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The European Respiratory Journal Oct 1994The presentation of a Nocardia infection is quite variable. We report a case of nocardiosis presenting as endobronchial obstruction with postobstructive pneumonia and...
The presentation of a Nocardia infection is quite variable. We report a case of nocardiosis presenting as endobronchial obstruction with postobstructive pneumonia and atelectasis, in a patient with a low index of suspicion for bronchogenic carcinoma. Our report emphasizes the importance of considering the diagnosis of endobronchial nocardiosis in patients with endobronchial obstruction and a low index of suspicion for carcinoma, as well as those with a high index of suspicion, but with repeatedly negative biopsies.
Topics: Bronchial Diseases; Bronchial Neoplasms; Diagnosis, Differential; Humans; Male; Middle Aged; Nocardia Infections; Nocardia asteroides
PubMed: 7828703
DOI: 10.1183/09031936.94.07101903 -
Radiographics : a Review Publication of... 2012A widening spectrum of increasingly advanced bronchoscopic techniques is available for the diagnosis and treatment of various bronchopulmonary diseases. The evolution of... (Review)
Review
A widening spectrum of increasingly advanced bronchoscopic techniques is available for the diagnosis and treatment of various bronchopulmonary diseases. The evolution of computed tomography (CT)-multidetector CT in particular-has paralleled these advances. The resulting development of two-dimensional and three-dimensional (3D) postprocessing techniques has complemented axial CT interpretation in providing more anatomically familiar information to the pulmonologist. Two-dimensional techniques such as multiplanar recontructions and 3D techniques such as virtual bronchoscopy can provide accurate guidance for increasing yield in transbronchial needle aspiration and transbronchial biopsy of mediastinal and hilar lymph nodes. Sampling of lesions located deeper within the lung periphery via bronchoscopic pathways determined at virtual bronchoscopy are also increasingly feasible. CT fluoroscopy for real-time image-guided sampling is now widely available; electromagnetic navigation guidance is being used in select centers but is currently more costly. Minimally invasive bronchoscopic techniques for restoring airway patency in obstruction caused by both benign and malignant conditions include mechanical strategies such as airway stent insertion and ablative techniques such as electrocauterization and cryotherapy. Multidetector CT postprocessing techniques provide valuable information for planning and surveillance of these treatment methods. In particular, they optimize the evaluation of dynamic obstructive conditions such as tracheobronchomalacia, especially with the greater craniocaudal coverage now provided by wide-area detectors. Multidetector CT also provides planning information for bronchoscopic treatment of bronchopleural fistulas and bronchoscopic lung volume reduction for carefully selected patients with refractory emphysema.
Topics: Bronchial Diseases; Bronchography; Bronchoscopy; Humans; Minimally Invasive Surgical Procedures; Preoperative Care; Radiography, Interventional; Surgery, Computer-Assisted; Tomography, X-Ray Computed
PubMed: 22977038
DOI: 10.1148/rg.325115133 -
The Clinical Respiratory Journal Dec 2022Bronchoscopic TransParenchymal Nodule Access (BTPNA) technology is mainly used for sampling or ablative treatment of lung parenchymal lesions that cannot be reached by...
Bronchoscopic TransParenchymal Nodule Access (BTPNA) technology is mainly used for sampling or ablative treatment of lung parenchymal lesions that cannot be reached by bronchoscopy and its appendages, generally for palliative treatment of some lung tumors. We used BTPNA to treat a 32-year-old young woman with pulmonary tuberculosis and successfully perforated her occluded left main bronchus. Her left atelectasis was recovered, and a silicone stent was inserted to preserve the shape of the left main bronchus.
Topics: Female; Humans; Adult; Bronchial Diseases; Bronchoscopy; Airway Obstruction; Pulmonary Atelectasis; Tuberculosis
PubMed: 36279147
DOI: 10.1111/crj.13544 -
International Journal of Clinical and... 2014Amyloidosis is a spectrum of diseases characterized by abnormal extracellular accumulation of proteinaceous material; its precise etiology still remains unclear. It may... (Review)
Review
Amyloidosis is a spectrum of diseases characterized by abnormal extracellular accumulation of proteinaceous material; its precise etiology still remains unclear. It may affect multiple organs, of which the commonest sites are larynx, bronchus and kidney. Laryngeal amyloidosis is usually a localized phenomenon rarely associated with systemic involvement, here we report a case of laryngeal amyloidosis with tracheobronchial involved. The patient was 31-years old. He had a history of open surgical operation for laryngeal amyloidosis in the left ventricle 4-years ago. This time he was suffered by amyloid deposition in his right ventricle, the lesion was excised on staged laryngoscopy under general anesthesia. After 20-months follow-up, the post-operative recovery was wonderful. The bronchoscopy examination and computerized tomography scan for chest demonstrated he also had right main bronchus amyloidosis. Being of no dyspnea, he was unwilling to accept an operation on bronchus. Though amyloidosis is a benign lesion, up to date, there are no curable treatments for such a disease, for severe cases, it may be fatal as a result of airway obstruction or respiratory failure. Here we review the pertinent references on this subject, and discuss the main managements for amyloidosis on larynx and bronchus.
Topics: Adult; Amyloidosis; Bronchial Diseases; Humans; Laryngeal Diseases; Laryngoscopy; Male; Reoperation; Tomography, X-Ray Computed; Tracheal Diseases; Treatment Outcome
PubMed: 25400802
DOI: No ID Found -
Advances in Respiratory Medicine 2019Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases... (Review)
Review
Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases risk of pulmonary complications. Due to many mechanisms involved in pathophysiology the treatment is complex. Among them the formation of fibrin casts inside airways constitutes a prominent element. The material residing in tracheobronchial tree causes ventilation-perfusion mismatch, complicates mechanical ventilation, provides a medium for bacterial growth. Many studies of animal models and single centre human studies investigated inhaled anticoagulation regimens employing heparin in management of inhalation injury. Simultaneously safety, especially in connection with possible bleeding risk, was the subject of research. The results suggest positive impact on treatment results, with low risk of side effects. This paper revise the available clinical data on inhaled heparin use in patients with burns.
Topics: Anticoagulants; Bronchial Diseases; Heparin; Humans; Smoke Inhalation Injury; Tracheal Diseases
PubMed: 31282560
DOI: 10.5603/ARM.2019.0029 -
Anaesthesia May 1991
Topics: Aged; Bronchial Diseases; Bronchoscopy; Hemorrhage; Humans; Male
PubMed: 2035813
DOI: 10.1111/j.1365-2044.1991.tb09582.x -
Medical Science Monitor : International... Oct 2021BACKGROUND Post-tuberculosis bronchomalacia (PTBM) is one of the main conditions occurring in patients after tracheobronchial tuberculosis (TBTB), and is also associated...
BACKGROUND Post-tuberculosis bronchomalacia (PTBM) is one of the main conditions occurring in patients after tracheobronchial tuberculosis (TBTB), and is also associated with the recurrence of symptoms. The present study aimed to investigate the predictors of PTBM in patients who had been undergoing appropriate TB treatment. MATERIAL AND METHODS Clinical data of 104 patients with symptomatic airway stenosis after TBTB between January 01, 2019 and June 31, 2020 were recorded and analyzed. The association between baseline clinical characteristics, laboratory results, and PTBM was calculated with logistical regression. The time from onset of bronchoscopic intervention was examined by Kaplan-Meier estimates; differences between the 2 groups were tested by the log-rank test. RESULTS Fifty-seven patients (54.81%) had PTBM. In the multivariate logistical analysis, the left main bronchus stenosis lesion (odds ratio [OR]=3.763), neutrophil (NEUT) count (OR=1.527), and platelet (PLT) (OR=1.010) count were predictors of PTBM. During follow-up, patients with BM had a significantly longer duration from onset of bronchoscopic intervention than patients without BM (hazard ratio=2.412, P<0.0001). Further, all patients needing long-term bronchoscopic intervention therapy were subsequently identified as having PTBM. Additionally, blood PLT counts were significantly decreased to normal levels in the non-BM group (P<0.05), but not in the BM group (P>0.05). CONCLUSIONS PTBM is most likely to occur in the left main bronchus. The inflammatory and immune responses associated with NEUT and PLT may represent therapeutic targets of PTBM. Our study is the first to report that decreased blood PLT count has the potential to monitor the treatment response.
Topics: Adult; Bronchi; Bronchial Diseases; Bronchomalacia; Bronchoscopy; Constriction, Pathologic; Female; Humans; Male; Mycobacterium tuberculosis; Neutrophils; Platelet Count; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Tomography, X-Ray Computed; Tuberculosis, Pulmonary; Young Adult
PubMed: 34620816
DOI: 10.12659/MSM.931779 -
Journal of the American Veterinary... Feb 2009To determine prevalence of various radiographic signs in cats with feline bronchial disease (FBD) and evaluate intra- and interobserver variability in radiographic...
OBJECTIVE
To determine prevalence of various radiographic signs in cats with feline bronchial disease (FBD) and evaluate intra- and interobserver variability in radiographic interpretation for examiners with variable degrees of experience in radiographic interpretation.
DESIGN
Retrospective case series.
ANIMALS
40 cats with FBD and 40 control cats without thoracic disease.
PROCEDURES
Radiographic abnormalities in cats with FBD were scored by consensus of 2 radiologists. Radiographs of control cats and cats with FBD were examined twice by 5 other individuals, and diagnostic accuracy and observer agreement were assessed.
RESULTS
In cats with FBD, the most common radiographic signs were bronchial (n=37) and unstructured interstitial (30) lung patterns, lung hyperinflation (31) and hyperlucency (21), aerophagia (19), and lung soft tissue opacities (11). Ratios of lung inflation on ventrodorsal views were significantly higher in cats with FBD. For the 5 examiners, sensitivity ranged from 71% to 89% and specificity ranged from 43% to 74%. Intraobserver agreement was good (N=0.47 to 0.60), but the agreement between examiners was only poor to good (N=0.22 to 0.70). For most examiners, significant associations were found between examiner diagnosis (correct vs incorrect), level of examiner certainty, and bronchial pattern severity.
CONCLUSIONS AND CLINICAL RELEVANCE
Findings suggested that several radiographic abnormalities can commonly be seen in cats with FBD but highlighted the limitations of thoracic radiography. Examiner diagnosis and level of confidence were significantly associated with severity of a bronchial pattern.
Topics: Animals; Bronchial Diseases; Cat Diseases; Cats; Clinical Competence; Diagnosis, Differential; Female; Male; Observer Variation; Radiography, Thoracic; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Severity of Illness Index
PubMed: 19210258
DOI: 10.2460/javma.234.3.367 -
British Journal of Anaesthesia Mar 2003In the last decade, stents suitable for the management of tracheobronchial stenoses and obstruction have evolved from bulky prostheses requiring tracheal resection to... (Review)
Review
In the last decade, stents suitable for the management of tracheobronchial stenoses and obstruction have evolved from bulky prostheses requiring tracheal resection to small devices that are self-expanding and can be inserted using fibreoptic techniques. The experience base for this review is more than 100 patients between 1989 and 2001 who have been anaesthetized for stent insertion. Early cases required rigid bronchoscopy for the routine of insertion. Anaesthetic techniques have evolved from those that were designed and developed for laser surgery in the central airways. The advent of modern devices now extends the variety of anaesthetic management techniques that can be used. But the original one, based on the requirement for use of a rigid bronchoscope, is best for dealing with complications and extracting problem stents. The most frequent complication of the processes of stent insertion has been respiratory failure because of carbon dioxide retention, consequent on obstruction with secretions in the area of the carina. The nature of central airway problems suggests that anaesthesia induction, management and teaching should not be founded on the conventional model-base of upper airway obstruction.
Topics: Adult; Airway Obstruction; Anesthesia; Bronchial Diseases; Bronchoscopy; Constriction, Pathologic; Equipment Design; Humans; Intubation, Intratracheal; Laryngeal Masks; Postoperative Complications; Preoperative Care; Radiography; Stents; Tracheal Stenosis
PubMed: 12594151
DOI: 10.1093/bja/aeg053 -
Internal Medicine (Tokyo, Japan) Jun 1998There is a considerable overlap between diffuse panbronchiolitis (DPB) and bronchiolar disease associated with rheumatoid arthritis. The present study assessed how these... (Comparative Study)
Comparative Study
There is a considerable overlap between diffuse panbronchiolitis (DPB) and bronchiolar disease associated with rheumatoid arthritis. The present study assessed how these conditions could be differentiated. The subjects included 25 DPB patients and 15 RA patients with bronchiolar disease (RA-BD). Patients with either condition had chronic cough, purulent sputum, dyspnea and coarse crackles. Most patients with either DPB or RA-BD had a history of sinusitis as well as elevated cold hemagglutin titers and decreased levels in partial pressure of oxygen (PaO2), forced expiratory volume in one second (FEV1.0) and V 25/Ht. On histological examination, both conditions also shared various histological patterns although panbronchiolitis lesions were more common in DPB than RA-BD (68% vs 20%) and bronchiolar obliteration appeared to occur at more proximal sites in RA-BD than DPB. However, there were important differences: long-term treatment with erythromycin had less effect in RA-BD than DPB, and the frequency of HLA B54 tended to be higher in DPB than RA-BD (50.0% vs 22.2%), suggesting that they are distinct conditions.
Topics: Adult; Aged; Anti-Bacterial Agents; Arthritis, Rheumatoid; Bronchi; Bronchial Diseases; Bronchiolitis; Diagnosis, Differential; Erythromycin; Female; HLA-B Antigens; Humans; Male; Middle Aged; Prognosis; Respiratory Function Tests
PubMed: 9678682
DOI: 10.2169/internalmedicine.37.504