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At least 271 records · Page 15Linked to original sources
PubMed2004

Stenting of the mainstem bronchus in children: a word of caution.

We present two patients with critical hemorrhage following expandable metallic stenting of the left mainstem bronchus in children. Stent migration with erosion into a bronchial artery leading to mycotic pseudoaneurysm formation and overwhelming pulmonary hemorrhage occurred in both patients. One patient died from uncontrollable hemoptysis. The second patient was salvaged by left pneumonectomy and patch repair at the site of mycotic aortic rupture. Stenting of a mainstem bronchus, particularly in cyanotic children must be approached with extreme caution.

Airway Obstruction↗
PubMed2004

Leiomyoma of an accessory tracheal bronchus.

We present a rare case of leiomyoma arising in an accessory right bronchus in a 55-year-old man who had been treated for bronchial asthma. Diagnosis was established on the results of bronchoscopic biopsy. An emergency operation was performed because the patient had begun to complain of severe dyspnea. The tumor was completely removed by electrocautery with a wire snare by rigid bronchoscopy. Postoperative bronchoscopic findings revealed a tracheal bronchus arising above the carina, and the root of the tumor existed in the orifice of the branch. Final histology revealed a leiomyoma.

Bronchi↗
PubMed1988

Traumatic rupture of ascending aorta and left main bronchus.

A 14-year-old male pedestrian was hit by a truck and admitted with respiratory distress and subcutaneous emphysema. Aortography revealed disruption of the ascending aorta. Bronchoscopy revealed rupture of the left main bronchus at the carina. Both lesions were repaired using a median sternotomy, cardiopulmonary bypass, and a transpericardial approach for the bronchial repair. To our knowledge, this is the first report of successful repair of a combined rupture of a major bronchus and the ascending aorta.

Adult↗
PubMed1998

Surgical resection of lung cancer originating in a tracheal bronchus.

We experienced a case of lung cancer that developed from a tracheal bronchus in an 80-year-old man. The tumor was completely resected by right upper lobectomy and resection of the tracheal bronchus as well as dissection of the mediastinal lymph nodes. Postsurgical pathologic staging was stage IB (T2 N0 M0) adenocarcinoma.

Adenocarcinoma↗
PubMed2000

Left upper lobe bronchus reimplantation for nonpenetrating thoracic trauma.

Trauma to the tracheobronchial tree has been diagnosed and treated with increasing frequency over the last several decades. However, most reports have dealt with management of injuries to the trachea and main stem bronchi, as approximately 80% of blunt tracheobronchial injuries occur within this area. With few exceptions, injury to the lobar bronchi has resulted in thoracotomy and lobectomy. We describe a patient with an injury to the left upper lobe bronchus who presented with delayed obstruction of the airway by fibrogranulation tissue. A successful segmental resection of the bronchial occlusion with reimplantation was performed, thereby preserving the patient's otherwise normal left upper lobe. This case demonstrates that resection and reimplantation of an injured lobar bronchus are feasible, even in a delayed setting.

Adolescent↗
PubMed1977

Studies on the pathogenesis of ischemic cell injury XV. Reversal of ischemic cell injury in hamster trachea and human bronchus by explant culture.

Hamster tracheal epithelium survived 3 hours of total ischemia at 37 degrees C as demonstrated by its ability to be maintained in organ culture for 7 days subsequent to the ischemic episode. Epithelium ischemic for longer periods did not survive in culture. Human bronchial epithelium obtained from surgically resected lungs showed the acute effects of ischemia, i.e., the cells had dilated endoplasmic reticulum and swollen mitochondria. These cellular effects of ischemia were, however, reversed by placing the bronchus in explant culture. Bronchus obtained at autopsy, 2 to 3 hours following death, showed epithelial cells suffering severe ischemic cell injury, most of which did not survive in culture, but in some cases, a few basal cells survived to form a non-keratinizing squamous epithelium.

Animals↗
PubMed1980

Benign tumors of the lung and bronchus.

Benign tumors of the lung and bronchus are a heterogeneous group of lesions that usually present as asymptomatic, solitary, peripheral lung nodules or, less commonly, as endobronchial lesions causing obstructive symptoms. All endobronchial lesions should be removed surgically to alleviate symptoms and to prevent destruction of distal lung tissue. Parenchymal lesions may present challenging problems in clinical diagnosis and management. Most patients will ultimately require thoracotomy for histologic confirmation of benignity. It is probable that newer diagnostic procedures will allow a more accurate nonoperative diagnosis in certain patients in the near future. At the present time, expeditious limited thoracotomy affords a safe, rapid, and effective treatment for patients with a benign tumor of the lung or bronchus.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1981

Malignant melanoma of the bronchus.

A case of malignant melanoma of the bronchus is presented. The tumor obstructed the left main stem bronchus. Secondary pneumonia was probably caused by Hemophilus influenzae.

Autopsy↗
PubMed1985

Characterization of pulmonary macrophages and bronchus-associated lymphoid tissue (BALT) macrophages in the rat. An enzyme-cytochemical and immunocytochemical study.

Three subpopulations of macrophages present in the lung, viz. pulmonary alveolar macrophages (PAM), pulmonary tissue macrophages (PTM), and macrophages in the bronchus-associated lymphoid tissue (BALT), were compared using enzyme-cytochemical and immunocytochemical methods. BALT macrophages can be distinguished from PAM and PTM on the basis of their enzyme reaction products. With three monoclonal antibodies, ED1, ED2, and ED3, that recognize different antigen determinants of rat macrophages, the three subpopulations could be clearly distinguished. PAM are ED1-positive and PTM are ED2-positive. The macrophage subpopulation scattered throughout BALT is ED1-positive; macrophages situated at the peripheral site of BALT, near artery and bronchus, are ED2-positive. No ED3-positive macrophages were observed either in the lung or in BALT. These results are discussed with respect to the possible relationship between the subpopulations of pulmonary macrophages.

5'-Nucleotidase↗
PubMed1994

[Rupture of the left bronchus during intubation by Carlens tube].

The authors report a case of left main bronchus rupture following endotracheal intubation with a Carlens double-lumen tube. The bronchus rupture occurred during a cure of gastro-oesophageal-reflux and resection of oesophageal diverticula through a left thoracotomy. The patient was a 65-year-old woman treated with corticosteroids for an Addison's disease. The weakness of the bronchial wall initiated by the steroid hormones was an important factor contributing to the perforation. There is also a higher risk of rupture during oesophageal surgery because of surgical dissection and stretch on the tracheobronchial airway. This case demonstrates that such a complication can occur without ventilatory failure. A rupture must be recognized and treated surgically very rapidly. Recommendations regarding the use of double-lumen endotracheal tubes are reviewed in order to decrease the occurrence of such a complication.

Addison Disease↗
PubMed1997

[A rare cause of accidental selective intubation: right upper lobar bronchus originating from the trachea].

A case of accidental selective intubation of a right upper lobar bronchus originating from the trachea, in a woman with a normal preoperative chest X-ray, is reported. The preoperative diagnosis of an asymptomatic tracheal bronchus is often difficult on a standard chest X-ray, especially since a chest X-ray is no longer systematically included in the preanaesthetic assessment. Therefore, the presence of a bronchial malformation should be considered as a cause of ventilatory problems, particularly those occurring after tracheal intubation.

Anesthesia, General↗
PubMed1998

Successful reoperation for severe left bronchus compression after repair of persistent truncus arteriosus with interrupted aortic arch.

Signs of the left bronchus compression, caused by aneurysmatic dilatation of the aortic root with severe aortic regurgitation, occurred 5 months after repair of the truncus arteriosus with interrupted aortic arch in an 85-day-old infant. At reoperation the dilated ascending aorta was replaced with a 14-mm Dacron tube. The aortic valve was replaced with an 18-mm Carbomedics valve. Compression of the left bronchus and the right pulmonary artery were released. The right pulmonary artery was enlarged with a pericardial patch and the original homograft was replaced with a new one. The patient remains in good clinical condition 2 years later.

Aorta, Thoracic↗
PubMed1999

Endothelin-1 potentiates cholinergic nerve-mediated contraction in human isolated bronchus.

That endothelin-1(ET-1) plays a mediator role in asthma is consistent with reports of ET-1-induced potentiation of cholinergic nerve-mediated contraction in airways from various animal species. This study examined the effect of ET-1 on cholinergic contractions in human isolated bronchus. Macroscopically nondiseased human bronchial tissue was obtained from 23 patients with respiratory tumours. An electrical field stimulation (EFS) frequency that produced one third of the contraction at 30 Hz (EFS30) was estimated. The effect of ET-1 on these EFS-evoked contractions was assessed. EFS-evoked contractions were frequency-dependent and abolished by either atropine or tetrodotoxin. Thus, EFS-induced contractions were mediated by acetylcholine from cholinergic nerves. ET-1 (3 nM) potentiated EFS-evoked contractions by 10+/-2% EFS30 (p<0.05) without any significant effect on contractions induced by exogenous acetylcholine. Neither the ET(A) receptor-selective antagonist BQ-123 (3 microM) nor the ET(B) receptor-selective antagonist BQ-788 (10 microM) alone significantly altered ET-1-induced potentiation of EFS-evoked contractions. However, in the combined presence of both BQ-123 and BQ-788, ET-1-induced potentiation of EFS-evoked contractions was abolished. Thus, prejunctional endothelinA and endothelinB receptors appear to mediate endothelin-1-induced potentiation of electrical field stimulation-evoked cholinergic contractions in human bronchus. This suggests another potentially important mechanism through which endothelin-1 could increase bronchial tone in asthma.

Adult↗
PubMed2001

A possible role of lipoxygenase in the activation of vanilloid receptors by anandamide in the guinea-pig bronchus.

1. In the absence of indomethacin, anandamide did not contract the guinea-pig bronchus at concentrations up to 100 microM. In the presence of indomethacin (10 microM), anandamide induced concentration-related contractions with a pEC(50) value of 5.18+/-0.11. It was significantly less potent than capsaicin (pEC(50) 7.01+/-0.1). The anandamide uptake inhibitor AM404, produced only a 14.1+/-3.22% contraction at 100 microM. All experiments were conducted in the presence of PMSF (20 microM). 2. The vanilloid receptor antagonist, capsazepine (10 microM), significantly attenuated the contractile effect of anandamide, the response to 100 microM anandamide being 40.53+/-7.04% in the presence of vehicle and 1.57+/-8.93% in the presence of 10 microM capsazepine. The contractile actions of anandamide and AM404 were markedly enhanced by the peptidase inhibitor thiorphan. 3. The log concentration-response curve of anandamide was unaltered by the CB1 receptor antagonist, SR141716A. The pEC(50) values for anandamide were 4.88+/-0.08 and 5.17+/-0.19 in the presence of vehicle and SR141716A (1 microM) respectively. 4. The lipoxygenase inhibitors 5,8,11,14-eicosatetraynoic acid (ETYA) and 5,8,11 eicosatriynoic acid (ETI) reduced the effect of 100 microM anandamide from 34.7+/-1.9% (vehicle) to 7.7+/-5% (ETYA, 10 microM) and from 41.85+/-4.25% (n=6) (vehicle) to 10.31+/-3.54 (n=6) (ETI, 20 microM). Neither inhibitor significantly affected contraction of the tissue by substance P. 5. This study provides evidence that anandamide acts on vanilloid receptors in the guinea-pig isolated bronchus. These data raise the possibility that the contractile action of anandamide may be due, at least in part, to lipoxygenase metabolites of this fatty acid amide that are vanilloid receptor agonists.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed2000

Immunohistochemical analysis of Bcl-2 protein in early squamous cell carcinoma of the bronchus treated with photodynamic therapy.

Photodynamic therapy (PDT) in early squamous cell carcinoma of the bronchus has been shown to result in complete response (CR) and cure. However, local recurrence after PDT develops frequently even after complete remission. Because the effect of PDT had been reported to depend on apoptosis, and apoptosis is inhibited by bcl-2 protein, the relationship between the expression of bcl-2 protein and local recurrence after PDT was examined immunohistochemically. From 1983 to 1997, 50 patients with 59 early squamous cell carcinoma of the bronchus received PDT, and a CR was obtained in 43 lesions (72.8%). As there was no recurrence among tumours that were disease-free for more than 2 years, in this study the tumours were defined as cured when recurrence did not occur 2 years subsequent to the receiving of PDT. Of these CR lesions, 31 carcinomas (53.4%) resulted in a cure. Bcl-2 immunoreactivity was detected in 23 tumours (46.9%) and p53 immunoreactivity was detected in 22 tumours (44.9%). When all tumours were divided into either a large tumour with a longitudinal tumour length of 10 mm or more, or a small tumour with a length of less than 10 mm, the large tumour expressed more bcl-2 protein than the small tumour (P = 0.0155). The degree of bcl-2 expression was significantly related with tumour size (P = 0.0155). The expression of bcl-2 and p53 protein was not associated with the cure rate due to PDT. Tumour length and T status in TNM staging were significantly related to the cure by univariate analysis. T status was the only predictor of the cure according to mutivariate analysis. Of 42 CR lesions, the expression of neither bcl-2 nor p53 protein was associated with local recurrence; only T status was significantly associated (P = 0.008). The relationship between the expression of oncoprotein and local recurrence after PDT was not documented in this study. The success of PDT may depend on the exact assessment of tumour size under optimized PDT illumination.

Aged↗
PubMed2000

The bronchoconstrictive action of evodiamine, an indoloquinazoline alkaloid isolated from the fruits of Evodia rutaecarpa, on guinea-pig isolated bronchus: possible involvement on vanilloid receptors.

Evodiamine, a constituent of Evodiae Fructus (Evodia rutaecarpa Benth., Rutaceae), produced a bronchial contraction that is resistant to atropine and abolished by pretreatment with a mixture of the NK1 and NK2 receptor antagonists. Contractile responses to evodiamine were examined in guinea-pig isolated bronchus and compared with those to capsaicin. Both compounds evoked bronchial contraction in a concentration-dependent manner. Maximal contractions for evodiamine and capsaicin were observed at concentrations of 3 microM and 1 microM, respectively. Capsazepine (10 microM), an established antagonist of vanilloid receptor (capsaicin receptor), competitively inhibited the bronchial contraction evoked by evodiamine, suggesting that evodiamine activated vanilloid receptors. Evodiamine (3 microM) and capsaicin (1 microM) produced complete crossed tachyphylaxis. Both compounds desensitized tissues to subsequent additions of either evodiamine or capsaicin. These results suggest that the evodiamine-induced contractile response of the bronchus could be attributed to the resultant tachykinin release from sensory neurons by binding of evodiamine to vanilloid receptors. Rutaecarpine, which belongs to the same indoloquinazoline-type alkaloid as evodiamine, showed neither bronchoconstrictive, desensitizing effects nor vanilloid antagonistic effects at all the concentrations examined (up to 200 microM).

Animals↗
PubMed2002

Esophageal necrosis and perforation of the left main bronchus following photodynamic therapy of esophageal carcinoma.

Photodynamic therapy is an effective palliative treatment of esophageal cancer. Minor complications associated with this therapy include pleural effusions, fever or esophageal strictures. In addition to this major complications such as respiratory-esophageal fistula and bronchus perforation have been described. We report here our experience with a patient who developed a complete esophageal necrosis and perforation of the left main bronchus following photodynamic therapy. The surgical and intensive care management of the patient is described and the literature discussed.

Bronchial Diseases↗
PubMedDate not supplied

[Clinical relevance of the tracheal bronchus].

We report about 6 infants with serious respiratory disease who revealed a tracheal bronchus on bronchoscopic or bronchographic examination. In two of these children this finding seemed to be the main problem; it could be cured by surgical or conservative therapy. The course of the further 4 children's disease was determined by additional serious malformations (Oesophageal atresia, congenital heart disease, anomalies of the pulmonary arteries). In these cases, the tracheal bronchus did not influence the clinical course significantly.

Abnormalities, Multiple↗