl (group PF) or TCI-delivered propofol plus remifentanil with HFJV (group PRH). Patients in the group PF received 50 μg of fentanyl and 1.5 mg/kg of propofol, and additional 20 mg of propofol according intraoperative reactivity; patients in the group PRH received an initial doses of propofol and remifentanil 4μg/ml and 4ng

  3. 纤维支气管镜下经皮扩张气管切开术在口腔颌面外科的应用%Clinical application of fiberoptic bronchoscopy-assisted percutaneous dilatational tracheostomy in oral and maxillofacial surgery

    Institute of Scientific and Technical Information of China (English)

    陆俊睿; 黄燕; 姜虹

    2011-01-01

    目的:探讨纤维支气管镜引导下经皮扩张气管切开术在口腔颌面外科的应用价值.方法:选择因手术需要行预防性气管切开的口腔颌面外科患者60例,随机分为3组(n=20):经典手术气管切开组(A组)、经皮扩张气管切开组(B组)、纤维支气管镜引导下经皮扩张气管切开组(C组).观察并记录3组的气管切开操作时间、出血量、一次性置管成功率、血氧饱和度(spO2)变化和并发症的差异.采用SPSS 17.0软件包对数据进行统计学分析.结果:与经典手术A组相比,B组和C组在气管切开中的操作时间显著缩短,出血量和并发症减少,一次性置管成功率显著提高(P<0.05).与B组相比,C组在操作时间上显著减少,一次性置管成功率显著提高(P<0.05).结论:纤维支气管镜引导下经皮扩张气管切开术安全有效,在口腔颌面外科手术中有较高的应用价值.%PURPOSE: To investigate the clinical value of fiberoptic bronchoscopy -assisted percutaneous dilatational tracheostomy in oral and maxillofacial Burger)'. METHODS: Sixty patients who needed prophylactic surgical tracheotomy in oral and maxillofacial surgery were randomly divided into 3 groups (n=20):Classic surgical tracheotomy group (group A), percutaneous dilational tracheostomy group (group B) and fiberoptic bronchoscopy -assisted percutaneous dilational tracheostomy group (group C). The timing of procedure, hemorrhage, one -time successful rate, SpO2 changes and complications in three groups were recorded and analyzed with SPSS 17.0 software package. RESULTS: Compared with group A, group B and group C had a shorter time of procedure, less bleeding, higher one-time successful rate and lower complications(P<0.05). Compared with group B, the time of procedure reduced and the one-time successful rate increased significantly in group C (P<0.05). CONCLUSION: The safety and efficiency with fewer complications of fiberoptic bronchoscopy-assisted percutaneous

  4. The effect of bronchoalveolar lavage by bronchoscopy for the prevention and treatment of patients with pulmonary infection after severe burns%经纤维支气管镜支气管肺泡灌洗对防治重度烧伤患者肺部感染的影响

    Institute of Scientific and Technical Information of China (English)

    李香彭; 毛学飞; 孟浩; 许柳柳; 张柳

    2012-01-01

    目的 探讨重度烧伤后早期经纤维支气管镜支气管肺泡灌洗对防治肺部感染的影响.方法 将75例重度烧伤患者随机分为实验组(35例)和对照组(40例).实验组在常规治疗基础上早期采用经纤维支气管镜支气管肺泡灌洗,对照组仅予常规治疗,未予支气管肺泡灌洗.结果 实验组35例患者中13例(37.14%)出现肺部感染,9例感染控制(69.23%,9/13),感染控制时间(13.1±1.4)天;对照组40例患者中29例(72.50%)出现肺部感染,10例感染控制(34.48%,10/29),感染控制时间(16.4±3.6)天.实验组感染率明显低于对照组(P<0.01),感染控制率明显高于对照组(P<0.05),平均感染控制时间明显短于对照组(P<0.01).结论 经纤维支气管镜支气管肺泡灌洗能有效防治重度烧伤后并发肺部感染,具有推广和应用价值.%Objective To discuss the effect of bronchoalveolar lavage by bronchoscopy for early prevention and treatment of pulmonary infection after severe burns . Methods 75 patients with severe burns were randomly divided into experimental group ( n = 35 ) and control group ( n = 40 ). The experimental group received early treatment of bronchoalveolar lavage on the basis of conventional therapy . The control group only received conventional treatment without bron - choalveolar lavage. Results Of the 35 cases in the experimental group , 13 cases (37. 14% ) had pulmonary infection, 9 cases of infection were controlled (69. 23% ,9/13) , the time of infection control was (13. 1 ±1.4) days; Of the 40 cases in the control group , 29 cases (72. 50% ) had lung infection, 10 cases of infection were controlled (34. 48% , 10/29) , the time of infection control was (16.4 ± 3. 6) days. The infection rate in the experimental group was significantly lower than in the control group (P <0. 01). The infection control rate in the experimental group was significantly higher than in the control group (P <0. 05). The average time of infection control in

  5. Avaliação da utilidade diagnóstica da fibrobroncoscopia óptica na tuberculose pulmonar BAAR negativa na prática clínica de rotina Evaluation of the diagnostic utility of fiberoptic bronchoscopy for smear-negative pulmonary tuberculosis in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Alonso Soto

    2012-12-01

    Full Text Available Avaliamos o rendimento diagnóstico da fibrobroncoscopia óptica no diagnóstico de tuberculose pulmonar com baciloscopia negativa em pacientes atendidos em um hospital de referência em Lima, Peru. Dos 611 pacientes submetidos ao procedimento, 140 (23% foram diagnosticados com tuberculose com base nas amostras de LBA. Ser mais jovem e do sexo masculino foi associado a culturas positivas. Além disso, 287 pacientes realizaram baciloscopia de escarro após a broncoscopia, e os resultados aumentaram o rendimento diagnóstico em 22% em relação às amostras de LBA. Concluímos que amostras de LBA e de escarro pós-broncoscopia tiveram um bom rendimento diagnóstico nos pacientes com suspeita de tuberculose pulmonar com baciloscopia negativa.We evaluated the diagnostic yield of fiberoptic bronchoscopy for the diagnosis of smear-negative pulmonary tuberculosis in patients treated at a referral hospital in Lima, Peru. Of the 611 patients who underwent the procedure, 140 (23% were diagnosed with tuberculosis based on the analysis of BAL samples. Being young and being male were significantly associated with positive cultures. In addition, 287 patients underwent post-bronchoscopic sputum smear testing for AFB, the results of which increased the diagnostic yield by 22% over that obtained through the analysis of BAL samples alone. We conclude that the analysis of BAL samples and post-bronchoscopic sputum samples provides a high diagnostic yield in smear-negative patients suspected of having pulmonary tuberculosis.

  6. 经纤维支气管镜阿米卡星肺泡灌洗治疗多重耐药鲍曼不动杆菌呼吸机相关性肺炎的临床观察%Clinical Observation of Treatment on Multidrug-resistant Acinetobacter Baumannii Ventilator-associated Pneumonia with Amikacin by Fiberoptic Bronchoscopy Lavage

    Institute of Scientific and Technical Information of China (English)

    吕光宇; 蒋文芳; 蔡天斌; 张友华

    2015-01-01

    目的:评估经纤维支气管镜阿米卡星肺泡灌洗治疗多重耐药治疗鲍曼不动杆菌(multidrug-resistant acinetobacter baumanii,MDR-Ab)呼吸机相关肺炎(ventilator-associated pneumonia,VAP)的效果和安全性。方法将42例多重耐药鲍曼不动杆菌呼吸机相关性肺炎的机械通气患者随机分为观察组和对照组,每组21例。两组均使用头孢哌酮舒巴坦钠3.0 g,1次/6小时并每日行支气管肺泡灌洗吸痰,观察组每日支气管肺泡灌洗治疗结束后用阿米卡星0.4 g加10 mL生理盐水灌洗,对照组使用阿米卡星7.5 mg/kg静脉滴注1次/天。记录治疗前后急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)、临床肺部感染评分(clinical pulmonary infection score,CPIS)、血清肌酐(Cr)、C-反应蛋白(CRP),比较两组治疗结束时支气管肺泡灌洗液细菌学检查转阴率、28 d病死率。结果与治疗前相比,两组APACHEⅡ评分、CPIS、CRP治疗后均有下降(P0.05), while the control group has signiifcantly higher levels of Cr than before treatment (P0.05)]. Conclusion Treatment of multidrug-resistant acinetobacter baumannii ventilator-associated pneumonia by ifberoptic bronchoscopy lavage was better than intravenous administration of amikacin, and can achieve higher bacterial clearance rate, while effectively reducing nephrotoxicity.

  7. 喉罩下经支气管镜钬激光联合氩气刀和二氧化碳冷冻治疗儿童获得性重度声门下狭窄%Study on tracheal intubation related severe subglottic stenosis under laryngeal mask by using holmium laser combined with argon plasma coagulation and cryotherapy through bronchoscopy

    Institute of Scientific and Technical Information of China (English)

    许煊; 祝彬; 石苗茜; 任海丽; 封志纯

    2015-01-01

    目的:探讨2例气管插管相关性重度声门下狭窄喉罩下支气管镜诊断及介入治疗的操作方法、有效性及安全性。方法2例男性患儿,年龄分别为4和11个月,因气管插管后出现脱机困难及呼吸困难,经CT及支气管镜检查,诊断为气管插管相关的重度声门下狭窄,在对家长进行详细告知支气管镜下介入手术不可预知情况并由家长签字同意后,遂对2例患儿进行经喉罩支气管镜下钬激光联合氩气刀和二氧化碳( CO2)冷冻治疗,分析患儿的临床资料、并发症及术后转归、随访情况。结果2例手术过程顺利,例1术后紧贴声门下的肉芽组织被完全清除,2例患儿声门下环形狭窄完全解除,治疗前呼吸道狭窄处周长约2.5 mm,治疗后,周长达5.2 mm,4.0 mm支气管镜进出无障碍,术后气管导管均成功拔除,呼吸困难均明显改善。2例患儿治疗后即刻、7 d、30 d和90 d镜下检查结果示狭窄处开放良好。术中有血氧饱和度下降及心率增快或减慢,暂停操作及恢复给氧后立即恢复,术中及术后未见异常血流动力学改变,2例目前仍在随访中。结论经喉罩钬激光、氩气刀及CO2冷冻治疗可用于后天性肉芽组织增生引起的声门下狭窄,方法安全、有效,近期效果显著,远期仍在进一步随访评估。%Objective To explore the operating methods,the effectiveness and safety for 2 cases of tracheal in-tubation related severe subglottic stenosis under laryngeal mask by using bronchoscopy in the diagnosis and interven-tional treatment. Methods Two male patients ( age at 4 and 11 months) both had difficulty breathing and weaning failure after endotracheal intubation,who were diagnosed with severe subglottic stenosis through CT and bronchoscopy examination. All parents signed their consent after being fully informed of treatment risks. Two cases were treated under bronchoscopic holmium laser combined with argon plasma coagulation and

  8. [Effects of the preparation on anxiety before bronchoscopy].

    Science.gov (United States)

    Léophonte, P; Delon, S; Dalbiès, S; Fontes-Carrère, M; de Carvalho, E G; Lepage, S

    2000-03-01

    In their daily practice, the nurses note the patients' anxiety when they are in hospital for diagnosis exams. Considering this observation, we wanted to assess the potential benefits provided by the behavioural and relational techniques, such as sophrology, maintenance of the help relation, visualization-relaxation. In order to carry out this survey, we adopted the model of Betty NEUMAN, who relies on the concept of homeostasis and on the stress theory of Hans Seyle. The measurement of anxiety by the STAI (State Trait Anxiety Inventory), a scale worked out by SPIELBERGER, enabled us to prove that these relational tools, used by the nurses, made it possible for the patients to better mobilize their adjustment or coping strategies. Recommendations concerning the management of anxiety were set out as not to trigger an attitude of vigilant coping. PMID:10897742

  9. CLINICAL PROFILE OF PRIMARY LUNG CANCER AND ROLE OF BRONCHOSCOPY

    OpenAIRE

    Bharate; Mhaisekar; Jadhav,, M.B.

    2015-01-01

    INTRODUCTION: Cancer is a Latin word meaning "A CRAB". The Greek word for a crab is "KARKINES" and Sanskrit word is "KARKARA ” . (1 ) Lung cancer is one of the commonest fatal neoplastic disease s in the world . It is at the first place at central and North India and at second place at south India. It is estimated that, every year in India, about 30,000 new lung cancer cases are registered .

  10. Comparison of autofluorescence imaging bronchoscopy and white light bronchoscopy for detection of lung cancers and precancerous lesions

    OpenAIRE

    Wang Y; Wang Q.; Feng J; Wu Q

    2013-01-01

    Yan Wang,1,* Qing Wang,2,* Jing Feng,1,3 Qi Wu41Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Respiratory Department of the First People's Hospital of Kunming, Yunnan, People's Republic of China; 3Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA; 4Respiratory Department of Tianjin Haihe Hospital, Tianjin, People’s Republic of China *These two authors contributed ...

  11. Avaliação do risco de contaminação por bactérias, no paciente submetido à broncoscopia, após o reprocessamento do broncoscópio Evaluation of the risk of bacterial contamination in the patient submitted to bronchoscopy, after reprocessing the bronchoscope

    Directory of Open Access Journals (Sweden)

    NANCY SPEKLA GRANDE

    2002-09-01

    bronchoscopy at the Hospital São Paulo of Unifesp University, State of São Paulo. Methods: From 1997 to 1998, bronchoscope reprocessing included cleaning, rinsing with sterile or potable water, followed by rinsing with 2% glutaraldehyde for 20 minutes, rinsing again with sterile or potable water, and rinsing with 70% ethyl alcohol, and forced-air drying through the suction channel. Samples of 65 patients were collected for microbiologic tests by instilling sterile saline solution through the suction channel of the bronchoscope. Results: After reprocessing, the following were found in the samples: Staphylococcus epidermidis, Enterobacter sp, Acinetobacter baumanni, Streptococcus viridans, Staphylococcus aureus, Streptococcus beta hemoliticus A, Staphylococcus coagulase negative, and mycobacterial growth was found in the culture of five samples. Conclusions: Bronchoscope disinfection with 2% glutaraldehyde was not sufficient to assured disinfection of the scope and the presence of Staphylococcus epidermidis shows that there was bronchoscope contamination due to handling after disinfection.

  12. The Clinical Significances of Soluble Receptor for Advanced Glycation Endproducts in Bronchoscopy Alveolus Lavage Fluid among Patients with COPD%COPD纤维支气管镜肺泡灌洗液中可溶性晚期糖基化终末产物受体水平的临床意义

    Institute of Scientific and Technical Information of China (English)

    杨兴官; 雷超; 胡占升

    2014-01-01

    Objective To discuss the clinical significances of soluble receptor for advanced glycation end-products ( sRAGE)in bronchoscopy alveolus lavage fluid( BALF)in patients with COPD. Methods A total of 40 patients with COPD who were admitted to the department of intensive care unit of the First Hospital Affiliated to Liaoning Medical University from Oc-tober 2012 to May 2013,were selected as the COPD group,meanwhile 40 patients with non-COPD were selected as the non-COPD group,and these COPD patients were divided into mild group(12 cases),moderate group(10 cases),severe group (10 cases),very severe group(8 cases). The sRAGE concentrations in BALF were detected by enzyme-linked immunosor-bent assay(ELISA). Results The concentration of sRAGE in BALF of patients in the COPD group(191 ±71)ng/L was sig-nificantly higher than that in the non-COPD group(55 ±56)ng/L(t=9. 44,P<0. 001). The concentration of sRAGE in BALF of COPD patients in the mild group,moderate group,severe group and very severe group was(111 ± 44) ng/L,(184 ±45)ng/L,(226 ±34)ng/L,and(273 ±30)ng/L,respectively,there were significant differences in concentration of sRAGE among these groups(F=30. 48,P<0. 001),and the concentration of sRAGE in very severe COPD group was signifi-cantly higher than that in severe COPD group,the concentration of sRAGE in severe COPD group was significantly higher than that in moderate group,the concentration of sRAGE in moderate group was significantly higher than that in mild group( P <0. 05 ) . Linear correlation analysis results showed that the concentration of sRAGE in BALF of COPD patients were negatively cor-related with FEV1%(r= -0. 738,P <0. 05). Conclusion The concentration of sRAGE in BALF of COPD patients was higher than that of non-COPD patients;The concentration of sRAGE in BALF is related to severity of COPD,it could be used as an index of the prognosis evaluation of COPD.%目的:探讨纤维支气管镜肺泡灌洗液中可溶性晚期

  13. 不同靶浓度舒芬太尼TCI辅助表面麻醉用于OSAS患者纤维支气管镜引导经鼻清醒气管插管术的效果%Efficacy of different target concentrations of sufentanil TCI used to supplement topical anesthesia for fiber-optic bronchoscopy-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    徐雪; 董秋月; 戚翔; 李蔚; 梁治; 高璐超

    2013-01-01

    Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2% lidocaine mixed with 1% ephedrine for topical anesthesia in both groups.In addition 1% tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product > 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR > 30% of baseline values and rate-pressure product > 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P < 0.05).Compared with group S1,the airway obstruction score were

  14. Determination of upper incisor- vocal cords and upper incisor- carinal distance: fiberoptic bronchoscopy

    Directory of Open Access Journals (Sweden)

    Noyan Ashraf MA

    2008-09-01

    Full Text Available "nBackground: The insertion of endotracheal tube is essential for most surgical operations, mechanically ventilated patient in ICU wards, During cardiopulmonary resuscitation and so for transport of patients. The aim of this study was determination of airway related distances in Iranian patients. "nMethods: In a cross- sectional study during year 2007 in Imam Khomeini university Hospital a total of 75 ASA class I and II patients who were admitted to pulmonary ward evaluated for determination of incisor-vocal cord and incisor- carina distances. The nasal nare- vocal cord distance was determined too. "nResults: A total of 71 patients, 45(63% male and 26(36.6% female were evaluated. The Incisor-vocal cord distance in males and females was 16.83±0.75mm against 15.04±1.12mm (P=0.03. The difference of nare-vocal cords and Incisor- vocal cord  distances was 2-3Cm "nConclusions: There was direct association between height and tracheal length in the study patients. The tracheal length (suitable insertion depth in our patients was different from the recommendations (23 & 21 Cm for men and women for non- Iranian, 25.9 versus 22.6 for Iranian men and women respectively. The difference of nasal nare-vocal cord and upper incisor-vocal cord distances in our patients was 2-3 cm, the lower range of accepted or reported one. We offer to do another experience with larger study group to apply the data to Iranian population. "nKeywords: Trachea, insertion depth, vocal cord, carina, oral, nasal.

  15. Subglottic granuloma after aortic replacement: resection via flexible bronchoscopy after an emergency tracheostomy

    OpenAIRE

    Nose, Naohiro; So, Tetsuya; Sekimura, Atsushi; Miyata, Takeaki; Yoshimatsu, Takashi

    2014-01-01

    A subglottic granuloma is one of the late-phase complications that can occur after intubation. It can cause a life-threatening airway obstruction; therefore, a rapid diagnosis and appropriate treatment plan is necessary. A 62-year-old male had undergone an emergency total arch replacement for acute aortic dissection. Postoperative ventilation support had been performed until the 15th postoperative day (POD). He was discharged from the hospital on POD 30. On POD 50, he was brought to our hospi...

  16. In vivo electrical bioimpedance characterization of human lung tissue during the bronchoscopy procedure. A feasibility study

    OpenAIRE

    Sánchez Terrones, Benjamín; Vandersteen, Gerd; Martín Robles, Irene; Castillo Villegas, Diego; Torrego Fernández, Alfons; Riu Costa, Pere Joan; Schoukens, Johan; Bragós Bardia, Ramon

    2013-01-01

    Lung biopsies form the basis for the diagnosis of lung cancer. However, in a significant number of cases bronchoscopic lung biopsies fail to provide useful information, especially in diffuse lung disease, so more aggressive procedures are required. Success could be improved using a guided electronic biopsy based on multisine electrical impedance spectroscopy (EIS), a technique which is evaluated in this paper. The theoretical basis of the measurement method and the instrument developed are de...

  17. Percutaneous dilatational tracheostomy without fiber optic bronchoscopy-Evaluation of 80 intensive care units cases

    NARCIS (Netherlands)

    J.A. Calvache (Jose Andrés); R.A. Molina García (Rodrigo); A.L. Trochez (Adolfo); J. Benitez (Javier); L.A. Flga (Lucía Arroyo)

    2013-01-01

    textabstractBackground: The development of percutaneous dilatational tracheostomy techniques (PDT) has facilitated the procedure in Intensive Care Units (ICU). Objective: To describe the early intra and post-operative complications in ICU patients requiring percutaneous dilatational tracheostomy usi

  18. Novel use of laryngeal mask airway classic excel™ for bronchoscopy and tracheal intubation

    Directory of Open Access Journals (Sweden)

    Anusha Kannan

    2013-01-01

    Full Text Available The usage frequency and scope of supraglottic airway devices in anesthesia has expanded since the original laryngeal mask airway (LMA prototype was invented by Dr Archie Brain in the early 1980s. Today, anesthesiologists are spoilt-for-choice with more than thirty options. The LMA Classic Excel™ was introduced to anesthesia practice in 2009; designed with an epiglottic elevating bar and a removable airway connector to facilitate tracheal intubation using the LMA as a conduit. We present a case report of a women diagnosed with papillary carcinoma of thyroid, who underwent bronchoscopic assessment of the trachea and subsequent intubation for an en-bloc dissection and removal of thyroid gland through the LMA Classic Excel™.

  19. A SAFE TECHNIQUE OF ANAESTHESIA FOR BRONCHOSCOPY & REMOVAL OF FOREIGN BODY IN TRACHEOBRONCHIAL TREE IN CHILDREN: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Murthy

    2014-09-01

    Full Text Available A case report of successful removal of F.B from tracheo-bronchial tree in a child under general anaesthesia & skeletal muscle relaxation and ventilation given by Jet-Ventilator through no-6 (Fig. Ureteric bougie

  20. Superiority of Spacer/Mask Topical Anesthetic Compared with Conventional Spray and Gargle Method for Fibreoptic Bronchoscopy

    Directory of Open Access Journals (Sweden)

    RC Balkissoon

    1996-01-01

    Full Text Available OBJECTIVE: To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.

  1. Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: a case report

    OpenAIRE

    Rodrigo, Damith; Rathnapala, Amila; Senaratne, Wijitha

    2015-01-01

    Introduction Therapeutic total lung lavage under general anesthesia is the current mainstay of treatment for pulmonary alveolar proteinosis, which is a rare lung disease characterized by alveolar accumulation of surfactant. Therapeutic limited bronchoalveolar lavage is considered an alternative treatment to conventional total lung lavage. Case presentation A 61-year-old, previously healthy, Sri Lankan Moor woman presented to our facility with progressively worsening difficulty in breathing an...

  2. Color Fluorescence Ratio for Detection of Bronchial Dysplasia and Carcinoma In situ

    NARCIS (Netherlands)

    Lee, P.; Berg, van den R.M.; Lam, S.; Gazdar, A.; Grunberg, K.; McWilliams, A.; LeRiche, J.; Postmus, P.E.; Sutedja, G.

    2009-01-01

    Background: Autofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead to excessive biopsy and increased procedural time. Onco-LIFE, a device that combines fluorescence and reflectance imaging, allows nume

  3. Uso de mascarilla laríngea para fibrobroncoscopía en lactantes durante ventilación mecánica USE OF LARYNGEAL MASK WHILE FLEXIBLE BRONCHOSCOPY IS PERFORMED IN INFANTS UNDER MECHANICAL VENTILATION

    OpenAIRE

    CECILIA ALVAREZ G.; JOSÉ IGNACIO RODRIGUEZ C.; RICARDO RONCO M.; ANDRÉS CASTILLA M.; EUGENIA CAMPOS N.; IGNACIO SÁNCHEZ D.

    2002-01-01

    La mascarilla laríngea (ML) se utiliza para el manejo de la vía aérea en adultos y niños bajo anestesia general con el objetivo de evitar la intubación traqueal y su uso se ha extendido para fibrobroncoscopía bajo anestesia general. Durante ventilación mecánica (VM) la fibrobroncoscopía (FB) se limita a tubos endotraqueales (TET) > 4,5 mm de diámetro ya que el fibrobroncoscopio con canal de succión más pequeño es de 3,5 mm. Nuestro objetivo fue evaluar la utilidad de la ML para FB en niños so...

  4. 线粒体在支气管平滑肌细胞增殖中的调控作用%Regulation Effects of Mitochondria to Bronchoscopy Smooth Muscle Cell Proliferation

    Institute of Scientific and Technical Information of China (English)

    张允健

    2012-01-01

    慢性阻塞性肺疾病(COPD)是一种常见的慢性疾病,支气管平滑肌细胞(BSMC)增殖是COPD重要的病理特征之一.氧化应激可刺激多种细胞增殖,亦可能刺激支气管平滑肌细胞增殖,进而导致COPD的发生和加重.在氧化应激状态下,线粒体通过调节线粒体融合蛋白2表达调节BSMC的增殖、分化、凋亡.现就线粒体在BSMC增殖中发挥的调控作用进行综述.%Chronic obstructive pulmonary disease(COPD )is a kind of common chronic disease, bronchus smooth muscle cells( BSMC )proliferation is one oi the important pathological characteristics. Oxidative stress can stimulate many kinds oi cells proliferation, oxidative stress may as well stimulate bronchus smooth muscle cells proliferation, and then induce COPD generation and aggravation. In the state of oxidative stress, mitochondria regulates the piolifeiation, differentiation, apoptosis of BSMCs through regulate mitofusin2( Mfn2 ) expression. Here is to make a review on the mitochondria role in the regulation of BSMC proliferation.

  5. Fibrobroncoscopía en recién nacidos prematuros al momento de la extubación: Comunicación preliminar POST EXTUBATION FIDEROPTIC BRONCHOSCOPY IN PRE-TERM NEONATES: PRELIMINARY REPORT

    OpenAIRE

    FRANCISCO PRADO A.; VERÓNICA PEÑA N.; PATRICIO VARELA B

    2003-01-01

    En recién nacidos (RN) la fibrobroncoscopía rutinaria postextubación podría identificar precozmente lesiones adquiridas en la vía aérea, subdiagnosticadas por la presencia de enfermedad pulmonar severa. Se planificó un estudio abierto, prospectivo en UTI neonatológica durante 1 año desde agosto/2000. Objetivo: Evaluar la seguridad y eficiencia de FBC dentro de las 72 h de extubación. Criterios de exclusión: < 750 g, < 7 días de vida, inestabilidad hemodinámica, hemorragia intracraneana, FiO2 ...

  6. Virtual reality simulation of basic pulmonary procedures

    DEFF Research Database (Denmark)

    Konge, Lars; Arendrup, Henrik; von Buchwald, Christian;

    2011-01-01

    Background: Virtual reality (VR) bronchoscopy simulators have been available for more than a decade, and have been recognized as an important aid in bronchoscopy training. The existing literature has only examined the role of VR simulators in diagnostic bronchoscopy. The aim of this study was to...

  7. Impact of a bronchial genomic classifier on clinical decision making in patients undergoing diagnostic evaluation for lung cancer

    OpenAIRE

    Ferguson, J. Scott; Van Wert, Ryan; Choi, Yoonha; Rosenbluth, Michael J.; Smith, Kate Porta; Huang, Jing; Spira, Avrum

    2016-01-01

    Background Bronchoscopy is frequently used for the evaluation of suspicious pulmonary lesions found on computed tomography, but its sensitivity for detecting lung cancer is limited. Recently, a bronchial genomic classifier was validated to improve the sensitivity of bronchoscopy for lung cancer detection, demonstrating a high sensitivity and negative predictive value among patients at intermediate risk (10–60 %) for lung cancer with an inconclusive bronchoscopy. Our objective for this study w...

  8. Bronchoscopic procedures and lung biopsies in pediatric lung transplant recipients.

    Science.gov (United States)

    Wong, Jackson Y; Westall, Glen P; Snell, Gregory I

    2015-12-01

    Bronchoscopy remains a pivotal diagnostic and therapeutic intervention in pediatric patients undergoing lung transplantation (LTx). Whether performed as part of a surveillance protocol or if clinically indicated, fibre-optic bronchoscopy allows direct visualization of the transplanted allograft, and in particular, an assessment of the patency of the bronchial anastomosis (or tracheal anastomosis following heart-lung transplantation). Additionally, bronchoscopy facilitates differentiation of infective processes from rejection episodes through collection and subsequent assessment of bronchoalveolar lavage (BAL) and transbronchial biopsy (TBBx) samples. Indeed, the diagnostic criteria for the grading of acute cellular rejection is dependent upon the histopathological assessment of biopsy samples collected at the time of bronchoscopy. Typically, performed in an out-patient setting, bronchoscopy is generally a safe procedure, although complications related to hemorrhage and pneumothorax are occasionally seen. Airway complications, including stenosis, malacia, and dehiscence are diagnosed at bronchoscopy, and subsequent management including balloon dilatation, laser therapy and stent insertion can also be performed bronchoscopically. Finally, bronchoscopy has been and continues to be an important research tool allowing a better understanding of the immuno-biology of the lung allograft through the collection and analysis of collected BAL and TBBx samples. Whilst new investigational tools continue to evolve, the simple visualization and collection of samples within the lung allograft by bronchoscopy remains the gold standard in the evaluation of the lung allograft. This review describes the use and experience of bronchoscopy following lung transplantation in the pediatric setting. PMID:25940429

  9. Foreign body retrieval in children with respiratory symptoms and no history of aspiration.

    Science.gov (United States)

    Hamdan, A L; Mroueh, S M; Bitar, F F; Farhat, F T

    2000-10-01

    To asses the role of bronchoscopy and its yield in children with respiratory symptoms and no typical history of radiological evidence of foreign body aspiration (FBA), we reviewed the records of all patients who underwent bronchoscopy at our institution between 1985 and 1995 and had no history of choking, witnessed FBA or clear radiological evidence of FBA (N = 54, age range 4 months to 16 years). These were subdivided into two subgroups, those with positive bronchoscopy, and those with negative bronchoscopy. Respiratory symptoms and their duration, signs and radiological findings did not differ in both subgroups. PMID:11330222

  10. MULTIPLE PULMONARY CHONDROMATA - A RARE CAUSE OF NEONATAL RESPIRATORY-DISTRESS

    NARCIS (Netherlands)

    HOEKSTRA, MO; BERTUS, PM; NIKKELS, PGJ; KIMPEN, JLL

    1994-01-01

    A neonate with respiratory distress due to a right pneumothorax is presented. After drainage of the pneumothorax, atelectasis of the entire right lung developed. Because the atelectasis persisted, bronchoscopy was performed. On bronchoscopy the carina and right main-stem bronchus could not be visual

  11. Spirometer-controlled Cine-Magnetic Resonance Imaging for Diagnosis of Tracheobronchomalacia in Pediatric Patients

    NARCIS (Netherlands)

    Ciet, P.; Wielopolski, P.; Manniesing, R.; Lever, S.; Bruijne, M. de; Morana, G.; Muzzio, P.C.; Lequin, M.H.; Tiddens, H.A.W.M.

    2014-01-01

    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children is re

  12. Management of dogs and cats with endotracheal tube tracheal foreign bodies.

    Science.gov (United States)

    Nutt, Laura K; Webb, Jinelle A; Prosser, Kirsten J; Defarges, Alice

    2014-06-01

    Two cats and 3 dogs were treated for an endotracheal tube tracheal foreign body (ETFB) during recovery from general anesthesia. Bronchoscopy was used to remove the ETFB. Animals were clinically normal at discharge. While rare, ETFB can occur upon recovery from anesthesia. Bronchoscopy is an effective way to remove ETFB. PMID:24891640

  13. 肺肿瘤99mTc-MDP显像、CT、纤支镜、肿瘤标志物对比研究%Comparative Study of 99mTc MDP Imaging,X CT,Fibro optic Bronchoscopy and Tumor Marker in Diagnosis of Lung Neoplasms

    Institute of Scientific and Technical Information of China (English)

    谢昌辉; 马志海; 李秀江; 张玉萍; 高凤彤

    2002-01-01

    目的探讨99mTc羟基亚甲二磷酸(MDP)SPECT显像(MDPSI)、CT、纤支镜(FB)和肿瘤标志物(TM)检查诊断肺癌的临床价值.方法对63例经病理证实的肺肿瘤患者和10例正常对照进行早期(5 min)MDPSI,CT、FB和TM检查,以病理为标准比较分析诊断效能.结果肺癌对99mTc MDP的摄取明显高于良性病灶和正常对照,以摄取比值>1.8为判断标准,MDPSI诊断肺癌的灵敏度、特异性和准确率分别为90.2%、90.9%和90.4%;CT、FB和TM分别为92.2%、63.6%和83.6%、63.9%、100%和69.0%、66.7%、68.2%和67.1%;MDPSI和CT联合诊断肺癌的灵敏度、特异性和准确率分别为96.1%、95.5%和95.9%.结论 MDPSI对肺癌的诊断有较高的临床价值,与CT结合分析可进一步提高肺癌诊断的准确性.

  14. Fluoroscence bronhoscopy

    Directory of Open Access Journals (Sweden)

    Tomić Ilija

    2003-01-01

    Full Text Available Background. Fluorescence bronchoscopy is one of the methods of the early detection of lung cancer that involves the large airways. The method is based on the detection of the altered autofluorescence of malignantly transformed tissue, and confirmed by biopsy and histopathologic examination. Method. Fluorescence bronchoscopy was performed in 18 patients, mean age of 51.2 years (male n=12, female n=6 due to the suspected lung cancer. Fluorescence bronchoscopy was performed using the Xillix LIFE-Lung System Vancouver, Canada. After conventional white-light bronchoscopy, the tracheobronchial tree was illuminated by blue light (442 nm using helium-cadmium laser, and the results of autofluorescence were classified into three classes. Normal mucosa was of green fluorescence (Class I abnormal mucosa was red or dark brown fluorescence (Class II and II, which was the indication for performing biopsy. Results. Normal endoscopy findings were established in 15 patients by conventional bronchoscopy. In the same group, by fluorescence bronchoscopy, Class I of fluorescence (normal finding was found in 9 patients, while Class II changes occured in 6 patients. Histopathologic analysis of bronchial mucosa with Class II changes was performed detecting planocellular carcinoma in situ in one patient. Tumor-like changes were detected in 3 patients by conventional bronchoscopy and were determined as Class III changes by fluorescence bronchoscopy. By the biopsy of these chages carcinoma was documented in 2 patients while in one patient metaplasia of epithelium and granulation tissue around aspirated foreign body was detected. Conclusion. Fluorescence bronchoscopy is one of the methods for detecting metaplasia, carcinoma in situ and cancerous changes of bronchial epithelium in the large airways. However, the high rate of falsely positive findings represents a limitation of this method.

  15. Fatal Pulmonary Hemorrhage Through Fiberoptic Broncoscopy in a Well Controlled Diabetic Female With Mucormycosis

    Directory of Open Access Journals (Sweden)

    P. Di Carlo

    2008-01-01

    Full Text Available A rare case of invasive pulmonary mucormycosis complicated by fatal massive haemoptysis through bronchoscopy in a patient with a well controlled diabetes is reported. Histological features of infection are reported and the characteristic aspects of the staining are discussed. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi and fatal massive bleeding occurring because of biopsy sampling. Caution is warranted in the use of bronchoscopy sampling in patients with radiological features of cavitated lesions of fungal origins. Better preventive and early therapeutic antifungal treatments are needed to avoid this serious complication.

  16. Nocardia infection

    Science.gov (United States)

    ... testing may involve taking a tissue sample by: Brain biopsy Bronchoscopy Lung biopsy Skin biopsy Sputum culture ... than one antibiotic. Surgery may be done to drain pus that has collected in the skin or tissues ( abscess ).

  17. Pulmonary carcinoma. Diagnostic and bronchoscopic treatment

    International Nuclear Information System (INIS)

    A historical recount of the bronchoscopy is made, from its beginnings 100 years ago, in a same way some techniques of diagnostic and treatment are mentioned, as the laser, fluorescence, cryotherapy, etc

  18. Virtual reality simulation of basic pulmonary procedures

    DEFF Research Database (Denmark)

    Konge, Lars; Arendrup, Henrik; von Buchwald, Christian;

    2011-01-01

    find out whether the simulations of both diagnostic bronchoscopies and more advanced procedures were realistic, and whether clinical experience in bronchoscopy was associated with better and faster performance of basic pulmonary procedures in the simulator. Methods: Thirty physicians performed 8...... to be realistic and all the physicians agreed that VR bronchoscopy simulation is a good way to learn bronchoscopy. The more experienced physicians performed faster than the less experienced physicians. The simulator feedback did not allow for an assessment of the quality of the performed biopsies....... Conclusions: Simulation of performing the procedures was significantly less realistic than the simulation of the anatomy and the scope. It was impossible to use the simulator metrics to assess the quality of the biopsies. Despite these deficiencies, clinicians recommend the use of VR simulators in the...

  19. Danish Guidelines 2015 for percutaneous Dilatational Tracheostomy in the Intensive Care Unit

    DEFF Research Database (Denmark)

    Madsen, Kristian Rørbæk; Guldager, Henrik; Rewers, Mikael;

    2015-01-01

    Percutaneous dilatational tracheostomy is a common procedure in intensive care. This updated Danish national guideline describes indications, contraindications and complications, and gives recommendations for timing, anaesthesia, and technique, use of fibre bronchoscopy and ultrasound guidance, as...

  20. How Is Sarcoidosis Diagnosed?

    Science.gov (United States)

    ... doctor may do a bronchoscopy (bron-KOS-ko-pee) to get a small sample of lung tissue. During this procedure, a thin, flexible tube is passed through your nose (or sometimes your mouth), down your throat, ...

  1. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... Beth Israel some pretty elaborate and technically advanced diagnostic procedures for us using advanced bronchoscopy, and I’ ... I, Walter and Sam, we all have those type of things. This is the hot scissors that ...

  2. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... Beth Israel some pretty elaborate and technically advanced diagnostic procedures for us using advanced bronchoscopy, and I’ ... Once we have the pulmonary function tests and medical clearance, and if after the preoperative evaluation shows ...

  3. Comparison of airway immunopathology of eosinophilic bronchitis and asthma

    OpenAIRE

    Brightling, C.; Symon, F; Birring, S; Bradding, P; Wardlaw, A; PAVORD, I

    2003-01-01

    Methods: Exhaled nitric oxide was measured and induced sputum, bronchoscopy, bronchial wash (BW), bronchoalveolar lavage (BAL), and bronchial biopsy were performed in 16 subjects with eosinophilic bronchitis, 15 with asthma, and 14 normal controls.

  4. In-vivo kinetics of inhaled 5-Aminolevulinic acid-Induced Protoporphyrin IX fluorescence in bronchial tissue

    Directory of Open Access Journals (Sweden)

    Gamarra Fernando

    2007-04-01

    Full Text Available Abstract Background In the diagnosis of early-stage lung cancer photosensitizer-enhanced fluorescence bronchoscopy with inhaled 5-aminolevolinic acid (5-ALA increases sensitivity when compared to white-light bronchoscopy. This investigation was to evaluate the in vivo tissue pharmacokinetics of inhaled 5-ALA within the bronchial mucosa in order to define the time optimum for its application prior to bronchoscopy. Methods Patients with known or suspected bronchial carcinoma were randomized to receive 200 mg 5-ALA via inhalation 1, 2, 3, 4 or 6 hours before flexible fluorescence bronchoscopy was performed. Macroscopically suspicious areas as well as areas with visually detected porphyrin fluorescence and normal control sites were measured spectroscopically. Biopsies for histopathology were obtained from suspicious areas as well as from adjacent normal areas. Results Fluorescence bronchoscopy performed in 19 patients reveals a sensitivity for malignant and premalignant changes (moderate dysplasia which is almost twice as high as that of white-light bronchoscopy, whereas specificity is reduced. This is due to false-positive inflammatory lesions which also frequently show increased porphyrin fluorescence. Malignant and premalignant alterations produced fluorescence values that are up to 5 times higher than those of normal tissue. According to the pharmacokinetics of porphyrin fluorescence measured by spectroscopy, the optimum time range for 5-ALA application is 80–270 min prior to fluorescence bronchoscopy, with an optimum at 160 min. Conclusion According to our results we propose inhalation of 5-ALA 160 min prior to fluorescence bronchoscopy, suggesting that this time difference provides the best tumor/normal tissue fluorescence ratio.

  5. SHOX2 DNA Methylation is a Biomarker for the diagnosis of lung cancer based on bronchial aspirates

    OpenAIRE

    Liloglou Triantafillos; Wille Ulrike; Weickmann Sabine; Tetzner Reimo; Distler Jürgen; Lewin Jörn; Seemann Stefanie; Flemming Nadja; Seegebarth Anke; Schlegel Thomas; Kneip Christoph; Dietrich Dimo; Liebenberg Volker; Schmidt Bernd; Raji Olaide

    2010-01-01

    Abstract Background This study aimed to show that SHOX2 DNA methylation is a tumor marker in patients with suspected lung cancer by using bronchial fluid aspirated during bronchoscopy. Such a biomarker would be clinically valuable, especially when, following the first bronchoscopy, a final diagnosis cannot be established by histology or cytology. A test with a low false positive rate can reduce the need for further invasive and costly procedures and ensure early treatment. Methods Marker disc...

  6. Cough-induced Tracheobronchial Mucosal Bleeding.

    Science.gov (United States)

    Hira, Harmanjit Singh

    2011-01-01

    A 56-year-old man presented with moderate hemoptysis. It was preceded by a severe bout of cough. Flexible bronchoscopy showed diffuse tracheobronchial mucosal petechiae and bleeding. The patient was not suffering with any coagulopathies. He did not receive antiplatelet drugs. Hemoptysis resolved with cough suppressant. Subsequent bronchoscopy revealed the complete resolution of petechiae. The mechanism of bleeding after the bout of coughing is discussed. PMID:23169019

  7. Untersuchungen zur Mikrosatellitenalteration an zellfreien Desoxyribonukleinsäuren aus der Bronchiallavage bei Patienten mit Lungenkarzinom und Patienten mit benignen Lungenerkrankungen

    OpenAIRE

    Carstensen, Tim

    2011-01-01

    The early confirmation of the diagnosis of a lung carcinoma is the most significant prognostic factor. New findings concerning diagnostic methods are therefore of paramount importance. The key element of lung carcinoma diagnostics is the bronchoscopy. The recovery of bronchial lavage fluid (BLF) during bronchoscopy is an additional procedure, which is of relevance in tumours that are bronchoscopically not visible (extrabronchially or peripherally located tumours). So far B...

  8. Pulmonary Parenchymal Lymphoma Diagnosed by Bronchoscopic Cryoprobe Lung Biopsy.

    Science.gov (United States)

    Schiavo, Dante; Batzlaff, Cassandra; Maldonado, Fabien

    2016-04-01

    A 51-year-old man presented with progressively worsening lung infiltrates and respiratory failure. Extensive investigations including bronchoscopy with bronchoalveolar lavage and conventional transbronchial forceps biopsies failed to establish the diagnosis. After transfer to our institution, he underwent repeat bronchoscopy with transbronchial cryobiopsy, which provided large, high-quality biopsy specimens establishing the diagnosis of parenchymal diffuse large B-cell lymphoma. PMID:26496093

  9. An Analysis of Inhalation Injury Diagnostic Methods and Patient Outcomes.

    Science.gov (United States)

    Ching, Jessica A; Ching, Yiu-Hei; Shivers, Steven C; Karlnoski, Rachel A; Payne, Wyatt G; Smith, David J

    2016-01-01

    The purpose of this study was to compare patient outcomes according to the method of diagnosing burn inhalation injury. After approval from the American Burn Association, the National Burn Repository Dataset Version 8.0 was queried for patients with a diagnosis of burn inhalation injury. Subgroups were analyzed by diagnostic method as defined by the National Burn Repository. All diagnostic methods listed for each patient were included, comparing mortality, hospital days, intensive care unit (ICU) days, and ventilator days (VDs). Z-tests, t-tests, and linear regression were used with a statistical significance of P value of less than .05. The database query yielded 9775 patients diagnosed with inhalation injury. The greatest increase in mortality was associated with diagnosis by bronchoscopy or carbon monoxide poisoning. A relative increase in hospital days was noted with diagnosis by bronchoscopy (9 days) or history (2 days). A relative increase in ICU days was associated with diagnosis according to bronchoscopy (8 days), clinical findings (2 days), or history (2 days). A relative increase in VDs was associated with diagnosis by bronchoscopy (6 days) or carbon monoxide poisoning (3 days). The combination of diagnosis by bronchoscopy and clinical findings increased the relative difference across all comparison measures. The combination of diagnosis by bronchoscopy and carbon monoxide poisoning exhibited decreased relative differences when compared with bronchoscopy alone. Diagnosis by laryngoscopy showed no mortality or association with poor outcomes. Bronchoscopic evidence of inhalation injury proved most useful, predicting increased mortality, hospital, ICU, and VDs. A combined diagnosis determined by clinical findings and bronchoscopy should be considered for clinical practice. PMID:26594867

  10. Cryoextraction: A novel approach to remove aspirated chewing gum

    Directory of Open Access Journals (Sweden)

    Edmundo Rubio

    2013-01-01

    Full Text Available The extraction of aspirated foreign bodies can prove challenging at times, requiring even rigid bronchoscopy. Cryotherapy probes have been reported to help with extraction of foreign bodies. We present a case where successful "cryoextraction" was performed on an aspirated chewing gum. The case highlights the fact that this technique is useful to extract all materials that have water content. This technique can be performed through flexible bronchoscopy and can save patients from more aggressive approaches.

  11. The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury

    OpenAIRE

    Spyropoulou, G.A.; Iconomou, T.; Tsagarakis, M.; Tsoutsos, D.

    2005-01-01

    The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest ra...

  12. Cryoextraction: A novel approach to remove aspirated chewing gum

    OpenAIRE

    Edmundo Rubio; Prag Gupta; Susanti Ie; Michael Boyd

    2013-01-01

    The extraction of aspirated foreign bodies can prove challenging at times, requiring even rigid bronchoscopy. Cryotherapy probes have been reported to help with extraction of foreign bodies. We present a case where successful "cryoextraction" was performed on an aspirated chewing gum. The case highlights the fact that this technique is useful to extract all materials that have water content. This technique can be performed through flexible bronchoscopy and can save patients from more aggressi...

  13. Multimodality bonchoscopic imaging of tracheopathica osteochondroplastica

    Science.gov (United States)

    Colt, Henri; Murgu, Septimiu D.; Ahn, Yeh-Chan; Brenner, Matt

    2009-05-01

    Results of a commercial optical coherence tomography system used as part of a multimodality diagnostic bronchoscopy platform are presented for a 61-year-old patient with central airway obstruction from tracheopathica osteochondroplastica. Comparison to results of white-light bronchoscopy, histology, and endobronchial ultrasound examination are accompanied by a discussion of resolution, penetration depth, contrast, and field of view of these imaging modalities. White-light bronchoscopy revealed irregularly shaped, firm submucosal nodules along cartilaginous structures of the anterior and lateral walls of the trachea, sparing the muscular posterior membrane. Endobronchial ultrasound showed a hyperechoic density of 0.4 cm thickness. optical coherence tomography (OCT) was performed using a commercially available, compact time-domain OCT system (Niris System, Imalux Corp., Cleveland, Ohio) with a magnetically actuating probe (two-dimensional, front imaging, and inside actuation). Images showed epithelium, upper submucosa, and osseous submucosal nodule layers corresponding with histopathology. To our knowledge, this is the first time these commercially available systems are used as part of a multimodality bronchoscopy platform to study diagnostic imaging of a benign disease causing central airway obstruction. Further studies are needed to optimize these systems for pulmonary applications and to determine how new-generation imaging modalities will be integrated into a multimodality bronchoscopy platform.

  14. Detection of early bronchial cancer by autofluorescence: results in patients with H&N cancer

    Science.gov (United States)

    Gabrecht, Tanja; Radu, Alexandre; Zellweger, Matthieu; Lovisa, Blaise; Goujon, Didier; Grosjean, Pierre; van den Bergh, Hubert; Monnier, Philippe; Wagnières, Georges

    2007-07-01

    Head and neck (H&N) cancer patients have a high incidence of second primary tumours in the tracheobronchial tree. Diagnostic autofluorescence bronchoscopy (DAFE) has shown promising results in the detection of early neoplastic and pre-neoplastic changes in the bronchi. We have investigated the medical impact of DAFE in a population of H&N cancer patients. The bronchoscopies were performed using a modified commercially available DAFE system. Endoscopic imaging of the tissue autofluorescence (AF) was combined with an online image analysis procedure allowing to discriminate between true and false positive results. White light (WL) bronchoscopy was performed as a control. Twenty-one patients with high lung cancer risk factors underwent WL and AF bronchoscopy with this improved system. Forty-one biopsies were taken on macroscopicall suspicious (WL or AF positive) sites. Seven patients were found to have second primary tumours in the bronchi. The sensitivity for the detection of these early lesions with the DAFE was 1.6 times larger than the sensitivity of WL bronchoscopy only. The positive predictive value (PPV) for AF is 79% (33% for WL alone). The PPV of both methods together is 100%. DAFE proved to be efficient for the detection of second primary lesions in H&N cancer patients and can be used as a simple addition to pre-operative work-up or follow-up in this patient population.

  15. Foreign body in children?s airways

    Directory of Open Access Journals (Sweden)

    Cassol Vitor

    2003-01-01

    Full Text Available OBJECTIVE: To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. METHOD: Time series of children who underwent bronchoscopies for foreign bodies aspirated into the airway between March 1993 and July 2002. Each patient was analyzed for age, sex, initial clinical diagnosis, nature and location of the foreign body, duration of symptoms between aspiration and bronchoscopy, radiological findings, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. RESULTS: Thirty-four children, 20 (59% boys, ages ranging from nine months to nine years (median = 23 months. In 32 (94% children the foreign body was removed by rigid bronchoscope, and two resulted in thoracotomy. Foreign bodies were more frequent in children under three years of age (66%. A clinical history of foreign body inhalation was obtained in 27 (80% cases. Most of the foreign bodies removed were organic (65% and more frequently found in the right bronchial tree (59%. Foreign bodies were removed within 24 hours in 18 (53% cases. The most frequent radiographic findings were: unilateral air trapping, atelectasis and radiopac foreign body. Major bronchoscopy complications occurred in seven children (22%, and there were no deaths. CONCLUSIONS: More attention is necessary to the respiratory symptoms of aspirations, mainly in boys at early ages, with clinical history and compatible radiological findings. Most foreign bodies removed were of organic nature. In this case series, therapeutic rigid bronchoscopy was effective with few complications.

  16. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

    Directory of Open Access Journals (Sweden)

    Yu Zhang

    2013-06-01

    Full Text Available Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods: The clinical features of 2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results: The ratio of male/female was 4.8:1 and the peak onset age was 60 - 69 years old. The major pathological type was squamous cell carcinoma (44.5%, then adenocarcinoma (25.9% and small cell lung cancer (18.3%. The incidence of squamous cell carcinoma was the highest in males (50.6%, while that of adenocarcinoma in females (56.2%. The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can significantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  17. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

    Institute of Scientific and Technical Information of China (English)

    Zhang Yu; Yu Like; Xie Haiyan; Hu Weihua; Hao Keke; Xia Ning

    2013-01-01

    Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods:The clinical features of2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results:The ratio of male/female was 4.8:1 and the peak onset age was 60~69 years old. The major pathological type was squamous cell carcinoma (44.5%), then adenocarcinoma (25.9%) and small cell lung cancer (18.3%). The incidence of squamous cell carcinoma was the highest in males (50.6%), while that of adenocarcinoma in females (56.2%). The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can signiifcantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  18. A retrospective study of anaesthetic management of foreign bodies in airway- a two & half years experience

    Directory of Open Access Journals (Sweden)

    Jyoti V Kulkarni

    2007-01-01

    In 17 % patients foreign body was located in subglottic region, in 59 % patients FB was in right main bronchus and in 24% patients it was in left main bronchus. In 33 % patients bronchoscopy was done within 72 hours of appearance of symptoms while in 51% patients bronchoscopy was done after 72 hours to one week of appearance of symptoms. In 16% patients bronchoscopy was done after one week. Twenty percent patients required tracheostomy and 3% patients required bronchodilators, nebuliza-tion and ventilatory support in immediate post operative period. All patients were managed under general anaesthesia using ketamine, suxamethonium, oxygen and halothane. All patients were ventilated through side arm of ventilating bronchoscope.All patients were discharged from hospital & no death was reported.

  19. Foreign Body Aspiration in Pregnancy

    Directory of Open Access Journals (Sweden)

    Andrew L. Atkinson

    2012-01-01

    Full Text Available A 24-year-old morbidly obese African American gravida 1, with a history of severe asthma complicated by multiple inpatient admissions, presents at 30 weeks gestation with a foreign body in her left main stem bronchus. After a failed bronchoscopy postpartum, the patient slipped into respiratory failure and was subsequently intubated, spending two weeks in the intensive care unit. After two more attempts of trying to retrieve the foreign object from her lung via bronchoscopy, she eventually contracted a postobstructive pneumonia and underwent a left lower lung lobectomy for curative treatment.

  20. Corpo estranho traqueal em cão

    Directory of Open Access Journals (Sweden)

    A.S Gouvêa

    2012-06-01

    Full Text Available The occurrence of a tracheal foreign body in a three-month-old male Poodle referred to a Teaching Veterinary Hospital due to acute coughing, gagging and nausea is reported. A bronchoscopy under general anesthesia was performed in order to obtain a diagnose. During the bronchoscopy a foreign body (maize popcorn was observed in the intrathoracic trachea. The surgeon attempted to remove it by endoscopy, but no success was achieved. Therefore, an open procedure was performed and the foreign body removed. The patient progressed satisfactorily after the thoracotomy.

  1. Cushing’s like syndrome in typical bronchial carcinoid a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ilaria Pedicelli

    2016-01-01

    Full Text Available Cushing’s syndrome occurred in 1–5% of cases of bronchial carcinoids. In this paper we describe a case of typical bronchial carcinoid in a nonsmoker young male with clinical manifestations mimicking a Cushing’s syndrome. The patient performed chest radiograph and computed tomography. Fiberoptic bronchoscopy revealed the presence of an endobronchial mass occluding the bronchus intermedius. A rigid bronchoscopy was necessary for the conclusive diagnosis and for partial resection of the intraluminal tumor. Despite of the presence of Cushingoid features, the normal blood levels of ACTH and cortisol excluded the coexistence of a Cushing’s syndrome.

  2. Surgical management of atypical lateral tracheal collapse in a dog.

    Science.gov (United States)

    Johnson, L R; Krahwinkel, D J; McKiernan, B C

    1993-12-15

    Tracheal collapse is often diagnosed in small-breed dogs through use of conventional radiography or fluoroscopy, by which the dorsoventral orientation of the collapse can be seen. In the dog of this report, an unusual lateral form of tracheal collapse was diagnosed by means of bronchoscopy after multiple radiographic procedures had failed to define a cause for cough and dyspnea. Surgical reinforcement of the abnormal region of the trachea resulted in resolution of clinical signs and in reduction in dynamic airway collapse, which was documented on follow-up bronchoscopy. PMID:8307818

  3. Medical image of the week: granulation tissue

    Directory of Open Access Journals (Sweden)

    Ganesh A

    2014-03-01

    Full Text Available A 57 year old woman presented with a tickling sensation in the back of throat and intermittent bleeding from the healing stoma one month after decannulation of her tracheostomy tube. On bronchoscopy a granuloma with surrounding granulation tissue was present in the subglottic space (Figure 1. Argon plasma coagulation (APC was performed to cauterize the granulation tissue (Figure 2. Formation of granulation tissue after tracheostomy is a common complication which can result in tracheal stenosis. APC and electrocautery using flexible bronchoscopy has been shown to safely and effectively remove the granulation tissue.

  4. Reduced turnover times make flexible optical reusable scope with EndoSheath® Technology significantly cost-effective

    OpenAIRE

    Gupta, Deepak; Srirajakalidindi, Arvind; Wang, Hong

    2012-01-01

    EndoSheath bronchoscopy (Vision Sciences, Inc.) uses a sterile, disposable microbial barrier that may meet the growing needs for safe, efficient, and cost effective flexible bronchoscopy. The purpose of this open-label comparative study was to compare and calculate the costs-per-airway-procedure of the reusable fiberscope when used with and without EndoSheath® Technology; and to record the turnover time from the completion of the use of each scope until its readiness again for the next use. S...

  5. Successful use of extracorporeal membrane oxygenation for acute respiratory failure in a patient with chronic granulomatous disease☆, ☆☆, ★

    OpenAIRE

    Madden, Jesse L; Schober, Michelle E; Meyers, Rebecka L.; Bratton, Susan L.; Holland, Steven M.; Hill, Harry R; Rollins, Michael D

    2012-01-01

    A 9-year-old boy presented with pneumonia, bilateral pulmonary lesions, and fulminant respiratory failure requiring support with extracorporeal membrane oxygenation (ECMO). Open lung biopsy and subsequent bronchoscopy identified Nocardia cyriacigeorgica and Burkholderia cepacia pneumonia. Chronic granulomatous disease (CGD) was diagnosed by an abnormal neutrophil oxidative burst assay. An aggressive diagnostic and therapeutic strategy, which included ECMO, allowed for patient survival and ret...

  6. Plastic Bronchitis in a Child Presenting as Surgical Emphysema

    Directory of Open Access Journals (Sweden)

    Nikita Tripathi

    2015-12-01

    Full Text Available Plastic bronchitis (PB refers to the presence of inspissated Bronchial casts (BC is uncommon in children.Our case presented with subcutaneous emphysema as the dominant manifestation and was suspected to have foreign body in airway, but bronchoscopy revealed a bronchial cast. Subcutaneous emphysema as the initial/sole manifestation of plastic bronchitis is very rare in children.

  7. Application of serum surface-enhanced laser desorption/ionization proteomic patterns in distinguishing lung cancer patients from healthy people

    Institute of Scientific and Technical Information of China (English)

    YANG Shuan-ying; XIAO Xue-yuan; ZHANG Wang-gang; SUN Xiu-zhen; ZHANG Li-juan; ZHANG Wei; ZHOU Bin; CHEN Guo-an; HE Da-cheng

    2005-01-01

    @@ Screening and early diagnosis of lung cancer relies mainly on chest X-ray, low-dose computed tomography, bronchoscopy, sputum cytology, and measurement of tumor markers such as carcinoembryonic antigen (CEA), cytokeratin-19 fragments (Cyfra21-1), and neuron-specific enolase (NSE).

  8. Foreign Body in Left Main Bronchus.

    Science.gov (United States)

    Dhadke, Shubhangi V; Chaudhari, Amit L; Deshpande, Neelima S; Dhadke, Vithal N; Sangle, Shashikala A

    2015-07-01

    Tracheobronchial foreign body (TFB) aspiration is rare in adults, although incidence rates increases with advancing age. We report a case of foreign body in left main bronchus in an adult female who had no risk factor. She was successfully treated with removal of betel nuts by bronchoscopy. Unusual presentation and high index of suspicion can help in proper management. PMID:26731835

  9. 77 FR 68209 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2012-11-15

    ... Services a. Bronchoscopy (APC 0415) b. Upper Airway Endoscopy (APC 0075) 9. Other Services a. Payment for... inpatient admission was not medically necessary. In the CY 2013 OPPS/ASC proposed rule (77 FR 45155 through... Hospitals and CAHs through 2013, exactly as finalized for 2012. We recently issued a final rule (77 FR...

  10. Lung cancer

    International Nuclear Information System (INIS)

    This article is about the diagnosis, treatment and monitoring of lung cancer. Before the treatment the histological samples allowing the diagnosis as well as its histological variety. The diagnosis include techniques such as bronchoscopy, ultrasound, tomography, puncture and endoscopic thoracotomy. The chemotherapy and radiotherapy are the main techniques used for the treatment

  11. BRONCHOPULMONARY COMPLICATIONS OF INDOOR POLLUTION IN IRANIAN RUSTIC POPULATION

    OpenAIRE

    Kazem Amoli

    1994-01-01

    Chronic bronchopulmonary disorders occurred in a large number of rustic females who used to bake bread at their dwellings under unhgyienic conditions. Bronchoscopy revealed advanced pathological changes with characterised black areas infiltrating the bronchial walls. Findings in ten patients who referred with acute chronic respiratory symptoms and a positive history of indoor pollution are described with an emphasis on their bronchoscopic changes.

  12. A case of haemoptysis due to endobronchial fibroma, a rare benign tumour of lung

    Directory of Open Access Journals (Sweden)

    Das Sibes

    2008-01-01

    Full Text Available A case of recurrent haemoptysis due to fibroma is described in a 55 years old male patient. Clinical examination revealed anaemia and bilateral basal crepitations. Chest X - ray showed no abnormality. Bronchoscopy revealed polypoid fibroma in left main bronchus. It was removed bonchoscopically with no recurrence during 12 months follow up.

  13. Bronchoscopic lung biopsy for diagnosis of miliary tuberculosis

    Directory of Open Access Journals (Sweden)

    Aggarwal A

    2005-01-01

    Full Text Available Background: Miliary tuberculosis is often treated empirically in India in the absence of a positive diagnosis based on sputum examination. We investigated the role of fiberoptic bronchoscopy for diagnosis of this disease. Methods : Records of patients undergoing fiberoptic bronchoscopy and bronchoscopic lung biopsy, and diagnosed to have miliary tuberculosis, over a four year period were evaluated. Two to four lung biopsy specimens were obtained from each patient and examined microscopically after Hematoxylin-eosin and Zeihl-Neelson staining. Results : Thirty one patients of miliary tuberculosis (19 men and 12 women underwent fiberoptic bronchoscopy during the study period. No endobronchial abnormality was noted in any patient. Bronchoscopic lung biopsy yielded adeqaute specimen in all but one patient. Granulomatous inflammation was noted in 21 (67.7% patients on histopathological evaluation of biopsy specimens; of them, acid-fast bacilli were demonstrated in one patient. One patient (3.2% had normal alveolar architecture. In the other 8 patients (25.8%, nonspecific pulmonary interstitial inflammation and/or mild fibrosis were seen. Bronchial wash specimens showed acid-fast bacilli in only one patient; this patient also had granulomatous inflammation on lung biopsy. All patients tolerated bronchoscopy well and there were no procedure-related complications. Conclusion: Bronchoscopic lung biopsy is a safe procedure and an effective method of establishing diagnosis of miliary tuberculosis in a majority of patients with this disease. Bronchial washings do not provide significant additional information in this regard.

  14. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... And unfortunately, it’s normally detected in a late stage, you know, and even when detected early, you ... the bronchoscopy, the next important part is to stage. And that’s very critical in determining the outcome ...

  15. Acute Scedosporium apiospermum Endobronchial Infection in Cystic Fibrosis.

    Science.gov (United States)

    Padoan, Rita; Poli, Piercarlo; Colombrita, Domenico; Borghi, Elisa; Timpano, Silviana; Berlucchi, Marco

    2016-06-01

    Fungi are known pathogens in cystic fibrosis patients. A boy with cystic fibrosis boy presented with acute respiratory distress. Bronchoscopy showed airways obstruction by mucus plugs and bronchial casts. Scedosporium apiospermum was identified as the only pathogen. Bronchoalveolar lavage successfully resolved the acute obstruction. Plastic bronchitis is a new clinical picture of acute Scedosporium endobronchial colonization in cystic fibrosis patients. PMID:26967814

  16. Diseases of the bronchi

    International Nuclear Information System (INIS)

    Roentgenologic semiotics of acute and chronic bronchites has been presented. It is shown, that in the combined daignosis of bronchi diseases roentgenograp hy and roentgenoscopy of lungs, roentgenofunctional tests and bronchography shou ld be used. For the diagnosis of broncholithiases, retention cysts and foreign bodies in bronchi the tomography, bronchography and bronchoscopy are used

  17. Spontaneous pneumothorax due to bronchopleural fistula following reirradiation for locoregionally recurrent squamous cell lung cancer.

    Science.gov (United States)

    Ota, Takayo; Suzumura, Tomohiro; Sugiura, Takamune; Hasegawa, Yoshikazu; Yonesaka, Kimio; Makihara, Masaru; Tsukuda, Hiroshi; Tada, Takuhito; Fukuoka, Masahiro

    2016-05-01

    Spontaneous pneumothorax following radiotherapy for pulmonary malignancy is an unusual clinical condition. Here, we report a case of a 78-year-old male suffering from dyspnea during radiotherapy for squamous cell lung cancer of the right main bronchus. Imaging studies and fiberoptic bronchoscopy revealed that pneumothorax was due to a bronchopleural fistula. PMID:27190612

  18. EXERCISE-INDUCED PULMONARY HEMORRHAGE AFTER RUNNING A MARATHON

    Science.gov (United States)

    We report on a healthy 26-year-old male who had an exercise-induced pulmonary hemorrhage (EIPH) within 24 hours of running a marathon. There were no symptoms, abnormalities on exam, or radiographic infiltrates. He routinely participated in bronchoscopy research and the EIPH was e...

  19. Pulmonary alveolar proteinosis

    OpenAIRE

    Chan, Adrian Kwok Wai; Takano, Angela; Hsu, Ann Ling; Low, Su Ying

    2014-01-01

    We report a 68-year-old female who presented with chronic cough and progressive dyspnoea. Computed tomography of the thorax and subsequent bronchoscopy confirmed the diagnosis of pulmonary alveolar proteinosis (PAP), which was treated with whole lung lavage. This case is reported in view of the low incidence of PAP.

  20. Respiratory tuberculosis and current potenti

    International Nuclear Information System (INIS)

    Materials on possibility of diagnosing the lungs bronchi tuberculosis on the background of development failures are presented. It is noted that for a faster tuberculosis diagnostics it is necessary to use not only the clinical-roentgenological data but also the data on diagnostical bronchoscopy and bioscopy of bronchial mucous membrane and lungs tissue

  1. Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

    Directory of Open Access Journals (Sweden)

    Ravi Narayanasamy

    2009-12-01

    Full Text Available Abstract Background The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. Case presentation A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula Conclusions This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

  2. Infection with Crenosoma vulpis lungworm in a dog in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Husník, R.; Sloboda, M.; Kovaříková, S.; Koudela, Břetislav

    2011-01-01

    Roč. 48, č. 1 (2011), 56-58. ISSN 0440-6605 Institutional research plan: CEZ:AV0Z60220518 Keywords : Crenosoma vulpis * fox lungworm * larvoscopy * chronic cough * bronchoscopy Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 0.773, year: 2011

  3. Foreign body aspiration in children: experience of 1160 cases.

    Science.gov (United States)

    Eren, Sevval; Balci, Akin Eraslan; Dikici, Bünyamin; Doblan, Mehmet; Eren, Mehmet Nesimi

    2003-03-01

    Hospital records of 1160 children Watermelon seeds, found in 414 (38.7%) children, were the most commonly aspirated foreign bodies. Open surgical procedures were required for 21 (1.8%) children. Bronchial rupture related to bronchoscopy occurred in four children, two of whom died post-operatively. The overall mortality rate was 0.8%. PMID:12648322

  4. Minimally invasive diagnosis of sarcoidosis by EBUS when conventional diagnostics fail

    DEFF Research Database (Denmark)

    Eckardt, J; Olsen, K E; Jørgensen, O D; Licht, R B

    2010-01-01

    Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. EBUS has also proved to be a valuable diagnostic tool for patients with different intrathoracic lesions who remain...... undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration....

  5. Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report.

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2009-01-01

    BACKGROUND: The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. CASE PRESENTATION: A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula CONCLUSIONS: This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

  6. Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2009-12-24

    Abstract Background The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. Case presentation A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula Conclusions This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

  7. Tracheomalacia - congenital

    Science.gov (United States)

    ... the problem is. Other tests may include: Airway fluoroscopy -- a kind of x-ray that shows the images on a screen Barium swallow Bronchoscopy -- camera down the throat to see the airways and lungs CT scan Lung function tests Magnetic resonance imaging (MRI)

  8. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998.

    Science.gov (United States)

    Debeljak, A; Sorli, J; Music, E; Kecelj, P

    1999-10-01

    The authors reviewed their experience with therapeutic bronchoscopy for removal of tracheobronchial foreign bodies in the adult. Bronchoscopy records and collection of foreign bodies in the endoscopic department were retrospectively examined. Among 37,466 bronchoscopies performed between 1974-1998, 62 (0.2%) were performed for the removal of tracheobronchial foreign bodies. Medical history was suggestive of foreign body aspiration in 33 patients and the chest radiograph was suggestive in 10 patients. The procedure was performed with the flexible bronchoscope in 42 patients (68%), rigid bronchoscope in 4 (6%), and with both in 16 (26%) patients. Foreign bodies were found in the right bronchial tree on 42 occasions, in the left on 20 and in the trachea once. In 39 patients, inflammatory granulations were found around the foreign body. The origins of the foreign bodies included: bone fragments (n=31), vegetable (n=10), broncholith (n=8), a part of dental prosthesis (n=7), endodontic needle (n=2), a metallic (n=2), or plastic (n=1) particle, a tracheostomy tube (n=1) and a match (n=1). In one patient, 2 foreign bodies were found. The foreign bodies were successfully removed in all but 2 patients (3%). The most useful instruments for removal were alligator forceps and the wire basket. Foreign bodies in the tracheobronchial system are rare in adults. They can be successfully removed in the majority of patients under either flexible or rigid bronchoscopy. PMID:10573222

  9. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... the pulmonary standpoint, we usually do what we call a “bronchoscopy,” which is a small endoscopic camera, ... it is, you can also have what we call a “transthoracic needle biopsy.” Some of them, obviously ...

  10. 017. Exogenous acute lipoid pneumonitis from animal fat aspiration (part of intestine)

    Science.gov (United States)

    Gkika, Dimitra; Manos, Emmanouil; Kolovos, Dimitrios; Batsouli, Vassiliki; Pathiaki, Eirini; Mavromati, Evagelia; Divani, Smaroula; Vardouli, Anna; Panagopoulos, Angelos; Karkanis, Konstantinos; Angel, Jacob

    2015-01-01

    Objective In the aspiration of animal fats, bronchoscopy is promptly necessary, not only for removing the foreign body but also for its therapeutic importance in order to avoid severe lipoid pneumonia, because fat acids are very toxic for the bronchial mucosa. Methods Patient 84 years old, nonsmoker, with a medical history of heart disease under acenocoumarol, referred accidental aspiration of cooked animal intestine, 12 hours ago, with rough cough and dyspnea that started instantly. To be noted, the patient presented with wheezing in both lungs. Thoracic CT scan images reveal a suspicion of aspiration, confirmed by indirectly evidence (right middle lobe atelectasis and also mediastinum transposition to the left and consolidation with atelectasis in the left lower lobe, as evidence of previous infections-possible aspirations, emerged from his case story). Therefore, urgent bronchoscopy was performed and the foreign body, that was movable with the cough, was removed. Bronchial lavage was performed due to acute infection in whole bronchial tree. A reactive granuloma tissue was noted in the entrance of the middle lobe, but because of the anticoagulant intake biopsy wasn’t performed. During his hospitalization the patient was under antibiotics, bronchodilators and corticosteroids. Results At the time of revaluation, two weeks after, the patient was non symptomatic while the new CT scan showed evidence of residual infection in the left lung and atelectasis of the right middle lobe on the left. Bronchoscopy was reperformed and biopsy was taken in the entrance of the right middle lobe because of the noted reactive granuloma tissue, seen at the first bronchoscopy. No signs of bronchial inflammation were found (impressive improvement due to immediate intervention). Conclusions Animal fat aspiration causes acute bronchial inflammation and therefore, lipoid pneumonia within a few hours, due to rapid hydrolysis of releasing fatty acids. Removing the animal fat with the

  11. Deformable image registration for multimodal lung-cancer staging

    Science.gov (United States)

    Cheirsilp, Ronnarit; Zang, Xiaonan; Bascom, Rebecca; Allen, Thomas W.; Mahraj, Rickhesvar P. M.; Higgins, William E.

    2016-03-01

    Positron emission tomography (PET) and X-ray computed tomography (CT) serve as major diagnostic imaging modalities in the lung-cancer staging process. Modern scanners provide co-registered whole-body PET/CT studies, collected while the patient breathes freely, and high-resolution chest CT scans, collected under a brief patient breath hold. Unfortunately, no method exists for registering a PET/CT study into the space of a high-resolution chest CT scan. If this could be done, vital diagnostic information offered by the PET/CT study could be brought seamlessly into the procedure plan used during live cancer-staging bronchoscopy. We propose a method for the deformable registration of whole-body PET/CT data into the space of a high-resolution chest CT study. We then demonstrate its potential for procedure planning and subsequent use in multimodal image-guided bronchoscopy.

  12. Unusual Presentation of Metallic Foreign Body Aspiration after Penetrating Neck Trauma

    Directory of Open Access Journals (Sweden)

    Reza Bagheri

    2013-11-01

    Full Text Available A 25 year-old Construction worker underwent neck laceration following penetrating neck trauma in a falling incident. The 3rd tracheal ring was injured which was initially repaired and the patient was discharged in good general condition. (Figure 1 shows the patient’s neck view after discharge from hospital.Two months later the patient was again admitted due to provocative coughing and a metal foreign body was detected in his right main bronchus. (Figure 2 shows CXR of the patient and Figure 3 demonstrates CT scan of the same patient. Finally the patient underwent rigid bronchoscopy to remove the foreign body. (Figure 4 shows the foreign body after rigid bronchoscopy.

  13. In vivo endoscopic autofluorescence microspectro-imaging of bronchi and alveoli

    CERN Document Server

    Bourg-Heckly, G; Vever-Bizet, C; Viellerobe, B

    2008-01-01

    Fibered confocal fluorescence microscopy (FCFM) is a new technique that can be used during a bronchoscopy to analyze the nature of the human bronchial and alveolar mucosa fluorescence microstructure. An endoscopic fibered confocal fluorescence microscopy system with spectroscopic analysis capability was developed allowing real-time, simultaneous images and emission spectra acquisition at 488 nm excitation using a flexible miniprobe that could be introduced into small airways. This flexible 1.4 mm miniprobe can be introduced into the working channel of a flexible endoscope and gently advanced through the bronchial tree to the alveoli. FCFM in conjunction with bronchoscopy is able to image the in vivo autofluorescence structure of the bronchial mucosae but also the alveolar respiratory network outside of the usual field of view. Microscopic and spectral analysis showed that the signal mainly originates from the elastin component of the bronchial subepithelial layer. In non smokers, the system images the elastin...

  14. Tracheobronchopathia Osteochondroplastica

    Directory of Open Access Journals (Sweden)

    F Noorani

    2008-04-01

    Full Text Available Tracheobronchopathia Osteochondroplastica (TO is a rare disorder of large airways with unknown etiology which is characterized by cartilaginous and bony nodules lining the mucosa of the trachea and major bronchi. Generally, it is benign and asymptomatic, but it may present with cough, exertional dyspnea and wheezing. It could therefore be mistaken with asthma and chronic obstructive pulmonary disease . The diagnosis is usually made on bronchoscopy and confirmed on histology .We describe two cases of TO with characteristic bronchoscopic and histological findings. The first one had exertional dyspnea and hoarseness for more than 3 years and the second one had exertional dyspnea for more than 10 years .In both of the cases, fiber optic bronchoscopy was performed which revealed numerous white,hard,irregular nodules on trachea and main bronchi. The pathologic diagnosis of bronchoscopic biopsy was TO.

  15. An unusual cause of recurrent spontaneous pneumothorax: the Mounier-Kuhn syndrome.

    Science.gov (United States)

    Unlu, Elif Nisa; Annakkaya, Ali Nihat; Balbay, Ege Gulec; Aydın, Leyla Yilmaz; Safcı, Sinem; Boran, Mertay; Guclu, Derya

    2016-01-01

    We present a case of 63-year-old man who was referred to the emergency department with a right-sided pneumothorax. He had a history of spontaneous pneumothorax for 2 times. The chest computed tomographic scan showed tracheobronchomegaly with an increase in the diameter of the trachea and right and left main bronchus. Fiberoptic bronchoscopy revealed enlarged trachea and both main bronchus with diverticulas. These findings are consistent with a diagnosis of Mounier-Kuhn syndrome. Mounier-Kuhn syndrome is a rare clinical and radiologic condition. It is characterized by a tracheal and bronchial dilation. Diagnosis is made by computed tomography and bronchoscopy. Mounier-Kuhn syndrome should be kept in mind in the differential diagnosis of recurrent spontaneous pneumothorax. PMID:26127019

  16. Endobronchial Cartilage Rupture: A Rare Cause of Lobar Collapse.

    Science.gov (United States)

    Dasa, Osama; Siddiqui, Nauman; Ruzieh, Mohammed; Javaid, Toseef

    2016-01-01

    Endobronchial cartilage rupture is a rare clinical condition, which can present in patients with severe emphysema with sudden onset shortness of breath. We present a case of a 62-year-old male who presented to our emergency department with sudden onset shortness of breath. Chest X-ray showed lung hyperinflation and a right lung field vague small density. Chest Computed Tomography confirmed the presence of right middle lobe collapse. Bronchoscopy revealed partial right middle lobe atelectasis and an endobronchial cartilage rupture. Endobronchial cartilage rupture is a rare condition that can present as sudden onset shortness of breath due to lobar collapse in patients with emphysema and can be triggered by cough. Bronchoscopic findings include finding a collapsed lung lobe and a visible ruptured endobronchial cartilage. A high index of suspicion, chest imaging, and early bronchoscopy can aid in the diagnosis and help prevent complications. PMID:27525149

  17. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Undiagnosed Chest Tumors

    DEFF Research Database (Denmark)

    Eckardt, Jens; Olsen, Karen E; Licht, Peter B

    2010-01-01

    BACKGROUND: A number of patients with radiologically suspicious chest tumors remain undiagnosed despite bronchoscopy or CT-guided fine-needle aspiration (CT-FNA). Such patients are often referred for mediastinoscopy, which is an invasive surgical procedure that poses a small but significant risk to...... December 2008), 601 patients underwent EBUS under general anesthesia. Two hundred ninety-three (293) patients had an established diagnosis of lung cancer and were referred to us for mediastinal staging. The remaining 308 patients had a radiologically suspicious lesion and had been investigated previously...... by CT and bronchoscopy, including brush cytology, but remained undiagnosed. RESULTS: Overall, EBUS was able to diagnose 55% of the 308 patients. Diagnostic yield was significantly higher in central parenchymal lesions (72%) compared with enlarged lymph nodes (54%) or peripheral lesions (43%) (P < 0...

  18. Coexistence of squamous cell tracheal papilloma and carcinoma treated with chemotherapy and radiotherapy: a case report

    Science.gov (United States)

    Paliouras, Dimitrios; Gogakos, Apostolos; Rallis, Thomas; Chatzinikolaou, Fotios; Asteriou, Christos; Tagarakis, Georgios; Organtzis, John; Tsakiridis, Kosmas; Tsavlis, Drosos; Zissimopoulos, Athanasios; Kioumis, Ioannis; Hohenforst-Schmidt, Wolfgang; Zarogoulidis, Konstantinos; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-01-01

    Background Papillomatosis presents, most frequently, as multiple lesions of the respiratory tract, which are usually considered benign. Malignant degeneration into squamous cell carcinoma is quite common, although curative approaches vary a lot in modern literature. Case report We report a case of a 66-year-old male patient with the coexistence of multiple squamous cell papilloma and carcinoma in the upper trachea with severe airway obstruction that was diagnosed through bronchoscopy and treated by performing an urgent tracheostomy, followed by concurrent chemotherapy and radiotherapy. There was no evidence of recurrence after a 12-month follow-up period. Conclusion This study underlines the diagnostic and therapeutic value of bronchoscopy as well as multimodality palliative treatment in such cases. To the best of our knowledge, this is the first study to describe an immediate treatment protocol with tracheostomy and concurrent chemotherapy/radiotherapy in a patient with squamous cell tracheal papilloma and carcinoma. PMID:26730195

  19. Intraoperative endobronchial rupture of pulmonary hydatid cyst: An airway catastrophe

    Directory of Open Access Journals (Sweden)

    Richa Gupta

    2013-01-01

    Full Text Available Hydatid cyst disease of lungs may not be symptomatic. It may present as spontaneous rupture in pleura or a bronchus. During spontaneous breathing, cyst content of endobronchially ruptured pulmonary hydatid cyst is mostly evacuated by coughing. However, during positive pressure ventilation such extruded fragments may lodge into smaller airway leading to an airway catastrophe. We present such accidental endobronchial rupture of pulmonary hydatid cyst during surgery, its prompt detection, and management by rigid bronchoscopy.

  20. Tracheobronchial foreign body in children - 10 years experience

    OpenAIRE

    Balica, NC; Poenaru, M; Marin, AH; Iovanescu, G; Stefanescu, HE; Boia, ER; Doros, C

    2015-01-01

    Introduction: Presentation of ENT Department - Timisoara 10 years experience of in the diagnosis and treatment of tracheobronchial foreign body in children. We studied 93 children, aged between 10 months and 8 years.Methods: The diagnosis of airways penetrating syndrome was established on history, clinical examination, cardiopulmonary X-ray, CT (virtual bronchoscopy) and rigid videotracheobronhoscopy. Foreign body removal was performed using pediatric Karl-Storz tracheobronhoscopy kit, unde...

  1. A Rare Fungal Infiltration of Lungs in a Healthy Young Girl

    OpenAIRE

    Sushma Sood; Uma Chaudhary; Gupta, K. B.; Nidhi Goel; Anupama Gupta; Rajesh Gupta

    2011-01-01

    Cunninghamella bertholletiae is an opportunistic fungal organism found in soil and is a rare cause of human disease. The few reported cases of C. bertholletiae have involved immune compromised hosts. We report a case of C. bertholletiae in an otherwise healthy patient presenting with persistent high-grade fever and pulmonary infiltration resistant to antibiotics. The organism is isolated through bronchoscopy and responded to broad spectrum antifungal. This is the first case of C. bertholletia...

  2. [Surgical treatment of bronchiectases in elderly patients].

    Science.gov (United States)

    Danilov, G P; Makeeva, R P; Shornikov, V A; Zil'ber, E K; Akopov, A L

    2010-01-01

    The authors present experiences with surgical treatment of 29 patients (aged 50-64 years) with bronchiectases. Early and late results were analyzed. It was shown that complex approach to the estimation of the findings of radiography, spiral computed tomography, investigation of the external respiration function, fibrobronchoscopy and bronchoscopy, if necessary, allowed operating the patients older than 50 years with local forms of bronchiectases which gave good results. PMID:21137257

  3. Abnormal movement of the arytenoid region as a cause of upper airway obstruction.

    OpenAIRE

    Nagai, A.; Kanemura, T; Konno, K.

    1992-01-01

    A 75 year old woman presented with a three week history of severe dyspnoea and cough. Auscultation and spirometry suggested extrathoracic inspiratory airway obstruction, and bronchoscopy showed abnormal motion of the arytenoid region (supraglottic area), causing upper airway obstruction only during forced inspiratory efforts. Sedatives improved the symptoms within a week. It is suggested that reversible malfunction of the arytenoid region can be responsible for upper airway obstruction.

  4. Paediatrisk pulmonologi

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S E; Schiøtz, P O

    2001-01-01

    Paediatric pulmonology (paediatric respiratory medicine) concerns such lung diseases in children as asthma, pneumonia, cystic fibrosis, primary ciliary dyskinesia, chronic interstitial pneumonia, bronchopulmonary dysplasia and congenital abnormalities. This specialty has been approved as an...... paediatric organisations. The training syllabus emphasises routine in the clinical diagnosis and treatment of the diseases, as well as methods such as lung function in all age groups, bronchoscopy, biopsy, and others. This article summarises the status of this specialty, and the training syllabus, and...

  5. Sweet's syndrome with pulmonary involvement: Case report and literature review ☆

    OpenAIRE

    Fernandez-Bussy, S.; Labarca, G.; Cabello, F; Cabello, H.; Folch, E.; Majid, A

    2012-01-01

    A 74 year old female presented with fever, associated with papules and plaque in her upper and lower extremities. Exams revealed blood leukocytosis and a positive urine culture. Antibiotic therapy was initiated with no clinical response. After 1 week, chest X-ray showed right upper lobe alveolar infiltrate. A skin biopsy of the lesion showed infiltration by neutrophils, consistent with Sweet's Syndrome. Patient's condition progressively worsened, requiring oxygentherapy. Bronchoscopy and bron...

  6. Bronchoalveolar Lavage Enzyme-Linked Immunospot for Diagnosis of Smear-Negative Tuberculosis in HIV-Infected Patients

    OpenAIRE

    Cattamanchi, Adithya; Ssewenyana, Isaac; Nabatanzi, Rose; Cecily R Miller; den Boon, Saskia; Davis, J. Lucian; Andama, Alfred; Worodria, William; Samuel D Yoo; Cao, Huyen; Huang, Laurence

    2012-01-01

    Background Peripheral blood interferon-gamma release assays (IGRAs) have sub-optimal sensitivity and specificity for diagnosis of active pulmonary tuberculosis (TB). However, assessment of local immune responses has been reported to improve the accuracy of TB diagnosis. Methods We enrolled HIV-infected adults with cough ≥2 weeks’ duration admitted to Mulago Hospital in Kampala, Uganda and referred for bronchoscopy following two negative sputum acid-fast bacillus smears. We performed an ELISPO...

  7. Diagnostic value of procalcitonin, CRP, leukocytes and BAL neutrophils for pulmonary complications in the immunocompromised host

    Directory of Open Access Journals (Sweden)

    Daiana Stolz

    2006-12-01

    Full Text Available We evaluated the diagnostic accuracy of laboratory biomarkers and BAL differential cell count for the diagnosis of bacterial infection in severe immunosuppressed patients. One-hundred and seven consecutive patients undergoing bronchoscopy for suspected pulmonary infection were included in this study. Assessment included history, clinical examination, chest image studies, CRP, procalcitonin (ProCT, leukocyte counts, and BAL results. Patients were classified as having proven, possible, and non-bacterial infection.

  8. Lung Diseases - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... Respiratoire) - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Bronchoscopy हिन्दी (Hindi) Bilingual PDF ...

  9. Tracheal metastasis of small cell lung cancer

    OpenAIRE

    De, Sajal

    2009-01-01

    Endotracheal metastases of primary lung cancer are rare. Only one case of tracheal metastasis from small cell lung cancer has been reported in literature. Here, we report a rare case of a 45-year-old woman who was admitted for sudden-onset breathlessness with respiratory failure and required ventilatory support. Endotracheal growth was identified during bronchoscopy, and biopsy revealed endotracheal metastasis of small cell lung cancer.

  10. Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

    OpenAIRE

    Shannon Ruzycki; Willis H. Tsai; Davidson, Warren J.

    2015-01-01

    Tracheal bronchus is a rare anatomic variant in which a bronchus originates from the trachea. Patients may be asymptomatic or present with a variety of respiratory symptoms. We present a case of a patient who presented with a history of poorly controlled asthma and a persistent abnormality of the flow-volume loop. Bronchoscopy revealed a tracheal bronchus with narrowed right-sided bronchial orifices. An unrecognized tracheal bronchus may result in serious complications during elective or emer...

  11. Endobronchial metastasis of follicular thyroid carcinoma presenting as hemoptysis: A case report

    Directory of Open Access Journals (Sweden)

    Kushwaha RAS

    2008-01-01

    Full Text Available Endobronchial metastasis secondary to follicular thyroid carcinoma is extremely rare. Here, we report a case of follicular thyroid cancer in 58-year-old male who presented with hemoptysis. Computed tomography of the chest revealed multiple lung metastases. Flexible fiberoptic bronchoscopy revealed a fragile polypoid mass 5 cm distal to the vocal cords; biopsy taken from this mass revealed follicular thyroid carcinoma.

  12. Changes in the Lung Microbiome following Lung Transplantation Include the Emergence of Two Distinct Pseudomonas Species with Distinct Clinical Associations

    OpenAIRE

    Dickson, Robert P; Erb-Downward, John R.; Freeman, Christine M.; Walker, Natalie; Scales, Brittan S.; Beck, James M.; Martinez, Fernando J; Curtis, Jeffrey L.; Lama, Vibha N.; Huffnagle, Gary B.

    2014-01-01

    Background Multiple independent culture-based studies have identified the presence of Pseudomonas aeruginosa in respiratory samples as a positive risk factor for bronchiolitis obliterans syndrome (BOS). Yet, culture-independent microbiological techniques have identified a negative association between Pseudomonas species and BOS. Our objective was to investigate whether there may be a unifying explanation for these apparently dichotomous results. Methods We performed bronchoscopies with bronch...

  13. A rarely seen mucoepidermoid carcinoma of the left main bronchus

    Directory of Open Access Journals (Sweden)

    Mustafa Kuzucuoglu

    2014-01-01

    Full Text Available Mucoepidermoid carcinomas (MEC are rare malignant tumors that originate in the submucosal bronchial glands, and complete resection usually correlates with favorable prognosis. A 54-year-old male patient was diagnosed with high-grade MEC in the left main bronchus via bronchoscopy. After the patient was diagnosed with metastatic lung cancer, chemotherapy was started. Two years after the diagnosis, the patient is still alive.

  14. Squamous Cell Carcinoma of the Lung with Osteoclast- Like Giant Cells: A Rare Case

    OpenAIRE

    Yetkin AĞAÇKIRAN; Gezer, Suat; FINDIK, GÖKTÜRK; İrfan TAŞTEPE

    2010-01-01

    Stromal reactions including benign osteoclast-like giant cells are rarely seen within carcinomas. They are even extremely rare in lung carcinomas.A 61-year-old male patient who had marked volume loss in the right lung radiologically was admitted. Fiberoptic bronchoscopy was performed, an endobronchial lesion arising from the right upper lobe bronchus and nearly completely obstructing the right main bronchus was detected and multiple biopsies were taken. Histopathological examination of these ...

  15. BRONCHOPULMONARY COMPLICATIONS OF INDOOR POLLUTION IN IRANIAN RUSTIC POPULATION

    Directory of Open Access Journals (Sweden)

    Kazem Amoli

    1994-06-01

    Full Text Available Chronic bronchopulmonary disorders occurred in a large number of rustic females who used to bake bread at their dwellings under unhgyienic conditions. Bronchoscopy revealed advanced pathological changes with characterised black areas infiltrating the bronchial walls. Findings in ten patients who referred with acute chronic respiratory symptoms and a positive history of indoor pollution are described with an emphasis on their bronchoscopic changes.

  16. Two cases of broncho-pulmonary foregut malformations

    Directory of Open Access Journals (Sweden)

    Εleftherios D. Spartalis

    2009-01-01

    Full Text Available SUMMARY. Congenital broncho-pulmonary malformations are mostly asymptomatic. They are diagnosed during the investigation of a pulmonary infection or after a chest x-ray. Fetal ultrasound, chest x-ray, ventilation-perfusion scan, CT, MRI, barium meal, esophagoscopy, bronchoscopy and digital angiography can be used for further investigation. Surgical excision was our treatment of choice and had a significally good prognosis. Pneumon 2009; 22(2:178–185.

  17. Anastomotic Airway Complications after Lung Transplantation

    OpenAIRE

    Cho, Eun Na; Haam, Suk Jin; Kim, Song Yee; Chang, Yoon Soo; Paik, Hyo Chae

    2015-01-01

    Purpose Anastomotic airway complications are a major cause of morbidity and mortality after lung transplantation (LTx). In this study, the authors identified types and clinical outcomes of airway complications after LTx. Materials and Methods All bronchial anastomotic complications were analyzed in a total of 94 LTx cases involving 90 recipients who underwent surgery between July 2006 and May 2014. Fifteen LTx cases (14 recipients) with incomplete medical records for fiberoptic bronchoscopy (...

  18. Quality control in microarray assessment of gene expression in human airway epithelium

    OpenAIRE

    Attiyeh Marc A; Harvey Ben-Gary; Wang Wei; Hackett Neil R; O'Connor Timothy P; Raman Tina; Dang David T; Teater Matthew; Crystal Ronald G

    2009-01-01

    Abstract Background Microarray technology provides a powerful tool for defining gene expression profiles of airway epithelium that lend insight into the pathogenesis of human airway disorders. The focus of this study was to establish rigorous quality control parameters to ensure that microarray assessment of the airway epithelium is not confounded by experimental artifact. Samples (total n = 223) of trachea, large and small airway epithelium were collected by fiberoptic bronchoscopy of 144 in...

  19. Bronchopulmonary Kaposi's sarcoma in patients with AIDS.

    OpenAIRE

    Mitchell, D. M.; McCarty, M.; Fleming, J.; Moss, F. M.

    1992-01-01

    BACKGROUND: Kaposi's sarcoma is the most common secondary neoplasm to complicate HIV infection and may cause pulmonary disease. METHODS: A prospective study was carried out in 140 consecutive patients who were HIV seropositive and required bronchoscopy for new respiratory symptoms of at least two weeks' duration, with either a chest radiographic abnormality or abnormality of pulmonary function. The patients were classified into those with single local endobronchial lesions of Kaposi's sarcoma...

  20. A rare benign tumor of the lung: Inflammatory myofibroblastic tumor – Case report

    OpenAIRE

    Demirhan, Ozkan; Ozkara, Selvinaz; YAMAN, Mustafa; Kaynak, Kamil

    2013-01-01

    A fifty year old lady who was operated for thyroid cancer two years ago and completed adjuvant therapy, underwent a computer tomography (CT) of the chest during her follow up. The CT showed a mass lesion in the right lung, located to the lateral segment of the middle lobe. There were no intrabronchial lesions on bronchoscopy. Positron emission CT (PET CT) showed a dense hypermetabolic mass located in the right middle lobe lateral segment and having malignant characteristics. A videothorascopi...

  1. Two cases of broncho-pulmonary foregut malformations

    OpenAIRE

    Εleftherios D. Spartalis; Elias Lachanas; Dionisios Pavlopoulos; Othonas P. Michail; Anna Karakatsani; Perikles Tomos

    2009-01-01

    SUMMARY. Congenital broncho-pulmonary malformations are mostly asymptomatic. They are diagnosed during the investigation of a pulmonary infection or after a chest x-ray. Fetal ultrasound, chest x-ray, ventilation-perfusion scan, CT, MRI, barium meal, esophagoscopy, bronchoscopy and digital angiography can be used for further investigation. Surgical excision was our treatment of choice and had a significally good prognosis. Pneumon 2009; 22(2):178–185.

  2. Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure*, **

    OpenAIRE

    Lis, Grzegorz; Cichocka-Jarosz, Ewa; Jedynak-Wasowicz, Urszula; Glowacka, Edyta

    2014-01-01

    Plastic bronchitis (PB), although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enala...

  3. Primary tracheobronchial amyloidosis associated with tracheobronchomegaly evaluated by novel four‐dimensional functional CT

    OpenAIRE

    Uddin, A.K.M. Nizam; Mansfield, Darren R.; Farmer, Michael W.; Lau, Kenneth K.

    2015-01-01

    Abstract Amyloid is a heterogeneous family of extracellular proteinaceous deposits characterized by apple‐green birefringence on polarized light microscopy. There are rare case reports of these extracellular deposits accumulating in the upper and central airways. Progressive infiltration may impair glottic and airway function with some cases requiring intervention to improve flow. Bronchoscopy and lung function testing provide dynamic information to monitor for disease progression; however, t...

  4. DIAGNOSTIC VALUE OF BRONCHOALVEOLAR LAVAGE IN LEUKEMIC AND BONE MARROW TRANSPLANT PATIENTS: THE IMPACT OF ANTIMICROBIAL THERAPY

    OpenAIRE

    John Norman Greene; Abraham Tareq Yacoub; Dani Thomas; Carol Yuan; Frank Walsh; David Solomon; Skai Schwartz; Arthur Andrews

    2014-01-01

    BackgroundPneumonia carries significant morbidity and mortality in leukemic and bone marrow transplant patient.  The development of pulmonary infiltrates in the setting of such immunocompromise raises concern for both infectious and non-infectious etiologies, some of which are potentially treatabl.  Performing bronchoscopy provides several different options for sampling the lower respiratory tract.  Among these, bronchoalveolar lavage (BAL) is especially effective at collecting samples from t...

  5. Pulmonary involvement of peripheral T-cell lymphoma manifesting as crazy paving pattern

    OpenAIRE

    Fraser, Traci; Nagarur, Amulya

    2015-01-01

    Crazy paving pattern is a finding on computed tomography of the chest that is characterized by interlobular septal thickening and ground-glass opacities. Though classically associated with pulmonary alveolar proteinosis, the differential diagnosis for this pattern is broad, and initial workup includes bronchoscopy with bronchoalveolar lavage to evaluate for malignancy, diffuse alveolar hemorrhage, pulmonary alveolar proteinosis, infection, and eosinophilic pneumonia. Herein we present an unus...

  6. A case of cough variant asthma undiagnosed for 16 years

    OpenAIRE

    Sridaran, Sankar; Gonzalez-Estrada, Alexei; Aronica, Mark A.

    2014-01-01

    A 64-year-old female patient presented with a 16-year history of persistent dry cough that was undiagnosed after workups at several healthcare facilities. The patient denies wheezing, shortness of breath or sputum production. Previous workups include chest imaging, transthoracic echocardiogram (TTE), laryngoscopy, spirometry and bronchoscopy, all of which were unremarkable. During her current evaluation, spirometry was ordered again for the patient, which showed a post-bronchodilator improvem...

  7. Bronchopulmonary sequestration in a 60 year old man

    OpenAIRE

    Naffaa, Lena; Tank, Jay; Ali, Sara; Ong, Cesar

    2014-01-01

    We report a case of bronchopulmonary sequestration (BPS) in a 60 year old man with recurrent cough. After failed antibiotic therapy for presumed left lower lobe (LLL) pneumonia seen on chest radiographs, bronchoscopy was performed revealing cryptogenic organizing pneumonia. Further work-up with thoracic imaging demonstrates a feeding artery from the thoracic aorta to the LLL consolidation indicating the presence of BPS. A brief review of the clinical and radiological features and management o...

  8. Bilateral pulmonary nodules in an adult patient with bronchiolitis obliterans-organising pneumonia

    OpenAIRE

    Kopanakis, Antonios; Golias, Christos; Patentalakis, Michalis; Mermigkis, Christos; Charalabopoulos, Alexandros; Peschos, Dimitrios; Batistatou, Anna; Charalabopoulos, Konstantinos

    2009-01-01

    A 58-year-old male ex-smoker was admitted to hospital because of nodular infiltrates on chest x rays. He was complaining of fatigue, dyspnoea with exertion, low grade fever and weight loss. Physical examination was unremarkable. Bronchoscopy was inconclusive but revealed endobronchial lesions of chronic active inflammation. The diagnosis of cryptogenic organising pneumonitis bronchiolitis obliterans-organising pneumonia (COP-BOOP) was established by open lung biopsy. Proliferative bronchiolit...

  9. Kikuchi Fujimoto disease associated with cryptogenic organizing pneumonia: case report and literature review

    OpenAIRE

    Hua Feng; Zhu Lei

    2010-01-01

    Abstract Background The association of Kikuchi Fujimoto disease (KFD) with cryptogenic organizing pneumonia (COP) is extremely rare. We report a case of simultaneous diagnosis of KFD and COP. Case Presentation A 33-year-old male presented with a 1-month cough illness and fever lasting for 5 days. The chest radiograph revealed double lower lobe infiltrate, which was unresponsive to antibiotics. A cervical lymph node was first found in the development of this disease. Bronchoscopy, bronchoalveo...

  10. Not Your Typical Pneumonia: A Case of Exogenous Lipoid Pneumonia

    OpenAIRE

    Simmons, Ashley; Rouf, Emran; Whittle, Jeff

    2007-01-01

    The constellation of chronic cough, dyspnea, and hemoptysis can include a broad range of differential diagnoses. Although uncommon, exogenous lipoid pneumonia (ELP) should be considered when patients present with this symptom complex. We report a case of a 72-year-old female who presented with hemoptysis, cough, and dyspnea. The admission computed tomography scan of the chest revealed progressive interstitial infiltrates. Bronchoscopy revealed diffuse erythema without bleeding. Culture and cy...

  11. Analysis of fatty acids in Ghee and olive oil and their probable causal effect in lipoid pneumonia

    OpenAIRE

    Zein Mirghani; Tayseer Zein; Samuel Annoble; John Winter; Randa Mostafa

    2010-01-01

    Aim: To analyze and identify the fatty acids found in homemade ghee and in olive oil and compare those to fatty acids found in bronchoalevolar lavage of children with lipoid pneumonia.Methods: The fatty acids found in homemade fat ”Ghee” and olive oil were analyzed by gas chromatography. Methyl ester derivatives suitable for GC analysis were prepared directly from olive oil or from Ghee using anhydrous methanolic-HCl. Bronchoscopy and bronchoalevolar lavage was performed in eight children age...

  12. Medical image of the week: sarcoidosis

    OpenAIRE

    Knox KS

    2013-01-01

    A 42 year old African-American man from Indianapolis presented with cough and skin lesions. ACE level was elevated at 86 μg/L. Spirometry was normal except for a diffusing capacity 52% of predicted. Imaging was suggestive of sarcoidosis versus granulomatous infection. Bronchoscopy with bronchoalveolar lavage cytospin revealed a lymphocytic alveolitis (27% lymphocytes) with a CD4:CD8 ratio of 6.2:1 by flow cytometry. Biopsy showed classic noncaseating granulomas and no organisms supportin...

  13. Mounier-Kuhn Syndrome

    OpenAIRE

    Schiettecatte, E.; Hedent, E Van; Van Herreweghe, R; Verstraete, K

    2015-01-01

    Background: A 38-year-old male with no medical history complains about hemoptysis, chest pain, dyspnea on exertion and a cough. He has a history of occasional smoking, but had quitted smoking 1 year previously. There is a normal saturation and normal spirometry. Clinical examination and auscultation are also normal. Because of these complaints CT scan of the thorax was performed. For further diagnostic workup bronchoscopy was performed afterwards.

  14. Pattern of Pulmonary Function Test Abnormalities in Anthracofibrosis of the Lungs

    OpenAIRE

    Mirsadraee, Majid; Asnaashari, Amir; Attaran, Davood

    2012-01-01

    Background The objective of this study was to discuss the spirometric characteristics of anthracofibrosis which is a from of bronchial anthracosis associated with deformity. Materials and Methods Forty anthracofibrosis subjects who were diagnosed with bronchoscopy were enrolled in this prospective study. Static and dynamic spirometry plus lung volumes and diffusion capacity were measured in this group and compared to a healthy control group. Results Dyspnea (95%), cough (86%) and wheezing (68...

  15. Diffuse interstitial lung infiltrates in a smoker with human immunodeficiency virus infection

    OpenAIRE

    Vasudevan, Viswanath P.; Praveen K. Jinnur; Vishal Verma; Sasikanth Nallagatla

    2011-01-01

    Pulmonary Langerhans cell histiocytosis is a rare interstitial lung disease characteristically affecting middle-aged smokers. It has unpredictable clinical course and may be associated with malignant neoplasms. Opportunistic lung infections are frequently considered when patients with Human immunodeficiency virus (HIV) infection present with respiratory symptoms and an abnormal chest X-ray. Though fiberoptic bronchoscopy with bronchoalveolar lavage is diagnostic for infectious etiologies, sur...

  16. Medical image of the week: tooth impaction and extraction

    Directory of Open Access Journals (Sweden)

    Afaq T

    2012-12-01

    Full Text Available A 66-year-old gentleman with a history Friedreich’s ataxia underwent a dental extraction procedure just prior to 4 weeks of traveling abroad. He was seen in emergency room for increasing weakness, cough and low grade fevers. His chest x-ray revealed a foreign body in the right main bronchus (Figure 1. He underwent bronchoscopy with forceps and basket removal of partially impacted teeth from the bronchus intermedius (Figure 2.

  17. Sealing of tracheoesophageal fistula using a Y stent through fiberoptic bronchoscope during general anesthesia under laryngeal mask airway

    OpenAIRE

    Ye, Ling; Yang, Pingliang; Zuo, Yunxia

    2014-01-01

    A 64-yr-old man was admitted because of repeated pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula (15 mm) in the right posterior trachea 1 cm beyond the carina. Coated nickel-titanium shape memory alloy Y shaped stent was planned to seal this fistula under general anesthesia. We took advantage of laryngeal mask airway to insert the fiberoptic bronchoscope to guide the stent placement. Our method of sealing a large tracheoesophageal fistula w...

  18. In vivo endoscopic autofluorescence microspectro-imaging of bronchi and alveoli

    OpenAIRE

    Bourg-Heckly, G.; Thiberville, L.; Vever-Bizet, C.; Viellerobe, B.

    2008-01-01

    Fibered confocal fluorescence microscopy (FCFM) is a new technique that can be used during a bronchoscopy to analyze the nature of the human bronchial and alveolar mucosa fluorescence microstructure. An endoscopic fibered confocal fluorescence microscopy system with spectroscopic analysis capability was developed allowing real-time, simultaneous images and emission spectra acquisition at 488 nm excitation using a flexible miniprobe that could be introduced into small airways. This flexible 1....

  19. Production of mucoid microcolonies by Pseudomonas aeruginosa within infected lungs in cystic fibrosis.

    OpenAIRE

    Lam, J; Chan, R.; Lam, K.; Costerton, J W

    1980-01-01

    Direct electron microscopic examination of postmortem lung material from cystic fibrosis patients infected with Pseudomonas aeruginosa has shown that these bacterial cells form distinct fiber-enclosed microcolonies in the infected alveoli. Similar examination of bronchoscopy material from infected cystic fibrosis patients showed that the fibres of the enveloping matrix are definitely associated with the bacterial cells. The fibers of the extracellular matrix stain with ruthenium red and are t...

  20. Airway Management in a Mental Retardation Patient with Temporo-mandibular Joint Ankylosis

    Directory of Open Access Journals (Sweden)

    Rauf GÜL

    2012-01-01

    Full Text Available Temporo-mandibular joint (TMJ ankylosis makes it impossible orotracheal intubation for general anesthesia because of limited mouth opening. We applied a nasotracheal intubation via fiberoptic bronchoscopy (FOB guidance on a 36 years old mental retarded (MR patient with bilateral TMJ, having extremely limited mouth opening. As a result, nasotracheal intubation via FOB is reliable technique on even mental retarded patients with extremely limited opening.

  1. A rare case report of tracheal leech infestation in a 40-year-old woman

    OpenAIRE

    Zhang, Peng; Zhang, Rui; Zou, Jian; Zhu, Tao

    2014-01-01

    Leeches are the very rare types of airway foreign body. Here we report a rare case of a 40-year-old woman with tracheal leech infestation. A 40-year-old woman presented 2-month history of dyspnea, occasional haemoptysis. There were foreign body sensation in throat, cough and hoarseness. Computed Tomography (CT) revealed some soft tissue shadow in the upper trachea. Eventually a 5 cm long living leech was smoothly removed from trachea by rigid bronchoscopy under sevoflurane general anesthesia....

  2. Endobronchial Ultrasound Changed the World of Lung Cancer Patients: A 11-Year Institutional Experience.

    Directory of Open Access Journals (Sweden)

    Chia-Hung Chen

    Full Text Available The role of advanced bronchoscopic diagnostic techniques in the detection and staging of lung cancer has increased sharply in recent years. The development of endobronchial ultrasound (EBUS improved minimally invasive mediastinal staging and diagnosis of peripheral lung lesions (PLLs. We investigated the impact of using EBUS as a diagnostic method for tissue acquisition in lung cancer patients.In a single center observational retrospective study, 3712 subjects were diagnosed with lung cancer from 2003 to 2013 (EBUS was introduced in 2008. Thus, we divided the data into two periods: the conventional bronchoscopy period (2003 to 2007 and the EBUS period (2008 to 2013.A total of 3712 patients were included in the analysis. Comparing the conventional bronchoscopy period with the EBUS period data, there has been a significant reduction in the use of diagnostic modalities: CT-guided biopsy (P < 0.0001 and pleural effusion cytology (P < 0.0001. The proportion of subjects diagnosed using bronchoscopy significantly increased from 39.4% in the conventional period to 47.4% in the EBUS period (P < 0.0001. In the EBUS period, there has also been a significant increase in the proportion of patients proceeding directly to diagnostic surgery (P < 0.0001. Compared to bronchoscopy, the incidence of complications was higher in those who underwent CT guide biopsy. The incidence of iatrogenic pneumothorax significantly decreased in the EBUS period.Advanced bronchoscopic techniques are widely used in the diagnosis of lung cancer. At our institution, the increasing use of EBUS for providing lung cancer diagnosis has led to a significant reduction in other diagnostic modalities, namely CT-guided biopsy and pleural effusion cytology. These changes in practice also led to a reduction in the incidence of complications.

  3. Metabolomic analysis of bronchoalveolar lavage fluid from cystic fibrosis patients

    OpenAIRE

    Wolak, Justyna E.; Esther, Charles R.; O’Connell, Thomas M.

    2009-01-01

    Metabolite profiles of bronchoalveolar lavage fluid (BALF) from pediatric patients with cystic fibrosis (CF) were correlated to the degree of airway inflammation using nuclear magnetic resonance spectroscopy-based metabolomics. BALF was collected from 11 children with CF during clinically indicated bronchoscopy. The spectra from BALF with high levels of neutrophilic airway inflammation displayed signals from numerous metabolites, whereas the spectra from subjects with low levels of inflammati...

  4. Tracheal agenesis: A rare but fatal congenital anomaly

    OpenAIRE

    Ergun, Suzan; Tewfik, Ted; Daniel, Sam

    2011-01-01

    In this report we describe a newborn with a rare case of Type II tracheal agenesis and bronchoesophageal fistula. Polyhydramnios and suspected esophageal atresia were identified during routine pre-natal ultrasound screening. Upon delivery, rigid bronchoscopy, esophagoscopy, and intraoperative fluoroscopy were performed, where both bronchi and the carina showed unusual horizontal orientation making it difficult to identify the fistula. However, a post mortem CT confirmed the diagnosis of an is...

  5. AUTOIMMUNE HEMOLYTIC ANEMIA IN A PATIENT WITH ENDOBRONCHIAL TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Sangeeth Kumar

    2013-04-01

    Full Text Available ABSTRACT - A 23 year old male presented with severe autoimmune hemolytic anemia in association with constitutional symptoms suggest ive of TB with calcified lesion on X ray chest. A diagnosis of endobronchial TB was c onfirmed with bronchoscopy and sputum for Ziehl Neelsen stain was positive and the patient responded to antituberculosis treatment. There are few case reports of auto immune hemolytic anemia with endobronchial TB.

  6. Serious complications of an obstructive upper airway infection in a young child

    OpenAIRE

    2009-01-01

    A 15-month old boy was admitted to our intensive care unit (ICU) cyanotic, unresponsive, apneic, pulseless, with fixed, dilated pupils and a Glasgow Coma Score (GCS) of 3/15. Prompt cardiopulmonary resuscitation (CPR) was initiated and cardiac function was resumed after 10 minutes. The boy was intubated but could not be ventilated because of a thick, viscous secretion obstructing the trachea and causing total airway obstruction. Bronchoscopy revealed laryngotracheitis as the reason for airway...

  7. Pulmonary alveolar proteinosis induced by hydrofluoric acid exposure during fire extinguisher testing

    OpenAIRE

    Kim, Yujin; Shin, JiYoung; Kang, ShinMyung; Kyung, SunYoung; Park, Jeong-woong; Lee, SangPyo; Lee, Sangmin; Jeong, Sung Hwan

    2015-01-01

    Introduction Automatic fire suppression systems use hydrofluorocarbons (HF) to extinguish fires chemically. At high temperatures, HF can release hydrofluoric acid (HFA), a toxic, potentially lethal gas. Case report A 52-year-old male visited our Pulmonary Division with dyspnea of 8-months duration. He had been working at a facility that manufactured fire extinguishers. Bronchoscopy was performed and a transbronchial lung biopsy was taken from the right lower lobe. After the patient was diagno...

  8. Unmasking of tracheomalacia following short-term mechanical ventilation in a patient of adult respiratory distress syndrome

    OpenAIRE

    Hegde, Harihar V; Bhat, Ravi L; Shanbag, Raghunath D; M P Bharat; P Raghavendra Rao

    2012-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are susceptible to airway malacia, which may be unmasked following mechanical ventilation or tracheostomy decannulation. Dynamic imaging of central airways, a non-invasive test as effective as bronchoscopy to diagnose airway malacia, has increased the recognition of this disorder. We describe a 70-year-old woman admitted with adult respiratory distress syndrome. She had cardiorespiratory arrest on admission, from which she was success...

  9. A Case of Significant Endobronchial Injury due to Recurrent Iron Pill Aspiration

    OpenAIRE

    Kwak, Joo-Hee; Koo, Gun woo; Chung, Sung Jun; Park, Dong Won; Kwak, Hyun Jung; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Pyo, Ju Yeon; Oh, Young-Ha; Kim, Tae-Hyung

    2015-01-01

    Gastric mucosal damage by iron pills is often reported. However, iron pill aspiration is uncommon. Oxidation of the impacted iron pill causes bronchial mucosal damage that progresses to chronic bronchial inflammation, necrosis, endobronchial stenosis and rarely, perforation. We reported a case of a 92-year-old woman with chronic productive cough and significant left-sided atelectasis. Bronchoscopy revealed substantial luminal narrowing with exudative inflammation of the left main bronchus. Br...

  10. Successful non-operative management of a contained tracheal tear following iatrogenic endotracheal tube injury

    Directory of Open Access Journals (Sweden)

    Valerie Luks

    2014-12-01

    Full Text Available We describe the case of a 5-year-old girl who was intubated in the field and sustained a severe tracheal injury resulting in a pneumothorax and extensive subcutaneous emphysema. She was treated without operative intervention and this tracheal tear was observed by serial bronchoscopy. After 6 weeks the trachea was well healed; in select cases non-operative management is a safe and effective strategy for contained tracheal injuries.

  11. Induced sputum in HIV- infected patients: diagnosis of acute pulmonary diseases Escarro induzido nos pacientes infectados pelo HIV: diagnóstico das doenças pulmonares agudas

    OpenAIRE

    Glória Maria de Oliveira; Alexander Magno Cordeiro; Giovanni Antonio Marsico; Juan Miguel Rentería; Carlos Alberto Guimarães

    2009-01-01

    OBJECTIVE: To make a narrative review of the accuracy of induced sputum for diagnosis of pulmonary disease in HIV-infected patients. Data sources: The MEDLINE, LILACS, EMBASE and the Cochrane Library were searched. reference lists, abstracts of conference proceedings and scientific meetings were hand searched. METHODS: Study selection: Fifteen articles that specifically addressed the stated purpose were selected. Data extraction: Yield of sputum induction and fiberoptic bronchoscopy with bron...

  12. Clinical risk factors and bronchoscopic features of invasive aspergillosis in Intensive Care Unit patients

    OpenAIRE

    ALIYALI, M.; HEDAYATI, M.T.; HABIBI, M.R.; KHODAVAISY, S.

    2013-01-01

    Summary Introduction. Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunocompromised patients. During recent years, a rising incidence of IA in Intensive Care Unit (ICU) patients has been reported. The patterns of IA related infection may differ according to the type of underlying disease. Unfortunately little is known about the characteristics of IA in ICU patients. In the present study we assessed IA related clinical and bronchoscopy findings in ICU patien...

  13. Endobronchial metastasis in breast cancer.

    OpenAIRE

    Albertini, R E; Ekberg, N L

    1980-01-01

    Ten patients with endobronchial metastasis from primary breast cancer were found among 1200 fibreoptic bronchoscopies. Six of these patients had radiological signs suggesting bronchial obstruction. The diagnosis was verified in nine cases by means of bronchoscopic biopsy or cytology and in one by thoracotomy. Endobronchial metastasis should be considered when symptoms or chest films suggest endobronchial disease in a patient with a history of breast cancer.

  14. Management of a congenital tracheoesophageal fistula in a young Spanish water dog

    OpenAIRE

    Kaminen, Pia S; Viitanen, Sanna J; Lappalainen, Anu K.; Kipar, Anja; Rajamäki, Minna M.; Laitinen-Vapaavuori, Outi M

    2014-01-01

    Background Tracheoesophageal fistula (TEF) in dogs is a rare disease with only few reports in the literature. This report aims to contribute to the current literature on suitable diagnostic methods for TEF and to provide follow-up information after successful surgical treatment. Case presentation A seven-month-old intact female Spanish Water Dog was presented for further investigation of recurrent respiratory symptom. Bronchoscopy revealed a small hole-like defect in the tracheal wall at the ...

  15. Management of a congenital tracheoesophageal fistula in a young Spanish water dog

    OpenAIRE

    Kaminen, P S; Viitanen, S J; A.K. Lappalainen; Kipar, A.; Rajamäki, M M; Laitinen-Vapaavuori, O M

    2014-01-01

    BACKGROUND: Tracheoesophageal fistula (TEF) in dogs is a rare disease with only few reports in the literature. This report aims to contribute to the current literature on suitable diagnostic methods for TEF and to provide follow-up information after successful surgical treatment. CASE PRESENTATION: A seven-month-old intact female Spanish Water Dog was presented for further investigation of recurrent respiratory symptom. Bronchoscopy revealed a small hole-like defect in the tracheal wall at...

  16. Left lower lobe torsion following upper lobectomy-prompt recognition and treatment improve survival

    OpenAIRE

    Alassar, Aiman; Marchbank, Adrian

    2014-01-01

    Lobar torsion is a rare but life-threatening complication after lung resection. We report a case of left lower lobe torsion in 57-year-old women after upper lobectomy for underlying lung cancer. Definitive diagnosis of lung torsion was made at exploratory thoracotomy following abnormal chest radiography and bronchoscopy on the first post-operative day. An emergency completion pneumonectomy was performed and left lower lobe was resected. The post-operative course was uncomplicated and patient ...

  17. Iatrogenic Pulmonary Nodule in a Heart Transplant Recipient

    OpenAIRE

    Mehta, Atul C.; Juan Wang; Jarmanjeet Singh; Joseph Cicenia

    2014-01-01

    A 58-year-old female with a history of non-Hodgkin lymphoma and end-stage nonischemic cardiomyopathy from Adriamycin toxicity underwent orthotic heart transplantation during June 2013. She developed shortness of breath in September 2013 and was suspected to have invasive pulmonary aspergillosis. A flexible bronchoscopy (FB) with a transbronchial biopsy (TBBx) was performed. She was found to have a focal lung nodule in the same location at the site of the TBBx on day 13 after the FB. Spontaneo...

  18. An audit of morbidity and mortality associated with foreign body aspiration in children from a tertiary level hospital in Northern India

    Directory of Open Access Journals (Sweden)

    Aparna Williams

    2014-01-01

    Full Text Available Background: There is paucity of data regarding the morbidity and mortality of rigid bronchoscopy in children for foreign body (FB retrieval from India. The aim was to audit data regarding anaesthetic management of rigid bronchoscopy in children and associated morbidity and mortality. Materials and Methods: Hospital records of all patients below 18 years of age undergoing rigid bronchoscopy for suspected FB aspiration (FBA between January 1, 2002 and December 31, 2011 were audited to assess their demographic profile, anaesthetic management, complications, and postoperative outcomes. The children were divided into early and late diagnosis groups depending on whether they presented to the hospital within 24 hours of FBA, or later. Results: One hundred and forty children, predominantly male (75%, with an average age of 1-year and 8 months, presented to our hospital for rigid bronchoscopy during the study period. Majority of children presented in the late diagnosis group (59.29% vs. 40.71%. The penetration syndrome was observed in 22% of patients. Majority of patients aspirated an organic FB (organic: Inorganic FB = 3:1, with peanuts being the most common (49.28%. A significantly higher number of children presented with cough (P = 0.0001 and history of choking (P = 0.0022 in the early diagnosis group and crepitations (P = 0.0011 in the late diagnosis group. Major complications included cardiac arrest (2.1%, pneumothorax (0.7%, and laryngeal oedema (9.3%. The average duration of hospitalization in our series was 3.08 ± 0.7 days. Conclusions: Foreign body aspiration causes considerable morbidity, especially when diagnosis is delayed.

  19. Vocal Hoarseness and a Subglottic Mass

    OpenAIRE

    Rafizadeh, Sassan; Yoneda, Ken; Zeki, Amir A.

    2015-01-01

    We report a patient with tracheopathia osteoplastica (TPO), a rare or perhaps underrecognized disorder, detected in approximately 1 in every 2000 to 5000 patients who undergo bronchoscopy. TPO is marked by proliferation of bony and cartilaginous spurs leading to airway stenosis. Multiple submucosal cartilaginous and osseous nodules can develop in the respiratory tract and may involve the entire trachea and mainstem bronchi. Symptoms may range from a completely silent condition to life-threate...

  20. Bronchial inflammation in chronic bronchitis assessed by measurement of cell products in bronchial lavage fluid.

    OpenAIRE

    Riise, G. C.; Ahlstedt, S.; Larsson, S.; Enander, I.; Jones, I; Larsson, P.; Andersson, B

    1995-01-01

    BACKGROUND--Bronchial inflammation in chronic bronchitis has not been characterised as well as in asthma. The present study was undertaken to assess whether a characteristic pattern of bronchial inflammatory markers could be found in patients with chronic bronchitis. METHODS--Bronchoscopy with bronchial lavage was performed in 42 patients with chronic bronchitis and in 13 healthy controls. Twenty three of the patients had non-obstructive chronic bronchitis and 19 had chronic bronchitis and ch...

  1. Comprehensive diagnosis and treatment of patients with deforming bronchitis

    International Nuclear Information System (INIS)

    A total of 1067 patients aged from 15 to 82 years who suffered from deforming bronchitis were examined. All the patients underwent X-ray examination, forced external respiration test, bronchofibroscopy with biopsy and radionuclide study of the lungs whose results were the basis for establishing a diagnosis of deforming bronchitis with an accuracy of 99,8%. Therapeutical bronchoscopies made in patients with deforming bronchitis were an effective therapeutical tool in 96,9-98,1% of cases

  2. Localized Tracheal Amyloidosis

    OpenAIRE

    Juričevski, Ivan; Vrčić, Mihovil; Vrčić, Alka; Budimir, Ivan; Križanac, Šimun; Tuđman, Zdenko; Varga, Damir

    2005-01-01

    Amyloidosis is a disorder characterized by localized or diffuse deposition of fibrillary proteins in the extracellular space, causing progressive damage to tissue structure and organ function. Any organ system of the body may be involved by amyloidosis. A case is presented of localized tracheal amyloidosis in a 62-year-old man treated for active lung tuberculosis. Among other procedures, diagnostic workup included bronchoscopy, which revealed tumor-like lesions of tracheal mucosa. Histologic ...

  3. SHOX2 DNA Methylation is a Biomarker for the diagnosis of lung cancer based on bronchial aspirates

    Directory of Open Access Journals (Sweden)

    Liloglou Triantafillos

    2010-11-01

    Full Text Available Abstract Background This study aimed to show that SHOX2 DNA methylation is a tumor marker in patients with suspected lung cancer by using bronchial fluid aspirated during bronchoscopy. Such a biomarker would be clinically valuable, especially when, following the first bronchoscopy, a final diagnosis cannot be established by histology or cytology. A test with a low false positive rate can reduce the need for further invasive and costly procedures and ensure early treatment. Methods Marker discovery was carried out by differential methylation hybridization (DMH and real-time PCR. The real-time PCR based HeavyMethyl technology was used for quantitative analysis of DNA methylation of SHOX2 using bronchial aspirates from two clinical centres in a case-control study. Fresh-frozen and Saccomanno-fixed samples were used to show the tumor marker performance in different sample types of clinical relevance. Results Valid measurements were obtained from a total of 523 patient samples (242 controls, 281 cases. DNA methylation of SHOX2 allowed to distinguish between malignant and benign lung disease, i.e. abscesses, infections, obstructive lung diseases, sarcoidosis, scleroderma, stenoses, at high specificity (68% sensitivity [95% CI 62-73%], 95% specificity [95% CI 91-97%]. Conclusions Hypermethylation of SHOX2 in bronchial aspirates appears to be a clinically useful tumor marker for identifying subjects with lung carcinoma, especially if histological and cytological findings after bronchoscopy are ambiguous.

  4. Comparison of imaging techniques in the diagnosis of bridging bronchus.

    Science.gov (United States)

    Baden, W; Schaefer, J; Kumpf, M; Tzaribachev, N; Pantalitschka, T; Koitschev, A; Ziemer, G; Fuchs, J; Hofbeck, M

    2008-05-01

    Bridging bronchus (BB) is a rare, congenital bronchial anomaly that is frequently associated with congenital cardiac malformations, especially left pulmonary artery sling. It represents an anomalous bronchus to the right originating from the left main bronchus. Discrimination from other bronchial anomalies is important, since BB is frequently associated with bronchial stenoses due to abnormal cartilage rings. This case study describes the findings of bronchoscopy, bronchography and multidetector computed tomography (MDCT) in three patients. Bronchoscopy was helpful in the description of the severity and length of bronchial stenoses. However, it was not possible to establish a diagnosis of BB based on this method in two patients, since it is difficult or even impossible to differentiate the bifurcation from the pseudocarina. It was not possible to establish the correct diagnosis in all patients based on bronchography or MDCT. MDCT was able to depict the relationship of bronchial and vascular structures, which is particularly important in patients with pulmonary artery sling. Multidetector computed tomography is preferable to bronchography as it is less invasive and due to its short acquisition time it can be performed in children with severe respiratory disease. In the current authors' experience, detection of cartilage rings still requires flexible bronchoscopy. PMID:18448507

  5. Kasus Serial : Aspirasi Peluit pada Anak

    Directory of Open Access Journals (Sweden)

    Aci Mayang Sari

    2015-01-01

    Full Text Available AbstrakKasus aspirasi benda asing selalu memberikan tantangan bagi dokter spesialis Telinga Hidung TenggorokKepala dan Leher (THT-KL. Aspirasi benda asing lebih sering terjadi pada anak-anak khususnya pada umur 1-3tahun dan jarang terjadi pada dewasa. Aspirasi peluit pada anak merupakan kasus yang banyak terjadi pada golonganbenda asing anorganik. Untuk menegakkan diagnosis aspirasi benda asing diperlukan ketajaman anamnesis,pemeriksaan fisik dan hasil radiografi. Bronkoskopi merupakan teknik yang digunakan sebagai alat diagnostik danterapeutik pada kasus aspirasi benda asing. Kasus aspirasi peluit pada tiga orang anak (2 laki-laki dan 1 perempuantelah dilaporkan dan ditatalaksana menggunakan teknik bronkoskopi kaku.Kata kunci: Aspirasi benda asing, benda asing peluit, bronkoskopiAbstractForeign body aspiration continues to provide challenges for otorhinolaryngologists. Foreign body aspiration ismore common in children, especially at the age of 1-3 years and rarely occurs in adults. Whistle aspiration in childrenis a case that occurs in many inorganic foreign body type. The diagnosis of foreign body aspiration based ondiscernment anamnesis, physical examination and radiographic results. Bronchoscopy is a technique that is used as adiagnostic and therapeutic tool in cases of foreign body aspiration.Cases of whistle aspiration in 3 children (2 malesand 1 femalewas reported and treated using rigid bronchoscopy technique. Arial 9 italicKeywords: foreign body aspiration, a whistle foreign body, bronchoscopy.

  6. SHOX2 DNA Methylation is a Biomarker for the diagnosis of lung cancer based on bronchial aspirates

    International Nuclear Information System (INIS)

    This study aimed to show that SHOX2 DNA methylation is a tumor marker in patients with suspected lung cancer by using bronchial fluid aspirated during bronchoscopy. Such a biomarker would be clinically valuable, especially when, following the first bronchoscopy, a final diagnosis cannot be established by histology or cytology. A test with a low false positive rate can reduce the need for further invasive and costly procedures and ensure early treatment. Marker discovery was carried out by differential methylation hybridization (DMH) and real-time PCR. The real-time PCR based HeavyMethyl technology was used for quantitative analysis of DNA methylation of SHOX2 using bronchial aspirates from two clinical centres in a case-control study. Fresh-frozen and Saccomanno-fixed samples were used to show the tumor marker performance in different sample types of clinical relevance. Valid measurements were obtained from a total of 523 patient samples (242 controls, 281 cases). DNA methylation of SHOX2 allowed to distinguish between malignant and benign lung disease, i.e. abscesses, infections, obstructive lung diseases, sarcoidosis, scleroderma, stenoses, at high specificity (68% sensitivity [95% CI 62-73%], 95% specificity [95% CI 91-97%]). Hypermethylation of SHOX2 in bronchial aspirates appears to be a clinically useful tumor marker for identifying subjects with lung carcinoma, especially if histological and cytological findings after bronchoscopy are ambiguous

  7. The characteristics of Greek training and experience in pulmonary endoscopic techniques: Is it time for changes?

    Directory of Open Access Journals (Sweden)

    Grigoris Stratakos

    2011-01-01

    Full Text Available SUMMARY.OBJECTIVES. This study aimed to report the characteristics of thetraining in pulmonary endoscopy provided in Greece and to evaluatequantitive and qualitive parameters of interventional endoscopyperformance among Greek pneumonologists. METHOD. A speciallydesigned questionnaire was completed by 171 specialists and fellowsin pulmonology and the responses were analyzed. RESULTS. An agedifference in endoscopic skills was observed; 97% of the respondentsaged 50 years (p=0.016. In spite of a high rateof training, 65% of respondents reported performing less than 50bronchoscopies per year. In addition, 21% were familiar with thetechnique of transbronchial needle aspiration (ΤΒΝΑ, but only 19%of them performed over 30 procedures per year. Other advanceddiagnostic techniques including endobronchial ultrasound (EBUS,auto-fluorescence and medical thoracoscopy are performed by asmall minority of pulmonologists while therapeutic techniques (i.e.rigid bronchoscopy, electrocautery, cryotherapy and laser therapyby very few (5-12%. The majority of respondents would welcomeadditional training, not only in advanced interventional techniquesbut also in standard bronchoscopy; 94% agreed that they wouldbenefit from the publication of practice guidelines on endoscopictechniques, and 71% supported the instruction in endoscopy ofall pulmonologists during their fellowship. CONCLUSIONS. Theendoscopic training provided to Greek pneumonologists could beimproved considerably and initiatives should be taken in order toupgrade and unify both the teaching of endoscopic techniques andthe services provided. Pneumon 2011, 24(1:48-55.

  8. Tracheobronchial Involvement of Rosai-Dorfman Disease: Case Report and Review of the Literature.

    Science.gov (United States)

    Boissière, Louis; Patey, Martine; Toubas, Olivier; Vella-Boucaud, Juliette; Perotin-Collard, Jeanne-Marie; Deslée, Gaëtan; Lebargy, Francois; Dury, Sandra

    2016-02-01

    Rosai-Dorfman Disease (RDD) is a rare non-neoplastic entity, also known as sinus histiocytosis with massive lymphadenopathy (SHML), characterized by a benign proliferation of histiocytes in lymph nodes. Localized forms of RDD involving the tracheobronchial tree are very rare. There is no consensus regarding the management of central airway forms and recurrence is frequent.We report the case of an 81-year-old Caucasian woman admitted in 2014 for chronic cough. Her main medical past history included a diagnosis of sinonasal RDD in 1996 with recurrent obstructive rhinosinusitis requiring repeated sinonasal surgery, and a diagnosis of tracheal RDD in 2010 with 2 asymptomatic smooth lesions (5 and 7 mm) on the anterior tracheal wall. Physical examination was normal in 2014. Pulmonary function tests showed an obstructive pattern. Computed tomographic scan revealed a mass arising from the anterior wall of the trachea that projects into the tracheal lumen. Fiberoptic bronchoscopy showed a hypervascular multilobular lesion (2 cm) arising from the anterior tracheal wall and causing 50% obstruction of the tracheal lumen. Mechanical resection with electrocoagulation of the tracheal mass was performed by rigid bronchoscopy with no complication. Histological examination demonstrated tracheal RDD. One year after endotracheal resection, the patient presented no recurrence of cough and the obstructive pattern had resolved.Reports on tracheobronchial involvement are scarce. Symptomatic tracheobronchial obstruction requires mechanical resection by rigid bronchoscopy or surgery. Recurrence is frequent, justifying long-term follow-up. PMID:26886634

  9. Air-Q laryngeal airway for rescue and tracheal intubation.

    Science.gov (United States)

    Ads, Ayman; Auerbach, Frederic; Ryan, Kelly; El-Ganzouri, Abdel R

    2016-08-01

    We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report. All personal identifiers that could lead to his identification have been removed from this report. A 59-year-old man was scheduled for a flexible and rigid bronchoscopy with possible laser excision of tracheal stenosis. He had a history of hypertension, atrial fibrillation, and diabetes. Assessment of airway revealed a thyromental distance of 6.5 cm, Mallampati class II, and body weight of 110 kg. He had hoarseness and audible inspiratory/expiratory stridor with Spo2 90% breathing room air. After induction and muscle relaxation, tracheal intubation and flexible bronchoscopy were achieved without incident. The patient was then extubated and a rigid bronchoscopy was attempted but failed with Spo2 dropping to 92%; rocuronium 60 mg was given, and reintubation was accomplished with a 7.5-mm endotracheal tube. A second rigid bronchoscopy attempt failed, with Spo2 dropping to 63%. Subsequent direct laryngoscopy revealed a bloody hypopharynx. A size 4.5 Air-Q LA was placed successfully and confirmed with capnography, and Spo2 returned to 100%. The airway was suctioned through the Air-Q LA device, and the airway was secured using a fiberoptic bronchoscope to place an endotracheal tube of 7.5-mm internal diameter. The case was canceled because of edema of the upper airway from multiple attempts with rigid bronchoscopy. The patient was transported

  10. Treatment of intrathoracic grass awn migration with video-assisted thoracic surgery in two dogs.

    Science.gov (United States)

    Shamir, Shelly; Mayhew, Philipp D; Zwingenberger, Allison; Johnson, Lynelle R

    2016-07-15

    CASE DESCRIPTION A 17-month-old sexually intact male Vizsla and a 2-year-old spayed female mixed-breed dog were examined because of suspected intrathoracic grass awn migration. CLINICAL FINDINGS Thoracic CT revealed focal areas of pulmonary infiltration in the right caudal lung lobe in one dog and in the left caudal lung lobe in the other. In 1 patient, bronchoscopy revealed 2 grass awns in the bronchi. Results of thoracic radiography and bronchoscopy were unremarkable in the second patient; however, a grass awn was recovered from the tonsillar crypt during oropharyngeal examination. TREATMENT AND OUTCOME In both dogs, grass awns were successfully retrieved from the pleural cavity by means of video-assisted thoracic surgery during 1-lung ventilation. In one patient, a grass awn was recovered bronchoscopically from the left caudal lung lobe bronchus and another was visualized distally in an accessory lung lobe bronchus but could not be retrieved. This dog underwent accessory lung lobectomy. The second dog underwent left caudal lung lobectomy. Both patients recovered uneventfully from surgery, were discharged from the hospital, and had no apparent recurrence of clinical signs at telephone follow-up 31 months and 18 months after surgery. CLINICAL RELEVANCE With careful case selection, successful management of intrathoracic grass awn migration in dogs can be achieved by means of video-assisted thoracic surgery. Comprehensive preoperative evaluation including both computed tomography and bronchoscopy is suggested. Further investigation is necessary to evaluate whether treatment of this condition with video-assisted thoracic surgery is as effective as with traditional open thoracotomy. PMID:27379598

  11. Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment

    International Nuclear Information System (INIS)

    Objective: To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. Methods: A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. Results: The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most commonly pneumonia), which were found to be associated with longer aspiration time (p = 0.03). Mechanical ventilation was required in 7 children (10.1%), and multiple bronchoscopies were performed in 5 (7.2%). Conclusions: A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention at children younger than three years of age. (author)

  12. Bronchofibroscope-assisted percutaneous dilatational tracheostomy%纤维支气管镜辅助下经皮气管切开术7例报告

    Institute of Scientific and Technical Information of China (English)

    杨弋; 黄魏宁

    2011-01-01

    Objective To investigate bronchoscopy in percutaneous dilatational tracheostomy applications. Methods During percutaneous dilatational tracheostomy, bronchoscopy was used for real-time monitoring the trachea of 7 cases. Results All patients with successful surgery, the operation time of an average of 12 minutes, mean blood loss of about 5 ml. One case of postoperative bleeding of about 20ml, local wound gauze packing to stop bleeding. Conclusion Bronchoscopy-assisted Percutaneous tracheotomy used for confirming the accuracy of the needle and guide wire into the trachea, can improve the reliability of operation.%目的 探讨纤维支气管镜在经皮气管切开术中的应用.方法 在进行经皮气管切开术的同时应用纤维支气管镜实时监视气管内情况7例.结果 全部患者手术顺利,手术操作时间平均12分钟,术中出血平均约5 ml.其中1例患者术后渗血约20ml,局部伤口填塞止血纱布后血止.结论 纤维支气管镜应用于经皮气管切开手术证实穿刺针和导丝是否准确进入气管,可以提高手术的可靠性与安全性.

  13. Bronchus sign on thin-section computed tomography is a powerful predictive factor for successful transbronchial biopsy using endobronchial ultrasound with a guide sheath for small peripheral lung lesions: a retrospective observational study

    International Nuclear Information System (INIS)

    Recent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed. We retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients). The total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8–79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions. Our results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS

  14. Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

    International Nuclear Information System (INIS)

    The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs

  15. Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)

    1998-05-01

    The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs.

  16. A prospective cohort study: probe based confocal laser endomicroscopy for peripheral pulmonary lesions (Conference Presentation)

    Science.gov (United States)

    Matsumoto, Yuji; Izumo, Takehiro; Hiraishi, Yoshihisa; Tsuchida, Takaaki

    2016-03-01

    Introduction: The diagnostic value of bronchoscopy for peripheral pulmonary lesions (PPLs) has improved since the application of radial endobronchial ultrasound (R-EBUS). Though R-EBUS indicates the position of the PPL, there is often a discrepancy between the obtained R-EBUS image and the diagnostic outcome. Meanwhile, probe based confocal laser endomicroscopy (pCLE) is a novel technique which provides in vivo real-time image of the contacted surface structures. However, its findings have not been established yet. Methods: Consecutive patients who have underwent bronchoscopy for PPLs were prospectively enrolled. R-EBUS with a guide sheath (GS) was inserted to the target PPL under X-ray fluoroscopic guidance. When an adequate R-EBUS image (within or adjacent to) was obtained, pCLE was sequentially inserted through the GS. Then pCLE image was scanned and biopsy was performed where an abnormal finding was estimated. The pCLE findings of PPLs and the background were recorded and analyzed exploratorily. Results: We analyzed 19 cases that we could get appropriate tissues. In all cases, bronchial walls showed longitudinal elastic fibers whereas alveolar walls formed grid-like elastic fiber networks. Conversely, discontinuous, crushed or aggregated alveolar structures accompanied by thickened and distorted fibers were detected in PPLs. Some cases showed dark hollow with fragmented or granular fluorescence. On the other hand, 11 cases (57.9%) indicated normal elastic fibers and needed the position change (3 cases; approached other bronchus, 6 cases; adjusted the position, 2 cases; penetrated the covered bronchial wall). Conclusion: The pCLE has a potential to improve the efficacy of diagnostic bronchoscopy for PPLs.

  17. Eosinophilic pleural effusion complicating allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Kirschner, Austin N; Kuhlmann, Erica; Kuzniar, Tomasz J

    2011-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is primarily a disease of patients with cystic fibrosis or asthma, who typically present with bronchial obstruction, fever, malaise, and expectoration of mucus plugs. We report a case of a young man with a history of asthma who presented with cough, left-sided pleuritic chest pain and was found to have lobar atelectasis and an eosinophilic, empyematous pleural effusion. Bronchoscopy and sputum cultures grew Aspergillus fumigatus, and testing confirmed strong allergic response to this mold, all consistent with a diagnosis of ABPA. This novel and unique presentation of ABPA expands on the differential diagnosis of eosinophilic pleural effusions. PMID:21311176

  18. Cough quality in children: a comparison of subjective vs. bronchoscopic findings

    Directory of Open Access Journals (Sweden)

    Cox Nancy C

    2005-01-01

    Full Text Available Abstract Background Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors. The study aims were to compare (1 cough quality (wet/dry and brassy/non-brassy to bronchoscopic findings of secretions and tracheomalacia respectively and, (2 parent's vs clinician's evaluation of the cough quality (wet/dry. Methods Cough quality of children (without a known underlying respiratory disease undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6. Kappa (K statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy. Results Median age of the 106 children (62 boys, 44 girls enrolled was 2.6 years (IQR 5.7. Parent's assessment of cough quality (wet/dry agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93. When compared to bronchoscopy (bronchoscopic secretion grade 4, clinicians' cough assessment had the highest sensitivity (0.75 and specificity (0.79 and were marginally better than parent(s. The area under the ROC curve was 0.85 (95%CI 0.77–0.92. Intra-observer (K = 1.0 and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94 was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1. Sensitivity and specificity for brassy cough (for tracheomalacia were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86. Conclusions Dry and wet cough in children, as determined by clinicians and

  19. Pulmonary zygomycosis in a diabetic patient

    Directory of Open Access Journals (Sweden)

    Anuradha K

    2006-01-01

    Full Text Available We report a case of pulmonary zygomycosis in an adult male diabetic patient who presented with fever and altered sensorium initially and later developed streaky haemoptysis. Bronchoscopy showed picture of necrotizing pneumonia. Sputum was negative for fungal elements on admission but later bronchial wash and repeat sputum samples were positive by microscopy and culture showed growth of Rhizopus species. Immediately the patient was put on amphotericin B but had a bout of massive haemoptysis and succumbed. A high index of suspicion is needed for an early diagnosis and aggressive treatment of this infection in view of the high mortality rate.

  20. Fluoroscopy-Guided Treatment of a Bronchopleural Fistula with a Platinum Vascular Occlusion Coil and N-butly-2-cyanoacrylate (NBCA) : A Case Report

    International Nuclear Information System (INIS)

    A bronchopleural fistula (BPF) following a pulmonary resection is relatively rare; however, it has high morbidity and mortality rates, despite advancements in treatment. Treatment options for a BPF include surgical procedures, conservative therapy, medical therapy, and in particular, the use of a bronchoscopy and different glues, coils, and sealants. This paper discusses a case of the treatment of a postoperative BPF, which is not identified on the bronchoscope, using a platinum vascular occlusion coil (microcoil) and N-butly-2-cyanoacrylate (NBCA) under fluoroscopic guidance. We hereby assert that such an approach as a combination might be an improvement to the minimally-invasive treatment methods currently in use

  1. A bronchoscopic navigation system using bronchoscope center calibration for accurate registration of electromagnetic tracker and CT volume without markers

    International Nuclear Information System (INIS)

    Purpose: Various bronchoscopic navigation systems are developed for diagnosis, staging, and treatment of lung and bronchus cancers. To construct electromagnetically navigated bronchoscopy systems, registration of preoperative images and an electromagnetic tracker must be performed. This paper proposes a new marker-free registration method, which uses the centerlines of the bronchial tree and the center of a bronchoscope tip where an electromagnetic sensor is attached, to align preoperative images and electromagnetic tracker systems. Methods: The chest computed tomography (CT) volume (preoperative images) was segmented to extract the bronchial centerlines. An electromagnetic sensor was fixed at the bronchoscope tip surface. A model was designed and printed using a 3D printer to calibrate the relationship between the fixed sensor and the bronchoscope tip center. For each sensor measurement that includes sensor position and orientation information, its corresponding bronchoscope tip center position was calculated. By minimizing the distance between each bronchoscope tip center position and the bronchial centerlines, the spatial alignment of the electromagnetic tracker system and the CT volume was determined. After obtaining the spatial alignment, an electromagnetic navigation bronchoscopy system was established to real-timely track or locate a bronchoscope inside the bronchial tree during bronchoscopic examinations. Results: The electromagnetic navigation bronchoscopy system was validated on a dynamic bronchial phantom that can simulate respiratory motion with a breath rate range of 0–10 min−1. The fiducial and target registration errors of this navigation system were evaluated. The average fiducial registration error was reduced from 8.7 to 6.6 mm. The average target registration error, which indicates all tracked or navigated bronchoscope position accuracy, was much reduced from 6.8 to 4.5 mm compared to previous registration methods. Conclusions: An

  2. Case Report: Pulmonary Papillomatosis in a Patient Presenting with Cough and Hemoptysis.

    Science.gov (United States)

    Zhang, Zhou; Chang, Melisa; Moreta-Sainz, Luis M

    2015-01-01

    A previously healthy patient was seen in the Emergency Department for evaluation of a one-month history of cough and one-day history of hemoptysis. A computed tomography scan of the thorax found a mass on the right lower pulmonary lobe and a mass on the left upper lobe. A biopsy specimen of the right lobe lung mass, obtained during bronchoscopy, demonstrated papilloma. This case report, from a pulmonologist's perspective, includes a comprehensive review of the patient's clinical presentation and outcome, as well as a discussion of recurrent respiratory papillomatosis. PMID:26176580

  3. [The indication of panendoscopy in the search for synchronous and metachronous head and neck cancer].

    Science.gov (United States)

    Dulguerov, N; Dulguerov, P

    2013-10-01

    Head and neck cancer result from excessive tobacco and alcohol consumption. The survival has not improved in the last decades despite better loco-regional control, mainly because of secondary cancers. Head and neck cancer is associated to a high rate of synchronous esophageal and lung tumors and an annual 4% rate of new metachronous malignancies. The role of panendoscopy is evolving: a flexible esophagoscopy with Lugol's iodine staining should be performed and a chest CT-scan should replace bronchoscopy. During follow-up, metachronous malignancy should be searched for in the head and neck region; investigation beyond the head and neck is questionable since prognosis is poor. PMID:24187750

  4. Foreign body aspiration through tracheotomy: a case report.

    Science.gov (United States)

    Figueiredoi, Ricardo R; Machado, Walter S

    2005-01-01

    A 70 year-old man, with a 7-year tracheotomy because of a laryngeal tumor, had an accident during daily canulla cleansing procedure, aspirating a piece of the cleaning brush. Chest radiograph showed metallic foreign body at the right inferior bronchus. Rigid bronchoscopy was performed under general anesthesia, with no resistance in passing the tube through the glottis. The foreign body was easily removed and the patient had no complications. After leaving the hospital, the patient was sent to the ENT service where he used to be followed up. PMID:16446923

  5. Medical image of the week: tracheal stenosis

    Directory of Open Access Journals (Sweden)

    Hsu W

    2013-07-01

    Full Text Available A 43-year-old woman was seen in clinic for dyspnea on exertion that began several months ago. Prior workup included a computed tomography of the chest with mild narrowing noted in the upper trachea. Pulmonary function tests (Figure 1 showed a flat inspiratory loop with a normal expiratory loop, which suggests a variable extrathoracic obstruction. On bronchoscopy, a tracheal stenosis was seen just past the vocal cords (Figure 2, Figure 3. Balloon dilation (Figure 4 of the stenosis returned the area to normal caliber.

  6. Cervical approach for repair of congenital tracheo-esophageal fistula presenting in an adult.

    Directory of Open Access Journals (Sweden)

    Albuquerque K

    1993-10-01

    Full Text Available Congenital tracheo-esophageal fistula without esophageal atresia was diagnosed on barium swallow radiography and esophagoscopy findings in an adult patient presenting with difficult in swallowing. The fistulous opening seen on the anterior wall of the esophagus led to the trachea. On bronchoscopy, the tracheal opening was located posteriorly 5 cm below the vocal cords. Successful repair was undertaken via a left cervical approach. The anatomical and developmental basis for the preferred approach is discussed with a brief literature review on the subject.

  7. Clinical value of radiological methods in evaluation and therapy of severe thoracic trauma

    International Nuclear Information System (INIS)

    Plain chest radiographs allow the diagnosis of most intrathoracic injuries. However, they are only momentary pictures and give no information on the respiratory function. A tension pneumothorax, rib fractures and subcutaneous emphysema should be diagnosed clinically before radiographs are taken. Computed tomography is helpful in evaluation of intrapulmonary lesions, hemothorax, rupture of the diaphragm and dislocation of the heart. Further diagnostic tools include aortography in suspected aortic rupture, sonography in cardiac injuries and hemopericardium, bronchoscopy in suspected bronchial or tracheal rupture, ECG and enzyme determinations in cardiac contusion, and eventually pneumoperitoneum in suspected rupture of the diaphragm. (orig.)

  8. Idiopathic pulmonary hemosiderosis complicated by Down syndrome.

    Science.gov (United States)

    Watanabe, Hirofumi; Ayusawa, Mamoru; Kato, Masataka; Chou, Ami; Komori, Akiko; Abe, Yuriko; Matsumura, Masaharu; Kamiyama, Hiroshi; Izumi, Hiroyuki; Takahashi, Shori

    2015-10-01

    We report the case of a 9-year-old girl with Down syndrome (DS) diagnosed with idiopathic pulmonary hemosiderosis (IPH). Although acute pneumonia complicated by hemolytic anemia was suspected, IPH was finally diagnosed on bronchoscopy. Treatment with prednisolone achieved good clinical response. An association between IPH and DS was not able to be identified, but immunological issues in DS may contribute to the onset of IPH. Recurrent and intractable respiratory symptoms with marked infiltrative shadows in the bilateral lungs and complicated by severe anemia in patients with DS should suggest IPH. PMID:26508184

  9. Mucoepidermoid carcinoma of the lung in a 6-year-old boy

    Directory of Open Access Journals (Sweden)

    Peer Wildbrett

    2012-01-01

    Full Text Available Primary malignant lung tumours, especially the mucoepidermoid cancer of the bronchus, are very uncommon in childhood. Obtaining the diagnosis might be difficult due to unspecific initial symptoms but early detection and treatment is crucial for a good long-term survival. Bronchoscopy is considered the "gold standard" for making the diagnosis. The recommended therapy for a mucoepidermoid lung cancer is sleeve lobectomy with favourable overall survival after complete resection. We report the case of a 6-year-old boy with a right-upper-lobe bronchus tumour. The histological examination revealed a low-grade mucoepidermoid carcinoma.

  10. A bronchoscopic navigation system using bronchoscope center calibration for accurate registration of electromagnetic tracker and CT volume without markers

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xiongbiao, E-mail: xiongbiao.luo@gmail.com [Robarts Research Institute, Western University, London, Ontario N6A 5K8 (Canada)

    2014-06-15

    Purpose: Various bronchoscopic navigation systems are developed for diagnosis, staging, and treatment of lung and bronchus cancers. To construct electromagnetically navigated bronchoscopy systems, registration of preoperative images and an electromagnetic tracker must be performed. This paper proposes a new marker-free registration method, which uses the centerlines of the bronchial tree and the center of a bronchoscope tip where an electromagnetic sensor is attached, to align preoperative images and electromagnetic tracker systems. Methods: The chest computed tomography (CT) volume (preoperative images) was segmented to extract the bronchial centerlines. An electromagnetic sensor was fixed at the bronchoscope tip surface. A model was designed and printed using a 3D printer to calibrate the relationship between the fixed sensor and the bronchoscope tip center. For each sensor measurement that includes sensor position and orientation information, its corresponding bronchoscope tip center position was calculated. By minimizing the distance between each bronchoscope tip center position and the bronchial centerlines, the spatial alignment of the electromagnetic tracker system and the CT volume was determined. After obtaining the spatial alignment, an electromagnetic navigation bronchoscopy system was established to real-timely track or locate a bronchoscope inside the bronchial tree during bronchoscopic examinations. Results: The electromagnetic navigation bronchoscopy system was validated on a dynamic bronchial phantom that can simulate respiratory motion with a breath rate range of 0–10 min{sup −1}. The fiducial and target registration errors of this navigation system were evaluated. The average fiducial registration error was reduced from 8.7 to 6.6 mm. The average target registration error, which indicates all tracked or navigated bronchoscope position accuracy, was much reduced from 6.8 to 4.5 mm compared to previous registration methods. Conclusions: An

  11. Right cranial lung lobe torsion after a diaphragmatic rupture repair in a Jack Russell terrier

    Directory of Open Access Journals (Sweden)

    Terzo E

    2008-03-01

    Full Text Available Abstract A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture. Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity. Ultrasonographic studies, bronchoscopy and subsequent exploratory thoracotomy confirmed a diagnosis of a right cranial lung lobe torsion (LLT, with an anomalous caudodorsal displacement of the affected lobe. LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair.

  12. Late Onset Isolated Traumatic Pneumomediastinum in a Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Kemal Erenler

    2013-04-01

    Full Text Available Pneumomediastinum (PM is defined as the presence of gas or free air in mediastinum. Pneumomediastinum may ocur either by trauma or spontaneously. Traumatic PM is frequently seen after blunt thoracic trauma, head trauma, after endoscopy-bronchoscopy (osephagus perforation, tracheobronchial injury and due to mechanical ventilation. Pneumomediastinum after blunt trauma is a lethal injury that generally occurs in adults with concomittant injuries such as rib fractures, hemo-pneumothorax and thoracic vascular injuries after high-energy traumas. We represent case report of a late onset isolated traumatic PM in a child and aim to underline the difficulty and importance of diagnosis of this lethal injury in the emergency department.

  13. The clinical features of foreign body aspiration into the lower airway in geriatric patients

    Directory of Open Access Journals (Sweden)

    Lin LJ

    2014-09-01

    Full Text Available Lianjun Lin,1 Liping Lv,2,* Yuchuan Wang,1 Xiankui Zha,2 Fei Tang,2 Xinmin Liu1,* 1Geriatric Department, Peking University First Hospital, Beijing, People’s Republic of China; 2Pulmonary Intervention Department, Anhui Chest Hospital, Hefei, People’s Republic of China *These authors contributed equally to this work Purpose: To analyze the clinical features of foreign-body aspiration into the lower airway in geriatric patients. Patients and methods: The clinical data of 17 geriatric patients with foreign-body aspiration were retrospectively analyzed and compared with 26 nongeriatric adult patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2000 and June 2014.Results: (1 In the geriatric group, the most common symptoms were cough and sputum (15 cases, 88%, dyspnea (six cases, 35%, and hemoptysis (four cases, 24%. Five patients (29% in the geriatric group could supply the history of aspiration on their first visit to doctor, a smaller percentage than in the nongeriatric group (13 cases, 50%. Only three cases in the geriatric group were diagnosed definitely without delay. Another 14 cases were misdiagnosed as pneumonia or lung cancer, and the time of delayed diagnosis ranged from 1 month to 3 years. Complications due to delay in diagnosis included obstructive pneumonitis, atelectasis, lung abscess, and pleural effusion. (2 Chest computed tomography demonstrated the foreign body in three cases (21% in the geriatric group, which was lower than the positive proportion of detection in the nongeriatric group (nine cases, 35%. The most common type of foreign body in the geriatric group was food, such as bone fragments (seven cases, 41% and plants (seven cases, 41%, and the foreign body was most often lodged in the right bronchus tree (eleven cases, 65%, especially the right lower bronchus (seven cases, 41%. Flexible bronchoscopy removed the foreign body successfully in all patients

  14. Bronchial mucoepidermoid tumour in a child presenting with organomegaly due to secondary amyloidosis: case report and review of the literature

    International Nuclear Information System (INIS)

    Childhood bronchial mucoepidermoid tumours (BMET) are rare. A 12-year-old boy with hepatosplenomegaly underwent liver biopsy which diagnosed amyloidosis. Chest radiograph and CT, performed for recurrent respiratory symptoms, identified a left lower lobe tumour, which was subsequently excised. Histology showed a BMET. A literature review reveals 51 reported cases of BMET in children. Common presenting symptoms include fever, cough and recurrent pneumonia. Diagnosis is often delayed and patients with recurrent respiratory symptoms should undergo CT or bronchoscopy. The association between amyloidosis and BMET in this case is unique and has not been previously described, but may be coincidental. (orig.)

  15. Successful Bronchoscopic Cryorecanalization in a Case of Endobronchial Lipoma

    Directory of Open Access Journals (Sweden)

    B. Lamprecht

    2011-01-01

    Full Text Available Endobronchial lipomas are rare benign tumors; less than 150 cases have been reported so far. Bronchial occlusion usually leads to a misdiagnosis of asthma/COPD or malignancy. We report the case of a 67-year-old man with a history of heavy smoking (100 pack years, dyspnea on exertion, cough, and malaise who was treated for pneumonia for three weeks. Due to nonresolving atelectasis of the superior segment of the right lower lobe, a malignant endobronchial tumor was suspected. Rigid bronchoscopy with cryorecanalization led to both the definite histopathological diagnosis of endobronchial lipoma and the reopening of an endoluminal airway obstruction during one procedure.

  16. Gallium uptake in tryptophan-related pulmonary disease

    International Nuclear Information System (INIS)

    We describe a patient who developed fever, fatigue, muscle weakness, dyspnea, skin rash, and eosinophilia after taking high doses of tryptophan for insomnia for two years. A gallium-67 scan revealed diffuse increased uptake in the lung and no abnormal uptake in the muscular distribution. Bronchoscopy and biopsy confirmed inflammatory reactions with infiltration by eosinophils, mast cells, and lymphocytes. CT scan showed an interstitial alveolar pattern without fibrosis. EMG demonstrated diffuse myopathy. Muscle biopsy from the right thigh showed an inflammatory myositis with eosinophilic and lymphocytic infiltrations

  17. CT-guided fine-needle biopsy (FNB) in histological characterization of mediastinum and lung lesions

    International Nuclear Information System (INIS)

    CT-guided percutaneous thin-needle biopsy is the method of choice in the histological characterization of mediastinum and lung lesions in which a diagnosis could not be reached trough non-invasive methods such as cytology of the sputum, or biopsy during bronchoscopy. FNB represents an alternative to diagnostic thoracotomy: it is, in fact, less invasive, it can be carried out with no need for hospitalization, and has low incidence of complicatios. FNB diagnostic accuracy 89,6%, sensitivity 87,6% and specificity 98%. Our series includes 419 percataneous fineneedle biopsies

  18. Complete bronchial transaction due to severe blunt trauma and chest; treatment and outcomes : A distinct entity

    OpenAIRE

    Rikki Singal; Dalal, Ashwani K.; Usha Dalal; Attri, Ashok K.; Samita Gupta; Rakesh Sadhu; Pradeep Sahu

    2012-01-01

    An 18-year-young male patient came to the emergency department with history of severe blunt trauma. He was having respiratory distress and diagnosed as bronchial injury on the right side. A chest tube was put immediately and there was continuous air leak in the form of air bubbles in the intercostal chest tube bag with each inspiratory effort. Chest injury can be a life-threatening condition, if not managed timely and properly. Bronchoscopy showed injury over the right main bronchus. The feat...

  19. Complete bronchial transaction due to severe blunt trauma and chest; treatment and outcomes : A distinct entity

    Directory of Open Access Journals (Sweden)

    Rikki Singal

    2012-01-01

    Full Text Available An 18-year-young male patient came to the emergency department with history of severe blunt trauma. He was having respiratory distress and diagnosed as bronchial injury on the right side. A chest tube was put immediately and there was continuous air leak in the form of air bubbles in the intercostal chest tube bag with each inspiratory effort. Chest injury can be a life-threatening condition, if not managed timely and properly. Bronchoscopy showed injury over the right main bronchus. The features of this uncommon entity are discussed, with special emphasis on early diagnosis and surgical management.

  20. Bronchopulmonary sequestration in a 60 year old man.

    Science.gov (United States)

    Naffaa, Lena; Tank, Jay; Ali, Sara; Ong, Cesar

    2014-10-01

    We report a case of bronchopulmonary sequestration (BPS) in a 60 year old man with recurrent cough. After failed antibiotic therapy for presumed left lower lobe (LLL) pneumonia seen on chest radiographs, bronchoscopy was performed revealing cryptogenic organizing pneumonia. Further work-up with thoracic imaging demonstrates a feeding artery from the thoracic aorta to the LLL consolidation indicating the presence of BPS. A brief review of the clinical and radiological features and management options of BPS are listed, with particular emphasis on the various imaging modalities and techniques in the diagnosis and pre-surgical planning of intralobar sequestration. PMID:25426223

  1. Medical image of the week: sarcoidosis

    Directory of Open Access Journals (Sweden)

    Knox KS

    2013-02-01

    Full Text Available A 42 year old African-American man from Indianapolis presented with cough and skin lesions. ACE level was elevated at 86 μg/L. Spirometry was normal except for a diffusing capacity 52% of predicted. Imaging was suggestive of sarcoidosis versus granulomatous infection. Bronchoscopy with bronchoalveolar lavage cytospin revealed a lymphocytic alveolitis (27% lymphocytes with a CD4:CD8 ratio of 6.2:1 by flow cytometry. Biopsy showed classic noncaseating granulomas and no organisms supporting the diagnosis of sarcoidosis. The patient’s symptoms and radiographic findings improved with 20 mg prednisone every other day for 3 months duration.

  2. Bronchial mucoepidermoid tumour in a child presenting with organomegaly due to secondary amyloidosis: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, S.; Kader, E. [Univ. of Cape Town, Dept. of Paediatric Radiology, Rondebusch, Cape Town (South Africa)

    2001-05-01

    Childhood bronchial mucoepidermoid tumours (BMET) are rare. A 12-year-old boy with hepatosplenomegaly underwent liver biopsy which diagnosed amyloidosis. Chest radiograph and CT, performed for recurrent respiratory symptoms, identified a left lower lobe tumour, which was subsequently excised. Histology showed a BMET. A literature review reveals 51 reported cases of BMET in children. Common presenting symptoms include fever, cough and recurrent pneumonia. Diagnosis is often delayed and patients with recurrent respiratory symptoms should undergo CT or bronchoscopy. The association between amyloidosis and BMET in this case is unique and has not been previously described, but may be coincidental. (orig.)

  3. Value of hilar tomography in children with positive tuberculin reaction and not inoculated with BCG

    International Nuclear Information System (INIS)

    X-ray films of the thorax in two levels were prepared of 15 children of 3-14 years of age who had not been BCG-inoculated, after the tuberculin test had shown a positive reaction. Besides bacteriology and bronchoscopy, tomography of the hilus and of the anterior mediastinum was performed to exclude hilar lymph node enlargements. In this manner, it became possible to disclose an enlargement of lymphatic nodes in four children in whom plain radiography of the thorax had not yielded any abnormal findings. (orig.)

  4. Cerebral air embolism after pleural streptokinase instillation.

    Science.gov (United States)

    Janisch, Thorsten; Siekmann, Ullrich; Kopp, Rüdger

    2013-12-01

    Iatrogenic pulmonary barotrauma and cerebral arterial gas embolism (CAGE) may complicate a variety of medical procedures, such as certain types of surgery, drug administration through thoracic drainage, pneumoperitoneum, cystoscopy, bronchoscopy, etc. Hyperbaric oxygen treatment following the guidelines for CAGE in diving is the treatment of choice. Pleural streptokinase instillation is a common treatment for parapneumonic pleural effusion and may lead to CAGE. We present such a complication in a 79-year-old woman with a left-sided empyema. Neurological recovery was reasonable, but a left hemiparesis persisted. Prompt treatment of CAGE is necessary to avoid permanent injury and severe disability. PMID:24510333

  5. Tracheo-esophageal fistula: Successful palliation after failed esophageal stent

    Directory of Open Access Journals (Sweden)

    Rakesh K Chawla

    2012-01-01

    Full Text Available The incidence of tracheo-esophageal (TO fistula is on the rise, especially after palliative management for esophageal malignancies. We report a case of cancer of esophagus who after chemotherapy and radiotherapy developed TO fistula. Placement of an esophageal stent helped him in taking food orally, but his cough and dyspnoea continued to worsen. Fibreoptic bronchoscopy demonstrated a severely compressed trachea secondary to protrusion of esophageal stent which responded very well to an Ultraflex-covered tracheal stent and the patient achieved relief from cough and dyspnoea.

  6. A 45-year-old man with shortness of breath and eosinophilia.

    Science.gov (United States)

    Yamamoto, Haru; Khan, David A

    2016-05-01

    A 45-year-old man who presented with dyspnea and chest tightness was found to have obstructive lung disease and eosinophilia of 10,300 eosinophils/μL. The differential diagnosis encompassed causes of primary eosinophilia and secondary eosinophilia associated with pulmonary disease, including asthma, environmental allergic reaction, eosinophilic granulomatosis with polyangiitis, allergic bronchopulmonary aspergillosis, acute eosinophilic pneumonia, chronic eosinophilic pneumonia, parasitic infections, tuberculosis, fungal infection, sarcoidosis, mastocytosis, drug reaction with eosinophilia and systemic symptoms, lymphoproliferative hypereosinophilic syndrome, and myeloproliferative hypereosinophilic syndrome. Infectious workup, fiberoptic bronchoscopy with biopsy, and tests for myeloproliferative mutations help differentiate among these causes. Identifying the underlying cause of eosinophilia is imperative in guiding treatment. PMID:27178895

  7. Foriegn Bodies of the Tracheobronchial tree and Esophagus

    Directory of Open Access Journals (Sweden)

    A. DALIL-TOJARI

    1975-01-01

    Full Text Available Report of 850 cases of foreign bodies in the air and food passages is presented. The incidence of the accident was more in children between the age of 1-6 years than others. No sex difference was noted for the incidence of the accident The presence of leech as a foreign body in this report is of interest General anesthesia is recommended in the case that foreign bodies are present in the air way of children. In these cases bronchoscopy, with oxygenation by insuflation in brochoscope or Ventury 50 or other similar techniques is recommended.

  8. Fractured metallic tracheostomy tube: A rare complication of tracheostomy.

    Science.gov (United States)

    So-Ngern, Apichart; Boonsarngsuk, Viboon

    2016-01-01

    Although tracheostomy is a well-accepted procedure for airway management, some early and late complications may occur. Fracture of the tracheostomy tube (TT) is a rare complication, particularly in a patient with long-term use. Herein we report a case of fractured metallic TT migrating into the tracheobronchial tree. Rigid bronchoscopy was performed through the tracheostomy stoma and the fractured tube was successfully removed by a balloon catheter. Appropriate cleaning, routine careful examination, and scheduled replacement of the TT may help prevent this complication. PMID:27489759

  9. Utilization of the Organ Care System Lung for the assessment of lungs from a donor after cardiac death (DCD) before bilateral transplantation.

    Science.gov (United States)

    Mohite, P N; Sabashnikov, A; García Sáez, D; Pates, B; Zeriouh, M; De Robertis, F; Simon, A R

    2015-07-01

    In this manuscript, we present the first experience of evaluating donation after circulatory death (DCD) lungs, using the normothermic preservation Organ Care System (OCS) and subsequent successful transplantation. The OCS could be a useful tool for the evaluation of marginal lungs from DCD donors as it allows a proper recruitment and bronchoscopy in such donations in addition to continuous ex-vivo perfusion and assessment and treatment during transport. The OCS could potentially be a standard of care in the evaluation of marginal lungs from DCD. PMID:25332197

  10. Iatrogenic “buffalo chest” bilateral pneumothoraces following unilateral transbronchial lung biopsies in a bilateral lung transplant recipient

    Directory of Open Access Journals (Sweden)

    Leith Sawalha

    2015-01-01

    Full Text Available We present a 54 year old male patient who had a bilateral lung transplant sixteen years ago for Alpha-1 Antitrypsin Deficiency-related emphysema. He was referred for flexible bronchoscopy with transbronchial biopsies to evaluate new mild exertional dyspnea and worsening of his FEV1. Eight transbronchial biopsies were done from the right middle lobe and the right lower lobe. Post procedure he developed bilateral pneumothoces that required emergent bilateral pleural ‘pigtail’ catheters. To our knowledge, this is the first reported case of bilateral pneumothoraces that developed after a unilateral procedure in a bilateral lung transplant recipient relatively late after the transplant.

  11. A case of endobronchial lipoma mimicking bronchial asthma

    Directory of Open Access Journals (Sweden)

    Sevket Ozkaya

    2009-05-01

    Full Text Available Sevket Ozkaya1, Hasan Demir1, Serhat Findik21Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, TurkeyAbstract: Endobronchial lipoma is a rare neoplasm of the tracheobronchial tree and it may cause irreversible pulmonary damage due to recurrent pneumonia. Rarely, it may mimic bronchial asthma. We present a 53-year-old woman with an endobronchial lipoma, which had been treated as a bronchial asthma for four years. She also had developed recurrent pneumonia three times.Keywords: endobronchial lipoma, asthma, radiology, bronchoscopy

  12. Paraneoplastic Choreoathetosis in a Patient with Small Cell Lung Carcinoma and Anti-CRMP5/CV2: A Case Report

    DEFF Research Database (Denmark)

    Lassen, Lisbeth Landschoff; Somnier, Finn; Aydin, Dogu

    2016-01-01

    signs of primary or metastatic tumors were revealed on chest X-ray, MRI or whole-body PET scan. EEG and bronchoscopy were also unremarkable. However, 6 months after the onset, a repeated PET scan and subsequent bronchoscopic biopsy revealed SCLC. In spite of chemotherapy, the SCLC progressed, and the...... patient died 14 months after the onset of the symptoms. Conclusion: We report paraneoplastic choreoathetosis associatedwith anti-CRMP5/CV2 antibodies. Such published case histories are rare. Although expected, we did not find any reduced signal intensity at the basal ganglia on the T1-weighted or...

  13. [Mucoepidermoid carcinoma in a 13-year-old girl; report of a case].

    Science.gov (United States)

    Fujita, Koichi

    2009-05-01

    A 13-year-old girl was referred to our hospital for chest pain and atelectasis of left upper lobe on chest X-ray film. Bronchoscopy revealed an endobronchial tumor obstructing left main bronchus. Left upper lobectomy with bronchoplasty was performed. The tumor was a polyp 34 x 17 x 17 mm in size and obstructed left main bronchus. Histologically the tumor was a low-grade malignant mucoepidermoid carcinoma with malignant pleural effusin. The patient has been well and free of recurrence for 8 years postoperatively. PMID:19425387

  14. Early thoracotomy in the treatment of non calcified solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Thoracotomy and resection of non calcified solitary pulmonary nodule is analysed in 19 asymptomatic patients during 7 years . The therapeutical validity of early thoracotomy is evaluated. No postoperative deaths are reported. Its is concluded that pre-operative differential diagnostic procedure between benign and malign nodules may not always be decisive, and that an early thoracotomy is indicated in every case since the incidence of malign tumors is frequent. Some aspects discussing the diagnosis techniques as computerized tomography, bronchoscopy, X radiation and planigraphy are presented. (M.A.C.)

  15. Left Lung Torsion: Complication of Lobar Resection for an Early Stage Lung Adenocarcinoma

    Science.gov (United States)

    Moussaly, Elias; Abou Yassine, Ali

    2016-01-01

    Lobar torsion is a fatal but fortunately rare occurrence following lung resection. Early clinical signs and radiographic features may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further parenchymal necrosis and deadly gangrene. We report a case of left lower lobe torsion in a 76-year-old female following elective upper lobectomy for underlying lung adenocarcinoma. Diagnosis was made following highly suggestive radiographic findings prompting bronchoscopy and revision thoracotomy. An emergency detorsion failed to restore lung viability and was followed by completion pneumonectomy. The patient recovered and was discharged on the seventh postoperative day. PMID:27293912

  16. Left Lung Torsion: Complication of Lobar Resection for an Early Stage Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Wissam Mansour

    2016-01-01

    Full Text Available Lobar torsion is a fatal but fortunately rare occurrence following lung resection. Early clinical signs and radiographic features may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further parenchymal necrosis and deadly gangrene. We report a case of left lower lobe torsion in a 76-year-old female following elective upper lobectomy for underlying lung adenocarcinoma. Diagnosis was made following highly suggestive radiographic findings prompting bronchoscopy and revision thoracotomy. An emergency detorsion failed to restore lung viability and was followed by completion pneumonectomy. The patient recovered and was discharged on the seventh postoperative day.

  17. Left Lung Torsion: Complication of Lobar Resection for an Early Stage Lung Adenocarcinoma.

    Science.gov (United States)

    Mansour, Wissam; Moussaly, Elias; Abou Yassine, Ali; Nabagiez, John; Maroun, Rabih

    2016-01-01

    Lobar torsion is a fatal but fortunately rare occurrence following lung resection. Early clinical signs and radiographic features may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further parenchymal necrosis and deadly gangrene. We report a case of left lower lobe torsion in a 76-year-old female following elective upper lobectomy for underlying lung adenocarcinoma. Diagnosis was made following highly suggestive radiographic findings prompting bronchoscopy and revision thoracotomy. An emergency detorsion failed to restore lung viability and was followed by completion pneumonectomy. The patient recovered and was discharged on the seventh postoperative day. PMID:27293912

  18. Renal cell carcinoma manifests primarily as endobronchial mass: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Rina Mukherjee

    2015-01-01

    Full Text Available Endobronchial metastasis (EBM from renal cell carcinoma (RCC is a very rare entity, though pulmonary metastasis of RCC is common. Here, we present a case of RCC with EBM, in which the primary tumor was detected after the detection of secondary. A 60-year-old man presented with cough for last 2 months. Contrast enhanced computed tomography (CECT chest followed by bronchoscopy revealed an endobronchial mass at left bronhi. CECT whole abdomen revealed a left-sided renal space occupying lesion (SOL. CT guided fine needle aspiration cytology of the SOL proved it as a RCC. Palliative bronchoscopic removal of endobronchial mass by snaring diathermy was done.

  19. [Experience of medical assistance in the hosital of Plesetsk Cosmodrome under conditions of large patient load after explosion of a launch vehicle].

    Science.gov (United States)

    Plekhanov, V N; Mel'nikov, O N; Shut', A D

    2013-11-01

    Military hospital of Plesetsk Cosmodrome was founded on 20 December 1958. The aims of the hospital were always connected with medical support of the cosmodrome, including emergency situations. On 18 March 1980 a Vostok-2M rocket exploded on its launch pad during a fuelling operation. Experience of medical assistance under conditions of large patient load showed the necessity of constant readiness to medical assistance to patients with combined pathology (burn injury, orthopedic trauma and thermochemical injury of the upper respiratory tract), expediency of compact patient accommodation along with the modern anaesthetic machine and readiness to frequent suction bronchoscopy. PMID:24611312

  20. Tracheo-esophageal fistula in children: a diagnosis to keep in mind. Two case reports and review of the literature = Fístula traqueoesofágica en niños: un diagnóstico para tener en cuenta. Reporte de dos casos y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Olga Lucía Morales Múnera

    2013-07-01

    Full Text Available The tracheo-esophageal fistula without esophageal atresia is a rare type esophageal malformation. It has a multifactorial etiology including environmental and genetic factors. Common clinical manifestations are coughing and choking after meals, cyanosis and/or recurrent pneumonia. Diagnosis requires a high clinical suspicion index. Fistula confirmation is done with imaging studies including upper digestive series, video-fluoroscopy or with the use of bronchoscopy wich allows direct visualization of the fistula or methylene blue passage through the abnormal communication. Fistula closure can be done endoscopically or surgically, in both cases with good results.

  1. Taylor′s approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists

    Directory of Open Access Journals (Sweden)

    Jindal Parul

    2009-01-01

    Full Text Available We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor′s approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

  2. Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

    Directory of Open Access Journals (Sweden)

    Conte Sergio C

    2012-08-01

    Full Text Available Abstract Background The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation We describe a case of tracheoesophageal prosthesis’ (TEP aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.

  3. Lung donor selection criteria

    OpenAIRE

    Chaney, John; Suzuki, Yoshikazu; Cantu, Edward; van Berkel, Victor

    2014-01-01

    The criteria that define acceptable physiologic and social parameters for lung donation have remained constant since their empiric determination in the 1980s. These criteria include a donor age between 25-40, a arterial partial pressure of oxygen (PaO2)/FiO2 ratio greater than 350, no smoking history, a clear chest X-ray, clean bronchoscopy, and a minimal ischemic time. Due to the paucity of organ donors, and the increasing number of patients requiring lung transplant, finding a donor that me...

  4. Primary pulmonary mucinous cystadenocarcinoma presenting as a complex bronchocele: a case report

    Directory of Open Access Journals (Sweden)

    Raza Syed Arsalan

    2009-08-01

    Full Text Available Abstract Introduction Primary pulmonary mucinous cystadenocarcinoma is a rare variety of lung cancer. It is characterized pathologically by copious mucin production predominantly in the extracellular space. This tumour has a remarkably favorable prognosis. Case presentation We present imaging and histopathological findings of primary pulmonary mucinous cystadenocarcinoma presenting as a complex bronchocele in a 67-year-old Caucasian woman. Conclusion Diagnosis of pulmonary mucinous cystadenocarcinoma should be considered in patients presenting with bronchocele that has suspicious imaging features, because the results of fine needle aspiration cytology and bronchoscopy are frequently inconclusive in these tumours. Positive emission tomography has an important role in helping to identify these tumours.

  5. Alveolar damage in AIDS-related Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Prentø, P; Junge, Jette;

    1997-01-01

    OBJECTIVE: Pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of AIDS. Despite this, many basic aspects in the pathogenesis of HIV-associated P carinii pneumonia are unknown. We therefore undertook a light and electron microscopic study of transbronchial...... biopsy specimens to compare pathologic features of P carinii pneumonia and other HIV-related lung diseases. DESIGN AND PATIENTS: Thirty-seven consecutive HIV-infected patients undergoing a diagnostic bronchoscopy. RESULTS: P carinii pneumonia was characterized by an increase in inflammation, edema...

  6. August 2014 pulmonary case of the month: a physician's job is never done

    Directory of Open Access Journals (Sweden)

    Poulos E

    2014-08-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 75-year-old man presented with recurrent minimally productive cough, dyspnea, fatigue, low-grade fevers, and weight loss in November 2013. The patient had been treated twice as an outpatient with antibiotics in the previous 6 weeks for pneumonia. PMH, FH, SH: The patient has a history of obstructive sleep apnea but is not compliant with his prescribed continuous positive airway pressure. He also as a history of obesity, dyslipidemia, and peripheral vascular disease. There is no significant family history. He is a retired brick layer with a 50 pack-year smoking history but quit a few weeks prior to admission. He drinks a case of beer/week. Physical Examination: VS stable. There were no significant findings on physical examination. Radiography: A chest radiograph (Figure 1 was performed. What should be done next? 1. Bronchoscopy with bronchoalveolar lavage; 2. Bronchoscopy with transbronchial biopsy; 3. Needle biopsy; 4. Thoracentesis; 5. Video-assisted ...

  7. Successful Treatment of Complicated Tracheobronchial Rupture Using Primary Surgical Repair

    Directory of Open Access Journals (Sweden)

    Ching-Yang Wu

    2005-09-01

    Full Text Available Traumatic tracheobronchial disruption is a life threatening injury in the pediatric population.The clinical presentations are variable depending on whether the peribronchial tissuesremain intact. A high index of clinical suggestion and accurate interpretation of radiologicalfindings are necessary to diagnose the injury. Delays in treatment increase the risk of deathand complications. We report a 9-year-old boy who presented with subcutaneous emphysema,bilateral pneumothorax, pneumomediastinum, and respiratory failure. Bronchoscopyrevealed a complex rupture of the airway over the junction of the right main upper lobar andintermediate bronchus. Emergent surgical intervention was performed via a right posterolateralthoracotomy after bilateral chest tube insertion. End-to-end anastomosis of the disruptedbronchus was completed with interrupted absorbable 4-0 vicryl without additional coveringof the anastomosis with pleural or muscle flap and intra-operative bronchoscopy showed anormal anastomotic relationship after the procedure was completed. The patient was dischargedin good condition 10 days after the operation. At 6 months of follow up, he hadgood health status and bronchoscopy showed good patency over the anastomotic region.

  8. The study of risk factors affecting the prognosis of lung abscess

    Directory of Open Access Journals (Sweden)

    Aghajan Zadeh M

    2000-09-01

    Full Text Available In spite the emergence of potent and broad spectrum antibiotics and recent advances in bronchoscopy and pulmonary physiotherapy, still there is a high rate of morbidity and mortality because of lung abscess. The objective of this study is the indication of risk factors, which have undesirable effects on the prognosis of lung abscess. In a retrospective study, all cases of lung abscess who was confined to bed during 1994 to 1999 in Rasht were collected and analyzed. From 52 cases, 40 (77% were male and 12 (23% were female. The mean duration of stay was 20 day (15 to 35. The secondary cause for lung abscess was as follows: 10 cases (19% COPD, 10 cases (19% preumonia, 15 cases (29% bronchiectasia 2 cases lung cancer, 2 cases lung hydatid cyst and 3 cases atelectasia. Extrapulmonary causes of lung abscess were consist of: 10 case (10% aspiration, 10 case (19% esophageal diseases tending to reflux, 5 case (9% periodontal disease. The factors, which had underiable effects on prognosis of disease were lung cancer, anemia, hypoalbuminemia, age over 60, abscess with pseudomonas, abscess cavity greater thus 8 cm, lower lobe in right lung and TB. Because of high mortality and morbidity of lung abscess, due attention for internal drainage, bronchoscopy, physiotherapy and timed surgery are seriously indicated.

  9. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  10. Tracheobronchial foreign bodies in children - a retrospective study of 2,000 cases in Northwestern China.

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  11. Canine chronic bronchitis: a pathophysiologic evaluation of 18 cases

    International Nuclear Information System (INIS)

    Eighteen dogs with chronic bronchitis were studied using physiologic, radiologic, microbiologic, and pathologic techniques. Twelve of these dogs were evaluated before and after two weeks of oral bronchodilator administration. Thoracic radiographs, tidal breathing flow-volume loops, radioaerosol ventilation scans, airway appearance at bronchoscopy, and airway pathology were abnormal in the majority of dogs studied. There was a significant relationship between abnormal ventilation scans and abnormal results for PaO2 and end-tidal airflow. Bronchoscopy revealed excessive mucus and inflammation of airway mucosa in all 16 dogs undergoing this procedure. Endoscopically obtained aerobic bacterial cultures grew mixed bacterial flora in only three dogs. Increased numbers of neutrophils in 14 dogs were detected by airway lavage cytology. A large number of eosinophils were seen in airway lavages obtained from two dogs; these two dogs also had evidence for eosinophilic bronchitis on endobronchial biopsy. Oral bronchodilator administration resulted in clinical and expiratory airflow improvements in most dogs, but had no effect on PaO2 or on the radioaerosol-scan abnormalities. The presence of both the physiologic and pathologic airway abnormalities of chronic bronchitis in dogs presented to a veterinary hospital with chronic unexplained cough was confirmed, suggesting that aerobic bacteria do not play an etiologic role in most cases

  12. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  13. Method for endobronchial video parsing

    Science.gov (United States)

    Byrnes, Patrick D.; Higgins, William E.

    2016-03-01

    Endoscopic examination of the lungs during bronchoscopy produces a considerable amount of endobronchial video. A physician uses the video stream as a guide to navigate the airway tree for various purposes such as general airway examinations, collecting tissue samples, or administering disease treatment. Aside from its intraoperative utility, the recorded video provides high-resolution detail of the airway mucosal surfaces and a record of the endoscopic procedure. Unfortunately, due to a lack of robust automatic video-analysis methods to summarize this immense data source, it is essentially discarded after the procedure. To address this problem, we present a fully-automatic method for parsing endobronchial video for the purpose of summarization. Endoscopic- shot segmentation is first performed to parse the video sequence into structurally similar groups according to a geometric model. Bronchoscope-motion analysis then identifies motion sequences performed during bronchoscopy and extracts relevant information. Finally, representative key frames are selected based on the derived motion information to present a drastically reduced summary of the processed video. The potential of our method is demonstrated on four endobronchial video sequences from both phantom and human data. Preliminary tests show that, on average, our method reduces the number of frames required to represent an input video sequence by approximately 96% and consistently selects salient key frames appropriately distributed throughout the video sequence, enabling quick and accurate post-operative review of the endoscopic examination.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2006-08-15

    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.)

  15. Virtual endoscopy of the upper, central and peripheral airways with multirow detector CT

    International Nuclear Information System (INIS)

    Virtual endoscopy of the upper, central and peripheral airways (virtual laryngoscopy or virtual bronchoscopy) produces endoluminal images similar to those of fiberoptic endoscopy. In particular, virtual endoscopy is useful for the assessment of endoluminal tumor extent and tracheobronchial stenosis. Especially since the introduction of multirow detector CT, high-resolution virtual-endoscopic images of the airways can be reconstructed. Either surface rendering or volume rendering can be used for realistic depiction of the airways. Semitransparent color-coded volume rendering is advantageous, because adjacent structures can be displayed in addition to endoluminal views. A major advantage of virtual endoscopy over fiberoptic endoscopy is its non-invasiveness. With virtual endoscopy, even a high-grade stenosis is passable, enabling evaluation of the distal airways. Disadvantages are its inability to depict mucosal color and to perform therapeutic maneuvers. In comparison to other CT display modes, virtual endoscopy allows a more realistic assessment of tracheobronchial stenosis than axial CT slices and multiplanar reformats. Virtual endoscopy of the airways can be used complementary to fiberoptic endoscopy before tracheotomy, stent implantation or lung resection and for post-operative follow-up. In the future, virtual airway endoscopy will be increasingly applied for interactive virtual reality guidance of airway procedures such as bronchoscopy and surgery. (orig.)

  16. [Bronchial rupture in blunt thoracic trauma].

    Science.gov (United States)

    López Espadas, F; Zabalo, M; Encinas, M; Díaz Regañón, G; Pagola, M A; González Fernández, C

    2000-12-01

    In closed chest trauma, bronchial rupture is an unusual but potentially serious complication, with an associated mortality rate of 30%. Recent decades have seen an increase in incidence parallel to greater use of transport. Eighty percent of injuries are located 2.5 cm from the carina. Diagnosis is based on clinical signs, imaging and bronchoscopy. Subcutaneous emphysema and respiratory insufficiency are the most common findings. Images show the presence of pneumothorax, pneumomediastinum or both. Bronchoscopy is the diagnostic method of choice and must be performed early. Treatment consists of reestablishing anatomical continuity of the tracheobronchial tree by surgical repair if the lesion affects more than a third of the circumference and/or pneumothorax is not resolved after two chest drainages. This type of injury should be recognized and treated early, both to restore lung function and to prevent associated complications caused by delay. However, initial findings are seldom specific, requiring the physician to display a high degree of suspicion and explaining why diagnosis often comes late. PMID:11171438

  17. Mechanical complication of endobronchial tuberculosis

    Directory of Open Access Journals (Sweden)

    Quratulain Fatima Kizilbash

    2015-01-01

    Full Text Available A 19-year-old Vietnamese lady was diagnosed with culture positive, left upper lobe pulmonary tuberculosis for which medical treatment was initiated. Four months into treatment, she developed a 'rubber-band-like' stretching sensation in her left chest with wheezing and shortness of breath. Decreased respiratory excursion over the left lung was present on physical-examination. Chest-Xray revealed left-upper-lobe collapse with leftward deviation of the trachea and mediastinum. CT thorax revealed a long segment of stenosis in the left mainstem bronchus. FEV1 was 1.26 L (45% predicted, FVC 1.53 L (49% predicted, FEV1/FVC 82% (95% predicted indicating airway limitation. Ventilation-perfusion scan noted 9.8% ventilation to the left lung and 92.8% to the right lung and 7.6% perfusion to the left lung and 92.4% to the right lung. Bronchoscopy was notable for pin point stenosis of the left mainstem bronchus beyond which was inflamed mucosa and abnormal cartilage rings in the left upper and middle lobe bronchi. Nine months of medical therapy for tuberculosis along with oral steroid taper was completed successfully; however the patient has required six serial bronchscopies with dilatations without stent placement at four to six week intervals due to partial restenosis, with the last bronchoscopy at four months after completion of tuberculosis therapy.

  18. The impact on diagnosis of lung cancer by endoscopic technology development%内镜技术发展对肺癌诊断的影响

    Institute of Scientific and Technical Information of China (English)

    傅毅立; 李辉

    2009-01-01

    近年来,一些新技术在支气管镜下的应用得以实现.例如支气管内超声(EBUS)技术、自动荧光支气管镜(AFB)技术、电磁导航支气管镜技术(ENB)、荧光共聚焦显微镜(FCFM)技术及光干涉断层扫描(OCT)技术等,均从不同角度和层面解决了以往传统技术手段存在的缺陷.虽然目前这些技术手段还有待进一步完善和临床验证,但其必然会对肺癌的诊断和治疗产生巨大的影响.%In recent years, with the development of some new techniques based on bronchoscopic skills, such as endobronchial ultrasonography, autofluorescence bronchoscopy, electromagnetic navigation bronchoscopy, fibered confocal fluorescence microendoscopy and optic coherence tomography of the advent of technology, which solved the shortcomings of traditional technology from different areas and dimensions. Although these techniques need to be improved and clinical verified further, it was believed that the great impact on diagnosis and treatment of lung cancer should be made by them.

  19. Impact of multidetector CT-angiography on the emergency management of severe hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau-Lemoine, Ludivine [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Khalil, Antoine, E-mail: antoine_khalil@yahoo.fr [Service de Radiologie, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Pathological Angiogenesis and Vessel Normalization, Center for Interdisciplinary Research in Biology, CNRS UMR 7241/INSERM U1050, Collège de France, Paris (France); Prigent, Hélène [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Carette, Marie-France [Service de Radiologie, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Université Pierre et Marie Curie, Paris VI (France); Fartoukh, Muriel [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France); Université Pierre et Marie Curie, Paris VI (France); Parrot, Antoine [Service de Pneumologie et Réanimation, Hôpital Tenon, HUEP, APHP, 4 rue de la Chine, 75020 Paris (France)

    2013-11-01

    Background: Multidetector CT-angiography (MDCTA) is commonly used in patients with severe haemoptysis requiring admission to intensive care unit. However, the impact of MDCTA on the management of severe haemoptysis in emergency setting is poorly evaluated. Methods: We prospectively compared data provided by clinical bedside evaluation (clinical examination, chest-X-ray and fiberoptic bronchoscopy) to MDCTA data in terms of lateralization, location of the bleeding site, etiology as well as impact on the treatment choice. Results: Over a 13-month period, 87 patients (men n = 58, median age = 61 years, median haemoptysis expectorated volume = 180 mL) were included. Etiology was mainly (67%) bronchiectasis, tuberculosis sequelae and tumor. MDCTA and clinical bedside evaluation were equally effective in determining lateralization (87.4% and 93.1%, respectively, p = 0.23) and location (85% and 82.7%, respectively, p = 0.82) of the bleeding site. MDCTA was significantly more accurate than the clinical bedside strategy in determining the haemoptysis cause (86% and 70%, respectively, p = 0.007). Moreover, MDCTA suggested the involvement of systemic arteries as bleeding mechanism in 92% of cases, leading to the modification of the treatment initially considered after bedside evaluation in 21.8% of patients. Conclusion: MDCTA provides useful information for the management of patients with severe haemoptysis, especially in the treatment choice. Thus, in the absence of emergency fiberoptic bronchoscopy (FOB) requirement for airways management, MDCTA should be the first-line procedure performed in emergency clinical setting.

  20. CT findings of plastic bronchitis in children after a Fontan operation

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Jhang, Won Kyoung; Kim, Young Hwee; Ko, Jae Kon; Park, In Sook [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea); Park, Jeong-Jun; Yun, Tae-Jin; Seo, Dong-Man [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea)

    2008-09-15

    Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. To describe the CT findings in plastic bronchitis in children after a Fontan operation. Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes. (orig.)

  1. CT findings of plastic bronchitis in children after a Fontan operation

    International Nuclear Information System (INIS)

    Plastic bronchitis is a rare cause of acute obstructive respiratory failure in children. Life-threatening events are much more frequent in patients with repaired cyanotic congenital heart disease, and most frequent following a Fontan operation. Commonly, the diagnosis is not made until bronchial casts are expectorated. Detailed CT findings in plastic bronchitis have not been described. To describe the CT findings in plastic bronchitis in children after a Fontan operation. Three children with plastic bronchitis after a Fontan operation were evaluated by chest CT. Bronchial casts were spontaneously expectorated and/or extracted by bronchoscopy. Airway and lung abnormalities seen on CT were analyzed in the three children. CT demonstrated bronchial casts in the central airways with associated atelectasis and consolidation in all children. The affected airways were completely or partially obstructed by the bronchial casts without associated bronchiectasis. The airway and lung abnormalities rapidly improved after removal of the bronchial casts. CT can identify airway and lung abnormalities in children with plastic bronchitis after a Fontan operation. In addition, CT can be used to guide bronchoscopy and to monitor treatment responses, and thereby may improve clinical outcomes. (orig.)

  2. Endobronchial Actinomycosis Mimicking Lung Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Sezen Sabanci Kucukaltun

    2014-08-01

    Full Text Available Pulmonary actinomycosis is usually occured as a result of aspiration of the organism contained in the oropharingeal secretions. It could cause a pulmonary mass, pneumonia or pleural involvement and also rarely an endobronchial lesion. A 63 year old nonsmoker male patient admitted our clinic with complaints of dry cough, dyspnea and wheezing which have been continiuing for 6 months. The patient with type 2 diabetes mellitus for 15 years had a partial collapse in right middle lobe and elevation at right diafragma contour in computerized tomography of the thorax . An endobronchial lesion in the intermediate bronchi was viewed with fiberoptic bronchoscopy. Biopsy result showed no finding of malignancy, colonies of actinomycosis were seen. As a result of oral penicillin based antibiotic therapy for 21 days, radiological and clinical regression were detected. A prominent regression was seen in the lesions at control bronchoscopy.As a result, for the differantial diagnosis of endobronchial lesions, especially if immunosupressive disease is present, fungal infections should also be kept in mind. [Cukurova Med J 2014; 39(4.000: 946-949

  3. Spirometer-controlled cine magnetic resonance imaging to diagnose tracheobronchomalacia in pediatric patients

    DEFF Research Database (Denmark)

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra;

    2014-01-01

    covering the thorax using a 3D SPGR sequence. 3D-Dynamic-scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter greater than 50% at end-expiration in the static and dynamic scans.The success rate of the cine-MRI protocol was 92%. Cine-MRI...... restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration...... was compared with bronchoscopy or chest-CT in 7 subjects. TBM was diagnosed by cine-MRI in 7 out of 12 children (58%) and was confirmed by bronchoscopy or CT. In 4 patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans.Spirometer-controlled cine-MRI is a promising...

  4. Medical image of the week: right middle lobe syndrome

    Directory of Open Access Journals (Sweden)

    Cristan EA

    2016-05-01

    Full Text Available No abstract available. Article truncated at 150 words. A 73 year-old woman, a lifetime non-smoker, presented to the pulmonary clinic with chronic dyspnea on exertion and cough. Physical exam was unremarkable and pulmonary function testing showed normal spirometry. A chest radiograph revealed calcified mediastinal adenopathy and increased density in the right middle lobe region (Figure 1. A computed tomography scan of the chest revealed significant narrowing of the right middle lobe bronchus with partial atelectasis and prominent calcified mediastinal lymphadenopathy (Figure 2. Bronchoscopy showed no endobronchial lesions but there was evidence of extrinsic compression surrounding the right middle lobe orifice. An endobronchial biopsy revealed noncaseating granulomas. Bronchoscopy cultures and cytology were negative and this was presumed to be from a previous infection with histoplasmosis given the patient’s long-term residence in an endemic area. Given chronic narrowing of right middle lobe bronchus with persistent atelectasis of the right middle lobe, the patient was diagnosed with right middle lobe syndrome. ...

  5. In vivo endoscopic autofluorescence microspectro-imaging of bronchi and alveoli

    Science.gov (United States)

    Bourg-Heckly, G.; Thiberville, L.; Vever-Bizet, C.; Viellerobe, B.

    2008-02-01

    Fibered confocal fluorescence microscopy (FCFM) is an emerging technique that can be used during bronchoscopy to analyze the nature of the human bronchial mucosa and alveolar network fluorescence microstructure. An endoscopic fibered confocal fluorescence microscopy system with spectroscopic analysis capability was developed allowing realtime, simultaneous images and emission spectra acquisition, at 488 nm excitation, using a flexible miniprobe. This flexible 1.4 mm miniprobe can be introduced into the working channel of a flexible endoscope and gently advanced through the bronchial tree up to the alveoli. FCFM in conjunction with bronchoscopy is able to image the in vivo autofluorescence microstructure of the bronchial mucosa but also the alveolar respiratory network outside of the usual field of view. In the normal bronchi, reproducible images were obtained, characterized by a highly organized fibered network. Precancerous lesions exhibited alterations of this fibered network. Microscopic and spectral analysis showed that the signal mainly originates from the elastin component of the bronchial subepithelial layer. In non smokers, the system images the elastin backbone of the aveoli. In active smokers, a strong autofluorescence signal appears from alveolar macrophages. The FCFM technique appears promising for in vivo exploration of the bronchial and alveolar extracellular matrix.

  6. Impact of multidetector CT-angiography on the emergency management of severe hemoptysis

    International Nuclear Information System (INIS)

    Background: Multidetector CT-angiography (MDCTA) is commonly used in patients with severe haemoptysis requiring admission to intensive care unit. However, the impact of MDCTA on the management of severe haemoptysis in emergency setting is poorly evaluated. Methods: We prospectively compared data provided by clinical bedside evaluation (clinical examination, chest-X-ray and fiberoptic bronchoscopy) to MDCTA data in terms of lateralization, location of the bleeding site, etiology as well as impact on the treatment choice. Results: Over a 13-month period, 87 patients (men n = 58, median age = 61 years, median haemoptysis expectorated volume = 180 mL) were included. Etiology was mainly (67%) bronchiectasis, tuberculosis sequelae and tumor. MDCTA and clinical bedside evaluation were equally effective in determining lateralization (87.4% and 93.1%, respectively, p = 0.23) and location (85% and 82.7%, respectively, p = 0.82) of the bleeding site. MDCTA was significantly more accurate than the clinical bedside strategy in determining the haemoptysis cause (86% and 70%, respectively, p = 0.007). Moreover, MDCTA suggested the involvement of systemic arteries as bleeding mechanism in 92% of cases, leading to the modification of the treatment initially considered after bedside evaluation in 21.8% of patients. Conclusion: MDCTA provides useful information for the management of patients with severe haemoptysis, especially in the treatment choice. Thus, in the absence of emergency fiberoptic bronchoscopy (FOB) requirement for airways management, MDCTA should be the first-line procedure performed in emergency clinical setting

  7. Activated protein C inhibits neutrophil migration in allergic asthma: a randomised trial.

    Science.gov (United States)

    de Boer, J Daan; Berger, Marieke; Majoor, Christof J; Kager, Liesbeth M; Meijers, Joost C M; Terpstra, Sanne; Nieuwland, Rienk; Boing, Anita N; Lutter, René; Wouters, Diana; van Mierlo, Gerard J; Zeerleder, Sacha S; Bel, Elisabeth H; van't Veer, Cornelis; de Vos, Alex F; van der Zee, Jaring S; van der Poll, Tom

    2015-12-01

    Asthma patients show evidence of a procoagulant state in their airways, accompanied by an impaired function of the anticoagulant protein C system. We aimed to study the effect of recombinant human activated protein C (rhAPC) in allergic asthma patients.We conducted a randomised, double-blind, placebo-controlled, proof-of-concept study in house dust mite (HDM) allergic asthma patients. Patients were randomised to receive intravenous rhAPC (24 µg·kg(-1)·h(-1); n=12) or placebo (n=12) for 11 h. 4 h after the start of infusion, a first bronchoscopy was performed to challenge one lung segment with saline (control) and a contralateral segment with a combination of HDM extract and lipopolysaccharide (HDM+LPS), thereby mimicking environmental house dust exposure. A second bronchoscopy was conducted 8 h after intrabronchial challenge to obtain bronchoalveolar lavage fluid (BALF).rhAPC did not influence HDM+LPS induced procoagulant changes in the lung. In contrast, rhAPC reduced BALF leukocyte counts by 43% relative to placebo, caused by an inhibitory effect on neutrophil influx (64% reduction), while leaving eosinophil influx unaltered. rhAPC also reduced neutrophil degranulation products in the airways.Intravenous rhAPC attenuates HDM+LPS-induced neutrophil migration and protein release in allergic asthma patients by an effect that does not rely on coagulation inhibition. PMID:26381519

  8. Contribution of interventional radiology to diagnosis and staging of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    The value of percutaneous radiological fine needle biopsy of the thorax will be discussed in relation to sputum cytology, bronchoscopy, mediastinoscopy and open biopsy. Commun indications for fine needle biopsies are the solitary pulmonary nodule, unless it shows definite radiological criteria of a benign lesion, chest wall lesions including Pancoast tumors as well as pulmonary lesions, which were negative on bronchoscopy. Contraindications - in part relative - are coagulopathy, pulmonary arterial and venous hypertension, bullous emphysema, chronic obstructive pulmonary disease, diseases of the lung with an oxygen tension of less than 60 mm Hg and positive pressure mechanical ventilation. Fluoroscopy is the preferred method for localization. CT guidance is used for mediastinal and hilar lesions as well as for pulmonary lesions close to large vessels and for small lesions which are not clearly identified by fluoroscopy in two planes. The sensitivity of fine needle biopsy in the diagnosis of primary lung cancer was 87% in a total of 963 patients. The most common complication was pneumothorax which occurred in 27% of the biopsies guided by fluoroscopy and in 36% of those guided by CT. Catheter drainage of pneumothorax was performed in one third of these patients. Hemoptysis and local parenchymal hemorrhage were found in less than 5% and were without clinical consequence. In addition to technique, results and complications of percutaneous thoracic biopsies, methods of adrenal and liver biopsy in patients with carcinoma of the lung will be discussed. (Author)

  9. Infections requiring surgery following transbronchial biopsy in lung cancer patients. A retrospective study

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the risk factors for severe infections developing as a complication of transbronchial biopsy in lung cancer patients. From April 2001 to March 2007, 1091 patients underwent bronchoscopy at our institution. We reviewed the records of 5 of these patients diagnosed with lung cancer and who developed lung abscess or cavitary infection after transbronchial biopsy necessitating surgical resection. The 5 patients (4 men, 1 woman; mean age at diagnosis, 62.4 years; range, 42-78 years) were all smokers and were immunocompetent. One patient suffered from diabetes mellitus. Of the 5 patients, chest CT revealed a cavitary lesion in 2 patients, central low attenuation in 2 patients, and a small nodule in 1 patient. The longest tumor diameter ranged from 20-60 mm (mean, 42 mm). Sputum cultures taken prior to bronchoscopy showed no significant bacterial growth in 4 of the patients, with 1 patient showing Streptococcus pneumoniae. Three cases showed elevated serum C-reactive protein. Histologically, the diagnosis was squamous cell carcinoma in 3 patients and adenocarcinoma in 2 patients. The risk factors for the development of a lung abscess after transbronchial biopsy include large mass lesions with central necrosis or cavitary lesions. (author)

  10. Levodropropizine in the premedication to fibrebronchoscopy.

    Science.gov (United States)

    Guarino, C; Cautiero, V; Cordaro, C; Catena, E

    1991-01-01

    The aim of the study was to evaluate the efficacy of cough-preventing treatment with levodropropizine, a drug inhibiting peripheral cough reflexes, in patients undergoing bronchial endoscopy. Sixteen patients, aged 37-73 years, suffering from chronic obstructive lung disease in the hypersecretory phase, were included in the study. The experiment was designed as double blind with double observer, controlled versus placebo. As comparative efficacy parameters were considered the number of anaesthetic boluses (lidocaine at 2%) administered during and immediately after the manoeuvre. The number of coughs during and 10 min after bronchoscopy was registered on a magnetic tape and read by a blinded observer thereafter. Levodropropizine was given as oral drops (20 each time, equal to 60 mg active drug) 12 h and 1 h before bronchoscopy. Data analysis was performed by descriptive statistical tests and by the non-parametric Wilcoxon test for paired samples. Levodropropizine treatment significantly reduced the number of anaesthetic enemas (p less than 0.01), and presented an excellent tolerability and safety profile. PMID:1794298

  11. Tracheal diverticulum: an unusual cause of chronic cough and recurrent respiratory infections.

    Science.gov (United States)

    Takhar, Rajendra Prasad; Bunkar, Motilal; Jain, Shubhra; Ghabale, Sanjay

    2016-03-01

    Tracheal diverticulum (TD) defined as a typical benign out-pouching of the tracheal wall due to structural weakness, congenital or acquired in origin, resulting in paratracheal air cysts. It is rarely diagnosed in clinical practice with only limited reports in the literature. Most cases found incidentally in the postmortem examination and located on the right side. Uncomplicated TDs are usually asymptomatic and when symptoms have occurred, they usually present with non-specific symptoms like pharyngeal discomfort, cough, dyspnea, and recurrent respiratory infection due to either the compression of adjacent organs or secondary bacterial infection. Imaging techniques like thoraco-cervical multi-slice spiral computed tomography (CT) and fiber-optic bronchoscopy are important diagnostic tools for this entity. Asymptomatic TDs usually require no treatment and managed conservatively while surgical excision is indicated in cases of compression of adjacent organs and recurrent infections. Here we report a case of tracheal diverticulum on the left side, which was diagnosed as part of a work-up for chronic cough and recurrent chest infection in a 40 year old female who was already on bronchodilator without any relief. Diagnosis of TD was based on findings of computed tomography, revealing small bud like projection on left para tracheal region and further confirmed by fiber-optic bronchoscopy while the barium contrast study showed no esophageal communication. She was managed conservatively and referred for surgical excision. PMID:27266290

  12. CT findings of the chest in adults with aspirated foreign bodies

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Shapiro-Feinberg, M. [Dept. of Diagnostic Imaging, Sapir Medical Center, Kfar Saba (Israel); Rozenman, J.; Apter, S.; Hertz, M. [Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Smorjik, J. [Dept. of Pulmonary Medicine, Sapir Medical Center, Kfar Saba (Israel)

    2001-04-01

    The aim of this study was to assess the imaging findings in adult patients with tracheobronchial foreign body aspiration. Nineteen patients (11 men and 8 women; age range 26-89 years) with foreign-body aspiration were retrospectively reviewed. Nine patients were outpatients with non-specific symptoms and ten were hospitalized with nonresolving pneumonia (n=6), after detection of a dental fragment on a chest radiograph following intubation (n=3), and there was one mentally retarded patient with empyema. An aspirated dental fragment was seen on a chest radiograph in 3 patients and an endobronchial foreign body on CT in 16, appearing as a dense structure within the bronchial lumen. The foreign body was right sided in 14 cases and left sided in 5. Three cases were missed at first interpretation. Associated findings on CT were volume loss, hyperlucency with air trapping and bronchiectasis in the affected lobe. Thirteen patients were managed with bronchoscopy, whereas 2 needed thoracotomy. In 1 patient bronchoscopy failed to detect a foreign body, indicating a false-positive CT diagnosis. One patient expelled an aspirated tablet and two refused invasive procedure. The foreign bodies found mainly were bones and dental fragments. A high clinical suspicion is necessary to diagnose a foreign body. Since CT is often used to evaluate various respiratory problems in adults, it may be the first imaging modality to discover an unsuspected aspirated foreign body in the bronchial tree. (orig.) (orig.)

  13. Aspergillus and mucormycosis presenting with normal chest X-ray in an immunocompromised host

    Science.gov (United States)

    Gupta, Vipin; Rajagopalan, Natarajan; Patil, Mahantesh; C, Shivaprasad

    2014-01-01

    Invasive aspergillus and mucormycosis infection are not uncommon in immunocompromised individuals. Endobronchial fungal infections have been reported in the literature, especially in patient's with diabetes complicated by diabetic ketoacidosis, but end bronchial coinfection with aspergillus and mucormycosis without pulmonary involvement has not been described in the literature. We report the case of a woman with diabetes who presented with gastrointestinal symptoms, ketoacidosis and respiratory distress, with an apparently normal chest X-ray. Investigations revealed a cavitatory lesion in the left lower lobe of the lungs on CT scan. Bronchoscopy revealed intense mucosal oedema and whitish plaques at the lower end of the trachea and right main stem bronchus with a normal left bronchial tree. Microbiological and pathological results confirmed aspergillus and mucormycosis. Despite aggressive medical management, the patient deteriorated and died of respiratory failure. Strong suspicion of invasive fungal infections in immunocompromised patients with respiratory failure and minimal chest infiltrates, early fibreoptic bronchoscopy and early aggressive treatment is crucial for the patient's survival. PMID:24717585

  14. [A case of endobronchial lesion due to infection with Mycobacterium intracellulare].

    Science.gov (United States)

    Iwashima, Daisuke; Suganuma, Hideki; Kobayashi, Jun

    2006-08-01

    A 53-year-old man was hospitalized in April 2001 because of left cervical lymphadenopathy and a mass shadow in the left lingular segment. Bronchoscopy revealed an elevated lesion in the left main bronchus, but a biopsy showed no specific findings. A left cervical lymph node biopsy revealed lymphoid hyperplasia only and no malignancy. After the patient was discharged, bronchial irrigation solution from the left lingular segment was found to be positive for Mycobacterium intracellulare. In July 2001 the shadow in the left lingular segment had worsened, and bronchoscopy was performed again. This revealed ulceration in the left main bronchus and edematous narrowing of the bronchial lumen at the opening of the lingular segment. A granulated lesion accompained by severe inflammation was seen in a biopsied specimen taken from the same site. Bronchial lesion induced by an acid-fast-stain positive nontuberculosis mycobacteria was noted. Treatment with rifampicin (RFP), clarithromycin (CAM), ethambutol (EB), and streptomycin (SM) was started, but a rash most likely caused by RFP developed, and RFP was replaced by ciprofloxacin (CPFX). The treatment was continued and symptoms improved. Since non-tuberculous mycobacteriosis accompanied with bronchial lesions is rare, a case report was made. PMID:16972655

  15. Radiation bronchitis and stenosis secondary to high dose rate endobronchial irradiation

    International Nuclear Information System (INIS)

    The purpose of the study was to describe a new clinical entity observed in follow-up bronchoscopies in patients who were treated with high dose rate and medium dose rate remote afterloading brachytherapy of the tracheobronchial tree. Patients were treated by protocol with medium dose rate, 47 patients receiving 1000 cGy at a 5 mm depth times three fractions, high dose rate 144 patients receiving 1000 cGy at a 10 mm depth for three fractions and high dose rate 151 patients receiving cGy at a 10 mm depth for three fractions followed by bronchoscopy. Incidence of this entity was 9% for the first group, 12% for the second, and 13% for the third group. Reactions were grade 1 consisting of mild inflammatory response with a partial whitish circumferential membrane in an asymptomatic patient; grade 2, thicker complete white circumferential membrane with cough and/or obstructive problems requiring intervention; grade 3, severe inflammatory response with marked membranous exudate and mild fibrotic reaction; and grade 4 a predominant fibrotic reaction with progressive stenosis. Variables associated with a slightly increased incidence of radiation bronchitis and stenosis included: large cell carcinoma histology, curative intent, prior laser photoresection, and/or concurrent external radiation. Survival was the strongest predictor of the reaction. Radiation bronchitis and stenosis is a new clinical entity that must be identified in bronchial brachytherapy patients and treated appropriately. 23 refs., 3 figs., 7 tabs

  16. Respiratory effects of particulate matter air pollution: studies on diesel exhaust, road tunnel, subway and wood smoke exposure in human subjects

    Energy Technology Data Exchange (ETDEWEB)

    Sehlstedt, Maria

    2011-07-01

    Background: Ambient air pollution is associated with adverse health effects, but the sources and components, which cause these effects is still incompletely understood. The aim of this thesis was to investigate the pulmonary effects of a variety of common air pollutants, including diesel exhaust, biomass smoke, and road tunnel and subway station environments. Healthy non-smoking volunteers were exposed in random order to the specific air pollutants and air/control, during intermittent exercise, followed by bronchoscopy. Methods and results: In study I, exposures were performed with diesel exhaust (DE) generated at transient engine load and air for 1 hour with bronchoscopy at 6 hours post-exposure. Immunohistochemical analyses of bronchial mucosal biopsies showed that DE exposure significantly increased the endothelial adhesion molecule expression of p-selectin and VCAM-1, together with increased bronchoalveolar lavage (BAL) eosinophils. In study II, the subjects were exposed for 1 hour to DE generated during idling with bronchoscopy at 6 hours. The bronchial mucosal biopsies showed significant increases in neutrophils, mast cells and lymphocytes together with bronchial wash neutrophils. Additionally, DE exposure significantly increased the nuclear translocation of the aryl hydrocarbon receptor (AhR) and phosphorylated c-jun in the bronchial epithelium. In contrast, the phase II enzyme NAD(P)H-quinone oxidoreductase 1 (NQO1) decreased after DE. In study III, the 2-hour exposures took place in a road tunnel with bronchoscopy 14 hours later. The road tunnel exposure significantly increased the total numbers of lymphocytes and alveolar macrophages in BAL, whereas NK cell and CD56+/T cell numbers significantly decreased. Additionally, the nuclear expression of phosphorylated c-jun in the bronchial epithelium was significantly increased after road tunnel exposure. In study IV, the subjects were exposed to metal-rich particulate aerosol for 2 hours at a subway station

  17. STUDY OF TIME LAPSE IN FOREIGN BODY ASPIRATION IN RELATION TO CHEST X - RAY AND TYPE OF FOREIGN BODY

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    Salma

    2015-10-01

    Full Text Available INTRODUCTI ON: Foreign body aspiration in pediatrics is a potentially fatal accident which will continue until children explore their surroundings with their hand and mouth. Pediatric aspirations will persist until mankind exists. Not all foreign body aspirations are witnessed hence chances of delay in diagnosing an aspiration are high. Delay in diagnosis depends on site and character of foreign body aspirated. The chest x - ray findings and type of foreign body extracted vary depending on the duration the foreign body remains in airway . OBJECTIVE: To study the X - ray finding in pediatric airway aspiration and its relation to time lapse, the type and site of lodgment of foreign body extracted via bronchoscopy. The type of foreign body in relation to time lapse in aspiration. MATERIAL AND METHODS: This was a prospective study done in Bapuji child health institute and research center, JJM Medical College, Davangere . History and pre bronchoscopy x - Ray finding were noted for 65 children who were posted for suspicious bronchoscopy from August 2011 to September 2013. 11 children were excluded from study as they showed no foreign body on bronchoscopy. Time lapse in aspir ation and seeking medical care was noted. The bronchoscopic findings regarding site of foreign body lodgment and type of foreign body were recorded. The type of foreign body and variation of x - ray picture in relation to time lapse in aspiration were noted. Data collected was analyzed using descriptive statistics. RESULT: It was observed that mean age was 28 months. About 80% of the cases were between 1 to 3 years age. 82% (n=53/54 were radio lucent foreign body, only 1.5% (n=1/54 were radio o paque. Site of lodgment of foreign body was right main bronchus in 48% (n=26/54, left main bronchus 46% (n=25/54 , tracheal 1.85% (n=1/54, subglottic 1.85% (n=1/54, carinal 1.85% (n=1/54, multiple site i.e. left bronchus +right bronchus+ carinal 1.85% (n=1/54. Groundnut was most common

  18. MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Edward Y. [Children' s Hospital Boston and Harvard Medical School, Departments of Radiology and Medicine, Pulmonary Division, Boston, MA (United States); Mason, Keira P. [Children' s Hospital Boston and Harvard Medical School, Department of Anesthesiology, Boston, MA (United States); Zurakowski, David [Children' s Hospital Boston and Harvard Medical School, Department of Orthopedic Surgery, Boston, MA (United States); Waltz, David A. [Children' s Hospital Boston and Harvard Medical School, Department of Medicine, Division of Respiratory Diseases, Boston, MA (United States); Ralph, Amy; Riaz, Farhana [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Boiselle, Phillip M. [Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

    2008-01-15

    Mediastinal aortic vascular anomalies are relatively common causes of extrinsic central airway narrowing in infants with respiratory symptoms. Surgical correction of mediastinal aortic vascular anomalies alone might not adequately treat airway symptoms if extrinsic narrowing is accompanied by intrinsic tracheomalacia (TM), a condition that escapes detection on routine end-inspiratory imaging. Paired inspiratory-expiratory multidetector CT (MDCT) has the potential to facilitate early diagnosis and timely management of TM in symptomatic infants with mediastinal aortic vascular anomalies. To assess the technical feasibility of paired inspiratory-expiratory MDCT for evaluating TM among symptomatic infants with mediastinal aortic vascular anomalies. The study group consisted of five consecutive symptomatic infants (four male, one female; mean age 4.1 months, age range 2 weeks to 6 months) with mediastinal aortic vascular anomalies who were referred for paired inspiratory-expiratory MDCT during a 22-month period. CT angiography was concurrently performed during the end-inspiration phase of the study. Two pediatric radiologists in consensus reviewed all CT images in a randomized and blinded fashion. The end-inspiration and end-expiration CT images were reviewed for the presence and severity of tracheal narrowing. TM was defined as {>=}50% reduction in tracheal cross-sectional luminal area between end-inspiration and end-expiration. The presence of TM was compared to the bronchoscopy results when available (n = 4). Paired inspiratory-expiratory MDCT was technically successful in all five patients. Mediastinal aortic vascular anomalies included a right aortic arch with an aberrant left subclavian artery (n = 2), innominate artery compression (n = 2), and a left aortic arch with an aberrant right subclavian artery (n = 1). Three (60%) of the five patients demonstrated focal TM at the level of mediastinal aortic vascular anomalies. The CT results were concordant with the

  19. 支架置入治疗48例良性气管狭窄的近期疗效评价%Eevaluation of short-term efficacy of stent treatment on 48 patients with bengin tracheal stenosis

    Institute of Scientific and Technical Information of China (English)

    李亚强; 陈如华; 李强

    2011-01-01

    Objective To evaluate the short-term efficacy of stent insertion through bronchoscopy for the treatment of bengin tracheal stenosis. Methods The data of 48 patients with benign tracheal stenosis were retrospectively analysed. The changes of tracheal diameter, forced expiratory volume in the first second, and dyspnea index were observed through bronchoscopy before and after stent insertion. Results Tracheal diameter increased from (5.15 ±1.96) mm to ( 10.60 ± 2.88) mm ( P <0. 01 ). Forcedexpiratory volume in the first second increased from (1.45±0.51) L to (2.46±0.48) L ( P <0.01).Dyspnea index decreased from 3.06±0.85 to 0.88±0.33 ( P<0.01).Conclusions The short-term efficacy of stent insertion through bronchoscopy is clear for the treatment of bengin tracheal stenosis, but there may be some complications.%目的 评价纤维支气管镜下支架置人治疗良性气管狭窄的近期疗效.方法 回顾性分析第二军医大学附属长海医院1999年至2007年良性气管狭窄患者48例,观察支气管镜下支架置入前后气管直径、第1秒用力呼气容积、气促评分的变化.结果 狭窄段气管直径由术前的(5.15士1.96)mm增加到(10.60±2.88)mm(P<0.01).第1秒用力呼气容积由术前的(1.45±0.51)L增加到(2.46±0.48)L(P<0.01).气促评分由术前的3.06±0.85减少到0.88±0.33(P<0.01).结论 支气管镜下支架置人治疗良性气管狭窄近期疗效明确,但可出现一定的并发症.

  20. “One-stop shop” spectral imaging for rapid on-site diagnosis of lung cancer: a future concept in nano-oncology

    Directory of Open Access Journals (Sweden)

    Darwiche K

    2013-11-01

    Full Text Available Kaid Darwiche,1 Paul Zarogoulidis,1,2 Leslie Krauss,3 Filiz Oezkan,1 Robert Fred Henry Walter,1,4 Robert Werner,4 Dirk Theegarten,4 Leonidas Sakkas,5 Antonios Sakkas,5 Wolfgang Hohenforst-Scmidt,6 Konstantinos Zarogoulidis,1 Lutz Freitag11Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany; 2Pulmonary Department, Oncology Unit, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 3CytoViva, Inc, Auburn, AL, USA; 4Institute of Pathology and Neuropathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany; 5Pathology Department, G Papanikolaou General Hospital, Thessaloniki, Greece; 6II Medical Department, Coburg Regional Clinic, University of Wuerzburg, Coburg, GermanyBackground: There are currently many techniques and devices available for the diagnosis of lung cancer. However, rapid on-site diagnosis is essential for early-stage lung cancer, and in the current work we investigated a new diagnostic illumination nanotechnology.Methods: Tissue samples were obtained from lymph nodes, cancerous tissue, and abnormal intrapulmonary lesions at our interventional pulmonary suites. The following diagnostic techniques were used to obtain the samples: endobronchial ultrasound bronchoscopy; flexible bronchoscopy; and rigid bronchoscopy. Flexible and rigid forceps were used because several of the patients were intubated using a rigid bronchoscope. In total, 30 tissue specimens from 30 patients were prepared. CytoViva® illumination nanotechnology was subsequently applied to each of the biopsy tissue slides.Results: A spectral library was created for adenocarcinoma, epidermal growth factor receptor mutation-positive adenocarcinoma, squamous cell carcinoma, usual interstitial pneumonitis, nonspecific interstitial pneumonitis, typical carcinoid tumor, sarcoidosis, idiopathic pulmonary fibrosis, small cell

  1. Aspirasi Benda Asing Paku dengan Komplikasi Atelektasis Paru dan Aspirasi Benda Asing Jarum Pentul Tanpa Komplikasi

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    Novialdi .

    2015-05-01

    Full Text Available Abstrak Aspirasi benda asing bronkus adalah masalah yang sering  pada anak-anak dan merupakan masalah seriusserta bisa berakibat fatal. Sebagian besar aspirasi benda asing di bronkus pada anak-anak karena kecenderunganmemasukkan sesuatu ke mulut, pertumbuhan gigi molar yang belum lengkap, kurangnya pengawasan dari orang tuadan lain-lain. Aspirasi jarum pentul di bronkus biasanya terjadi pada wanita remaja muslim yang menggunakan jilbab.Benda asing tajam di bronkus harus segera dikeluarkan dalam kondisi dan peralatan optimal untuk mencegahkomplikasi yang timbul. Komplikasi akibat aspirasi benda asing tajam yang paling sering berupa perforasi jalan nafas,trakeitis, bronkitis, jaringan granulasi, efusi pleura dan atelektasis. Tindakan bronkoskopi merupakan pilihan untukekstraksi benda asing tajam yang teraspirasi. Dilaporkan dua kasus aspirasi benda asing tajam di bronkus yaitu padaseorang anak laki-laki, berusia 6 tahun dengan aspirasi paku dengan komplikasi atelektasis paru dan seorang anakperempuan, berusia 14 tahun dengan aspirasi jarum pentul tanpa komplikasi yang telah berhasil diekstraksimenggunakan bronkoskopi kaku.Kata kunci: benda asing tajam di bronkus, aspirasi paku, aspirasi jarum pentul, atelektasis, bronkoskopi kaku  Abstract Bronchial foreign body aspiration is a common problem in children and it is a serious problem that can befatal. Most of bronchial foreign body aspiration occur in children because of the tendency to put something into themouth, the molar growth is not yet complete, the lack of supervision from parents and others situation . Aspiration of apin in the bronchi usually occurs in adolescent Muslim women who wear headscarf. Sharp foreign bodies in thebronchi must be removed immediately and the optimal equipment to prevent complications. Complications due tosharp foreign bodies aspiration most often in the form of perforation, tracheitis, bronchitis, granulation tissue, pleuraleffusion and atelectasis. Bronchoscopy

  2. Chest trauma: A case for single lung ventilation

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    Nagaraj Pandharikar

    2016-01-01

    Full Text Available Chest trauma is one of the important causes of mortality and morbidity in pediatric trauma patients. The complexity, magnitude, and type of lung injury make it extremely challenging to provide optimal oxygenation and ventilation while protecting the lung from further injury due to mechanical ventilation. Independent lung ventilation is used sporadically in these patients who do not respond to these conventional ventilatory strategies using double-lumen endotracheal tubes, bronchial blocker balloons, etc. However, this equipment may not be easily available in developing countries, especially for pediatric patients. Here, we present a case of severe chest trauma with pulmonary contusion, flail chest, and bronchopleural fistula, who did not respond to conventional lung protective strategies. She was successfully managed with bronchoscopy-guided unilateral placement of conventional endotracheal tube followed by single lung ventilation leading to resolution of a chest injury.

  3. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

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    Ataman Köse

    2014-01-01

    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  4. [Radiological examinations that have disappeared].

    Science.gov (United States)

    Puylaert, Carl B A J; Puylaert, Julien B C M

    2011-01-01

    If a radiologist from 1950 could travel in time to 2011, he or she would be baffled to see how few of the radiological examinations he was familiar with, remain. We review the radiological examinations that have disappeared since X-rays were discovered, and include the causes of their disappearance. Barium studies have mainly been replaced by endoscopy, oral cholecystography by ultrasound, and intravenous urography by CT-scan. Angiography by means of a direct puncture of carotid artery and aorta has been replaced by Seldinger angiography. Pneumencephalography and myelography have been replaced by CT and MRI. Bronchography has been replaced by bronchoscopy and CT-scan, arthrography by MRI and arthroscopy. Many other radiological examinations have been replaced by ultrasound, CT or MRI. PMID:21447222

  5. Bronchography in patients with persistent cough

    International Nuclear Information System (INIS)

    Bronchography was performed together with a fibre-optic bronchoscopic study in 98 patients with persistent cough, 33 of whom also had haemoptysis. Finally there were chronic bronchitis in 62 patients, bronchiectasis in 21, subacute bronchitis in 9, inflammatory residuals in 3, pulmonary tuberculosis in 2 patients and metastases in one. In chronic bronchitis, the value of plain chest radiography was low. It was normal in 34 of 62 cases (55%), bronchography in 12 cases (19%). Mild cases of bronchitis were more numerous in bronchography than seen by scopist. Bronchiectasis was found in 21 patients, four of these unexpectedly (two in a tbc scar). Additionally, three cases were overdiagnosed by the radiologist on chest films and eight cases by the scopist with bronchoscopy. In patients with persistent cough and haemoptysis, bronchography mainly revealed alterations of bronchitis. (orig.)

  6. Nasogastric tube syndrome induced by an indwelling long intestinal tube.

    Science.gov (United States)

    Sano, Naoki; Yamamoto, Masayoshi; Nagai, Kentaro; Yamada, Keiichi; Ohkohchi, Nobuhiro

    2016-04-21

    The nasogastric tube (NGT) has become a frequently used device to alleviate gastrointestinal symptoms. Nasogastric tube syndrome (NTS) is an uncommon but potentially life-threatening complication of an indwelling NGT. NTS is characterized by acute upper airway obstruction due to bilateral vocal cord paralysis. We report a case of a 76-year-old man with NTS, induced by an indwelling long intestinal tube. He was admitted to our hospital for treatment of sigmoid colon cancer. He underwent sigmoidectomy to release a bowel obstruction, and had a long intestinal tube inserted to decompress the intestinal tract. He presented acute dyspnea following prolonged intestinal intubation, and bronchoscopy showed bilateral vocal cord paralysis. The NGT was removed immediately, and tracheotomy was performed. The patient was finally discharged in a fully recovered state. NTS be considered in patients complaining of acute upper airway obstruction, not only with a NGT inserted but also with a long intestinal tube. PMID:27099450

  7. Carcinosarcoma of the Lung Associated with Neurofibromatosis Type 1: A Case Re

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    Rana ÇİTİL

    2012-01-01

    Full Text Available Neurofibromatosis or von Recklinghausen's disease is the most common inherited syndrome predisposing to neoplasia. Carcinosarcoma is a rare malignant mixed tumor of the lung. Association of carcinosarcoma of lung with Neurofibromatosis-1 is not common. A 57-year-old man presented with history of fever, cough, hemoptysis, breathlessness, weight loss, chest pain. Multiple cutaneous neurofibromas and café au lait spots were revealed by physical examination. A homogeneous opacity was found in the right middle and right upper zone on posterior-anterior chest radiography. A 8x8x7 cm mass that had irregular borders in right upper posterior and apical segment was seen on contrast enhanced chest computed tomography. On bronchoscopy, the lumen of right upper apical segment was obstructed with vegetating tumoral lesion. The biopsy taken from this region was diagnosed as carcinosarcoma by histopathological and immunohistochemical examination.A rare case with carcinosarcoma of the lung and Neurofibromatosis-1 was reported.

  8. A rare case of fibrostenotic endobronchial tuberculosis of trachea

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    Cassiopia Cary

    2015-12-01

    Full Text Available Endobronchial tuberculosis (EBTB is a sequelae of pulmonary tuberculosis (TB that extends to the endobronchial or endotracheal wall causing inflammation, edema, ulceration, granulation or fibrosis of mucosa and submucosa. This case depicts a 20 year old foreign-born woman with a history of active pulmonary TB on anti-TB chemotherapy, who presented with worsening stridor, dyspnea, cough and weight loss. The disease state was diagnosed with multiple modalities including, spirometry, CT scan of the neck, and bronchoscopy. The biopsies of the tracheal web revealed fibrotic tissue without any granulomas or malignancy establishing the diagnosis of EBTB. Serial balloon dilations and anti-neoplastic therapy with Mitomycin C was used to accomplish sufficient airway patency to relieve her symptoms. ETBT is a rare consequence of TB, which although has a low incidence in the United States, so physicians should have a high clinical suspicion based on the need for prompt intervention.

  9. An unusual cause for recurrent chest infections.

    LENUS (Irish Health Repository)

    Lobo, Ronstan

    2012-10-01

    We present a case of an elderly non-smoking gentleman who, since 2005, had been admitted multiple times for recurrent episodes of shortness of breath, wheeze, cough and sputum. The patient was treated as exacerbations of chronic obstructive pulmonary disease (COPD) and\\/or lower respiratory tract infections. Bronchoscopy was done which revealed multiple hard nodules in the trachea and bronchi with posterior tracheal wall sparing. Biopsies confirmed this as tracheopathia osteochondroplastica (TO). He had increasing frequency of admission due to methicillin-resistant Staphylococcus aureus and pseudomonas infections, which failed to clear despite intravenous, prolonged oral and nebulised antibiotics. The patient developed increasing respiratory distress and respiratory failure. The patient died peacefully in 2012. This case report highlights the typical pathological and radiological findings of TO and the pitfalls of misdiagnosing patients with recurrent chest infections as COPD.

  10. Bronchial leiomyoma, a case report and review of literature

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    José Cárdenas-García, MD

    2014-01-01

    Full Text Available A 44 year old male former smoker from Ecuador presented with productive cough for 3 weeks, positive tuberculin skin test, 40 lbs weight loss and right lower lobe collapse. He denied wheezing or hemoptysis. He was treated with antibiotics and ruled out for tuberculosis with negative sputum smear. Bronchoscopy showed an endobronchial lesion at the distal end of bronchus intermedius as cause of the collapse. Endobronchial biopsy of the lesion revealed an endobronchial leiomyoma, a rare cause of endobronchial tumor. The patient underwent bilobectomy as definite therapy for the leiomyoma due to its large size and possible extra-luminal extension, which made it not amenable to bronchoscopic resection or bronchoplasty. Differential diagnoses of endobronchial lesions are discussed along with clinical, radiographic, pathologic characteristics and various treatment modalities for endobronchial leiomyomas.

  11. Isolated pauci-immune pulmonary capillaritis

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    Ashok Kumar Mehrotra

    2015-01-01

    Full Text Available A young house wife presented with low grade fever, cough, haemoptysis and SOB of unknown aetiology for 40 days duration. Respiratory system examination revealed diffuse crepts and rhonchi. Other organ system examination did not reveal any abnormality. X-ray chest PA view and CT thorax showed diffuse bilateral necrotising nodular lesions of various sizes with small pleural effusion. She also had low resting oxygen saturation with falling haematocrit. Her Serum was week positive for p-ANCA and negative for MPO-ANCA. Bronchoscopy revealed continuous bloody aspirates. We could not isolate any organisms in any of the specimens from her and she was unresponsive to any of the antibiotics either. Based on the clinical, laboratory data, radiological features and positive outcome to pulse therapy of methylprednisolone and cyclophosphamide, she was diagnosed as a case of IPIPC.

  12. Sarcoidosis with Major Airway, Vascular and Nerve Compromise

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    Hiroshi Sekiguchi

    2013-01-01

    Full Text Available The present report describes a 60-year-old Caucasian woman who presented with progressive dyspnea, cough and wheeze. A computed tomography scan of the chest showed innumerable bilateral inflammatory pulmonary nodules with bronchovascular distribution and a mediastinal and hilar infiltrative process with calcified lymphadenopathy leading to narrowing of lobar bronchi and pulmonary arteries. An echocardiogram revealed pulmonary hypertension. Bronchoscopy showed left vocal cord paralysis and significant narrowing of the bilateral bronchi with mucosal thickening and multiple nodules. Transbronchial biopsy was compatible with sarcoidosis. Despite balloon angioplasty of the left lower lobe and pulmonary artery, and medical therapy with oral corticosteroids, her symptoms did not significantly improve. To the authors’ knowledge, the present report describes the first case of pulmonary sarcoidosis resulting in major airway, vascular and nerve compromise due to compressive lymphadenopathy and suspected concurrent granulomatous infiltration. Its presentation mimicked idiopathic mediastinal fibrosis.

  13. Invasive procedures with questionable indications

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    Sergei V. Jargin

    2014-12-01

    Full Text Available Insufficient coordination of medical research and partial isolation from the international scientific community can result in application of invasive methods without sufficient indications. Here is presented an overview of renal and pancreatic biopsy studies performed in the course of the operations of pancreatic blood shunting into the systemic blood flow in type 1 diabetic patients. Furthermore a surgical procedure of lung denervation as a treatment method of asthma as well as the use of bronchoscopy for research in asthmatics are discussed here. Today, the upturn in Russian economy enables acquisition of modern equipment; and medical research is on the increase. Under these circumstances, the purpose of this letter was to remind that, performing surgical or other invasive procedures, the risk-to-benefit ratio should be kept as low as possible.

  14. Churg–Strauss Syndrome Presenting with Endobronchial Masses

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    Veli Çetinsu

    2015-12-01

    Full Text Available Churg–Strauss syndrome is a condition with unknown etiology and asthma, allergic rhinitis, eosinophilic infiltration of blood and tissues, and transient infiltration of the lungs. It occurs mostly in the 3rd–4th decades of life with an incidence of 2.4/1000000. Presentation frequently involves nodular lung infiltrations, infiltrations with cavity, ground-glass appearance, and alveolar opacity. However, endobronchial mass is an unexpected presentation. In the current case report, we present a 45-year-old male patient who was receiving asthma therapy for 5 years. In the last follow-up visit, we identified a mass in the right hilum on X-ray radiography and performed fiberoptic bronchoscopy. Pathologic examination of biopsy material verified the diagnosis of Churg–Strauss syndrome. Bronchial mass is an unexpected presentation of Churg–Strauss syndrome and pathologic examination is essential to distinguish it from pulmonary malignancies

  15. Mixed Pulmonary Infection with Penicillium notatum and Pneumocystis jiroveci in a Patient with Acute Myeloid Leukemia

    Science.gov (United States)

    Tehrani, Shabnam; Hemmatian, Marjan

    2016-01-01

    Penicillium notatum is a fungus that widely exists in the environment and is often non-pathogenic to humans. However, in immunocompromised hosts it may be recognized as a cause of systemic mycosis. A 44-year-old man with acute myeloid leukemia (AML) was admitted to our hospital with fever and neutropenia. Due to no improvement after initial treatment, he underwent bronchoscopy. The patient was found to have P. notatum and Pneumocystis jiroveci infection, and therefore was given voriconazole, primaquine and clindamycin. The patient was successfully treated and suffered no complications. Conclusion: This case highlights P. notatum as a cause of infection in immunocompromised patients. To the best of our knowledge, mixed lung infection with P. notatum and P. jiroveci in a patient with AML has not been previously reported.

  16. Diagnostic use of PCR for detection of Pneumocystis carinii in oral wash samples

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Jensen, Jens Ulrik Stæhr; Benfield, T;

    1998-01-01

    There is a need to develop noninvasive methods for the diagnosis of Pneumocystis carinii pneumonia in patients unable to undergo bronchoscopy or induction sputum. Oral wash specimens are easily obtained, and P. carinii nucleic acid can be amplified and demonstrated by PCR. In routine clinical use...... was compared to a previously described PCR protocol (mitochondrial RNA) run in a research laboratory. Both PCR methods amplified a sequence of the mitochondrial rRNA gene of P. carinii. Paired bronchoalveolar lavage (BAL) and oral wash specimens from 76 consecutive human immunodeficiency virus type 1...... wash specimens and 100, 91, 90, and 100%, respectively, for BAL specimens. Our results suggest that oral wash specimens are a potential noninvasive method to obtain a diagnostic specimen during P. carinii pneumonia infection and that it can be applied in a routine diagnostic laboratory....

  17. Airway management of a rare huge-size supraglottic mass

    International Nuclear Information System (INIS)

    Laser excision of a huge-sized supraglottic mass nearly obstructing the airway passage is a real challenge to anesthesiologists. Upper airway obstruction due to neoplasm in supraglottic region, is traditionally managed by preoperative tracheostomy, however, such a common procedure can potentially have an impact on long-term outcome. A 26-year-old patient presented with dysphagia caused by left cystic vallecular synovial sarcoma. The airway was successfully secured via fiberoptic bronchoscopy, followed by excision of the supraglottic tumor with CO2 laser surgery. Tracheostomy was not required. The patient was discharged from the hospital on the 4th day of surgery. This case, highlights the possibility to secure the airway passage without performing preoperative tracheostomy resulting in good outcome and short hospital stay. (author)

  18. Bronchoscopic resection of endobronchial inflammatory myofibroblastic tumor: A case report and systematic review of the literature

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    Animesh Ray

    2014-01-01

    Full Text Available Inflammatory myofibroblastic tumour (IMT is a rare tumour affecting the tracheo-bronchial tree in the adult population. The clinical presentation of this tumour is diverse and diagnosis can be definitively clinched by histopathological examination. Treatment of this tumour usually requires surgical resection with bronchoscopic resection being described in few cases. We describe a 32 year old male presenting with hemoptysis who was diagnosed to have IMT. Resection of the tumour was done with the help of rigid bronchoscopy. Post-resection, hemoptysis stopped and no recurrence of tumour was noted on subsequent follow-up. We also present a systematic review of literature of all the cases of tracheo-bronchial IMT treated with bronchoscopic resection and conclude it to be a useful alternative to surgery in such cases.

  19. Clinical review: Airway hygiene in the intensive care unit

    Science.gov (United States)

    Jelic, Sanja; Cunningham, Jennifer A; Factor, Phillip

    2008-01-01

    Maintenance of airway secretion clearance, or airway hygiene, is important for the preservation of airway patency and the prevention of respiratory tract infection. Impaired airway clearance often prompts admission to the intensive care unit (ICU) and can be a cause and/or contributor to acute respiratory failure. Physical methods to augment airway clearance are often used in the ICU but few are substantiated by clinical data. This review focuses on the impact of oral hygiene, tracheal suctioning, bronchoscopy, mucus-controlling agents, and kinetic therapy on the incidence of hospital-acquired respiratory infections, length of stay in the hospital and the ICU, and mortality in critically ill patients. Available data are distilled into recommendations for the maintenance of airway hygiene in ICU patients. PMID:18423061

  20. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava.

    Science.gov (United States)

    Zhu, Daxing; Qiu, Xiaoming; Zhou, Qinghua

    2015-11-01

    A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC) utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava. PMID:26582230

  1. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  2. Low Prevalence of Chronic Beryllium Disease among Workers at a Nuclear Weapons Research and Development Facility

    Energy Technology Data Exchange (ETDEWEB)

    Arjomandi, M; Seward, J P; Gotway, M B; Nishimura, S; Fulton, G P; Thundiyil, J; King, T E; Harber, P; Balmes, J R

    2010-01-11

    To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with HRCT (N=49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage (BAL) and transbronchial biopsies. The mean duration of employment at the facility was 18 yrs and the mean latency (from first possible exposure) to time of evaluation was 32 yrs. Five of the workers had CBD at the time of evaluation (based on histology or HRCT); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.

  3. Anesthetic management of an infant for aortopexy

    Directory of Open Access Journals (Sweden)

    Shruti Kumar

    2013-01-01

    Full Text Available Tracheomalacia is a rare condition characterized by weakness of tracheobronchial cartilaginous bridges. Severe weakness results in tracheal collapse during inspiration, obstructing normal airflow. Tracheomalacia may also be associated with esophageal atresia, tracheoesophageal fistula, and gastroesophageal reflux. Aortopexy is an established surgical procedure for treatment of severe tracheomalacia. A 2-month-old boy was scheduled for aortopexy. He had already undergone repair of tracheoesophageal fistula and had failed multiple attempts at extubation. Intraoperative flexible fiberoptic bronchoscopy was performed to guide the amount and direction of aortopexy for assuring the most effective tracheal decompression. Since tracheomalacia is best assessed in a spontaneously breathing patient, it was an anesthetic challenge to maintain an adequate depth of anesthesia while allowing the patient to breathe spontaneously. Throughout the intraoperative period, SpO 2 remained ≥96%. Following the procedure, the trachea was extubated and patient was able to breathe normally.

  4. A rare case of esophageal lung in a neonate.

    Science.gov (United States)

    Patil, Megharanjini; Sutagatti, Jagadish; Bhavikatti, Mohan; Nayak, Puneet V

    2016-01-01

    We report a rare case of esophageal lung in a neonate who presented with repeated chest infections and respiratory distress. Chest radiograph revealed increased opacification of the right lung with reduced lung volume and air bronchograms. Further evaluation with computed tomography (CT) showed the presence of only left mainstem bronchus at the tracheal bifurcation. Right mainstem bronchus originated from distal esophagus and aerated the right lung. Nasogastric tube was inserted into the stomach with injection of small amount of dilute barium through it, which established the communication of right mainstem bronchus with esophagus. Advanced CT scan imaging by virtual bronchoscopy and volume rendering further delineated the anatomical abnormality precisely prior to surgery. Surgical findings confirmed the diagnosis. PMID:27413267

  5. A rare tumor of trachea: Inflammatory myofibroblastic tumor diagnosis and endoscopic treatment

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    Mehmet Akif Özgül

    2014-01-01

    Full Text Available Inflammatory myofibroblastic tumors (IMTs are rare childhood neoplasms, with benign clinical course. Although etiology of IMTs are not clear, recent studies have reported that IMT is a true neoplasm rather than a reactive or inflammatory lesion. IMTs are rarely seen in adults and tracheal involvement is also rare both in adults and also in children. We describe a 16-year old female patient who was misdiagnosed and treated as asthma in another center for a few months and presented with acute respiratory distress due to upper airway obstruction. Computerized tomography (CT of the chest and rigid bronchoscopy revealed a mass lesion that was nearly totally obliterating tracheal lumen. Bronchoscopic resection was performed under general anesthesia and the final pathological diagnosis was tracheal IMT.

  6. Smoke inhalation injury during enclosed-space fires: an update

    Directory of Open Access Journals (Sweden)

    Ana Carolina Pecanha Antonio

    2013-06-01

    Full Text Available In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection

  7. [Chronic disseminated intravascular coagulopathy in a dog with lung worm infection].

    Science.gov (United States)

    Schmitz, S; Moritz, A

    2009-06-01

    The clinical and laboratory findings in a 1-year-old male Jack Russel Terrier dog with lung worm induced coagulopathy are described. The diagnosis was based upon history, clinical findings, radiography, endoscopy, cytology and laboratory results. The presenting complaint was chronic cough. Radiographically, a diffuse interstitial to bronchial lung pattern was observed. Blood analysis revealed thrombocytopaenia and prolonged coagulation times. Disseminated intravascular coagulopathy (DIC) was diagnosed based on D-dimer and fibrinogen measurements, and by thrombelastogram results. After stabilisation of the patient, bronchoscopy with a bronchoalveolar lavage was performed, where large amounts of lung worm larvae were found cytologically. After treatment with fresh frozen plasma and fenbendazole, coagulation parameters improved and the cough resolved. PMID:19496048

  8. Severe Unilateral Atelectasis after Induction of General Anesthesia: Due to Aspiration of Oropharyngeal Secretion?

    Directory of Open Access Journals (Sweden)

    Myoung Jin Ko

    2014-10-01

    Full Text Available A 27-year-old man underwent general anesthesia for arthroscopic Bankart repair surgery. Glycopyrrolate was administered for premedication and anesthesia was induced with propofol and rocuronium. After tracheal intubation, the patient’s position was changed to right lateral position for operation. Gradual elevation of airway pressure and decrease of oxygen saturation occurred, and was suspected to be due to endobrochial intubation. Nonetheless, the endotracheal tube was drawn to 22 cm at the upper incisor and breathing sound was not auscultated overthe right lung field. Bronchoscopy was performed for diagnosis, right main bronchus was filled withclear mucus secretion. After suction of the secretion, ventilation was improved. After finishing the operation, a chest X-ray showed aspiration pneumonia overthe right lung. The patient was treated with antibiotics and discharged uneventfully 5 days postoperatively.

  9. Rare Upper Airway Anomalies.

    Science.gov (United States)

    Windsor, Alanna; Clemmens, Clarice; Jacobs, Ian N

    2016-01-01

    A broad spectrum of congenital upper airway anomalies can occur as a result of errors during embryologic development. In this review, we will describe the clinical presentation, diagnosis, and management strategies for a few select, rare congenital malformations of this system. The diagnostic tools used in workup of these disorders range from prenatal tests to radiological imaging, swallowing evaluations, indirect or direct laryngoscopy, and rigid bronchoscopy. While these congenital defects can occur in isolation, they are often associated with disorders of other organ systems or may present as part of a syndrome. Therefore workup and treatment planning for patients with these disorders often involves a team of multiple specialists, including paediatricians, otolaryngologists, pulmonologists, speech pathologists, gastroenterologists, and geneticists. PMID:26277452

  10. CT digital radiography: Alternative technique for airway evaluation in physically disabled patients

    International Nuclear Information System (INIS)

    Evaluation of the airway for the presence of granulation tissue prior to removal of a tracheostomy is essential to prevent sudden respiratory decompensation secondary to obstruction. Airway examination in a brain and/or spinal cord injured patient is especially difficult under fluoroscopy. The patient's lack of mobility results in poor visualization of the trachea, secondary to the overlying dense osseous components of the shoulders and thoracic cage. A CT localization view (digital view), which allows manipulation and magnification of the digital data in order to see the hidden airway and detect associated obstructing lesions, is proffered as an alternative technique to high KV, magnification technique. Thirteen examinations were performed satisfactorily in eleven patients examined by this technique with little expenditure of time, physical exertion, and irradiation. The sensitivity, specificity and accuracy of digital airway examination were 100%, 67% and 92% respectively with bronchoscopy used as the standard. (orig.)

  11. What's in a name? Expiratory tracheal narrowing in adults explained

    International Nuclear Information System (INIS)

    Tracheomalacia, tracheobronchomalacia, and excessive dynamic airway collapse are all terms used to describe tracheal narrowing in expiration. The first two describe luminal reduction from cartilage softening and the latter refers to luminal reduction from exaggerated posterior membrane movement. Expiratory tracheal narrowing is a frequent occurrence that can cause symptoms of airway obstruction, such as dyspnoea, wheeze, and exercise intolerance. The accurate diagnosis and quantification of expiratory tracheal narrowing has important aetiological, therapeutic, and prognostic implications. The reference standard for diagnosis has traditionally been bronchoscopy; however, this method has significant limitations. Expiratory tracheal disorders are readily detected by four-dimensional dynamic volume multidetector computed tomography (4D-CT), an emerging, non-invasive method that will potentially enable detection and quantification of these conditions. This review discusses the morphological forms of expiratory tracheal narrowing and demonstrates the utility of 4D-CT in the diagnosis, quantification, and treatment of these important conditions

  12. Idiopathic Pulmonary Hemosiderosis With Allergic Asthma Diagnosis in a Pediatric Patient.

    Science.gov (United States)

    Eldem, İrem; İleri, Talia; İnce, Elif; Asarcikli, Fikret; Pekpak, Esra; Çakmakli, Hasan F; Ceyhan, Koray; Uysal, Zümrüt

    2015-10-01

    Idiopathic pulmonary hemosiderosis (IPH) is a rare disorder with unknown pathogenesis that usually presents in the first decade of life. As a result of diffuse alveolar hemorrhage, respiratory symptoms such as cough attacks, hemoptysis, dyspnea, and recurrent and refractory iron-deficiency anemia (IDA) are observed. We present an 8-year-old girl who was followed up with recurrent IDA and allergic asthma and later diagnosed with IPH. IPH was confirmed by the presence of hemosiderin-laden macrophages in bronchoalveolar lavage obtained by bronchoscopy and exclusion of the secondary causes of pulmonary hemosiderosis. Glucocorticoids and iron supplementation were started. Clinical and laboratory improvement was observed with therapy. Our case illustrates that refractory/recurrent IDA with any pulmonary symptoms may be the only presenting feature of IPH. PMID:26241728

  13. A case of aspirated foreign body pop corn maize seed in an infant successfully treated - Sur Hospital experience

    Directory of Open Access Journals (Sweden)

    Fahim Ahmed Shah

    2015-07-01

    Full Text Available Here we are reporting a case of an infant who accidentally aspirated a maize seed while eating pop corn unattended with no one nearby! This popcorn was hard and unpoped and probably hard enough to be chewed by the small infant. The child was brought from periphery to the emergency department of our secondary care Centre in a collapsed state from where he was immediately taken to operation theatre and in general anesthesia with bronchoscopy the foreign body was retrieved and child was saved and successfully treated. The object of this case report is to highlight the importance of this kind of emergency and to note that aspiration causing complete upper airway obstruction is an emergency requiring immediate intervention

  14. Uncommon presentation of pulmonary aspergilloma

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

    Full Text Available Cases of pulmonary aspergilloma without any predisposing factors are rarely reported. Clinical presentation varies from case to case. Here, we report a case of pulmonary aspergilloma in a 60-year-old male patient who was admitted to the Intensive Respiratory Care Unit with spontaneous pneumothorax. The patient had a history of dyspnea on exertion since 9 months and mild haemoptysis since the last 6 months. A computerised tomographic scan of the lungs showed a lesion in the left main bronchus along with obstructive emphysema of the right lung, moderate pneumothorax and mediastinal emphysema. Bronchoscopy was performed and the biopsy samples were processed for histopathological examination and culture on Sabouraud′s dextrose agar, which yielded growth of Aspergillus flavus. Repeat sputum samples also yielded the growth of A. flavus . The patient responded to intravenous liposomaamphotericin B and intercostal drainage.

  15. External radiation therapy for roentgenographically occult lung cancers

    International Nuclear Information System (INIS)

    From January 1982 to May 1991, the authors have treated 13 cases of a roentgenographically occult lung cancer by using a 4∼10 MV photon beam. All 13 patients were males whose ages ranged from 53 to 84 years (mean: 71.4 years) and each was a heavy cigarrette smoker. In each instance, a sputum cytologic study uncovered abnormal findings and bronchoscopy revealed a localized cancer. For radiotherapy, radiation doses ranged from 50∼70 Gy (mean: 64.0 Gy), and the radiation field ranged from 25.75 to 90 cm2 (mean: 43.2 cm2). During the follow-up period of 11 to 68 months (mean: 34.2 months), 2 patients died of the carcinoma, 1 still has the carcinoma, and 3 died of other causes. The 5-year survival rate was 62%. (author)

  16. A Case of Pneumonia Caused by Pneumocystis Jirovecii and Cryptococcus Neoformans in a Patient with HTLV-1 Associated Adult T- Cell Leukemia/Lymphoma: Occam's Razor Blunted.

    Science.gov (United States)

    Desai, Anish; Fe, Alexander; Desai, Amishi; Ilowite, Jonathan; Cunha, Burke A; Mathew, Joseph P

    2016-02-01

    Adult T-cell leukemia/lymphoma (ATLL) is usually preceded by infection with human T-cell lymphotropic virus I (HTLV-I). Patients with ATLL frequently get opportunistic infections of the lungs, intestines, and central nervous system. Pneumocystis pneumonia is commonly known as an AIDS defining illness. Grocott's methenamine silver stain of bronchoalveolar lavage (BAL) samples obtained via bronchoscopy remain the gold standard for diagnosis. Pulmonary cryptococcosis is seen in patients with T-cell deficiencies and a diagnosis is made by culture of sputum, BAL, or occasionally of pleural fluid. We present the second case of coinfection with these two organisms in a patient with ATLL who was successfully treated with trimethoprim-sulfamethoxazole, corticosteroids, and fluconazole. We illustrate the need for high clinical vigilance for seeking out an additional diagnosis, especially in immunocompromised patients if they are not improving despite receiving appropriate treatment. PMID:27024978

  17. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    Science.gov (United States)

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097

  18. Tracheobronchomalacia post-pneumonectomy: A late complication

    Directory of Open Access Journals (Sweden)

    Ashima Datey

    2013-01-01

    Full Text Available An 83-year-old male presented with dyspnoea and stridor. He had undergone pneumonectomy 40 years ago. CT scan revealed gross shift of mediastinum (post-pneumonectomy syndrome with tortuous trachea kinked at the thoracic inlet. Fibre optic bronchoscopy showed a near total expiratory closure of trachea, right main bronchus, and segmental bronchi confirming tracheobronchomalacia. He was managed with long length, low tracheostomy in view of his poor general condition of permitting more invasive procedures. He showed adequate clinical improvement and was discharged home. Tracheobronchomalacia in post-pneumonectomy syndrome requires emergent management. Its occurrence after 40 years is very rare and may be easily missed. It can be diagnosed with dynamic CT and FOB. Although invasive management with stenting or surgical methods is routinely advised, conservative care can be effective in selected cases.

  19. Add-on treatment with nebulized hypertonic saline in a child with plastic bronchitis after the Glenn procedure

    Directory of Open Access Journals (Sweden)

    Grzegorz Lis

    2014-01-01

    Full Text Available Plastic bronchitis (PB, although a rare cause of airway obstruction, has mortality rates up to 50% in children after Fontan-type cardiac surgery. We present the case of an 18-month-old female patient with PB following pneumonia. At 6 months of age, the patient underwent the Glenn procedure due to functionally univentricular heart. Fiberoptic bronchoscopy revealed complete blockage of the left bronchus by mucoid casts. Pharmacotherapy consisted of glucocorticosteroids, azithromycin, and enalapril maleate. The child also received nebulized 3% NaCl solution, which proved to be beneficial. In children submitted to Fontan-type procedures, physicians must be alert for PB, which can be triggered by respiratory tract infection.

  20. Pleural effusion: what lies underneath?

    Science.gov (United States)

    Rodrigues, L Vaz; Raposo, J; Mendonça, C; Figueiredo, A; Barata, F; Meruje, M; Pires, J

    2009-01-01

    Malignant mesothelioma is a tumour of serous surfaces mainly arising at the pleura or the peritoneum. The diagnosis encompasses multiple problems as there is no pathognomonic hallmark for the disease, there are multiple histological types and the differentiation from other tumours, such as adenocarcinoma or metastatic pleural disease, can represent quite a challenge. Usually a diagnosis of malignant mesothelioma carries a dismal prognosis with scarce therapeutical options.The present report concerns a patient with a diagnosis of malignant pleural mesothelioma with endobronchial extension. Biopsy specimens were obtained through fibreoptic bronchoscopy and blind needle pleural biopsy. The final diagnosis was only possible after careful histological evaluation with a combination of immunohistochemical markers. PMID:21686530

  1. Middle lobe syndrome: a singularly rare presentation of complicated pulmonary hydatid disease.

    Science.gov (United States)

    Kunal, Shekhar; Pilaniya, Vikas; Shah, Ashok

    2016-01-01

    Imaging is crucial to the diagnosis of pulmonary hydatid disease, as it is often the first modality that raises suspicion of the disease. Middle lobe syndrome (MLS) as a presentation of this disease is a distinct rarity. A 45-year-old woman, a never-smoker, presented with cough and streaky haemoptysis. Imaging demonstrated a trapezoidal opacity with its base towards the hilum and contiguous with the right cardiac border. The reformatted sagittal view confirmed the diagnosis of MLS. Fibreoptic bronchoscopy (FOB) revealed an avascular white membranous structure wholly occluding the medial segment of the middle lobe. This was completely removed through gentle suction. Bronchial aspirate revealed hooklets of hydatid and echinococcal serology was positive. Subsequently, three cycles of albendazole were administered with remarkable clinical and radiological improvement. To the best of our knowledge, this is the first detailed description of MLS caused by pulmonary hydatidosis that was completely removed through FOB. PMID:27045051

  2. Proteomics as the Tool to Search for Lung Disease Markers in Bronchoalveolar Lavage

    Directory of Open Access Journals (Sweden)

    Isabelle Noël-Georis

    2001-01-01

    Full Text Available Most lung disorders are known to be associated to considerable modifications of surfactant composition. Numerous of these abnormalities have been exploited in the past to diagnose lung diseases, allowing proper treatment and follow-up. Diagnosis was then based on phospholipid content, surface tension and cytological features of the epithelial lining fluid (ELF, sampled by bronchoalveolar lavage (BAL during fiberoscopic bronchoscopy. Today, it appears that the protein content of ELF displays a remarkably high complexity, not only due to the wide variety of the proteins it contains but also because of the great diversity of their cellular origins. The significance of the use of proteome analysis of BAL fluid for the search for new lung disease marker proteins and for their simultaneous display and analysis in patients suffering from lung disorders has been examined.

  3. Radiation bronchitis in lung cancer patient treated with stereotactic radiation therapy

    International Nuclear Information System (INIS)

    We report a case of chronic radiation bronchitis that developed in a patient with lung cancer treated with fractionated stereotactic radiation therapy. A 73-year-old woman with a medically inoperable T1N0M0 adenocarcinoma of the lung was treated with stereotactic radiation therapy. By using eight non-coplanar ports, 50 Gy/5 fractions was delivered in two weeks. At four weeks, a partial response was obtained with no acute adverse reaction. She developed severe cough at six months. Fiberoptic bronchoscopy revealed thick circumferentially coated bronchial mucosa in close proximity to the tumor site. At 12 months, follow-up study confirmed marked stenotic change in the B6 segmental bronchus without tumor progression. (author)

  4. Percutaneous needle aspiration biopsy of chest lesions: effectiveness when using an 18-gauge needle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Min; Jung, Gyoo Sik; Kim, So Sun; Huh, Jin Do; Joh, Young Duk; Huh, Bang [College of Medicine, Kosin National University, Busan (Korea, Republic of)

    1995-01-15

    Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fluoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. In 160 patients (89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions (120 malignant and 33 benign lesions) and 7 mediastinal lesions. The diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax (n = 11) and hemothorax (n = 1): six of them required treatment with chest tube and the remainder showed spontaneous resorption. PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.

  5. Percutaneous needle aspiration biopsy of chest lesions: effectiveness when using an 18-gauge needle

    International Nuclear Information System (INIS)

    Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fluoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. In 160 patients (89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions (120 malignant and 33 benign lesions) and 7 mediastinal lesions. The diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax (n = 11) and hemothorax (n = 1): six of them required treatment with chest tube and the remainder showed spontaneous resorption. PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions

  6. [New therapeutic approaches in 2015 in pulmonary medicine].

    Science.gov (United States)

    Smith, Catherine; Plojoux, Jérôme; Lucker, Lise; Lador, Frédéric; Janssens, Jean-Paul

    2016-01-13

    During the past year, among the many novelties in the field of pulmonary medicine, the authors chose to focus on 4 items: the positive contribution of systemic steroids on clinical improvement and length of stay in patients hospitalized for community-acquired pneumonia; the interesting results obtained with high flow oxygen, heated and humidified, in acute care and in normocapnic respiratory failure, a device which warrants further clinical testing in other indications; the now documented benefits of lung volume reduction procedures by bronchoscopy using coils in severe emphysema with hyperinflation; and the publication of new recommendations regarding pulmonary hypertension, with an emphasis on new molecules and their efficacy, on an early use of combination treatments, and on the importance of expert centres in managing these patients. PMID:26946711

  7. Isolated pauci-immune pulmonary capillaritis.

    Science.gov (United States)

    Mehrotra, Ashok Kumar; Gupta, Prahlad Rai; Khublani, Trilok Kumar; Anupam; Soni, Shridha; Feroz, Asif

    2015-01-01

    A young house wife presented with low grade fever, cough, haemoptysis and SOB of unknown aetiology for 40 days duration. Respiratory system examination revealed diffuse crepts and rhonchi. Other organ system examination did not reveal any abnormality. X-ray chest PA view and CT thorax showed diffuse bilateral necrotising nodular lesions of various sizes with small pleural effusion. She also had low resting oxygen saturation with falling haematocrit. Her Serum was week positive for p-ANCA and negative for MPO-ANCA. Bronchoscopy revealed continuous bloody aspirates. We could not isolate any organisms in any of the specimens from her and she was unresponsive to any of the antibiotics either. Based on the clinical, laboratory data, radiological features and positive outcome to pulse therapy of methylprednisolone and cyclophosphamide, she was diagnosed as a case of IPIPC. PMID:25624599

  8. Transbronchial lung biopsy (TBLB) in diagnosing pulmonary alveolar proteinosis (PAP): forgotten role in Australia?

    Science.gov (United States)

    Tung, Alvin H; Grace, Julienne; O'Kane, Gabrielle M; Kumar, Karthik

    2015-12-01

    Transbronchial lung biopsy (TBLB) is uncommonly performed in non-malignant conditions because of its low sensitivity and small tissue samples. It is not routinely performed in Australia to investigate idiopathic pulmonary fibrosis, although it can be a useful adjunct in obtaining tissue diagnosis in selected conditions in interstitial lung disease (ILD). A 52-year-old non-smoker received a living unrelated renal transplant in January 2014 but developed insidious onset of dyspnea on exertion 1 year later. Computed tomography of the thorax showed bilateral persistent ground glass opacifications with a characteristic crazy paving pattern, although P neumocystis jirovecii pneumonia was more concerning. He was treated as P neumocystis jirovecii pneumonia but his initial bronchoscopy failed to confirm either diagnoses. He then went on to TBLB that showed the presence of periodic acid-Schiff staining material. We conclude that TBLB is a useful adjunct to obtain histological diagnosis of ILD in carefully selected patients with appropriate radiological indications. PMID:26740882

  9. [Cough and hypoxemia as clinical manifestation of pulmonary alveolar proteinosis. Clinical case report].

    Science.gov (United States)

    Nieto, Mary; Dicembrino, Manuela; Ferraz, Rubén; Romagnoli, Fernando; Giugno, Hilda; Ernst, Glenda; Siminovich, Monica; Botto, Hugo

    2016-06-01

    Alveolar proteinosis is a rare chronic lung disease, especially in children, characterized by abnormal accumulation of lipoproteins and derived surfactant in the intra-alveolar space that generates a severe reduction of gas exchange. Idiopathic presentation form constitutes over 90% of cases, a phenomenon associated with production of autoimmune antibodies directed at the receptor for granulocyte-macrophage colony-stimulating factor. A case of a girl of 5 years of age treated because of atypical pneumonia with unfavorable evolution due to persistent hypoxemia is presented. The diagnosis is obtained through pathologic examination of lung biopsy by thoracotomy, as treatment is carried out by 17bronchopulmonary bronchoscopy lavages and the patient evidences marked clinical improvement. PMID:27164343

  10. Flow-volume loop abnormality detecting a previously unrecognized right upper lobe tracheal bronchus

    Directory of Open Access Journals (Sweden)

    Shannon Ruzycki

    2015-01-01

    Full Text Available Tracheal bronchus is a rare anatomic variant in which a bronchus originates from the trachea. Patients may be asymptomatic or present with a variety of respiratory symptoms. We present a case of a patient who presented with a history of poorly controlled asthma and a persistent abnormality of the flow-volume loop. Bronchoscopy revealed a tracheal bronchus with narrowed right-sided bronchial orifices. An unrecognized tracheal bronchus may result in serious complications during elective or emergent endotracheal intubation. Spirometry testing may reveal abnormalities of the flow-volume loop associated with altered airflow. Relying on spirometric values without assessing the shape of the flow-volume loop may lead to misdiagnosis and inappropriate management of lung pathology.

  11. Intravenous immune globulins (IVIg) treatment for organizing pneumonia in a selective IgG immune deficiency state.

    Science.gov (United States)

    Gueta, Itai; Shoenfeld, Yehuda; Orbach, Hedi

    2014-12-01

    We describe herein a 61-year-old woman who presented with fever, night sweats and cough. The diagnosis of pneumonia was established, but with symptom recurrence following antibiotic therapy, further diagnostics were performed. Biopsy via bronchoscopy revealed cryptogenic organizing pneumonia, and later on follow-up, a selective IgG immune deficiency was also diagnosed. Initial treatment of high-dose glucocorticoid therapy induced remission, but with dose reduction recurrence was observed. Intravenous immune globulin treatment was initiated and induced a successful clinical and radiological remission. Few cases of cryptogenic organizing pneumonia and hypogammaglobulinemia have been reported. To our knowledge, this is the fourth case described of cryptogenic organizing pneumonia with a hypogammaglobulinemia state and the first reported case of a selective immune deficiency state treated successfully with intravenous immune globulins. PMID:25391610

  12. Kikuchi Fujimoto disease associated with cryptogenic organizing pneumonia: case report and literature review

    Directory of Open Access Journals (Sweden)

    Hua Feng

    2010-03-01

    Full Text Available Abstract Background The association of Kikuchi Fujimoto disease (KFD with cryptogenic organizing pneumonia (COP is extremely rare. We report a case of simultaneous diagnosis of KFD and COP. Case Presentation A 33-year-old male presented with a 1-month cough illness and fever lasting for 5 days. The chest radiograph revealed double lower lobe infiltrate, which was unresponsive to antibiotics. A cervical lymph node was first found in the development of this disease. Bronchoscopy, bronchoalveolar lavage and lung biopsy established the diagnosis of COP, while a lymph node biopsy was consistent with KFD. The patient improved on steroids. Conclusions KFD and COP are possible part of a disease continuum, rather than separate entities.

  13. MRI tracheomalacia (TM) assessment in pediatric patients: feasibility study

    DEFF Research Database (Denmark)

    Ciet, P.; Wielopolski, P.; Lever, S.;

    2011-01-01

    Purpose: TM is an excessive narrowing of the intrathoracic part of the trachea. TM is a common congenital pediatric anomaly, but it’s often not recognized due to its unspecific clinical presentation. The aims of our study are: 1) to develop cine-MRI sequences to visualize central airways in static...... perform spirometry controlled breathing maneuvers (peak flow and coughing) using a MRI compatible spirometer. “Static” 13-second breath-hold scans covering the entire thoracic region were acquired at end-inspiration and end-expiration using a 3D GRE with TR/TE=1.2/0.5 ms, alpha = 2, sagittal isotropic...... the required breathing maneuvers. Images of central airways during static and dynamic conditions were acquired and could be analyzed. Three out of the 8 children had a TM just above the carina during forced expiration, confirmed by bronchoscopy. Conclusion: This pilot study shows that Dynamic-MRI is...

  14. Lipoid pneumonia in a gas station attendant.

    Science.gov (United States)

    Yampara Guarachi, Gladis Isabel; Barbosa Moreira, Valeria; Santos Ferreira, Angela; Sias, Selma M De A; Rodrigues, Cristovão C; Teixeira, Graça Helena M do C

    2014-01-01

    The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to presenting with a respiratory infection that was hard to resolve. The patient underwent bronchoscopy with bronchoalveolar lavage, which, on cytochemical (oil red O) evaluation, was slightly positive for lipid material in the foamy cytoplasm of alveolar macrophages. Due to his occupational history and radiographic abnormalities suggestive of lipoid pneumonia, a lung biopsy was performed to confirm the diagnosis. The patient was serially treated with segmental lung lavage and showed clinical, functional, and radiological improvement. PMID:25374742

  15. Lipoid pneumonia secondary to long-term use of evening primrose oil.

    Science.gov (United States)

    Rabahi, Marcelo Fouad; Ferreira, Andreia Alves; Madeira, João Gabriel Piccirilli; Galvao, Paulo Menzel; Pinto, Sebastião Alves

    2010-01-01

    Lipoid pneumonia is an underdiagnosed disease that is caused by the aspiration of lipid particles into the lungs. Although most of the reported cases have been associated with the use of mineral oil as a laxative, other lipid substances can also cause the disease. We report the case of a 50-year-old female patient with a complaint of productive cough who was initially diagnosed with bronchial hyperresponsiveness and gastroesophageal reflux disease (GERD). The patient was treated for GERD. Because the productive cough persisted, the patient underwent chest CT, fiberoptic bronchoscopy, and open lung biopsy. She was diagnosed with lipoid pneumonia. The patient was questioned regarding the use of lipid substances, and she reported the chronic use of evening primrose oil. After the discontinuation of the substance and the maintenance of GERD treatment, her condition improved. PMID:21085832

  16. Lipoid pneumonia caused by oil mist exposure from a steel rolling tandem mill

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, M.R.; Balmes, J.R.; Robins, J.M.; Smith, G.J.

    1981-01-01

    Five of nine active tandem mill operators exposed at work to aerosolized hydrocarbon mist were referred for evaluation of respiratory complaints. The worker with the longest exposure had reduced lung volumes; he was admitted to the hospital for detailed study. Exercise studies revealed work load limited by ventilation and arterial oxygen desaturation. Flexible fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy revealed evidence of lipoid pneumonia. Assessment of the mill revealed levels of respirable oil mist by personal samplers throughout the area far below the currently accepted standard of 5 mg/M3. These findings confirm a 20-year-old hypothesis of J.G. Jones regarding the hazard of oil mist in this industrial setting.

  17. Lipoid Pneumonia in a Gas Station Attendant

    Directory of Open Access Journals (Sweden)

    Gladis Isabel Yampara Guarachi

    2014-01-01

    Full Text Available The exogenous lipoid pneumonia, uncommon in adults, is the result of the inhalation and/or aspiration of lipid material into the tracheobronchial tree. This is often confused with bacterial pneumonia and pulmonary tuberculosis due to a nonspecific clinical and radiologic picture. It presents acutely or chronically and may result in pulmonary fibrosis. We describe here a case of lipoid pneumonia in a gas station attendant who siphoned gasoline to fill motorcycles; he was hospitalized due to presenting with a respiratory infection that was hard to resolve. The patient underwent bronchoscopy with bronchoalveolar lavage, which, on cytochemical (oil red O evaluation, was slightly positive for lipid material in the foamy cytoplasm of alveolar macrophages. Due to his occupational history and radiographic abnormalities suggestive of lipoid pneumonia, a lung biopsy was performed to confirm the diagnosis. The patient was serially treated with segmental lung lavage and showed clinical, functional, and radiological improvement.

  18. Acute pneumonia in a fire-eater.

    Science.gov (United States)

    Dell' Omo, M; Murgia, N; Chiodi, M; Giovenali, P; Cecati, A; Gambelunghe, A

    2010-01-01

    Fire-eater's lung, an acute exogenous lipoid pneumonia, is caused when street performers accidentally inhale pyrofluids. We report the case of a young fire-eater who, 12 hours after inhaling an iso-alkanebased pyrofluid, developed fever, dyspnoea, dry cough and intense right chest pain. Radiographic signs of pneumonia emerged two days later. Computed tomography (CT) scans visualized an irregular area of parenchymal consolidation with an air bronchiologram and peripheral ground-glass opacities in the right middle lobe. The diagnostic work-up included microbiological and lung function tests, optic fibre bronchoscopy and an in-depth cyto-immunological analysis of bronchoalveolar lavage fluid. Symptoms gradually improved over a few days. A CT scan one month later showed the thickened parenchymal area in the right middle lobe had almost completely disappeared. PMID:21244782

  19. Infected tracheal diverticulum: a rare association with alpha-1 antitrypsin deficiency

    Directory of Open Access Journals (Sweden)

    Cecília Beatriz Alves Amaral

    2014-12-01

    Full Text Available Tracheal diverticulum, defined as a benign outpouching of the tracheal wall, is rarely diagnosed in clinical practice. It can be congenital or acquired in origin, and most cases are asymptomatic, typically being diagnosed postmortem. We report a case of a 69-year-old woman who was hospitalized after presenting with fever, fatigue, pleuritic chest pain, and a right neck mass complicated by dysphagia. Her medical history was significant: pulmonary emphysema (alpha-1 antitrypsin deficiency; bronchiectasis; and thyroidectomy. On physical examination, she presented diminished breath sounds and muffled heart sounds, with a systolic murmur. Laboratory tests revealed elevated inflammatory markers, a CT scan showed an air-filled, multilocular mass in the right tracheal wall, and magnetic resonance imaging confirmed the CT findings. Fiberoptic bronchoscopy failed to reveal any abnormalities. Nevertheless, the patient was diagnosed with tracheal diverticulum. The treatment approach was conservative, consisting mainly of antibiotics. After showing clinical improvement, the patient was discharged.

  20. Diffuse interstitial lung infiltrates in a smoker with human immunodeficiency virus infection

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    Viswanath P Vasudevan

    2011-01-01

    Full Text Available Pulmonary Langerhans cell histiocytosis is a rare interstitial lung disease characteristically affecting middle-aged smokers. It has unpredictable clinical course and may be associated with malignant neoplasms. Opportunistic lung infections are frequently considered when patients with Human immunodeficiency virus (HIV infection present with respiratory symptoms and an abnormal chest X-ray. Though fiberoptic bronchoscopy with bronchoalveolar lavage is diagnostic for infectious etiologies, surgical lung biopsies are preferred to diagnose noninfectious lung diseases and to help guide appropriate therapy. In the present study, we report a case of progressive bilateral lung infiltrates in a smoker with HIV infection which presented a diagnostic dilemma in view of coexistent HIV infection. Analysis of clinical symptomatology aided by surgical lung biopsy helped in diagnosis.

  1. High prevalence of Pneumocystis jirovecii colonization in Brazilian cystic fibrosis patients.

    Science.gov (United States)

    Pederiva, Marco A; Wissmann, Gustavo; Friaza, Vicente; Morilla, Rubem; de La Horra, Carmen; Montes-Cano, Marco A; Goldani, Luciano Z; Calderón, Enrique J; Prolla, João C

    2012-07-01

    A high rate of Pneumocystis jirovecii colonization was observed in Brazilian cystic fibrosis (CF) patients (13 out of 34; 38.2%) who underwent bronchoscopy between March 2006 and August 2009 at the Hospital de Clinicas de Porto Alegre, Brazil. Bronchoalveolar lavage samples were collected from these patients and studied by nested PCR amplification of the mitochondrial gene coding for the large subunit ribosomal RNA (mtLSUrDNA). The observed rate of colonization was higher than that reported in European populations. Genotypic characterization of the mtLSUrDNA locus revealed a predominance of the polymorphisms 85C/248C (genotype 1) and 85T/248C (genotype 3), with all samples possessing the wild-type genotype of dihydropteroate synthase. These findings suggest that cystic fibrosis patients could be an important reservoir and source of P. jirovecii infection. Further studies are required to elucidate the role of this common fungal colonization in the evolution of CF patients. PMID:22206262

  2. Diffuse pulmonary ossification. A case report

    International Nuclear Information System (INIS)

    The diffuse pulmonary ossification (DPO) is a rare disease characterized by metaplastic formation of bony tissue in the lung parenchyma. Generally it is associated with other disorders as mitral stenosis and interstitial fibrosis. Sometimes the DPO is idiopathic. We report the case of a 49-year-old man who presented with cough and hemoptysis. The radiological findings suggested an interstitial lung disease. The fiber optic bronchoscopy was normal. The pulmonary function tests showed a mild airway obstruction. The bacteriological and serological studies for tuberculosis, mycosis, and collagen-vascular disease were negatives. An open lung biopsy was performed and the pathologic findings were interpreted as diffuse pulmonary ossification (DPO). Any other disease was found; so, in this case the DPO was classified as idiopathic

  3. Invasive aspergillosis: results of multicenter study

    Directory of Open Access Journals (Sweden)

    N. N. Klimko

    2014-01-01

    Full Text Available We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008. Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %, main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %, cytostatic chemotherapy (57 %, corticosteroid treatment (45 %, and allogeneic hematopoietic stem cells transplantation (29 %. The pathogens – A. fumigatus (42 %, A. niger (33 %, and A. flavus (21 %. The main site of infection were lungs (86 %. 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01, adequatetherapy with voriconazole (p = 0.002 and secondary antifungal prophylaxis (p = 0.0003 were positive prognostic factors for survival of patients with invasive aspergillosis.

  4. Invasive aspergillosis: results of multicenter study

    Directory of Open Access Journals (Sweden)

    N. N. Klimko

    2014-09-01

    Full Text Available We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008. Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %, main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %, cytostatic chemotherapy (57 %, corticosteroid treatment (45 %, and allogeneic hematopoietic stem cells transplantation (29 %. The pathogens – A. fumigatus (42 %, A. niger (33 %, and A. flavus (21 %. The main site of infection were lungs (86 %. 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01, adequatetherapy with voriconazole (p = 0.002 and secondary antifungal prophylaxis (p = 0.0003 were positive prognostic factors for survival of patients with invasive aspergillosis.

  5. Canine tracheal collapse.

    Science.gov (United States)

    Tappin, S W

    2016-01-01

    Tracheal collapse occurs most commonly in middle-aged, small breed dogs. Clinical signs are usually proportional to the degree of collapse, ranging from mild airway irritation and paroxysmal coughing to respiratory distress and dyspnoea. Diagnosis is made by documenting dynamic airway collapse with radiographs, bronchoscopy or fluoroscopy. Most dogs respond well to medical management and treatment of any concurrent comorbidities. Surgical intervention may need to be considered in dogs that do not respond or have respiratory compromise. A variety of surgical techniques have been reported although extraluminal ring prostheses or intraluminal stenting are the most commonly used. Both techniques have numerous potential complications and require specialised training and experience but are associated with good short- and long-term outcomes. PMID:26780854

  6. Hemoptysis Caused by Leech Infestation: A Unique Case

    Directory of Open Access Journals (Sweden)

    Latif Moini

    2013-04-01

    Full Text Available Hemoptysis in the patients suffered from pulmonary tuberculosis (TB may be resulted by active TB or the complications of such disease which appears as bronchiectasis, fungal lesions deployed in tuberculosis cavities or Rasmussen aneurysm, Bronchiolitis or relapse and sometimes, it may be considered as caused by reasons irrelevant to TB. In this report, the patient is a 69-year-old man as complained of hemoptysis with a treated TB experience that was found as normal in the preliminary review of X-ray and CT. During bronchoscopy, a live leech (bloodsucker was found in hypopharynx area that was swallowed after repeated attempts to remove it through the gastrointestinal tract and its suction signs were appeared as a mucosal mass in the hypopharynx area. The patient had no symptoms during his stay in the hospital.

  7. Foreign body aspiration mimicking croup syndrome: Case report

    Directory of Open Access Journals (Sweden)

    Suna Asilsoy

    2008-01-01

    Full Text Available The term croup refer to a group of conditions involving inşammation of the upper airway that leads to a cough that sounds like a bark, difficulty breathing, and a grunting noise or inspiratory stridor during breathing. The most common characteristics of these ailments are upper airway obstruction. The obstruction level determines the degree of respiratory distress and rarely causes respiratory failure as well. Except for croup the other causes of acute upper airway obstruction in children are inhalated foreign bodies, retropharyngeal abscess, bacterial tracheitis and epiglottitis. Two cases presented to the emergency department with the diagnosis of croup syndrome. A 9 month old girl had an incremental stridor which was lasting for two months. She underwent rigid bronchoscopy with removal of an undefined foreign body organized at vocal cord level. The other case, a 19 month old boy, was admitted with cardiac arrest. On observation after a choking episode he ejected a piece of peanut spontaneously.

  8. A Case of Bone Aspiration Mimicking Asthma in an Adult Patient

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-03-01

    Full Text Available Foreign body aspiration is an urgent condition that requires immediate diagnosis and intervention. It is generally seen in children and in elderly patients with neurological problems and rarely seen in healthy adults. There may be some clinical signs and symptoms in patients with foreign body aspiration from mild to severe; such as cough, shortness of breath and respiratory arrest. A 52-year-old woman applied to our clinic with the complaints of cough and shortness of breath, and she was misdiagnosed and treated as asthma for three months. The chest radiograph showed heterogenous opacity in the right paracardiac region, computerized tomography revealed the foreign body aspiration in right main bronchus and peripheric pneumonia. Flexible bronchoscopy examination was processed and the foreign body was excluded safely with the aim of crocodile forceps. Foreign body aspiration should be kept in the mind in a adult patient with a sudden onset of asthma like disorder.  

  9. Recurrent respiratory papillomatosis with pulmonary involvement; Papilomatose respiratoria recorrente com envolvimento pulmonar

    Energy Technology Data Exchange (ETDEWEB)

    Ikawa, Marcos Hiroyuki [Universidade Federal de Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem; Meirelles, Gustavo Souza Portes [Centro de Medicina Diagnostica Fleury, Sao Paulo, SP (Brazil)]. E-mail: gmeirelles@gmail.com

    2008-01-15

    A five-year-old girl developed hoarseness with gradual worsening at the age of eight months. Three months later, she underwent bronchoscopy in which papillomas in the vocal cords, larynx and trachea were observed. Because of serious bronchospasm crises and respiratory failure, she needed several hospitalizations, definitive tracheostomy and multiple endoscopic procedures for papilloma excision. The most recent chest radiography (Figure A) and computed tomography (CT) scans (Figures B and C) showed a nodule inside the trachea and multiple pulmonary nodules, cysts and consolidations. The anatomopathological findings from curettage of the lesions revealed benign squamous-cell papillomas. Recurrent respiratory papillomatosis (RRP) is directly related to the human papillomavirus (HPV). Its spread to the lower airways is uncommon, with involvement of trachea and/or proximal bronchi in 5% of the patients, and extension to the lungs in only 1% of the cases. (author)

  10. CT digital radiography: Alternative technique for airway evaluation in physically disabled patients

    Energy Technology Data Exchange (ETDEWEB)

    Mandell, G.A.; Harcke, H.T.; Brunson, G.; Delengowski, R.; Padman, R.

    1987-10-01

    Evaluation of the airway for the presence of granulation tissue prior to removal of a tracheostomy is essential to prevent sudden respiratory decompensation secondary to obstruction. Airway examination in a brain and/or spinal cord injured patient is especially difficult under fluoroscopy. The patient's lack of mobility results in poor visualization of the trachea, secondary to the overlying dense osseous components of the shoulders and thoracic cage. A CT localization view (digital view), which allows manipulation and magnification of the digital data in order to see the hidden airway and detect associated obstructing lesions, is proffered as an alternative technique to high KV, magnification technique. Thirteen examinations were performed satisfactorily in eleven patients examined by this technique with little expenditure of time, physical exertion, and irradiation. The sensitivity, specificity and accuracy of digital airway examination were 100%, 67% and 92% respectively with bronchoscopy used as the standard.

  11. Extrinsic tracheal compression caused by scoliosis of the thoracic spine and chest wall degormity: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Kyong min Sarah; Lee, Bae Young; Kim, Hyeon Sook; Song, Kyung Sup; Kang, Hyeon Hul; Lee, Sang Haak; Moon, Hwa Sik [St. Paul' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2014-05-15

    Extrinsic airway compression due to chest wall deformity is not commonly observed. Although this condition can be diagnosed more easily with the help of multidetector CT, the standard treatment method has not yet been definitely established. We report a case of an eighteen-year-old male who suffered from severe extrinsic tracheal compression due to scoliosis and straightening of the thoracic spine, confirmed on CT and bronchoscopy. The patient underwent successful placement of tracheal stent but later died of bleeding from the tracheostomy site probably due to tracheo-brachiocephalic artery fistula. We describe the CT and bronchoscopic findings of extrinsic airway compression due to chest wall deformity as well as the optimal treatment method, and discuss the possible explanation for bleeding in the patient along with review of the literature.

  12. [Management of a 4MRGN Acinetobacter baumanii outbreak in a burn unit].

    Science.gov (United States)

    Siemers, F; Fanghänel, S; Bergmann, P A; Tamouridis, G; Stuttmann, R; Stolze, B; Hofmann, G O

    2014-08-01

    Patients with 4MRGN Acinetobacter baumanii infections in a burn unit represent great challenge. The structured management with 7 involved patients in such a situation is presented. After discovering the infectious trigger a management team is established. An immediate stop for further admissions was announced and all infected room areas and medical equipment were analysed for infection foci. The infected patients were transferred to regional hospitals or a rehabiltation hospital after finishing all surgical procedures. In one case, for whom further operations were needed, a transfer to a separated area of the intermediate care unit (IMC) within the hospital was arranged. The performed analysis of infection foci indicated a bronchoscopy tower to be the infection source. The outbreak was terminated after transferring all patients, final disinfection and subsequent nebulisation with 5-6% hydrogen peroxide within 18 days. PMID:25162239

  13. Syngeneic peripheral blood stem cell transplantation with immunosuppression for hepatitis-associated severe aplastic anemia

    Directory of Open Access Journals (Sweden)

    Aleksandar Savic

    2010-12-01

    Full Text Available Hepatitis-associated aplastic anemia occurs in up to 10% of all aplastic anemia cases. Syngeneic bone marrow transplantation is rare in patients with severe aplastic anemia and usually requires pre-transplant conditioning to provide engraftment. We report on a 29-year-old male patient with hepatitis-associated severe aplastic anemia who had a series of severe infectious conditions before transplantation, including tracheal inflammation. Life-threatening bleeding, which developed after bronchoscopy, was successfully treated with activated recombinant factor VII and platelet transfusions. Syngeneic peripheral blood stem cell transplantation using immunosuppressive treatment with antithymocyte globulin and cyclosporin A without high-dose pre-transplant conditioning was performed, followed by complete hematologic and hepatic recovery.

  14. Severe nitrofurantoin lung disease resolving without the use of steroids

    Directory of Open Access Journals (Sweden)

    Bhullar S

    2007-01-01

    Full Text Available We report a case of an elderly woman who developed a severe, chronic pulmonary reaction to nitrofurantoin therapy that she had taken continuously for three years to prevent urinary tract infections. The patient was taking no other drug known to cause lung disease but the diagnosis was delayed by failure to recognize the association between nitrofurantoin and adverse drug reactions affecting the lung. When originally seen, the patient was unable to care for herself due to dyspnea. Bronchoscopy with biopsy ruled out other causes of her pulmonary disease. Immediate withdrawal of nitrofurantoin led to substantial, sustained improvement and disappearance of symptoms over several months without administration of corticosteroids. Nitrofurantoin toxicity should always be considered in any person taking that drug who develops bilateral infiltrates.

  15. Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult.

    Science.gov (United States)

    Kotsifas, Konstantinos; Metaxas, Eugenios; Koutsouvelis, Ioannis; Skoutelis, Athanassios; Kara, Panayiota; Tatsis, George

    2011-01-01

    Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement. PMID:21577261

  16. Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

    Directory of Open Access Journals (Sweden)

    Konstantinos Kotsifas

    2011-01-01

    Full Text Available Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.

  17. Pulmonary eosinophilia associated to treatment with natalizumab

    Directory of Open Access Journals (Sweden)

    Elena Curto

    2016-01-01

    Full Text Available Natalizumab (Tysabri® is a leukocytes chemotaxis inhibitor that decreases the leukocytes passage through the hematoencephalic barrier and it is currently used in relapsing-remitting forms of multiple sclerosis (MS. We present a patient with allergic rhinoconjunctivitis diagnosed with MS who started treatment with natalizumab. She began to show mild asthmatic symptoms until she needed admission to the hospital due to respiratory insufficiency. Blood tests showed peripheral eosinophilia and the thoracic computed tomography scan demonstrated pulmonary infiltrates. The bronchoscopy with the bronchoalveolar lavage resulted in eosinophilic alveolitis. No evidence of bacterial, fungal and parasitic infection, connective tissue disease, or vasculitis were observed. After discontinuation of natalizumab, the patient improved without other treatments. As MS is a prevalent disease and the use of natalizumab is increasing, we consider important to point out that this drug can be associated with pulmonary eosinophilia, especially in patients with allergic rhinoconjunctivitis or asthma.

  18. Cytologic diagnosis of pulmonary lesions.

    Science.gov (United States)

    Rossi, Esther Diana; Mulè, Antonino; Maggiore, Claudia; Miraglia, Antonella; Lauriola, Libero; Vecchio, Fabio Maria; Fadda, Guido

    2004-01-01

    The major types of cytologic preparations used in most laboratories to detect the lesions of the lower respiratory tract (LRT) are examined. These methods include sputum, bronchial washing, bronchial brushing, bronchoalveolar lavage (BAL) and fine-needle aspiration biopsy (FNAB). Sputum represents the simplest and most cost-effective sampling method even though fiberoptic bronchoscopy and radiologic guided FNAB are superseding it as the first diagnostic choice in most cases. There are advantages and disadvantages associated with each technique:bronchial brushing and FNABs tend to preserve both the cellular details and their architectural arrangement whereas sputum and bronchial washing often cause a variable degree of cellular degeneration and fragmentation. As a result, most pulmonary lesions may be detected and correctly diagnosed if multiple techniques are used to acquire diagnostic material. CT-guided FNAB represents the most effective method to achieve a correct diagnosis in pulmonary tumors. PMID:15852720

  19. Medical image of the week: right neck mass with thoracic extension

    Directory of Open Access Journals (Sweden)

    Siddiqi TA

    2013-05-01

    Full Text Available A 28-year-old female with a history of chronic pancreatitis s/p total pancreatectomy and auto-islet cell transplantation developed a progressively enlarging right neck mass of 4 weeks duration. Coccidioides IgM antibodies were negative and IgG antibodies were positive by immunoassay (EIA, with titers 1:4 by complement fixation (CF. Fine needle aspiration with subsequent excisional biopsy of the right neck mass was performed and showed reactive lymphoid hyperplasia without fungal elements. Bronchoscopy with right upper lobe endobronchial biopsy and 4R lymph node endobronchial ultrasound-fine needle aspiration revealed granulomatous inflammation and Coccidioides spherules on Gomori's methenamine silver stain. Fungal cultures from the right neck mass fine needle aspiration, endobronchial biopsy, and 4R lymph node grew Coccidioides after three weeks of culture.

  20. Management of an unusual presentation of foreign body aspiration.

    Science.gov (United States)

    Ramadan, H H; Bu-Saba, N; Baraka, A; Mroueh, S

    1992-08-01

    Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery. PMID:1402375

  1. Combination of fluorescence imaging and local spectrophotometry in fluorescence diagnostics of early cancer of larynx and bronchi

    International Nuclear Information System (INIS)

    The results of comparative studies of autofluorescence and 5-ALA-induced fluorescence of protoporphyrin IX, used in the diagnostics of early cancer of larynx and bronchi, are presented. The autofluorescence and 5-ALA-induced fluorescence images of larynx and bronchial tissues are analysed during the endoscopic study. The method of local spectrophotometry is used to verify findings obtained from fluorescence images. It is shown that such a combined approach can be efficiently used to improve the diagnostics of precancer and early cancer, to detect a primary multiple tumours, as well as for the diagnostics of a residual tumour or an early recurrence after the endoscopic, surgery or X-ray treatment. The developed approach allows one to minimise the number of false-positive results and to reduce the number of biopsies, which are commonly used in the white-light bronchoscopy search for occult cancerous loci. (laser biology and medicine)

  2. One Patient, Three Malignancy:Hodgkin Lymphoma, Maltoma, Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ümit Bayol

    2010-12-01

    Full Text Available A sixty-three-year-old man who had had Hodgkin lymphoma twenty years earlier and laryngeal mucosa associated lymphatic tissue lymphoma (MALToma two years earlier and had been treated with radiotherapy and chemotherapy was admitted to our ward with cough and hemoptysis. Physical examination revealed decreased breath sounds on the left hemitorax incomparison to the right. On chest x-ray and thoracic CT, at the left hilar region, there was a 6x5x5cm-sized, malignant-appearing mass with invasion to the hilar vascular structures. An endobronchial lesion was seen on fiberoptic bronchoscopy. The histology of the biopsy specimen was reported as squamous cell carcinoma. The patient was treated with chemotherapy and radiotherapy with the diagnosis of stage 3B lung carcinoma and is still on treatment. We want to present this case with literature reviews, as lymphoma, MALToma and carcinoma in the same patient is extremely rare.

  3. Histopathologic Consideration of Fiducial Gold Markers Inserted for Real-Time Tumor-Tracking Radiotherapy Against Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: Internal fiducial gold markers, safely inserted with bronchoscopy, have been used in real-time tumor-tracking radiotherapy for lung cancer. We investigated the histopathologic findings at several points after the insertion of the gold markers. Methods and Materials: Sixteen gold markers were inserted for preoperative marking in 7 patients who subsequently underwent partial resection of tumors by video-assisted thoracoscopic surgery within 7 days. Results: Fibrotic changes and hyperplasia of type 2 pneumocytes around the markers were seen 5 or 7 days after insertion, and fibrin exudation without fibrosis was detected 1 or 2 days after insertion. Conclusions: Because fibroblastic changes start approximately 5 days after gold marker insertion, real-time tumor-tracking radiotherapy should be started >5 days after gold marker insertion

  4. A case of interstitial lung disease associated with gemcitabine treatment in a patient with locally advanced pancreatic cancer following proton beam radiotherapy

    International Nuclear Information System (INIS)

    A 69-year-old woman who had locally advanced pancreatic cancer underwent proton beam radiotherapy (67.5 GyE/25 Fr) concurrent with gemcitabine chemotherapy (GEM 800 mg/m2 day 1, 8) at Hyogo Ion Beam Medical Center, followed by GEM chemotherapy (1,000 mg/m2 day 1, 8, 15/28 day) at Kobe University Hospital. She visited our hospital because she was suffering from dyspnea 212 days after first administration of GEM. A chest computed tomography revealed that infiltrations were spreading in the bilateral lung fields. A bronchoscopy showed diffuse alveolar hemorrhage. We diagnosed GEM related interstitial lung disease with diffuse alveolar hemorrhage. We introduced steroid pulse therapy (methylprednisolone 1 g/day) for 3 days followed by oral prednisolone (40 mg/day), which was tapered gradually. She recovered and was discharged on the 24th day after admission. (author)

  5. CD4 lymphocyte counts and serum p24 antigen of no diagnostic value in monitoring HIV-infected patients with pulmonary symptoms

    DEFF Research Database (Denmark)

    Orholm, M; Nielsen, T L; Nielsen, Jens Ole; Lundgren, Jens Dilling

    1990-01-01

    The diagnostic value of the CD4 cell counts and the HIV p24 antigen were evaluated in a consecutive series of 105 HIV-infected patients experiencing 128 episodes of pulmonary symptoms which required bronchoscopy. One-third of patients with opportunistic infection (OI) had CD4 counts greater than 0.......200 x 10(9)/l, and 60% of patients without OI had CD4 counts less than 0.200 x 10(9)/l; 47 and 42% of patients with and without OI, respectively, had detectable p24 antigen in serum. Only 36% of the patients with OI presented the combination of CD4 cells less than 0.200 x 10(9)/l and p24 in serum. In...... conclusion, the CD4 cell counts and the presence of p24 antigen in serum had a very limited predictive value for the presence of OI in HIV-infected patients with pulmonary symptoms....

  6. A fifteen years'experience in the diagnosis and treatment of benign lung tumors

    International Nuclear Information System (INIS)

    Even the most sophisticated examinations, such as computerized tomography and percutaneous fine needle biopsy, often do not allow a certain preoperative diagnosis of benign lung cancer. The clinical history may also be deceiving: a smoker over 35 years of age need not necessarily have a primary lung cancer, but this event is frequent enough to justify a diagnostic thoracotomy. In our series, chest tomography proved to be useful and sometimes revealed unsuspected lesions. In contrast, bronchoscopy is useful only for centrally located lesions, and the same is true for bronchial washing and brushing. Finally, thoracotomy, possibly an axillary one with enucleation or possibly transegmentary resection, is the most frequent operation in benign lung tumors, because of the unfailing diagnosis and for the minimal functional damage to the patient. A diagnostic thoracotomy may also avoid the psychologic stress suffered by a patient with a simple but undiagnosed benign lung tumor

  7. AN INTERESTING RARE CASE OF BENIGN CONGENITAL OESOPHAGO - BRONCHIAL FISTULA PRESENTING IN ADULTHOOD – A CASE REPORT

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    Narayan

    2013-10-01

    Full Text Available BSTRACT: Congenit al broncho - oesophageal fistula is a rare entity in adult patients. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis . Even rarer than its occurrence with the above - mentioned s ymptoms is its presentation with bronchiectasis. Here we report a rare case of a congenital broncho - oesophageal fistula presenting with bronchiectasis in a 20 - year - old male, came to us with chronic productive cough and recurrent upper respiratory infection s, diagnosed incidentally on upper GI endoscopy. The condition was later confirmed on bronchoscopy and CT chest - soft tissue. The patient was treated with right thoracotomy, excision of the fistulous tract and primary repair with pedicle subcostal muscle gr aft. Post - op recovery was uneventful. Patient discharged on 6 th post operative day with ICD

  8. Coinfection of pulmonary mucormycosis and aspergillosis presenting as bilateral vocal cord palsy

    Science.gov (United States)

    Mahadevaiah, Arun H; Rajagopalan, Natarajan; Patil, Mahantesh; C, Shivaprasad

    2013-01-01

    Invasive pulmonary coinfection with Mucor and Aspergillus is rare. Bilateral vocal cord paralysis resulting from coinfection with these two fungi to our knowledge has not been reported in the literature. We report a young woman with diabetes who presented with symptoms of community acquired pneumonia in association with hoarseness of voice. Investigations revealed air space consolidation of the right upper lobe, evidence of mediastinal involvement extending into the paratracheal space and entrapment of right upper lobe pulmonary artery. Bronchoscopy revealed bilateral vocal cord paralysis and sloughing of mucosa of the right upper lobe bronchus and the bronchus intermedius. Microbiological and pathological results confirmed Mucor and Aspergillus. Extensive vascular and mediastinal involvement precludes surgical debridement. Despite aggressive medical management the patient deteriorated and died of respiratory failure. Strong suspicion of invasive fungal infections in immune compromised patients presenting with unresolving pneumonia and hoarseness of voice, early aggressive treatment is crucial for the patient survival. PMID:23964036

  9. Successful intubation of a difficult airway due to a large obstructive vocal cord polyp augmented by the delivery of a transtracheal injection of local anaesthetic.

    Science.gov (United States)

    George, Jayan; Kader, Jishar Abdul; Arumugam, Sivasundari; Murphy, Anthony

    2015-01-01

    We describe a case of a very difficult intubation which was safely navigated through careful planning. Our patient presented initially with increasing hoarseness and shortness of breath over a 6-month period. This was investigated and the patient was found to have a large vocal cord mass and was referred for urgent microlaryngoscopy and vocal cord polypectomy. On the day of surgery the obstruction was noted and awake fiberoptic bronchoscopy was used with a remifentanil infusion. Given the mass was large and increased in size with expiration, the time frame to pass the tube was extremely short. We delivered a transtracheal injection of local anaesthesia. This approach allowed for safe passage of the endotracheal tube. In patients such as this it may be worth considering the use of a transtracheal injection in the first instance. PMID:26628451

  10. Diagnostic use of PCR for detection of Pneumocystis carinii in oral wash samples

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Jensen, Jens Ulrik Stæhr; Benfield, T; Svendsen, U G; Lundgren, Jens Dilling; Lundgren, Bettina

    1998-01-01

    , easy sample processing and single-round PCR are needed to ensure rapid analysis and to reduce the risk of contamination. We developed a single-round Touchdown PCR (TD-PCR) protocol with the ability to detect PCR inhibition in the specimen. The TD-PCR was evaluated in a routine diagnostic laboratory and...... was compared to a previously described PCR protocol (mitochondrial RNA) run in a research laboratory. Both PCR methods amplified a sequence of the mitochondrial rRNA gene of P. carinii. Paired bronchoalveolar lavage (BAL) and oral wash specimens from 76 consecutive human immunodeficiency virus type 1......-infected persons undergoing a diagnostic bronchoscopy were included. The TD-PCR procedure was quicker than the mitochondrial PCR procedure (<24 versus 48 h) and, compared to microscopy, had sensitivity, specificity, and positive and negative predictive values of 89, 94, 93, and 91%, respectively, for oral...

  11. A 35-year old woman with productive cough and breathlessness.

    Science.gov (United States)

    Kalai, Umasankar; Hadda, Vijay; Madan, Karan; Arava, Sudheer; Ali, Firdaus; Jain, Neetu; Mohan, Anant

    2015-01-01

    A 35-year-old lady was seen in the outpatient clinic owing to fever, cough with mucopurulent expectoration, and breathlessness for the duration of 1 month. She had history of similar episodes treated with antibiotics four times during last 2 years. There was no history of recurrent sinusitis, diarrhea, and skin or soft tissue infection. She had no history of diabetes mellitus or steroid intake. She denied any history of facial trauma or dental infection in the past. There was no history of tuberculosis in her or in the family. Radiograph and CT scan of the chest revealed right upper lobe consolidation. Flexible fibreoptic bronchoscopy revealed multiple nodules at opening of right upper lobe bronchus. This clinicopathological conference describes the details of differential diagnoses, difficulties in achieving the final diagnosis and management of such patient. PMID:26664183

  12. Successful closure of a bronchopleural fistula by intrapleural administration of fibrin sealant: A case report with review of Literature

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    Pranabh Shrestha

    2014-01-01

    Full Text Available Context: There are no established guidelines for the proper treatment of patients with bronchopleural fistulas (BPFs. Apart from attempts to close the fistula, emphasis of treatment and management is placed on preventive measures, early administration of antibiotics, drainage of the empyema and aggressive nutritional and rehabilitative support. Case Report: A 53-year-old male presented with nausea, vomiting, and dry cough with eventual respiratory failure. He was found to have an empyema of the left hemithorax which was managed with thoracostomy drainage and antibiotics. However, he had persistent air leak through the chest tube due to a BPF. Bronchoscopy failed to localize the involved segment. Application of fibrin glue through the chest tube succeeded in completely sealing the leak. Conclusion: To our knowledge, this is the first case report in which fibrin glue was successfully used intrapleurally to close a BPF related to an empyema.

  13. A rare case of occupational lung disease – Talcosis

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    Sathish Kumar M, Dhipu Mathew, Thilagavathy, Aruna Shanmuganathan, Srinivasan R

    2014-07-01

    Full Text Available Talcosis/ Talcpneumoconiosis is one of the rarer forms of magnesium silicate induced lung disease, It usually occurs in the fourth decade and affects people working in talc related industries like roof, shingle, pharmaceutical companies, talcum powder industries, electric ceramics, rubber industry etc. We report a case of talc pneumoconiosis/talcosis in a 51yr old male who presented with breathlessness and dry cough for the past 5 yrs and progressively worsening for the past 5 days. Who was working in a talcum powder manufacturing company for >28yrs in the packaging section. The diagnosis was possible by history, clinical examination, Chest X-ray, PFT/DLCO, HRCT chest, Bronchoscopy & Trans bronchial lung biopsy showing interstitial fibrosis.

  14. [A case of pulmonary dirofilariasis diagnosed by biopsy, immunological tests and the clinical course without operation].

    Science.gov (United States)

    Magono, Naoki; Yosimatu, Harukazu; Suzuki, Yujiro; Yamada, Eiichi; Kasai, Yositaka; Masuya, Daiki; Kondo, Takesi

    2009-06-01

    A 52-year-old woman who was a pet trimmer by occupation and had four cats, presented with cold-like symptoms. Her chest radiograph and CT scan on admission showed a tumor about 4cm in size with spicula and ground-glass opacity in the right middle lobe. We performed fiberoptic bronchoscopy and CT-guided percutaneous needle lung biopsy on the suspicion of lung cancer, but the tissue consisted largely of granulation tissue with eosinophilic infiltration and no findings of malignancy. The cold-like symptoms subsided and C-reactive protein became within the normal range. Because of the histological findings, her occupation and her pets, we suspected pulmonary dirofilariasis. We asked the National Institute for Infectious Diseases for specific IgG antibody assays to various parasite antigens, which showed positive finding for pulmonary dirofilariasis. We therefore diagnosed pulmonary dirofilariasis and did not perform an operation. PMID:19601520

  15. Transnasal tracheobronchial stenting for malignant airway narrowing under local anesthesia: Our experience of treating three cases using this technique

    Directory of Open Access Journals (Sweden)

    Jayanta Medhi

    2016-01-01

    Full Text Available Purpose: To study the technical feasibility of tracheobronchial stenting via transnasal route under bronchoscopy and fluoroscopic guidance in severe malignant airway strictures using self-expandable nitinol stents. Materials and Methods: We describe three patients with malignant airway strictures, treated entirely via transnasal route under local anesthesia using bronchoscopic and fluoroscopic guidance. Nasal route allowed convenient access to the airway for the bronchoscope across the stricture and a guidewire was introduced through its working channel. The 18F tracheal stent and the 6F bronchial stent assembly could be easily introduced and deployed under bronchoscopic (reintroduced through the other nostril and fluoroscopic guidance. Results: We achieved technical success in all the three patients with immediate relief of dyspnea. Conclusion: Transnasal airway stenting with self-expandable nitinol stent using bronchoscopic and fluoroscopic guidance under local anesthesia is a safe and effective method with minimal patient discomfort.

  16. Medical image of the week: healthcare-associated pneumonia secondary to aspiration

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    Nissim L

    2015-07-01

    Full Text Available A 57 year-old bedbound paraplegic man developed a worsening productive cough after being hospitalized for several days. He was brought to the radiology suite for a CT scan of the chest, revealing a soft tissue density within his right main-stem bronchus, with volume loss of his right lung (Figure 1. Bronchoscopy was performed, yielding a 2 cm piece of broccoli, successfully removed with forceps (Figure 2. Culture from the bronchial aspirate was positive for Pseudomonas aeruginosa. The patient’s respiratory status dramatically improved after removal of the foreign body and commencement of pathogen-directed antibiotics. This study illustrates a dramatic example of healthcare-associated pneumonia (HCAP secondary to aspiration, as described by the American Thoracic Society / Infectious Diseases Society of America (1.

  17. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

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    Liang JM

    2015-08-01

    Full Text Available Jianmin Liang,1 Juan Hu,1 Huimin Chang,2 Ying Gao,1 Huanan Luo,1 Zhenghui Wang,1 Guoxi Zheng,1 Fang Chen,1 Ting Wang,1 Yeye Yang,1 Xiaohui Kou,1 Min Xu1 1Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi’an Jiaotong University, 2Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Xi’an Medical University, Xi’an, People’s Republic of China Abstract: The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs. We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs, anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01. Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. Keywords: respiratory tract foreign body, children, diagnosis, treatment

  18. Bronchoscopic assessment of airway retention time of aerosolized xylitol

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    Kearney William R

    2006-02-01

    Full Text Available Abstract Background Human airway surface liquid (ASL has abundant antimicrobial peptides whose potency increases as the salt concentration decreases. Xylitol is a 5-carbon sugar that has the ability to lower ASL salt concentration, potentially enhancing innate immunity. Xylitol was detected for 8 hours in the ASL after application in airway epithelium in vitro. We tested the airway retention time of aerosolized iso-osmotic xylitol in healthy volunteers. Methods After a screening spirometry, volunteers received 10 ml of nebulized 5% xylitol. Bronchoscopy was done at 20 minutes (n = 6, 90 minutes (n = 6, and 3 hours (n = 5 after nebulization and ASL was collected using microsampling probes, followed by bronchoalveolar lavage (BAL. Xylitol concentration was measured by nuclear magnetic resonance spectroscopy and corrected for dilution using urea concentration. Results All subjects tolerated nebulization and bronchoscopy well. Mean ASL volume recovered from the probes was 49 ± 23 μl. The mean ASL xylitol concentration at 20, 90, and 180 minutes was 1.6 ± 1.9 μg/μl, 0.6 ± 0.6 μg/μl, and 0.1 ± 0.1 μg/μl, respectively. Corresponding BAL concentration corrected for dilution was consistently lower at all time points. The terminal half-life of aerosolized xylitol obtained by the probes was 45 minutes with a mean residence time of 65 minutes in ASL. Corresponding BAL values were 36 and 50 minutes, respectively. Conclusion After a single dose nebulization, xylitol was detected in ASL for 3 hours, which was shorter than our in vitro measurement. The microsampling probe performed superior to BAL when sampling bronchial ASL.

  19. Clinical and radiological features of bronchiolitis obliterans in children

    International Nuclear Information System (INIS)

    Objective: To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchiolitis in children. Methods: We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection (2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection); The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchoscopy, pulmonary function test, chest radiograph and thin- section CT features and their characteristic appearance. Results: All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions: In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in

  20. Image-based rendering method for mapping endoscopic video onto CT-based endoluminal views

    Science.gov (United States)

    Rai, Lav; Higgins, William E.

    2006-03-01

    One of the indicators of early lung cancer is a color change in airway mucosa. Bronchoscopy of the major airways can provide high-resolution color video of the airway tree's mucosal surfaces. In addition, 3D MDCT chest images provide 3D structural information of the airways. Unfortunately, the bronchoscopic video contains no explicit 3D structural and position information, and the 3D MDCT data captures no color or textural information of the mucosa. A fusion of the topographical information from the 3D CT data and the color information from the bronchoscopic video, however, enables realistic 3D visualization, navigation, localization, and quantitative color-topographic analysis of the airways. This paper presents a method for topographic airway-mucosal surface mapping from bronchoscopic video onto 3D MDCT endoluminal views. The method uses registered video images and CT-based virtual endoscopic renderings of the airways. The visibility and depth data are also generated by the renderings. Uniform sampling and over-scanning of the visible triangles are done before they are packed into a texture space. The texels are then re-projected onto video images and assigned color values based on depth and illumination data obtained from renderings. The texture map is loaded into the rendering engine to enable real-time navigation through the combined 3D CT surface and bronchoscopic video data. Tests were performed on pre-recorded bronchoscopy patient video and associated 3D MDCT scans. Results show that we can effectively accomplish mapping over a continuous sequence of airway images spanning several generations of airways.

  1. ROLE OF TRANS BRON CHIAL LUNG BIOPSY IN DIFFUSE PARENCHYMAL LUNG DISEASES

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    Methuku

    2015-08-01

    Full Text Available Diffuse parenchyma lung disease (DPLD encompasses a hetero - geneous group of disorders, characterized by a spectrum of inflammatory and fibrotic changes affecting alveolar walls and air spaces. They comprise over 200 entities and include a wide spectrum of diseases, many uncommon and many of unknown etiology. The incidence and prevalence rates of DPLD have not been precisely estimated due to difficulties in ascertaining a specific diagnosis on a specific disease. MATERIAL & METHODS : Prospective observational study done on 20 adult patients with radiologically diffuse parenchymal lung disease admitted between January 2010 and May 2015 in Govt. General & Chest Hospital, Hyderabad were subjected for Transbronchial Lung Biopsy via flexible fibreoptic bronchoscopy, without fluoroscopic guidance. RESULTS : Out of 20 patients studied adequate lung tissue was obtained in 15 patients, yield of the procedure was 75%. Out of 15 patient’s histopathological diagnosis of chronic interstitial pneumonia is seen in 5 members, interstitial fibrosis is seen in 4 members, non caseating granulomas seen in 4 members, pulmonary alveolar protenosis was seen in 1 member and normal lung histopathology was seen in 1 members. Diagnostic yield of the procedure was 93.3% and overall diagnostic yield was 70%. Two patients developed post procedure pneumothorax. Both of them underwent closed - tube thoracostomy, lung expanded well and ICD was removed in 4 days. No significant bleeding was observed in any patient. No mortality was observed after the procedure . CONCLUSIONS : Transbronchial lung biopsy through flexible bronchoscopy is a simple, safe and effective procedure for the diagnosis of diffuse parenchymal lung diseases. Complications were observed in only few patients out of twenty, which were successfully managed with ICD.

  2. Argon Plasma Coagulation Combined with Covered Stent Placement for Management of Tracheobronchial Stenoses/occlusions as well as Esophagorespiratory Fistulas

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    Hongwu WANG

    2010-09-01

    Full Text Available Background and objective It is a complex problem and difficult treatment for tracheobronchial stenoses/occlusions involving in carina. The aim of this study is to investigate the feasibility and efficiency of argon plasma coagulation (APC and bifurcated covered Z-type stents (CZTS placement for the treatment of tracheobronchus stenoses and esophagorespiratory fistula (ERF. Methods Thirty-two cases with airway disorders were retrospectively reviewed for the treatment of APC and CZTS placement. Under the bronchoscopic guidance, APC was first given in patients with airway stenoses, then CZTS was placed under the fluoroscopic and flexible bronchoscopic guidance either with airway stenoses or ERF. Results APC was first given in 19 patients with airway stenoses. Airway structures were significantly improved after APC procedure (57.4%-72.1% before APC vs 12.8%-25.8% after APC. Thirty-two CZTS were technically successfully placed in 30 out of 32 cases involving in carinal bifurcation. After APC and stent placement, short breath index was significantly reduced and karnofsky physical score (KPS increased obviously. The endobronchial defects were successfully palliated with bifurcated CZTS placed under fluoroscopy and flexible bronchoscopy in 12 out of 13 patients with ERFs. There is no bleeding introprocedure. Mucous retention was very common in all types of the stents less than 2 weeks after stenting, which required debridement by bronchoscopy and could be prevented by normal saline solution nebulizations. Granuloma developed at the ends of stents after 1 month of stenting which all of them were treated successfully with APC and CO2 cryosurgery. Conclusion Utilization of APC and retrieval bifurcated CZTS placement is a simple and safe protocol for the management of airway complex stenoses involving the tracheal carina and ERF.

  3. [Bronchial mucoepidermoid carcinoma].

    Science.gov (United States)

    Bregante, J I; Rituerto, B; Font de Mora, F; Alonso, F; Andreu, M J; Figuerola, J; Mulet, J F

    1998-07-01

    We submit the case of a child afflicted with a mucoepidermoid bronchial tumor. The patient is a boy, aged seven, who after undergoing antibiotic treatment for six weeks because of a fever and atelectasia-condensation in the right lower lobe showed no signs of clinical improvement and was sent to our department to undergo further study and treatment. A bronchoscopy performed shows a polypoid mass that partially blocks the main bronchial tube a few milimiters under the access to the right upper lobe. A biopsy is carried out and the anatomopathological test shows there is a low degree epidermoid carcinoma. We decide to perform a lobectomy which for the tumor location and the lung condition has to be medium and lower right. We proceed to remove the adenopaty of hilium not affected by the tumor. The postoperative period develops without incidents. A check-up bronchoscopy performed three months later shows two polypoid masses in the right bronchial tube which, once a biopsy is performed, proved to be granulation tissue. Twelve months after undergoing surgery, the patient's condition is good, there is no evidence of tumor relapse and the breathing capacity is adequate, though there is an obstructive restrictive pattern in the espirometry. Even taking into consideration that lung tumors are extremely unusual, the epidermoid carcinoma is the one which most frequently occurs. The tumor's low malignancy is a sign that points to a good prognosis. Performing conservative surgery by means of bronchoplasty should be taken into account so as to keep the sequelae on the lung condition to a minimum, even though in this case the tumor location made it impossible. PMID:12602035

  4. Acute tracheobronchial injuries: Impact of imaging on diagnosis and management implications

    International Nuclear Information System (INIS)

    Purpose: To evaluate the role of chest radiography, single-slice CT and 16-row MDCT in the direct evidence of tracheobronchial injuries. Methods: Patients with acute tracheobronchial injury were identified from the registry of our level 1 trauma center during a 5-year period ending July 2005. Findings at chest radiograph and CT were compared to those shown at bronchoscopy. Results: Eighteen patients with tracheobronchial injury - three patients with cervical trachea injury, eight with thoracic trachea injury and seven with bronchial injury - were identified. Twelve patients had a blunt trauma (67%), six patients had a penetrating (iatrogenic) injury (33%). Chest radiograph directly identified the site of tracheal injury in four cases, showing overdistension of the endotracheal cuff in three cases and displacement of the endotracheal tube in one case. At the level of the bronchi, chest radiograph demonstrated only one injury. CT directly identified the site of tracheal injury in all the cases showing the overdistension of the endotracheal cuff at the level of the thoracic trachea (three cases), posterior herniation of the endotracheal cuff at the thoracic trachea (three cases), lateral endotracheal cuff herniation at the thoracic trachea (one case), tracheal wall discontinuity at the cervical (one case) and at the thoracic trachea (one case) and displacement of endotracheal tube at the cervical trachea (two cases). At the level of the bronchi, CT correctly showed the site of injury in six case including: discontinuity of the left main bronchial wall (two cases), the 'fallen lung' sign (one case), right main bronchial wall enlargement (one case), discontinuity of the right middle bronchial wall (two cases). In one case, CT showed just direct 'air leak' at the level of the carina suggesting main bronchus injury. This finding was confirmed by bronchoscopy. Conclusion: Chest radiograph was helpful for the assessment of iatrogenic tracheal injuries. CT detected the site

  5. In vivo imaging of the airway wall in asthma: fibered confocal fluorescence microscopy in relation to histology and lung function

    Directory of Open Access Journals (Sweden)

    Bel Elisabeth H

    2011-06-01

    Full Text Available Abstract Background Airway remodelling is a feature of asthma including fragmentation of elastic fibres observed in the superficial elastin network of the airway wall. Fibered confocal fluorescence microscopy (FCFM is a new and non-invasive imaging technique performed during bronchoscopy that may visualize elastic fibres, as shown by in vitro spectral analysis of elastin powder. We hypothesized that FCFM images capture in vivo elastic fibre patterns within the airway wall and that such patterns correspond with airway histology. We aimed to establish the concordance between the bronchial elastic fibre pattern in histology and FCFM. Second, we examined whether elastic fibre patterns in histology and FCFM were different between asthmatic subjects and healthy controls. Finally, the association between these patterns and lung function parameters was investigated. Methods In a cross-sectional study comprising 16 subjects (8 atopic asthmatic patients with controlled disease and 8 healthy controls spirometry and bronchoscopy were performed, with recording of FCFM images followed by endobronchial biopsy at the airway main carina. Elastic fibre patterns in histological sections and FCFM images were scored semi-quantitatively. Agreement between histology and FCFM was analysed using linearly weighted kappa κw. Results The patterns observed in histological sections and FCFM images could be divided into 3 distinct groups. There was good agreement between elastic fibre patterns in histology and FCFM patterns (κw 0.744. The semi-quantitative pattern scores were not different between asthmatic patients and controls. Notably, there was a significant difference in post-bronchodilator FEV1 %predicted between the different patterns by histology (p = 0.001 and FCFM (p = 0.048, regardless of asthma or atopy. Conclusion FCFM captures the elastic fibre pattern within the airway wall in humans in vivo. The association between post-bronchodilator FEV1 %predicted and

  6. Changes in the lung microbiome following lung transplantation include the emergence of two distinct Pseudomonas species with distinct clinical associations.

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    Robert P Dickson

    Full Text Available BACKGROUND: Multiple independent culture-based studies have identified the presence of Pseudomonas aeruginosa in respiratory samples as a positive risk factor for bronchiolitis obliterans syndrome (BOS. Yet, culture-independent microbiological techniques have identified a negative association between Pseudomonas species and BOS. Our objective was to investigate whether there may be a unifying explanation for these apparently dichotomous results. METHODS: We performed bronchoscopies with bronchoalveolar lavage (BAL on lung transplant recipients (46 procedures in 33 patients and 26 non-transplant control subjects. We analyzed bacterial communities in the BAL fluid using qPCR and pyrosequencing of 16S rRNA gene amplicons and compared the culture-independent data with the clinical metadata and culture results from these subjects. FINDINGS: Route of bronchoscopy (via nose or via mouth was not associated with changes in BAL microbiota (p = 0.90. Among the subjects with positive Pseudomonas bacterial culture, P. aeruginosa was also identified by culture-independent methods. In contrast, a distinct Pseudomonas species, P. fluorescens, was often identified in asymptomatic transplant subjects by pyrosequencing but not detected via standard bacterial culture. The subject populations harboring these two distinct pseudomonads differed significantly with respect to associated symptoms, BAL neutrophilia, bacterial DNA burden and microbial diversity. Despite notable differences in culturability, a global database search of UM Hospital Clinical Microbiology Laboratory records indicated that P. fluorescens is commonly isolated from respiratory specimens. INTERPRETATION: We have reported for the first time that two prominent and distinct Pseudomonas species (P. fluorescens and P. aeruginosa exist within the post-transplant lung microbiome, each with unique genomic and microbiologic features and widely divergent clinical associations, including presence during

  7. Bronchoplasty for Primary Broncho-Pulmonary Tumors

    International Nuclear Information System (INIS)

    Parenchyma-sparing procedures are widely used in patients with low-grade malignancies of the airway when anatomically suited lesions exist. This study was conducted to evaluate the short-term and the long-term results of bronchoplastic procedures for patients with centrally located primary bronchopulmonary tumors. Methods: Between 2000 and 2009, 36 patients with primary lung tumors required bronchoplasty were retrospectively analyzed. Preoperative assessment included computed tomography (CT) of the chest, bronchoscopy, and spirometry. Pre operative diagnosis was achieved by bronchoscopy for all patients, mediastinoscopy was done for patients with primary lung cancer. Neo adjuvant chemotherapy was given for 6 patients with non small cell lung cancer (NSCLC). Results: We had 15 males and 21 female, the mean age was 37 years and the mean hospital stay was 7.2 days. Operative procedures performed were:Sleeve lobectomy in 30 patients (13 right, 17 left), partial sleeve right pneumonectomy in 3 and bronchial resection with re-anastomosis in 3 (2 left, 1 right). Twelve patients (33.3%) suffered post-operative problems. There was one operative related mortality. Post operative pathology revealed: 27 patients with typical carcinoid, 2 with atypical carcinoid, 4 with squamous cell carcinoma, 2 with adenocarcifioma and one with hamartoma. Pathological TNM staging revealed: 17 patients with stage 1A, 11 with IB, 5 with IIA and 2 with stage IIIA. Follow-up data were available for all patients except two. Two patients died with disseminated disease 1.5 year and 2 years after surgery. The patient with hamartoma developed local recurrence 5 years later and re-excision was done. One patient with lung cancer developed bone metastases and was alive with disease, while the remaining 30 patient's were alive and disease free. The overall 5 years survival was 83.3%. Conclusion: Bronchoplastic resections achieve local control and long-term survival comparable to the standard resections in

  8. Bronchial artery embolization in the treatment of massive hemoptysis

    International Nuclear Information System (INIS)

    Objective was to evaluate the efficacy of bronchial arteriography and bronchial artery embolization (BAE) in the management of massive hemoptysis in a developing Asian country. A retrospective review was carried out from March 2000 to March 2005 to evaluate the demographics, clinical presentation, radiographic studies, bronchoscopy results, and complications of bronchial arteriography and BAE at a tertiary care hospital in Pakistan. Fourteen patients (9males, 5 females) with a mean age of 49 years underwent bronchial arteriography and BAE for massive hemoptysis. Hemoptysis was caused by bronchiectasis (10 patients), active pulmonary tuberculosis (3 patients), and lung malignancy (one patient). A CT scan of the chest was carried out in 11 patients, which revealed bronchiectasis (8 patients), cavity with infiltrates (3 patients), and mass lesion (one patient). Bronchoscopy was performed in all patients. Bleeding lobe or segment was identified in 12 patients. Bronchial arteriography revealed hypervascularity (13 patients), bronchial artery hypertrophy (5 patients), hypervascularity with shunting (one patient), dense soft tissue staining (7 patients), extravasation of contrast (one patient) pseudoaneurysm (one patient). Bronchial artery embolization was carried out in all patients. Rebleeding occurred within 24 hours in 2 patients who underwent surgery and within one week another 2 patients who were managed with repeat BAE. The complication of embolization occurred in one patient (transverse myelitis). Thirteen patients improved and were discharged home. One patient with terminal lung carcinoma died due to cardiogenic shock secondary to acute myocardial infarction. Bronchial artery embolization is an effective method for management of massive hemoptysis in developing countries and has a low complication rate. (author)

  9. Coexistence of squamous cell tracheal papilloma and carcinoma treated with chemotherapy and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Paliouras D

    2015-12-01

    Full Text Available Dimitrios Paliouras,1 Apostolos Gogakos,1 Thomas Rallis,1 Fotios Chatzinikolaou,2 Christos Asteriou,1 Georgios Tagarakis,3 John Organtzis,4 Kosmas Tsakiridis,5 Drosos Tsavlis,4 Athanasios Zissimopoulos,6 Ioannis Kioumis,4 Wolfgang Hohenforst-Schmidt,7 Konstantinos Zarogoulidis,4 Paul Zarogoulidis,4 Nikolaos Barbetakis1 1Thoracic Surgery Department, Theagenio Cancer Hospital, 2Department of Forensic Medicine and Toxicology, Faculty of Medicine, 3Department of Cardiothoracic Surgery, AHEPA University Hospital, 4Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 5Cardiothoracic Surgery Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, 6Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 7Medical Clinic I, “Fuerth” Hospital, University of Erlangen, Fuerth, Germany Background: Papillomatosis presents, most frequently, as multiple lesions of the respiratory tract, which are usually considered benign. Malignant degeneration into squamous cell carcinoma is quite common, although curative approaches vary a lot in modern literature.Case report: We report a case of a 66-year-old male patient with the coexistence of multiple squamous cell papilloma and carcinoma in the upper trachea with severe airway obstruction that was diagnosed through bronchoscopy and treated by performing an urgent tracheostomy, followed by concurrent chemotherapy and radiotherapy. There was no evidence of recurrence after a 12-month follow-up period.Conclusion: This study underlines the diagnostic and therapeutic value of bronchoscopy as well as multimodality palliative treatment in such cases. To the best of our knowledge, this is the first study to describe an immediate treatment protocol with tracheostomy and concurrent chemotherapy/radiotherapy in a patient with squamous cell tracheal papilloma and carcinoma

  10. Surgical Treatment of Hemoptysis: Analysis of 17 Cases

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    Ufuk Çobanoğlu

    2012-04-01

    Full Text Available Aim: In this study, the patients who underwent surgery for hemoptysis were analyzed retrospectively. The cases were discussed with the literature. Material and Method: Seventeen patients who were admitted to our hospital and underwent surgery for hemoptysis between 2004 and 2010, were retrospectively reviewed. Age, gender, underlying pulmonary disease, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality of the patients were reviewed. Results: Mean age of the 17 patients (6 women, 11 men was 37.4713.25. The most common causes of hemoptysis were lung cancer (29.41%, active pulmonary tuberculosis, bronchiectasis and hydatid cyst (17.64%. It was the first hemoptysis attack in 12(70.59% cases and was recurrent in 5(29.41% cases. 6 of 17 cases (32.30% had mild hemoptysis and in 3 of those (50% the reason of hemoptysis was lung cancer. The most common associating symptoms were cough and weakness (44.17%. There were abnormal findings on chest radiograph of the 8 (47.05% of the cases, while in thorax CT images of 13 (76.47% and 7 (58.33% of bronchoscopy. We treated these patients with posterolateral thoracotomy (12 cases and Video-Assisted Thoracoscopic Surgery (5 cases. The morbidity was seen in 3 patients (17.64%. The mortality rate was 5.88% (n:1. Recurrence developed in 1 (5.88% patients in this series. Discussion: As a result, the leading cause of the hemoptysis was lung cancer. It was seen that computed tomography has a higher value than fiberoptic bronchoscopy in diagnostic evaluation. Especially, if cause of hemoptysis in localized lesions, surgery should be considered a priority. Massive bleeding may require emergency surgical intervention.

  11. Aerosolized pentamidine: Effect on diagnosis and presentation of Pneumocystis carinii pneumonia

    International Nuclear Information System (INIS)

    The objective of this study was to determine the effect of previous aerosolized pentamidine therapy on diagnosis and presentation of Pneumocystis carinii pneumonia. This was a retrospective study of fifty-two consecutive patients with P. carinii pneumonia and underlying infection with the human immunodeficiency virus (HIV) who had bronchoscopy. Twenty-one patients who were on aerosolized pentamidine therapy served as the study group. Thirty-one patients who had not received the drug served as the control group. The yield of bronchoalveolar lavage for P. carinii pneumonia was 62% for the study group and 100% for the control group (P less than 0.05). This lower yield was significant for the subset of patients having their first episode of P. carinii pneumonia. The yield of transbronchial biopsy was similar for both groups of patients (81% compared with 84%). The yield of bronchoscopy was not influenced by use of zidovudine. Review of lavage specimen slides suggested that there may be fewer organisms present in patients receiving aerosolized pentamidine. An atypical roentgenographic presentation of upper lobe predominant infiltrates was seen in 38% of the study patients and 7% of the control patients. In addition, pneumothoraces and cystic changes were also frequently seen in the study patients. Gallium scans, when done, were also atypical in the study group. Markers of the severity of disease, however, were similar in both groups. The yield of bronchoalveolar lavage for P. carinii pneumonia in HIV-infected patients is lower in patients receiving aerosolized pentamidine. Unusual roentgenographic presentations and atypical gallium scans are also found in this setting

  12. Fluorescent microscopy and Ziehl-Neelsen staining of bronchoalveolar lavage, bronchial washings, bronchoscopic brushing and post bronchoscopic sputum along with cytological examination in cases of suspected tuberculosis

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    Vijay Kumar Bodal

    2015-01-01

    Full Text Available Objectives: Ever since the discovery of Mycobacterium tuberculosis in 1882, many diagnostic methods have been developed. However "The gold standard" for the diagnosis of tuberculosis (TB is still the demonstration of acid fast Bacilli (AFB by microscopic examination of smear or bacteriological confirmation by culture method. Materials and Methods: In suspected 75 patients with active pulmonary TB, the materials obtained bronchoscopically, were bronchoalveolar lavage (BAL, bronchial brushings, bronchial washings and post bronchoscopic sputum. Four smears were made from each of the specimen. Fluorescent Staining, Ziehl–Neelsen (ZN, Pap and May Grunwald-Giemsa (MGG stains were carried out for cytological examination. Results: Fluorescent stain yielded maximum AFB positivity in all the methods, that is 36 (48% in post fibre-optic bronchoscopy (FOB sputum and 19 (25.33% by fluorescence microscopy in both bronchial brushings and bronchial washings. Maximum yield of AFB with ZN staining 12 (16% was equal to the post FOB sputum and bronchial brushings samples. It was followed by 6 cases (8% in BAL and 4 (5.3% in bronchial washings. The cytological examination was suggestive of TB in only 8 (10.66% cases in bronchial washings and 6 (8% cases in post FOB collection. It was equal in BAL and Bronchial brushings each that is 5 (6.67%. Conclusion: Bronchoscopy is a useful diagnostic tool and fluorescent microscopy is more sensitive than ZN and cytology. On X-ray examination, other diseases like malignancy or fungus can also mimick TB. So apart from ZN staining or fluorescence microscopy, Pap and MGG stain will be worthwhile to identify other microorganisms.

  13. 三维CT在气管狭窄诊断中的应用%The Application of Three-Dimensional CT on the Diagnosis of Tracheal Stenoses

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    辛衍忠; 闫宇博; 张翔宇; 李吉尧; 崔键

    2011-01-01

    Objective: We evaluated the ability of three-dimensional CT to estimate tracheal stenoses in comparison to conventional fiberoptic bronchoscopy, with a view to assist thoracic surgeons in depicting the anatomical characteristics of tracheal strictures. Methods: Spiral CT was performed in 64 patients with suspected tracheal stenoses and in 20 normal subjects. Tracheal stenoses due to an endolu-minal neoplasm were detected in 52 patients, whilst traumatic tracheal stricture was observed in the other 12 patients. Multiplanar reformatting (MPR), volume rendering techniques (VRT) and virtual endoscopy (VE) for trachea evaluation were applied and findings were compared to fiberoptic bronchoscopy. The accuracy of the procedure in describing the localization and degree of stenosis was tested by two radiologists in a blinded controlled trial. Results: The imaging modalities tested showed the same stenoses as the ones detected by flexible bronchoscopy and achieved accurate and non-invasive morphological characterization of the strictures, as well as additional information about the extraluminal extent of the disease. No statistically significant differences were observed between bronchoscopic findings and the MPR, VRT and VE image evaluations (P = 0.715, 0.413 and 0.417 respectively). Conclusion: Three-dimensional CT may provide a high fidelity, noninvasive and reproducible evaluation of the trachea compared to bronchoscopy. They may play a role in assessment of airway patency distal to high-grade stenoses, and represent a reliable alternative method for patients not amenable to conventional bronchoscopy.%目的:我们检测三维CT在气管狭窄的诊断中的作用和纤维支气管镜相比较,用以帮助临床胸外科医生判断气管结构的解剖学特征.方法:对怀疑气管狭窄的患者64例及20例正常病例检查螺旋CT,其中52例发现腔内新生物造成狭窄,另外12例为外伤后狭窄,应用多平面重建(MPR)、容积重建技术(VRT)、仿

  14. Airtraq光学可视喉镜联合 Bougie探条或纤维支气管镜在气管插管中的应用%Application of airtraq optical laryngoscope with bougie or fiberoptic bronchoscope in trache-al intubation

    Institute of Scientific and Technical Information of China (English)

    孙剑; 蔡捍东; 赵志丹

    2015-01-01

    Objective To investigate the feasibility of using alrtraq optical laryngoscope to expose glottis for tracheal intubation under general anesthesia conditions with the help of bougie or fiberoptic bronchoscopy. Method 75 adult patients with ASA ratingⅠ~Ⅱ and difficulty level of intubation ( Mallampati classification)Ⅰ~Ⅱrequiring tra-cheal intubation were selected and divided into 3 groups: the alrtraq optical laryngoscope group (25 cases), the alrtraq optical laryngoscope with the help of bougie group (25 cases), and the alrtraq optical laryngoscope with the help of fiberoptic bronchoscopy group (25 cases); the success rate, time of intubation, and the incidence rate of anesthetic complications of different intubation methods were compared. Result The success rates of the alrtraq opti-cal laryngoscope with the help of bougie and the fiberoptic bronchoscope group were significantly higher than that of the alrtraq optical laryngoscope group (P<0. 05). The intubation time of the alrtraq optical laryngoscope with the help of bougie group was significantly less than that of the alrtraq optical laryngoscope group and the alrtraq optical laryngoscope with the help of fiberoptic bronchoscope group (P<0. 05). The incidence rate of anesthetic complica-tions in the alrtraq optical laryngoscope group was significantly higher than that of the alrtraq optical laryngoscope with the help of bougie group and the fiberoptic bronchoscopy group (P<0. 05). Conclusion Due to its high success rate, short intubation time and fewer anesthetic complications, combined application of alrtraq optical laryngoscope and bougie is a favorable choice in tracheal intubation.%目的:观察全身麻醉下运用Airtraq光学可视喉镜暴露声门后,辅助使用探条或纤维支气管镜配合行气管插管的可行性。方法选取75例择期需行气管内插管手术的成年患者为研究对象, ASA 评级Ⅰ~Ⅱ级,插管困难程度分级Ⅰ~Ⅱ级,随机分为Airtraq光学

  15. Aspiração de corpo estranho em crianças: aspectos clínicos, radiológicos e tratamento broncoscópico Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment

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    Andrea de Melo Alexandre Fraga

    2008-02-01

    years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. RESULTS: The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age, 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%, auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%, and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts. In the follow-up period, 29% presented complications (most commonly pneumonia, which were found to be associated with longer aspiration time (p = 0.03. Mechanical ventilation was required in 7 children (10.1%, and multiple bronchoscopies were performed in 5 (7.2%. CONCLUSION: A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher the risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention programs aimed at children younger than 3 years of age.

  16. Ruptura traumática de via aérea em criança: um desafio diagnóstico Traumatic airway disruption in a child: a diagnostic challenge

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    Andréa Maria Cordeiro Ventura

    2005-04-01

    Full Text Available OBJETIVO: Relatar um caso de ruptura da via aérea em criança vítima de trauma torácico decorrente de queda do tanque de lavar roupas. DESCRIÇÃO: Relato de caso descritivo. O paciente pré-escolar de 34 meses, do sexo masculino foi atendido na unidade de terapia intensiva pediátrica de Hospital Universitário. Foram realizados os seguintes procedimentos: radiografia simples e tomografia de tórax, endoscopia respiratória, toracotomia, antibioticoterapia, ventilação mecânica. A radiografia simples de tórax, tomografia computadorizada de tórax e endoscopia respiratória foram necessárias para definir o diagnóstico de ruptura traumática da via aérea associada a contusão pulmonar, pneumotórax, pneumomediastino e enfisema subcutâneo. O paciente foi submetido a toracotomia para reparação de lesão quase completa de brônquio principal esquerdo. Antibioticoterapia de largo espectro e suporte ventilatório contribuíram para resolução do caso sem seqüelas a médio prazo. COMENTÁRIOS: Na vigência de trauma torácico em criança, a busca diagnóstica por lesões incomuns, mas potencialmente letais, como a ruptura da via aérea, deve ser incessante, particularmente naqueles pacientes com fortes evidências clínicas. A complementação diagnóstica deve ser otimizada com a radiografia simples de tórax, a tomografia de tórax e o exame endoscópico que estabelece o diagnóstico definitivo.OBJECTIVE: To report a case of airway disruption in a child victim of blunt thoracic trauma due to falling off a sink. DESCRIPTION: Descriptive case report. A 34-month old boy victim of thoracic trauma was seen at the pediatric intensive care unit of a university hospital. Plain chest radiograph, thoracic computed tomography, bronchoscopy, thoracotomy, antibiotics, hemodynamic and respiratory support were performed. Plain chest radiograph, thoracic computed tomography and bronchoscopy were performed in order to arrive at a precise diagnosis of

  17. HDR intralumenal brachytherapy in bronchial cancer: review of our experience

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    The main indications for brachytherapy in the treatment of endobronchial cancer are dyspnea. postobstructive pneumonia and atelectasis, cough and hemoptysis resulting from broncus obstruction by exophytic intralumenal tumor growth. High Dose Rate intralumenal brachytherapy (HDRBT) may be combined with external beam radiotherapy (EBRT), in particular as almost all tumors are too large for HDRBT alone. From January 1992 to September 1995 we treated 268 patients affected by bronchial cancer, with EBRT combined with HDRBT. All patients were staged as IIIa-IIIb-IV but KPS was >60 and expectancy of life > than 3 months. After bronchoscopy and Tc simulation we found that almost 10% of patients were downstaged. Treatment was always realized delivering 60 Gy to the tumour volume and 50 Gy to the mediastinal structures with EBRT. Brachytherapy was performed during the radiotherapy course. In 38 patients HDRBT was realized just one time, at the beginning of EBRT, with a dose of 10 Gy calculated at 1cm from the central axis of the catheter. In 47 HDRBT was performed twice (at the beginning and at the end of EBRT) with a dose of 7 Gy calculated at 1 cm from the central axis. From 1994 we started a 3 fractions protocol (Timing: days 1.15.30) with a dose of 5 Gy calculated at 0.5 cm from the axis. Of the 183 patients introduced in the protocol 170 received the three fractions of HDRBT and 13 were excluded from the study for personal or clinical reasons. In 97% of cases the application did not need general anesthesia; local anesthesia has been sufficient supplemented by some drug for sedation and coughing. Anyway both bronchoscopy and HDRBT (with anterior-posterior and lateral chest X-ray) are performed in the same shielded room without the necessity of displacing the patient. In almost 60% of treatments we used just one endobronchial applicator. In case of tumor involvement of the carina, two applicators were introduced. By this a larger tumor volume can be treated with adequate

  18. Acute tracheobronchial injuries: Impact of imaging on diagnosis and management implications

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    Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy)]. E-mail: mscaglione@tiscali.it; Romano, Stefania [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Pinto, Antonio [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Sparano, Amelia [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Scialpi, Michele [Istituto di Radiologia Diagnostica ed Interventistica Policlinico Monteluce, Universita degli Studi di Perugia, Via Brunamonti 51, 06122 Perugia (Italy); Rotondo, Antonio [Dipartimento Universitario di Internistica Clinica e Sperimentale F. Magrassi-A. Lanzara, Sezione Scientifica di Diagnostica per Immagini, Facolta di Medicina e Chirurgia, Seconda Universita degli Studi di Naples (Italy)

    2006-09-15

    Purpose: To evaluate the role of chest radiography, single-slice CT and 16-row MDCT in the direct evidence of tracheobronchial injuries. Methods: Patients with acute tracheobronchial injury were identified from the registry of our level 1 trauma center during a 5-year period ending July 2005. Findings at chest radiograph and CT were compared to those shown at bronchoscopy. Results: Eighteen patients with tracheobronchial injury - three patients with cervical trachea injury, eight with thoracic trachea injury and seven with bronchial injury - were identified. Twelve patients had a blunt trauma (67%), six patients had a penetrating (iatrogenic) injury (33%). Chest radiograph directly identified the site of tracheal injury in four cases, showing overdistension of the endotracheal cuff in three cases and displacement of the endotracheal tube in one case. At the level of the bronchi, chest radiograph demonstrated only one injury. CT directly identified the site of tracheal injury in all the cases showing the overdistension of the endotracheal cuff at the level of the thoracic trachea (three cases), posterior herniation of the endotracheal cuff at the thoracic trachea (three cases), lateral endotracheal cuff herniation at the thoracic trachea (one case), tracheal wall discontinuity at the cervical (one case) and at the thoracic trachea (one case) and displacement of endotracheal tube at the cervical trachea (two cases). At the level of the bronchi, CT correctly showed the site of injury in six case including: discontinuity of the left main bronchial wall (two cases), the 'fallen lung' sign (one case), right main bronchial wall enlargement (one case), discontinuity of the right middle bronchial wall (two cases). In one case, CT showed just direct 'air leak' at the level of the carina suggesting main bronchus injury. This finding was confirmed by bronchoscopy. Conclusion: Chest radiograph was helpful for the assessment of iatrogenic tracheal injuries

  19. Análise do lavado broncoalveolar em vítimas de queimaduras faciais graves Bronchoalveolar lavage analysis in victims of severe facial burns

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    Eucir Rabello

    2009-04-01

    Full Text Available OBJETIVO: Analisar o lavado broncoalveolar (LBA de vítimas de queimaduras que inalaram fumaça a fim de identificar alterações que possam estar associadas à morte ou à sobrevida. MÉTODOS: Dezoito vítimas de queimaduras faciais foram submetidas a LBA até 24 h após o evento, sendo realizadas a análise do conteúdo celular e proteico, incluindo TNF-α, HLA-DR, CD14, CD68 e iNOS. RESULTADOS: Dos 18 pacientes submetidos à broncoscopia, 8 (44,4% morreram durante o seguimento. A média de idade dos pacientes que morreram foi significativamente maior (44,7 vs. 31,5 anos. A superfície corporal queimada foi em média de 60,1% nos pacientes que morreram e de 26,1% nos sobreviventes (p OBJECTIVE: To analyze bronchoalveolar lavage (BAL specimens of burn victims who inhaled smoke, in order to identify alterations associated with mortality or survival. METHODS: Eighteen victims of facial burns were submitted to BAL up to 24 h after the event. We investigated cell and protein content, including TNF-α, HLA-DR, CD14, CD68 and iNOS. RESULTS: Of the 18 patients submitted to bronchoscopy, 8 (44.4% died during the follow-up period. The mean age of patients who died was significantly higher (44.7 vs. 31.5 years. On average, the patients who died had burns covering 60.1% of the total body surface area, compared with 26.1% in the survivors (p < 0.0001. Of the 18 patients submitted to bronchoscopy, 11 (61.1% showed endoscopic signs of smoke inhalation injury, and 4 (36.4% of those 11 died. Of the 7 patients with no signs of smoke inhalation injury, 4 (57.1% died. The mean number of ciliated epithelial cells in the BAL fluid was significantly higher in the patients who died than in the survivors (6.6% vs. 1.4%; p = 0.03. There were no significant differences between the groups in terms of any of the other parameters evaluated. CONCLUSIONS: The total body surface area burned was a predictive factor for mortality. Increased numbers of ciliated epithelial cells

  20. 磷丙泊酚的临床应用研究进展%Clinical application of fospropofol:research advances

    Institute of Scientific and Technical Information of China (English)

    邹寿涛

    2015-01-01

    磷丙泊酚(fospropofol)为丙泊酚的前药,在体内经碱性磷酸酶水解后释放出丙泊酚,释放出来的丙泊酚具有独特的药理性质。安全性与有效性临床试验表明,该药的镇静作用与剂量成正比。磷丙泊酚使用剂量为6.5和8 mg/kg,用于结肠镜检、支气管镜检等内镜检查时镇静,疗效、安全性和耐受性都比较好;使用6.5 mg/kg剂量作为咪达唑仑的替代品用于口腔小手术时既镇静、安全且患者易于耐受。另外,磷丙泊酚用于老年患者支气管纤维镜检,不仅安全有效且患者苏醒快、满意度高,效果与年轻患者相似;采用静脉滴注/推注方式用于ICU患者短期麻醉诱导和镇静作用的维持,耐受性和有效性均可,也可以作为全身麻醉药用于行冠状动脉旁路移植手术患者。%Fospropofol is a prodrug of propofol which hydrolyzes in the body by alkaline phosphatase to liberate propofol. Propofol liberated from fospropofol has unique pharmacological properties. Fospropofol in doses of 6.5 or 8 mg/kg, is effective and well tolerated for the sedation of patients undergoing colonoscopy,flexible bronchoscopy. When administered intravenously by a dentist anesthesiologist at the indicated dose, it appearsed to be a safe, well-tolerated alternative to midazolam for intravenous moderate sedation during minor oral surgery procedures. In addition, fospropofol provides safe and effective sedation, rapid time to full alert, and high satisfaction in the elderly subset undergoing flexible bronchoscopy, which is comparable with outcomes in younger patients. Study suggested that fospropofol, administered in an infusion/bolus regimen, be tolerable and effective for short-term induction and maintenance of sedation in intensive care unit patients. Fospropofol also could be used to provide general anesthesia in patients undergoing coronary artery bypass graft surgery.