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At least 199 records · Page 11Linked to original sources
PubMed1999

Reverse mismatched ventilation-perfusion pulmonary imaging with accumulation of technetium-99m-DTPA in a mucous plug in a main bronchus: a case report.

The phenomenon of reverse mismatched ventilation-perfusion on pulmonary scintigraphy is a fairly common occurrence. We present a patient who was experiencing decreasing oxygen saturation and had a reverse mismatched ventilation-perfusion imaging pattern associated with radiotracer retention in a main bronchus. Technetium-99m-DTPA aerosol lung imaging showed tracer retention in the trachea and right main bronchus, absent ventilation in the right lung, and normal ventilation in the left lung. Technetium-99m-MAA perfusion lung images showed normal perfusion of the left lung and some perfusion in the right lung. These findings represented a reverse ventilation-perfusion mismatch. Reverse mismatched ventilation-perfusion, or totally absent ventilation with preservation of some perfusion in the right lung, resulted in functional intrapulmonary shunting, which explained the decreasing oxygen saturation observed in this patient. A concurrent portable chest radiograph showed elevation of the right hemidiaphragm, a shift of the mediastinum to the right, deviation of the endotracheal tube, narrowing of the intercostal space of the right thorax, and collapse of the right lower lobe. The radiographic findings of underventilation of the right lung with atelectasis of the right lower lobe were due to mucous plugging the right main bronchus.

Adult↗
PubMedDate not supplied

Rupture of a thoracic aneurysm in the left bronchus.

Aortobronchic fistula is a very unusual complication of thoracic aneurysm. We report the case of a 71-year old man with rupture of a thoracic aortic aneurysm in the left main bronchus. The patient had suffered a car crash fifteen years ago, without any evidence of aortic rupture at the time. Thereafter, he developed an aortic isthmic dilation (36 mm in diameter). The patient suffered from long standing pulmonary insufficiency and emphysema and was admitted several times on an urgent basis for acute dyspnea. During an hospitalization for respiratory distress, he presented haemoptysis and left lung hyperinflation secondary to partial fistulization and extrinsic compression of the main left bronchus. Isthmic aortic resection and prosthetic grafting was performed and the left main bronchus was closed by an autologous pericardial patch. Ten days later, following an air-leak from the bronchial closure, a transposed latissimus dorsi flap was used by the plastic surgeon to repair the defect. Nevertheless, the patient died from multisystemic failure six weeks later.

Aged↗
PubMed2001

[A case of adenoid cystic carcinoma of the left main bronchus, which was performed carinal resection and reconstruction while the aortic arch is pulled down].

A 55-year-old woman, who had treated as bronchial asthma for eight months, was admitted to our hospital. Chest CT scan showed a mass in the left main bronchus. Bronchoscopic examination revealed a tumor obstructing the left main bronchus and invading the left lower portion of the trachea. The pathologic diagnosis was adenoid cystic carcinoma. Primary resection of the left main bronchus and the carina with the objective and one-stoma-type carinal reconstruction were performed by the left thoracotomy. We pulled down the aortic arch to obtain an operative field, and carried out the operative procedure at the upper side of the aortic arch. As the resection margin contained residual tumor, the postoperative irradiation (50 Gy) was added.

Aorta, Thoracic↗
PubMed2001

[Diagnostic value of measuring resistance of airway in the bronchus diastole test for asthma].

OBJECTIVE: To discuss the variation of resistance of airway (Raw) and the diagnostic value of the bronchus diastole test for asthma patient. METHODS: The forced expiratory volume of the first second (FEV1) and Raw were measured. RESULTS: 1. The positive rate of FEV1 increase after the test was 68% (20/31). 2. There was a significant difference in percentage of FEV1 increase after the test between positive group and negative group. 3. After the bronchus diastole test, the Raw decreased significantly in both groups. CONCLUSION: The decrease of Raw after bronchus diastole test is more valuable for the asthma diagnosis than that of FEV1.

Adult↗
PubMed1992

[Reconstruction of trachea, carina and bronchus for tumors of the trachea, carina and lung].

This paper reports on 70 patients with tumors of the trachea, bronchus and lung treated by reconstruction of the trachea, carina and the main bronchus (21 cases) and sleeve lobectomy (49 cases). Postoperatively, 2 patients died of tracheo-innominate artery fistula and 2 developed empyema which was healed. There was no mortality in the sleeve lobectomy patients. The 3- and 5-year survival rates of the cancer patients treated by reconstruction of trachea, carina and main bronchus were 54.5%(6/11) and 33.3%(3/9), respectively. The 3- and 5-year survival rates of lung cancer patients treated by sleeve lobectomy were 46.6% (14/30) and 33.3% (7/21), respectively.

Adenocarcinoma↗
PubMed2004

[Prophylaxis and treatment of the incompetent stump of the primary bronchus and tracheobronchial anastomosis with using omentoplasty].

An analysis of risk factors of incompetence of the bronchus stump or tracheobronchial anastomosis has shown that the statistically reliable factors (p < 0.05) were: male gender of the patient, neglected lung cancer, high degree of purulent intoxication, preoperative gamma-therapy, certain kinds of performing sutures, the degree of acute respiratory insufficiency. The traditional methods of plasty of the primary bronchus stump or tracheobronchial anastomosis in patients with the high objective risk of the development of incompetence of their sutures are known to be not effective. An experience with 70 prophylactic and curative omentoplasties has shown than the application of the greater omentum for plasty can substantially reduce frequency of the formation of acute bronchopleural fistulas, but the technique of fixation of the omentum to the trachea and opposite primary bronchus is of great significance for realization of the omentum plasty potential.

Adult↗
PubMed2005

[Algorithm of preoperative preparation in surgical treatment of lung echinococcus complicated by a rupture into the bronchus].

The clinical material includes 10 years of observations of 289 patients with lung echinococcosis complicated by a rupture into the bronchus. Different operative interventions were performed in 278 cases. The indications for operation, their volume and preoperative preparation were based on clinico-rentgenological signs and divided into 4 groups: 1 - patients with a rentgenological sign of the folded chitin membrane, or a ring-shaped shadow; 2 - patients with non-homogeneous complicated cysts; 3 - patients with "floating chitin membrane"; 4 patients with a rupture of the cyst into the bronchus and pleural cavity simultaneously. The third group patients needed more intensive preoperative preparation while the fourth group patients had an indication to urgent drainage of the pleural cavity or urgent operations in the absence of the purulent discharge from the drains. So, the proposed algorithm of the preoperative preparation of lung echinococcosis patients complicated by a rupture into the bronchus facilitates the improvement of the management of this category of patients.

Adolescent↗
PubMed2006

[Bronchoplasty without lung resection for the complete transection of the left main bronchus due to blunt trauma].

Blunt bronchial injury is rare but crucial injury. A 17-year-old female was admitted due to traumatic injury. She was diagnosed with bilateral lung contusion, multiple rib fractures, spleen damage and the suspicion about the complete transection of the left main bronchus on X-ray and computed tomography (CT). She was brought to our hospital at 30 hours later from injury. Bronchoscopy revealed the complete transection and the edema of the left main bronchus. She underwent a resection of the disrupted portion and end-to-end anastomosis of left main bronchus without lung resection. We should be an immediate and accurate diagnosis of tracheobronchial disruption by X-ray, CT and bronchoscopy whenever we evaluate patients with blunt chest trauma.

Adolescent↗
PubMed2006

[Surgical treatment for tumors of trachea, carina and main bronchus].

OBJECTIVE: To review the experience in surgical treatment for tumors of trachea, carina and main bronchus. METHODS: From Jan. 1996 to Jun. 2004, 27 patients with tumor of trachea, carina or main bronchus underwent surgery including resection and reconstruction of trachea in 8, right/left pneumonectomy and carinal resection and reconstruction in 9 (6/3), right sleeve upper lobectomy and carnial resection with reconstruction of trachea and carina in 2, carina resection and reconstruction in 3, tumor removal through tracheal windows in 5. CPB (cardiopulmonary bypass) was used in 2 patients during surgery. RESULTS: There were 3 peri-operative deaths caused by acute respiratory failure in 2 and severe postoperative bleeding in 1 case. After follow-up of more than 6 months, no death or post-operative complication occurred. CONCLUSION: Resection and reconstruction for patients with tumor of trachea, main bronchus or carina can be performed with excellent results using effective surgical and anaesthetic methods with or without CPB assistance.

Adenocarcinoma↗
PubMed1990

[Successful re-reconstruction for complete disruption of the right main bronchus by blunt chest trauma].

A 22 year-old man was brought to our hospital about twenty-three minutes following a high-speed motorbicycle accident in which he had blunt chest trauma. He was in severe respiratory distress with marked dyspnea and restless with extensive subcutaneous emphysema involving anterior chest wall, cervical and bilateral inguinal regions. A chest X-ray revealed bilateral pneumothorax involving mediastinal emphysema and also fracture of right submandibular and clavicula. In spite of orotracheal intubation and insertion of bilateral chest tube, continuous air leak and pneumothorax did not improve. Bronchoscopy revealed the disruption of mucosa of the right main bronchus at the bifurcation. Emergency right thoracotomy was performed and there was the complete disruption of the right main bronchus. Anastomosis of the right main bronchus with circumferential resection was undertaken on May 30, 1987 about two hours after trauma. About three months after reconstruction, bronchoscopic examination revealed stomal stenosis with deformation of tracheobronchial cartilage and granulation. The stenosis showed severe irregularity by deformed cartilage and thickened scar, so widening by Nd-YAG laser vaporization was inadequate in effect. Seven months after first reconstruction, we performed re-reconstructive operation, right upper sleeve lobectomy with partial resection of carcina and right wall of trachea for scar with severe deformation of cartilage. Following the operation, the patient suffered from sepsis with pneumonitis accompanied by lung edema. This complication was treated successfully. We considered that acute pneumonitis was caused by reventilation with increase of perfusion after tracheobronchial reconstruction. Consequently, we thought it important to treat such patients with long term IPPB postoperatively with adequate medication for respiratory system.

Accidents, Traffic↗
PubMed1987

Invasion of human lung carcinoma into cartilage of the bronchus.

In vivo invasion of human carcinoma of the lung into the cartilage of the bronchus was studied by light microscopy. Tumor spread into the cartilage was found in 26% (60/229). It occurred in 38/128 epidermoid carcinoma (30%) and in 14/55 adenocarcinoma (25%), but was observed in only 1/17 large cell anaplastic carcinoma (6%). Degradation of cartilage matrix was found to be limited. Destroyed area measured 9.9 +/- 1.8 mm2 on average. Tumors able to destroy bronchus cartilage were similar in size compared to tumors without detectable invasion into cartilage. Analysis of pTN stages revealed no differences between both groups. Tumor volume in extrapulmonary lymph nodes was significantly larger in case of cartilage degradation. Patients with tumors degrading bronchus cartilage showed poorer survival (median survival 360 vs. 780 days, p less than 0.10). Immunohistology differentiating inflammatory cells (B lymphocytes, T lymphocytes, monocytes, granulocytes, macrophages) revealed no participation of inflammatory cells in tumorous degradation of cartilage. The findings suggest that hyalin cartilage is highly resistant to invasion of human lung carcinoma although evidence exists for proteolytic activity of human lung carcinoma.

Adenocarcinoma↗
PubMed1989

Influence of electrical field stimulation on antigen-induced contraction and mediator release in the guinea pig isolated superfused trachea and bronchus.

These studies examined the ability of electrical field stimulation (EFS) to influence antigen-induced responses in the guinea pig isolated trachea and main-stem bronchi. Airways isolated from guinea pigs actively sensitized to ovalbumin were superfused and stimulated transmurally with square pulses of 1 msec duration at a frequency of 16 pulses per sec. In the trachea, EFS caused an atropine-sensitive contraction followed by a maintained relaxation. The relaxation consisted of adrenergic and nonadrenergic components. In the bronchus, EFS caused a maintained contraction. This contraction was due to a combination of cholinergic (atropine-sensitive) and noncholinergic (capsaicin-sensitive) mechanisms. Histamine could not be detected in superfusate samples during electrical stimulation alone of either the trachea or bronchus. EFS significantly inhibited ovalbumin-induced tracheal contractions by about 30% without altering ovalbumin-induced histamine or immunoreactive peptido-leukotriene release from the tissues. EFS had a similar inhibitory effect on the contraction induced by application of exogenous histamine (10(-5) M). The electrical stimulus-induced inhibition of the antigen-induced contraction was abolished by tetrodotoxin and propranolol and reduced by a combination of atropine, propranolol and phentolamine. Norepinephrine (5 x 10(-6) M) inhibited ovalbumin-induced histamine release by about 30% without altering the contraction. Carbamylcholine had no effect on ovalbumin-induced histamine release. In the guinea pig bronchus, EFS stimulation had no effect on either histamine release or contraction induced by ovalbumin. These results demonstrate that in the guinea pig trachea nerve stimulation can significantly antagonize antigen-induced contractions and suggest that this is due to a functional antagonism by adrenergic and nonadrenergic relaxant neurotransmitters at the level of the airway smooth muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Histologic evaluation of lung and bronchus-associated lymphoid tissue in young turkeys infected with Bordetella avium.

One-day-old turkeys were inoculated intranasally with Bordetella avium. Noninoculated hatchmates were housed separately. At postinoculation weeks 1, 2, 3, 4, and 5, B avium-infected (BA+) and B avium-free (BA-) turkeys were necropsied; specimens of tracheas, intrapulmonary primary bronchi, and lung adjacent to primary bronchi were bacteriologically cultured. Lung tissue was collected for histologic examination. Lungs perfused with acetic acid were collected for evaluation to determine the size, number, and distribution of lymphoid nodules associated with primary bronchi. Bordetella avium was isolated from trachea and primary bronchi of all BA+ turkeys, but was never isolated from lung parenchyma. Acute purulent bronchitis was associated with colonization of the primary bronchi by B avium from postinoculation weeks 1 to 3. Macrophages and lymphocytes persisted in the peribronchial connective tissue for 5 weeks after inoculation. Bronchus-associated lymphoid tissue consisted of discrete lymphoid nodules protruding into the lumens of primary bronchi. Lymphoid nodules, morphologically similar in BA+ and BA- turkeys, were composed of nonciliated, cuboidal epithelium covering a zone of loosely arranged lymphocytes and macrophages and a deeper, sharply demarcated lymphoid follicle. Compared with bronchus-associated lymphoid tissue of BA- turkeys, lymphoid nodules of bronchus-associated lymphoid tissue in BA+ turkeys were more numerous and widely distributed along primary bronchi. In both BA- and BA+ turkeys, the mean diameter of lymphoid nodules doubled between 1 and 5 weeks of age.

Animals↗
PubMed1982

Autacoid and autonomic reactivity of bovine and ovine bronchus: modifications by antigenic sensitization.

Spirally cut bronchial strips, prepared from three bovine (horse plasma-sensitized calves, control calves and adult cattle) and two ovine (horse plasma-sensitized and control sheep) animal groups were studied in isolated organ baths and their responses to standard autacoid and autonomic agents were compared. All bovine preparations contracted to carbachol greater than 5 HT greater than histamine and relaxed to isoproterenol greater than adrenaline greater than phenylephrine. Responses of ovine bronchus to the above agonists were similar to bovine except to histamine which caused relaxations. Atropine antagonized carbachol-induced contractions while the relaxant responses of bronchial strips to isoproterenol and adrenaline were inhibited by propranolol in both ruminant species. Contractile effects of histamine were sensitive to mepyramine whereas cimetidine inhibited histamine-induced relaxations of ovine bronchus. The bronchial strips prepared from horse plasma-sensitized calves and sheep exhibited a significant (p less than .05) hyperreactivity to carbachol. The relaxant responses of sensitized calf bronchus to isoproterenol and adrenaline were also significantly (p less than .05) impaired when compared with respective controls. It is concluded that hypersensitization with foreign antigens might exaggerate the airway reactivity by rendering them hyperreactive to spasmogenic and hyporeactive to spasmolytic stimulation.

Animals↗
PubMed1984

Tracheal sleeve pneumonectomy for carcinomas of the proximal left main bronchus.

Although most primary cancers of the left main bronchus extending to the carina are inoperable, some patients with such a tumour may benefit from an extended, curative surgical procedure. This type of resection presents specific problems in reconstruction and physiologic management during operation. Between 1977 and 1983, five such patients were managed by left pneumonectomy followed by resection of the carina. They ranged in age from 49 to 65 years. None were irradiated before the procedure. In all cases, an end-to-end anastomosis was made between the right main bronchus and the mediastinal trachea. The high-flow catheter technique was used for ventilation during reconstruction. There were no operative deaths. Excessive bronchorrhea was noted in all patients and was aggravated by left recurrent nerve palsy in two. This report indicates that modern techniques of tracheobronchial reconstruction can be successfully applied in patients with locally advanced carcinoma of the proximal left main bronchus. This type of resection may be the treatment of choice in selected cases.

Aged↗
PubMed1983

A supernumerary bronchus of the right upper lobe.

A patient with a bronchogenic carcinoma in the right lower lobe was found during bronchography to have an accessory right superior cardiac bronchus. Inspection of the right lung at operation and a control bronchogram, made 6 months after right lower lobectomy, confirmed that the congenital anomaly was a supernumerary bronchus and not a cardiac bronchus which had migrated proximally.

Bronchi↗
PubMed1980

[An animal model of bronchus-stenosis (author's transl)].

The stenosis of the main bronchus is a serious disease. In many cases a surgical correction is necessary. However, compared to other surgical procedure the surgical reconstruction of the bronchus is relatively seldom done. Therefore it is not easy to answer some questions in this topic. A reproducible animals model might help to clarify some of this problems. In our experimental model the anodical current is used to produce the stenosis by putting an electrode in the bronchus after narcosis of a mini-pig. A surgical procedure is not necessary. In this way a maximum approach of the experimental model to a clinical situation is obtained.

Animals↗
PubMed1995

[Preoperative neoadjuvant chemotherapy with a combination of 5-fluorouracil, adriamycin and cisplatin (FAP) for advanced esophageal cancer invading trachea or main bronchus].

Conventional irradiation and systemic chemotherapy is scarcely effective for advanced esophageal cancer invading trachea or main bronchus. Therefore, to reduce the area of invasion and suppress distant metastasis, we have preoperatively treated 4 patients suffering from advanced esophageal cancer invading the trachea or main bronchus by neoadjuvant chemotherapy (FAP) as follows: 2 times every 4 weeks, CDDP 100 mg and ADR 50 mg on day 1 and continuous infusion of 5-FU 1,000 mg/day for 7 days. The response rate (PR) was 75% (3/4). In 2 of 4 patients (50%), no cancer cells except broad fibrosis were detected histologically in the region of the trachea or main bronchus suspected to be invaded. There was no severe complication. This FAP regimen is suspected to be useful chemotherapy for advanced esophageal cancer.

Aged↗