SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We describe the successful use of a portable extracorporeal membrane oxygenation machine for a patient with complete rupture of the left main bronchus after a road crash. The machine was used before and during left main bronchus reanastomosis at a community hospital 30 km from Melbourne, and then during acute interhospital transfer.
A 77-year-old male with lung cancer underwent a total left lung resection. During surgery, there was no ventilatory trouble such as hypoventilation or hypoxia. However, a mass was found in the right main bronchus by endobronchial fiberscopy before extubation. Because the mass could not be aspirated through the endobronchial fiberscope, we extracted it using basket-foreceps. We speculated that surgical procedures may have caused the tumor mass to move to the bronchus of the contralateral intact lung. Accordingly, fiberscopic examination of the airway before extubation should be mandatory, even if there is no ventilatory trouble during lung resection.
A 63-year-old male with an esophageal cancer invading the bronchus was treated with radiation therapy (70 Gy) from November 1995, resulting in the disappearance of the lesion. He was later readmitted due to dysphagia from the recurrence of the esophageal cancer. We diagnosed, by endoscopic and chest CT scan findings, that the esophageal cancer was invading the right bronchus. We inserted an expandable metallic stent endoscopically, and the patient could eat well. We performed two courses of FLEP chemotherapy (consisting of 5-FU, leucovorin, etoposide and cisplatin) from November 12, 1997. He then suffered from an esophagobronchial fistula, but was cured by a covered expandable metallic stent replacement. No esophageal stenoses or recurrences were seen endoscopically and he could eat well on December 7, 1998. The standard modality of treatment for patients with advanced esophageal cancer invading adjacent structures is not yet established, and the prognosis for such patients remains quite poor. We performed combination therapy with an expandable metallic stent replacement and FLEP chemotherapy, and improved the patient's quality of life. This form of therapy was thus proved useful for patients with esophageal cancer invading adjacent structures.
A 56-year-old-male with malignant pleural mesothelioma of the left lung underwent pneumonectomy and pleurectomy. Fiberoptic bronchoscopy was not done preoperatively. Anesthesia was induced rapidly and a double-lumen endobronchial tube was inserted. When we checked the position of the tube with a fiberoptic bronchoscope, we found that the normal right upper lobe bronchus was absent and that the inflated tracheal cuff had obstructed the right upper lobe bronchus originating above the carina. Then we changed the double-lumen endobronchial tube to a endotracheal tube with the blocker. Thereafter, the surgery was completed safely and his postoperative course was uneventful. Routine bronchoscopy is essential just after intubation and before extubation of the endobronchial tube in safe airway management. How to use a fiberoptic bronchoscope to check the position of a double-lumen endobronchial tube is also discussed.
We experienced a case of incomplete traumatic rupture of the bronchus which was operated on two months after a traffic accident. Traumatic rupture of the bronchus is rare after blunt chest injury but it can have serious consequences. Early surgical repair is recommended without repeated attempts to remove granulation tissue if the initial attempt at non-surgical repair results in failure, even in the case of incomplete rupture.
A 64-year old woman presented with an asymptomatic occlusion of the intermediate bronchus associated with a peripheral mass occupying the entire middle and lower lobes. As malignancy was suspected, inferior bilobectomy was done. There was a complete atelectasis of both lobes, with massive parenchymal necrosis. Pathological examinations suggested a tuberculous granuloma in the bronchus and parenchyma although tuberculous bacilli were not found. This case was unusual as congenital anomaly, and was suspected as bronchial tuberculosis.
OBJECTIVE: To understand the biologic and clinical characteristics of carcinoid tumor of trachea and bronchus and to find out rational surgical indications and approaches. METHODS: The clinical materials of 20 surgically treated patients with carcinoid of trachea and bronchus were retrospectively analyzed. RESULTS: All but one patient received radical tumor resection. Operative complication occurred in 2 patients. Of the 20 patients, 13 suffered from typical carcinoids (TC) and 7 from atypical carcinoids (AC). Immunochemical staining revealed that both the typical and atypical carcinoids were of neuroendocrine origin. The 5-, 10- and 15-year survival rate of TC patients was 100.0%, 7/8 and 3/4 respectively. Of the 7 patients with AC, 6 had not yet been 5 years after operation but were still alive, and one patient died of remote metastasis 2 years after operation. CONCLUSION: Surgical resection of carcinoid is indicated not only for early cases, but also for patients in stage III a and III b. The age and pulmonary function of the patients are the chief factors determining the surgical approach.
A 73-year-old woman was scheduled for right lower lobectomy. Her trachea was intubated with a left double-lumen endobronchial tube (Sheribronch, 35 Fr). There was no bleeding at the trachea or the bronchus during the operation. She received intravenous heparin (4000 IU.day-1) for anticoagulant therapy one hour after operation. On the first post-operative day, the mucosal bleeding in the left main bronchus was confirmed, which developed a granulomatous polyp on the 17th post-operative day. The anticoagulant therapy may have worsened slight mucosal damage caused by double lumen tube. It is important to select suitable tube size especially in patients who will receive anticoagulant therapy.
OBJECTIVE: To study the value of computed tomography (CT) in the diagnosis of traumatic injuries in the bronchus and lung. METHOD: A retrospective analysis was conducted of the CT and X-ray radiographic images of the bronchus and lung in 36 cases of traumatic injuries in the chest. RESULTS: Based on CT manifestations, the lung injuries of the 37 cases fell into 3 categories, namely mild, moderate and severe injuries. Of the 9 cases of mild lung injuries identified by CT, 5 failed to be detected by X-ray examination; in the 15 cases of moderate injuries, X-ray examination showed more confined areas of the injuries with lesser severity than CT did. In the rest 13 cases of severe injuries, only 9 were identified by X-ray. Bronchial injuries occurred in 3 case that were totally unidentifiable by X-ray and even routine CT scanning did not result in exact diagnoses. The injuries, however, were clearly demonstrated by thin-slice CT scan of the hila area after reconstruction of the images. CONCLUSION: Chest X-ray is not sufficient for traumatic chest injury examination in the emergency room that necessitates CT scanning of the chest.
OBJECTIVE: To evaluate the clinical application of CT virtual bronchoscope in foreign-body in bonchus. METHOD: The CT virtual bronchoscope were used in 21 cases with foreign-body in bronchus, all the images and reports were compared with the actual bronchoscopy. RESULT: The reports and images of CT virtual bronchoscope are very agreed with that of actual bronchoscopy. CONCLUSION: CT virtual bronchoscope is a very good complemental method in preoperative diagnosis of foreign-body in bronchus.
Right tracheal bronchus is a rare almost always asymptotic congenital malformation. We report a case of right tracheal bronchus associated with pneumonia tuberculosis of the apical segment of the upper right lobe. We describe the characteristic of this malformation and stress the role of computed tomography scan to detect these anomalies.
Intestinal, respiratory and genitourinary mucosal surfaces are the most important routes of entry for microbial pathogens. The stimulus of the mucosal immunity is not easy because the trigger keys for the activation do not follow the ones of the systemic immune response. In previous works we have demonstrated that some Lactic Acid Bacteria (LAB), when orally administered, can induce an enhance of the gut immune response. Taking into account the concept of a common mucosal response, we studied the effect of orally administered mice with Lactobacillus casei, L. acidophilus, L. rhamnosus, L. delbrueckii subsp. bulgaricus, Streptococcus salivarius subsp. thermophilus and Lactococcus lactis on the IgA secreting cells associated to bronchus. As shown before, oral immunostimulation with LAB induced an increase of the IgA* cells at intestinal level by a dose depending effect. In this study it is also showed that the LAB assayed, with exception of L. acidophilus, were able to enhance IgA+ cells at bronchial level, being also this effect dose dependent. The increment induced by some LAB in the number of IgA+ cells on the mucosa surface of the lower respiratory tract may be very important to prevent bronchus diseases.
We described the rare case of 26-year-old woman with a traumatic laceration of the right middle lobar bronchus. The patient suffered blunt chest trauma in a traffic accident. Chest roentgenography showed bilateral pneumothorax, right multiple rib and clavicle fractures and emphysema in the subcutaneous and mediastinal lesions. Bilateral thoracic drainages were performed under controlled mechanical ventilation. Massive air leakage from the right chest tube was observed. Bronchofiberscopy 2 days after the accident revealed laceration of the right middle lobar bronchus. A right middle lobectomy was performed via thoracotomy. The patient was discharged on hospital day 51. In terms of the rare bronchial laceration is discussed.
Experiments were designed to characterize receptor(s) that mediate nonadrenergic, noncholinergic contractions of the guinea pig hilar bronchus using selective neurokinin (NK)1 (CP 96,345) and NK2 (R396 and MEN 10,376) tachykinin receptor antagonists. Left and right hilar bronchi were studied as pairs in the presence of atropine, propranolol, phentolamine; indomethacin and thiorphan. (2S, 3S)-cis-2-(diphenylmethyl)-N-(2-methoxyphe nyl)-1-azabicyclo[2,2,2]octan-3-amine (CP 96,345) selectively antagonized contractions of the bronchus to the NK1 agonist Ac-[Arg6,Sar9,Met(O2)11]-SP(6-11) with a -log molar KB value of about 8.0. Similarly, Ac-Leu-Asp-Gln-Trp-Phe-Gly-NH2 (R396) and [Tyr5, D-Trp6,8,9, Lys10]-NKA(4-10) (MEN 10,376) selectively antagonized contractions to the NK2 agonist [beta Ala8]-NKA(4-10) with -log molar KB values of about 5.5 and 6.7, respectively. CP 96,345 (3 x 10(-7) M) had no effect on contractions evoked by transmural electrical stimulation (TES). However, both R396 (1 x 10(-5) to 1 x 10(-4) M) and MEN 10,376 (1 x 10(-6) to 1 x 10(-5) M) caused blockade of responses to TES. CP 96,345 (3 x 10(-7) M) antagonized TES-induced contractions only when studied after substantial blockade by R396 or MEN 10,376. Contractions to TES were not abolished by R396, MEN 10,376 or a combination of these antagonists with CP 96,345. R396 (1 x 10(-6) M) increased the maximum contraction to TES and potentiated the frequency-response curve in bronchi treated with MEN 10,376 (1 x 10(-6) M).(ABSTRACT TRUNCATED AT 250 WORDS)
The authors report on the extraction of a piece of peanut impacted into the antero-internal bronchus of the right middle lobe, inaccesible to rigid bronchoscopy. After 4 months, this foreign body was visualised by flexible endoscope and removed by this technique under general anesthesia. We initially used a brush to pull the foreign body out of the distal bronchus and then used a biopsy forceps to remove it. Three months later, the chest-X-ray is normal and the child is asymptomatic.
A 23-year-old female was admitted with dyspnea, dry cough, and rhonchi. No abnormalities were detected on chest roentgenogram. Fiber-bronchoscopy revealed a polypoid lesion with necrotic material occluding the left main bronchus. The pathological diagnosis of the biopsied material was low grade mucoepidermoid carcinoma. Following tumor reduction by Nd-YAG laser, it was clear that the primary lesion originated from the left upper bronchus. Sleeve lobectomy was performed, and the tumor was proved to be early lung cancer of hilar type with extension limited to the bronchial wall.
We report a case of esophageal cancer infiltrating the left main bronchus in which radical esophagectomy with clear surgical margins could be performed after preoperative radiochemotherapy. The patient was a 57-year-old man, who was found to have esophageal squamous cell carcinoma of the middle thoracic esophagus during a work-up of dysphagia. Bronchoscopy revealed an elevated region protruding into the lumen of the left main bronchus. After radiochemotherapy (liniac irradiation + low-dose FP therapy), the esophageal and bronchial lesion became smaller. The case was evaluated as a clinically complete response. Bronchoscopic ultrasonography showed a clear boundary between the membranous portion of the trachea and the esophageal wall. Based on these findings, the lesion was considered resectable and radical surgery, including 3-field lymph node dissection, was performed. The resected esophageal specimen had residual cancer cells in the muscularis propria covered with normal mucosa. However, the patient is currently healthy with no evidence of disease. The indication for surgical resection in cases of esophageal cancer with contiguous spread, and a good response to preoperative radiochemotherapy, is controversial. It is necessary to verify the effectiveness of surgical resection, as a secondary treatment, by accumulating data on cases such as the present one.
A case of mucoepidermoid carcinoma of the bronchus in a 7-year-old boy is reported. The patient underwent right pneumonectomy. Histologically, the tumor was a low-grade muco-epidermoid carcinoma arising from the bronchus with lymph node metastasis in the drainage area. Presence of lymph node metastasis in this low-grade tumor suggests the possibility of early progression of disease in what has until now been considered a very slow growing tumor. Aggressive surgery may be necessary in these situations.