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At least 595 records · Page 33Linked to original sources
PubMed2006

Percutaneous tracheostomy in a patient with mandibulo-maxillary interfixation with modified approach for bronchoscopic guidance--case report.

Percutaneous tracheostomy has replaced the surgical approach in many intensive care unit patients. In this case report, we present the use of percutaneous tracheostomy on a patient with mandibulo-maxillary interfixation. A 19-year-old male with severe maxillofacial injuries underwent mandibulo-maxillary interfixation. Percutaneous tracheostomy was planned. Because of the mandibulo-maxillary interfixation, however, neither direct laryngoscopy nor the fiberoptic bronchoscopy through the existing preformed nasal endotracheal tube could be utilized. A modified approach utilizing the fiberoptic bronchoscopy to safely withdraw the endotracheal tube was used. The bronchoscope was introduced from the other nostril and used to inspect the withdrawal of the ETT from outside. Our case demonstrates the feasibility of percutaneous tracheostomy in the setting of mandibulo-maxillary interfixation. To our knowledge this is the first report of percutaneous tracheostomy in this indication.

Adult↗
PubMed1991

Fibre-optic bronchoscopic evaluation of tracheal tube position.

Verification of tracheal tube position by fibre-optic bronchoscopy was evaluated in 20 critically ill adult patients. The distance between the carina and the tube was measured by direct visualization with a fibre-optic bronchoscope and compared with the corresponding measurement obtained from a concomitant chest radiograph. The measured values did not differ significantly and in 18 out of 20 patients the accuracy was within 2 cm. No adverse effects were observed. We conclude that verification of tracheal tube position by fibre-optic bronchoscopy is a safe alternative to chest X-ray.

Bronchoscopy↗
PubMed1991

Nosocomial infection and pseudoinfection from contaminated endoscopes and bronchoscopes--Wisconsin and Missouri.

Flexible fiber-optic endoscopes are widely used in the United States for diagnostic and therapeutic procedures. Between uses, endoscopes should be cleaned and disinfected either manually or by using automated machines. However, outbreaks have occurred among patients exposed to contaminated endoscopes or to inadequately disinfected bronchoscopes (1-4). This report summarizes one outbreak of nosocomially acquired infection (Wisconsin) and one of pseudoinfection (Missouri) linked to endoscopes contaminated during cleaning and disinfection by automated reprocessing machines.

Bacterial Infections↗
PubMed1991

[Bronchoscopic appearance of the bronchial mucosa in pulmonary venous hypertension].

The authors studied the bronchoscopic appearance of bronchial mucosa's vessel contour in pulmonary venous hypertension in 20 patients with mitral stenosis and in 20 with cardiomyopathy and/or aortic vitium. The submucous venous congestion was scored on the base of its extent and severity according to Ohmichi. They have observed a linear relation between the PPA (wedge) and PPA values in patients with mitral stenosis and the total scores indicatory of submucous venous congestion. The mean total scores of patients with mitral stenosis as well as cardiomyopathic patients showing volume-loading of the pulmonary circuit and/or aortic vitium differed to the benefit of the former. Mucosa's vessel contour of grade 3 was found in 12 patients with mitral stenosis and only in 4 cases of cardiomyopathy and/or aortic vitium, so that is more characteristic of mitral stenosis. In spite of this, condition of patients with cardiomyopathy and/or aortic vitium are considered more severe on the base of NYHA values. Taking both patient populations into consideration relation between NYHA-phase and the degree of total scores could not have been proved. Venous congestion on lower part of the left main bronchus was observed in every patient. Appearance of congestive bronchial mucosa has not occurred in pure precapillary pulmonary hypertension.

Aortic Valve Stenosis↗
PubMed1991

Results of bronchoscopically obtained lower airway cultures from adult sickle cell disease patients with the acute chest syndrome.

PURPOSE: The purpose of this study was to determine the frequency of bacterial pneumonia as a cause of the acute chest syndrome in adult patients with sickle cell disease based on bronchoscopically obtained lower airway cultures and to describe the clinical, laboratory, and roentgenographic features of the acute chest syndrome in a series composed entirely of adult patients with sickle cell disease. PATIENTS AND METHODS: We reviewed the hospital records from 19 episodes (18 patients) of acute chest syndrome in adult patients with sickle cell disease (greater than or equal to 19 years of age) who had undergone flexible bronchoscopy to obtain lower airway cultures between January 1979 and July 1987. We also recorded patients' clinical, laboratory, and roentgenographic characteristics. RESULTS: Pneumonia was diagnosed in four of 19 episodes (21%) of acute chest syndrome based on quantitative cultures obtained at bronchoscopy. The pneumonia was caused by Streptococcus pneumoniae in two patients and mixed aerobic and anaerobic organisms in the other two patients. Forty-four of 45 blood cultures were negative, and one grew Staphylococcus epidermidis, which was considered a contaminant. Chest roentgenograms revealed lower lobe involvement in 17 episodes (90%) and bilateral infiltrates in six (32%). Pleural effusions occurred in seven episodes (37%), and pleural fluid samples obtained from five of these revealed sterile exudates. CONCLUSION: The results of this retrospective study suggest that bacterial pneumonia is an uncommon cause of acute chest syndrome in adult patients with sickle cell disease. These results are consistent with previous retrospective studies using noninvasive techniques to diagnose pneumonia. Nevertheless, there appeared to be no reliable noninvasive variables that could accurately differentiate between patients with and without pneumonia and, consequently, we recommend empiric antibiotic therapy in addition to usual supportive care of these patients.

Adult↗
PubMed1990

[Pneumonia in patients with and without immunosuppression--value of bronchoscopic biopsy technics for the detection of pathogens].

Bronchoscopic diagnosis was performed in 91 patients with 100 episodes of fresh pneumonia. In already existing immunosuppression (n = 51, Group A) pathogens were most frequently identified via bronchoalveolar lavage (70%); in patients without immunosuppression (n = 49, Group B) the identification quota in respect of the central bronchial secretion (53%) and bronchoalveolar lavage (47%) were comparable. In Group A the most frequently occurring pathogens were Pneumocysti carinii (n = 18) and Aspergillus fumigatus (n = 7), in Group B Streptococcus pneumoniae (n = 8) and Staphylococcus aureus (n = 7).

Adult↗
PubMed1985

Bronchoscopic implantation of radioactive gold grains into endobronchial carcinomas.

We report the results of palliative treatment of non-resectable obstructing endobronchial carcinoma by bronchoscopic implantation of radioactive gold grains in 18 patients. Dyspnoea and collapse of a lobe or a lung were successfully treated in 13 cases where tumour was locally confined to a main or lobar bronchus. The response was maintained until death in nine of these patients but obstruction recurred in four longer surviving patients with tumours of main bronchus after a mean interval of 6 months. Treatment was less successful in five patients with tumour extending onto the trachea. The low penetration of interstitial radiation offers the advantage that normal lung and other tissues are not damaged, so that the procedure can be used in patients previously submitted to external radiotherapy.

Aged↗
PubMed1989

Diagnosis of pulmonary hamartoma by bronchoscopic transbronchial biopsy.

Intraparenchymal pulmonary hamartomas are benign lesions that cannot reliably be distinguished from malignant solitary pulmonary nodules by routine chest x-ray or computerized tomography. Thoracotomy or transthoracic needle aspiration or biopsy is usually required to establish the histologic diagnosis of hamartoma. We report a patient in whom a solitary pulmonary nodule was diagnosed as a pulmonary hamartoma by bronchoscopic transbronchial biopsy, obviating the need for a more invasive procedure. Fiberoptic bronchoscopy with transbronchial biopsies should be considered initially in the evaluation of a solitary pulmonary nodule. Special stains for cartilage and fat may aid in the diagnosis of pulmonary hamartomas.

Aged↗
PubMed1989

Endobronchial hamartoma removed by rigid bronchoscope.

An endobronchial hamartoma of the right lower lobe was discovered in a 60 yr old female patient. She had been diagnosed and treated for chronic intractable bronchial asthma for more than 10 yrs. The endobronchial hamartoma was successfully removed with a rigid bronchoscope.

Asthma↗
PubMed1989

[Bronchoscopic findings of adenocarcinoma of the lung].

Bronchoscopic and histopathological findings of adenocarcinoma of the lung were compared, and the outcome of chemotherapy or radiation therapy was examined. This study included 1,434 patients with adenocarcinoma of the lung who underwent bronchoscopy between May, 1962 and December, 1987 at the National Cancer Center Hospital. A definitive diagnosis was made histologically by biopsy studies in all patients. Bronchoscopy revealed a polypoid tumor in 47 (3.3%), nodular tumor in 318 (22.2%), obstruction in 462 (32.2%), infiltration in 162 (11.3%) and no finding in 445 (31.0%) of these patients. According to gross pathological examination, the polypoid type was observed in 45 (4.6%), stenosis type in 28 (2.8%), obstruction type in 664 (67.5%) and nodular type in 247 (25.1) Chemotherapy or radiation therapy was complete response in 15 (10.8%) and partial response in 32 (23.0%), the lesion showed regression in 50 (35.9%), no changes were noted in 23 (16.6%) and the disease progression was observed in 19 (13.7%). Bronchoscopy could be performed without difficulty and caused no complications and sufficient examination was possible in the outpatient clinic after discharge. Routine and repeated bronchoscopy is possible and useful in patients with adenocarcinoma of the lung. Since this examination allows determination of whether complete remission has been achieved, it is considered to contribute to reduction in the risk of early recurrence.

Adenocarcinoma↗
PubMed1988

[Significance of multiple biopsies using the fiber bronchoscope in the morphological diagnosis of central cancer of the lung].

The paper discusses the first experience with fiber bronchoscope--mediated sampling for histologic examination in 183 cases of central carcinoma of the lung. As a result, cancer was histologically identified in 98.9% and cytologically verified in 60.2%. Complex histologic and cytologic examination reliably established central carcinoma of the lung in 100%. Cancer was detected in 51.3-72% of bronchial biopsies (mean--64.7%).

Adenocarcinoma↗
PubMed1986

Cytopathologic diagnosis of pulmonary neoplasms in sputum and bronchoscopic specimens.

Cytopathologic techniques have been used for the detection and diagnosis of pulmonary neoplasms for many years. Cytopathologic examination of sputum is the most effective method for the detection of early squamous cell carcinoma, but it is not effective for diagnosing peripheral neoplasms, such as adenocarcinomas, in their early stages. Advanced neoplasms of any type, however, can be diagnosed in sputum. The cytopathologic examination of bronchoscopically obtained specimens is a valuable adjunct to biopsies in visible lesions. In addition, it may provide the only microscopic diagnosis in certain peripheral tumors or help in the localization of radiologically occult carcinomas detected by sputum cytology. Although cytopathologic diagnosis of cancer is highly accurate, certain benign conditions can mimic cancer and care must be taken in their interpretation. The type of neoplasm can be accurately diagnosed in well-differentiated carcinomas and small cell carcinomas but less accurately in poorly differentiated and large cell carcinomas. Utilization of proper collection and preparation techniques is crucial for optimal cytopathologic diagnosis.

Adenocarcinoma↗
PubMedDate not supplied

Cytologic diagnosis of pulmonary carcinoma on bronchoscopic brushing material.

The material obtained by brushing procedures under visual control from 370 consecutive patients with histologically confirmed primary carcinoma of the lung who underwent bronchoscopy was examined cytologically. The sputum of 276 of these patients was also investigated. The overall sensitivity of the bronchoscopically obtained cytology was 0.67; however, the values were 0.78 and 0.28, respectively, for the cases with and without visible lesions of the bronchi. Sputum examination enhanced the sensitivity to 0.79 overall and to 0.84 and 0.61, respectively, for the two groups, with a greater benefit for the group with negative bronchoscopy. The overall cytologic typing accuracy for 252 cases was 0.66, with a range of 0.19 to 0.86, depending on the histologic type. Typing failures were essentially related to adenocarcinomas and large-cell carcinomas.

Adenocarcinoma↗
PubMed1983

Laser bronchoscopic surgery.

Endoscopic laser bronchoscopy can be used to effectively palliate patients with compromised airways. The CO2 laser was utilized with a ventilating bronchoscope. This form of endoscopic surgery has the advantage of less postoperative edema, better hemostasis, more accurate tumor vaporization, and shortened operating time. Between 1975-79 33 laser bronchoscopies were carried out for airway obstruction. Palliation was achieved in most cases. Complications included intra-operative bleeding, tissue fragment occlusion of the airway, and an endotracheal fire. Laser bronchoscopy should be avoided in the presence of widespread metastatic disease, poorly differentiated or rapidly growing tumors, extrinsic tumor compression, or highly vascular tumors. A preliminary report is presented on the soft tissue effects of the argon laser, passed through a flexible coaxial cable in the canine trachea. Multiple transmural lesions were created. The use of the argon laser in the field of bronchoscopy remains controversial.

Adult↗
PubMed1983

[Bronchoscopic diagnosis of peripheral lung cancer].

The diagnostic value of bronchologic procedures in identification of peripheral cancer of the lung versus tumor's size, endoscopic pattern of bronchial lesion and tumor position with respect to the root of the lung was assessed. Rigid endoscopes and bronchofibroscopes were used in 806 patients with peripheral lung cancer. Bronchoscopic diagnosis of cancer was morphologically confirmed in 64.9% (respiratory endoscope alone--51.3 +/- 3%; bronchofibroscope or combined use of both devices--71.9 +/- +/- 2%).

Adenocarcinoma↗
PubMed1983

Use of the flexible fibre-optic bronchoscope in the diagnosis of lung carcinoma.

Bronchoscopy carried out in 367 patients because of a chest radiograph suggestive of lung carcinoma confirmed this diagnosis in 194 cases and excluded it in 173. The diagnosis of carcinoma was made by fibre-optic bronchoscopy in 141 cases (73%), by examination of biopsy specimens and bronchial brushings in 125, and by visualization and follow-up in 16. Visible tumours accounted for 40% of the malignant lesions and 79% of these were diagnosed on examination of biopsy specimens or brushings, compared with 55% of non-visible tumours. Of the tumours 131 were radiographically peripheral, and 60% of these were diagnosed with the fibre-optic bronchoscope. The diagnostic yield in the 63 proximal tumours was 98%.

Bronchoscopy↗
PubMed1981

Penetrating bullet wound of chest with bronchoscopic removal of bullet.

A case history is presented of a patient with a penetrating bullet wound of the chest in whom the 0.38 caliber bullet was unexpectedly found entirely within the lumen of the right lower lobe bronchus at bronchoscopy. A second bullet penetrating the abdomen necessitated an extensive abdominal operation and delayed removal of the intrabronchial bullet by 1 day. During the 1 day interval, distal migration of the intrabronchial bullet caused technical problems in removal which are discussed. The bullet was successfully removed with a rigid bronchoscope without subsequent complications. The limited literature on this rare occurrence is reviewed, and suggestions are made concerning management.

Abdominal Injuries↗