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At least 361 records · Page 20Linked to original sources
PubMed1990

[Diagnosis of pleural metastatic carcinoma with fibrous bronchoscope in thoracoscopy].

45 cases suspected pleural tumors were performed thoracoscopy with fibrous bronchoscope. The diagnoses were as follows: metastatic carcinoma 23 cases, pleural mesothelioma 3 cases, pleural tuberculosis 10 cases, non-specific inflammation 4 cases, lymphoma 1 case, Hamman-Rich syndrome 1 case, and unknown cause 3 cases. 93.3 percent of the patients (42/45) were diagnosed clearly. Hence it gives the feasibility of reasonable treatment in the patients. The method of examination and the sight in fibrous bronchoscope have been described in detail.

Adenocarcinoma↗
PubMed1990

[Treatment of spontaneous pneumothorax by electrocoagulation via a fiberoptic bronchoscope with a hysteroscope irrigation outer sheath as a thoracoscope].

Since 1981 in Yamagata Prefectural Central Hospital, the authors performed electro-coagulation therapy for air leakage from bullae (blebs) via a rigid thoracoscope in 31 patients with spontaneous pneumothorax. Among these patients, this treatment was unsuccessful in 14 patients (45.2%) because of 5 multiple or giant bullae and 9 cases in which it was impossible to visualize the bullae in the mediastinum or because of pleural adhesion. In order to widen the visual field and increase the mobility of the thoracoscope, we employed a fiberoptic bronchoscope with a hysteroscope outer sheath used for irrigation as a flexible thoracoscope. This method makes it possible to examine both mediastinal pleura and adhesive pleural space, and to electrocoagulate bullae which cannot be visualized by a rigid thoracoscope. It was possible to visualize the blebs in all 13 cases with spontaneous pneumothorax in which this examination was attempted. This therapeutic procedure causes the patients less pain and the hospitals more economical because no new thoracoscope is necessary. This method of thoracoscopic therapy of spontaneous pneumothorax using a fiberoptic bronchoscope is more successful, effective, economical and painless than by rigid thoracoscope and should be attempted before thoracotomy.

Adolescent↗
PubMed1990

[Bronchoscopic evaluation of 390 cases of hemoptysis without definite abnormality on the chest roentgenogram].

From Jan 1981 through Oct. 1988, fiberoptic bronchoscopic examination was undertaken in 390 patients with hemoptysis and basically normal chest roentgenogram or prominent pulmonary markings. A diagnosis of malignancy was made in sixteen cases (4.1 percent). The positive rates in was higher in those were heavy smokers or in patients of age greater than 40 years, whose bloody sputum rate were significantly higher than non-smoking patients whose age were less than 40 years, and patients coughed up cupfull of blood intermittently, (P less than 0.005). The absolute indication of bronchoscopic examination in patients with hemopstysis and a basically normal chest X-ray film are those who are greater than 40 years old, heavy smokers, coughing up bloody sputum and no improvement by active treatment for two weeks.

Adenocarcinoma↗
PubMed1989

[Anesthesia procedures for bronchoscopic intubation in a comparative study].

In 94 patients intubation by means of the fibre-optic bronchoscope was effected in various indication. Three different methods of anaesthesia were used: local anaesthesia + mild sedation; general anaesthesia + relaxation; sedation + analgesia. The experiences made with these methods--based on clinical observation and interrogation of the patients--reveal the special usefulness of local anesthesia for bronchoscopic intubation; this is probably the method of choice in practice.

Alfentanil↗
PubMed1989

[Introduction of tracheal intubation with the aid of an fiberoptic bronchoscope in inhalation injury].

This paper reported the clinical use of endotracheal intubation with the aid of fiberoptic bronchoscope in 17 patients with major burns (TBSA 91.38 +/- 6.41%) and inhalation injury during the early postinjury period, pre-operation and acute respiratory failure. The observations revealed that the use of transnasal endotracheal with the aid of fiberoptic bronchoscope significantly improved pulmonary ventilation and respiratory functions when the patients suffered from acute upper airway obstruction during the early postinjury period and acute respiratory failure caused by airway obstruction and atelectasis during the late postinjury period. The above results showed that this method is safe, simple and can significantly improve respiratory function and avoid tracheostomy. It is a valuable method for improving the treatment of patients with inhalation injury.

Adult↗
PubMed1989

[Bronchoscopic diagnosis of pulmonary tuberculosis in miners].

Two hundred and thirty nine records of bronchoscopic examination of miners from iron ore mines, including 114 patients with active pulmonary tuberculosis were studied and the frequency of specific and nonspecific endobronchitis and functional, anatomical and hemocirculatory disorders was determined. Qualitative estimation of the endoscopic symptoms and computer-assisted analysis enabled one to validate the direct and probabilistic bronchoscopically evident signs of active tuberculosis. The data on the mature, frequency and diagnostic value of some endoscopic signs should be considered in differentiation of tuberculosis in miners (without pneumoconiosis).

Adult↗
PubMed1986

Bronchial secretions and bronchial mucosa in children with cystic fibrosis: comparison of bronchoscopic, biochemical, bacteriological, microscopic and ultrastructural findings.

In children (mean age 12.1 +/- 2.9 years) with cystic fibrosis, 44 bronchoscopic examinations were done under general anaesthesia with muscle relaxation using a Friedel type ventilation bronchoscope. The endoscopic picture of the mucous membranes was compared with the state of the bronchial secretions, its bacteriologic findings and content of acid mucopolysaccharides and DNA fibres (semiquantitative estimations). In all patients biopsy of the mucous membrane (central part of the bronchial tree) was performed for light and electron microscopy. The degree of reddening, swelling of the mucous membrane and hypersecretion was in some agreement with the intensity of the cellular infiltration and the production of pus (microscopic investigation). Secondary ultrastructural changes were detected in nearly all children, consisting of cellular oedema, swelling of mitochondria, dilatation of the endoplasmatic reticulum, protrusion of cells and fusion of cilia, enlarged intercellular spaces, thickening of the epithelial basal membrane, increased number of goblet cells, microtubular abnormalities of the cilia, lesions of the apical cell membrane with loss of cilia and microvilli. These ultrastructural changes were not correlated with the above-mentioned signs of inflammation.

Adolescent↗
PubMed1985

[Bronchial secretion and bronchial mucosa in children with mucoviscidosis: results of comparative bronchoscopic, biochemical, bacteriologic, light and electron microscopic studies].

Twenty two patients with cystic fibrosis, 7 to 17 years of age, underwent each two bronchoscopic investigations, the second six months later than the first, in general anaesthesia with muscle relaxation using a ventilation bronchoscope and taking small biopsies of the mucous membrane. The degree of reddening, swelling of the mucous membranes and hypersecretion was in some agreement with the intensity of the cellular infiltration and the production of pus (microscopic investigation). Secondary ultrastructural changes were detected in nearly all children: e.g. cellular oedema, protrusion of cells and fusion of cilia, microtubular abnormalities of the cilia, lesions of the apical cell membranes and increased number of goblet cells. These changes of ultrastructure were not correlated to the mentioned signs of inflammation.

Adolescent↗
PubMed1988

Bronchoscopic findings in infants treated with high-frequency jet ventilation versus conventional ventilation.

To identify tracheobronchial abnormalities associated with assisted ventilation, 40 infants with respiratory distress syndrome randomized to receive either short-term (48 hours) conventional or high-frequency jet ventilation were studied. Flexible fiberoptic bronchoscopy (n = 13) was performed and/or clinical and radiographic assessments were used to evaluate for laryngeal, tracheal, and bronchial lesions. There was no bronchoscopic evidence of necrotizing tracheobronchitis after either high-frequency jet ventilation (n = 8) or conventional ventilation (n = 5). Laryngotracheomalacia and nodular vocal cords were the most common abnormalities noted, and they occurred with equal frequency in both groups. Study infants who were not bronchoscoped had no clinical or radiographic evidence of tracheal or mainstem bronchial obstruction. One patient did have microscopic evidence of necrotizing tracheobronchitis at autopsy, however. It is concluded that short-term treatment of respiratory distress syndrome with high-frequency jet ventilation may be performed without undue risk of tracheobronchial injury.

Bronchi↗
PubMed1988

False positive diagnosis of bronchogenic carcinoma based on bronchoscopic brushing and sputum cytology. A surgical point of view.

The problem of false positive diagnosis of bronchogenic carcinoma based on bronchoscopic brushing and sputum cytology is analysed. 1071 patients were reviewed, 230 of whom underwent "radical" resection. Diagnoses obtained from bronchoscopic brushing, sputum cytology and microscopic examination of surgical specimens were compared. The statistical analysis of the obtained results showed that "false positives" should be thoroughly evaluated. The concept of cancer in situ and the hypothesis of a multi-step evolution of bronchogenic carcinoma are briefly discussed.

Adult↗
PubMed1985

Carinal forceps biopsy via the fiberoptic bronchoscope in the routine staging of lung cancer.

Main carinal biopsy was carried out in 58 consecutive patients with endobronchial (endoscopically visible) bronchogenic carcinoma. Overall, the results of the biopsy were positive in 8 of 58 patients (13.8%). The biopsy results were positive in 6 of 15 (40%) patients whose carina appeared abnormal as compared with 2 of 43 (4.7%) whose carina appeared normal (P = .0025). In those patients with subtle carinal abnormalities (carinal widening or erythema) but without gross tumor involvement, the biopsy findings were positive in 5 of 14 (36%). Unlike in previous studies, a significant percentage of positive carinal biopsy findings was associated with left upper lobe lesions. There were no complications associated with the procedure. Although the yield on blind carinal biopsies (visually normal carina) with the flexible fiberoptic bronchoscope is lower than that previously reported with the rigid bronchoscope, it remains a low-risk procedure that can spare a number of patients the morbidity and expense of more invasive surgical staging when applied as a routine part of diagnostic bronchoscopy in patients with endoscopically visible bronchogenic carcinoma.

Bronchoscopy↗
PubMed1977

[Bronchoscopic biopsies of sarcoidoses in the stage I and II (author's transl)].

The material of the present study includes 96 cases of intrathoracic sarcoidosis, phase I and II. Diagnosis was established bronchoscopically in 63.5% of patients examined. The best results were obtained by trans-bronchial needle-biopsy at bronchoscopy. In phase I, this method established the diagnosis in 76.5% of cases, in phase II in 48%, and in the whole material (phase I and II together) in 64.4%. Biopsy of the bronchial mucous membrane gave a lower percentage of diagnosis: in phase I--32.5%, in phase II 48.7%, and in the whole material--40.2%. Needle-biopsy of the lymph nodes and two or three bronchial biopsies simultaneously proved to be the method of choice: Sarcoidosis was diagnosed in 80% of cases in which these two methods were used. Bronchoscopic methods are effective, well tolerated and do not entail any serious complications.

Biopsy, Needle↗
PubMed1984

[The role of combined bronchoscopic examination in the diagnosis of central peribronchial lung cancer].

A complex bronchoscopic study was conducted in 315 cases of central (predominantly peribronchial) cancer of the lung. Bronchial stenosis was diagnosed in all patients. Basic bronchoscopic signs of cancer-involved stenosis were described and the following three patterns--typical, relatively typical and atypical--were identified. The report discusses a rational combination of broncho-bioptic methods of examination as well as the sequence of their application depending on degree of stenosis, tumor site and orientation of affected bronchial branches. The following procedures are instrumental in reliable cytomorphological confirmation of bronchial cancer: fibrobronchoscopy or combined application of rigid and elastic endoscopes in T1 tumor; combined or rigid bronchoscopy in T2 and rigid bronchoscopy only in T3 tumor.

Adenocarcinoma↗
PubMed1983

Bronchoscopic diagnosis of pulmonary infections. Comparison of protected-specimen brush and cytology brush with lung aspirates.

In a recent study the use of a new plugged double-lumen protected-specimen brush with the flexible fiberoptic bronchoscope was advocated to isolate pathogens in lower respiratory tract infections while avoiding upper respiratory tract contamination. To compare the efficacy of this brush and a standard single-lumen cytology brush in identifying the etiologic agent in lower respiratory tract infections, we studied 18 patients with lung infections. Transthoracic lung aspiration was done in all but two patients in an attempt to identify the specific etiologic agent. In these two cases, cultures of specimens of blood or postmortem lung tissue yielded the causative organism. In 12 patients anaerobic or aerobic bacteria (or both) were identified, whereas one patient had a mixed bacterial and fungal infection. Using the cytology brush and the protected-specimen brush we identified at least one pathogen in 10 of 12 and 10 of 13 cases, whereas both brushes missed one or more causative organisms in 8 of 12 and 8 of 13 cases, respectively. Nonetiologic organisms were found in 8 of 12 cases by the cytology brush and 8 of 13 cases by the protected-specimen brush. Quantitative culture techniques improved the specificity of the brush results in infections where aerobes predominated. Our data show that bronchoscopic cultures of lower respiratory tract infections do not consistently recover the causative agent and are frequently subject to contamination by nonetiologic organisms. There was no difference between the brushes in avoiding contamination.

Adolescent↗
PubMedDate not supplied

Bronchoscopic diagnosis of malignancy in the lower airway. A cytologic review.

OBJECTIVES: To determine the significance of a "suspicious" cytology report, to evaluate diagnostic accuracy for these specimens in the laboratory and to review the correlation of tumor subclassification in cytology versus histology. STUDY DESIGN: Retrospective review and comparison of 269 bronchoscopic cytology and histology specimens from a six-year period, 1984-1990. The relative and combined sensitivities of the sampling methods were studied. RESULTS: There were 17 suspicious cytologic diagnoses during this period. One of 17 was a false suspicious diagnosis, representing 0.03% of all reports on submitted samples. There were no false positive cytologic diagnoses. The majority (94%) of patients with a suspicious cytologic report had a final diagnosis of malignancy. Carcinoma was diagnosed in 244 of the 269 patients. CONCLUSION: Combined bronchoscopic cytology and biopsy was more sensitive (92%) than biopsy alone (82%) in making the initial diagnosis.

Biopsy↗
PubMed1995

Clinical and bronchoscopic features of endobronchial tuberculosis.

Clinical and bronchoscopic features of endobronchial tuberculosis were retrospectively investigated in 24 patients. A barking cough was the most frequent chief complaint in 50% of patients. The typical apico-subclavian localization of pulmonary tuberculosis in adults was found in only 50% of patients; in one patient the lung fields were clear. Bronchoscopic features consisted of exudative lesions in 38% of cases, ulcerative lesions in 25%, granulomatous lesions in 25%, and ulcerative-granulomatous tumour-like lesions in 12%. In 12% of patients, a residual fibrotic stenosis was seen. It was concluded from our data that patients whose cough is barking and resistant to antitussive agents should be evaluated for endobronchial tuberculosis, and, therefore, the use of fibreoptic bronchoscopy is mandatory. We also conclude that diagnosis of endobronchial tuberculosis demands the use of corticosteroid therapy.

Adult↗
PubMed1996

The staging of lung cancer by bronchoscopic transbronchial needle aspiration.

The development of flexible transbronchial needles for hilar and mediastinal aspiration had made possible noninvasive staging at the time of the initial diagnostic bronchoscopic examination. Combining the specificity of TBNA with the sensitivity of thoracic CT scanning greatly enhances the utility of this procedure. A bronchoscopically oriented staging system that utilizes the complementary advantages of both of these techniques is outlined. The staging of bronchogenic carcinoma by TBNA is a safe and cost-effective technique that can be routinely utilized to stage lung cancer. Ultimately, its value will depend upon whether the initial encouraging reports of its use can be reproduced by bronchoscopists in practice.

Biopsy, Needle↗
PubMed1996

Investigating paediatric airways by non-bronchoscopic lavage: normal cellular data.

BACKGROUND: Bronchoscopic bronchoalveolar lavage in children to investigate bronchial disorders such as asthma has both ethical and procedural difficulties. OBJECTIVE: The aim of this study was to establish a standardized non-bronchoscopic method to perform bronchoalveolar lavage in children attending for elective surgery to obtain normal cellular data. METHODS: Bronchoalveolar lavage was performed on normal children (n = 55) by infusing saline (20 mL) through an 8 FG suction catheter passed after endotracheal intubation. Oxygen saturation, heart and respiratory rate were monitored during the bronchoalveolar lavage procedure. Cellular analysis and total protein estimation of the lavage fluid were performed. Epithelial lining fluid volume was calculated (n = 15) using the urea dilution method. RESULTS: The procedure was well tolerated by all children. Total cell count and differential cell count for children (macrophages 70.8 +/- 2.3%, lymphocytes 3.8 +/- 0.6%, neutrophils 5.7 +/- 1.0%, eosinophils 0.14 +/- 0.03%, epithelial cells 19.6 +/- 2.1%, mast cells 0.21 +/- 0.02%) were similar to those reported for adults. Age and sex comparisons revealed no differences between groups. The mean total protein recovered in the cell free supernatant was 49.72 +/- 4.29 mg/L and epithelial lining fluid volume was 0.82 +/- 0.11% of return lavageate. CONCLUSION: This method allows bronchoalveolar lavage to be performed safely and quickly on children attending for routine elective surgery. Using this method and taking the 'window of opportunity' of elective surgery, the presence or absence of airway inflammation could be studied in children with various patterns of asthma during relatively asymptomatic periods.

Adolescent↗