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At least 109 records · Page 6Linked to original sources
PubMed1997

Successful bronchotracheal reconstruction in esophageal bronchus: two case reports.

Esophageal bronchus is the most common congenital bronchopulmonary foregut malformation. Current surgical treatment is resection of anomalous pulmonary tissue, which is often hypoplastic and destroyed by infection. The authors report two cases of bronchotracheal reconstruction. The diagnosis was early, before 15 days of age. The anomalous pulmonary tissue had a pulmonary arterial supply and venous drainage as assessed by angiography and a good functional capacity on selective ventilation. Bronchotracheal anastomosis was successful in both cases: a right main bronchus at 25 days of age and a left main bronchus at 13 days of age. One child underwent reoperation 1 year later for bronchomalacia of the reimplanted bronchus. Both children are well with normal growth 3 and 7 years after surgery. Chest roentgenograms showed normal and symmetrical lung aeration. Tracheal reimplantation may be preferred to pulmonary resection when the anomalous pulmonary tissue is not destroyed. The pulmonary functional capacity is increased and the complications of pneumonectomy avoided.

Anastomosis, Surgical↗
PubMed1997

The effect of okadaic acid on non-adrenergic non-cholinergic contraction in guinea-pig isolated bronchus.

1. We have investigated the role of phosphatases in modulating contractile responses to electrical field stimulation (EFS), methacholine, substance P and capsaicin in guinea-pig isolated main bronchus by use of the phosphatase 1 and 2A inhibitor okadaic acid. 2. Non-adrenergic non-cholinergic (eNANC) contractile responses were elicited by EFS (3 Hz, 20 s, 0.5 ms max. voltage) in the guinea-pig isolated main bronchus in the presence of the non-selective muscarinic antagonist, atropine (1 microM), the non-selective beta-adrenoceptor antagonist; propranolol (1 microM), the neutral endopeptidase inhibitor thiorphan (10 microM) and the cyclo-oxygenase inhibitor, indomethacin (5 microM). Okadaic acid significantly attenuated eNANC contractile responses (% inhibition) elicited by EFS (0.01 microM, 15.2 +/- 26.9%; 0.03 microM, 30.4 +/- 13.9%; 0.01 microM, 39.8 +/- 5.1%; 0.3 microM, 59.5 +/- 8.7%; 1 microM 77.8 +/- 7.8%; P < 0.05, n = 4). In contrast, the inactive analogue 1-Nor okadaone (0.3 microM) failed to attenuate significantly eNANC contractile responses (% inhibition elicited by 1-Nor okadaone, -1.25 +/- 8.5% vs dimethylsulphoxide (DMSO), -13.5 +/- 21.5%; P > 0.05, n = 4). 3. Cholinergic contractile responses were elicited by EFS (1-30 Hz, 10 s, 0.5 ms max. voltage) in guinea-pig isolated bronchus in the presence of the nitric oxide synthase inhibitor, N omega-nitro-L-arginine methyl ester (L-NAME, 30 microM). Okadaic acid failed to attenuate significantly the contractile (% methacholine Emax) response elicited by EFS at all frequencies tested compared with the control (1 Hz, control, 22 +/- 7.9% vs okadaic acid, 18 +/- 7.7%; 3 Hz, control, 26 +/- 6.9% vs okadaic acid, 27 +/- 9.1%; 10 Hz, control, 36 +/- 7.6% vs okadaic acid, 33 +/- 8.9%; 30 Hz, control, 50 +/- 7.6% vs okadaic acid, 42 +/- 14%; P > 0.05, n = 4). 4. Okadaic acid (0.3 microM) failed to alter significantly the contractile potency (pD2) to capsaicin (okadaic acid, 9.0 +/- 0.5, vs DMSO, 9.2 +/- 0.4; P > 0.05 n = 6), substance P (okadaic acid, 7.6 +/- 0.3 vs DMSO, 8.2 +/- 0.2; P > 0.05 n = 7) or methacholine (okadaic acid, 6.4 +/- 0.2 vs DMSO, 6.4 +/- 0.3; P > 0.05 n = 4). 5. Okadaic acid (0.01-1 microM) did not appear to reverse substance P-induced tone. The maximal relaxant response (% reversal of substance P-induced tone) mediated by okadaic acid (1 microM) was 33 +/- 11.7% (n = 4), this was not significantly different from the DMSO (0.8%) or a time-dependent fall in tone of 34.3 +/- 23.1% (n = 4) and 33 +/- 15.8% (n = 4), respectively. Okadaic acid (0.3 microM) failed to augment isoprenaline-induced relaxation responses in substance P contracted bronchus (okadaic acid, 6.5 +/- 0.4 vs DMSO, 5.9 +/- 0.3; P > 0.05, n = 9). 6. These results indicate that protein phosphatases appear to regulate the release of sensory neuropeptides from airway sensory nerves in response to electrical field stimulation.

Animals↗
PubMed1999

Suc-[Glu9,Ala11,15]-endothelin-1 (8-21), IRL 1620, identifies two populations of ET(B) receptors in guinea-pig bronchus.

The pharmacological properties of endothelin receptors (ETR) were investigated in guinea-pig bronchus by comparing binding and functional results. In binding assays, both the ET(B) agonists, endothelin-3 (ET-3) and N-suc-[Glu9,Ala11,15]ET-1(8-21) (IRL 1620), and the antagonist, N-cis-2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D- 1-methoxycarbonyltryptophanyl-D-norleucine (BQ 788), showed biphasic inhibition curves of [125I]-endothelin-1 (ET-1) binding to bronchus membranes prepared from intact or epithelium-deprived tissue. IRL 1620 did not completely displace specifically [125I]-ET-1 bound to these tissue preparations. In the presence of the ET(A)-selective antagonist, cyclo(-D-Trp-D-Asp-L-Pro-D-Val-L-Leu) (BQ 123, 1 microM), IRL 1620 displacement curves were shallow but a complete inhibition was reached at a concentration of 1 microM. Both curves were better represented by two-site models. In addition, BQ 788 competition curves became monophasic when binding experiments were performed in the presence of 1 microM BQ 123. The non-selective agonist, ET-1, and BQ 123 inhibited [125I]-ET binding to bronchus membranes in dose-dependent fashions with monophasic curves. The contracting activity of IRL 1620 (0.55 nM- 1.6 microM) was tested on multiple-ring bronchial preparations pretreated with peptidase and cyclo-oxygenase inhibitors. BQ 788 shifted IRL1620 concentration-response curves to the right while BQ 123 did not influence bronchial responsiveness. In addition, a potentiation of the maximal response to the agonist was observed in BQ 788 treated bronchial rings. This effect was abolished by tissue pretreatment with Nomega-nitro-L-argininemethylester (L-NAME) or epithelium removal but not by pretreatment with atropine or iberiotoxin. Our results demonstrate that guinea-pig bronchus contains two populations of ET(B) receptors with different affinities for the ET(B)-selective agonist, IRL 1620. One ET(B) receptor population appears to activate bronchial muscle contraction while another on epithelial cells causes muscle relaxation through the release of nitric oxide (NO).

Animals↗
PubMed1996

Airway management for patients with a tracheal bronchus.

A tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea, causing hypoxaemia, atelectasis, or both, during anaesthesia. We describe two patients with a tracheal bronchus found before anaesthesia. One tracheal bronchus was found by tracheobronchoscopy and the other by chest x-ray. Because of recognition of the anomaly before operation, anaesthesia was uneventful in each patient.

Anesthesia, General↗
PubMed1999

Predicting the size of a double-lumen endobronchial tube using computed tomographic scan measurements of the left main bronchus diameter.

UNLABELLED: We investigated the use of chest computer tomographic (CT) scan measurement of the left mainstem bronchial diameter to predict the correct left-sided double-lumen endobronchial tube (DLT) size in Asian patients who may require smaller DLT sizes. Fifty consecutive Asian adults aged 17-80 yr with preoperative chest CT scans undergoing elective thoracic surgery were entered into the study. The measurements of the left main bronchus diameter were made by using the electronic calipers of the spiral scanner to the nearest millimeter. The sizes of DLT selected were 32F, 35F, 37F, 39F, and 41F for left main bronchus diameters of <10 mm, 10 mm, 11 mm, 12 mm, and >12 mm, respectively. All DLT placements were confirmed and positioned by using fiberoptic bronchoscopy. The tracheas of all patients were successfully intubated with the predicted DLT sizes. Thirty-four patients (68%) were predicted to require smaller DLTs (37F or smaller). Six patients were correctly predicted to receive 32F DLTs. Twelve patients (24%) received an oversized DLT, but none received an undersized DLT. The overall positive predictive value for the male and female patients was 84.4% and 61.1%, respectively. Our study showed that CT scan measurements of the diameter of the left bronchus were especially useful in choosing smaller DLTs. IMPLICATIONS: We used computer tomographic scans to measure the diameter of the left mainstem bronchus, then selected the size of the left-sided double-lumen endobronchial tube (DLT) accordingly. We found that we could predict the sizes of the DLT fairly accurately, especially the smaller DLTs.

Adolescent↗
PubMed1992

Pharmacological evidence for distinct endothelin receptors in guinea-pig bronchus and aorta.

The ETA receptor antagonist, BQ-123 (1 microM) potently antagonized endothelin-1 (ET-1) concentration-response curves in guinea-pig aorta (pKB = 7.1). However, 10 microM BQ-123 was without effect on ET-1-induced contractions in guinea-pig bronchus. The ETB-selective agonist, sarafotoxin S6c did not contract the aorta but was a potent and effective contractile agonist in the bronchus. BQ-123 (10 microM) was without effect on sarafotoxin S6c-induced contractions in the bronchus. These data provide evidence for distinct endothelin receptors in guinea-pig aorta and bronchus, which appear to be predominantly of the ETA and non-ETA, perhaps ETB, subtypes, respectively.

Animals↗
PubMed1993

Endothelin-induced contraction and mediator release in human bronchus.

1. To elucidate the role of acetylcholine and various autacoids in endothelin-1 (ET-1)-induced contraction in human bronchus, the effects of various receptor antagonists were examined. In addition, the ability of ET-1 to stimulate the release of histamine, peptidoleukotrienes and prostanoids was determined. 2. ET-1 was a potent and effective contractile agonist in human bronchus, possessing similar potency and efficacy to leukotriene D4 (LTD4); EC50 (-log M): ET-1 = 7.76 +/- 0.09, n = 7; LTD4 = 8.46 +/- 0.53, n = 7; P > 0.2; maximum response (% 10 microM pre-carbachol): ET-1 = 103.8 +/- 17.4, n = 7; LTD4 = 95.5 +/- 9.3, n = 7; P > 0.6. 3. The cyclo-oxygenase inhibitor, sodium meclofenamate (1 microM) or the potent and selective thromboxane receptor antagonist, SQ 29,548 (1 microM) were without significant effect on ET-1 concentration-response curves. 4. In the presence of sodium meclofenamate (1 microM), the muscarinic receptor antagonist, atropine (1 microM), the platelet activating factor (PAF) receptor antagonist, WEB 2086 (1 microM) or the combination of the H1-histamine receptor antagonist, mepyramine (10 microM) and the leukotriene receptor antagonist, SK&F 104353 (10 microM), were without marked effect on ET-1 concentration-response curves. In addition, the combination of all four receptor antagonists did not antagonize ET-1-induced contraction. 5. ET-1 (0.3 microM) did not stimulate the release of histamine or immunoreactive leukotrienes from human bronchus. 6. ET-1 (0.3 microM) significantly stimulated the release of prostaglandin D2 (PGD2), 9alpha, 11beta PGF2 (PGD2 metabolite), PGE2, 6-keto PGF1alpha (PGI2 metabolite), PGF2alpha, and thromboxane B2 (TxB2) a lower concentration, 10 nM, was without effect on prostanoid release. The production of PGD2 was increased 7.5 fold, whereas the release of the other prostanoids was stimulated only about 1.6 to 2.7 fold.7. These data provide evidence that ET-1 elicits contraction of human isolated bronchus predominantly via a direct mechanism with no significant involvement of the release of acetylcholine, leukotrienes,histamine or PAF. Although ET-1 increased the release of several prostanoids they did not have a significant modulatory effect on the smooth muscle contraction.

Acetylcholine↗
PubMed1995

Demonstration of supernumerary tracheal bronchus by computed tomographic scanning and magnetic resonance imaging.

A bronchus arising directly from the trachea is an infrequent congenital anomaly which usually represents the displaced origin of a normal bronchus. Rarely, a true supernumerary tracheal bronchus occurs supplying an associated tracheal lobe. The case is described of a patient in whom a supernumerary tracheal bronchus and tracheal lobe was demonstrated by computed tomographic scanning and magnetic resonance imaging.

Bronchi↗
PubMed1998

Tracheal bronchus: a cause of prolonged atelectasis in intubated children.

Tracheal bronchus is a common anomaly that occurs in approximately 2% of people. Two children with multiple medical problems which led to endotracheal intubation are described. The hospital course for each child was complicated by persistent right upper lobe atelectasis. The presence of a tracheal bronchus was not recognized in either case initially; identification of this anatomic variant allowed appropriate changes in airway management. The potential for tracheal bronchus to cause, or be associated with, localized pulmonary problems is reviewed. The diagnosis of tracheal bronchus should be considered early in the course of intubated patients with right upper lobe complications.

Bronchi↗
PubMed1980

Tracheal bronchus with regional ventilation and perfusion abnormalities.

Tracheal bronchus is an uncommon anomaly of the tracheobronchial tree. In the case presented, clinical and pathophysiologic abnormalities were associated with this anomaly. The tracheal bronchus supplied the right upper lobe of the lung. The bronchus intermedius arose directly from the trachea in place of the right main bronchus. It was accompanied by marked regional changes in ventilation and perfusion. We discuss the clinical significance of this unusual anomaly.

Aged↗
PubMed2005

Photodynamic therapy for submucosal tumor of the central bronchus.

A 75-year-old man was referred to our hospital because of the emphysema and tumor of the right intermediate bronchus. Thoracic CT scan and bronchoscopic examination demonstrated a spherical tumor of the right intermediate bronchus covering a normal mucosa. The biopsy specimen obtained from this tumor was histologically diagnosed as "glandular type of adenocarcinoma in the bronchus". Surgical treatment was not feasible because of poor pulmonary function. Therefore, the patient underwent Photodynamic therapy (PDT) using porfimer sodium (Photofrin) and an excimer dye laser. After 4 months, the tumor disappeared and there has been no recurrence for 3 years 3 months. PDT can affect a submucosal tumor of the central airway, and is safe for patients with poor pulmonary function. Our report recommends that PDT should be applied not only to early lung cancer but also submucosal tumor of the central bronchus.

Adenocarcinoma↗
PubMed1983

Ectopic right bronchus: indication for bronchography.

Ectopic right-sided bronchus is a rare anomaly. In this retrospective study, eight patients are described. All were from a population that clinically was suspected of suffering from chronic bronchitis. In one patient, the ectopic bronchus was missed on bronchoscopy but not on bronchography; in the other seven patients bronchoscopy and bronchography both revealed the ectopic bronchus. The first patient had a persistent inhomogeneous consolidation only in the ectopic area with extensive bronchiectasis; one patient had slight bronchiectasis; the other six patients had none of these pathologic alterations. Only in the first patient did the anomaly have therapeutic consequences, as there was an extensive bronchiectasis. In patients with a persistent inhomogeneous consolidation, only on the site of the apical segment of the right upper lobe may an ectopic bronchus with extensive bronchiectasis be suspected. In such patients, a bronchographic examination is indicated.

Adult↗
PubMed1999

The interrupted bronchus: a fluoroscopic sign of bronchial foreign body in infants and children.

OBJECTIVE: The objective is to describe the characteristic features of the interrupted bronchus sign and to determine the value of this sign in detection of bronchial foreign bodies. The interrupted bronchus sign refers to disruption of the air column in the main bronchi seen by fluoroscopy. CONCLUSION: The interrupted bronchus sign has a sensitivity of 100% for detection of foreign bodies in the main bronchi. This sign is particularly helpful when chest radiography shows atelectasis or pneumonia. The specificity of this sign for foreign bodies is only 71% because other endobronchial lesions can disrupt the air column. Nevertheless, the interrupted bronchus sign indicates the presence of bronchial occlusion and signifies the need for bronchoscopy. This sign is not sensitive for detection of foreign bodies in lobar or segmental bronchi.

Bronchi↗
PubMed1993

Relationships between divisions of the middle bronchus and vascularization patterns in the middle lung lobe.

In 100 right human lungs the main bronchus, the pulmonary artery and the pulmonary vein were injected with 65% methyl methacrylate and then digested in sulphuric acid. The resulting specimens were studied to observe the divisions of the middle lobe bronchus and the types of arterial and venous vascularization of this lobe. The lobe was always entered by one lobar bronchus, which usually divided into two segmental bronchi. In 53% of the middle lobes with this bronchial pattern there was one artery. When the lobar bronchus divided into three branches, at least two arteries entered the lobe in almost all cases. Complete consistency between the pattern of bronchial division and that of arterial vascularization of the middle lobe was found in almost two-thirds of cases. Associations between patterns of bronchial division and of venous drainage from the middle lobe were found in slightly more than half of the cases.

Adolescent↗
PubMed1987

Bridging bronchus and posterior left pulmonary artery: a unique association.

A 6-month-old female with a lifelong history of respiratory distress became increasingly difficult to manage and required right upper and middle pulmonary lobectomies for worsening emphysema and mediastinal shift. The postoperative course was stormy and confusing and the patient died despite emergency tracheostomy. The autopsy disclosed an anomalous bronchus to the right lower lobe, originating from the left mainstem bronchus. In addition, the left main pulmonary artery was positioned posterior to the left mainstem bronchus. Two other cases of bridging bronchus have been reported, but the association with posterior left pulmonary artery has not been described.

Adult↗
PubMed1999

[A case of sleeve resection of the left main bronchus for tuberculous bronchial lesion].

A 31-year-old woman was admitted to our center with left chest pain and dyspnea after treatment of pulmonary tuberculosis. Chest X-ray film showed atelectasis of left lower lobe and left deviation of the mediastium. Bronchofiberscopy revealed obstruction of the left main bronchus. Chest MRI showed intermediate intensity at the left main bronchus and very high intensity at the peripheral bronchus. We performed sleeve resection of the left main bronchus and anastomosed end to end with absorbable monofilament sutures. Postoperative course was uneventful. Bronchoplasty for tuberculous obstructive lesion is a useful procedure.

Adult↗
PubMed2001

[Complete transection of the left main bronchus due to a blunt chest trauma: report of a case].

A 62-year-old man was injured in a traffic accident. A chest roentgenogram showed pneumothorax, hemothorax, subcutaneous and mediastinal emphysema, multiple rib fractures, and a shift of the trachea to the right. Bilateral thorax drainage was performed, and air leakage from a left chest tube was observed. A chest computed tomogram demonstrated stenosis and deformation of the left main bronchus. Bronchofiberscopy revealed complete obstruction of the left main bronchus by the left main pulmonary artery. An emergency thoracotomy revealed complete transection of the left main bronchus and laceration. End-to-end anastomosis of the left main bronchus was performed with interrupted 4-0 PDS II suture. The patient was discharged at the 33rd hospital day.

Accidents, Traffic↗
PubMed2001

[Fatal stenosis of trachea and main bronchus due to compression by the spine and sternum in three patients with severe motor and intellectual disabilities].

Three patients with severe motor and intellectual disabilities developed fatal respiratory insufficiencies caused by stenosis of the trachea and main bronchus due to compression by the spine and trachea. The onset of respiratory insufficiency was by 20, 16, and 29 years of age. Chest computed tomography demonstrated deformation and narrowing of the trachea and main bronchus, and shortening of the distance between spine and sternum. Although respiratory insufficiency was temporarily relieved by insertion of a stent into the main bronchus in patient 1, he died at the age of 21 due to proliferation of granulation tissue. Patient 2 died of bleeding from the granulation tissue around the window of tracheotomy at the age of 18 years, and patient 3 died of recurrent pneumonia at the age of 34 years. In conclusion, stenosis of the trachea and bronchus observed in these patients was caused by progressive deformation of the thorax. The stenosis may result in sudden death or recurrent respiratory infections in patients with severe motor and intellectual disabilities.

Adolescent↗