ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;Argon plasma coagulation (APC) is a thermal coagulation technique that uses ionized argon to transmit high‐frequency electrical current, contact free, to tissue. APC has been used in surgery for more than 20 years, particularly for the hemostasis of superficial bleeding. Although APC has become well established in gastrointestinal endoscopy since its introduction in 1991, very few reports of its use in bronchoscopy exist to date. From June 1994 to June 1998. 364 patients (80 women. 284 men), 88% with a confirmed malignant tumor, were treated prospectively in a total of 482 sessions. The single most common indication was recanalization of malignant airway stenoses (186 patients). The defined therapy objective was achieved with good results in 67% of patients. More than 90% of interventions were performed with rigid bronchoscopy. Despite less penetration compared with Nd:YAG laser, extensive bronchial tumors were treatable, in which coagulated tumor fractions were removed either with forceps or bronchoscope tip. The second indication was bleeding in the central airways (119 patients). Acute hemostasis was achieved in 118 patients, 20% in whom the flexible technique under local anesthesia was used. In 34 patients. APC was successfully used to recanalize occluded stents. Rare indications included benign endobronchial tumor, fistula conditioning before fibrin adhesion, and the treatment of scar tissue stenosis. Summarizing all complications, a rate of 3.7% “per treatment” was recorded. Two patients died within 24 hours; their deaths were not directly related to APC. APC is an effective and safe technique for the treatment of bronchologic tumor ablation and hemostasis and can be used with local anesthetic with flexible bronchoscopy or rigid bronchoscopy with general anesthesia. Compared with Nd:YAG laser. APC is an economic alternative technique offering more effective hemostasis. Furthermore. APC is of particular value as a compliment to well‐known techniques, increasing the options in interventional bronchoscopy.Journal of Bronchology7:109‐117, 2000.APC, argon plasma coagulation; HF currency, high‐frequency electrical current

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:The purpose of the study was to examine the clinically relevant findings that were obtained only by autofluorescence bronchoscopy and not by white‐light bronchoscopy. Data from patients at risk for lung cancer who underwent both white‐light bronchoscopy and autofluorescence bronchoscopy were analyzed on a per‐patient and on a per‐bronchoscopy base. Clinically relevant findings were defined as follows: (1) histologic examination of bronchial biopsy specimen showing moderate dysplasia, severe dysplasia, or carcinoma in situ; (2) assessment by the bronchoscopist that the bronchial area to be treated endoscopically was better visualized by autofluorescence bronchoscopy, which was of influence on the treatment. A total of 224 bronchoscopies were performed in 114 patients. Endobronchial therapy was performed during 26 of these bronchoscopies. Clinical relevant findings resulted from 28 autofluorescence bronchoscopies in 18 patients. Twenty‐five of 101 intraepithelial neoplastic lesions were detected by autofluorescence bronchoscopy alone during 18 bronchoscopies in 14 patients. During 10 bronchoscopies in 9 patients, autofluorescence bronchoscopy resulted in a better visualization of the extent of endobronchial spread of tumor, which subsequently was treated with endobronchial therapy. We concluded that by adding autofluorescence bronchoscopy to white‐light bronchoscopy, clinically relevant information was obtained in 13% (28 of 223) of the bronchoscopies and in 16% (18 of 114) of the patients.Journal of Bronchology7:118‐121, 2000.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Lactate dehydrogenase (LDH) in the bronchoalveolar lavage fluid (BALF) of patients with acute respiratory distress syndrome (ARDS) was investigated to evaluate its potential as an indicator of lung injury. Twelve samples from six patients with ARDS and seven samples from five control patients were studied. Bronchoalveolar lavage was performed to measure the percentage of polymorphonuclear leukocytes, albumin, LDH concentration, and its isoenzyme in BALF. In ARDS patients, the percentage of polymorphonuclear leukocytes, albumin, and LDH concentrations in BALF proved to be significantly higher than in control subjects (p< 0.05). The level of BALF‐LDH isoenzyme 4 and 5 was higher than that of the other isoenzymes, and both 4 and 5 isoenzymes showed significant negative correlations with the Pao2/Fio2ratio (r= −0.730, andr= −0.759, respectively). The total activity of LDH and isoenzymes in BALF might reflect the extent of pulmonary cellular damage after decreased pulmonary oxygenation. Further investigation with a large number of patients will be needed to clarify the clinical usefulness of LDH isoenzyme in BALF.Journal of Bronchology7:122‐126, 2000.ARDS, acute respiratory distress syndrome; PMNs, polymorphonuclear leukocytes; BALF, bronchoalveolar lavage fluid; LDH, lactate dehydrogenase; BAL, bronchoalveolar lavage; P/F ratio, ratio of Pao2to Fio2; ANOVA, analysis of variance

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

&NA;It is sometimes difficult to evaluate infiltration of lung cancer to parabronchial tissue and intrabronchial wall using computed tomography (CT). Recently ultrasound‐guided flexible bronchoscopy (USFB) became available to investigate tumor invasion to the bronchial wall and lymph nodes. To evaluate tumor invasion by USFB, we selected 20 cases from 800 lung cancer patients who presented over a 2‐year period (from 1997 to 1999). All 20 cases were ambiguous for invasion and depth of tumor. Four of 7 cases evaluated as carcinomain situby chest CT and conventional bronchoscopy were diagnosed as early lung cancer by USFB. The condition of four of the 9 patients initially assessed with no tumor invastion to the aorta was diagnosed by USFB as tumor invasion to the aortic wall. Four cases were surveyed with regard to tracheal invasion. Two cases initially found to have invasion by CT were diagnosed with no infiltration to the tracheal wall by USFB. One case. found to have no invasion by CT. was diagnosed by USFB to have tracheal invasion. In 11 of the 20 patients (55%) examined, the depth of tumor and/or infiltration to aorta or trachea was corrected through the use of USFB. USFB was also helpful in accurately staging lung cancer.Journal of Bronchology7:127‐132, 2000.USFB, ultrasound‐guided flexible bronchoscopy; CT, computed tomography.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:We report a case of a patient with Kartagener syndrome and bronchiectasis who presented with prolonged course of unremitting fever and respiratory tract infection. Gram stain of multiple samples of expectorated sputa showed gramnegative rods and gram‐positive cocci. Despite treatment with broad‐spectrum oral and later intravenous antibiotics, her condition did not improve. However, bronchoscopic collection of bronchoalveolar lavage fluid showed abundance ofMycobacterium aviumcomplex (MAC), which was not previously detected on the sputa. In patients with ciliary dysfunction, including patients with Kartagener syndrome, yield of bronchoscopic bronchoalveolar lavage for diagnosis of mycobacteria is superior to expectorated sputa.Journal of Bronchology7:139‐142, 2000.MAC,Mycobacterium aviumcomplex; KS. Kartagener syndrome; BAL, bronchoalveolar lavage; PCD, primary ciliary dyskinesia

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:A 46 year‐old man with esophageal carcinoma complicated by a bronchoesophageal fistula presented with recurrent pneumonia in the same lung field. Bronchoscopic examination ruled out an endobronchial lesion. The first bronchoscopy only showed purulent secretions in the lumen of the right B6. A second bronchoscopy using methylene blue ingestion showed the blue dye gushing from the lumen of the right B6, and a bronchoesophageal fistula involving the superior segment of right lower lobe and esophagus was diagnosed. This report shows the limitation of routine bronchoscopy and underscores the value of using methylene blue ingestion during bronchoscopy in patients suspected of having a bronchoesophageal fistula.Journal of Bronchology7:143‐146, 2000.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathologic entity encompassing several clinical and imaging presentations. We report the case of a 42‐year‐old man clinically presenting with hemoptysis and multiple cavitary nodules on the computed tomography scan.Journal of Bronchology7:147‐151, 2000.BOOP, bronchiolitis obliterans organizing pneumonia; CT, computed tomography

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Tracheoceles (i.e., a large and isolated outpouching of the trachea) are rare and may be congenital or acquired. Acquired tracheoceles have never been reported after burn inhalation injury of the trachea, and there has only been one report of a tracheocele occurring after tracheostomy. We report on two patients with severe tracheal burn injury, requiring early tracheostomy in one, who presented with late tracheal stenosis and tracheoceles at 8 and 20 years, respectively, after their original injury. Treatment by Nd:YAG laser and stenting was successful in the treatment of tracheal stenosis, normalizing eupnea, and pulmonary function.Journal of Bronchology7:152‐155, 2000.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID