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At least 343 records · Page 19Linked to original sources
PubMed2000

Flexible bronchoscopic diagnosis of airway injuries after intubation in children.

BACKGROUND: Airway intubation injuries occur frequently but are often neglected because of spontaneous regression. Although most airway injuries that result from intubation resolve without sequelae, severe complications can develop even when initial symptoms of upper airway obstruction are absent. This retrospective study assessed the clinical features, flexible bronchoscopic findings, and clinical outcomes in children with airway intubation injuries. METHODS: From February 1998 to February 1999, 90 children underwent flexible bronchoscopic examination in our hospital. Fifteen of these patients (6 girls, 9 boys; age range, 1 mo to 5 yr; mean, 21.1 +/- 24.4 mo) were noted to have intubation injuries. RESULTS: The average time for symptoms to emerge after extubation was 1.8 days (range, 0-14 days). The airway intubation injuries diagnosed by flexible bronchoscopy were subglottic stenosis in seven patients, vocal cord granulation in four, supraglottic granulation in two, subglottic web in two, bronchial granulation in two, glottic stenosis in one, and tracheal stenosis in one; two cases were discovered incidentally during postoperative follow-up. Four patients had undergone repeated intubation and eventually required tracheostomy. CONCLUSIONS: The results of this study indicate that flexible bronchoscopy is a simple, safe, and useful technique for the diagnosis and follow-up of airway intubation injury. It should be performed on all patients who have symptoms of upper airway obstruction after extubation as well as those who have undergone long-term or emergency intubation.

Bronchoscopy↗
PubMed2001

[Comparison of types and drug sensitivity of bacteria isolated from sputum and bronchoscopic material. Analysis of results from routine diagnostic tests from 1995-1997].

Proper identification of the organism and determination of their sensitivity to antimicrobial agents, is the most important part of the management of patients with symptoms of respiratory system infections. In the case of pulmonary infections, the utility of sputum for diagnosing the cause of lower respiratory tract infections seems to be limited. In the patients receiving antibiotics, there is a high rate of colonization of the upper respiratory tract that may lead to the overgrowth of one or an other pathogen, making it more abundant in the upper than an lower respiratory tract. Also, the patients may be unable to provide adequate lower-respiratory-tract samples. For these reason, more invasive procedures have been recommended. These include bronchoscopy with bronchoalveolar lavage (BAL) sampling. The purpose of our study was to determine the value of sputum and BAL fluid on the basis of profile bacteria and their drug sensitivity isolated from the patients treated in Nat. Res. Inst. Tuber. and Lung Diseases in Warsaw during period of 3 years (1995-1997). On the basis of analysis of 5926 sputum samples and 3534 bronchoscopic materials we have found that the bacterial pathogens species and drug resistant pattern were similar in sputum samples as in materials of bronchoscopic procedures. The same bacterial species and numbers Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus were predominant in both type of clinical materials with near the same frequency.

Bronchoalveolar Lavage Fluid↗
PubMed2002

[Analysis of chromosomal aneuploidy in bronchoscopically gained cells].

OBJECTIVE: To study the feasibility of interphase fluorescence in situ hybridization (FISH) in detection of chromosomal aneuploidy in bronchoscopically gained cells from lung cancer patients and early diagnosis of lung cancer. METHOD: Cells gained from endobronchial brushings of 14 patients with lung cancer were examined by FISH with chromosomes 7, 8, 9 and 12 specific centromere probes. RESULT: Aneuploidy, mainly featured in gains of chromosomes 7, 8 and 12 and loss of chromosome 9 were observed in all of the 7 cases with cells from endobronchial brushings diagnosed as or suspicious of cancer cells by cytology. Aneuploidies of chromosomes 7, 8, and 9 were found in 3 of other 7 cases that appeared to be normal by cytologic criteria. CONCLUSION: Interphase FISH is feasible in detecting aneuploidy associated with malignancy in bronchoscopically gained cells that do not meet the criteria of malignancy by conventional cytologic study. This method may be applied to early diagnosis of lung cancer.

Aneuploidy↗
PubMed2002

[Detection of telomerase activity in bronchoscopic brush-off samples in patients with lung cancer].

BACKGROUND AND OBJECTIVE: Recent studies have shown that activation of telomerase plays an important role in carcinogenesis. However, there was few report on the level of telomerase activity in small samples from the patients with lung cancer. This study was designed to investigate the diagnostic significance of the detection of telomerase activity in bronchoscopic brush-off cells from the patients with lung cancer. METHODS: Telomeric repeat amplification protocol(TRAP)-based telomerase polymerase chain reaction(PCR)-enzyme-linked immunosorbent assay (ELISA) TRAP-PCR-silver staining were employed to detect telomerase activity in 56 samples of brushing cells from the patients with lung cancer and 10 samples with inflammation. RESULTS: The positive rate of telomerase activity in 56 biopsy samples of lung cancer group was significantly higher than that in inflammation group (P < 0.001). The sensitivity, specificity, and accuracy of detection of telomerase activity was 87.5%, 83.3%, and 86.3%, respectively. There was no significant difference in the positive rate of telomerase activity between central lung cancer and peripheral lung cancer. Positive rate of detection of telomerase activity in bronchoscopic brush-off cells was 46.4%. The positive rate of telomerase activity detected in TRAP-PCR-ELISA was higher than that detected in TRAP-silver staining, but the significant difference was not found. It was found that samples with low absorbing value detected in the quantified way would show weak positive with less ladder bands or vague ladder bands if detected in the latter way. CONCLUSION: The telomerase activity may be a good marker for diagnosis of lung cancer. Combined with cytologic measure, it is possible to raise the early diagnostic rate of lung cancer.

Adult↗
PubMed2003

Bronchoscopic lung volume reduction.

AIM: Because traditional lung volume reduction involves major surgery in unfit patients, resource implications are formidable. Many patients are too ill for consideration and overall survival rates have lead to questions about its continuation. We report on a new method of lung volume reduction, through a bronchoscopic approach. Patients with severe dyspnoea with end stage emphysema were recruited. Target areas for collapse therapy were upper lobes or segments with severe destruction, occupying a large volume, with surrounding lung compression and little perfusion. These were delineated radiologically and with ventilation-perfusion scanning. Endobronchial bloc-kade was initially with detachable, silicone balloons and later with especially designed and hospital manufactured stainless steel wire stents containing bio-compatible sponge. METHODS: Five males and 3 females with preoperative breathlessness at rest and muscle wasting were treated. Operative time was a mean of 67.5 min. Rehabilitation began immediately and 7 patients left hospital the following day. RESULTS: Five patients had improvements in well-being, dyspnoea, exercise tolerance, lifestyles and medication requirements. One patient survived at least 2 years and 2 are still alive 4(1/2) years later. Endoscopic balloon replacement with wire and sponge devices was required in 5 patients. Complications were related to intraoperative oxygenation problems in 2 patients and late infections in 4. CONCLUSIONS: Bronchoscopic lung volume reduction for the treatment of end-stage emphysema subjectively improved the majority of patients. The use of stents was promising: balloons were disappointing.

Aged↗
PubMed2002

[Correlation between bronchoscopically visible aspects and histopathologic results in patients with suspected lung cancer].

The aim of our study was to determine correlation between bronchoscopically visible lesions and histopathologic classification and whether cytology and histopathology can complement each other in diagnosis of pulmonary neoplasm. Fibroptic flexible bronchoscopy was performed in 208 patients who where suspected of having lung cancer--abnormal chest x-ray or hemoptysis. Material for histopathologic examination was obtained from bronchial brushings, bronchial forceps biopsy and bronchial washings. Positive results were classified as non--small cell or small cell carcinomas. All patients were questioned about smoking history. In 165 patients there were visible signs of neoplasm in bronchoscopic examination: tumor, necrosis, infiltration, compression. Histopathology was positive in 90 cases:small cell carcinoma 32%, non-small cell carcinoma 68%. In 23 cases material for histopathologic examination was obtained from both bronchial brushings and foceps biopsies: results were compatible in 78%. Bronchial brushings identified neoplasm in three additional cases. In analysed group of 208 patients cancer cells were found in 43%. Examination of bronchial brushings coplements forceps biopsy in diagnosing and typing lung neoplasms and could be performed more frequently in patients undergoing fiberoptic bronchoscopy.

Biopsy↗
PubMed2003

Bronchoscopic transillumination guidance for open standard surgical tracheostomy.

The standard tracheostomy technique, described in 1909 by Jackson, has been increasingly used in intensive care units. Since 1957, several different types of percutaneous tracheostomy techniques have been described and performed with the support of bronchoscopic transillumination. The authors present the case of a respiratory failure due to obstruction of the upper airway by an exceptionally large goiter, which was successfully resolved by a standard open surgical tracheostomy. In this case, surgical tracheostomy was preceded by bronchoscopic transillumination, which facilitated identification of the appropriate tracheostomy site.

Aged↗
PubMed1992

[A complication of bronchoscopical brushing cytology and biopsy for pulmonary tuberculoma].

Although bronchoscopical brushing cytology and biopsy are useful tools for differential diagnosis of localized abnormal lung shadows, they have some complications, one of which is bacterial infection. The patient was a 42-year-old female with a RUL coin lesion on chest roentgenogram, which was diagnosed as pulmonary tuberculoma through the bronchoscopical examination. The exam. was followed, however, by perifocal lung abscess with a cavity, which was believed to be anaerobic infection, and cured rapidly with initial intensive chemotherapy including RFP. Prophylactic use of antimicrobial drugs, which are also sensitive to anaerobic flora, would be necessary for preventing or minimizing such complication after bronchoscopy.

Adult↗
PubMed2003

[Heart arrest during fibro-bronchoscopic intubation in a patient with parapharyngeal space neoplasia].

A 37-year-old woman a diagnosis of squamous carcinoma of the tongue and a history of partial/hemiglossectomy with cervical lymphadenectomy and postoperative radiotherapy was scheduled for biopsy under general anesthesia given the suspicion of local recurrence. She underwent routine preparation for intubation with a fiberoptic bronchoscope with topical anesthesia of mucosal tissue without sedation. Syncope and asystole presented suddenly during intubation and external cardiopulmonary resuscitation and difficult ventilation through a face mask were necessary. She was finally intubated using a retrograde technique and recovered heartbeat after 20 minutes. No neurological sequelae were observed over the next few days. The etiologic diagnosis of this rare complication was later based on the appearance of the characteristic clinical profile of glossopharyngeal neuralgia-asystole syndrome in combination with parapharyngeal space lesion syncope syndrome; magnetic resonance findings of extensive neoplastic invasion of the space confirmed the diagnosis. Endotracheal intubation with a fiberoptic bronchoscope plays an important role in the management of the anticipated difficult airway. It is safe in the awake patient and facilitates the identification of structures, particularly when there are anatomical alterations due to neoplastic invasion, surgery, or radiotherapy. In the patient we describe, however, stimulation caused asystole.

Adult↗
PubMed2004

[A case of endobronchial mucormycosis with peculiar bronchoscopic findings].

Small cell lung cancer was diagnosed in a 54-year-old man in 1997. He had received 5 cycles of systemic chemotherapy and thoracic irradiation since 1997, and a favorable response had been achieved. In August 2001, pro-GRP was again elevated, and he was readmitted. Bronchoscopic findings revealed a white dendritic endobronchial mass on a cheese-like plug obstructing the left upper bronchus division. Numerous mucor hyphe and cancer cells were detected by transbronchial biopsy, and a fungal culture disclosed mucor. Although no antifungal drug was administered, the bronchial lesion disappeared after removal with biopsy forceps and 2 cycles of systemic anticancer chemotherapy. Endobronchial involvement of mucormycosis is rare and this case is unique because of the peculiar bronchoscopic finding with the endobronchial lesion.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

[Bronchoscopic lung biopsy with fluoroscopy to study 164 localized pulmonary lesions].

OBJECTIVE: To assess the usefulness of bronchoscopic lung biopsy (BLB) in the diagnosis of localized pulmonary lesions. METHODS: A prospective, descriptive study of consecutive patients with a suspected neoplastic nodule, mass, or infiltrate with nonspecific bronchoscopic findings after performing BLB with fluoroscopy. The lesions, clinical and patient characteristics, and outcomes were evaluated. RESULTS: One hundred sixty-four patients with a mean (SD) age of 65 +/- 12 years and a total of 156 masses or nodules and 8 infiltrates (144 neoplasms and 20 nonneoplastic lesions) participated in the study. On average, the lesion was 4.3 +/- 2 cm in diameter and 6 +/- 2 BLBs were performed on each patient, with a rate of serious complications of less than 1%. BLB was diagnostic in 113 cases (69% of the neoplasms and 70% of the nonneoplastic). In cases diagnosed by BLB, the lesions were larger (4.6 +/- 2 cm), more samples were obtained (6 +/- 2 biopsies), nondiagnostic endoscopic alterations were found (30%), and the bronchus sign was present (22%). Moreover, bronchoscopy was better tolerated by those patients. CONCLUSIONS: BLB with fluoroscopy increased the diagnostic yield of bronchoscopy for localized lesions with nonspecific findings, regardless of etiology. Larger neoplasms, the bronchus sign, good tolerance, and more tissue samples increased the number of diagnoses, with few complications.

Aged↗
PubMed2004

[Bronchoscopic treatment for malignant tracheobronchial stenose].

We evaluated a bronchoscopic treatment for malignant tracheobronchial stenose in 28 patients. We performed an ethanol injection treatment in 12 patients, bronchoscopic diode laser treatment in 16 patients and airway stent implantation in 6 patients by flexible bronchofiberscopy. Each of these treatments is comparatively an easy method with no serious adverse reaction. It is suggested that these treatments may be effective for tracheobronchial stenose if we select patients carefully and combine the methods listed here.

Aged↗
PubMed2004

[Therapeutic bronchoscopic treatment of postintubation tracheal stenosis: 5 cases].

Benign airway obstruction is known as curable by therapeutic bronchoscopic methods. Compared by surgical therapies it is comfortable and has no risks for the patients. For five patients who applied our clinic after tracheostomy and endotracheal intubation stenosis we used therapeutic bronchoscopic methods; "laser-stenotic silicon stent". In two patients after vaporization of membranous stricture by Neodimum Yttrium Aliminum Pevroskite Laser (Nd-YAP laser) who were seen posttracheostomy and postentubation; stenotic stent was implanted mechanically and/or by means of baloon dilatation. Membranous stricture area was coagulated by Nd-YAP-laser in other three cases and anatomic airway diameter was achieved mechanically and by baloon dilatation. In the follow up period we applied stenotic silicon stent implantation after second laser resection in whom restenosis observed. In conclusion; patients who had stenotic silicon stent implantation and having no problems in the follow up this therapeutic method is found to be curative.

Adult↗
PubMed2001

[Bronchoscopic diagnosis of lung tumours].

The role of diagnostic bronchoscopy in patients with lung tumours is to evaluate the presence, extent and character of endobronchial tumourous changes. Videobronchoscopes and ultrathin bronchoscopes introduced recently into clinical practice make more accurate evaluation of larger areas of the bronchial tree possible. The clinical impact of methods based on the principle of (auto)fluorescence is searched for. From sites affected with the tumour samples are taken for histological or cytological examination which in addition to evidence of a tumourous etiology specify the type of tumour. An integral part of the examination is staging when the extent of the tumour proper and the regional lymph nodes within the framework of the TNM classification is evaluated optically and by aimed sampling. Examination by endobronchial ultrasound makes it possible to assess more accurately the extent of tumourous affection in the bronchial wall or extrabronchially. The task of the brochologist is also to evaluate the possbility of bronchological intervention (laser, brachytherapy, stent etc.) for palliation of symptoms. Virtual bronchoscopy is the arteficial construction of the image of central airways created from CT scans which makes it possible to visualize sections of the central airways which are not accessible by bronchoscopy. Bronchoscopy is a method of fundamental importance for the diagnosis, therapy and control of complications and palliation of symptoms of lung tumours. This method cannot be replaced at the moment by any other method and its importance is apparent from the fact that the spectrum of bronchoscopic examinations in patients with lung tumours is steadily increasing.

Bronchoscopy↗
PubMed1992

[A case of bronchial actinomycosis associated with bronchoscopically removed broncholith].

A 57-year-old woman with bronchial actinomycosis associated with broncholith is presented. She had suffered from fever and productive cough for 7 years. Her chest roentgenograms showed atelectasis of the middle lobe and calcification in the middle lobe bronchus. Bronchoscopic examination revealed a broncholith covered with pus and granulomatous tissue. The biopsy specimen revealed sulfur granules containing a partially calcified lesion, and it was diagnosed as actinomycosis. After treatment with antibiotics, the broncholith became movable, and it was removed bronchoscopically. Its shape was like a molding of the right middle lobe bronchus. We speculate that the growth of this broncholith partially resulted from chronic inflammation associated with actinomycelial infection.

Actinomycosis↗
PubMed2005

Bronchoscopic electrocautery for palliation of post-anastomotic tracheal stricture in a patient with complete tracheal transection following blunt chest trauma.

There are many strategies available to treat palliation of airway obstruction due to benign or malignant conditions. The initial choice depends on the urgency of the situation, the extent of the disease process as assessed bronchoscopically, as well as the individual experience and preference of the physician. We present a rare case of complete tracheal transection following a traffic accident. Respiratory distress, which resulted from post-anastomotic tracheal stricture, developed progressively about 2 months after surgical repair. Symptomatic relief and improved ventilatory function were achieved in this patient once patency of the trachea was restored successfully using bronchoscopic electrocautery. The technique is a straightforward, safe, and quick method to palliate airway obstruction.

Adult↗
PubMed1991

Bronchoscopic protected specimen brush and bronchoalveolar lavage in the diagnosis of bacterial pneumonia.

Despite marked improvements in antibiotic therapy, the accurate diagnosis and treatment of bacterial lower respiratory tract infection remain a challenge. The bronchoscopic protected specimen brush and bronchoscopic bronchoalveolar lavage combined with quantitative bacterial cultures can provide sensitive and relatively specific information about lower airway flora. Both of these methods require strict observance of the required protocol, careful processing of the obtained specimens, and the absence of prior antibiotic therapy to obtain best results. These procedures are also of some utility in sickle cell acute chest syndrome, bronchiectasis, and in the immunocompromised host.

Bacteria↗
PubMed1990

Leiomyoma of the bronchus: report of a case successfully treated by Nd-YAG laser via fiberoptic bronchoscope.

A 42-year-old woman presented with chronic cough and dyspnea. A leiomyoma of the right middle lobe of the bronchus was diagnosed by bronchoscopic biopsy and treated successfully by neodymium-yttrium aluminum garnet laser, via fiberoptic bronchoscope. The presentations of bronchial leiomyoma are mainly due to partial or complete occlusion of the involved bronchus. Symptoms are mainly cough, wheeze, chest pain and fever, as a result of atelectasis, consolidation, collapse or bronchiectasis. The management of this benign tumor of the lung is discussed, and the importance of early diagnosis and conservative therapy are emphasized.

Adult↗