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Thorax Apr 1976The anatomical distribution of plasma cells and other cells containing immunoglobulin in the respiratory tract, and the relative proportions of the immunoglobulin... (Comparative Study)
Comparative Study Review
The anatomical distribution of plasma cells and other cells containing immunoglobulin in the respiratory tract, and the relative proportions of the immunoglobulin classes have been estimated on necropsy tissues from nine adult human subjects without respiratory disease, five non-smokers and four smokers, none of whom had cough or sputum. Cell counts on multiple sections stained by immunofluorescent methods for the presence of immunoglobulin were carried out on the upper trachea, main bronchus, and lower lobe bronchus. Cells containing immunoglobulin were found mostly in the submucous glands but were also present in the lamina propria of the tracheal and bronchial epithelium. These cells were present in the greatest concentration in the main bronchus and were always present in the lobar bronchus and, in most subjects, in the upper trachea. The cells were not always present round small bronchi and bronchioles and were virtually absent from alveolar walls. Cells containing IgA were much more numerous than those containing other immunoglobulin classes in all subjects except one, in whom IgG and IgE cells were equally numerous. Two subjects appeared to be significantly different from the rest. One non-smoking subject had a marked deficiency of IgA cells at all sampling sites, and one smoker had a marked excess of IgA cells. In spite of these two subjects there was no significant difference between smokers and non-smokers except in the lobar bronchus where the smokers had significantly more IgA cells than the non-smokers.
Topics: Adult; Aged; Bronchi; Cell Count; Female; Humans; Immunoglobulin A; Immunoglobulin E; Immunoglobulin G; Immunoglobulins; Lung; Male; Middle Aged; Plasma Cells; Smoking; Trachea
PubMed: 781899
DOI: 10.1136/thx.31.2.158 -
Multimedia Manual of Cardiothoracic... Jul 2019Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity...
Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that allows direct access to the segmental structures, is straightforward, and is versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins). Key aspects of the procedure include proper patient positioning, appropriate positioning of operating trocars, standardized technique to expose and dissect of the segmental vein, bronchus, and artery, and accurate division of the intersegmental plane and fissure.
Topics: Adenocarcinoma; Aged; Bronchi; Humans; Lung Neoplasms; Male; Pneumonectomy; Thoracoscopy
PubMed: 32191406
DOI: 10.1510/mmcts.2019.021 -
PloS One 2013Angiogenesis in the lung involves the systemic bronchial vasculature and becomes prominent when chronic inflammation prevails. Mechanisms for neovascularization...
Angiogenesis in the lung involves the systemic bronchial vasculature and becomes prominent when chronic inflammation prevails. Mechanisms for neovascularization following pulmonary ischemia include growth factor transit from ischemic parenchyma to upstream bronchial arteries, inflammatory cell migration/recruitment through the perfusing artery, and paracrine effects of lung cells within the left bronchus, the niche where arteriogenesis takes place. We analyzed left lung bronchoalveolar lavage (BAL) fluid and left bronchus homogenates after left pulmonary artery ligation (LPAL) in rats, immediately after the onset of ischemia (0 h), 6 h and 24 h later. Additionally, we tested the effectiveness of dexamethasone on decreasing inflammation (0-24 h LPAL) and angiogenesis at early (3 d LPAL; bronchial endothelial proliferation) and late (14 d LPAL; blood flow) stages. After LPAL (6 h), BAL protein, total inflammatory cells, macrophages, and polymorphonuclear cells increased significantly. In parallel, pro-angiogenic CXC chemokines increased in BAL and the left main-stem bronchus (CXCL1) or only within the bronchus (CXCL2). Dexamethasone treatment reduced total BAL protein, inflammatory cells (total and polymorphonuclear cells), and CXCL1 but not CXCL2 in BAL. By contrast, no decrease was seen in either chemokine within the bronchial tissue, in proliferating bronchial endothelial cells, or in systemic perfusion of the left lung. Our results confirm the presence of CXC chemokines within BAL fluid as well as within the left mainstem bronchus. Despite significant reduction in lung injury and inflammation with dexamethasone treatment, chemokine expression within the bronchial tissue as well as angiogenesis were not affected. Our results suggest that early changes within the bronchial niche contribute to subsequent neovascularization during pulmonary ischemia.
Topics: Animals; Bronchi; Bronchial Diseases; Cell Proliferation; Chemokine CXCL1; Chemokine CXCL2; Chemokines; Dexamethasone; Endothelial Cells; Lung; Male; Neovascularization, Pathologic; Rats; Rats, Sprague-Dawley; Reverse Transcriptase Polymerase Chain Reaction
PubMed: 23776670
DOI: 10.1371/journal.pone.0066432 -
Multimedia Manual of Cardiothoracic... Aug 2022This tutorial shows how to remove an aspirated foreign body via a lung-sparing operation using a transverse bronchotomy through a transthoracic approach. An...
This tutorial shows how to remove an aspirated foreign body via a lung-sparing operation using a transverse bronchotomy through a transthoracic approach. An 18-year-old woman was admitted for treatment of an aspirated foreign body. A pushpin was impacted in a subsegmental branch of the right lower lobe of her bronchus. The problem was managed successfully using a conservative surgical approach: The foreign body was removed from the lower-lobe bronchus, thereby avoiding the need for a lung resection. Starting with a posterolateral thoracotomy by harvesting a pedicled flap, the surgeon exposed and opened the bronchus to remove the impacted foreign body. The bronchial suture was covered by the pedicled flap. The endoscopic removal of aspirated foreign bodies, which is considered the first-line treatment, can be challenging and can lead to airway injury or stenosis. Described at the beginning of 20th century, transthoracic bronchotomy for foreign body removal remains a life-saving and lung-sparing procedure that should not be overlooked.
Topics: Adolescent; Bronchi; Bronchoscopy; Female; Foreign Bodies; Humans; Lung; Thoracotomy
PubMed: 36218297
DOI: 10.1510/mmcts.2022.043 -
American Journal of Respiratory and... Mar 2011
Topics: Bronchi; Bronchography; Bronchoscopy; Dyspnea; Exercise Tolerance; Humans; Incidental Findings; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 21471067
DOI: 10.1164/rccm.201009-1493IM -
British Journal of Anaesthesia Nov 1955
Topics: Anesthesia; Anesthesiology; Bronchi; Intubation, Intratracheal; Trachea
PubMed: 13269630
DOI: 10.1093/bja/27.11.556 -
Respiratory Care Nov 2018Airway remodeling is a characteristic structural change that occurs extensively in the airways of patients with asthma. The change can be evaluated by measuring airway...
BACKGROUND
Airway remodeling is a characteristic structural change that occurs extensively in the airways of patients with asthma. The change can be evaluated by measuring airway dimensions by using high-resolution computed tomography. This study aimed to explore the variation trends of airway dimensions from the second- to sixth-generation bronchi in subjects with asthma.
METHODS
Sixty subjects with asthma and 40 healthy controls underwent high-resolution computed tomography. The right upper lobe apical segmental bronchus, right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and the left lower lobe posterior basal segmental bronchus were identified on computed tomography images. The luminal area, wall area, and wall area percentage of each bronchus were measured from the second (lobar) to the sixth generation. The variation trends of these indices (luminal area, wall area, and wall area percentage) were then compared between the subjects with asthma and the healthy controls.
RESULTS
From the proximal to the distal airway, the luminal area and wall area decreased gradually, whereas the wall area percentage increased gradually in all the participants; the difference between the participants with asthma and the healthy controls in the luminal area, wall area, and wall area percentage increased gradually from the second (lobar) to the sixth generation; there was a significant difference between the participants with asthma and the healthy controls in the right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and left lower lobe posterior basal segmental bronchus wall area percentage ( = .001, .01 and .001, respectively) but not in the right upper lobe apical segmental bronchus wall area percentage ( = .050).
CONCLUSIONS
Airway remodeling in asthma was more prominent in distal airways and at lower lobe bronchi.
Topics: Adult; Airway Remodeling; Asthma; Bronchi; Case-Control Studies; Female; Humans; Male; Middle Aged; Organ Size; Tomography, X-Ray Computed
PubMed: 30389830
DOI: 10.4187/respcare.06050 -
Therapeutic Advances in Respiratory... 2018Location of the affected bronchus of pleural air leaks is the most important step of trans-bronchoscopic bronchial occlusion for the treatment of intractable... (Observational Study)
Observational Study
BACKGROUND
Location of the affected bronchus of pleural air leaks is the most important step of trans-bronchoscopic bronchial occlusion for the treatment of intractable pneumothorax. The balloon occlusion test is the most commonly used technique, but has failed in some cases. The aim of the present study was: (1) to determine if endo-bronchial end-tidal CO (EtCO) measurement can identify the affected bronchus that is the source of a persistent pleural air leak; and (2) to establish a methodology for endo-bronchial EtCO testing in locating affected bronchus in intractable pneumothorax.
METHODS
A total of 28 patients with intractable pneumothorax underwent bronchoscopy with (1) the balloon occlusion test for the identification of the affected bronchus; and (2) endo-bronchial EtCO measurement (EtCO test) at the orifices of the bronchus of the affected lung. The effectiveness of these two methods of affected bronchus identification were compared. The threshold EtCO (T-EtCO) was determined.
RESULTS
The positive rates of locating the affected bronchus by the endo-bronchial EtCO test, balloon occlusion test, and combination of the two techniques were 60.7% (17/28), 64.3% (18/28) and 96.4% (27/28), respectively. The average differences in EtCO between the affected bronchus and the main carina, main bronchus, and non-affected bronchus were (in mmHg) 4.41 ± 1.99 (95% confidence interval: 3.5, 5.3), 4.73 ± 2.10 (3.80, 5.66 ) and 5.57 ± 2.53 (4.45, 6.69), respectively.
CONCLUSIONS
(1) The endo-bronchial EtCO test is complementary to the balloon occlusion test of the leading bronchus. (2) A threshold (T-EtCO) value of >5 mmHg is optimal for this technique.
Topics: Aged; Biomarkers; Breath Tests; Bronchi; Bronchoscopes; Bronchoscopy; Carbon Dioxide; Catheters; Humans; Male; Middle Aged; Pneumothorax; Predictive Value of Tests; Prognosis; Prospective Studies; Reproducibility of Results
PubMed: 29480071
DOI: 10.1177/1753465818756564 -
BMC Pulmonary Medicine Mar 2021Foreign body ingestion is a common emergence in gastroenterology. Foreign bodies are most likely to be embedded in the esophagus. The sharp ones may penetrate the... (Review)
Review
BACKGROUND
Foreign body ingestion is a common emergence in gastroenterology. Foreign bodies are most likely to be embedded in the esophagus. The sharp ones may penetrate the esophageal wall and lead to serious complications.
CASE PRESENTATION
A 72-year-old Chinese female was admitted to our hospital with a 4-day history of retrosternal pain and a growing cough after eating fish. Chest computed tomography scan indicated that a high-density foreign body (a fish bone) penetrated through the esophageal wall and inserted into the left main bronchus. First, we used a rigid esophagoscope to explore the esophagus under general anesthesia. However, the foreign body was invisible in the side of the esophagus. Then, the fiberoptic bronchoscopy was performed. We divided the fish bone, which traversed the left main bronchus, into two segments under holmium laser and removed the foreign body successfully. The operation time was short and there were no complications. The patient was discharged 1 week postoperatively and was symptom free even under a liquid diet.
CONCLUSIONS
There are several challenges in the management of this rare condition. We applied the technique of interventional bronchoscopy to the management of esophageal foreign body flexibly in an emergency. A surgery was avoided, which was more invasive and costly.
Topics: Aged; Bronchi; Bronchoscopy; Esophagoscopes; Esophagus; Female; Foreign Bodies; Humans; Lasers, Solid-State; Tomography, X-Ray Computed
PubMed: 33731031
DOI: 10.1186/s12890-021-01458-x -
Surgery Today Mar 2022Bronchial stenoses are challenging complications after lung transplantation and are associated with high rates of morbidity and mortality. We report a series of patients...
PURPOSE
Bronchial stenoses are challenging complications after lung transplantation and are associated with high rates of morbidity and mortality. We report a series of patients who underwent bronchoplasty or sleeve resection for bronchial stenoses that did not resolve with endoscopic treatment after lung transplantation.
METHODS
Between 1995 and 2020, 497 patients underwent lung transplantation at our Institution. 35 patients (7.0%) experienced bronchial stenoses with a median time from transplantation of 3 months. Endoscopic management was effective in 28 cases (5.6%) while 1 patient required re-transplantation. Six patients (1.2%) underwent bronchoplasty or sleeve resection.
RESULTS
The procedures of the six patients who underwent bronchoplasty or sleeve resection were as follows: lower sleeve bilobectomy (n = 3), wedge bronchoplasty of the bronchus intermedius (n = 1), isolated sleeve resection of the bronchus intermedius (n = 1), and isolated sleeve resection of the bronchus intermedius (n = 1), associated with a middle lobectomy. All patients were discharged after a median time of 11 days. At a median of 12 months from surgery, two patients remain alive with a preserved pulmonary function. Four patients died after a median time of 56 months from bronchoplasty of causes that were not related to surgery.
CONCLUSIONS
Bronchial reconstructions are challenging procedures that can be performed in highly specialized centers. Despite this, they can be considered a good strategy to obtain a definitive resolution of stenosis after lung transplantation.
Topics: Bronchi; Constriction, Pathologic; Humans; Lung Neoplasms; Lung Transplantation; Pneumonectomy
PubMed: 34431010
DOI: 10.1007/s00595-021-02360-z