ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

To investigate whether atropine is necessary for premedication of flexible bronchoscopy (FFB), 93 patients who underwent bronchoscopy for different indications were randomly separated into two groups. Subjects in the first group were premedicated only with 10 mg of intramuscular (IM) diazepam, whereas the second group was given 10 mg of IM diazepam and 0.5 mg of IM atropine. Blood pressures and pulse rates were recorded before, during, and after FFBs. Blood glucose levels were measured before and after the procedures. Amounts of bronchial secretion and complications related to the procedure were recorded during and after FFBs. The blood pressures were found higher in both groups during the bronchoscopies, whereas only the diastolic blood pressures were significantly higher when compared with the values before FFBs in the atropine-treated group. There was no intergroup difference when increase in blood pressures was compared. The pulse rates were found increased during and after FFBs in both groups (P< 0.05), and the increase in Group II was significantly more when compared with Group I (P< 0.05). Blood glucose levels were measured significantly higher after bronchoscopy when compared with those before the procedure (P< 0.05); however, the increase showed no statistical difference between the groups. Complication rates and amounts of bronchial secretion were similar in both groups of patients. Routine application of atropine for premedication of FFB was found to have no advantages. Instead, it might have some potential disadvantages such as hyperglycemia and tachyarrhythmias in patients with diabetes mellitus and cardiac diseases, respectively.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Laser-induced fluorescence endoscopy (LIFE) is useful in detecting precancerous lesions, and endobronchial ultrasonography (EBUS) is useful in the determination of the depth of tumor invasion into the bronchial wall. We conducted a clinical trial to determine the efficacy of assessment with a combination of LIFE and EBUS in patients with intraluminal lung cancer. We performed conventional white light bronchoscopy (WLB) followed by LIFE in 54 patients, and 67 samples from sites of suspected lesions were taken for biopsy. If an endobronchial tumor was detected, EBUS was performed. We could detect 29 lesions (metaplasia, 17; moderate dysplasia, 1; carcinomain situ, 1; invasive carcinoma, 10) with WLB and LIFE; specifically, 12 lesions were detected when LIFE was used in addition to WLB (metaplasia, 9; moderate dysplasia, 1; carcinomain situ, 1; invasive carcinoma, 1). Six patients were selected for EBUS to be evaluated for the depth of tumor invasion. Two patients with early cancer lesions, which were restricted within the mucosa and submucosa but not outside the cartilage, were considered candidates for photodynamic therapy, 3 patients with invasive cancer were candidates for surgery, and 1 patient for chemoradiotherapy. These patients were treated successfully. The assessment of an endobronchial tumor with the combination of LIFE and EBUS proved to be useful in decision making for the type of therapy.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Inflammatory changes in acute respiratory distress syndrome (ARDS) were evaluated using bronchoalveolar lavage (BAL) to sample inflammatory cells of the lower respiratory tract. Currently, no reliable technique exists for harvesting large numbers of viable alveolar macrophages. We constructed a modified bronchoalveolar lavage (MBAL) cannula using a commercially available retrograde coronary sinus reperfusion cannula with a large central lumen for rapid fluid instillation, a distal balloon for bronchial seal, and distal side ports to prevent a high-pressure jet. In normal sheep, mean aspirate return was significantly higher using MBAL compared with bronchoscopy (69 ± 4 mL vs. 25 ± 1 mL;p≤ 0.001). We then compared macrophage yield using bronchoscopy and MBAL using their lethal dose 40% (LD40) smoke/burn sheep model of ARDS. Total macrophage recovery was significantly higher (more than 80 times) using MBAL compared with bronchoscopy (16.9 ± 3.6 × 106macrophages vs. 0.20 ± 0.06 × 106macrophages; p ≤ 0.009). Likewise, the number of macrophages per milliliter of aspirate was significantly higher with MBAL compared with bronchoscopy (0.46 ± 0.16 × 106macrophages/mL vs. 0.009 ± 0.003 × 106macrophages/mL;p≤ 0.05). We conclude the MBAL cannula enables harvest of significantly higher quantities of macrophages in smoke/burn-injured sheep, facilitating serial assessment of the pathophysiology of ARDS.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Actinomycosis is an infectious disease caused by certainActinomycesspecies.Actinomycesare Gram-positive, nonspore-forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. Cervicofacial, abdominal, pelvic, and thoracic infections ofActinomycesare not uncommon, but endobronchial actinomycosis is rarely reported. Endobronchial actinomycosis can be misdiagnosed as unresolving pneumonia, endobronchial lipoma, or malignancy. We report a 43-year-old man who presented with a productive cough and pulmonary consolidation at the right lower lobe on chest radiograph. Bronchoscopy revealed an obstruction of the right superior segment of the lower bronchus with an exophytic endobronchial mass. Endobronchial actinomycosis was confirmed by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of penicillin G followed by oral amoxicillin/clavulanic acid therapy for 3 months resulted in improved symptoms. Infiltrative consolidation on the chest radiograph was markedly decreased. Endobronchial actinomycosis should be included in the differential diagnosis of any endobronchial mass.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We report accidental inhalation of a needle in the bronchial airways of an intravenous drug user that remained undetected for 1 year. Sharp, penetrating foreign bodies may cause acute complications if they perforate air passages, and may cause chronic complications if they remain trapped for a long time. The foreign body was removed endoscopically without complications.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A 46-year-old woman came to our hospital 4 months after undergoing a tracheostomy performed at a different hospital. The endotracheal tube had been removed, and granulation tissue was present at the site of the tracheostomy. A magnetic resonance imaging scan and bronchoscopy indicated granulation tissue also present within the trachea. Two injections of triamcinolone (Kenacort-A), a synthetic adrenocortical hormone preparation, initially caused reduction in and then the disappearance of the granulation tissue, thus showing this hormone effective for its elimination. Granulation tissue formation subsequent to tracheostomy causes stenosis of the airway. The present case demonstrates an effective means for countering this problem.

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2001

数据来源: OVID